Red yeast rice may lower blood lipid levels

CM NEWS – Replacing daily intake of white rice with red yeast rice may have a positive lipid-lowering effects in patients with primary hyperlipidemia, a meta-analysis of 93 randomized trials concludes.

The study was released in Chinese Medicine journal and was a joint study by alternative medicine experts in Norway and traditional Chinese medicine researchers in Shanghai and Beijing.

The meta study analyzed data from 93 randomized trials which include a total of 9625 participants. Researchers find that hyperlipidemia patients who have consumed red rice show significant reduction of serum total cholesterol levels (weighted mean difference -0.91 mmol/L, 95% confidence interval -1.12 to -0.71), triglycerides levels (-0.41 mmol/L, -0.6 to -0.22), and LDL-cholesterol levels (-0.73 mmol/L, -1.02 to -0.043), and increase of HDL-cholesterol levels (0.15 mmol/L, 0.09 to 0.22), compared to placebo groups.

Researchers emphasize that the positive effect on lipid levels by red rice shown by these studies indicates short term benefits. Whether red rice should be recommended as an alternative treatments for primary hyperlipidemia requires further studies.

According to Medline, red yeast rice contains several compounds collectively known as Monacolins, substances known to inhibit cholesterol synthesis. One of these, “Monacolin K” is a potent inhibitor of HMG-CoA reductase, and is also known as Mevinolin or Lovastatin (Mevacor®, a drug produced by Merck & Co., Inc).

Medline also says:

There is limited evidence about the side effects of red yeast. Mild headache and abdominal discomfort can occur. Side effects may be similar to those for the prescription druglovastatin (Mevacor®). Heartburn, gas, bloating, muscle pain or damage, dizziness, asthma, and kidney problems are possible. People with liver disease should not use red yeast products.

In theory, red yeast may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary. A metabolite of Monascus called mycotoxin citrinin (CTN) in fermentation may be harmful.

Avoid red yeast rice products promoted as treatments for high cholesterol, FDA warns

Medicine News Today – The U.S. Food and Drug Administration is warning consumers not to buy or eat three red yeast rice products promoted and sold on web sites. The products may contain an unauthorized drug that could be harmful to health. The products are promoted as dietary supplements for treating high cholesterol.

The potentially harmful products are: Red Yeast Rice and Red Yeast Rice/Policosonal Complex, sold by Swanson Healthcare Products, Inc. and manufactured by Nature’s Value Inc. and Kabco Inc., respectively; and Cholestrix, sold by Sunburst Biorganics. FDA testing revealed the products contain lovastatin, the active pharmaceutical ingredient in Mevacor, a prescription drug approved for marketing in the United States as a treatment for high cholesterol.

“This risk is even more serious because consumers may not know the side effects associated with lovastatin and the fact that it can adversely interact with other medications,” said Steven Galson, M.D., M.P.H., director of FDA’s Center for Drug Evaluation and Research.

These red yeast rice products are a threat to health because the possibility exists that lovastatin can cause severe muscle problems leading to kidney impairment. This risk is greater in patients who take higher doses of lovastatin or who take lovastatin and other medicines that increase the risk of muscle adverse reactions. These medicines include the antidepressant nefazodone, certain antibiotics, drugs used to treat fungal infections and HIV infections, and other cholesterol-lowering medications.

FDA has issued warning letters advising Swanson and Sunburst Biorganics to stop promoting and selling the products. Companies that do not resolve violations in FDA warning letters risk enforcement actions, such as an injunction against continuing violations and a seizure of illegal products.

The FDA warning letters state that the products Red Yeast Rice, Red Yeast Rice/Policosonal Complex, and Cholestrix, sold on the firm’s websites, are unapproved new drugs that are marketed in violation of the Federal Food, Drug, and Cosmetic Act. The warning letters are available on FDA’s web site.

FDA advises consumers who use any red yeast rice product to consult their health care provider if they experience problems that may be due to the product.

Red yeast rice promotes bone formation

CM NEWS – Red yeast rice, rice fermented with a special purple-red mold, has been known for its abilities to lower cholesterol and blood lipid levels. A recent study opens up the possible use of red yeast rice to stimulate bone formation, which might be good news for patients with osteoporosis.

Rice yeast rice is fermented with a mold called Monascus purpureus (hongqu, 紅曲) and has been used in Chinese medicine for centuries. Scientists have long established that red yeast rice contains a natural form of statin.

What are statins? Statins are a group of drugs that are commonly used to reduce the level of cholesterol in the blood. They include atorvastatin, fluvastatin, pravastatin, rosuvastatin, and simvastatin. They each have different brand names. Statins work by blocking the action of a certain enzyme (chemical) in the liver which is needed to make cholesterol.

Statins, which control the first step in the biosynthesis of cholesterol, have been shown to stimulate bone formation in rodents both in vitro and in vivo. The effect is associated with an increased expression of the bone morphogenetic protein-2 (BMP-2) gene in bone cells.

What are bone morphogenetic proteins? One of the most critical components of building, healing and remodeling bone in humans is a process called osteoinduction. Bone Morphogenetic Proteins (BMPs), found in human blood and bones, are a group of growth factors and cytokines known for their ability to induce the formation of bone and cartilage.

BMPs have been used to stimulate the production of bone in animals and humans with great success.

FDA has approved the use of BMPs for anterior spinal fusion in the lumbar spine, and many other clinical trials have found these proteins to be effective in generating bone in other areas of the spine.

The spine research community is encouraged by BMPs and hopes they may someday be the standard for fusion procedures, reducing postsurgical pain and improve the effectiveness of spinal surgeries.

In the present study done at the University of Hong Kong, rabbits with bone defects created to their parietal bones were grafted with collagen matrix mixed with red yeast rice extract. In the control animal, two defects were grafted with collagen matrix alone.

In the control group, cells were cultured for three durations (24 hours, 48 hours and 72 hours) without any intervention. In the red yeast rice group, cells were cultured for the same durations with various concentrations of red yeast rice extract. Total protein, mitochondrial activity and bone cell formation were measured.

As a result, the test animal showed more formation of new bone in the defects than the control animal. The red yeast rice extract stimulated new bone formation in bone defects on the animals and increased bone cell formation in vitro.

The researchers explained that red yeast rice contains monacolins which are a family of HMG-CoA reductase inhibitors. Moreover, monacolin K is equivalent to the statin known as mevinolin or lovastatin. It is the function of the statin in red yeast rice that promotes bone formation.

Other active ingredients in red yeast rice include sterols (β-sitosterol, campesterol, stigmasterol, sapogenin), isoflavones and monounsaturated fatty acids.

The researchers induced that red yeast rice is a natural product with potential in treating bone defects and probably also osteoporosis.