Harvard Men's Health Watch

On call: Red yeast rice

Q. My last two blood tests showed that my cholesterol is too high. My doctor wants me to take a statin drug, but I'd rather use a natural remedy. I saw an ad for red yeast rice that says that it's as effective as the statins, and I can get it without a prescription — but should I?

A. "All-natural" products have an obvious appeal. Remember, though, that natural products are composed of chemicals — and in the case of red yeast rice, these chemicals may surprise you.

Red yeast rice is formed by a chemical reaction between rice and a particular yeast (Monascus purpureus). The fermentation reaction produces a family of chemicals called monacolins, which can lower cholesterol by inhibiting the liver enzyme HMG-CoA reductase. That makes this natural product sound pretty medicinal — and it should, since the statins lower cholesterol in exactly the same way. In fact, one of the most potent monacolins is mevinolin, which was named lovastatin when it became the first statin drug to be approved in the U.S. in 1987.

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