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Home > The red-colored yeast Monascus purpureus is a traditional Chinese food coloring and herbal remedy. It has been used medicinally in China for at least several hundred
years3 and has been a food ingredient for about 2000 years.
The yeast is grown on wet white rice, which becomes permeated with the colored yeast. The resulting red rice is dried and pulverized and the powder sold as a traditional remedy for promoting blood circulation, soothing upset stomach, and for other medical purposes.1,2 Modern RYR supplements are usually extracts of Red Yeast Rice — unneeded starches and gums have been removed to make the powdered product more potent, less perishable, and easily dosed. The Chinese name for such extracted RYR products is Xue Zhi Kang (aka ‘Xuezhikang’).6 Red yeast rice is “a dietary staple in many Asian countries, including China and Japan, with typical consumption ranging from 14 to 55 g/person/day (0.5 to 2 oz).”4 This substance could plausibly account for the low level of cardiovascular disease found in Asian populations.5 What we can’t tell youIn the U.S. and some other industrialized countries, government agencies like the U.S. Food and Drug Administration have adopted censorship as a method for intensifying their control over the supplement industry and its customers. Thus, FDA regulations prohibit us from telling you that any of our products are effective as medical treatments, even if they are, in fact, effective. Accordingly, we will limit our discussion of Red Yeast Rice to a brief summary of recent research, and let you draw your own conclusions about what medical conditions it may be effective in treating. How RYR affects cardiovascular disease
The dried yeast contains a family of compounds (‘monacolins’) that inhibit HMG-CoA reductase (an enzyme responsible for making cholesterol in the body9). These inhibitors are similar in chemical structure to the expensive ‘statin’ drugs that are sold as prescription remedies for high cholesterol. In addition, the red yeast contains a variety of other medically active compounds, including flavonoids and sterols, that may contribute to the yeast’s cholesterol-regulating activity.9,10 The monacolins in RYR also suppress the body’s production of C-Reactive Protein (‘CRP’). CRP is a protein involved in inflammation, and inflammation is considered to be the primary process that causes plaques to develop in arteries. By suppressing CRP, red yeast rice appears to be helping to suppress the inflammation responsible for atherosclerosis.5,9 The efficacy of RYRTen or more clinical studies of RYR have been performed; all have shown that RYR supplementation brings about significant reductions in LDL cholesterol and triglycerides — reductions of at least 30% are achievable in patients with high lipid levels.11 HDL (‘good cholesterol’) increased slightly in at least one study.12 In a 2003 animal study an extract of RYR actually reduced the size of atherosclerotic plaques in arteries.13 No clinical studies have directly compared RYR and statin drugs with regard to their maximum potential for improving cholesterol profiles. The results found in separate studies, however, have convinced clinical researchers that RYR is at least as effective as statin drugs, while causing far fewer side effects. Why should this be? The explanation usually given is that the dose of lovastatin provided by RYR supplements is far less than the dose used in prescription lovastatin drugs — consequently RYR users typically experience no lovastatin side effects. As for efficacy: the small size of the lovastatin dose provided by RYR is more than made up for by the presence of small amounts of various other substances which dramatically enhance this supplement’s effectiveness.10 Miscellaneous facts about RYR
Cost comparisonThe expensive way to lower the body’s LDL cholesterol levels is to use brand-name ‘statin’ drugs. There are six prescription statins currently on the market in the U.S. Although prices vary dramatically depending on who is selling them, the following prices represent the low end of the price range for non-generic statins:
Several of these are now available as generic drugs, at prices around $20/month. Red Yeast Rice extracts cost even less than generic statin drugs. For example, LifeLink’s Red Rice Yeast Extract costs about $17/month. These cost comparisons do not take into account the cost of dealing with side effects. It should be kept in mind that the statin drugs, whether brand-name or generic, contain fairly high dosages of single substances and therefore have more serious side effects than RYR which contains low doses of many active substances. CautionsRYR, like the statin drugs, suppresses the body’s levels of CoQ10 (coenzyme Q10, a substance required for metabolism).20,21 Users of RYR should therefore also use a CoQ10 supplement. Pregnant women should avoid using RYR or any statin drug.22,23 Sudden termination of RYR usage can have a significant rebound effect on C-Reactive Protein, LDL and HDL. (The same is true for statin drugs.) RYR users who want to stop using RYR — especially those with severe cardiovascular disease — should therefore reduce the dosage of RYR gradually over a period of about a week.8 Contraindications for lovastatin: pregnancy, nursing, liver or kidney impairment, co-administration with niacin, gemfibrozil, cyclosporin, azole antifungals, erythromycin, clarithromycin, nefazodone, protease inhibitors.9,22 Recommended reviews about RYRFor a good overview of the subject of Red Yeast Rice, LifeLink recommends the following review articles: footnotes: Patrick,9 Heber24, Raloff25, Wikipedia1, Lee26, Zarkov27. ConclusionAre Red Yeast Rice supplements effective for preventing or treating cardiovascular disease? We aren’t allowed to tell you, so you should take a look at some of the references cited here, and then decide for yourself. References[1] Red yeast rice Wikipedia article [2] Red Yeast Rice University of Maryland Medical Center website [3] Methods and compositions employing red rice fermentation products U.S. Patent #6,632,428 Mao Liang Zhang, et al. [4] Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Am J Clin Nutr. 1999 Feb;69(2):231-6 Heber D, Yip I, Ashley JM, Elashoff DA, Elashoff RM, Go VL [5] Serum C-reactive protein as a marker for wellness assessment. Ann Clin Lab Sci. 2006; 36(2):163-9 Kao PC, Shiesh SC, Wu TJ [6] Red yeast rice (Monascus purpureus) Mayo Clinic website [7] Cholestin inhibits cholesterol synthesis and secretion in hepatic cells (HepG2). Mol Cell Biochem. 2002 Apr;233(1-2):153-8 Man RY, Lynn EG, Cheung F, Tsang PS, O K. [8] Effects of withdrawal of Xuezhikang, an extract of cholestin, on lipid profile and C-reactive protein: a short-term time course study in patients with coronary artery disease. Cardiovasc Drugs Ther. 2006 Jun; 20(3):185-91 Hu CL, Li YB, Tang YH, Chen JB, Liu J, Tang QZ, Zhang QH, Huang CX [9] Cardiovascular disease: C-reactive protein and the inflammatory disease paradigm: HMG-CoA reductase inhibitors, alpha-tocopherol, red yeast rice, and olive oil polyphenols. A review of the literature. [PDF, 143KB] Altern Med Rev. 2001 Jun; 6(3):248-71 Patrick L, Uzick M [10] Plasma clearance of lovastatin versus chinese red yeast rice in healthy volunteers. J Altern Complement Med. 2005 Dec; 11(6):1031-8 Li Z, Seeram NP, Lee R, Thames G, Minutti C, Wang HJ, Heber D [11] Effects of xuezhikang, an extract of cholestin, on lipid profile and C-reactive protein: a short-term time course study in patients with stable angina. Clin Chim Acta. 2005 Feb; 352(1-2):217-24 Li JJ, Hu SS, Fang CH, Hui RT, Miao LF, Yang YJ, Gao RL [12] [Intervention of xuezhikang on patients of acute coronary syndrome with different levels of blood lipids] Zhongguo Zhong Xi Yi Jie He Za Zhi. 2004 Dec; 24(12):1073-6 Wang WH, Zhang H, Yu YL, Ge Z, Xue C, Zhang P [13] Hypolipidemic and anti-atherogenic effects of long-term Cholestin (Monascus purpureus-fermented rice, red yeast rice) in cholesterol fed rabbits. J Nutr Biochem. 2003 Jun; 14(6):314-8 Wei W, Li C, Wang Y, Su H, Zhu J, Kritchevsky D [14] Antiatherosclerotic efficacy of policosanol, red yeast rice extract and astaxanthin in the rabbit. Arzneimittelforschung. 2005; 55(6):312-7 Setnikar I, Senin P, Rovati LC [15] Dietary supplement or drug? The case of Cholestin [Editorial] American Journal of Clinical Nutrition, Vol. 69, No. 2, 175-176, February 1999 Richard J Havel [16] Warning Letters for Products Containing Red Yeast Rice FDA archives [17] [FDA forces Global Source and Consulting, Inc. to destroy RYR products] FDA archives, 2003 [18] [Transcript of Advisory Committee meeting to discuss OTC approval for low-dose lovastatin] [PDF, 5.7MB] FDA website. July 13, 2000 [19] FDA panel rejects sales of Mevacor over counter Boston Globe website. January 15, 2005 Diedtra Henderson [20] Muscle coenzyme Q10 level in statin-related myopathy. Arch Neurol. 2005 Nov; 62(11):1709-12 Lamperti C, Naini AB, Lucchini V, Prelle A, Bresolin N, Moggio M, Sciacco M, Kaufmann P, DiMauro S [21] Acute administration of red yeast rice (Monascus purpureus) depletes tissue coenzyme Q(10) levels in ICR mice. Br J Nutr. 2005 Jan; 93(1):131-5 Yang HT, Lin SH, Huang SY, Chou HJ [22] Mechanistic and epidemiologic considerations in the evaluation of adverse birth outcomes following gestational exposure to statins. Am J Med Genet A. 2004 Dec 15;131(3):287-98 Edison RJ, Muenke M [23] The role of maternal toxicity in lovastatin-induced developmental toxicity. Birth Defects Res B Dev Reprod Toxicol. 2004 Jun;71(3):111-23. Lankas GR, Cukierski MA, Wise LD. [24] Herbs and atherosclerosis. Curr Atheroscler Rep. 2001 Jan; 3(1):93-6 Heber D [25] Cholesterol medicine for eggs? Science News 2003 July 12 Janet Raloff [26] Red Yeast Rice and Cholesterol - A Critical Review MedicineNet.com website Dennis Lee, M.D. [27] [Red Yeast Rice questions] LifeLinkNet.com website Alexis Zarkov, Ph.D. |
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