Red Yeast Rice: Heart Helper – or Complete Waste of Money?
Have you been told you have high cholesterol?
Welcome to the club.
With one in six American adults diagnosed with high total cholesterol, you’re not alone.1
If you’re like many of these people, your doctor probably briefly mentioned some dietary changes, handed you a prescription for statin drugs, and sent you on your way.
And if you’ve heard about all the potential side effects of statins – from muscle aches, to depletion of coenzyme Q10, to liver toxicity – it’s no wonder you’re on the search for a natural alternative.
During this search, you likely came across one intriguing food that has been shown to lower high total and LDL cholesterol about as well as prescription statin drugs. In fact, it is so effective that it was banned by the U.S. Food and Drug Administration (FDA).
But just because it is natural, does that mean it is the right alternative?
Meet Red Yeast Rice…
Red yeast rice has been used in traditional Chinese medicine for millennia. It is produced when rice is fermented with various strains of red yeast, a mold called Monascus purpureus. Red yeast rice lends a bright red color to many Asian foods, but is also sold in capsules as a dietary supplement.
It is this capsule form that is mostly commonly used to lower LDL and total cholesterol levels. But there’s more to this story than just lowering total cholesterol.
The truth is, many experts now believe that total cholesterol means little when it comes to health. Instead, it’s more important to look at the whole picture: your levels of LDL cholesterol, HDL cholesterol, very-low density lipoprotein (VLDL) cholesterol, and triglycerides.
See, just because red yeast rice might lower total and LDL cholesterol doesn’t mean that it will lower your risk of cardiovascular disease – and that’s what we’re all really worried about, isn’t it?
Worse, many red yeast rice products may be ineffective, while others can cause the same harmful side effects as statin drugs. How do you know if you’re helping your health or putting it at risk? Or are you really just wasting your money?
There’s a Fungus Among Us…
As I indicated earlier, red yeast rice is produced when rice is fermented with a mold called Monascus purpureus. So the obvious question is, why would you want to supplement with something that comes from mold?
Because red yeast rice has been found to contain a number of compounds, including monacolins. One monacolin, called monacolin K, is identical to lovastatin (Mevacor), the first prescription statin drug to be approved by the FDA. Monacolin K inhibits HMG-CoA reductase, the enzyme that transforms HMG-CoA to cholesterol. The result? Decreased levels of total and LDL cholesterol.
So, if red yeast rice contains the same active compounds as statin drugs, it should also have the same effects, right?
Not so fast. Different statins are isolated from different types of fungus, including lovastatin, pravastatin, simvastatin, fluvastatin, atorvastatin, and rosuvastatin.
Some statins are more potent than others, may require different doses, and may trigger more side effects. At the same time, red yeast rice contains a number of different monacolins, some of which haven’t yet been isolated and made into statin drugs.
In other words, not all statins are created equal – and neither are all red yeast rice products. And prescription statins and red yeast rice products certainly aren’t all exactly the same. Comparing them is like comparing apples and oranges.
Let’s take a closer look.
Naturally Effective, But…
The research is clear about red yeast rice’s effectiveness in some areas. In one 1999 study, 83 men and women with high cholesterol were told to follow a low-fat, low-cholesterol diet. They were also given either 2.4 grams of red yeast rice a day or a placebo pill.
After eight weeks, researchers found that people who took red yeast rice experienced significant reductions in total and LDL cholesterol, as well as triglycerides levels. However, HDL cholesterol didn’t change.2
More recently, researchers tracked 42 men and women who took either four capsules of a red yeast rice product or a placebo every day. Sixteen weeks later, those on red yeast rice saw their LDL levels drop by 23 percent and their total cholesterol levels drop by more than 15 percent.3
Researchers have also looked at the effects of red yeast rice in people who previously took statins.
One 2009 study found that taking red yeast rice and making lifestyle changes for 24 weeks significantly reduced total and LDL cholesterol levels in people who had to stop taking statin drugs because of muscle pain.4 A similar study from 2010 showed that red yeast rice was just as effective at lowering cholesterol as the drug pravastatin.5
With results like these, it’s no wonder that many people hope to replace their prescription for statins with a bottle of red yeast rice.
But here’s the rub.
It’s not clear that taking a red yeast rice product will help reduce VLDL cholesterol, a particularly dangerous type of cholesterol that’s been linked to heart and artery disease.
Even more disappointing, there’s still no good evidence that red yeast rice can lower your risk of cardiovascular disease. In fact, it’s quite the opposite. Red yeast rice may deplete your levels of coenzyme Q10, a compound necessary for optimal cardiovascular health.
What’s the point of taking a drug or a supplement if it doesn’t truly improve your health?
A Firestorm of Controversy…
Those aren’t the only concerns to consider. Red yeast rice products present a real catch-22. Even though monacolin K occurs naturally in red yeast rice, it’s also the key ingredient in a statin drug.
Because of this, the FDA has ruled that red yeast rice can be sold as a dietary supplement – but only if it doesn’t contain monacolin K, the very ingredient that makes it effective at lowering cholesterol.
Yet, red yeast rice also contains a number of other monacolins, all of which appear to have the same effects as statin drugs. Two reviews show that the monacolin content of red yeast rice products varies widely, with some products containing negligible amounts.
In short, there’s no way to tell how much monacolin – if any – is in the red yeast rice you take.
As of 2010, there were more than 30 brands of red yeast rice available for sale in the United States – but there’s no clear way to know how much lovastatin they contain, if any.
According to one study of five red yeast rice products, total statin concentrations ranged between 1.5 and 25.2 mg per daily dose.6 That’s a huge difference!
Not Worth the Risk…
Don’t forget that true red yeast rice doesn’t just have similar benefits as statins. It also likely has the same unpleasant side effects.
These are generally mild and include headaches, heartburn, flatulence, dizziness, and nausea. Although red yeast rice appears safe for most people for up to three months, there’s just not enough data to know if taking it for longer periods is safe.
In fact, it’s possible that red yeast rice could also trigger more serious side effects. Statins have been shown to cause elevated liver and muscle enzymes, muscle aches, liver problems, and, rarely, a breakdown of muscle fibers (called rhabdomyolsis), which can lead to kidney failure.
Depending on the amount of statins your red yeast rice product contains, it could cause these effects, too.
Like statins, red yeast rice may interact with a number of other drugs, including those that can also harm the liver, such as acetominophen (Tylenol). You shouldn’t take red yeast rice if you also take a statin, drink alcohol, have liver disease, or are pregnant or nursing.
Statins are prescription drugs for a reason. They are effective at lowering cholesterol, but they also come with a slew of potentially dangerous side effects. Red yeast rice may be “natural” – but it isn’t necessarily a safe substitute. If you’re worried about taking statins (and you definitely should be), you should have the same concerns about red yeast rice products.
Think about it: If your red yeast rice product is free of statins, it’s probably useless. And if it does contain lovastatin or other monacolins, you could be lowering your cholesterol – but not your risk of cardiovascular disease – at the expense of your muscles, liver, and kidneys.
Do you really want to take that risk?
Go Truly Natural…
Unlike red yeast rice, there’s strong evidence that lifestyle changes can lower both cholesterol and cardiovascular disease.
So, pass up the red yeast rice and instead focus on doing the two things that matter the most.
First, add some form of high-intensity exercises 3-5 times a week for 20 minutes at a time, such as sprints, rowing, circuit training or something similar.
Second, eat a diet rich in real, whole, unprocessed, unrefined foods, focused primarily on clean protein sources such as wild fish, and organic or pastured beef or chicken with a hefty amount of leafy green vegetables chock full of phytonutrients, antioxidants, and healthy fiber.
This will give your brain and muscles the fuel to do the jobs they need to do while keeping your blood sugar, and insulin levels low – critical to maintaining optimal health.
Remember, keep an open mind to new ideas, but ALWAYS do your own homework…and combine that with common sense to figure out what’s best for YOU.
1 Centers for Disease Control and Prevention, “Cholesterol Facts”.
2 Heber D, Yip I, Ashley JM, et al. Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Am J Clin Nutr. 1999 Feb;69(2):231-6.
3Bogsrud MP, Ose L, Langslet G, et al. HypoCol (red yeast rice) lowers plasma cholesterol – a randomized placebo controlled study. Scand Cardiovasc J. 2010 Aug;44(4):197-200.
4Becker DJ, Gordon RY, Halbert SC, et al. Red yeast rice for dyslipidemia in statin-intolerant patients: a randomized trial. Ann Intern Med. 2009 Jun 16;150(12):830-9.
5Halbert SC, French B, Gordon RY, et al. Tolerability of red yeast rice (2,400 mg twice daily) versus pravastatin (20 mg twice daily) in patients with previous statin intolerance. Am J Cardiol. 2010 Jan 15;105(2):198-204.
6Lachenmeier DW, Monakhova YB, Kuballa T, Lobell-Behrends S, Maixner S, Kohl-Himmelseher M, Waldner A, Steffen C. NMR evaluation of total statin content and HMG-CoA reductase inhibition in red yeast rice (Monascus spp.) food supplements. Chin Med. 2012 Mar 22;7(1):8.
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