Cholesterol Supplement: Red Yeast Rice Extract

Red yeast, grown on fermented rice, has been used in China for more than 1,000 years to improve heart function (and give Peking duck its red color). It works by blocking an enzyme necessary in the formation of cholesterol and by speeding the removal of LDL from the blood. Think of it as nature's statin drug.

Red yeast rice extract is so similar to statins, in fact, that the FDA pulled one brand, Cholestin, from store shelves in the summer of 2002, saying it contained natural lovastatin, the same compound synthetically produced and sold as the prescription drug Mevacor. Cholestin's manufacturer quickly reformulated the product using policosanols, and it's still sold under the same brand name.

Other forms of red yeast rice extract continue to be available over the Internet and through specialty health food stores, individual physicians, and alternative health care providers. Although they haven't been as closely studied as Cholestin, these alternatives still have some cholesterol-lowering effects and may cost as little as one-fifth the price of prescription statins.

What the research shows: Researchers at the University of California, Los Angeles, studied the benefits of red yeast rice extract on 83 healthy adults with high LDL levels. For 12 weeks the participants received either the extract or a placebo and followed a low-fat, low-cholesterol diet. In the supplement group total cholesterol dropped an average of 46 points after eight weeks. There was no significant decrease in the placebo group. In a larger study conducted at 12 medical centers throughout the United States, 187 men and women with high cholesterol levels took Cholestin for eight weeks. Their total cholesterol dropped an average of 16 percent, from 242 milligrams per deciliter (mg/dl) to 204 mg/dl. Four weeks after they stopped taking the supplement, their counts rose again to prestudy levels.

Who should take it: Anyone with cholesterol levels high enough to require drug treatment, but who doesn't want to take a prescription drug, should consider it.

Recommended dose: Follow the manufacturer's directions.

Warnings/contraindications: Because red yeast rice extract is a natural form of statin, it may have the same side effects as statins, including heartburn, dizziness, muscle weakness, and a very slight chance of liver damage. Don't mix it with other statin-type cholesterol-lowering medications, although it can be safely combined with niacin supplements. Consider supplementing with coenzyme Q10 if you do decide to take red yeast rice extract. Since the extract is a statin, albeit a naturally occurring one, it can have the same lowering effects on coenzyme Q10 as any of the pharmaceutical statins.