Should You Take Red Yeast Rice to Lower Cholesterol?

Cleveland Clinic experts evaluate this supplement for reducing high cholesterol.

If you have high cholesterol, no doubt you know what statins are. These cholesterol-lowering drugs are often prescribed when diet and exercise changes don’t reduce high cholesterol. Statins work by interfering with the production of cholesterol in the liver, thereby lowering bad cholesterol and raising good cholesterol. While relatively safe for most people, some people should not take statins, and some people don’t tolerate the drug’s side effects. Red yeast rice, a “natural statin,” is an available alternative. Should you take this supplement? Experts on the Cleveland Clinic Prescriptive Wellness Committee weigh in on the pros and cons:

On the Pro Side: Red yeast rice lowers total and LDL (bad) cholesterol by about 20 and 25 percent respectively, say committee doctors. And when it’s combined with high-quality fish oils and lifestyle changes, red yeast rice may lower LDL cholesterol by as much as 45 percent.

A large study in China of people who had already had a heart attack showed a significant reduction in repeat complications with the use of red yeast rice. LDL cholesterol was lowered by about 20 percent in that population. Red yeast rice also contains plant sterols, which lower cholesterol further.

On the Con Side: Michael F. Roizen, MD, the Cleveland Clinic’s chief wellness officer, is not a fan of using red yeast rice to lower cholesterol. Many red yeast rice products contain citrinin, a toxin that causes kidney damage, he says. Consumers must avoid products containing any amount of citrinin, warns Dr. Roizen.

Another problem is that the concentration of lovastatin — the active ingredient in red yeast rice — is variable among brands, meaning that cholesterol-lowering effects may vary. Lovastatin is currently available by prescription, which Dr. Roizen says is a better bet. The prescription will have a standard amount of the drug, and you’ll avoid concerns of possible citrinin contamination.

Additionally, there is no evidence of fewer side effects from red yeast rice than from prescribed statins, points out Dr. Roizen. Red yeast rice can also be considerably more costly than prescribed generic statins, and it will not be covered by most insurance plans.

Committee Conclusion: Experts on the Cleveland Clinic Prescriptive Wellness Committee conclude that red yeast rice is a safe and effective product for lowering total and LDL cholesterol.

However, there are no documented advantages to its use over prescribed statins. Cleveland Clinic doctors therefore recommend prescribed statins over red yeast rice due to cost, side effects, ingredient consistency and concerns about citrinin toxicity.

If you do use red yeast rice, select a product that is high in lovastatin and documented to be citrinin-free, and remember to include it in your list of medications when you visit your doctor and other health care providers. Know that the dosage of red yeast rice depends on the manufacturer’s method of preparation, so follow the instructions on the label.

-- Let Cleveland Clinic help you lower high cholesterol
-- Improve your heart health
-- Find other vitamins and supplements that are good for you 

Learn more:
-- High Cholesterol Spotlight  
-- 30 Cholesterol-Lowering Tips from the Cleveland Clinic
-- 7 Foods That Lower Cholesterol 

NEXT... Should You Take Coenzyme Q10 If You Are Taking a Statin to Lower Cholesterol?

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