Editing Openai/69101fc6-f990-800a-9638-7716259af6c4 (section)

=== focused risk notes for your stack (what we can know & how to reduce risk) ===
* red yeast rice (RYR): works because it contains monacolin K (lovastatin). That means statin-like risks (myopathy, liver injury) and major variability in strength across brands; contamination with citrinin (a nephrotoxin) has been common. EFSA (2018 and 2025 updates) could not define a safe daily monacolin level and the EU now limits monacolin K exposure and tightened citrinin limits (100 µg/kg). U.S. FDA treats high-monacolin RYR as an unapproved drug. If you choose RYR anyway, treat it like a statin: baseline and 8–12 wk ALT/AST and CK, avoid if pregnant, and only buy third-party tested (NSF/USP) products with a citrinin COA. EFSA Journal<ref>{{cite web|title=EFSA Journal|url=https://efsa.onlinelibrary.wiley.com/doi/10.2903/j.efsa.2018.5368|publisher=EFSA Journal|access-date=2025-11-09}}</ref>European Food Safety Authority<ref>{{cite web|title=European Food Safety Authority|url=https://www.efsa.europa.eu/en/efsajournal/pub/9276|publisher=European Food Safety Authority|access-date=2025-11-09}}</ref>EUR-Lex<ref>{{cite web|title=EUR-Lex|url=https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX%3A32019R1901|publisher=eur-lex.europa.eu|access-date=2025-11-09}}</ref>PubMed<ref>{{cite web|title=PubMed|url=https://pubmed.ncbi.nlm.nih.gov/28641460/|publisher=pubmed.ncbi.nlm.nih.gov|access-date=2025-11-09}}</ref>
* vitamin K (in “essential antioxidants”): generally safe but interacts strongly with warfarin—consistency of intake matters. If you’re anticoagulated, this requires clinician guidance and INR monitoring. Office of Dietary Supplements<ref>{{cite web|title=Office of Dietary Supplements|url=https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/|publisher=Office of Dietary Supplements|access-date=2025-11-09}}</ref>Mayo Clinic<ref>{{cite web|title=Mayo Clinic|url=https://www.mayoclinic.org/diseases-conditions/thrombophlebitis/expert-answers/warfarin/faq-20058443|publisher=Mayo Clinic|access-date=2025-11-09}}</ref>
* curcumin/turmeric & ginger (in “NAC + ginger + curcumin”): potential bleeding-risk interactions with anticoagulants/antiplatelets; plus a documented, real-world issue: lead-chromate adulteration of turmeric in parts of the supply chain has caused elevated blood lead in humans. Use reputable brands with heavy-metal COAs. PMC<ref>{{cite web|title=PMC|url=https://pmc.ncbi.nlm.nih.gov/articles/PMC9586694/|publisher=pmc.ncbi.nlm.nih.gov|access-date=2025-11-09}}</ref>Stanford News<ref>{{cite web|title=Stanford News|url=https://news.stanford.edu/stories/2019/09/lead-found-turmeric|publisher=Stanford News|access-date=2025-11-09}}</ref>PubMed<ref>{{cite web|title=PubMed|url=https://pubmed.ncbi.nlm.nih.gov/37286126/|publisher=pubmed.ncbi.nlm.nih.gov|access-date=2025-11-09}}</ref>
* NAC: generally well-tolerated orally; potentiates nitroglycerin (can cause headache/hypotension)—important if you use nitrates. PubMed<ref>{{cite web|title=PubMed|url=https://pubmed.ncbi.nlm.nih.gov/3127076/|publisher=pubmed.ncbi.nlm.nih.gov|access-date=2025-11-09}}</ref>AHJournals<ref>{{cite web|title=AHJournals|url=https://www.ahajournals.org/doi/10.1161/01.cir.92.10.2855|publisher=ahajournals.org|access-date=2025-11-09}}</ref>ScienceDirect<ref>{{cite web|title=ScienceDirect|url=https://www.sciencedirect.com/science/article/pii/S0735109797000053|publisher=sciencedirect.com|access-date=2025-11-09}}</ref>
* creatine (in “longevity mix” or training stacks): consistent evidence it’s kidney-safe at typical doses in healthy people; can falsely raise serum creatinine without hurting GFR. If monitoring, include eGFR-cystatin C or measured GFR if concerned. PMC<ref>{{cite web|title=PMC|url=https://pmc.ncbi.nlm.nih.gov/articles/PMC10054094/|publisher=pmc.ncbi.nlm.nih.gov|access-date=2025-11-09}}</ref>BioMed Central<ref>{{cite web|title=BioMed Central|url=https://jissn.biomedcentral.com/articles/10.1186/s12970-021-00412-w|publisher=BioMed Central|access-date=2025-11-09}}</ref>
* probiotics/garlic: rare but real bleeding interactions (garlic) and very rare infections in the severely immunocompromised (probiotics). Disclose to your clinician before surgery/anticoagulation. NCCIH<ref>{{cite web|title=NCCIH|url=https://www.nccih.nih.gov/health/garlic|publisher=nccih.nih.gov|access-date=2025-11-09}}</ref>