What is it?
This supplement comes in a powder form made from cooked rice on which red yeast has been grown. It has been used for thousands of years in China. Western pharmaceutical companies have used one of the active ingredients, monaclonin K, as the basis of modern cholesterol lowering drugs.[i] [ii]
How Much Does it Lower Cholesterol?
In most people 2400mg of standardized red yeast rice lowers cholesterol as follows:
| Total Cholesterol
| Decreases 11-32%
|| Decreases 22%
|| Increases 0-20%
How does it compare to drug therapy?
It is interesting to note that drugs using monaclonin K (lovastatin, for example) contain dosages many times higher than a dose of red yeast rice. Yet when compared side by side red yeast rice works as well to lower cholesterol and is a fraction of the cost! A study comparing red yeast rice to Pravastatin (a cholesterol lowering drug) found that at twelve weeks the red yeast rice was almost twice as effective! [iii] The efficacy of the supplement at such a low dose has led researchers to believe that there are other active constituents in red yeast rice. i ii iii[iv] [v] [vi]
If you’ve read my Cholesterol Article, you know there is much more to heart disease than high cholesterol—oxidation and inflammation play bigger roles than cholesterol levels alone. For that reason it is important to look at not only the cholesterol lowering effects of red yeast rice, but at how much red yeast rice actually decreases risk of heart attack. A newer study did just that. In 2008 the study was published in the American Journal of Cardiology found a 50% reduction in heart attacks among a group given red yeast rice. The authors concluded that the product outperformed statins in preventing heart disease—and with no side-effects in the study.[vii] That becomes very important considering the high level of side effects involved in most statin trials. In many trials of statin drugs more people die in the study group than in the placebo group! (read my Cholesterol Article for more on that topic).
Like policosanol red yeast rice decreases the oxidation of cholesterol. This is important since oxidized LDL cholesterol has been implicated in the formation of and rupture of atherosclerotic plaques.
What else is it good for?
Red yeast rice possesses powerful antioxidant capabilities and has been shown in animal studies to dramatically reduce the rates of certain types of cancers. [viii] [ix]More research needs to be done in this area to find out what effect the supplement may have in human cancers.
Are there any side effects or drug interactions?
The available research indicates that red yeast rice is very safe to use short term at the recommended dosages. Studies monitoring liver function found no change with use of the supplement (one study using very high levels found a small, but acceptable, increase in liver enzymes in one subject [x]). Since red yeast rice does inhibit cholesterol synthesis in the liver in a similar fashion to drugs that have been known to reach toxic levels, it is wise to monitor liver function with blood tests during prolonged supplementation. This supplement should be used under supervision of a nutritionally minded doctor. If you are taking red yeast rice you should also take CoQ10--this is a naturally occurring enzyme in your body that is very important--it is depleted by chronic red yeast rice use. I suggest taking 50-300mg of CoQ10 per day with your red yeast rice.
Grapefruit juice should be avoided during supplementation since it has been known to increase blood levels of cholesterol lowering drugs.
[i] Heber D, Yip I, Ashley JM, et al. Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. American Journal of Clinical Nutrition. 1999;69:231–6.
[ii] Ma J, Li Y, Ye Q, Li J, Hua Y, Ju D, et al. Constituents of red yeast rice, a traditional Chinese food and medicine. J Agric Food Chem. 2000;48:5220-5225.
[iii] Wei J, Yang H, Zhang C, et al. A Comparative Study of Xuezhikang and Mevalotin in treatment of essential hyperlipidemia. Chinese Journal of New Drugs. 1997;6:265-268.
[iv] Bonovich, K, Colfer H, Davidson M, Dujovne C, Greenspan M, Karlberg R, et al. A Multi-Center, Self-Controlled Study of Cholestin In Subjects With Elevated Cholesterol. American Heart Association. 39th Annual Conference on Cardiovascular Disease Epidemiology and Prevention, Orlando, Fl. March 1999.
[v] Qin S, Zhang W, Qi P, Zhao M, Dong Z, Li Y , et al. Elderly patients with primary hyperlipidemia benefited from treatment with a Monacus purpureus rice preparation: A placebo-controlled, double-blind clinical trial. American Heart Association. 39th Annual conference on Cardiovascular Disease Epidemiology and Prevention, Orlando, Fl. March 1999.
[vi] Wang J, Lu Z, Chi J, 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. 1997;58:964-978.
[vii] Lu Z, Kou W, Du B, Wu Y, Zhao S, Brusco OA, Morgan JM, Capuzzi DM; Chinese Coronary Secondary Prevention Study Group, Li S. Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction. Am J Cardiol. 2008 Jun 15;101(12):1689-93. Epub 2008 Apr 11.
[viii] Yasukawa K, Takahashi M, Yamanouchi S, et al. Inhibitory effects of oral administration of Monascus pigment on tumor promotion in two-stage carcinogenesis in mouse skin. Oncology 1996;53:247-249.
[ix] Izawa S, Harada N, Watanabe Y, et al. Inhibitory effects of food coloring agents derived from Monascus on the mutagenicity of heterocyclic amines. Journal of agricultural and Food Chemistry. 1997;45:3980-3984.
[x] Lu ZL, Xu S, Kou WR. The clinical observation of treatment of hyperlipidemia with different doses of Xuezhikang. Fu-Wai Hospital of Cadiocvascular Disease, Chinese Xie-He Medical University and Chinese Acadamy of Science. National Symposium of Clinical Therapies for Cardiovascular Diseases. 1995;1997:53-57.
An excellent review is available online at http://www.naturalproducts.org/inpr/monographs_pdf/index.html.