Statins are a class of medications that lowers cholesterol levels by acting as hydroxymethyglutaryl-CoA (HMG-CoA) reductase enzyme inhibitors.1,2 According to the 2018 cholesterol guidelines3 by the American College of Cardiology (ACC) and American Heart Association (AHA), varying intensities of statin therapy are recommended for patients with atherosclerotic cardiovascular disease (ASCVD), high-risk of developing ASCVD, hypercholesterolemia, or other conditions as adjunct therapies to heart-healthy lifestyle and diet.
Statins are molecules that first originated from fungus.1,4 A Japanese scientist named Endo worked on a series of compounds from fungal metabolites that inhibited HMG-CoA.1 In the course of his work, lovastatin was discovered as a secondary fungal metabolite. Many fungi have since been shown to produce lovastatin.5 For many years, fungi were the sole source for the statins. Statins such as lovastatin and pravastatin are produced by fermentation of fungi. Simvastatin is produced by alkylation of lovastatin.5 Atorvastatin, fluvastatin, pitavastatin, and rosuvastatin are completely chemically synthesized, inspired by the naturally occurring statin molecules.
A fungus called Monascus purpureus makes a substance called monacolin K, which is the active ingredient in the statin lovastatin. Some, but not all, commercially available red yeast rice contains this statin molecule.6 Labeling of dietary supplements, like red yeast rice, does not specify the amount of monacolin K contained in the rice product. For this reason, levels of this statin-like molecule in red yeast rice cannot be determined and may not be safe.
References
- Sirtori CR. The pharmacology of statins. Pharmacol Res. 2014;88:3-11.
- Lennernas H, Fager G. Pharmacodynamics and pharmacokinetics of the HMG-CoA reductase inhibitors. Similarities and differences. Clin Pharmacokinet. 1997;32(5):403-425.
- Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018.
- Schachter M. Chemical, pharmacokinetic and pharmacodynamic properties of statins: an update. Fundam Clin Pharmacol. 2005;19(1):117-125.
- Subhan M, Faryal R, Macreadie I. Exploitation of Aspergillus terreus for the Production of Natural Statins. J Fungi 2016; 2 (2).
- National Center for Complementary and Integrative Health. Red Yeast Rice. https://nccih.nih.gov/health/redyeastrice. Accessed November 10, 2019.
