Dear Doc: I don’t like taking pills. When my doctor said I needed to take a drug to lower my cholesterol, I balked. Instead, I went and got red yeast — and it worked. The next time I went in, my cholesterol was lower. Why don’t more doctors recommend this supplement? — Dan from Eau Claire

Dear Dan: You’re right about red yeast. It does work because it contains monacolin K, a chemical that’s exactly the same as the drug in Lovastatin, the first statin drug on the market developed by Merck 30 years ago.

But let me caution you about several issues here, which is why I don’t recommend taking it.

First off, I went to consumerlab.com. They are my go-to place for up-to-date, great information for any supplement. They are similar to Consumer Reports — independent testing, paid for by subscriptions, no advertising. It’s information I can trust.

They and others found that a 600 milligram capsule of red yeast may have varying amounts of the active ingredient. In other words, you don’t get the same amount of the “active” element even though you may be taking the same milligram dose of red yeast. Different brands varied immensely, with some brands having 6.4 milligrams of active ingredient while others had only 0.4. Same label but a big difference. There is no truth in labeling when it comes to supplements. The federal Food and Drug Administration and congress has been asleep at the wheel when it comes to regulating these.

But now get this. Some of consumerlab.com’s top picks from a few years ago don’t hold muster today. In one case, the product had 80 percent less ingredient today than it did in 2014. Again I blame lack of government oversight for this consumer fraud.

Now, let’s move on to price. Let’s say you wanted to get the equivalent of 10 milligrams of Lovastatin a day. You would pay $28.95 a month for Natures Plus Herbal Active Natures Yeast – which turns out to have 1.6 mg of Lovastatin equivalent. Now if you go to Walmart you only pay $4 a month for 10 mg of Lovastatin. Sounds a bit pricey to me for a pretty label with miniscule benefit. To me it’s a dumb choice. Looks good, smells fishy.

The natural supplement industry does not regulate its pills. These are industrialized products, and just because a bottle has the veneer of being “natural” doesn’t mean it’s actually natural. It’s manufactured. In many cases, there is no quality control.

If you want to bring down your cholesterol naturally, see if you can do it with the Mediterranean diet. If not, take the generic statin medication — at least then you’ll know what you’re getting.

Hi, Dr. Z: I recently read your column on getting rid of ticks with the highly effective and naturally occurring substance permethrin. What you failed to mention is it’s toxic to cats. Please let your readers know. — L.M.

Dear L.M.: Good point. I did some research on this and found that NPR had a similar story about this tick research and was flooded with cat lovers telling their sad stories. It doesn’t mean you can’t use permethrin, but it does mean be careful. Don’t spray it around your feline friend.

And now on to itchy skin.

A column I wrote some time ago about relieving itchy skin has generated other reader suggestions I’d like to pass on. If you find yourself with itchy skin, give these a try.

Laundry detergent: Change brands and make it perfume-free with no dyes.

Fabric softener: Same advice; some even say stop using it.

Shower soap: Talk to your pharmacist or cosmetician about a dye- and fragrance-free soap to use. For this, I have often told my patients to consider Cetaphil or Alpha Keri brands.

Medications: If you’re on a medication, talk to your pharmacist. Some drugs will cause dry skin. Yours just might be on one of them so it’s worth investigating. Stay well.

This column provides general health information. Always consult your personal health care provider about concerns. No ongoing relationship of any sort is implied or offered by Dr. Paster to people submitting questions. Any opinions expressed by Dr. Paster in his columns are personal and are not meant to represent or reflect the views of SSM Health.

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