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
years 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.
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’).
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).” This substance could plausibly account for the low level of cardiovascular disease found in Asian populations.
What we can’t tell you
In 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
- RYR inhibits the body’s synthesis of cholesterol
- RYR inhibits the body’s production of C-Reactive Protein
The dried yeast contains a family of compounds (‘monacolins’) that inhibit HMG-CoA reductase (an enzyme responsible for making cholesterol in the body). 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.
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.
The efficacy of RYR
Ten 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. HDL (‘good cholesterol’) increased slightly in at least one study. In a 2003 animal study an extract of RYR actually reduced the size of atherosclerotic plaques in arteries.
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.
Miscellaneous facts about RYR
- In a recent experiment with rabbits, a profound suppression of atherosclerosis development was achieved by a supplement combination
consisting of RYR, policosanol, and the carotenoid ‘astaxanthin’ (the red substance in salmon and shellfish).
- Vitamin E has many of the same effects on cardiovascular disease as RYR, as has been shown in a number of clinical trials. But vitamin E acts through a different mechanism than RYR. It therefore makes sense to use these two supplements together
to take advantage of synergistic effects.
Cost comparison
The 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:
- Lipitor® (atorvastatin) — $78/month
- Lescol® (fluvastatin) — $64/month
- Mevacor® (lovastatin) — $60/month
- Pravachol® (pravastatin) — $95/month
- Zocor® (simvastatin) — $83/month
- Crestor® (rosuvastatin) — $91/month
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.
Cautions
RYR, like the statin drugs, suppresses the body’s levels of CoQ10 (coenzyme Q10, a substance required for metabolism). Users of RYR should therefore also use a CoQ10 supplement.
Pregnant women should avoid using RYR or any statin drug.
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.
Contraindications for lovastatin: pregnancy, nursing, liver or kidney impairment, co-administration with niacin, gemfibrozil,
cyclosporin, azole antifungals, erythromycin, clarithromycin, nefazodone, protease inhibitors.
Recommended reviews about RYR
For a good overview of the subject of Red Yeast Rice, LifeLink recommends the following review articles: footnotes: Patrick, Heber, Raloff, Wikipedia, Lee, Zarkov.
Conclusion
Are 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.