Derived from yeast grown on rice, red yeast rice has been a staple of some Asian countries for more than 1,000 years. When used as a supplement, there is evidence that red yeast rice may have many benefits, including lowering LDL or "bad" cholesterol. Read on to learn more about this powerful supplement and the facts behind the controversy.
What is Cholesterol?
It is important to first discuss cholesterol and what is a high level in the bloodstream. Total blood cholesterol is the number you receive as a test result and is the most common measurement of cholesterol. Cholesterol is measured in milligrams per deciliter of blood (mg/dL). The following are recommendations by the American Heart Association:
Less than 200 mg/dL is a desirable level that puts you at lower risk for coronary heart disease. A cholesterol level of 200 mg/dL or higher raises your risk.
200 to 239 mg/dL is considered borderline high
240 mg/dL and above is high blood cholesterol. A person with this level has more than twice the risk of coronary heart disease as someone whose cholesterol is below 200 mg/dL.
There are also two types of cholesterol. "Good" cholesterol is HDL or high-density lipoprotein and "bad" cholesterol is known as LDL's or low-density lipoprotein. The American Heart Association recommends 60 mg/dL and above for your HDL levels, and less than 100 mg/dL for your LDL levels.
What Exactly is Red Yeast Rice?
First documented in China, red yeast rice started being used during the Tang Dynasty in 800 A.D for gastric problems, stomach health and blood circulation. Monacolin is a substance found in red yeast rice that may help lower cholesterol. Monacolin derivatives are used to make statin drugs, which are prescribed for high cholesterol. According to the Mayo Clinic, red yeast rice in a dried, powdered form is called Zhi Tai. When extracted with alcohol, it is called Xue Zhi Kang.
How Does Red Yeast Rice Work?
Red yeast rice, when fermented under certain conditions, may contain significant amounts of mevinic acids, including lovastatin. Dr. Christopher Cannon, a cardiologist at Boston's Brigham and Women's Hospital, describes Lovastatin as "an HMG-CoA reductase inhibitor, more commonly known as a statin. Statins work by blocking HMG-CoA reductase, an enzyme that controls the rate of cholesterol production in the body. This causes the liver to make less cholesterol."
Red yeast rice may also contain plant sterols, such as beta-sitosterol, which are compounds that may also help lower cholesterol.
Studies Using Red Yeast Rice
A common complaint of statin medication, when used for lowering cholesterol, is that it causes muscle pain or myalgia. According to a study published in the Annals of Internal Medicine, an over-the-counter dietary supplement of red yeast rice sold at pharmacies and health-food stores may be a workable alternative for people who have statin-related muscle pain. The study pointed out that it seems, when combined with diet and lifestyle changes, red yeast rice supplements can lower LDL cholesterol levels by more than 20 percent without a substantial risk of muscle pain.
In the same study from the Annals of Internal Medicine the LDL levels of those taking the active red yeast rice had declined 27 percent in three months compared with 6 percent in the placebo group; at six months the decline in the active group was still more than 21 percent.
However, CNN reports that in 2008, the supplement-industry watchdog group ConsumerLab.com analyzed 10 brands of capsules whose labels advertised 600 milligrams of red yeast rice. When the products were tested in a lab they were found to contain wildly different amounts of lovastatin and other compounds. "There was a 100-fold difference from the lowest to the highest," says ConsumerLab.com president Tod Cooperman. An unexpectedly large dose of lovastatin could cause serious side effects and could interact with other drugs.
Warnings
CNN cautions consumers who buy red yeast rice off the shelf because they don't necessarily know what they're getting. The Food and Drug Administration does not regulate dietary supplements, and the contents and potency of red yeast rice pills have been shown to vary widely among manufacturers.
Lead study author David Becker, M.D., of Chestnut Hill Cardiology in Pennsylvania cautions that "red yeast rice isn't appropriate for everyone with high cholesterol." He explains that "people who have had a heart attack or who have significant blockages in their arteries due to atherosclerosis should not replace a statin or other medical therapy with red yeast rice, since statins are proven to reduce the risk of heart attack and death."
Managing cholesterol levels will take other efforts including adding in physical activity and modifying a daily diet. Be sure to receive an exam by a physician and consult with your doctor about what is right for you when it comes to high cholesterol, statins and red yeast rice supplementation.
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