Red Yeast Rice Extract

Cholesterol reduction has become part of the national standard in treating heart disease. A surge in cholesterol medication usage has also led to billions of dollars in medication prescriptions and a side effect list that must be monitored. Patients have sought various options to treat high cholesterol levels, including the supplement red yeast rice extract, to produce the benefit needed to lower cholesterol and protect the heart.

Red yeast rice extract (RYR) comes from a spice used in the Chinese culture for centuries. It has long been considered a treatment for the vascular system, but does it actually lower cholesterol? Current studies would suggest it does. Multiple studies have documented that RYR lowers total and LDL cholesterol along with triglycerides, and can even help raise good HDL cholesterol [Source: Zhao, Liu]. One literature review even suggested that RYR might have as positive of a benefit as the regular cholesterol medications (statin drugs) [Source: Liu]. This is great news because RYR is relatively cheap and found in supplement form in most health food stores.

Heart disease is more than just a cholesterol issue, however. One of the perceived major benefits of statin drugs, like Lipitor, are that they possibly help lower inflammation in the body. It's chronic inflammation in the body that is thought to contribute to chronic disease, like heart disease. RYR has demonstrated the ability to lower CRP levels, a test for chronic inflammation as a risk for heart disease [Source: Liu, Zhao]. Additionally, RYR has shown benefit in treating lipoprotein (a), another risk factor for heart disease that is often not checked during a regular screening [Source: Liu]. RYR has shown significant benefits for cholesterol, inflammation and even particle size (lipoprotein a). It has also shown protection to the very delicate lining of the blood vessels, the endothelium. This inner layer of the blood vessels is extremely sensitive to damage but is critically important to the health and function of the blood vessels. RYR has provided protection of this layer, demonstrating further versatility as a heart health supplement.

The most important statistic with any treatment for chronic disease is how well the treatment prevents death. It will not do us any good to take a supplement, like RYR, or pay for an expensive pharmaceutical, if lowering cholesterol does not help improve our life span. Many doctors have also shared concern that they are not confident prescribing RYR since they can not be sure it will prevent heart disease. Fortunately, a large study with more than 4,500 patients looked at RYR compared to a placebo over a four-year period to see if long-term safety data showed protection against heart disease and death [Source: Lu]. The study clearly demonstrated significant decreases in heart attack and death. This study is important because it ran over a period of several years and included several thousand patients. Patients can be more confident that RYR lowers cholesterol and inflammation, preserves the delicate, yet important, endothelial lining and also provides the end result of lowering the risks of heart attack and death.

RYR as Medication

RYR has gained more attention as patients became disenchanted with the side effects and costs of traditional medications. Traditional cholesterol medications, called statins (Lipitor, Zocor and Crestor, for example) are known to affect the liver. Regular blood tests to monitor the liver are recommended. These drugs are also associated with muscle aches, fatigue, change in mental function and, rarely, a very serious destruction of muscle tissue. Research has suggested that the effect statin drugs have on our memory and mental function can be more widespread than we think [Source: Muldoon]. These drugs are actually derivatives of red yeast rice, so it is understandable why they would have similar efficacy of RYR. This means they could also share some side effects. 

Fortunately, in the clinical setting, RYR is tolerated well. Research has also shown that RYR seems to have limited side effects, though some studies lasted only a few months [Source: Lu, Lin]. Some believe the reason statin medications can cause certain side effects, like muscle aches, is because they not only block the formation of cholesterol, but will also block the formation of CoQ10. CoQ10 is vital to basically every cell in the body, including the heart, brain and muscles. I recommend that every patient taking a statin drug also take CoQ10 to hopefully prevent any deficiency and potential side effects. I would extend this recommendation for those taking RYR as well. Even if the RYR is not causing side effects, taking CoQ10 benefits the body and helps avoid any deficiency. If muscle aches occur with RYR, stop the supplement and see if the muscle aches go away.

The usual recommended dose for RYR is 1.2 to 2.4 grams daily. One very important component in choosing a RYR product is to ensure that it is free of citrinin, a potentially toxic substance that has been found in some over-the-counter formulations. Working with a provider that is knowledgeable of which products these are, or reviewing the test results from ConsumerLab.com is recommended.

RYR is a simple supplement that provides various actions to support the body against heart disease. Beyond lowering bad cholesterol and triglycerides, it can also help fight inflammation and protect the important inner layers of the blood vessels. Most importantly, RYR has been shown to decrease major study endpoints like heart attack and death. It is a well-tolerated and cost-effective treatment for those who need help with their cardiac risk factors.

Lots More Information

Related Articles

Sources

  • Zhao, SP. (2003). Effect of xuezhikang, a cholestin extract, on reflecting postprandial triglyceridemia after a high-fat meal in patients with coronary heart disease. Atherosclerosis, 168(2):375-80.
  • Liu, J., Zhang, J., Shi, Y., Grimsgaard, S., Alraek, T., Fonnebo, V. (2006). Chinese red yeast rice (monascus purpureus) for primary hyperlipidemia: a meta-analysis of randomized controlled trials. Chin Med, 1:4.
  • Liu, L. (2003). Xuezhikang decreases serum lipoprotein(a) and C-reactive protein concentrations in patients with coronary heart disease. Clin Chem, 49(8):1347-52.
  • Zhao, SP. (2004). Xuezhikang, an extract of cholestin, protects endothelial function through antiinflammatory and lipid-lowering mechanisms in patients with coronary heart disease. Circulation, 110(8):915-20.
  • Lu, Z. (2008). Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction. Am J Cardiol, 101(12):1689-93.
  • Muldoon, MF. (2004). Randomized trial of the effects of simvastatin on cognitive functioning in hypercholesterolemic adults. Am J Med, 117(11):823-9.
  • Lin, CC. (2005). Efficacy and safety of Monascus purpureus Went rice in subjects with hyperlipidemia.  Eur J Endocrinol, 153(5):679-86.