Red Yeast Rice for Cholesterol: A Doctor's Guide to Benefits, Uses and Side Effects

By Dr. Kevin Passero

In recent years, red yeast rice has received a lot of attention as an alternative to widely prescribed statin drugs for its role in supporting healthy cholesterol levels. 

I often recommend red yeast rice supplements to patients in my clinics looking for a natural way to address their elevated cholesterol levels.

In this guide we’re going to explore the benefits of red yeast rice for cholesterol, what to look for in a red yeast rice supplement, and potential side effects to be aware of, so that you can have a comprehensive understanding of this natural ingredient.

Red Yeast Rice at a Glance

• Primary Component: Monacolins, flavonoids, sterols and isoflavones.
• Mechanism of Action: Inhibits cholesterol synthesis.
• Cholesterol Impact: Lowers total and LDL cholesterol.
• Additional Benefits: Anti-inflammatory, improves blood flow.
• Side Effects: Muscle pain, liver dysfunction, GI issues.
• Best For: Individuals not on statins and don’t have liver issues.

What is Red Yeast Rice?

The use of red yeast rice was widely used in traditional Chinese medicine going back more than 700 years, but the real breakthrough discovery came in the 1970s.

Red yeast rice is made by fermenting white rice with a special type of yeast called Monascus purpureus. It was found that this process produces a reddish-purple rice that’s teeming with a variety of bioactive compounds, including plant sterols, flavonoids, isoflavones, bio-active pigments and monacolins.

As modern medicine evolved, a professor by the name of Akira Endoa successfully isolated a unique monacolin in red yeast rice, called monacolin K. He later discovered that the compound had a chemical structure known for inhibiting HMG-CoA reductase, an enzyme involved in cholesterol production.

How Red Yeast Rice Works

• Red yeast rice is known to increase receptors involved in cholesterol metabolism.
These receptors, also known as Liver X receptors or LXRs, play a crucial role in regulating the uptake and processing of cholesterol in the body, thereby aiding in the clearance of cholesterol from the bloodstream.

• Red yeast rice also enhances enzymes involved in fat breakdown.
These enzymes are responsible for breaking down fats into smaller molecules that can be easily metabolized and utilized by the body. By boosting the activity of these enzymes, red yeast rice promotes the efficient breakdown of fats, including cholesterol, leading to lower lipid levels in the blood.

• Red yeast rice curbs accumulation of fat and cholesterol in the body.
Excessive accumulation of fat and cholesterol in the liver can lead to various health concerns. Red yeast rice aids in preventing this buildup by inhibiting the action of key liver enzymes that regulate the production of cholesterol, thereby supporting liver health and overall cholesterol balance.

Red Yeast Rice Benefits

While there are many health benefits to taking red yeast rice, its primary use continues to be what traditional Chinese medicine used it for over 700 years ago: enhance circulation and support cardiovascular health.

Modern science has now validated its use for cholesterol management, especially when it comes to the “bad” LDL type of cholesterol.

One early study evaluated the lipid-lowering efficacy of red yeast rice in hyperlipidemic patients. The treatment group experienced a reduction in total cholesterol by 21% and LDL cholesterol by 27%.

And a more recent review found similarly impressive results. Collective research indicates that red yeast rice effectively reduces LDL cholesterol by approximately 15%-34% versus the placebo, and has also demonstrated beneficial reductions of up to 45% versus placebo in the risk of atherosclerotic cardiovascular events.

5 Benefits of Taking Red Yeast Rice

1) Cholesterol Support: One of the most well-known benefits of red yeast rice is its ability to support LDL and total cholesterol levels. Studies have shown that red yeast rice can significantly reduce total cholesterol and LDL cholesterol.

2) Cardiovascular Support: Red yeast rice also helps support endothelial function and reduces arterial inflammation, both of which are crucial for maintaining cardiovascular health.

3) Anti-Inflammatory Properties: Research has found that red yeast rice is able to lower markers of C-reactive protein, one of the primary inflammatory markers linked to heart disease.

4) Improved Circulation: Studies indicates that reducing oxidative stress and improving endothelial function are two ways red yeast rice can enhance blood flow and support overall heart health.

5) Antioxidant Boost: The fermentation process of red yeast rice enhances its antioxidant properties, helping to protect the body from oxidative stress and free radical damage.

What to Look for in a Red Yeast Rice Supplement

When looking for a red yeast rice supplement, it’s critical to look for one that has clinically validated and standardized active ingredients. Additionally, red yeast rice supplements should be tested to ensure they are free from citrinin, a potentially harmful byproduct of the rice fermentation process.

Recommended Dosage for Red Yeast Rice

The typical dosage for a red yeast rice supplement ranges from 600-1,600 mg per day, usually divided into two doses. Given cholesterol synthesis is most active at night while you sleep, it’s best to take at least one dose in the evening. It’s important to follow the specific dosage instructions provided on the supplement label or by your healthcare provider.

Potential Red Yeast Rice Side Effects

While red yeast rice is generally well-tolerated, it can cause side effects in some individuals, particularly at higher doses. Common side effects may include:

• Muscle Pain and Weakness: Red yeast rice can cause muscle pain and weakness that is similar to those felt when taking other cholesterol control medications such as statin drugs. This is due to its effect on the same enzyme involved in muscle function.

• Liver Dysfunction: There have been reports of liver complications associated with red yeast rice when not taken as directed or under medical supervision. It is advisable to monitor liver function periodically if you are going to be taking red yeast rice long-term.

• Gastrointestinal Issues: Some individuals may experience digestive discomforts such as gas, bloating or stomach pain.

• CoQ10 Reduction: Red yeast rice may reduce levels of Coenzyme Q10 (CoQ10), a vital antioxidant for heart health. Taking a CoQ10 supplement can help mitigate this side effect.

Should You Be Taking Red Yeast Rice?

Red yeast rice is a powerful option for those looking to naturally support healthy cholesterol levels. However, it’s important to find a brand you trust to be clinically validated and standardized to contain the ideal amount of the active ingredients. Combining red yeast rice with other lifestyle changes may provide a comprehensive approach to cardiovascular wellness.

Note: Because of the specific mechanisms of action, red yeast rice should NOT be taken along with statins drugs or by those who have liver issues.