Who knew mushrooms could target muscle? In his talk during the Current Topics in Myositis session, Dr. Andrew Mammen presented the case of a gentleman who had muscle weakness, high CK levels and findings of an inflammatory myopathy after ingesting vitamin supplements. This patient presented well before the discovery of the HMGCR autoantibody. Turns out, one key ingredient in the supplement was oyster mushrooms - which actually contain an ingredient akin to lovastatin!
These mushrooms naturally contain up to 2.8% lovastatin equivalent on a dry weight basis. They are frequently found in Asian cuisine but also Czech and Slovak dishes. Cumulatively used, a mushroom soup recipe, for example, could greatly exceed the standard daily lovastatin prescription dose.
This is not the only natural ingredient that contains statin mimics. Red yeast rice also contains chemicals similar to statins.
These ingredients have been used in natural supplements and herbal medications as cholesterol lowering agents.
So always make sure to ask your patients about natural supplements and vitamins. Not only could these have implications for their health, but potential interactions with other prescription medications!