Dr. Zorba Paster: ‘Natural’ doesn’t mean safe when it comes to supplements

Dear Doc: My cholesterol is high. My doctor wants me to take a statin, but I’m afraid of its side effects. My friends tell me it’s safe, but my research tells me they’re wrong. I’m taking red yeast rice instead. My numbers are down. Hurray! Now I’m taking something safe and natural. What do you think? – J.K. from Racine

Dear J.K.: My default when it comes to supplements used to be “no harm, no foul.” That is until I saw some supplements that have “foul” written all over them. Red yeast rice is one of these.

A recent report in the British Medical Journal talked about a 64-year-old woman who took this stuff – 1,200 milligrams a day. When she took subsequent lab tests at her doctor’s office, she was thrilled with the results. Her cholesterol had dropped just as much as might be expected with a powerful statin.

Fast forward several months later. She went back to her doctor suffering from fatigue and bloating, noticing her urine was darker and her stools were lighter. And if that wasn’t enough, her eyes had started to turn yellow. She had – you might have guessed it – hepatitis. And, of all things, it was caused by red yeast rice.

This “natural” product contains monacolin K, the same active ingredient found in lovastatin, the first statin on the market in the U.S. What happened next? The woman stopped taking this supplement, her liver recovered, and she’s doing just fine.

This is not the first time red yeast rice has created problems; I’ve written about it in the past. Some of the producers of this so-called natural supplement – which you are supposed to assume means “safe” – were actually putting the pharmaceutical drug lovastatin in their bottle.

That continued for umpteen years until the Food and Drug Administration caught them and banned it.

My spin: When you get a pharmaceutical, a manufactured drug, you get quality control. You know what you’re getting with the dose of the medication and possible side effects. Somebody’s watching the store.

When you get a supplement, you don’t know where it was manufactured, and you don’t have the same quality control. What you usually have is a website that promises you the world but delivers something less. Buyer beware.

Update on night-shift workers

Research published in March in the British Medical Journal’s Occupational and Environmental Medicine publication shows that pregnant women who work two or more night shifts a week just might have a greater risk of miscarriage the following week. I want to emphasize the word might because this is an observational study, not a controlled one.

Researchers in Denmark analyzed the miscarriage rate of more than 22,000 pregnant women, looking at miscarriages that occurred after eight weeks of pregnancy. Women who worked more than two night shifts a week had a 32% higher risk of miscarriage. Additionally, the more night shifts they worked, especially if they were consecutive, the greater the risk.

If this is turns out to be a real finding, then it has far-and-wide implications for women because 1 out of 7 women in Europe do shift work, many of them in hospitals.

One theory is that night shifts expose moms-to-be to artificial light, disrupting the circadian rhythm that underlies melatonin production and thereby decreasing the amount of melatonin in the body. Melatonin has been shown to be important in maintaining a successful pregnancy, possibly by preserving the function of the placenta.

My spin: Previous studies have suggested pregnant women face a greater risk of miscarriage if they work night shifts, but they have been based on self-reports. This study deserves to be followed up – because if it holds true, it’s important for every pregnant woman to know. Stay well.