Any info on Red Yeast Rice (RYR) masking PSA?

[Justfor_]

Strange query indeed.

I had my monthly PSA test on Tuesday. For the whole week before that I was not taking my usual 20 mg of Atorvastatin + 10 mg Ezetimibe. In the meantime, I had ordered a bottle of Jarrow Formulas Red Yeast Rice +co-Q10. PSA came back as anticipated at 0.12, but the cholesterols had gone crazy. From my usual (under medication) ~150 tC it went to 218. This came as anything but a surprise to me as I have familial hypercholysterolemia and without medication my long term tC floats around 350. Most probably the latter is the reason for my PCa.

So, I did the following experiment: Took the Atorvastatin-Ezetimibe usual pill and over this a RYR capsule and next morning had another PSA test at the 2nd lab I usually use. The result was beyond reason: 0.05 vs 0.12 a day before.

PSA is reported to have a halving time from 2.5 to 3.5 days. Hence it is impossible such a decay to be attributed to the statin/RYR combo taken the night before. Only two possible explanations remain on the table: a) Lab gross error, as in the past variances between the two had been observed, but definitely not THIS high. b) RYR is masking the PSA test.

To solve the problem I am gearing up for a 3rd PSA test. I am considering two scenarios: a) Repeat taking statin&RYR tonight and test tomorrow at a 3rd lab that in the past has been found in close agreement with the 2nd. This will show whether 2nd lab was in error. b) Stop taking, for say a week, RYR and test again either with the 2nd or the 3rd lab. This will show whether RYR is masking the test.

What would you choose in my case? TIA

[Tall_Allen]

Statins may mask PSA.

bjui-journals.onlinelibrary...

karger.com/Article/Abstract...

I have no idea how long the effect will occur for after stopping it.

[Justfor_ in reply to Tall_Allen]

Thanks for the links but my numbers overrule them. If the pills could magically null any new PSA excretion, the one still circulating with the blood plus max 30% of inter-lab offset could not produce such a high difference. No way! Something ubnormal happened, that I will find out.

[kapakahi in reply to Tall_Allen]

Those studies are 8 and 10 years old, respectively. It seems to me that their results are counter-intuitive: Statins reduce cholesterol, and since the body uses cholesterol to make testosterone, I'd think that statins would reduce testosterone, which would have a beneficial effect on PCa, which in turn would reduce PSA. It's odd that statins would be shown to help prevent PCa but then to worsen outcomes of having PCa. Am I correct in making these links, and is there any new research on this?

[Tall_Allen in reply to kapakahi]

Unless you have more recent studies that show anything different, that is what we have to go by. Your intuitions should not dictate clinical practice - only empirical observation is useful. Statins have not been shown to prevent PCa. You are not correct in using correlations from some observational studies to infer causative relations.

[kapakahi in reply to Tall_Allen]

I should have said statin use is associated with lower risk of prostate cancer and of fatal PCa in some men. I was certainly not trying to dictate clinical practice based my intuitions - that would be risible. I didn't mean to infer a link between statins and PCa - I don't know enough to make such inferences, which is why I asked if my thoughts were correct. I was merely asking questions. Thanks for the response.

[Tall_Allen in reply to kapakahi]

It is also associated with higher risk of recurrence:

bjui-journals.onlinelibrary...

pubmed.ncbi.nlm.nih.gov/235...

pubmed.ncbi.nlm.nih.gov/303...

But I could have also pulled out observational studies showing an inverse association, or no association at all.

The best data we have so far (because it simulates a randomized clinical trial) points to its having no effect on incidence of prostate cancer:

nejm.org/doi/full/10.1056/N...

I was pointing to the problem of drawing conclusions from a limited set of observational data. Such data are only useful for raising hypotheses.

[Hidden in reply to kapakahi]

Maybe if cholesterol was reduced to zero but you would die from having zero cholesterol. Statins reduce cholesterol to healthier levels for those who have high cholesterol. Impact on testosterone is negligible if at all.

[Hidden]

HPF Cholestene is the brand I use. According to consumerlabs it has 5mg monacolin K (same active as Lovastatin).I'm also curious. My PSA fluctuates from <0.01 to 0.06. TC went from 200+ for my entire life (or at least when I first measured it at 17) to 135.

[Justfor_ in reply to Hidden]

Until now, my PSA had been working like having a clockwork under the hood. Highest log regression coefficient shy of .98. Reversing the PSA/time curve I could determine the test's date out of the PSA value, with say 1-2 weeks of error. This is the first and only decline along a time series comprising 20+ samples. Tomorrow a new test (3 tests within 4 days) will possibly shed some more light.

[Justfor_]

Third PSA test today came as a complete surprise: 0.15!!!

To sum it up, within 4 days 300% of variance.

On Tuesday lab#1 gave 0.12

On Wednesday lab#2 gave 0.05

On Friday lab#3 gave 0.15

I called lab#2 to let them know that their analyzer is broken.

The person signing the report searched the archives and told me that they run the test twice as they noticed that I had two previous tests, 1 and 2 months before, resulting into 0.113 and 0.104 accordingly. Both runs yielded the same result.

I am keeping the 0.12 as it is compliant with my prior history ( Log curve regression coefficient 0.983).

May this incident serve my fellow PCa survivors to realize the silliness of taking important treatment decisions based on isolated PSA tests.

The primary end point is that Red Yeast Rice did NOT interfere with the PSA test.

[Hidden in reply to Justfor_]

If doing this makes you happy, then that is awesome and part of me thinks this is a total waste of time and energy. Analyzing psa to the hundredths is not needed when decisions are made at the tenths for men who had RP. Everyone else it's mostly greater than 2.

[Daveofnj]

Switching labs introduces another unknown in the equation.

[Justfor_]

Switching yes, interleaving NO!

[miscdenver]

Hi to All:

I've been on Atorvastatin for 5+ years for borderline cholesterol readings.

None of my Primary/GP did a PSA check for 15 years and I had no idea of need to monitor PSA/Prostate (had heard of other's troubles related to it) until some symptoms showed up around new years, 2 months ago. Then my PSA was found at 25, subsequently Dx'd at T2c with 80% malignancy on left half and 1% on right. Opted for HT+HDRB+ 20 sessions of EBRT. Have had the Lupron shot, next stage will be EBRT in 2 months.

Something that I had not noticed before, that a test back in 2005 had a PSA reading of 2.85 which was not followed up by any of the Primarys I subsequently had. From there till now, it went up a straight shot to 25, so does not appear that the Statin I began in the interim did anything to the PSA increase.

Just my experience.

[User2008]

Hi Justfor_. I'm sorry to be so dense, but is the conclusion here that someone with PCa should take Red Yeast Rice or should STOP taking Red Yeast Rice? I've read all the comments and I can't tell... Is Red Yeast Rice considered a statin? Thanks so much.

[Justfor_ in reply to User2008]

The question was NOT whether to take it or not. Consequently, there is no answer to this. The question was, provided that you take it, is it possible that you get the wrong PSA value because of it? The answer to this is that in my case the wrong value was due to lab's error. RYR may contain a small quantity of a statin known as Lovastatin. May here signifies that the quantity varies from product to product. RSH1 takes a product that is believed to contain the highest quantity amid all similar supplements 5mg. Others have been found to contain only traces. As these supplements may come in direct competition with pharmaceutical products, supplement makers keep it intentionally low in order to avoid getting into trouble with your FDA. Hope this answer your questions.

[User2008 in reply to Justfor_]

It does. Thanks for the clarification.

[Avanat]

Just to add my two cents....when my husband sent a list of all the supplements he took, his oncologist said he could NOT continue Red Yeast Rice. I don’t remember if he said why but my husband stopped taking it.