Red yeast rice refers to a traditional Chinese medicinal product. Proponents suggest that it may reduce blood cholesterol and other fats in the blood. However, the composition of the product can vary, and it may contain harmful ingredients that can result in adverse effects.
Benefits of red yeast rice: Red yeast rice has gained attention as a natural supplement to help lower cholesterol. High cholesterol, particularly low-density lipoprotein (LDL) cholesterol, is a potential risk factor for heart disease. To lower cholesterol, a doctor can prescribe statins, but some people may not want to take medications and instead want to use natural alternatives such as red yeast rice.
A 2019 review relates that consuming monacolin K in red yeast rice on a daily basis can reduce LDL cholesterol plasma levels by 15–25% within 6–8 weeks. Additionally, red yeast rice may lower markers for inflammation and total cholesterol. The review suggests that consuming 3–10 milligrams (mg) of monacolin K daily may have low associated risks. Additionally, it indicates that red yeast rice is a safe and effective way to manage mild to moderate hypercholesterolemia in people with no additional cardiovascular risk factors. Other possible benefits, which may include it: controlling high blood pressure, being anti-inflammatory, being hypoglycemic (lowering blood sugar), having anti-cancer properties, being osteogenic (aiding bone formation).
Safety and risks: People produce the product through a fermentation process involving cooked rice kernels with a Monascaceae mold, typically Monascus purpureus, which turns the rice reddish-purple due to its pigmentation capability. The term purpureus is Latin for dark red. In addition to turning the rice red, the fermentation process with this yeast produces substances known as monacolins. Notably, monacolin K is chemically identical to an active ingredient in some statins, which can reduce the liver’s production of cholesterol. However, the composition of red yeast rice varies depending on the yeast strains and culture conditions. Not only may some products contain very little or no monacolin K, but they can also contain harmful contaminants, such as citrinin, which may damage the kidneys.
As such, it suggests that red yeast rice products should come with appropriate warnings and highlight the varying monacolin K content and the scarcity of long-term safety data for these products. A 2020 study emphasizes the variability in the strength of red yeast rice supplements available in the United States. Analyzing brands of red yeast rice for the presence of monacolin K, the study found that some products contained none, whereas, in others, the quantity ranged more than 60-fold from 0.09–5.48 mg per 1200 mg serving. Using recommendations for daily serving sizes, this could range more than 120-fold from 0.09–10.94 mg.
The FDA warns against using red yeast rice products, stating that people may risk severe muscle problems leading to kidney impairment. Furthermore, monacolin K present in red yeast rice may interact with medications, including: the antidepressant nefazodone, some antibiotics, drugs that people use to treat fungal and HIV infections, other cholesterol-lowering medications.
Additionally, the National Center for Complementary and Integrative Health warns that red yeast rice products may contain citrinin, a toxin that can lead to kidney failure. It adds that people who are pregnant, breastfeeding, or taking statins should avoid red yeast rice.
People who wish to try red yeast rice should consult their doctor first, especially if they currently take medications.
Sources: https://www.medicalnewstoday.com/articles/red-yeast-rice
https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.14599
