Red Yeast Rice Extract Explained

Red yeast rice extract is a popular supplement that is taken to help lower cholesterol levels. Red yeast rice extract is a substance taken from yeast (Monascus purpureu) that has been grown on white rice. Red yeast rice has been used as part of traditional Chinese medicine for hundreds of years. The extract contains plant sterols, isoflavones, healthy fatty acids, and most famously a form of statin known as monacolin K (also known as lovastatin).  

While research on red yeast rice is still relatively limited, studies have shown the extract significantly lowers total cholesterol levels and specifically LDL cholesterol (also known as the ‘bad cholesterol’) levels as well as triglycerides. The safety effectiveness of the supplement depends on the quality and processing of the extract- some red yeast rice extract supplements contain higher amounts of monacolin K than others, and some contain higher levels of harmful chemical compounds. Because red yeast rice contains a compound that is classified as a prescription drug (lovastatin) and it is potentially dangerous to consumers who are unaware of its contents, the FDA regulates the content of red yeast rice supplements. Over the counter red yeast rice products containing lovastatin are considered illegal in the United States, but there are plenty of products still on the market that contain the drug. Currently, there is no way to know if you are getting a safe or effective red yeast rice extract supplement when buying a product off the shelf. 

For safety, it is best to discuss red yeast rice extract with your healthcare provider before beginning the supplement. Your healthcare provider will discuss if a statin therapy is appropriate and safe for you, and can discuss the risks and benefits of a red yeast rice supplement. Some side effects include headache, liver problems, muscle problems, and elevated liver enzymes. Do not take red yeast rice if you are pregnant or nursing. Because of its potential statin content, red yeast rice can also interact with many medications and supplements. Your healthcare provider may recommend blood work before initiating red yeast rice extract. Talk to your doctor to find out if red yeast rice could be helpful for you! 

- Katie Schaeffer, MS, RDN, CDN, CDCES