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Red Yeast Rice Revisted for Lowering Cholesterol

Red Yeast Rice Revisted for Lowering Cholesterol

Red yeast rice is an increasingly popular dietary supplement which is used by people who have elevated cholesterol levels.  In fact, in 2006, American consumers spent $17 million dollars on this dietary supplement.  It has been used as an herbal medication in China for centuries.

Statins or HMG-CoA reductase inhibitors are currently the most effective lipid-lowering medications for the prevention of coronary artery disease.  Though they are generally well-tolerated, they can be associated with side effects including elevated hepatic or liver enzyme levels, gastrointestinal symptoms, and statin-associated myalgias which include both muscle pain and weakness.  Myositis which includes elevated creatine phosphokinase levels (CPK) and rhabdomyolysis (rapid break down of skeletal muscle tissue) are rarer but are serious complications of therapy. Statin-associated myalgias are dose-related and typically do occur without myositis.

As no definitive treatment for statin-associated myalgia (SAM)currently exists, many patients adopt alternative strategies including red yeast rice.  Though now more controversial, some patients with SAM have benefited from supplementing with coenzyme Q10.  Like statin type medication, red yeast rice contains lovastatin (monocolin k) that may inhibit HMG-CoA reductase and lower cholesterol levels.

A recent study (Becker et al, 2009) evaluated the effectiveness and tolerability of red yeast rice to treat dyslipidemia in patients who cannot tolerate statins.


Patients were assigned by random allocation software to receive red yeast rice, 1800 mg (31 patients), or placebo (31patients) twice daily for 24 weeks. All patients were concomitantly enrolled in a 12-week therapeutic lifestyle change program.


  • LDL cholesterol reduction of 1.11 mmol/l (43 mg/dl) at week 12.
  • Levels of HDL cholesterol (good cholesterol), liver enzymes, CPK, and pain severity did not differ between the red yeast rice group and placebo at weeks 12 or 24.


“Red yeast rice and therapeutic lifestyle change decrease LDL cholesterol level without increasing CPK or pain levels and may be a treatment option for dyslipidemic patients who cannot tolerate statin therapy.”

Side effects of Red Yeast Rice:

“Two (7%) of 29 patients in the red yeast rice group developed persistent intolerable myalgias and discontinued treatment. Their CPK levels were within normal limits.  Two other patients discontinued red yeast rice, 1 because of dizziness and 1 because of loose stools. All 4 patients remained in the study and completed the study protocol.  One of 30 patients in the placebo group developed persistent intolerable myalgias and discontinued treatment but completed the study protocol.”

ATP III Classification of LDL, Total, and HDL Cholesterol (mg/dL)

LDL Cholesterol – Primary Target of Therapy

  • <100 Optimal
  • 100-129 Near optimal/above optimal
  • 130-159 Borderline high
  • 160-189 High
  • >190 Very high

Total Cholesterol

  • <200 Desirable
  • 200-239 Borderline high
  • >240 High

HDL Cholesterol (good cholesterol)

  • <40 Low
  • >60 High


  1. Becker DJ, Gordon RY, Halbert SC, French B, Morris PB, Rader DJ.  Red yeast rice for dyslipidemia in statin-intolerant patients: a randomized trial.  Ann Intern Med. 2009 Jun 16;150(12):830-9, W147-9.


  • Karen Smith

    Interesting post on red yeast rice, indeed. Is it available everywhere? I want to try it out.

  • Jarret Morrow

    Hi, thank you for your comment. Due to concerns over potential side effects, you should discuss this with your physician before you take a red yeast rice product.

  • Shawn M

    Within the last month, I have seen it at both Whole Foods & Mollie Stones

  • Jarret Morrow

    Hi Shawn, thank you for sharing this info regarding the availability of Red Yeast Rice.

  • Jim

    I am 51, my cholesterol has been slightly high. I have tried several of the statin drugs but experienced muscle pain with each. I recently saw the study results for red yeast rice and fish oil, so I have been trying it for the past couple months. I seem to not have as much energy as without taking RYR but I don't have the severe muscle pain so it's tolerable. One thing I have noticed is my stool is somewhat red. Is this common? I am assuming it's due to the red color in RYR.

  • Jarret Morrow

    Jim, It's possible that the change in your stool color could be related to the RYR. I've heard other people complain about red/orange tool color from taking it. However, you should see your doctor to check your stool for occult blood to make sure that you don't have blood in your stool. It's possible that RYR can increase your risk of bleeding or it could be an unrelated medical issue. Either way, make sure you talk to your doctor about this.

  • Layne Haart

    I <3 your blog theme. Can I ask which one it is? I'd like to steal it for a blog I plan on building :D

  • Jarret Morrow, M.D.

    I've recently switched to the Hybrid theme framework. I'm using Hybrid-News as a child theme. It's a little more complicated to setup up than a typical Wordpress theme, but worth the effort.

  • Westley

    Great info about chinese red yeast rice! I'm thinking about talking to my doctor about trying red yeast rice to lower my cholesterol levels.

  • Clint Blumer

    I think that it is crucial to make certain that one purchases ANY dietary supplement from a reputable company and not rely on fly by night companies or those that are the "cheapest." You get what you pay for certainly applies here! Thanks, Clint Blumer

    • Jarret Morrow, M.D.

      Clint, you're absolutely right. There's a big difference in quality when it comes to different brands. Sometimes, it can be hard to tell which products are lower quality without some type of 3rd party testing.

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