Posted by: notdeaddinosaur | July 24, 2013

More Supplement Fraud

The Philadelphia Inquirer has a new section in the Sunday paper devoted to Health. Actually, it’s devoted to Medicine, but that term, while accurate, is so 20th century. Regardless, I enjoy perusing the new section, mainly to double-check the information presented. Most of the time, I’ve been impressed with its general accuracy. Too bad they blew it last week.

Guess what! Red yeast rice, a supplement marketed for reduction of cholesterol, actually works! Huzzah! Inquirer staff writer Curtis Skinner breathlessly touts new research confirming the findings reported here. Wow. Actually, what they were studying was whether or not adding phytosterols to red yeast rice helped lower lipids any more than red yeast rice itself. It didn’t. Hm; I wonder if that conclusion will put a dent in the $500 million-a-year business enjoyed by phystosterols. (Protip: Don’t bet on it.)

Here’s the thing, though: the active ingredient in red yeast rice — the stuff that does the actual lowering of the LDL cholesterol — is a substance called lovastatin. It’s the SAME DRUG originally marketed by Merck as Mevacor, and is now available generically. That’s right: the reason that this particular “supplement” works is that it contains an actual, effective, medically researched and proven DRUG.

At least red yeast rice is cheaper than lovastatin. OH WAIT! Red yeast rice retails for about $20 a bottle with maybe 30-60 tablets. Generic lovastatin is $4 at Walmart, Target, Kmart, and anywhere else that matches prices. Larger quantities? $10 for 90. Still better than any price I saw for red yeast rice.

It must be that supplements are more heavily regulated, their production is more standardized, and the tablet-to-tablet variability is less than commercially produced pharmaceuticals. OH WAIT! It’s exactly the other way around.

Maybe the red yeast rice is purer than the pharma product. Really? The standard dose of the supplement appears to be 600 mg. The pharmacologic dose for lovastatin is 20-40 mg. That means you’re getting fifteen to twenty times as much inactive red yeast rice byproduct in each capsule as you would in one lovastatin tablet (manufactured in a facility subject to regulatory inspection and oversight, instead of FSM knows where.)

It’s bad enough that ripping off consumers by advertising actual Nothing is still legal, but supplements are the ultimate in Buyer Beware. The most common explanation when supplements really do something — other than having blatant placebo effects on subjective complaints like “energy”, pain, nausea, etc. — is that they’re adulterated with active pharmaceuticals. “Natural Male Enhancement” works great if it’s spiked with viagra. Real drugs are smoke and mirrors for supplements, making Nothing look like Something.

Perhaps the whole idea of going through a doctor to diagnose and advise whether or not your cholesterol really needs to be lowered is what turns people off of the drug. Fine. Maybe lovastatin should be sold without a prescription. Hell, I’ll bet more people are harmed every year by aspirin than by statins. Go ahead and push that through the FDA. But quit touting the marvelous benefits of alleged non-pharmaceutical substances as pharmacologically efficacious when you’re really doing is pulling a whopper of a bait-and-switch.

For the record, I spoke with Mr. Skinner, the Inquirer staff writer, on the phone. He was unaware that red yeast rice contained a known pharmacologically active ingredient (or at least not one commercially available much more cheaply.) I can’t help but wonder whether the authors he quoted were similarly uninformed, and whether they being innocently or intentionally misleading.



  1. I don’t know why it surprises me anymore that many of my patients are willing to try so many unproven/dangerous “natural” supplements produced in someone’s bathroom, but run away from proven, thoroughly-examined medications.

    It must be big pharma. Damn big pharma and their medications. They’re just in it for the money, so of course they want you hooked on their drugs. That means their drugs are made of pixie dust and poison, right?

  2. People will buy all manner of bogus crap and spend loads of money on it even when there’s proven, less expensive alternatives that are regulated and inspected for safety by the government. I explain the red yeast thing on the order of once every couple of weeks. Nobody believes they are taking lovastatin, just unregulated, variably potent and quite possibly contaminated lovastatin. Instead of the FDA regulated standardize product for $4 at the pharmacy. Somebody pass me the pixie dust, please!

  3. So well said and thanks for saying it, Doc. Allupurinol is way cheaper than cherry pills for uric acid, too, I’ve found, though that’s a different case since the same thingie that makes the A work is not found in cherries as lovastatin is in red yeast rice. I’m just a consumer but I’ve found it hard to combat the pixie dust as well.

  4. Thank you for calling the reporter about that. Even if he had just been investigating the red rice yeast angle, he should have found the earlier research trying to test RRY efficacy that discovered it was nearly impossible to find an honest supplier of the stuff, so they couldn’t run the trial.

  5. You know how maddeningly inaccurate newspaper Health section articles are? It’s not just Health articles. You can safely assume that all their articles are at the same shoddy standards. Personally, the only thing I will miss when all newspapers finally die are the Sunday funnies and coupon inserts.

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