Red Yeast Rice Extract - Its not magic, Its a drug
by Michael Melgar, MD on March 8th, 2014

Red Yeast Rice Extract is a Chinese medicine which has been promoted as a "natural" treatement for high cholesterol. Proponents of this treatment ( usually not legitimate medical profesisonals) claim that it offers patients a way to lower their cholesterol without the side effects of medication.
As with many alternative therapies the assumption is that somehow we can magically have all the benefits of a conventional drug without any side effects. Unfortunately as I have stated before in my posts, there is no magic class of substances that can provide benefits with no risk of side effects. Natural is a meaningless and misleading word ( See Natural - What does that word mean?). Anything that you put in your body with the expectation of some beneficial effect is by definition a drug, and anything that has the possbility of producing beneficial changes in your biology is also likely to have an occasional unintended or unanticipated effect. We call these unwanted effects side effects.

Just because a particular treatment is made from something that comes from a plant doesn't mean it is any safer than a conventional treatment that is manufactured under strict quality control standards in a lab. So it comes as no surprise that Red Yeast Rice Extract contains no magic powers to lower cholesterol without side effects. In fact most users are completely unaware that this product works only because it contains one of the same statin drugs that we use to lower cholesterol. Statins are the drugs most frequently used by physicians to treat high cholesterol. They go by names such as Atorvastatin (Lipitor), Simvastatin (Zocor), Pravastatin ( Pravachol), Rosuvastatin (Crestor), and Lovastatin ( Mevacor).  Lovastatin is the magic ingredient that allows Red Yeast Rice Extract to lower cholesterol levels, but you wont find that on the label anywhere. Its not magic, its a drug.

For those who are using Red Yeast Rice Extract because they want a more "natural" way to treat their cholesterol, there is nothing about this product that is any more natural than standard treatments. Many people who decide to use Red Yeast Rice Extract do so in the belief that its safer but nothing could be further from the truth. Unlike standard drug treatments which have to meet strict quality control standards and are regulated by the FDA, products which fall into the supplement category are not regulated by any agency. This means that these products do not have to state their actual ingredients and they don't have to post the dose of any active ingredients assuming there are any. The actual dose if they do post it may be much less than claimed, much more than claimed, or there may be none at all. Even worse, these products can be adulterated with any number of other ingredients that may have unwanted effects and the user would never know because no one is checking.

We need to remember that statin drugs require a prescription for a reason. These are powerful drugs and while they are largely safe and very effective there is still a small chance of side effects. For this reason patients on these drugs need to be monitored. An occasional side effect is muscle pains, but less commonly, a small percentage of patients may develop liver inflammation. Doctors screen for this before starting a stain medication and monitor for evidence of liver enzyme elevation with routine blood work periodically when patients are on cholesterol medications. If a problem is detected the medication is stopped and the problem resolves. If however a patient is not properly screened for liver disease before the medication is started or they are not monitored on the medication and a problem is not recognized, severe liver damage can rarely occur. Patients taking Red Yeast Rice Extract are not only getting an unknown dose of a powerful drug with unknown possible contaminants but they are not being monitored. For patients who really care about safety this is the worst of all possible choices to make.

For some patients cost may be the main concern. Some statin drugs, especially branded ones like Crestor can cost as much as $200 a month, but cost does not have to be an issue. Lovastatin, the very statin found in Red Yeast Rice Extract can be purchased at stores like Walmart and Target for pennies a day.  A 90 day supply can be purchased without any insurance for as little as $10 which works out to about $40 a year. Lovastatin can significantly lower cholesterol and reduce the risk of heart disease when used properly and monitored but it makes no sense to take a product like Red Yeast Rice Extract when the real Lovastatin is available so inexpensively.

The bottom line is that Red Yeast Rice extract is NOT safer than other statins. It has the same potential side effects as any other statin but has the potential for unknown and widely fluctuating doses from one bottle to the next. Its purity can not be assured. It may be adulterated with other unknown substances. Taking it without proper medical supervision is potentially dangerous, and it doesn't save its users any money.

The only magic in Red Yeast Rice Exctract is the way its manufacturers lighten the wallets of its users while pretending to be the safer natural way to treat their cholesterol.


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