Red yeast rice

Red yeast rice is a dietary staple in some Asian countries; it reportedly contains several compounds that inhibit cholesterol production. This new study supports similar findings for the ingredient, with American researchers reporting in Annals of Internal Medicine that it could indeed help reduce blood lipid levels in people intolerant to statins.

Photograph of red yeast rice.

This page was last updated by Bernard Preston on 6th January, 2023.

It's generally assumed that if your cholesterol is significantly raised you have to take medication or risk having a stroke or major cardiovascular disaster.

The question is whether there are simple dietary changes and natural substances that are as effective.

Humans are usually very reluctant to make dietary changes. They would rather take expensive medication and risk the extremely deleterious side effects than give up their favourite foods.

Perhaps more important, are there other natural foods that we could start eating that would obviate the need to give up our favourites? Could red yeast rice, for example make a difference?

Red yeast rice

Red yeast rice is a natural nutritional supplement for those with high blood fats. Research shows that taken with fish oil and some lifestyle changes not only was the drop in cholesterol even greater than Simvastatin but there was also significant weight loss.


Simvastatin vs therapeutic lifestyle changes and supplements[1] is a randomized primary prevention trial, reported in the journal Mayo Clin Proc; you could google it and find the abstract yourself.

Here's a summary of their findings. It is a randomised trial using over 70 patients with raised cholesterol. They compared these three interventions with Simvastatin.

  1. Red yeast rice for food daily.
  2. Fish oil supplements.
  3. Lifestyle changes.

The above intervention was more effective in lowering LDL-C than statins.

Perhaps more important is that on the conservative treatment, patients' triglycerides dropped by 29% and they lost on average 5,5 percent of their weight.

Pending confirmation in larger trials, this multifactorial, alternative approach to lowering lipids has promise for a subset of patients unwilling or unable to take statins.

The authors made the following conclusion. "Lifestyle changes combined with ingestion of red yeast rice and fish oil reduced LDL-C in proportions similar to standard therapy with simvastatin."

Red yeast supplements

“Lipid-Lowering Efficacy of Red Yeast Rice in a Population Intolerant to Statins.”

“The present report has provided real-world evidence of LDL cholesterol reduction with non selected, over-the-counter red yeast rice therapy in an outpatient population intolerant to other lipid medications.”

- American Journal of Cardiology.

Dietary supplements of red yeast rice may reduce LDL cholesterol levels by 21 per cent; and offer a blood lipid lowering alternative for people intolerant to statins, says the study.

Reductions in total cholesterol levels of 15 per cent were also reported. 92% of participants tolerated the dietary supplement, according to findings published in the American Journal of Cardiology.

The research was done at the University of Tennessee, Allegheny General Hospital in Pittsburgh; and UC.

“Producing red yeast rice under controlled conditions could provide a widely available and safe dietary supplement for lowering cholesterol,” they added.

Regulatory approval in Europe

Only recently the European Commission’s Standing Committee on the Food Chain and Animal Health in Brussels deemed the ingredient not to be a "novel," a decision that facilitates the use of the ingredient in dietary supplements without having to undergo approval.

Consideration of the ingredient’s status was requested by the EU headquarters in Brussels, and Italy confirmed that food supplement products containing the rice were indeed on the Italian market before the Novel Food Regulation entered into law in 1997.

Study details

Led by Dr Paul Thompson from the University of Connecticut, the researchers collected data on 25 people who received red yeast rice supplements for at least four weeks. All of them were intolerant to statins, and noted adverse effects including muscle pain and gastrointestinal intolerance.

Do you have other bad side effects since taking statins such as aching legs, loss of libido or even impotence?

The authors also noted several key limitations of their study, including that it was “small, unblinded anduncontrolled; and retrospective.” Patients selected their own rice preparation.

Bernard Preston's comment

Let's say you have total cholesterol of 240 mg/dL, which is considered moderately high. A 15% reduction means your total cholesterol drops to 204 which is reasonably good.

More important if your LDL cholesterol is 130 mg/dL (high), a 21% drop means your low density lipoprotein level would be 103. Below 100 is considered ideal.

Do you know what the high cholesterol symptoms are?

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