Photo courtesy of Weil Lifestyle
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Dr. Debunker
Cholesterol Busters
By Andrew Weil, M.D., January & February 2008
Q: My doctor wants to put me on a statin drug to lower my cholesterol. Is there anything natural I could try instead?
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A: Statin drugs are fairly safe and very effective at lowering LDL (“bad”) cholesterol. But they can disturb liver and muscle function in some people, occasionally so much that use must be stopped.
Yet I believe there is a good natural alternative: red yeast rice, a fermented food that has a long history of use in Chinese cooking. The first prescription statin, Mevacor (lovastatin), was isolated from a mold, and many molds, yeasts, and mushrooms produce this particular statin. The brick-red yeast that grows on rice yields a family of ten different statin compounds, lovastatin among them.
A well-designed, controlled human study done at UCLA in 1999 showed a standardized extract of red yeast rice to be effective at lowering cholesterol, with a low incidence of side effects. Unfortunately (in my opinion), the FDA ordered this product off the market because the agency deemed it an unapproved drug rather than a dietary supplement (it contained then-patented lovastatin). And last August the FDA warned consumers away from three other red yeast rice products after testing them and finding lovastatin. The FDA’s concern is that people who take these supplements might be vulnerable to lovastatin’s side effects without knowing it.
But other brands of red yeast rice are still on shelves. I have seen good results in patients using them: satisfactory lowering of LDL cholesterol with very, very few problems. The reason there are fewer side effects is that red yeast rice presents the body with a complex of related statin molecules rather than a single molecule, a difference I have noted in my studies of medical botany.
If you want to try red yeast rice, talk to your doctor about the dosage. The starting dose is 600 milligrams (mg) twice a day, with meals; the maximum is 1,200 mg twice a day. After using the extract for two months, get your lipid levels checked, as well as your liver function. If your LDL cholesterol is still not low enough, ask your doctor about adding 10 mg a day of Zetia (ezetimibe), a nonstatin drug that works well with statins to lower cholesterol levels.
Whether you are on a prescribed statin or red yeast rice—never both—taking 60 to 120 mg a day of CoQ10 has been shown to protect and enhance muscle metabolism, including that of heart muscle. Statins inhibit synthesis of CoQ10, so it’s important to increase your levels of this vital compound.
In the September & October 2007 issue, Dr. Weil answered a question about vaccine safety. We received so many letters from readers asking specifically about the shingles vaccine that we published the following Q & A in the current issue.
Q: Do you recommend that people 60 and over get the shingles vaccine, Zostavax?
A: Yes. Having had shingles last year—a most unpleasant experience— I can only say I wish I had had the vaccine. Incidence of shingles is high in people over 60, and the vaccine is safe and effective.
A pioneer in the field of integrative medicine, Andrew Weil, M.D., is a bestselling author and the editorial director of www.drweil.com.
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