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A case report of myopathy from consumption of red yeast

Section of Atherosclerosis and Vascular Medicine, Department of Medicine, Baylor College of Medicine and Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart Center, 6550 Fannin Street, M.S. A-601, Houston, TX 77030, USA.
Journal of Clinical Lipidology (Impact Factor: 3.9). 02/2008; 2(1):60-2. DOI: 10.1016/j.jacl.2007.12.005
Source: PubMed
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    • "In addition to cholesterol use, statins are exploited for their antiinflammatory and antimicrobial actions [4] [5] [6]. Lately, many studies have been made on red yeast rice that have the adverse effects of its constituent lovastatin, including an increased risk of myopathy [7] [8] [9] [10] [11] [12]. Two of the statins, mevastatin and lovastatin, which are formed in specific biofermentation processes, are secondary metabolites of fungus and are formed via polyketide biosynthesis (PKBS). "
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    ABSTRACT: Statins were separated and quantified with gas chromatography-mass spectrometry (GC-EI-MS/MS) using total ion monitoring (TIC) and multiple reactions monitoring (MRM). The MRM method in statins determination has a novelty value, since there are no previous studies on their simultaneous analysis in environmental or plant samples. The method development and optimization was challenging due to the physicochemical similarities of the silylated lovastatin, simvastatin, pravastatin, fluvastatin, and atorvastatin. The results showed that the use of MRM decreased their detection and quantification limits by factors of 2-10 compared to that obtained in TIC monitoring. The concentration calibration was made between 247.5ng/L and 9900ng/L. Limits of detection and quantification were between 50ng/L (lovastatin)-500ng/L (pravastatin) and 250ng/L (lovastatin)-1000ng/L (pravastatin), respectively. Based on the MRM results, the wood bark and phloem samples contained lovastatin, lovastatin-lactone, simvastatin, simvastatin-lactone, and pravastatin. Their concentrations were 250-3000μg/L, i.e. 4.2-50mg/kg in phloem and bark. However, they were not detected in fluids made with Pleurotus ostreatus fermentation of wood core.
    Full-text · Article · Feb 2014 · Journal of pharmaceutical and biomedical analysis
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    • "In addition to cholesterol use, statins are exploited for their antiinflammatory and antimicrobial actions [4] [5] [6]. Lately, many studies have been made on red yeast rice that have the adverse effects of its constituent lovastatin, including an increased risk of myopathy [7] [8] [9] [10] [11] [12]. Two of the statins, mevastatin and lovastatin, which are formed in specific biofermentation processes, are secondary metabolites of fungus and are formed via polyketide biosynthesis (PKBS). "

    Full-text · Article · Jan 2014
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    • "At this stage, we conclude that the benefits of red yeast rice do not outweigh its risks. The consumer that uses the current products marketed as food supplement is not adequately informed about the risks, particularly the risk of myopathy when co-administering other medications [28]. The consumer is also not informed that those with a history of statin intolerance may face extreme danger caused by the use of red yeast rice [29]. "
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    ABSTRACT: Red yeast rice (i.e., rice fermented with Monascus spp.) is currently sold via the Internet as a dietary supplement. Claims state that red yeast rice has the ability to lower blood cholesterol concentrations. The mechanism of action is well characterised because the red yeast rice constituent monacolin K is identical with lovastatin, an inhibitor of the hydroxymethylglutaryl-CoA (HMG-CoA) reductase that is used in many cholesterol-lowering medicinal products. The aim of this article is to evaluate the properties of red yeast rice products that are marketed via the Internet. Three out of five analyzed products may reach the daily dosage of 10 mg lovastatin, which is necessary for the substantiation of health claims on the maintenance of normal blood LDL-cholesterol levels as suggested by the Scientific Opinion of the European Food Safety Authority. 10 mg is also the starting dosage of medicinal lovastatin products on the German market. From a regulatory standpoint, red yeast rice products would rather have to be sold as medicinal products than as food supplements as they clearly exhibit a pharmacological action that is comparable to approved statin-containing medicinal products. This also implies potential adverse effects and interactions, about which the consumer is insufficiently informed in the case of food supplements. The lack of control over the Internet market is evidenced by the fact that four of the tested products were not marketable in conventional trade in Germany due to violations of labelling rules.
    Full-text · Article · Jul 2012 · Deutsche Lebensmittel-Rundschau: Zeitschrift für Lebensmittelkunde und Lebensmittelrecht
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