Red Yeast Rice for Lowering Cholesterol
Red yeast rice is rice fermented using Monascus purpureus, a type of mold that gives the rice a distinct red-purplish color. Red yeast rice has been used in cooking and in traditional Chinese medicine for centuries. The mold used in the production of red yeast rice is from the same family as the mold that was used to isolate lovastatin, a drug (statin) that revolutionized the treatment of high blood cholesterol. It is thus not surprising that red yeast rice contains a compound, monacolin K, that is chemically identical to lovastatin. In addition to monacolin K, red yeast rice contains 13 other members of the monacolin family, CoQ10, isoflavones and sterols. Such rich pharmacological portfolio is thought to be the reason why red yeast rice shows high effectiveness in lowering cholesterol – in clinical trials, the amount of lovastatin within red yeast rice supplements was considerably lower (4.8 mg) than the commonly prescribed dose of lovastatin (20-40 mg). The lower dose of lovastatin in red yeast rice is also believed to be the reason why patients taking the supplements experience fewer side effects than patients taking prescription statin drugs.
The presence of a registered drug, lovastatin, in the red yeast rice supplements presents a conundrum for consumers in the US. To abide by the U.S. Food and Drug Administration’s (FDA) rules, companies that sell red yeast rice must not provide any information on the amount of monacolin K (lovastatin) present in the supplements. The lack of information on the amount of active ingredients in a dietary supplement presents a considerable challenge not only for patients but for doctors as well.
Several studies found dramatic variations in the composition of red yeast rice supplements. The amount of monacolin K present in different products varied from 20 to 60 fold! In addition, some of the tested supplements contained citrinin, a potentially toxic compound associated with poor manufacturing practices. Without a label containing information about the amount of active ingredients and contaminants, consumers lack guidance in choosing a safe and beneficial product. Despite these serious uncertainties, red yeast rice continues to be widely used.
How to use
In clinical trials, patients were taking from 500 to 3600 mg red yeast rice with lovastatin content varying between 2 mg and 11.4 mg. The duration of treatment also differed between 6 weeks and 6 months. Because of this variability and lack of information on the contents of red yeast rice supplements, always consult your doctor prior to taking red yeast rice supplements. Your doctor will not only be able to guide you in terms of proper dosing but will also evaluate the success of therapy and possible side effects by monitoring relevant blood biomarkers (lipid levels, liver enzymes).
Statins are known to cause various side effects, from muscle pain to liver damage. Since adverse effects get more serious with higher doses of statins, it is it is important not to take red yeast rice supplements if you are already taking prescription statins.
Many drugs interact with red yeast rice. Do not take the supplements with drugs that can damage liver or muscles. In addition, avoid alcohol while taking red yeast rice products to minimize the risk of liver damage.
Grapefruit juice can significantly increase the level of statins in the blood and thus potentiate both their desired and adverse effects. Although no study investigated the exact relationship between red yeast rice and grapefruit juice, it is important to be aware of their possible interaction and to practice caution when combining those two.
Statins in red yeast rice can lower the levels of a very important coenzyme (enzyme helper) CoQ10. The levels of CoQ10 can be determined by a simple blood test. If you are deficient, ask your doctor about CoQ10- supplementation.
Red Yeast Rice supplements
It is difficult to choose a high-quality red yeast rice product, given the uncertainty relating to the supplements’ contents.
Some of the products that have been used in clinical trials have been removed from the market as the companies making them failed to conform to the FDA rules.
The only product that has been well characterized and also proven effective in clinical trials is the organic red yeast rice manufactured by the Sylvan Bio (HeartShape) red yeast rice.
HeartShape Red Yeast Rice
Last updated: October 2, 2017