Red Yeast for Cholesterol: It Works, BUT…

John’s cholesterol is high but he doesn’t like taking prescription drugs. Should he take red yeast as a “natural” alternative? Evidence shows that it is effective in lowering cholesterol.

In 1994, the Diet Supplement Health and Education Act was passed, allowing the fiction that “natural” medicines are really “foods” and need not be regulated the way prescription medicines are. Do we need to supplement our diet with red yeast? Do we suffer from a red yeast deficiency? Of course not. People are really taking it as a medicine, not as a supplement to their diet.

If you take a prescription drug, the FDA ensures that it contains the amount the label says, that it doesn’t contain any contaminants, and that it has been tested and found safe and effective. You also get a list of known side effects and drug interactions. If you take a diet supplement you don’t get any of those safeguards.

Red yeast contains lovastatin, the same thing that’s in prescription Mevacor. If it’s not fermented properly, it contains citrinin, a mycotoxin that causes liver damage. It also contains some other stuff; we’re not sure what all the other stuff does.

An independent testing agency, ConsumerLab, recently tested 10 red yeast products. The amount of active ingredient varied by more than 100-fold, and some of the products contained practically none. More worrisome, 4 of the 10 products contained kidney-damaging citrinin. [Product review: Red yeast rice supplements.ConsumerLab.Com, July 18, 2008]

The FDA has ordered several manufacturers to stop marketing red yeast for cholesterol control, but it can still be sold without specific cholesterol-lowering claims. The FDA has issued a warning to consumers. http://www.fda.gov/bbs/topics/NEWS/2007/NEW01678.html

You might think you could use information from ConsumerLab to choose a good brand, but there’s no guarantee that future batches of that brand will be consistent. Prescription drugs carry some risks of their own; why compound the risks by taking something less studied and less regulated? Buyer beware!

This article was originally published in Swift, the online newsletter of the James Randi Educational Foundation.

Dr. Hall is a contributing editor to both Skeptic magazine and the Skeptical Inquirer. She is a weekly contributor to the Science-Based Medicine blog and is one of its editors. She has also contributed to Quackwatch and to a number of other respected journals and publications. She is the author of Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon and co-author of the textbook, Consumer Health: A Guide to Intelligent Decisions.