| RED YEAST RICE SIDE EFFECTS AND BENEFITS 2009 |
What is red yeast rice?
Red Yeast Rice is a unique natural product native to China that's been used in
Asian traditional medical systems since approximately 800 A.D. It is produced by
the fermentation of red yeast (Monascus purpureus) with white rice. However,
manufacturers need to carefully produce the product to avoid the presence of
citrinin, a toxic by-product of the fermentation process.
Thompson Coon JS and Ernst E from Universities of Exeter and Plymouth, UK,
reviewed 25 randomized clinical studies for 11 herbal products in the treatment of
hypercholesterolemia (high cholesterol levels). They concluded that guggul
(Commiphora mukul), fenugreek (Trigonella foenum-graecum), red yeast rice,
and artichoke (Cynara scolymus) have been most extensively studied and have
demonstrated reductions in total serum cholesterol levels of between10% and
33%.
While, Patrick L and Uzick M explained that red yeast rice contains lovastatin(a
HMG-CoA reductase inhibitor which inhibits cholesterol synthesis in the body) as
well as other cholesterol-lowering compounds, some with antioxidant effects. [2]
Heber D from University of California, Los Angeles pointed out that red yeast rice
is likely to be able to directly impact the process of atherosclerosis consequently,
it may prevent cardiovascular diseases. [3]
ANIMAL STUDIES
Researchers have studied the tong-term effects of red yeast rice extract on
serum lipids and severity of atherosclerosis in rabbits. In the study, the
researchers fed the rabbit with the extract together with 0.25% cholesterol for 200
days. They found 25% and 40% reductions in total cholesterol with respect to
doses of 0.4 and 1.35 g/kg/day of the red yeast rice. They also observed a
reduction of serum LDL cholesterol, triglycerides and atherosclerotic index. [7]
CLINICAL STUDIES
There are a few clinical studies about the effect of red yeast rice on cholesterol
levels. Most of the subjects are either patients suffered from hyperlipidermia or
coronary artery disease. All studies reviewed show the efficacy of red yeast rice
on cholesterol-lowering. To simplify this report, I summarized the results of the
"most recent studies".
A recent clinical study has demonstrated that ingestion of a red yeast rice extract
(Xuezhikang) led to rapid reduction of C-reactive protein levels within 24 h and
lipid profile within 2 weeks. The researchers believed that red yeast rice extract
might have clinically benefits for patients with coronary artery disease. In the
study, they randomly assigned 48 consecutive patients with stable angina to
1200 or 2400 mg/day of a red yeast rice extract (Xuezhikang). They found that
the red yeast rice extract Xuezhikang reduced total cholesterol, low-density
lipoprotein (LDL) cholesterol, median plasma C-reactive protein levels and in
mean plasma C-reactive protein levels significantly. AThe higher dose of the red
yeast rice extract Xuezhikang (2400 mg/day) resulted in significantly greater
reductions in total cholesterol TC and low-density lipoprotein LDL cholesterol
compared with 1200 mg/day group (p<0.05, p<0.01, respectively. While, they
observed a less reduction in triglycerides (TG) levels and no significant
difference in mean high-density lipoprotein (HDL) cholesterol levels compared
with baseline. [5]
In another study of patients with coronary heart disease at dose of 1200 mg/d for
6 weeks, researchers also observed the reduction of lipid levels and improvement
of inflammation after the administration of the red yeast rice extracts. [8]
Hyperlipidemia is a well-known risk factor for atherosclerosis and statins are
widely used to treat patients with elevated levels of lipids in their plasma.
Notwithstanding the proven benefits of statin drugs on both primary and
secondary prevention of heart disease, the high cost of statin treatment, in
addition to possible side effects such as liver function abnormalities, may limit
their widespread use. We conducted a study on a natural product as an
alternative to statin treatment. Cholestin, a dietary supplement, is prepared from
rice fermented with red yeast (Monascus purpureus), which has been shown to
significantly decrease total cholesterol levels in hyperlipidemic subjects. Our
objective was to determine the cellular effect of Cholestin on cholesterol
synthesis in human hepatic cells (HepG2) and the mechanism by which it caused
a change in lipid metabolism.
A red yeast extract was found to have a direct inhibitory effect on HMG-CoA
reductase activity (78-69% of control). In the study, researchers found this red
yeast extract (25-100 microg/mL) were significantly reduced cholesterol levels in
human hepatic cells HepG2in a dose-dependent manner (81-45% of control,
respectively). They found and association of this reduction with the decreased
synthesis and secretion of both unesterified cholesterol (54-31 and 33-14% of
control, respectively) and cholesteryl ester (18-6 and 37-19% of control,
respectively). Thus, one of the anti-hyperlipidemic actions of the red yeast rice in
the study was a consequence of an inhibitory effect on cholesterol biosynthesis in
hepatic cells. [9]
RED YEAST RICE SIDE EFFECTS
Researchers from Catholic University of Rome reported that a sixty-three year old
woman presented with severe hypertransaminasemia. For six months she had
been taking Equisterol, an over-the-counter lipid-lowering product containing
guggulsterol and red yeast rice extract. After she stopped to take Equisterol, her
liver functions returned to normal. [AA3]
Researchers from Taipei Medical University evaluated the effect of high doses of
red yeast rice on coenzyme Q10 (CoQ10) levels in the tissues of 85 ICR mice.
They found that CoQ10 levels in liver and heart declined dramatically 30 minutes
after the ingestion of red yeast rice. And, the effect persists for 24 hours and it is
dose proportional. [4]
A case of red yeast rice side effects was reported by researchers at James H.
Quillen College of Medicine, East Tennessee State University. A middle-aged
man presented with joint pain and muscle weakness that had begun 2 months
before presentation. Three months before presentation, he had begun to take a
herbal preparation of red rice. Laboratory testing revealed a moderately elevated
creatine phosphokinase level. Symptoms and laboratory abnormalities resolved
with discontinuation of the red rice. Eight months later, he resumed the product
and his creatine phosphokinase level rose again. The researchers believed that
the active ingredient, i.e. lovastatin, in the red rice was the cause of his
myopathy.. [6]
Because the active ingredient of red yeast rice is lovastatin, theorically the side
effects of red yeast rice should be similar to the side effect of the prescription
lovastatin (i.e. Mevacor). Rhabdomyolysis is a known complication of hepatic
3-methylglutaryl coenzyme A reductase (HMG-CoA) inhibitor (statin) therapy for
post-transplant hyperlipidemia, and thus monitoring for this effect is indicated.
Researchers from University of Toronto reported a case of an herbal
preparation-induced rhabdomyolysis in a stable renal-transplant recipient,
attributed to the presence of red yeast rice (Monascus purpureus) within the
mixture. The condition resolved when consumption of the product ceased. [AA4]
A few manufacturers developed red yeast rice product containing CoQ10 to
support healthy cardiovascular and immune system function.
Reference [1] Herbs for serum cholesterol reduction: a systematic view. J Fam
Pract. 2003 Jun;52(6):468-78. [2] Patrick L and Uzick M Cardiovascular disease:
C-reactive protein and the inflammatory disease paradigm: HMG-CoA reductase
inhibitors, alpha-tocopherol, red yeast rice, and olive oil polyphenols. A review of
the literature. Altern Med Rev. 2001 Jun;6(3):248-71. [3] Herbs and
atherosclerosis. Curr Atheroscler Rep. 2001 Jan;3(1):93-6. [4] Yang HT et al,
Acute administration of red yeast rice (Monascus purpureus) depletes tissue
coenzyme Q(10) levels in ICR mice. Br J Nutr. 2005 Jan;93(1):131-5. [5] Li JJ et
al, Effects of xuezhikang, an extract of cholestin, on lipid profile and C-reactive
protein: a short-term time course study in patients with stable angina. Clin Chim
Acta. 2005 Feb;352(1-2):217-24. [6] Smith DJ and Olive KE Chinese red
rice-induced myopathy. South Med J. 2003 Dec;96(12):1265-7. [7] Wei W et al,
Hypolipidemic and anti-atherogenic effects of long-term Cholestin (Monascus
purpureus-fermented rice, red yeast rice) in cholesterol fed rabbits. J Nutr
Biochem. 2003 Jun;14(6):314-8. [8] Zhao SP et al, Xuezhikang, an extract of
cholestin, protects endothelial function through antiinflammatory and
lipid-lowering mechanisms in patients with coronary heart disease. Circulation.
2004 Aug 24;110(8):915-20. Epub 2004 Aug 16. [9] Man RY et al, Cholestin
inhibits cholesterol synthesis and secretion in hepatic cells (HepG2). Mol Cell
Biochem. 2002 Apr;233(1-2):153-8. [AA1] A Substitute for Those Who Can't Take
Statins? HealthDay Mon Jun 15, 2009 [AA2] Fish Oil, Red Yeast Rice Cut
Cholesterol WebMed July 23, 2008 [AA3] Grieco A, Miele L, Pompili M, Biolato M,
Vecchio FM, Grattagliano I, Gasbarrini G.Acute hepatitis caused by a natural
lipid-lowering product: when "alternative" medicine is no "alternative" at all J
Hepatol. 2009 Jun;50(6):1273-7. Epub 2009 Mar 31 [AA4] Prasad GV, Wong T,
Meliton G, Bhaloo S. Rhabdomyolysis due to red yeast rice (Monascus
purpureus) in a renal transplant recipient.Transplantation. 2002 Oct
27;74(8):1200-1
Red Yeast Rice is a unique natural product native to China that's been used in
Asian traditional medical systems since approximately 800 A.D. It is produced by
the fermentation of red yeast (Monascus purpureus) with white rice. However,
manufacturers need to carefully produce the product to avoid the presence of
citrinin, a toxic by-product of the fermentation process.
Thompson Coon JS and Ernst E from Universities of Exeter and Plymouth, UK,
reviewed 25 randomized clinical studies for 11 herbal products in the treatment of
hypercholesterolemia (high cholesterol levels). They concluded that guggul
(Commiphora mukul), fenugreek (Trigonella foenum-graecum), red yeast rice,
and artichoke (Cynara scolymus) have been most extensively studied and have
demonstrated reductions in total serum cholesterol levels of between10% and
33%.
While, Patrick L and Uzick M explained that red yeast rice contains lovastatin(a
HMG-CoA reductase inhibitor which inhibits cholesterol synthesis in the body) as
well as other cholesterol-lowering compounds, some with antioxidant effects. [2]
Heber D from University of California, Los Angeles pointed out that red yeast rice
is likely to be able to directly impact the process of atherosclerosis consequently,
it may prevent cardiovascular diseases. [3]
ANIMAL STUDIES
Researchers have studied the tong-term effects of red yeast rice extract on
serum lipids and severity of atherosclerosis in rabbits. In the study, the
researchers fed the rabbit with the extract together with 0.25% cholesterol for 200
days. They found 25% and 40% reductions in total cholesterol with respect to
doses of 0.4 and 1.35 g/kg/day of the red yeast rice. They also observed a
reduction of serum LDL cholesterol, triglycerides and atherosclerotic index. [7]
CLINICAL STUDIES
There are a few clinical studies about the effect of red yeast rice on cholesterol
levels. Most of the subjects are either patients suffered from hyperlipidermia or
coronary artery disease. All studies reviewed show the efficacy of red yeast rice
on cholesterol-lowering. To simplify this report, I summarized the results of the
"most recent studies".
A recent clinical study has demonstrated that ingestion of a red yeast rice extract
(Xuezhikang) led to rapid reduction of C-reactive protein levels within 24 h and
lipid profile within 2 weeks. The researchers believed that red yeast rice extract
might have clinically benefits for patients with coronary artery disease. In the
study, they randomly assigned 48 consecutive patients with stable angina to
1200 or 2400 mg/day of a red yeast rice extract (Xuezhikang). They found that
the red yeast rice extract Xuezhikang reduced total cholesterol, low-density
lipoprotein (LDL) cholesterol, median plasma C-reactive protein levels and in
mean plasma C-reactive protein levels significantly. AThe higher dose of the red
yeast rice extract Xuezhikang (2400 mg/day) resulted in significantly greater
reductions in total cholesterol TC and low-density lipoprotein LDL cholesterol
compared with 1200 mg/day group (p<0.05, p<0.01, respectively. While, they
observed a less reduction in triglycerides (TG) levels and no significant
difference in mean high-density lipoprotein (HDL) cholesterol levels compared
with baseline. [5]
In another study of patients with coronary heart disease at dose of 1200 mg/d for
6 weeks, researchers also observed the reduction of lipid levels and improvement
of inflammation after the administration of the red yeast rice extracts. [8]
Hyperlipidemia is a well-known risk factor for atherosclerosis and statins are
widely used to treat patients with elevated levels of lipids in their plasma.
Notwithstanding the proven benefits of statin drugs on both primary and
secondary prevention of heart disease, the high cost of statin treatment, in
addition to possible side effects such as liver function abnormalities, may limit
their widespread use. We conducted a study on a natural product as an
alternative to statin treatment. Cholestin, a dietary supplement, is prepared from
rice fermented with red yeast (Monascus purpureus), which has been shown to
significantly decrease total cholesterol levels in hyperlipidemic subjects. Our
objective was to determine the cellular effect of Cholestin on cholesterol
synthesis in human hepatic cells (HepG2) and the mechanism by which it caused
a change in lipid metabolism.
A red yeast extract was found to have a direct inhibitory effect on HMG-CoA
reductase activity (78-69% of control). In the study, researchers found this red
yeast extract (25-100 microg/mL) were significantly reduced cholesterol levels in
human hepatic cells HepG2in a dose-dependent manner (81-45% of control,
respectively). They found and association of this reduction with the decreased
synthesis and secretion of both unesterified cholesterol (54-31 and 33-14% of
control, respectively) and cholesteryl ester (18-6 and 37-19% of control,
respectively). Thus, one of the anti-hyperlipidemic actions of the red yeast rice in
the study was a consequence of an inhibitory effect on cholesterol biosynthesis in
hepatic cells. [9]
RED YEAST RICE SIDE EFFECTS
Researchers from Catholic University of Rome reported that a sixty-three year old
woman presented with severe hypertransaminasemia. For six months she had
been taking Equisterol, an over-the-counter lipid-lowering product containing
guggulsterol and red yeast rice extract. After she stopped to take Equisterol, her
liver functions returned to normal. [AA3]
Researchers from Taipei Medical University evaluated the effect of high doses of
red yeast rice on coenzyme Q10 (CoQ10) levels in the tissues of 85 ICR mice.
They found that CoQ10 levels in liver and heart declined dramatically 30 minutes
after the ingestion of red yeast rice. And, the effect persists for 24 hours and it is
dose proportional. [4]
A case of red yeast rice side effects was reported by researchers at James H.
Quillen College of Medicine, East Tennessee State University. A middle-aged
man presented with joint pain and muscle weakness that had begun 2 months
before presentation. Three months before presentation, he had begun to take a
herbal preparation of red rice. Laboratory testing revealed a moderately elevated
creatine phosphokinase level. Symptoms and laboratory abnormalities resolved
with discontinuation of the red rice. Eight months later, he resumed the product
and his creatine phosphokinase level rose again. The researchers believed that
the active ingredient, i.e. lovastatin, in the red rice was the cause of his
myopathy.. [6]
Because the active ingredient of red yeast rice is lovastatin, theorically the side
effects of red yeast rice should be similar to the side effect of the prescription
lovastatin (i.e. Mevacor). Rhabdomyolysis is a known complication of hepatic
3-methylglutaryl coenzyme A reductase (HMG-CoA) inhibitor (statin) therapy for
post-transplant hyperlipidemia, and thus monitoring for this effect is indicated.
Researchers from University of Toronto reported a case of an herbal
preparation-induced rhabdomyolysis in a stable renal-transplant recipient,
attributed to the presence of red yeast rice (Monascus purpureus) within the
mixture. The condition resolved when consumption of the product ceased. [AA4]
A few manufacturers developed red yeast rice product containing CoQ10 to
support healthy cardiovascular and immune system function.
Reference [1] Herbs for serum cholesterol reduction: a systematic view. J Fam
Pract. 2003 Jun;52(6):468-78. [2] Patrick L and Uzick M Cardiovascular disease:
C-reactive protein and the inflammatory disease paradigm: HMG-CoA reductase
inhibitors, alpha-tocopherol, red yeast rice, and olive oil polyphenols. A review of
the literature. Altern Med Rev. 2001 Jun;6(3):248-71. [3] Herbs and
atherosclerosis. Curr Atheroscler Rep. 2001 Jan;3(1):93-6. [4] Yang HT et al,
Acute administration of red yeast rice (Monascus purpureus) depletes tissue
coenzyme Q(10) levels in ICR mice. Br J Nutr. 2005 Jan;93(1):131-5. [5] Li JJ et
al, Effects of xuezhikang, an extract of cholestin, on lipid profile and C-reactive
protein: a short-term time course study in patients with stable angina. Clin Chim
Acta. 2005 Feb;352(1-2):217-24. [6] Smith DJ and Olive KE Chinese red
rice-induced myopathy. South Med J. 2003 Dec;96(12):1265-7. [7] Wei W et al,
Hypolipidemic and anti-atherogenic effects of long-term Cholestin (Monascus
purpureus-fermented rice, red yeast rice) in cholesterol fed rabbits. J Nutr
Biochem. 2003 Jun;14(6):314-8. [8] Zhao SP et al, Xuezhikang, an extract of
cholestin, protects endothelial function through antiinflammatory and
lipid-lowering mechanisms in patients with coronary heart disease. Circulation.
2004 Aug 24;110(8):915-20. Epub 2004 Aug 16. [9] Man RY et al, Cholestin
inhibits cholesterol synthesis and secretion in hepatic cells (HepG2). Mol Cell
Biochem. 2002 Apr;233(1-2):153-8. [AA1] A Substitute for Those Who Can't Take
Statins? HealthDay Mon Jun 15, 2009 [AA2] Fish Oil, Red Yeast Rice Cut
Cholesterol WebMed July 23, 2008 [AA3] Grieco A, Miele L, Pompili M, Biolato M,
Vecchio FM, Grattagliano I, Gasbarrini G.Acute hepatitis caused by a natural
lipid-lowering product: when "alternative" medicine is no "alternative" at all J
Hepatol. 2009 Jun;50(6):1273-7. Epub 2009 Mar 31 [AA4] Prasad GV, Wong T,
Meliton G, Bhaloo S. Rhabdomyolysis due to red yeast rice (Monascus
purpureus) in a renal transplant recipient.Transplantation. 2002 Oct
27;74(8):1200-1
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Acidophilus
Almond
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CLA
Cod Liver Oil
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Colostrum
Dandelion
EGCG
Echinacea
Eleuthero
Ellagic Acid
Eve. Primrose Oil
Fish Oil
Flaxseed
Garlic
Ginger
Ginseng
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Discuss with your doctor before taking any alternative medicine. This article is for
reference only, it is not a medical advice. All rights reserved. Do not copy this article to
other website or blog.
reference only, it is not a medical advice. All rights reserved. Do not copy this article to
other website or blog.
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| A good news for those who stopped taking statins because of side effects: A recent study of 62 people who stopped taking statins because of side effects reported a significant cholesterol-lowering effect of a commercially available nonprescription red yeast rice product. The average drop in cholesterol was 43 points at 12 weeks. The participants took three 600-milligram vials of red yeast rice twice a day. Each vial had only one milligram of lovastatin, so they took about 6 mg a day. The participants also followed a lifestyle change program, including education on nutrition, exercise and relaxation techniques. [AA1] In fact, a year ago, somebody has already reported that supplements of fish oil and red yeast rice, coupled with lifestyle changes in diet and exercise habits, can reduce cholesterol as much as standard cholesterol- lowering medications known as statins, according to a new study. [AA2] The equivalent dose of lovastatin is 6 mg a day. The lowest strength of Mevacor (lovastatin tablet) is 20 mg, but the prescription does not request patients to follow a restrictive lifestyle plan. I wonder if a patient takes only 6 mg of Mevacor and follows that lifestyle plan, will this combined therapy also allow a significant cholesterol-lowering effect, with a minimal side effects? It is a common sense that the severity of side effect is proportional to the dose. Anyway, exercise, a balanced diet with supplements, rest, sleep and peaceful environment are important to our health. |