Red yeast rice (RYR) has been eaten for centuries, mainly in Asia. There it's known for its medicinal properties in aiding digestion and circulation. In the West, it's become increasingly popular as an alternative lipid-lowering agent, especially among people who can't tolerate or aren't comfortable taking prescription statin drugs.
Just what is it? Should you consider taking it if you have high cholesterol?
When rice is fermented with the fungus Monascus purpureus (a type of yeast), it takes on a reddish-purple color. It's eaten fresh or dried and also pasteurized and sold as a paste. As the rice ferments, several chemical compounds are formed, including monacolin K, which is chemically identical to the drug lovastatin.
In controlled studies, RYR was shown to raise HDL (healthy lipids) and lower LDL and triglycerides (unhealthy lipids). A large Chinese study showed a marked decrease in heart attacks among patients taking RYR for nearly 5 years.
Here's the difference between RYR and lovastatin:
Lovastatin is a prescription medication which is standardized and regulated by the government. You know just what (and how much) you're getting.
RYR is an over-the-counter "food supplement". The amount of monacolin K can vary from one product to another. In a recent study of 12 different brands of RYR, scientists found levels of monacolin K that varied widely – from 0.10 mg to 10.09 mg per capsule.
An additional concern with RYR is the possible presence of the toxin citrinin, another byproduct of the fermentation process. Four out of the 12 brands of RYR tested had high levels of citrinin.
So the main question is whether you want to take a regulated and standardized prescription drug or an unregulated and non-standardized food supplement.
If prescription statins don't work for you, you may want to ask your physician about RYR. (It can have some of the same side effects as statins, so it should be taken under your doctor's supervision.) Obviously there are companies who do produce a reliable product – the challenge is finding the right one.
As for me, I'll stick with prescription statins until RYR becomes standardized and regulated.