Q Do you believe there is an advantage to using red yeast rice instead of a pharmaceutical statin drug? Are there still side effects to be concerned about?
A Of all the natural supplements available to help lower cholesterol, red yeast rice extracts are by far the most effective. Red yeast rice (Monascus purpureus) has a long history of use in China as a natural food coloring and healthful ingredient. It is a source of naturally occurring statins, and because it delivers a mix of those compounds rather than a single molecule, it is much less likely to cause the side effects that sometimes occur with the pharmaceutical versions.
As you may know, in 2001 the FDA banned the sale of the most popular brand of red yeast rice extract, Cholestin, because one of its components (lovastatin) was already a patented drug when Cholestin came on the market (the product now sold as "Cholestin" in the United States does not contain any red yeast rice. You can still obtain Cholestin that contains red yeast rice extract in some European countries, and other brands of red yeast rice extract are still sold in the United States. Because supplements are unregulated and the demand for quality ingredients is growing, some products will not actually contain any red yeast rice extract and will be ineffective. If you don't get satisfactory results, you can always switch to a better-quality brand or even to a prescribed statin.
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The most common side effects of prescribed statin drugs are headache, digestive upset, liver dysfunction and muscle pain. These last two problems can be serious, but statins are well tolerated by most people, and serious side effects are rare. Red rice yeast supplements can cause the same side effects in sensitive people, but in my experience the incidence is significantly less than with the purified prescription compounds.
I recommend that anyone who takes statins or red yeast rice extract supplements for cholesterol control should also take 90 to 120 mg of coenzyme Q10 every day, since these drugs inhibit the body's natural synthesis of CoQ10, which is needed for formation of ATP, our bodies' energy currency. (That may account for the muscle pain that some people experience.)
No matter what supplement or drug you use for cholesterol control, be sure to get at least 30 minutes a day of aerobic exercise and reduce the amount of saturated fat and trans-fats in your diet. Other beneficial lifestyle changes include drinking green tea, eating one clove of garlic per day (diced or crushed in food) and consuming more soluble fiber (such as oat bran), foods rich in omega-3 fatty acids (good sources include salmon, sardines and walnuts), and plenty of leafy greens and fresh fruits.
Dizzy every day?
Q I'm a 25-year-old male and have been suffering from what my doctor calls vertigo. But it seems as if he is just guessing at the diagnosis. I am a graphic designer, and I get dizzy while working on the computer. At times of high computer work, I feel dizzy 24/7. What could be causing this and what should I do?
A Vertigo and dizziness are two distinct sensations. Many people think vertigo is fear of heights, because they've seen Alfred Hitchcock's famous film "Vertigo." However, this symptom is more than simple dizziness and not necessarily associated with a fear of heights.
Vertigo is the disconcerting sense of movement when you're standing still, the feeling that the world is whirling around you. Or else you feel as if you're actually revolving. Vertigo can be associated with nausea and the inability to maintain balance, and can be debilitating, especially if it occurs frequently. Among its many causes are circulatory disturbances in the brain and damage to the nerves involved in hearing. It also can be triggered by viral infections in the inner ear. Too frequently, doctors are not able to pin down the cause.
Dizziness, on the other hand, generally means feeling lightheaded, faint, weak or unsteady. It can result from sudden drops in blood pressure (typically after sitting up or standing up quickly), an inadequate output of blood from the heart due to blocked arteries, an abnormal heart rhythm or other conditions. Dizziness can also be associated with inner-ear disorders, infections or reactions to drugs. A report published in the February 2007 issue of the Archives of Otolaryngology-Head & Neck Surgery found that almost all study participants (who had dizziness for unknown causes) also had psychiatric or neurological conditions including anxiety disorders, migraine, traumatic brain injury and abnormalities in the body system that controls involuntary actions. For these people, treatment depends on the cause.
Since your dizziness is associated with long hours at the computer, it could be due to repetitive use and strain of neck muscles, poor posture while typing or improper breathing. A related problem is development of "trigger points" — focal areas of tenderness and irritability, particularly in the neck muscle called the sternocleidomastoid. These primarily come from long hours spent typing with shoulders raised, frequent or prolonged telephoning, and bending the head and neck over a keyboard or looking at a monitor screen for long periods of time.
You can discover if you have these by simply pinching the straplike muscles that go from your ear to your collar bone. If you notice tender areas here, you may have trigger points in these muscles, and they may be contributing to your problem. If so, you could consult an osteopath skilled in cranial therapy for treatment. You can also try self-massage, periodic stretching and taking frequent breaks from the computer. I would also recommend doing my "relaxing breath" (visit my Web site, www.drweil.com, for details) periodically during your breaks.
If you do suffer from vertigo, the conventional treatment is a drug called meclizine (Antivert, Bonine), which doesn't always work and can cause drowsiness, among other side effects. Instead, I usually recommend a trial of the herb Ginkgo biloba, which increases blood flow to the brain. Try two capsules three times a day over two months. I would also suggest a session or two of cranial osteopathy and possibly acupuncture.
"Vertigo and dizziness are two distinct sensations."
— Dr. Andrew Weil