RED YEAST RICE IS CHOCK FULL OF MONACOLIN K, a substance that can lower your total blood cholesterol, low-density lipoprotein (LDL or “bad”) cholesterol, and triglycerides. Today, I want to share how I lowered my cholesterol levels over the past year.
Red yeast rice’s potential benefits include the following:
- heart health improvements
- metabolic syndrome risk reduction
- decreased inflammation
- cancer risk reduction
While you may have only noticed the pills on your pharmacy or grocery store shelves recently, folks have known about the medicinal properties of red yeast rice for hundreds of years.
Chinese and Koreans have used red yeast rice to make alcoholic beverages and various fermented foods since ancient times. The Japanese have used it to produce tofuyo (Okinawan-style fermented tofu) in Japan since the 18th century.
To prepare Okinawa-style tofu, also known as shima-dofu, one ferments tofu in red yeast, rice malt, and awamori (an alcoholic beverage). Adding red yeast gives tofuyo its reddish color.
Following prolonged fermentation, preparers slice tofuyo into tiny cubes that you can nibble. The flavor? Think rich and creamy with an intense aroma. The texture is like cream cheese.
Have you tried shima-dofu? If you answered yes, count yourself lucky — during its development in the Ryuku kingdom era — only the emperor, his family, and select nobles could enjoy it.
Today, I want to explore red yeast rice’s benefits, potential risks, and dose recommendations. We’ll look at how I lowered my cholesterol.
“The mind is like tofu. It tastes like whatever you marinate it in.”
― Sylvia Boorstein
What is cholesterol?
We have cholesterol circulating in our blood. As the cholesterol volume increases, the risk to your health can rise. High cholesterol is generally associated with a higher risk of cardiovascular diseases such as stroke and heart disease. I check my cholesterol levels every year.
There are two cholesterol types, including LDL (“bad”) cholesterol and HDL (“good” cholesterol). Too much LDL can be unhealthy, as can not enough HDL. When the balance is off, cholesterol can slowly accumulate in the inner walls of the arteries feeding our heart and brain.
HDL takes LDL (bad) cholesterol away from the arteries and back to the liver, where the LDL is broken down and excreted from the body. HDL carries approximately one-third to one-fourth of blood cholesterol.
When cholesterol joins other substances in our bloodstream, we can get thick, firm deposits on the inside wall of the arteries, resulting in arterial narrowing and hardening. We call this condition atherosclerosis. If a blood clot forms and obstructs one of these narrowed arteries, we can suffer a heart attack or stroke.
https://watchlearnlive.heart.org/index.php?moduleSelect=athero
What are lipids?
Let’s talk a bit more about the chemistry underlying red yeast rice. The substance is known for its ability to combat high lipid levels in the blood. Lipids are a diverse group of organic compounds containing fats, oils, hormones, and certain membrane components that are grouped (because they do not readily interact with water).
Triglycerides, a particular lipid type, are sequestered as fat in adipose (fat) cells. Adipose cells are an energy storage plant and also provide thermal insulation. Lipids have several functions, including:
- Lipids such as steroid hormones are chemical messengers between our cells, tissues, and organelles. Lipids can also transmit signals within a cell.
- Phospholipids molecules help form the membranes of cells and organelles, intracellular structures. The membranes are exceptionally thin structures made from two layers of phospholipid molecules. The structures separate cells from their environments and compartmentalize a cell’s interior.
Hydrophilic molecules have an affinity for water; they are “water-loving.” On the other hand, lipids are hydrophobic (“water-fearing”). Some lipids are amphipathic — part hydrophilic and part hydrophobic.
Here’s the thing about amphipathic lipids: They exhibit a unique behavior in water; lipids spontaneously form ordered molecular aggregates. Their hydrophilic ends stick outside (contacting water), and the hydrophobic parts are inside (shielded from water). These characteristics are critical to the role of the lipid as a fundamental component of the membranes of our cells and organelles.
How I lowered my cholesterol: Red yeast rice
Red yeast rice results from yeast (Monascus purpureus) grown on white rice. The powdered yeast-rice mixture, a dietary staple in Asia, is used in traditional Chinese medicine. You may know red yeast rice as an oral supplement.
But is red yeast rice an effective natural medicine for lowering cholesterol? We know it contains monacolin K, the same ingredient in the prescribed cholesterol-lowering drug lovastatin. And does red yeast rice have other medicinal properties?
Red yeast rice can lower total blood cholesterol levels, low-density lipoprotein (LDL) cholesterol, and triglyceride levels.
A review of 21 studies discovered that red yeast rice reduced cholesterol (total and LDL), triglycerides, and blood pressure when combined with statin drugs.
What about red yeast rice without statin drugs? A scientific review of 30 studies showed that red yeast rice reduces the risk for major adverse cardiovascular events. The study authors observe that red yeast rice is not likely to be more effective than statins. However, given the dose is typically lower, the red yeast rice supplements may have less toxicity.
Mediterranean diet plus red yeast rice
An Italian study looked at the cholesterol-lowering effects of a Mediterranean diet alone or in combination with red yeast rice (Evidence-Based Complementary and Alternative Medicine, Dec. 23, 2013). The six-month trial demonstrated that people who followed a Mediterranean diet lowered their cholesterol levels. Adding red yeast rice brought cholesterol down even further.
Red yeast rice issues
Red yeast rice supplements and other supplements are not well-regulated, at least in the United States. The Food and Drug Administration has largely abdicated responsibility regarding non-prescribed drug alternatives. As a result, it can be challenging to determine the trustworthiness of over-the-counter supplements.
Researchers looked at whether the Food and Drug Administration’s manufacturing standards led to standard concentrations of the statin monacolin K in red yeast rice supplements. The results of one study are troubling.
Of 26 brands examined, following the manufacturers’ recommendations for daily consumption appeared to be associated with a wide range of monacolin K doses; in fact, the highest differed from the lowest level by 120 times. Despite FDA manufacturing standards, the strength and composition of red yeast rice supplements sold in retail stores in the USA are unpredictable.
The product manufacturers did not indicate the monacolin K quantity on the label of any brand. Only seven percent of the products advised consumers to avoid consuming the supplement with prescription statins.
Randomized clinical trials show that some specific proprietary formulations of red yeast rice (providing 4.8 to 24 milligrams of monacolin K daily) can lead to short-term improvements in lipid lowering. These benefits are similar to prescription statins such as simvastatin.
Manufacturers make prescription tablets of lovastatin in 10 mg, 20 mg, and 40 mg dosages. The monacolin K quantity in a recommended daily serving of some red yeast rice supplements overlaps with the dosages of prescription tablets. Unfortunately, in the real world, we see wide variability in monacolin K content.
As red yeast rice supplements may contain prescription-level doses of statins, the supplements can offer risks similar to those of statins.
Because these risks are dose-related, the risks of red yeast rice supplements are particularly concerning if you are taking a prescription statin. Unfortunately, 93 percent of the supplement labels examined in one study did not mention this concern of combining the supplements with prescription statins.
Red yeast rice — specific side effects
The Mayo Clinic (USA) offers that red yeast rice can cause mild side effects, such as:
- Abdominal discomfort
- Heartburn
- Gas
- Headache
- Dizziness
As we discussed, red yeast rice often contains monacolin K, the prime ingredient in the prescription cholesterol-lowering drug lovastatin. Side effects of the latter can include liver damage and muscle disorders like myopathy.
Pregnant women should avoid red yeast rice, as should those breastfeeding or trying to become pregnant.
Possible drug interactions include alcohol (using both alcohol and red yeast rice can raise your risk of liver damage). Other potential drug interactions include:
- Cyclosporine (Neoral, Sandimmune). Using this immunosuppressive drug with red yeast rice may increase myopathy risk.
- Cytochrome P450 3A4 (CYP3A4) inhibitors. Taking red yeast rice with drugs, such as erythromycin, that inhibit this enzyme can increase the risk of red yeast rice side effects.
- Grapefruit. Drinking grapefruit juice and red yeast rice might increase the supplement’s risks.
- Gemfibrozil (Lopid). Taking this cholesterol drug with red yeast rice can increase myopathy risk.
- Liver-harming drugs, herbs, and supplements. Monacolin K can cause liver damage in some people. Taking red yeast rice with these drugs, herbs, and supplements may increase your liver damage risk.
- Niacin. Taking red yeast rice with high-dose niacin may increase myopathy risk.
- St. John’s wort. Taking this supplement with red yeast rice can reduce red yeast rice’s effectiveness.
- Statin. Using red yeast rice with other statins may increase side effect risks.
If you are going to use red yeast rice supplements, most major supplement brands on the market generally recommend taking between 1,200–2,400 milligrams daily, divided into two or three doses. The optimal effective dose is unknown, so be cautious about lessening the probability of side effects.
Because of the potential side effects of red yeast rice, please speak with your healthcare provider to determine the optimal dosage for you.
How I lowered my cholesterol: I have used red yeast rice supplements over the last year to drop my LDL cholesterol significantly. I was surprised to learn of the perils of my habit.
If you choose to use red yeast rice supplements, try to select a high-quality one. Please ensure the supplements come from a certified Good Manufacturing Practices (cGMP) facility, which meets US Food and Drug Administration criteria.
Sometimes, the supplements are tested for purity and ingredients (by third parties) to ensure the supplement is properly labeled and that the product is contaminant-free. Buyer beware: So-called natural products and supplements come with some risks.
Thank you for joining me today to look at how I lowered my cholesterol with red yeast rice supplements.
The information I provided in this blog is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you seek medical advice, diagnoses, or treatment. I am not liable for risks or issues associated with using or acting upon the information in this blog. Thank you for joining me in this brief look at how I lowered my cholesterol using red yeast rice.
