Does Red Yeast Rice Work?

December 10, 2011 5:40 AM

My doctor wants me to take red yeast rice supplements to lower cholesterol. However, I read that it is illegal to sell red-yeast rice supplements in the USA that contain the active ingredient (natural statins). If this is correct, then taking them is obviously a waste of time and money. Can anybody confirm the efficacy of red-yeast rice supplements?
posted by Seymour Zamboni to health & fitness (14 answers total)

I have several family members who are taking red rice yeast supplements and claim it is working to lower their cholesterol. I have one family member for whom it is not helping. I have no idea where they are getting their yeast or what kind it is, but I'm 99% certain it comes from the united states.
posted by dpx.mfx at 5:48 AM on December 10, 2011

In order to be sold legally in the US without being regulated by the FDA as drugs, nutritional supplements can't make any specific health claims. Apparently, what the FDA has decided that means for Red Yeast Rice is that the manufacturers are not permitted to tell consumers anything about whether the pills contain natural statins or how much they might contain, if any. I would ask your doctor why, if s/he wants you to take a statin, s/he wants you to take an unknown dose rather than a prescription dose that is tested and regulated as safe and effective for your condition.
posted by decathecting at 5:49 AM on December 10, 2011 [8 favorites]

And that is a good thing. "Nutritional supplements" is a fancy way of saying "unproven therapies" in the best case, quack snake oil in the more common case.
posted by spitbull at 5:56 AM on December 10, 2011

I tried real statins like lipitor. My creatine levels spiked and I had to discontinue use. When my doctor suggested red yeast rise, he did quote a peer-reviewed study that showed it can work, but I don't have the specific reference.
posted by Seymour Zamboni at 5:58 AM on December 10, 2011

To add to what Decathecting said: red yeast rice supplements used to contain the same active ingredient as commercially-made statin drugs, but the FDA banned that back in 2001. I would be very concerned that your doctor does not know that. If your doctor has determined that you need a statin drug, your doctor should prescribe one for you, or you should find another doctor who can.
posted by deadmessenger at 6:00 AM on December 10, 2011 [3 favorites]

Your doctor notes that you have a bad reaction to statins, and prescribes you statins in a different form - which from the links seems to be what the active part of red yeast rice is. It's not just about not knowing the doses in the supplement, it's also about the fact that this doesn't seem to be an alternative to statins at all.

There are other medications that have lipid lowering effects - not as effective as statins, but good alternatives for people who can't tolerate statins. I honestly don't know why any doctor would prefer a treatment where you don't know the amount of active ingredient you get in each dose, and where the patient is known to be intolerant to the active ingredient, over these alternatives.
posted by Coobeastie at 7:34 AM on December 10, 2011 [2 favorites]

Not much time but just throwing this out there for you.

A quick google scholar search pulled up this paper that is cited very often(~300 times)and it looks like a small, placebo-controlled study.

As for dangers of an unregulated substance, this study loooked at the amount of monacolin in different red yeast rice supplement,and they found wide variability, which would be expected if not standardized. The danger from an unknown amount is: what is the right dosage?Too little,then no effect of the substance on the desired endpoints, too much,you risk adverse events. Because this is not FDA-regulated, I'd also concerned if there are contaminants in what you purchase (these have been found in other supplements).

As an FYI, there are lot of ongoing or completed small clinical studies evaluating it (so maybe it is/will be promising), but this is far from what you would see for an approved drug.
posted by Wolfster at 8:19 AM on December 10, 2011

Using a sample of only one and anecdotal evidence my MIL has a miryad of health problems and the doctor was hesitant to put her on lipitor or such because she has had strong reactions to different drugs. She went instead on a mix of Red Rice Yeast, Fish Oil and something else (the name escapes me I can chase it up with her if you want I know she had to take it at night as it caused her hot flashes) in 6 months she halved her triglycerides and cut her cholesterol levels by almost the same amount. She was being monitored by a doctor when she did this and having seen what she was eating I know she didn't change her diet or anything else to explain it.
posted by wwax at 8:23 AM on December 10, 2011

My mom was told by her doc to take red rice yeast. I gather it's pretty common in the medical community to recommend it. She had no problems with it.
posted by St. Alia of the Bunnies at 9:15 AM on December 10, 2011

Here is a 2007 Medical News Today article about an (the?) FDA warning against taking red yeast rice bought over the internet.

And here is a 2009 MNT article about a study by two cardiologists who claim it works well for people who don't want to take prescription statins for some reason:

Cardiologists David Becker, M.D., and Ram Gordon, M.D., Chestnut Hill Cardiology, studied 62 patients with high cholesterol in the first randomized, double-blinded placebo-controlled trial to evaluate red yeast rice in patients with a history of statin-associated myalgias (side effects that include muscle pain and weakness). ...


"Every physician has patients who refuse to take statins or have significant side effects from them," says Dr. Becker. "One of the largest challenges in the medical community has been that there is no agreement or consensus on how to treat these patients. We are convinced that our research may lead to some answers."
posted by jamjam at 10:00 AM on December 10, 2011

Red yeast rice contains lovastatin. Lovastatin is also available in pills. Your body can't tell the difference. If you take a pill, you know exactly how much lovastatin you're getting. If you take RYR, you don't.

Lovastatin and Lipitor are more likely to cause muscle problems than some other statins. Pravastatin, which is available cheap (WalMart sells 30 for $4, 90 for $10) is less likely to cause muscle problems.
posted by neuron at 11:35 AM on December 10, 2011

Once lovastatin gained FDA approval as a drug natural products containing it, such as red yeast rice, were banned as adulterated substances. This does not mean that they do not work. Rather they contain a drug and have not gone through the drug approval process.
posted by caddis at 11:45 AM on December 10, 2011

It may be worth inquiring about the details of your condition - LDL particle size, and so on. Statin drugs have shown no mortality benefit in most populations and actually shift LDL to the more harmful small-pattern profile; their benefits may be a side effect of their anti-inflammatory nature. If you haven't attacked this problem through diet, it may be worthwhile to consider every angle of attack here. And as others have said, lovastatin in RYR is a real statin - do monitor your condition re: your trouble with other statins if you try it.
posted by Earl the Polliwog at 10:42 PM on December 10, 2011

my MIL has a miryad of health problems and the doctor was hesitant to put her on lipitor or such because she has had strong reactions to different drugs. She went instead on a mix of Red Rice Yeast, Fish Oil and something else

FYI: A NIH study was terminated early because the combination of a statin drug and Niacin introduced an increased risk of strokes without providing any additional benefit to patients.
posted by SpecialK at 10:33 PM on December 11, 2011