red yeast rice, risk of red yeast rice, red yeast rice safe, statins compare

Cholesterol is not the only risk factor that is important for heart health, but it remains an important indicator. People with heart disease need to take care not to let their dangerous LDL cholesterol get out of control. As a result, many of them end up taking a statin-type cholesterol-lowering medication. Unfortunately, not everyone tolerates such medications well. How do statins compare to other ways of lowering cholesterol?

How Do Statins Compare to Red Yeast Rice?

Q. I am a woman who had a heart attack and bypass surgery two years ago. I was then prescribed three different statins, one at a time. They all caused me severe pain. Nevertheless, I had to continue.

Last summer, I noticed that I could not use my right leg to get out of the pool. When I attempted to use my right leg, holding the handrail did not help. It was impossible. I mentioned it to the cardiologist, but he did not appear concerned. I just let it go and only used my left leg to get out of the pool at the gym.

Then last summer I fell twice with no warning. And I again fell during our summer vacation this year. I believe these falls are also related to the statin.

Finally the cardiologist agreed to place me on red yeast rice instead of a statin. So far, so good. I am regaining the strength in my right leg. I can now use it to get out of the pool.

My concern is that a friend took red yeast rice for a few months and lost the strength in his arms. He stopped it and is in recovery mode now. Is muscle weakness a side effect of red yeast rice?

Red Yeast Rice and Muscle Reactions:

A. Statin-linked muscular damage appears to be, in part, related to dose. Red yeast rice (RYR) contains lovastatin, although it is present in lower doses than those found in conventional prescription drugs. There is evidence that it can lower LDL cholesterol (Cicero et al, Nutrition & Metabolism, Sept. 25, 2017). Adding phytosterols (plant compounds such as beta-sitosterol) may increase the effectiveness of RYR.

One small trial found that many people who don’t tolerate statins do well on red yeast rice (Becker et al, Annals of Internal Medicine, June 16, 2009).  That said, some people are so sensitive to statin side effects that even RYR causes pain and muscle weakness (Philibert et al, Therapie, Oct. 27, 2016). Some physicians are adamant that RYR is not an appropriate substitute for statin therapy (Dujovne, American Journal of Medicine, Oct. 2017).

You may find our Guide to Cholesterol Control and Heart Health useful, as it contains other non-statin strategies for controlling LDL.

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