In my last post I mentioned that I see a lot of patients with high cholesterol and triglycerides whose doctors want to or have already put them on Statin drugs. Some of them are even taking two or more at once.

But statin drugs are not without a frightening array of risks– pain, inflammation, liver damage, Lou Gehrig’s disease ALS, and memory loss. And according to the Mayo Clinic


the risks are greater under the following conditions:

• Taking multiple medications to lower your cholesterol
• Being female
• Having a smaller body frame
• Being age 65 or older
• Having kidney or liver disease
• Having type 1 or 2 diabetes

What is crazy is many of my patients on multiple meds to lower cholesterol are female and over 65….

Given that once you are on statins you have to stay on them for the rest of your life, it would seem prudent to at first try conservative measures like diet and exercise before jumping into a lifelong relationship with a dangerous drug.

My last post discussed diet.

Exercise is a no-brainer: you have to do it and there are no excuses. Being overweight and not exercising is a double whammy– excess weight boosts harmful bad cholesterol, while inactivity depresses protective good cholesterol. Eating too many carbs and sugar, which often goes hand in hand raises deadly triglycerides.

Losing weight if needed and exercising more reverse these trends. At a minimum you need 30 minutes 6 days a week. That could be walking the dog 15 minutes 2x a day. Just do it, as the slogan goes.

Role of Genetics in High Cholesterol

There are people who have such a high genetic factor that even with a perfect diet and lifestyle they still have high cholesterol. Even in those cases, it seems much more reasonable to try Red Yeast extract first.

Red Yeast (Monascus purpureus)

Red yeast rice or red rice yeast is the dried version of a red yeast ( Monascus purpureus ) that is grown on rice. Originally from China, known as Zhi Tai in Mandarin, it has been used in Chinese Medicine as a “blood vitalizer” since the Tang dynasty (800 C.E.) Many of the class of medicinals known as blood vitalizers have cholestoral fighting properties.

According to the Mayo clinic website,

“It contains several compounds collectively known as monacolins, substances known to inhibit cholesterol synthesis. One of these, “monacolin K,” is a potent inhibitor of HMG-CoA reductase, and is also known as mevinolin or lovastatin (Mevacor®, a drug produced by Merck & Co., Inc). “

Red rice yeast is a natural source of statins, but unlike pharmaceutical products, it provides a mix of these compounds rather than a single one. The complex mixture interacts with the body more smoothly and is less likely to cause toxicity.

According to the Mayo Clinic

“Since the 1970s, human studies have reported that red yeast lowers blood levels of total cholesterol, low-density lipoprotein/LDL (“bad cholesterol”), and triglyceride levels. “

The Mayo site then goes on to give Red Yeast an A for this function, which means “strong scientific evidence for this use.”

And Red Yeast may have additional benefits according to the Mayo Clinic site.

Coronary heart disease

Preliminary evidence shows that taking Monascus purpureus by mouth may result in cardiovascular benefits and improve blood flow. Additional study is needed before a firm recommendation can be made.


Early human evidence suggests the potential for benefits in diabetics. Additional study is needed before a firm recommendation can be made.

Issue of Standardization and Quality Control

Mayo then discusses the very real issue, which also occurs with generic drugs made in India and China, of standardization. That is why I always recommend Solaray Brand red yeast. http://www.amazon.com/Solaray-Red-Yeast-Rice-capsules/dp/B0001QNH5S

This is the brand I have had success with my nutrition patients here in San Diego. One patient who then switched to a cheaper version from a large discount chain, saw her cholesterol go back up.

Does Red Rice Yeast have any risks?

Red Rice Yeast is a natural source for monacolin K, the active ingredient in one of the big statin drugs. But, like other whole plant medicines, it contains a far smaller amount (in this case 1/5th the amount) plus other buffers and co-factors. This may explain why in recent studies mentioned by Anderw Weil, M.D., only 7% of the patients had muscle stiffness

It should also be noted that, like anyone taking pharmaceutical statins, red yeast users should be on daily supplements of coenzyme Q10 (CoQ10). Statins inhibit the body’s production of this coenzyme along with lowering cholesterol. CoQ10 is necessary for optimum function of muscles, including heart muscle.

Red Rice Yeast, or Diet and Exercise?

Obviously, with even a small risk, wouldn’t it be a much better choice to try lowering your cholesterol with diet and exercise first, and then try red yeast if unsuccessful?

I had an elderly heart patient here in San Diego who went to the Scripps Clinic heart disease program ready for heart surgery, and opted into the diet and exercise program. His diet was radical–no red meat at all; but he reversed his heart disease, avoided open heart surgery, and I still run in to him at Whole Foods Market 15 years later!

As always, please discuss these issues with your M.D. before going off any meds. Also, please refer to the Mayo clinic website for information on who should potentially not take Red rice yeast, like people with liver disease and on blood thinners.


copyright Eyton J. Shalom, M.S., L.Ac. San Diego, CA All Rights Reserved, Use With Permission Ayurveda, Acupuncture, and Chinese Medicine in San Diego https://www.bodymindwellnesscenter.com

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