Red Yeast Rice

Last Updated: January 4, 2024

Red yeast rice (RYR) is a fermented rice used traditionally in East Asia as a medicine and food. Supplementation with RYR seems to reduce cholesterol levels and may improve overall cardiovascular health. The main active compound in RYR is monacolin K, which is identical to the cholesterol-lowering medication lovastatin.

dosageDosage
examine-databaseExamine Database
research-feedResearch feed
Red Yeast Rice is most often used forCardiovascular Health.The Examine Database covers Atherosclerosis,Type 2 Diabetes, and 3 other conditions and goals.
57 references on this page
14,669 participants in trials and 4 meta-analyses
Red Yeast Rice is linked to 5 conditions and outcomes. Get Examine+ to unlock these insights and the details of over 50,000 other studies.
What is red yeast rice?

Red yeast rice (RYR) is a fermented rice with a long history of use as a food and medicine in East Asia.[8] RYR is produced by fermenting white rice (Oryza sativa) with an edible fungus, most commonly Monascus purpureus, which results in the production of a variety of bioactive compounds and pigments, the latter of which imparts a reddish-purple color to the rice.[7] The primary active compound in RYR is thought to be monacolin K, which is structurally identical to the cholesterol-lowering medication lovastatin.[7] However, the type and amount of monacolins present in RYR can vary depending on the fermentation conditions and the type of yeast used.[9] The majority of research on RYR has examined its effects on dyslipidemia and general cardiovascular health, with promising results.

What are the traditional uses of red yeast rice?

What are red yeast rice’s main benefits?

In clinical trials, RYR consistently demonstrates the ability to improve lipid profiles in people with dyslipidemia. RYR seems to reduce low-density lipoprotein (LDL) cholesterol, triglyercides, total cholesterol, and apolipoprotein B; it also seems to increase high-density lipoprotein (HDL) cholesterol.[5][10] Overall, RYR is thought to reduce LDL cholesterol by 15 to 25% within 6 to 8 weeks, and its effect on lipid profiles is comparable to moderate-intensity statin medications (first-line cholesterol-lowering medications).[11][5] RYR may improve markers of atherosclerosis and protect against major adverse cardiac events; however, most of this research has been conducted in Chinese populations, and its generalizability to other populations is not clearly established.[3][12][4] RYR may also reduce systemic inflammation, as suggested by reductions in C-reactive protein, although this effect is less thoroughly researched.[13][14][15]

Does red yeast rice impact bone health?

Can red yeast rice be a replacement for statin medications?

What are red yeast rice’s main drawbacks?

RYR appears to be well-tolerated by most people, and generally, studies have not found differences in rates of side effects between RYR and placebo.[9][16] Despite this, several case reports have suggested that, on rare occasions, RYR supplementation at normal dosages (equivalent to 3–10 mg daily of monacolin K) may cause rhabdomyolysis (dangerous muscle breakdown) or hepatitis (liver inflammation).[17] Rhabdomyolysis is a known risk of treatment with prescription statin medications, including lovastatin, and is estimated to occur in 1 in every 10,000 people.[18][19] Hepatitis has also very rarely been observed with lovastatin treatment.[20] Additionally, RYR supplements can contain citrinin which is a potentially harmful compound produced during fermentation. Citrinin can be toxic to the liver and kidneys and care should be taken to choose an RYR supplement that is citrinin-free.[7]

Importantly, monacolin K is metabolized by cytochrome P450 3A4 (CYP3A4) enzymes. Medications or foods that inhibit CYP3A4 (e.g., verapamil, clarithromycin, ketoconazole, ritonavir, grapefruit) can lead to increased levels of monacolin K in the blood and this combination should be avoided.[9] Additionally, RYR should not be taken in addition to statin medications. This combination may increase the risk of serious side effects and isn’t likely to provide additional therapeutic benefits.[17][5]

Lastly, there is a concerning degree of variability in the content of monacolin K in RYR, and most supplements are not transparent about how much of this active compound they contain. For example, a study conducted in the United States found that the amount of monacolin K in 26 tested supplements differed up to 60-fold.[21] This could lead to inconsistencies in the effectiveness of RYR supplementation.

How does red yeast rice work?

RYR contains a variety of compounds with biological activity, but monacolins — a class of metabolites produced through fungal fermentation — are considered the main active ingredients. Monacolins, particularly monacolin K, work in the same way as statin medications, which involves the inhibition of a key enzyme involved in cholesterol synthesis, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase.[4] Therefore, RYR effectively reduces the body's own synthesis of cholesterol. Interestingly, the pigments found in RYR may also contribute to this lipid-lowering effect. Animal research suggests that these pigments may influence lipid metabolism and lead to an increase in the excretion of cholesterol, triglycerides, and bile acids in the feces.[22]

What are other names for Red Yeast Rice?
Note that Red Yeast Rice is also known as:
  • RYR
  • Hongqu
  • Red koji
  • Angkak
  • Monascus
  • Red fermented rice
  • Red mold rice
  • Xueshikang (a Traditional Chinese Medicine standardized extract)
  • Zhibituo (a Traditional Chinese Medicine standardized extract)
Red Yeast Rice should not be confused with:
  • Lovastatin (active ingredient)
  • Monascus purpureus (mold used in processing)
Dosage information

⚠️ Caution: Not all RYR supplements contain the main active ingredient, monacolin K

Since monacolin K is identical to the prescription medication lovastatin, some countries, including Canada and the United States, only allow the sale of RYR supplements containing trace amounts of monacolin K. This could diminish the efficacy of RYR supplementation.[1][2]

In clinical trials, the most common dosage of RYR is 600 mg twice daily. This dose has demonstrated effectiveness for reducing LDL cholesterol, improving atherosclerosis, and lowering the risk of major adverse cardiac events.[3][4][5] Importantly, most clinical trials have used a traditional Chinese medicine standardized extract, Xuezhikang. At a dose of 600 mg twice daily, Xuexhikang would provide about 10 mg daily of the active compound monacolin K, which is suggested to be the adequate amount for reducing LDL cholesterol.[6][7] Ultimately, most supplements don’t disclose the amount of monacolin K they contain, which makes it challenging to ensure adequate doses are achieved.

Supplements Demystified: Get Our Unbiased, Evidence-Based Guide

Examine Database: Red Yeast Rice
Create a free account to unlock more rows for free
Show Conditions
Atherosclerotic Signs
C
Small Improvement
What works and what doesn't?

Unlock the full potential of Examine

Get started
Research FeedRead all studies
Red yeast rice for lowering cholesterol

July 2, 2024

#Dietitians

•

Cardiovascular Health

•

High Cholesterol

In this meta-analysis of clinical trials in participants with high cholesterol, red yeast rice reduced LDL cholesterol to a clinically meaningful degree.

Does taking a supplement containing red yeast rice and fish oil improve blood lipids?

February 14, 2024

Cardiovascular Health

•

High Cholesterol

•

Omega-3 Fatty Acids

Create a free account to unlock this study summary.

(Get started with your free account)

Blanditiis fuga ab deserunt dolorum sit. Recusandae exercitationem cumque officiis ipsam necessitatibus excepturi nemo. Necessitatibus labore velit molestias similique distinctio commodi dolore magnam quos. Laudantium minima veniam id corrupti soluta perferendis a quaerat nam. In exercitationem reprehenderit dolorum temporibus illo vel. Officia officia impedit.

Red yeast rice is effective for reducing LDL-C

November 2, 2021

Cardiovascular Health

•

High Cholesterol

Full study summary unlocked for Examine+ members (Sign in)

Quia nisi ipsam voluptates incidunt voluptate maiores recusandae eius commodi. Ipsam illum repellat nam earum debitis. Hic occaecati quaerat nisi dicta. Ducimus ducimus eveniet deserunt consectetur sunt et voluptas perspiciatis iusto. Atque accusamus dignissimos illo. A suscipit porro veniam asperiores voluptatum. Aut deserunt voluptatem nobis. Iusto error et cum rerum mollitia.

Can LEVELIP DUO® naturally lower your LDL-C?

December 7, 2020

#ConflictOfInterest

•

#Dietitians

•

Cardiovascular Health

Full study summary unlocked for Examine+ members (Sign in)

Sequi corrupti quod itaque iusto commodi culpa ea. Corrupti minima voluptatum in. Unde error explicabo nemo. Architecto occaecati nobis nisi quas dolore ullam molestias. Sed mollitia accusantium distinctio. Architecto provident quidem tempora. Molestiae voluptates libero debitis cum harum quasi libero doloribus ratione. Esse quasi labore aspernatur nam vitae. Officiis beatae soluta possimus dolores voluptatum nisi aspernatur. Quas pariatur cumque expedita ipsam.

Don't miss out on the latest research

Frequently asked questions
What is red yeast rice?

Red yeast rice (RYR) is a fermented rice with a long history of use as a food and medicine in East Asia.[8] RYR is produced by fermenting white rice (Oryza sativa) with an edible fungus, most commonly Monascus purpureus, which results in the production of a variety of bioactive compounds and pigments, the latter of which imparts a reddish-purple color to the rice.[7] The primary active compound in RYR is thought to be monacolin K, which is structurally identical to the cholesterol-lowering medication lovastatin.[7] However, the type and amount of monacolins present in RYR can vary depending on the fermentation conditions and the type of yeast used.[9] The majority of research on RYR has examined its effects on dyslipidemia and general cardiovascular health, with promising results.

What are red yeast rice’s main benefits?

In clinical trials, RYR consistently demonstrates the ability to improve lipid profiles in people with dyslipidemia. RYR seems to reduce low-density lipoprotein (LDL) cholesterol, triglyercides, total cholesterol, and apolipoprotein B; it also seems to increase high-density lipoprotein (HDL) cholesterol.[5][10] Overall, RYR is thought to reduce LDL cholesterol by 15 to 25% within 6 to 8 weeks, and its effect on lipid profiles is comparable to moderate-intensity statin medications (first-line cholesterol-lowering medications).[11][5] RYR may improve markers of atherosclerosis and protect against major adverse cardiac events; however, most of this research has been conducted in Chinese populations, and its generalizability to other populations is not clearly established.[3][12][4] RYR may also reduce systemic inflammation, as suggested by reductions in C-reactive protein, although this effect is less thoroughly researched.[13][14][15]

Update History