From the Guidelines
Red yeast rice can reduce total cholesterol by approximately 10-30% and LDL ("bad") cholesterol by 15-25%. These reductions typically occur over a period of 8-12 weeks of regular supplementation. The cholesterol-lowering effect of red yeast rice is primarily due to its active component monacolin K, which is structurally identical to the prescription medication lovastatin. Monacolin K works by inhibiting HMG-CoA reductase, an enzyme crucial for cholesterol production in the liver.
- Typical effective doses range from 1,200 to 2,400 mg daily, usually divided into two doses.
- However, it's essential to note that red yeast rice products vary significantly in their monacolin content, which affects their potency.
- Before starting red yeast rice supplementation, consult with a healthcare provider, especially if you're taking other medications, as it may interact with certain drugs including statins, blood thinners, and certain antifungals.
- Side effects can be similar to prescription statins, including muscle pain and liver enzyme elevations, so medical supervision is recommended 1. Some studies suggest that the degree of risk reduction depends on the extent of lowering, not on the therapeutic modality, with statins lowering LDL-C by 35% to 55% 1. However, the most recent and highest quality study on the topic of red yeast rice is not explicitly stated in the provided evidence, but based on the available information, red yeast rice can be a viable option for reducing cholesterol levels, with the understanding that its effects and interactions should be closely monitored by a healthcare provider 1.
From the Research
Red Yeast Rice and Cholesterol Reduction
- Red yeast rice (RYR) has been shown to reduce low-density lipoprotein (LDL) cholesterol levels by approximately 15-34% versus placebo 2.
- The reduction in LDL-cholesterol is accompanied by a proportional decrease in total and non-high-density lipoprotein cholesterol, plasma apolipoprotein B, and high-sensitivity C-reactive protein 3, 4.
- Consuming monacolin K, a component of RYR, on a daily basis reduces LDL cholesterol plasma levels between 15% and 25% within 6 to 8 weeks 3, 4.
- RYR supplementation has also demonstrated beneficial reductions of up to 45% versus placebo in the risk of atherosclerotic cardiovascular disease (ASCVD) events in secondary prevention studies 2.
Variability in Reduction Percentage
- The percentage reduction in cholesterol levels may vary depending on the study, with some studies reporting reductions of 15-25% 3, 4 and others reporting reductions of 15-34% 2.
- The variability in reduction percentage may be due to differences in the formulation and dosage of RYR used in the studies, as well as the population being studied.
Safety and Efficacy
- RYR has been shown to be a safe and effective supplement for managing mild to moderate hypercholesterolemia in people with no additional cardiovascular risk factors 3, 2, 4.
- The risk associated with daily consumption of 3-10 mg monacolin K is minimal, with mild myalgias seen only in the frailest patients 3, 4.