Wednesday, December 23, 2009

Red yeast rice and your cholesterol

Saw an interesting article in American Family Physician. It was actually a summary of an article published in the Annals of Internal Medicine June, 2009.

Questions posed: Is Red Yeast Rice effective in Statin-Intolerant Patients?

Typically when patients have high cholesterol, as physicians, we initially recommend therapeutic lifestyle change (TLC) for a couple months. This is when the patient gets the message that they have to change the way they eat and start exercising. Some patients respond but the vast majority don't. "I'm too busy, I don't have time." My response is, "You have to make time to exercise or take time to take a pill." That pill is usually a STATIN class of cholesterol lowering medications. These are the ones you see on TV named Lipitor, Crestor and Zocor for example. These medicines can be prescribed by your doctor and usually your liver function tests need to be monitored periodically.

Now some patients do actually have an allergic reaction to STATIN medications and cannot take them. So they need alternatives. This article addressed one of these alternatives, Red Yeast Rice.

The Study:
Patients were enrolled in 12 weeks of a lifestyle change program and received Red Yeast Rice 1800mg twice daily for 24 weeks. Baseline LDL cholesterol was measured. At the conclusion of the study, the Read Yeast Rice group showed significantly lower LDL cholesterol levels.

The Answer:
The authors concluded that Red Yeast Rice in conjunction with therapeutic lifestyle change may be useful for treating hyperlipidemia in patients who cannot tolerate STATIN therapy.

So this information is good right? Go out and buy your read yeast rice, immediately? I don't think it's a bad thing but you do have to watch the fine print. These patients were in a 12 week lifestyle change program. Likely, provided nutritional and exercise education. I can provide that, but not for 12 weeks. Yes, the medicine helped but it's not clear how much what the lifestyle changes program entailed and to what extent the effect was.

The question always arises, "Doc, what can I do to lower my cholesterol."
The answer is Diet and Exercise and Weight loss. Other options include: Fish Oils, Red wine, 2 servings of oatmeal a day and avoiding saturated fats.

You can read the article yourself at:

Bryan Glick, DO