Many doctors routinely prescribe statins to lower cholesterol. Yet up to 10 percent of patients taking the drugs complain of muscle aches, memory problems, and other side effects. But the doctors also are open to supplements if their value and safety can be demonstrated.

Now a new study suggests that an over-the-counter dietary supplement sold at pharmacies and health-food stores may be a workable alternative for people who have statin-related muscle pain. In one study, researchers recruited people who had high cholesterol but had discontinued statin-type drugs because of muscle pain or weakness. The study from Pennsylvania showed that in 60 patients who had to stop taking statin drugs because of muscle pain, taking Red yeast rice (RYR) and initiating lifestyle changes for 24 weeks significantly reduced total and LDL cholesterol levels, compared to taking a placebo and making the same lifestyle changes. Studies have shown that compared to 20 mg doses of statin drugs, which may decrease LDL levels from 18 to 55 percent, red yeast rice can drop LDL by 34 percent or more. People taking red yeast rice lowered both bad LDL and total cholesterol significantly and did not suffer serious side effects. The most common dose of red yeast rice is 2.4 grams a day taken in two doses at breakfast and dinner to lower cholesterol.

Red yeast rice (RYR), a product made from cultivating rice with the mold Monascus purpureus, has been used in China for centuries to treat circulatory and digestive disorders - and apparently without a bit of controversy. Other names for this substance are Hong Qu, Monascus, Xue Zhi Kang and Zhi Tai. The Food and Drug Administration (FDA) does not regulate dietary supplements, and the contents and potency of red yeast rice pills have been shown to vary widely among manufacturers. Among the compounds in the supplement is a natural form of lovastatin, which does not appear to have any of the possible toxic liver side effects of prescription strength statins. In 2007, the U.S. Food and Drug Administration issued a statement to consumers, warning them of risks and telling them to stay away from three different brands of red yeast rice supplements because they contained higher levels of lovastatin. There are also isoflavones and monounsaturated fatty acids in the supplement.

There are natural statins in red yeast rice, so it is not surprising that some readers have reported muscle problems while taking this supplement. Since it does contain a form of statin, the cautions applying to prescription varieties apply, that is, patients should watch out for muscle problems and possible changes in liver function. In some patients, the supplements may cause a recurrence of muscle pain, or other serious muscle problems that are more difficult to detect. Red yeast rice can cause digestive upset and dizziness. Women who are pregnant or planning to become pregnant and children under 18 years should not take this supplement. Anyone who takes RYR should be under medical supervision.