Imma Akin

Dear Dr. Spence,



I have been unable to tolerate any of the statin medications like lipitor or zocor due to muscle pain. Is there any alternative? My bad cholesterol is through the roof.



Signed,

Imma Akin



Dear Imma,



A recent study performed at the University of Pennsylvania has shown that red yeast rice therapy performs similarly to pravastatin (pravachol) in head to head trials. They randomized 43 patients who had previously been unable to take statins due to muscle pain, to either red yeast rice or pravastatin. The lowering of LDL (bad cholesterol) was 27% in the statin group and 30% in the red yeast rice group proving that the alternative therapy was just as effective. Though muscle pain was still a possibility, it was half of what was seen with the pravastatin.

Red yeast rice is made by fermenting polished rice with strains of a particular yeast. It has been a staple of Asian culture and medicine for centuries. Its actions are similar to prescription drugs in that they lower cholesterol by inhibiting a key step in cholesterol production in the liver. Not all practitioners have adopted the use of red yeast rice due to lack of knowledge about the product and the general lack of FDA regulation of the various preparations.

A Chinese analysis from 2006 examined 93 separate trials that involved nearly 10,000 patients. It showed that not only can red yeast rice lower LDL cholesterol as effectively as some statins, it also appeared to increase HDL (good cholesterol) and improve triglycerides. Most importantly, red yeast rice seemed to be extremely well tolerated.

Given that so many people suffer muscle pain as a result of being given statin medication, it seems only natural to look for alternative sources of cholesterol lowering. Red yeast rice is a low cost option for those in need of additional help. The remaining question is – does it provide any true protection against heart attack, stroke, or death? This, unfortunately, is less clear. Medications like zetia have fallen out of favor despite their ability to lower LDL, as they have not proven to decrease death rates. Future studies may elucidate the positive effect that red yeast rice has. Until that time, we have to simply rely on the data at hand.

In your case, I think that red yeast rice would be a great option. Other options include fish oil, flaxseed oil, red wine, and garlic (among others). They all work to a lesser degree but they may be more tolerable. Remember! According to statistics, a decrease of 2 mg/dl in LDL represents a 1% risk reduction in heart disease, so every little bit counts.

Do you have any medical questions or concerns that you would like addresses? You can contact Dr. Spence by email at panhandledailydose@hotmail.com or by mailing your question to Daily Dose, P.O. Box 6107, Marianna, FL 32446.