Red yeast rice has been used in Chinese cuisine and traditional medicine for centuries. But what’s garnered the most interest in recent decades is its cholesterol-lowering ability.1 If you have a high cholesterol problem or hyperlipidemia, this is a natural alternative to statins, with the potential to improve your lipid profile. But should you use it?
Red yeast rice is produced by fermenting the Monascus purpureus yeast on rice and is known variously as hong qu (in China), ang khak (in China and Japan), beni koji, red koji or simply koji (in Japan), or red mold or red yeast rice (in the United States).
Red Yeast Rice Lowers Total And LDL Cholesterol Levels
Studies show that serum cholesterol levels in people with hyperlipidemia decreased when they took red yeast rice. Over a 2-month period, participants who took it daily saw a drop in total serum cholesterol by 22.7 percent and low-density lipoprotein (LDL) cholesterol by 30.9 percent.2
In another study, researchers gave 2.4 g of red yeast rice as a daily supplement to otherwise healthy test subjects with hyperlipidemia. None were on any kind of lipid-lowering drug treatment. They experienced a significant decrease in LDL cholesterol as well as total cholesterol levels at the end of the 8-week treatment period. The good high-density lipoprotein (HDL) cholesterol levels did not change significantly.3
Monacolin K In It Resembles Cholesterol-Lowering Lovastatin
Red yeast rice contains a bioactive substance known as monacolins. Of these, one in particular called monacolin K has been found to be chemically identical to the statin drug lovastatin. And like lovastatin, this monacolin can also help reduce cholesterol levels in the body. The European Food Safety Authority has even gone on record about the ability of red yeast rice preparations containing 10 mg or more of Monacolin K to help normalize blood cholesterol levels.4
Red Yeast Rice Also Contains Other Nutrients That Lower Cholesterol
Besides monacolins, red yeast rice also contains isoflavones, phytosterols, and unsaturated fatty acids. All of these could also have a part in the cholesterol-lowering effect of the food. Researchers studying red yeast rice found that it had less monacolin than is typical in statin drugs but it was able to produce a comparable effect. For instance, red yeast rice contains an average of 0.2 percent of monacolin K per 5 mg. Prescription statin drugs like lovastatin come in doses of 20 to 40 mg.5 This led them to believe that these other compounds may also have a beneficial effect on cholesterol levels.6
In addition, red yeast rice also has plant sterols called beta-sitosterol and campesterol that modulate your body’s absorption of cholesterol in the intestine. It also contains fiber, magnesium, and B complex vitamins like niacin that help decrease serum lipid levels.7
Red Yeast Rice May Be Better For Those Who Cannot Tolerate Statins
Statin drugs may sometimes result in side effects like weakness or muscle pain. This can be debilitating for some people, making it almost impossible for them to continue taking the statins on an ongoing basis. Studies by the National Center for Complementary and Integrative Health have found that for this category of people, taking red yeast rice did not pose similar problems. In other words, this may offer hope to those who can’t tolerate regular statin drugs.8
One study also found that those who could not tolerate other lipid-lowering drugs like statins on a daily basis saw total cholesterol level go down by 13 percent and LDL cholesterol dip by 19 percent after taking red yeast rice for 4 or more weeks.9
But The FDA Has Banned The Sale Of Monacolin K-Rich Red Yeast Rice
While red yeast rice may have some compelling health benefits going for it, there’s a caveat. The US Food and Drug Administration deems monacolin K a pharmaceutical drug. It has warned against the use of all red rice yeast products and bans the sale of any that contain “non-negligible” levels of monacolin K.
So, Red Yeast Rice Products In The USA May Not Help Your Cholesterol
Because of this, the red yeast rice products sold in the United States may not actually have any of monacolin A in them. Those being sold with more than trace amounts are treated as unapproved drugs with all the attendant risks and are illegal.10
This also means that the formulation of red yeast rice used in many clinical studies, which back up claims of red yeast rice’s cholesterol-lowering ability, is no longer being sold in the United States. In other words, the benefits of monacolin K-containing red yeast rice seem well established, but whether or not the product you’re buying has any bioactive substances that can deliver on this promise is a gamble.
Follow Safety Tips If You Choose To Use Red Yeast Rice
If you decide to use red yeast rice, whether with monacolin K or simply containing other cholesterol-lowering nutrients, for the purposes of lowering LDL cholesterol, there are some things to be cautious of. Some people also should avoid taking it.11
- Do not treat red yeast rice as a substitute for proper treatment and medication. Consult a doctor and treat this as an add-on – one that you should run by your doctor.
- Be wary of buying red yeast rice supplements from unknown online sources – there’s a risk of contaminated products.
- Reported side effects from using red yeast rice include dizziness, stomach ache, flatulence, heartburn, muscle weakness. Watch out for these and stop use if they do occur.12
Avoid Red Yeast Rice If You Are Pregnant Or Have Kidney Disease
- If you are pregnant or nursing, avoid taking red yeast rice as not enough is known about its effects on pregnancy or during lactation.
- If you are already on prescription statin drugs, avoid taking red yeast rice.
- If you have liver or kidney disease, it’s best to stay off red yeast rice. It has been seen to cause liver toxicity, muscle weakness and pain (myopathy), and rhabdomyolysis (break down of muscle fiber into kidney-damaging compounds).
|↑1||Red Yeast Rice. Michigan Medicine, University of Michigan.|
|↑2||Wang, Junxian, Zongliang Lu, Jiamin Chi, Wenhua Wang, Meizhe Su, Wenrong Kou, Pulin Yu et al. “Multicenter clinical trial of the serum lipid-lowering effects of a Monascus purpureus (red yeast) rice preparation from traditional Chinese medicine.” Current Therapeutic Research 58, no. 12 (1997): 964-978.|
|↑3, ↑5||Heber, David, Ian Yip, Judith M. Ashley, David A. Elashoff, Robert M. Elashoff, and Vay Liang W. Go. “Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement.” The American journal of clinical nutrition 69, no. 2 (1999): 231-236.|
|↑4||Nguyen, Thu, Mitchell Karl, and Antonello Santini. “Red Yeast Rice.” Foods 6, no. 3 (2017): 19.|
|↑6||Red yeast rice. University of Maryland Medical Center.|
|↑7||Erdoğrul, Özlem, and Sebile Azirak. “Review of the studies on the red yeast rice (Monascus purpureus).” Turkish Electronic journal of biotechnology 2, no. 5 (2004): 37-49.|
|↑8||Red Yeast Rice. National Center for Complementary and Integrative Health.|
|↑9||Venero, Carmelo V., Jose V. Venero, Dale C. Wortham, and Paul D. Thompson. “Lipid-lowering efficacy of red yeast rice in a population intolerant to statins.” The American journal of cardiology 105, no. 5 (2010): 664-666.|
|↑10, ↑11||Red Yeast Rice. National Center for Complementary and Integrative Health.|
|↑12||Red yeast rice. Memorial Sloan Kettering Cancer Center.|