How Safe is Red Yeast Rice? 6 Facts You Need to Know!

How Safe is Red Yeast Rice

How Safe is Red Yeast Rice?


Red yeast rice has been touted as a natural and safe alternative to statins for folks with elevated levels of cholesterol.


It’s a reddish purple fermented rice and has been used in Chinese cuisine and Traditional Chinese Medicine for centuries. Its use in Traditional Chinese Medicine has been traced back to approximately 800 AD during the Tang Dynasty where it’s mainly used to invigorate the body, revitalize the blood and aid in digestion.


How did red yeast rice acquire its reputation as a supposedly safer alternative to statins?


According to the University of Maryland Medical Center, red yeast rice contains chemicals that are similar to prescription statin medications. One of these, called monacolin K, has the same makeup as the drug lovastatin (Mevacor) which is a prescription drug for folks with high cholesterol.


Basically if it contains the same chemicals as statins, then by definition, red yeast rice also a statin but sold as a supplement instead. And just like statins, there are adverse effects that need to be considered.


So if it has the same chemical ingredients i.e. monacolins as statins then how safe is it?


Red Yeast Rice is Not Regulated like Statins


Unlike statins that can only be prescribed by doctors, red yeast rice can be bought off the shelf and online from health food stores so anyone can buy the supplement.


Statins like Lipitor and Crestor are regulated by health authorities and when your doctor prescribes them to you, he or she knows the precise dosage of the drug(s) that you should be taking. And he or she can lower the dosage if you experience any adverse effects. Also the dosage(s) can be adjusted based to your regular blood tests which include looking for high liver enzyme readings.


But that’s not the case for red yeast rice because you won’t know how high the dosage of the monacolins is in the red yeast rice since it won’t be stated on the supplement label. In addition different strains of red yeast rice have different levels of monacolins and that makes it much harder to know and find out.


In fact there has been some controversy over the US Food and Drug Administration and Pharmanex, Inc which manufactures Cholestin® a brand of red yeast rice. According to the Mayo Clinic, “The U.S. District Court in Utah ruling in March 2001 states that RYRE (Red Yeast Rice extract) is an unapproved drug. Thus, the RYRE known as Cholestin® is no longer available in the United States.”


What supplement companies in the US have done is that they avoid and bypass this FDA restriction by mentioning on their websites and on the supplements’ labels that they red yeast rice is no more “fermented according to traditional Asian methods” and they don’t mention that it lowers cholesterol or is good for cholesterol management.

How Safe is Red Yeast Rice
Red yeast rice is a statin


Outside the US, supplement companies do still mention that it lowers cholesterol as in the case of Hypocol which mentions that it “is specially recommended for use by healthy adult men and post-menopausal women concerned about maintaining desirable healthy cholesterol levels naturally. It is suitable for individuals whose total serum cholesterol levels fall within the borderline risk bracket.”


The Adverse Effects are the Same as Those of Statins


This is because the monacolins found in red yeast rice are the same as those found in statins, that’s the reason why it is able to lower cholesterol level as much as statins. But if you think that taking red yeast rice is a safer alternative to statins, think again!


Its adverse effects are about the same as statins:


  • Red yeast rice depletes the body of Coenzyme Q10 or CoQ10 which is essential for heart health and muscle function. According to Dr. Andrew Weil, “It assists in maintaining the normal oxidative state of LDL cholesterol, helps assure circulatory health, and supports optimal functioning of the heart muscle. CoQ10 may also help support the health of vessel walls. In addition, Coenzyme Q10 may play a role in reducing the number and severity of migraine headaches, and improving sperm motility in men.”

CoQ10 deficiency “has been associated with cardiovascular problems including angina, arrhythmia, heart failure and high blood pressure. Problems with blood sugar regulation, gingival (gum) health, and stomach ulcers have also been associated with CoQ10 deficiency. Those who are taking statins to lower cholesterol are at particular risk for deficiency, because not only do statins reduce cholesterol levels, but they also block CoQ10 synthesis in the body. Low CoQ10 levels in patients on statins can contribute to the common side effects of statin therapy such as fatigue and aching joints and muscles.”

How Safe is Red Yeast Rice
Red yeast rice can cause muscle pain & weakness


  • It also can cause muscle pain and weakness known as rhabdomyolysis: this seems to be a common side effect experienced by those who are prescribed statins and like I mentioned before, red yeast rice is also a statin although in supplement form. Researchers feel that one reason could be because it activates the atrogin-1 gene which plays a key role in muscle atrophy. This is bad news especially for seniors because age related muscle loss or sarcopenia strikes one third of those above age 50. Folks who “have musculoskeletal disorders or those taking cyclosporine, cytochrome P450-3A blocking agents, or macrolide antibiotics” will need to be extra cautious if and when taking red yeast rice.


  • Inflammation of the liver: According to the Mayo Clinic, “statin use could cause an increase in the level of enzymes that signal liver inflammation.” That’s why your doctor may order a liver enzyme test if you’re put on statins so that if there’s any increase in liver enzymes he or she can lower the dosage or switch you to another brand. With red yeast rice, there’s no way of knowing how much monacolins (the statin chemicals) are in the supplement.


  • Elevated blood sugar levels and increased Type 2 diabetes risk: even though the risk is supposedly small, the US Food and Drug Administration, “has issued a warning on statin labels regarding blood glucose levels and diabetes.” Now if your doctor has prescribed statins for you, he can order a glucose tolerance test and include the HbA1C test into your lipid profile if he or she thinks you’re at risk of getting Type 2 diabetes from statins. If you taking red yeast rice please go to your doctor and ask for these tests just to make sure your risk of getting Type 2 diabetes is minimized. If you’re already a diabetic and are on medication to lower your blood sugar, be sure to check with your doctor if you want to try red rice yeast as well just in case there’s some interaction with other medications.


  • According to the Mayo Clinic, red yeast rice can also cause rashes so folks with skin disorders need to be careful. 


  • The Mayo Clinic also states, “use cautiously in people who have kidney problems. Red yeast rice (RYR) may be harmful to the kidneys.”


  • Red yeast rice “may worsen symptoms such as gas, heartburn, inflammatory bowel disease, and nausea.” So folks with stomach and digestive issues need to be wary as well.



  • If you have low iron levels, be careful of the supplement because it “may affect hemoglobin.”



  • Red yeast rice “may increase the risk of nerve damage so if you have damaged nerves be very careful when using the supplement.


  • If you’ve got a bleeding disorder or you’re taking medications that increase bleeding risk you may want to check with your doctor before taking red yeast rice because it can increase risk of bleeding.


  • Red yeast rice can also lower blood pressure so if you’re taking medications for hypertension, please check with your doctor before taking red yeast rice.



  • If you’re taking ranitidine (Zantac®) you’re at risk of kidney damage if you also take red yeast rice so be sure to check with your doctor before attempting to try the supplement.


With so many adverse effects, are you sure you want to take the risk with red yeast rice? Besides assessing heart disease risk based on total cholesterol and LDL is flawed science.


Total Cholesterol and LDL are Poor Predictors of Heart Disease


At the risk of sounding like a broken record, I’ll say it again: total cholesterol and LDL aren’t good predictors of heart disease; in fact they’re downright really bad predictors. The idea that if you reduce total cholesterol and LDL your heart disease risk will be lessened is based on flawed science because there’s no link at all!


How Safe is Red Yeast Rice
Cholesterol and LDL are poor predictors of heart disease

In 2011, the Science Daily published a study by the Texas A & M University where researchers found that not only is LDL not as bad as current medical opinion deems it to be, it is also needed for seniors who exercise. 


The researchers examined 52 seniors aged 60 to 69 and discovered that when they were put on exercise programs those who gained the most lean muscle mass had the highest levels of LDL after they completed their workouts.


Professor Steve Riechman who led the study said, “It shows that you do need a certain amount of LDL to gain more muscle mass. There’s no doubt you need both – the LDL and the HDL – and the truth is, it (cholesterol) is all good. You simply can’t remove all the ‘bad’ cholesterol from your body without serious problems occurring.”


He added, “LDL serves a very useful purpose. It acts as a warning sign that something is wrong and it signals the body to these warning signs. It does its job the way it is supposed to. People often say, ‘I want to get rid of all my bad (LDL) cholesterol,’ but the fact is, if you did so, you would die,”


Professor Riechman concluded, “Everyone needs a certain amount of both LDL and HDL in their bodies. We need to change this idea of LDL always being the evil thing – we all need it, and we need it to do its job.”


In another large review, researchers combed through the PubMed database In December 2015 and went through 19 publications covering 30 cohort peer reviewed studies which included 68,094 participants. In the end, the researchers said that what they found contradicted the commonly held belief that LDL cholesterol caused heart disease.


In fact, what they discovered was exactly the opposite: that for seniors above 60 years old, higher levels of LDL were associated with a lower mortality rate. Their conclusion was that higher levels of LDL were “not linked to all-cause or cardiovascular mortality.” Professor Uffe Ravnskov of the University of Lund in Sweden who led the study called for “the rationale for a re-evaluation of guidelines recommending pharmacological reduction of LDL-C in the elderly as a component of cardiovascular disease prevention strategies.”


Low Cholesterol can harm You!


There’s so much bad press drummed up by mainstream medicine that we fail to realize that low cholesterol isn’t only NOT beneficial, it can be downright harmful! Look at these studies….


In 2007 the Journal of the American College of Cardiology published a study which looked at over 41,000 patients records and found that people who were put on statins to lower their LDL, “the risk of cancer is significantly associated with lower achieved LDL-C levels.”


A 1997 study found that, “Among men aged 70 years and older, categorically defined depression was three times more common in the group with low plasma cholesterol (<4·14 mmol/L or 170 mg/dl) than in those with higher concentrations.”


How Safe is Red Yeast Rice
Low cholesterol can cause depression

Another Dutch study of men aged 40 to 70 also found that, “Men with a lower cholesterol level (≤4.5 mmol/l or 174 mg/dl) have a higher prevalence of depressive symptoms than those with a cholesterol level between 6 and 7 mmol/l (232 and 270 mg/dl).”


 A University of Minnesota study found that “A serum cholesterol level less than 4.14 mmol/L (less than 160 mg/dL) was also associated with a significantly increased risk of death from cancer of the liver and pancreas; digestive diseases, particularly hepatic cirrhosis; suicide; and alcohol dependence syndrome.”


Lipid Ratios are Better Predictors of Heart Disease Risk


According to Dr. Joseph Mercola, a renowned functional medicine specialist, “A better predictor is the ratio between your high-density lipoproteins (HDL) and total cholesterol. HDL is an important factor in the fight against heart disease. Your ratio between HDL and total cholesterol (or HDL divided by your total cholesterol, multiplied by 100) should ideally be above 24 percent.”


“Triglycerides are another type of cholesterol formed in your body with excess blood sugar from the metabolism of carbohydrates. They are a significant risk factor in the development of heart disease. Your triglyceride to HDL ratio (triglycerides divided by HDL, multiplied by 100) should ideally be below 2 percent.”


Part of Dr. Mercola’s view is confirmed by this Brazilian study where researchers found that “the ratio of triglycerides to HDL-cholesterol or to HDL-c were robustly associated with disease extent. Elevation in the ratio of TG to HDL-c was the single most powerful predictor of extensive coronary heart disease among all the lipid variables examined.”


Getting Your Lipid Profile in Shape


There are much less risky and easier ways to get your lipid profile in shape other than taking red yeast rice or statins.


Do these and your lipid profile will improve….


  • Totally avoid highly refined carbohydrates, sugar and processed food.
  • Totally avoid margarine, shortening and other hydrogenated fats: these are trans fats that promote atherosclerosis which will lead to heart disease.
  • Get your carbs from vegetables, low carb fruits, seeds, some roots and tubers like sweet potatoes and carrots if you don’t have Type 2 diabetes or weight to lose.
  • Avoid commercial vegetable and seed oils like soya oil, corn oil, canola oil and safflower oil.
  • Use mono saturated and saturated fats like olive oil, avocado oil and coconut oil to cook.
  • Eat avocados and olives: they’re high in mono saturated fats.
  • Include lots of wild caught fish and seafood like oysters and squids, pasture raised and free roaming meat and eggs into your diet.
  • Use low temperature cooking methods.
  • Take a fish oil supplement to boost Omega 3 intake which can slash triglyceride levels.
  • Start a regular exercise program.
  • Avoid smoking and if you’re smoking stop.


Don’t buy into the “the lower your cholesterol, the better your heart health will be” hogwash that’s been drummed into our heads by the health authorities for decades.

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