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Red Yeast Rice

Uses

Botanical names:
Monascus purpureus

Parts Used & Where Grown

This substance, native to China, is a fermentation by-product of cooked non-glutinous rice on which red yeast has been grown.1 The dried, powdered red yeast rice is used medicinally.

What Are Star Ratings?

This supplement has been used in connection with the following health conditions:

Used for Why
3 Stars
High Cholesterol
600 to 1,200 mg with 2.5 to 5 mg of monacolin K twice daily
Red yeast rice contains a compound that is well known to inhibit production of cholesterol in the liver.

contains a compound called monacolin K (also known as lovastatin) that reduces production of cholesterol by inhibiting HMG-CoA reductase, a key enzyme in cholesterol synthesis. Multiple clinical trials have shown red yeast rice can effectively lower high total, LDL-, and non-HDL-cholesterol levels. In fact, six to eight weeks of treatment with red yeast rice extract has been found to reduce LDL-cholesterol levels by 15–25%.

Lovastatin (Mevacor)and several of its analogs, collectively called statins, are used as prescription drugs used to treat high cholesterol. However, a typical daily dose of red yeast rice extract provides 10 mg or less monacolin K, while a common dose of lovastatin is 20 to 40 mg per day. It has been suggested that other compounds, including other monacolins, present in red yeast rice work together with monacolin K to produce a greater cholesterol-lowering effect than would be expected from the small amount of monacolin K alone. Nevertheless, monacolins in red yeast rice products vary widely and are often not accurately quantified on labels, and red yeast rice has demonstrated a similar adverse side effect profile to lovastatin. Because HMG-CoA reductase also plays a role in synthesis of coenzyme Q10, an antioxidant needed for mitochondrial energy production, a small amount of coenzyme Q10 is sometimes included in red yeast rice supplements.

A randomized controlled trial comparing a monacolin K-containing red yeast rice product and a monacolin K-free red yeast rice product to placebo found only the monacolin K-containing supplement lowered cholesterol levels. An uncontrolled clinical trial in 25 subjects with low to moderate cardiovascular risk found supplementing with red yeast rice providing 3 mg monacolin K plus 30 mg of coenzyme Q10 daily for one year reduced total, LDL-, and non-HDL-cholesterol, as well as triglyceride and high-sensitivity C-reactive protein (hs-CRP, a marker of vascular inflammation) levels. In addition, vascular characteristics had improved at the end of the trial. In a controlled trial that included 104 participants with high cholesterol levels enrolled in a diet and lifestyle program, those additionally treated with a red yeast rice supplement providing 10 mg monacolin K and 30 mg coenzyme Q10 per day had greater reductions in total and LDL-cholesterol levels, as well as blood pressure, than those receiving no supplements.

2 Stars
Heart Attack (Xuezhikang; for post-event treatment only, not acute attacks )
300 mg twice a day (with doctor supervision)
In one trial that included patients with a previous history of a heart attack, supplementing with a particular brand of Chinese red yeast rice that contained 6 mg per day of lovastatin (a statin drug) reduced risk of death from heart disease. 
In a double-blind trial that included patients with a previous history of a heart attack, supplementation with a particular brand of Chinese red yeast rice (Xuezhikang) in the amount of 300 mg twice a day for an average of 4.5 years reduced the death rate from heart disease by about one-third, compared with a placebo. Xuezhikang is grown by a method that increases its content of lovastatin (a statin drug), and patients in this study received about 6 mg per day of lovastatin from taking Xuezhikang. It is not known whether other red yeast rice products would produce similar benefits.
2 Stars
High Triglycerides
13.5 mg total monacolins daily
Although primarily used to lower high serum cholesterol, red yeast rice extract, high in monacolins, has been found to significantly lower serum triglyceride levels.

Although primarily used to lower high serum cholesterol, extract, high in monacolins, has been found to significantly lower serum triglyceride levels. People in the trial took 1.2 grams (approximately 13.5 mg total monacolins) of a concentrated red yeast rice extract per day for two months. The sale of Cholestin has been banned in the United States, as a result of a lawsuit alleging patent infringement. Other red yeast rice products currently on the market differ from Cholestin in their chemical makeup. None contain the full complement of 10 monacolin compounds that are present in Cholestin, and some contain a potentially toxic fermentation product called citrinin. Until further information is available, red yeast rice products other than Cholestin cannot be recommended.

Traditional Use (May Not Be Supported by Scientific Studies)

Since 800 A.D., red yeast rice has been employed by the Chinese as both a food and a medicinal agent. Its therapeutic benefits as both a promoter of blood circulation and a digestive stimulant were first noted in the traditional Chinese pharmacopoeia, Ben Cao Gang Mu-Dan Shi Bu Yi, during the Ming Dynasty (1368–1644).2 Practitioners of Traditional Chinese Medicine use red yeast rice to treat abdominal pain due to stagnant blood and dysentery, as well as external and internal trauma.3 In addition to its therapeutic applications, red yeast rice has been used for centuries as a flavor enhancer, a food preservative, and a base for a Taiwanese alcoholic rice-wine beverage.4, 5

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