Red Yeast Rice

Red yeast rice is a traditional Chinese medicine that has been purported to lower cholesterol.  Several types of the extract are sold as supplements.

Red yeast rice may be appealing because it's "natural," but you need to be careful.  Experts have not studied it extensively.  The ideal dosing and long-term safety are unclear.  It could be dangerous for some people.  And because the ingredients of different brands of red yeast rice extract might vary so much, it's hard to make firm statements about its effectiveness or safety.

What Is Red Yeast Rice?

Red yeast rice is a substance that's extracted from rice that's been fermented with a type of yeast called Monascus purpureus.  It's been used in China and other Asian countries for centuries as a traditional medicine.  It's also used as a food coloring, additive, and preservative.

Red yeast rice naturally contains several ingredients that may help control cholesterol levels.  These include a number of monacolins, most importantly monacolin K.  It also contains sterols, isoflavones, and monounsaturated fatty acids, or "healthy fats."

Is Red Yeast Rice a Drug or a Supplement?

Confusingly, the answer is both.  One of the most important ingredients in red yeast rice is monacolin K.  It's also known as lovastatin, the active ingredient in the prescription drug Mevacor.

So on one hand, red yeast rice is a traditional remedy that helps lower cholesterol.  On the other, the pharmaceutical manufacturer of Mevacor argues that it owns the rights to the ingredient lovastatin.

This confusion extends to how the supplement is sold in the U.S.  Because red yeast rice contains a substance classified as a prescription drug, the FDA has attempted to control its sale.  In 2007, the FDA asked that three red yeast rice products -- Cholestrix by Sunburst Organics and two red yeast rice formulations by Swanson Healthcare Products (Red Yeast Rice and Red Yeast Rice/Policosonal Complex) -- be withdrawn from the market because they contained lovastatin.  The FDA cited a risk of severe muscle problems that could lead to kidney disease.

Despite the FDA's attempts, many people in the U.S. still manage to get similar red yeast rice extracts from other countries or the Internet.

How Well Does Red Yeast Rice Lower Cholesterol?

Studies have shown that red yeast rice can significantly lower levels of total cholesterol and specifically LDL, or "bad" cholesterol.  One showed that taking 2.4 grams per day of red yeast rice reduced LDL levels by 22% and total cholesterol by 16% in 12 weeks.  Another study showed that taking 1.2 grams per day lowered LDL levels by 26% in just eight weeks.

However, the studies of red yeast rice have so far been fairly small and didn't last long enough to reveal the long-term effects.