Plant Stanols To Lower Cholesterol Levels
Dr. Hazen recommends plant stanols as another nonprescription way to help lower LDL cholesterol levels. Unlike statins and red yeast rice extract, which prevent the body from making cholesterol, plant stanols keep the body from absorbing cholesterol. In one study, plant stanols , helped reduce LDL levels by 15-18%. However, a typical range is 4-14%.
The Supposed Benefits Of Red Yeast Rice
People in East Asian countries that practice Traditional Chinese Medicine have used red yeast rice for thousands of years to help people manage health problems, such as:
slow blood circulation
As a food, red yeast rice can form part of a healthy diet. But the manufacturers of red yeast rice supplements claim that they can reduce blood cholesterol levels.
Red Yeast: Health Benefits Side Effects Uses Dose & Precautions
- Summary: · Red yeast supplements are manufactured by culturing Monascus purpureus yeast on rice at carefully controlled temperature and growing conditions
- Matching search results: Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate
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Data Sources Searches And Extraction
Relevant articles published between April 2001 and January 2019 were searched using PubMed and an Austrian data source . Combinations of key terms, which included red yeast rice, pharmacokinetics, monacolin K, p-glycoprotein, side effects, pharmacodynamics and lovastatin were used. Additionally, reference lists of the included articles and key systemic reviews were checked manually.
Why Take Red Yeast Rice
Red yeast rice has been used in traditional Chinese medicine for centuries to improve digestion and circulation. The most beneficial effect is its potential to lower cholesterol. Many people opt for supplements as opposed to statins because of the potential side effects. Research links statins with possible side effects like liver damage, kidney damage, memory loss and skeletal muscle damage. It also has the potential to control weight gain and possibly prevent obesity. Studies also show that it may have anticancer properties and may help reduce inflammation that leads to serious health conditions.
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Should People Take Red Yeast Rice The Fda Said No
So lets see if weve got this straight. Cholestin was derived from Chinese red yeast, a product that has been used in China for hundreds of years and has been written up in a pharmacopoeia from the Ming Dynasty . It has clear cholesterol-lowering power on a par with many prescription drugs. Moreover, people in China and Japan have been using it as both medicine and food for centuries. Those in the Asian American communities of the U.S. have consumed it at least since World War II.
The FDA has ignored thousands of products that have no quality control, no standardization, and no proof of effectiveness and complained that herb companies arent spending money to do high-quality research. The manufacturers of Cholestin went to significant lengths to prove in a randomized, placebo-controlled trial that its product works. It also assured standardization and purity. Instead of cheering, the FDA slapped its wrists. Sound crazy? We thought so over 20 years ago.
A Federal District Court ruled on February 16, 1999, that Cholestin was a dietary supplement and not a drug subject to FDA approval. It could be sold legally under the Dietary Supplement and Health and Education Act of 1994. The judge held unlawful and set aside the FDAs effort to ban access to Cholestin.
In 2001 the maker of Cholestin changed the formula to contain policosanol compounds instead of red yeast rice. We could not determine if the product is still available today.
Is Red Yeast Rice Safe
There are genuine safety concerns about some red yeast rice products. Because monacolin K acts as a natural statin, some supplements work more like medications. However, the FDA regulate supplements and medications in different ways.
The FDA have banned red yeast rice products that contain more than tiny amounts of monacolin K, and this means they might not reduce your cholesterol as much as they promise.
The fermentation process for making red yeast rice can also introduce a poisonous byproduct called citrinin. Citrinin is a mycotoxin a toxic substance that can develop while fermenting rice in Monascus.
If you are worried about your blood cholesterol levels, its better to speak with your doctor rather than take a supplement with unknown levels of active ingredients.
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Safety Of Red Yeast Rice For High Cholesterol In Individuals With Statin Intolerance
|The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.|
|First Posted : March 20, 2008Results First Posted : January 18, 2010Last Update Posted : January 18, 2010|
|Dietary Supplement: Red Yeast RiceDrug: PravastatinBehavioral: Lifestyle modification program||Phase 2|
20 million Americans are actively treated with statins at an annual cost of 16 billion dollars. Statins are effective therapeutic agents for reducing LDL cholesterol and have documented effectiveness. However, a significant subset of patients , cannot tolerate lipid lowering statin therapy due to intolerable muscle-related symptoms characterized by muscle pain and/or weakness. These symptoms affect quality of life and lead to poor adherence.
Patients may seek alternative therapies to manage hypercholesterolemia if they have been intolerant of statin therapy. One commonly used alternative treatment option is the Chinese herb red yeast rice extract. Several small studies performed in China, have suggested this treatment is efficacious and well tolerated. In the U.S. red yeast rice is sold over the counter a dietary supplement.
The specific aims include:
How To Find And Use Red Yeast Rice
Red yeast rice supplements are extremely easy to find at your local health store or online. Any RYR supplement should be taken with food. It is also best taken with CoQ10 to prevent deficiency in CoQ10.
What about the best red yeast rice dosage? Most studies have used a standardized extract of 600 milligrams taken two to four each day so that can be 1,200 milligrams twice a day, which is equivalent to 600 milligrams four times per day or 2,400 milligrams per day. At least one study has shown that elderly individuals who took 1,200 milligrams of RYR every day for eight weeks did not have any major side effects.
The amount of monacolins in RYR supplements can differ since manufacturers can use various yeast strains and fermentation processes. Some research has shown that the amount of monacolin in RYR supplements can be anywhere from zero to 0.58 percent of the final product. This was just one study with different brands, but its still pretty interesting.
Red yeast rice reviews vary but often say that it only took some people with high cholesterol supplementing their diets with RYRE for a matter of months before they saw a significant decrease in their cholesterol numbers.
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Red Yeast Rice Information
- Summary: In Traditional Chinese Medicine , the dosage of dietary or supplemental red yeast rice can be quite high. But the right dose for adults may be different,
- Matching search results: Qin S, Zhang W, Qi P, Zhao M, Dong Z, Li Y , et al. Elderly patients with primary hyperlipidemia benefited from treatment with a Monacus purpureus rice preparation: A placebo-controlled, double-blind clinical trial. American Heart Association. 39th
What Should I Watch For While Using This Medication
Visit your doctor or health care professional for regular check-ups. You may need regular tests to make sure your liver is working properly.
Tell you doctor or health care professional right away if you get any unexplained muscle pain, tenderness, or weakness, especially if you also have a fever and tiredness.
Some drugs may increase the risk of side effects from this supplement. If you are given certain antibiotics or antifungals, you should stop taking this supplement during those treatments. Check with your doctor or pharmacist for advice.
If you are scheduled for any medical or dental procedure, tell your healthcare provider that you are taking this supplement. You may need to stop taking this supplement before the procedure.
Do not use this drug if you are pregnant or breast-feeding. Serious side effects to an unborn child or to an infant are possible. Talk to your doctor or pharmacist for more information.
Herbal or dietary supplements are not regulated like medicines. Rigid quality control standards are not required for dietary supplements. The purity and strength of these products can vary. The safety and effect of this dietary supplement for a certain disease or illness is not well known. This product is not intended to diagnose, treat, cure or prevent any disease.
The Food and Drug Administration suggests the following to help consumers protect themselves:
Always read product labels and follow directions.
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What Is The Correct Dosage Of Red Yeast Rice Extract
Keep in mind that the amount of monacolin — perhaps the most important ingredient — in a red yeast rice extract can vary a lot. There are many different strains of the yeast. Different types of fermentation are used. One study of different brands of red yeast rice supplements showed that the amount of monacolin ranged from 0% to 0.58%.So even though studies have shown that RYRE can lower cholesterol, you can’t really know if the supplement brand you’re using will have that effect.
Cooper Complete Red Yeast Rice Supplements
Cooper Completes Red Yeast Rice Supplement is physician-formulated and contains 1000 mg red yeast rice per two capsules.
It is best to take red yeast rice with food. Taking red yeast rice at bedtime may be more beneficial if you only take it once per day. The liver generally makes most cholesterol at night when dietary intake is the lowest. This allows more of the red yeast rice to reach the liver. Dont take red yeast rice if you are pregnant, trying to become pregnant or breastfeeding. You should avoid taking red yeast rice with antifungal medications such as Diflucan, antibiotics and anti-depressants such as St. Johns Wort. Taken over a long period of time by healthy adults, red yeast rice supplements may help lower blood cholesterol. Consult with your health care provider if you plan to take red yeast rice supplements.
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Effectiveness And Safety Of Statins
Dr. Laffin said that certain statins may have different efficacies with respect to lowering LDL-C, based on their % decrease. They are generally grouped into low-, moderate-, and high intensity, he said.
In general, statins that have the most efficacy, the highest potency, are rosuvastatin, which was used in this study, and atorvastatin, said Dr. Wong.
Dr. Laffin said that statins were generally very safe. While some people taking statins complain of muscle pain, previous research suggests that this is partly attributable to a effect.
Although nearly 30% of those studied quit their treatment due to muscle pain, researchers found the actual incidence of discomfort to be only about 5% more among patients taking a statin, compared with patients given a placebo.
The nocebo effect of statins and the studies that rigorously demonstrate this actually shows that statin-associated muscle symptoms are quite rare, Dr. Laffin said.
However, Dr. Wong added that myopathy can be a side effect of statins for some people.
Some studies show over 25%. In terms of life threatening complications from statins, the incidence is very low, she said.
Should Woman Take Red Yeast Rice
Q. My wife and I are vegans. We are very health conscious, so we were surprised when her doctor suggested that she start taking a statin. Her cholesterol is right around 200, which doesnt seem that high to us.
She would rather take red yeast rice than a synthetic drug to see if it would be helpful. Do you have any recommendations?
Another reader also wants to know if there is a safe red yeast rice supplement:
Q. I would like to take a Red Yeast Rice supplement for my slightly elevated bad cholesterol . I read that I should choose a high-quality supplement made in a certified facility that meets Food and Drug Administration standards.
I have no idea how to determine this. Probably other consumers would also appreciate your guidance.
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Fast Forward To Today Should People Take Red Yeast Rice
A small randomized placebo-controlled trial in Japan found that RYR lowered LDL and total cholesterol as well as blood pressure . A systematic review of 30 articles concluded that red yeast rice reduces mortality rates and major cardiac events .
Finding a safe and effective supplement may be harder than you would think, however. The FDA does not regulate dietary supplements and provides no assurance of quality. The agency does not actually certify the manufacturing plants that make dietary supplements. It is difficult to determine the quality of such products.
Many studies demonstrate that red yeast rice can lower total and LDL cholesterol .
According to the International Lipid Expert Panel:
RYR preparations have been demonstrated to be safe and effective in reducing LDL-C and CV events.
If You Are Considering Red Yeast Rice
- Do not use red yeast rice to replace conventional care or to postpone seeing your health care provider about a health problem.
- Do not use red yeast rice dietary supplements if you are pregnant, trying to become pregnant, or nursing a child. If you are considering giving a child a red yeast rice dietary supplement, it is especially important to consult the childÃ¢â¬â¢s health care provider.
- Do not take red yeast rice in addition to prescription statin drugs.
- Many websites, including sales sites, have information about red yeast rice. Be cautious when you evaluate information from the web not all of it is trustworthy. For more information, see the NCCIH fact sheet Finding and Evaluating Online Resources.
- Federal regulations for dietary supplements are very different fromÃ¢â¬âand less strict thanÃ¢â¬âthose for drugs. For more information about dietary supplements, see NCCIHÃ¢â¬â¢s fact sheet Using Dietary Supplements Wisely.
- Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.
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What To Do Instead
To lower your LDL, eat a heart-healthy diet that includes plenty of fiber from whole grains, fruit, vegetables, and beansand limit your intake of saturated fat-laden red meats and full-fat dairy products. Losing excess weight, exercising regularly, and quitting smoking have all been shown to increase HDL, or good cholesterol, and have been associated with reduced risks of heart attack and stroke.
If you do need the power of a drug to lower your cholesterol, you are better off taking a prescription statin that is regulated by the Food and Drug Administration. That way, your doctor will be able to choose the correct medication for your condition. You will also know exactly how much of the active ingredient each pill contains, along with the risk factors and potential effects associated with it. For more information about statins, see our Consumer Reports Best Buy Drug report.
Taking prescription statins is also gentler on your wallet. A months worth of some generic statin drugs can cost as little as $4 at pharmacies like Kroger, Sam’s Club, and Walmart, and statins are covered by most insurance plans, according to Consumer Reports Best Buy Drugs. Meanwhile 30 days worth of red yeast rice can cost about $13, and won’t be covered by your insurance.
May Have Anticancer Properties
Although current research is limited to animal and test-tube studies, some evidence suggests that red yeast rice may help reduce the growth and spread of cancer cells.
One study found that giving mice with prostate cancer red yeast rice powder significantly decreased tumor volume compared with a control group .
However, more research is needed to evaluate the effects of red yeast rice on other types of cancer in humans.
Specifically, further studies should be done to determine how the potential anticancer effects of red yeast rice may affect the general population.
Red yeast rice may decrease your risk for heart disease and metabolic syndrome, reduce inflammation in the body, and potentially possess anticancer properties. However, more research is needed.
However, there are some potential downsides to red yeast rice as well. They include:
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Safety Of Red Yeast Rice
Inducers or inhibitors of CYP450 may alter plasma concentrations of monacolin K. For this reason, the simultaneous use of nutraceuticals with certain foods or drugs that are CYP450 inhibitors may increase the myotoxicity risk and, although rarely, cause rhabdomyolysis.4143 Even if chronic use of monacolins could cause mild to moderately severe side effects, they are usually safe and well tolerated. The one exception is citrinin, which is a mycotoxin metabolite derived from Monascus fermentation.44 In several animal studies, chronic use of citrinin is nephrotoxic and gradually leads to hyperplasia of the renal tubular epithelium, renal adenomas, and sometimes to renal tumors . Furthermore, citrinin causes reproductive toxicity, malformations, and certain embryo toxicity .45,46 The European Food Safety Agency has determined that the maximum dose of citrinin that can be ingested in humans without experiencing nephrotoxicity is 20 g/kg per day.47 However, neither genotoxic nor carcinogenic effects can be excluded with certainty. Certain RYR supplements labeled 600 mg/capsule have been detected with citrinin levels that exceed 114 g/capsule, so that the recommended dosage of four capsules per day would significantly exceed the EFSA recommended level.11