There are statin alternatives -- but check with a doctor first
Few things annoy a doctor as much as a patient making a decision to stop a medication without consulting the physician. That's just what happened, repeatedly, to Dr. David Becker, cardiologist at the University of Pennsylvania Health System. "I saw dozens of people in my practice. I'd run the cholesterol panels, and I'd say, 'Good job. You're staying on the Lipitor or Zocor,' " he says. But it turns out their good results weren't because of the cholesterol-lowering statins he had prescribed.
Instead, many of them had followed the advice of infomercials or the grapevine, and decided to begin taking fish oil and red yeast rice supplements instead of statins.
After a literature search found no good studies on the alternative regimen, he began a study and found that an aggressive lifestyle intervention, combined with fish oil and red yeast rice supplements, lowered cholesterol about the same amount as did treatment with the cholesterol-lowering drug simvastatin. Results were published in the July issue of Mayo Clinic Proceedings.
His research group enrolled 74 adults with high cholesterol (an average of about 240 mg/dL total cholesterol), half of whom received a prescription for a standard dose of 40 milligrams of the drug simvastatin and a brochure urging them to eat better and exercise more.
The other half went through a 12-week program, at 3 1/2 hours a week, of intense education on nutrition, exercise and relaxation. The second group was instructed to eat a Mediterranean diet, limiting total fat to less than 25% of total calories. An exercise physiologist instructed the group to gradually increase aerobic exercise to five to six times a week, 30 to 45 minutes each session. And the second group also took three fish oil capsules, 600 milligrams each, twice a day along with two red yeast rice capsules, 600 milligrams each, twice a day.
At the end of the 12-week trial, the group on the alternative regimen had a drop in cholesterol of about 40%, exactly the same as the drop seen by the group that took prescription drugs.
But Becker has some important caveats. "This was just one short, small study," he says. "It's really meant for people who do not have known coronary disease. If you've had a stroke or heart attack or known cardiovascular disease, you should be on a statin."
Another problem is that, because supplements aren't regulated, the over-the-counter pills found in health food stores vary tremendously in the amount of active ingredient. (The website consumerlab.com tests supplements and can help guide your decisions -- but it will cost you: $29.95 for a year's subscription. And note: Products constantly change.) Three red yeast rice supplements, Cholestrix sold by Sunburst Biorganics and two others sold by Swanson Health Products, were banned by the FDA when they were found to have levels of natural lovastatin high enough to cause kidney damage.
susan.brink@latimes.com
