Caution Urged on Cholesterol-Lowering Supplement

[Zach]

Another story which shows that just because a supplement is "all natural" does not always make it safe.



http://www.nytimes.com/2010/11/02/health/research/02nostrums.html?hpw

Nostrums: Caution Urged on Cholesterol-Lowering Supplement

By RONI CARYN RABIN

Americans trying to avoid cholesterol-lowering drugs are spending tens of millions of dollars each year on Chinese red yeast rice, a supplement found to lower LDL, or “bad,” cholesterol.

But the amount of the active ingredient in the supplement varies widely from one brand to another and possibly from batch to batch, a new study has found. And one in three tested products contained a substance that may be toxic to the kidneys.

For the study, published Monday in Archives of Internal Medicine, scientists analyzed samples from a dozen red yeast rice products. While some capsules contained as little as 0.1 milligram of the active ingredient, known as monacolins, others contained 11.15 milligrams.

Four tested samples contained citrinin, a fungus that causes kidney failure in animals.

Earlier studies by the same authors had reported that red yeast rice did effectively lower LDL cholesterol. Now the authors are urging caution, noting that as supplements, the products are not regulated by the Food and Drug Administration and are not standardized. The F.D.A. has warned consumers not to use red yeast rice products that claim to lower cholesterol.

“Our take on it is that red yeast rice, unlike a lot of unproven herbal products, really works,” said the lead author, Dr. Ram Y. Gordon, a cardiologist at Chestnut Hill Hospital, part of the University of Pennsylvania Health System. “But because of what we found, there are inherent problems in saying that this is good for people.”

[PMP]

Thanks for that, Zach.  I've wondered about that supplement.  My "bad" cholesterol level is just that...bad.  My father is on dialysis, and he swears his having been on Lipitor is the reason for his kidney failure.  No way to know if he's right, of course, but it makes me wary to go on Lipitor, though, if a doctor thinks I should go that route one day.  That's one reason that supplement had caught my eye.  Will have to think twice (or three times) about it!! 

[Hemodoc]

Red rice yeast is a natural statin.  Nothing wrong with that by itself, the problem comes down to quality control issues as they pointed out in this article.  There are many natural herbs with great medicinal potential all of which likewise suffer from this same issue.  The artificial distinction to natural medicines and medicines in general is done at the forgetting of the history of medicine to include willow bark and aspirin, foxglove plant and digoxin.  St. John's Wort has been studied extensively and the active ingredients are Hypericum.  It is effective for mild depression but does have side effects to include the serotonin syndrome if taken in excess or in combination with other antidepressants known as SSRI's such as prozac.

The entire herbal remedy business is not regulated by the FDA leading to the quality issues as well lack of further definitive studies in many cases where we are not following up on possible medical breakthroughs as has been done for centuries with the hundreds of other natural remedies that are now standard medicines as well.  Why not continue in the tradition of medicine learning from these plants and expanding our knowledge base instead of truncating the system to one based more on business principles than science.  There is much to learn from herbal remedies if and when those that promote herbal remedies advance beyond alchemy and enter once again into traditional science principles that has brought us the miracles of modern medicine today.

As far as the Lipitor issue, elevated cholesteral is a risk factor for progression of renal disease in those at risk.  The main risk with the statins is liver damage not renal damage. In fact, several studies show a benefit of renal function with statins.

http://www.mayoclinicproceedings.com/content/82/11/1381.full