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What happens to your cholesterol when you take red yeast rice

Key takeaways

  • Red yeast rice may help lower mild to moderate cholesterol, but check with your doctor before trying it.
  • Safety and quality may vary, so choose independently tested products.
  • Side effects may include stomach problems, headaches, and rare kidney problems due to contamination.

Red yeast rice is a supplement touted as a way to lower cholesterol without prescription drugs. It may be an effective treatment for some, but there are reports of side effects and varying safety and effectiveness.

What effect does red yeast rice have on your cholesterol?

  • Red yeast rice may lower cholesterol in people with slightly to moderately high cholesterol because of a compound called The K of Monaco.
  • Monacolin K is structurally identical to lovastatina prescription statin that lowers cholesterol and triglycerides.
  • Studies have shown that red yeast rice extract, when it contains sufficient monacolin Khas reduced LDL (“bad”) cholesterol by 15% to 34%.
  • Red Yeast Rice Extract May Lower Cholesterol as much as low dose statins in people with mild to moderately high LDL levels, but not in those with very high cholesterol levels.

What is red yeast rice?

Red yeast rice is produced by ferment a mushroomgenerally A purple monk, on rice. It has a bright red or purple color. It is available as supplements in the form of capsules, powders and tablets.

Through fermentation, rice can develop a substance known as monacolin Kwhich may provide similar benefits to lovastatin.

However, the the amount of monacolin K depends on fermentation conditions, and many commercial products contain little or no detectable monacolin K.

Does red yeast rice reduce the risk of heart disease?

Red yeast rice may reduce the risk of cardiovascular disease (CVD) by the following means:

  • Reduce cholesterol: High cholesterol, especially LDL, is a risk factor for cardiovascular disease. Red yeast rice may reduce the risk of cardiovascular disease by lowering LDL cholesterol.
  • Other risk factors: While some studies suggest that red yeast rice may reduce total cholesterol, apolipoprotein B, and blood pressure, others have not shown similar benefits.

The benefits of red yeast rice in reducing the risk of heart disease are not yet clear and more research is needed.

Red Yeast Rice or Statins: Which Works Best?

Studies show that red yeast rice maybe as effective as low-dose statinslike lovastatin.

However, the effectiveness depends on the quantity of monacolin Kwhich varies considerably between brands and is often overlooked.

Unlike supplements, the Food and Drug Administration (FDA) regulates prescription statinswhich means that they suffered rigorous testing and their the effects are more predictable.

​​How does red yeast rice compare to diet and lifestyle changes?

What follows lifestyle changes effectively lowers cholesterol in some people:

  • Consider following a Mediterranean diet
  • Exercise regularly (at least 150 minutes of moderate activity per week)
  • Get enough, quality sleep (7 to 9 hours per night)
  • Limit your alcohol consumption
  • Manage your stress through therapy, mindfulness or other relaxation techniques

Few studies have compared natural remedies, like red yeast rice, to lifestyle changes. However, early research suggests that the combination of the two can reduce LDL cholesterol more effective than lifestyle changes alone.

For best results:

  • Work closely with your healthcare provider
  • Adopt a healthy lifestyle as a foundation
  • Consider taking cholesterol-lowering supplements or prescription medications if necessary

Is red yeast rice safe for you?

Not all red yeast rice supplements are safe or effective. Consider the following before trying them:

  • It has mild to moderate side effects. Research suggests that red yeast rice may cause mild to moderate side effects, including constipation, diarrhea, nausea, gas, abdominal pain, headache, eczema (also called atopic dermatitis), and bladder inflammation (cystitis).
  • It can cause kidney damage due to toxic amounts of the contaminant citrinin.. There are case reports of kidney damage from red yeast rice, possibly due to a contaminant called lemon.
  • It can be dangerous for people with kidney disease. Due to the risk of kidney damage from possible contaminants, avoid red yeast rice in people with existing kidney disease or at increased risk.
  • Monacolin K Levels May Vary. In a test of 28 red yeast rice supplements, two contained no detectable monacolin K. The rest contained 0.09 to 5.48 mg per 1,200 mg. Most studies support the benefits of 3 to 10 mg.
  • It may interact with statins. Red yeast rice may worsen the cholesterol-lowering effects of statins, which could cause cholesterol levels to drop too far.
  • It may contain lovastatin. Tests have found that lovastatin is illegally added to some red yeast rice products, and the FDA has issued warnings against these products.
  • Long-term safety is unknown. Studies evaluating the safety of red yeast rice last from four to 24 weeks.
  • Avoid it during pregnancy or breastfeeding. The safety of red yeast rice during pregnancy or breastfeeding has not been established.

Choosing a food supplement

In the United States, the FDA does not regulate dietary supplements the way it does prescription drugs. Therefore, some supplements may not contain the ingredients listed on the label or in the amounts listed.

When choosing a supplement, look for products that are independently tested or certified by organizations such as NSF, US Pharmacopeia (USP), or ConsumerLab.com. For personalized advice, consult your healthcare professional, a registered dietitian nutritionist (RD or RDN) or a pharmacist.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts in our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. NIH National Center for Complementary and Integrative Health. Red yeast rice.

  3. Minamizuka T, Koshizaka M, Shoji M et al. Low-dose red yeast rice with monacolin K lowers LDL cholesterol and blood pressure in Japanese people with mild dyslipidemia: a multicenter randomized trial. Asia Pac J Clin Nutr. 2021;30(3):424-435. doi:10.6133/apjcn.202109_30(3).0009

  4. Trogkanis E, Karalexi MA, Sergentanis TN et al. Safety and effectiveness of consumption of the nutraceutical “red yeast rice extract” for the reduction of hypercholesterolemia in humans: a systematic review and meta-analysis. Nutrients. 2024;16(10):1453. Published May 11, 2024. doi:10.3390/nu16101453

  5. Doewes RI, Gharibian G, Zadeh FA et al. An updated systematic review on the effects of aerobic exercise on human blood lipid profile. Current problem Cardiol. 2023;48(5):101108. doi:10.1016/j.cpcardiol.2022.101108

  6. Flatscher M, Garnier A, Marques-Vidal P et al. Impact of the Mediterranean diet on lipid composition in the Colaus-PsyColaus study. Nutrients. 2023;15(21):4659. Published November 3, 2023. doi:10.3390/nu15214659

  7. Wang YH, Zhang SS, Li HT, Zhi HW, Wu HY. Acute kidney injury induced by rhabdomyolysis after administration of red yeast rice supplement: a case report. Case of the world J Clin. 2023;11(23):5547-5553. doi:10.12998/wjcc.v11.i23.5547

  8. Righetti L, Dall’Asta C, Bruni R. Risk assessment of RYR dietary supplements: perception versus reality. Front nut. 2021;8:792529. Published December 7, 2021. doi:10.3389/fnut.2021.792529

  9. Cohen PA, Avula B, Khan IA. Variability in concentration of red yeast rice supplements purchased from major retailers. Eur J Previous Cardiol. 2017;24(13):1431-1434. doi:10.1177/2047487317715714


By Sarah Anzlovar, MS, RD

Sarah is a registered dietitian nutritionist in private practice and holds a master’s degree in nutrition communications from the Friedman School of Nutrition Science and Policy at Tufts University. She completed her training in dietetics at Brigham and Women’s Hospital, a teaching hospital of Harvard University.

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