Red yeast rice (RYR) is the product of yeast ( Monascus purpureus ) grown on rice, and is served as a dietary staple in some Asian countries. It contains several compounds collectively known as Monacolins, substances known to inhibit cholesterol synthesis. One of these, "Monacolin K" is a potent inhibitor of HMG-CoA reductase, and is also known as Mevinolin or Lovastatin (Mevacor®, a drug produced by Merck and Co., Inc).

Red yeast rice extract (RYRE) has been sold as a natural cholesterol-lowering agent in over the counter supplements, such as CholestinTM(Pharmanex, Inc). However, there has been legal and industrial dispute as to whether red yeast rice is a drug or dietary supplement, involving this manufacturer, the U.S. Food and Drug Administration (FDA) and the pharmaceutical industry (particularly producers of HMG-CoA reductase inhibitor prescription drugs or "statins").

The use of RYR in China was first documented in the Tang Dynasty in 800 A.D. A detailed description of its manufacture is found in the ancient Chinese pharmacopoeia, Ben Cao Gang Mu-Dan Shi Bu Yi, published during the Ming Dynasty (1368-1644). In this text, RYR is proposed to be a mild aid for gastric problems (indigestion, diarrhea), blood circulation and spleen and stomach health. RYR in a dried, powdered form is called ZhiTai. When extracted with alcohol it is called XueZhiKang.

According to the Pharmanex website (accessed in September 2003), new and improved CholestinTMcontains policosanol, a natural product from the wax of honey bees called Apis mellifera . It no longer contains any red yeast. Policosanols are potent inhibitors of cholesterol synthesis and have been well-studied in clinical trials in Cuba and South America.

Synonyms

Angkak, Beni-koju, Hong Qu, Hung-chu, Monascus, Red Koji, Red Leaven, Red Rice, Red Rice Yeast, Red Yeast Rice, Went, XueZhiKang, ZhiTai.

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidence

High cholesterol

Since the 1970s, human studies have reported that red yeast lowers blood levels of total cholesterol, low-density lipoprotein/LDL ("bad cholesterol"), and triglyceride levels. In March 2001, a U.S. District Court ruled that the red yeast rice extract product CholestinTMcontained the same chemical as the prescription cholesterol-lowering drug lovastatin (Mevacor®) and therefore could not be sold without a prescription. Lovastatin, like other "statin" drugs, has been shown in multiple well-designed controlled trials to reduce total cholesterol and LDL levels. CholestinTMhas since been reformulated to contain different ingredients (such as policosanol)Policosanols are thought to potent inhibitors of cholesterol synthesis and have been well-studied in clinical trials in Cuba and South America. As of June 14, 2005, the manufacturers website says that Cholestin recently has been reformulated with a unique proprietary blend of ingredients including Lipidol™.Other products containing red yeast rice extract can still be purchased, mostly over the Internet. However, these products may not be standardized, and effects are not predictable. For lowering cholesterol, there is better evidence for using prescription drugs such as lovastatin.

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Anthrax, anti-inflammatory, artherosclerosis, blood circulation problems, bruised muscles, bruises, cancer, colic in children, cuts, diarrhea, dysentery (bloody diarrhea), hangover, high blood pressure, indigestion, postpartum problems, spleen problems, stomach problems, wounds.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older):

Capsules: 1,200 milligrams of concentrated red yeast powder two times per day by mouth with food has been used.

The average consumption of naturally occurring red yeast rice in Asia has been reported as 14-55 grams/day.

Children (younger than 18 years):

There is not enough scientific evidence to recommend red yeast for children.

Tags: Herbal Medicine, Heart Disease

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