Recently one of our reader's was visiting a new primary physician. As they reviewed the results of his blood work, the doctor made suggestions for lowering his blood cholesterol level to avoid using prescription medication. The blood lipid levels were similar to his past records and his prior doctor never recommended taking action. Among dietary changes, she suggested the use of red yeast rice.
Red yeast rice (RYR) is actually a product of yeast (monascus purpureus) that is grown on rice. It's been used for centuries in Chinese medicine and other Asian cultures for various ailments, including to help lower cholesterol. RYR is marketed as a "natural" substance under various names including cholestin, monascus, Zhi Tai, hong qu, red koji, and red rice. It may reduce LDL (low-density lipoproteins = "bad guys") and triglyceride levels, and increase HDL (high-density lipoproteins = good guys.) But the decision to use it or not, is just not that easy.
RYR is most often sold in the U.S. as an herbal supplement even though it contains ingredients that are considered drugs. The FDA regulates all medications, however it does not oversee the supplement industry which includes both natural and herbal sources; there is no regulation for manufacturing RYR that would assure purity, amount of drug present, and its safety for use. In fact, some brands of RYR supplements have been found to contain toxic metals and citrinic acid. The FDA has worked to encourage manufacturers to list potential side effects. At this time, ideal dosing or long-term safety has not been determined.
The major active ingredient in RYR is monacolin or lovastin, the same active ingredient in the prescription cholesterol lowering medication Mevacor. The amount present in each supplement varies considerably due to the lack of regulation, making studies and use difficult. A couple of short term studies have shown RYR to be beneficial in reducing cholesterol, though many more studies are needed that look at larger groups to even begin to recommend it's use.
Side effects for RYR are the same as for the prescription medication: headache, heartburn and upset stomach along with possible deterioration of skeletal muscle and kidney failure. Alcohol intake increases these risks. People with liver disease, asthma, infections, compromised immune systems, pregnant, nursing, consume over 2 alcoholic drinks each day, and who are on prescription lovastin should not use RYR, unless recommended by their physician. ALWAYS check with your doctor before taking any supplements, including RYR. (It feels like I just zipped off a warning list for a prescription drug ad!)
I talked with one physician (M.D.) about the use of Red Yeast Rice. He definitely prefers the use of prescription medications if lifestyle changes (exercise and diet) are not successful. These meds contain active ingredients have been well researched; concentrations are known, and are made in carefully controlled for safety. That makes sense to me.
If your cholesterol levels are too high, talk with your doctor. All of us should be focusing on good nutrition and increased exercise to help reduce cholesterol and other risks of heart disease. Be sure to include plenty of fatty fish, walnuts, flaxseed, oats, beans, barley and plenty of fruits and vegetables.
To Your Health!