Red yeast rice may work like statins, but it isn’t regulated
Q: My wife and I are very health conscious, so we were surprised when her doctor suggested that she start taking a statin. Her cholesterol is right around 200, which doesn’t seem that high to us. She would rather take red yeast rice than a synthetic drug to see if it would be helpful. Do you have any recommendations?
A: Red yeast rice is a traditional Chinese medicinal food that dates back several centuries. It was used to flavor, color and preserve food. The natural compounds (monacolins) produced by red yeast contain statins, including lovastatin. This was the original drug in this class, first sold under the brand name Mevacor. A small, randomized placebocontrolled trial in Japan found that red yeast rice lowered LDL and total cholesterol as well as blood pressure (Asia Pacific Journal of Clinical Nutrition, September 2021). A systematic review of 30 articles concluded that red yeast rice reduces mortality rates and major cardiac events (Frontiers in Pharmacology, Feb. 21, 2022).
Finding a safe and effective supplement may be harder than you would think. The Food and Drug Administration does not regulate dietary supplements and provides no assurance of quality. ConsumerLab.com recently tested some red yeast rice products and found that many did not contain adequate amount of lovastatin. In addition, some products were contaminated with citrinin, which can be harmful to the kidneys. The analysis did reveal that HPF Cholestene had adequate levels and no citrinin. To read the full report, visit ConsumerLab.com. There is a subscription fee.
Q: I’ve been suffering with menopausal symptoms for months. After taking Vitex twice a day for roughly four weeks, I’m starting to feel some relief. Prior to taking Vitex, I would get six or seven hot flashes in a 24-hour period, some with night sweats. Now, I have just one or two mild hot flashes during the day and sleep through the night. Aside from hot flashes, I credit Vitex with helping ease some other symptoms of perimenopause: anxiety and general fogginess. I’m grateful that this herb doesn’t seem to have any detrimental side effects!
A: Vitex agnus-castus, or chasteberry, was traditionally used for premenstrual or perimenopausal problems. A small randomized controlled trial in Korea found that Vitex extracts alleviated hot flashes (vasomotor symptoms) and anxiety better than placebo (Korean Journal of Family Medicine, November 2019).
In addition, a study that lasted a year found that women taking a combination of isoflavones, Vitex and magnolia extracts had significant reduction in vasomotor symptoms, mood disorders and sleep disorders (Gynecological Endocrinology, April 2022). We’re pleased to learn that Vitex is helping you.
Q: Is there any problem taking alprazolam to get to sleep? I’ve been doing this for years. Would melatonin work as well?
A: Alprazolam (Xanax) is a benzodiazepine approved for anxiety but not insomnia. Benzos are considered inappropriate for older people. Stopping may make sleeping much harder, though, and requires medical supervision. Melatonin won’t substitute for alprazolam, but it may help you readjust your sleep-wake cycle (Neuropsychopharmacology, July 2022).