Think ‘natural’ remedies have fewer side-effects than statins? Think again

FIve years ago, I had a stroke out of the blue. I was only in my mid-50s and there was no apparent reason for it. I was fit and healthy, didn’t smoke and had low blood pressure.

Subsequently, doctors found I had a hole in my heart, which I was born with and which had probably caused it. I had a tiny umbrellashaped device put into my heart to close the hole.

In the meantime, the medical protocol demands that anyone who’s had a stroke should be put on statins. As my cholesterol reading was 5.6 — the latest guidelines say cholesterol should be below five — I duly did as I was told.

I tried them for six months, but they made me feel excruciatingly tired. I could barely walk the dog the mile or so around our local park. I would also forget things and, worst of all, I felt depressed.

These are all known side-effects thought to affect 20 per cent of people taking statins. There are seven million people in Britain on statins, which are now the most commonly prescribed medication.

The National Institute for health and Care excellence (NICe) has recently changed the guidelines, meaning an extra 4.5 million people in england will qualify for the cholesterol-lowering medication.

Anyone thought to have a 10 per cent risk of a heart attack or stroke can be offered a daily dose of atorvastatin 10mg — previously this was recommended only for people with a 20 per cent risk.

After putting up with the sideeffects for six months, I read up on cholesterol and decided that, as a woman of a certain age, I was not too concerned about my slightly raised levels.

I knew my stroke had not been caused by furred arteries, but a hole i n my heart, and I had spoken to my stroke physician about coming off statins, who didn’t demur.

I was already pretty healthy — I cycle daily and swim twice a week — but decided to cut out cheese from my diet and took up nordic walking. Nevertheless, each time I saw my GP, she nagged me about my cholesterol.

Then, last year, a friend told me about r ed yeast r i ce — supposedly a natural alternative to statins. It has been used for centuries in China as a food and medicine.

It’s made by fermenting a yeast called Monascus purpureus over red rice. In Chinese medicine, it is used to lower cholesterol, improve circulation The and aid digestion.

product I used was claimed to ‘help maintain normal bl ood cholesterol levels’. There was no mention of side-effects on the packet and at the very least if it worked it would keep the GP off my back — at my last check just before Christmas, my cholesterol was up to 6.8.

I’d told her I would like to try to lower it through dietary changes. She r el uctantly agreed, but asked me to have my cholesterol checked again in three to six months’ time.

In the meantime, I started to pop the pills once a day and thought no more about it. But after about three weeks, I felt more tired than usual.

I was sleeping badly and waking up shattered. I also felt low and depressed — unheard of for me.

At first, I couldn’t understand what could be wrong. Then I remembered the red yeast rice pills.

A quick online search later and I was shocked to discover they contain chemicals known as monacolins, which have a similar effect to statins. Some red yeast rice products, like the one I took, contain substantial amounts of a particular type of monacolin known as monacolin K.

It has the same chemical structure as a statin called lovastatin, which is widely used in the U.S. and works in the same way in the liver, inhibiting an enzyme that helps the body make cholesterol.

In fact, the two substances are so similar that red yeast rice supplements are banned in the U.S., as the Food and Drugs Administration (FDA) ruled that because they contain monacolin K, they are effectively an unapproved drug.

however, in Britain we follow guidelines from the european Food Safety Authority ( eFSA), which has given red yeast rice approval for use as a supplement.

The wording of the report says: ‘Monacolin K contributes to the maintenance of normal blood cholesterol levels.’

But some experts are worried that the eFSA guidelines are not stringent enough.

Because it is marketed as a ‘ natural’ f ood supplement, people may not realise the active i ngredients i n such products are basically a statin.

‘Monacolin K is essentially a statin-like product being sold under the guise of a f ood supplement,’ says dietitian Linda Main.

She advises the cholesterol charity heart UK, which is working with the Department of health to toughen up the wording of the eFSA guidance.

‘Consumers need to be aware that taking excess amounts of this product, especially on top of a statin prescription, could put them at risk of serious side-effects,’ she says.

What’s more, people may take ‘natural’ supplements without the supervision of their GP or other medical professionals.

‘ Drugs such as lovastatin should be taken only in carefully monitored doses prescribed to produce maximum benefit with minimum harm,’ says Professor Peter Weissberg, medical director of the British heart Foundation. Taking unregulated amounts of such substances is potentially dangerous.

‘Ideally, patients with heart disease should not take red yeast rice supplements.

‘But if they do, it is essential they tell their doctor in order to avoid a potentially harmful interaction with conventional medicines, which are prescribed for their proven health benefits,’ he says.

The red yeast rice pills I took

are made by Quest. ‘We would always recommend anyone taking medication or under medical supervision should discuss taking a supplement with their GP,’ says Sharon Morey, the company’s nutrition adviser.

A further concern is that it’s not always clear how much of this ‘natural’ statin is in any of these supplements, nor is there an agreed safe dosage. On the packaging of the pills I took, it says there is 115mg of concentrated red yeast rice, providing 3.45mg of monacolin K, per pill, HOWever, to be taken twice a day.

not al l products make this i nf ormation c l ear. research in 2010 by i ndependent U. S. company ConsumerLab analysed the ingredients of 12 red yeast rice products bought over the counter or on the internet.

It found that while each brand was said to contain 600mg of red yeast rice, the level of monacolins, including monacolin K, ranged from 0.31mg to 11.15mg per capsule — a low dose of lovastatin is 10mg a day.

This variation is because there are many strains of the yeast and different types of fermentation.

The same study highlighted another potential danger. In four out of the 12 brands looked at there were ‘elevated levels’ of citrinin — a toxin produced during the fermentation process of red yeast rice.

Citrinin in l arge doses is known to cause kidney damage and alter liver metabolism.

While there’s little data on the side- effects of red yeast rice, they’re believed to be similar to those of low-dose statins.

Last year, the French Food Agency, ANSeS, was so concerned about red yeast rice it issued a warning after it reported 25 adverse events in people using the supplement. These included muscle cramps and weakness and one case of pancreatitis. While I won’t be taking red yeast rice supplements again, annoyingly, they seem to work. When I had a cholesterol check just after I stopped taking the pills, it had plummeted to 5.4. Perhaps that’s not surprising as they are, in effect, a low- dose statin — and not such an alternative after all.