Why I Don’t Recommend Red Yeast Rice Cholesterol-Lowering Supplements

· ·

Red yeast rice contains the drug lovastatin and may also contain kidney toxins.

Discuss
Languages

    Selecting a language opens the video on YouTube with captions enabled.

  • English
Republish

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Among cholesterol-lowering dietary supplements, red yeast rice extract, produced by a purplish-red mold, is one of the only things that have been shown to actually reduce the risk of cardiovascular events. Based on studies including more than 10,000 patients, red yeast rice extract cut the risk of a subsequent heart attack in half, and significantly decreased not just sudden death but premature death in general. No wonder, since it can decrease LDL cholesterol by an average of 36 points––comparable to what’s seen with low doses of cholesterol-lowering statin drugs. That’s because it is a statin drug. The mold produces lovastatin, the identical compound in the pill sold as Mevacor. In fact, that’s how the drug was first produced—by having that exact mold make it. No wonder it’s lowering cholesterol and saving lives.

So, are red yeast rice supplements suitable substitutions for statins? Unfortunately, no, since there’s such a large variability in statin content. So, predicting or understanding dose-related efficacy and safety is practically impossible. For example, this study on the variability in strength of red yeast rice supplements purchased from the mainstream retailers GNC, Walgreens, Walmart, and Whole Foods: researchers analyzed 28 brands of red yeast rice supplements.

The active ingredient, lovastatin, also known as monacolin K, was not detected at all in two brands, and in the other 26 brands, the quantity ranged more than 60-fold. Following the manufacturers’ recommendations for daily servings, the quantity consumed per day would range more than a hundred-fold. In the United States, manufacturers don’t list the amount, but in Europe, where they do, not a single supplement matched what it said on the label. Nine were lower, 24 were higher, and three basically had nothing. So, in other words, Buyer Beware!

An independent U.S. laboratory recently analyzed ten popular red yeast rice products, and most didn’t contain any, and those results were even worse than previous years.

But wait, what’s this about 30% being contaminated with a kidney toxin called citrinin, exceeding the allowable safety limit by 65-fold?

The U.S. Food and Drug Administration has been warning consumers for years to avoid red yeast rice products because they contain kidney toxins, including citrinin, a type of mold toxin, which is considered toxic to the kidneys, liver, and fetus, found at high levels contaminating up to 80% of red yeast rice products. Given that it’s also classified as a DNA-damaging compound, Europe dropped the maximum amount permitted in food supplements down to 100 μg/kg. Thirty-seven red yeast rice supplements were screened. Guess how many exceeded the safety limit: 97%! 36 out of 37. Only a single product was compliant. And all of them contained the toxin, even though four of the products swore they were “citrinin free.” Liars. The bottom line is this toxin is almost always present and above safety limits.

In Japan, there was an outbreak of serious kidney problems linked to red yeast rice supplements causing hundreds of hospitalizations and five deaths, which is particularly alarming because the supplement company had evidently addressed the known citrinin concern by using a mold strain reportedly incapable of producing citrinin. It turns out the batch was contaminated by another type of mold that made a different kind of kidney toxin. So, as far as I’m concerned, if you want to take a statin drug, just take a statin drug; so, by law you know exactly how much you’re getting, and you don’t have to worry about mold toxin contamination issues. Modern medicine contains lots of examples of natural substances whose active ingredients were identified, isolated, studied, standardized, and regulated to create a product whose net benefits outweigh the harms. Without these steps, we are left relying on anecdotes, hearsay, and blind faith that a substance will have its desired effect.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Among cholesterol-lowering dietary supplements, red yeast rice extract, produced by a purplish-red mold, is one of the only things that have been shown to actually reduce the risk of cardiovascular events. Based on studies including more than 10,000 patients, red yeast rice extract cut the risk of a subsequent heart attack in half, and significantly decreased not just sudden death but premature death in general. No wonder, since it can decrease LDL cholesterol by an average of 36 points––comparable to what’s seen with low doses of cholesterol-lowering statin drugs. That’s because it is a statin drug. The mold produces lovastatin, the identical compound in the pill sold as Mevacor. In fact, that’s how the drug was first produced—by having that exact mold make it. No wonder it’s lowering cholesterol and saving lives.

So, are red yeast rice supplements suitable substitutions for statins? Unfortunately, no, since there’s such a large variability in statin content. So, predicting or understanding dose-related efficacy and safety is practically impossible. For example, this study on the variability in strength of red yeast rice supplements purchased from the mainstream retailers GNC, Walgreens, Walmart, and Whole Foods: researchers analyzed 28 brands of red yeast rice supplements.

The active ingredient, lovastatin, also known as monacolin K, was not detected at all in two brands, and in the other 26 brands, the quantity ranged more than 60-fold. Following the manufacturers’ recommendations for daily servings, the quantity consumed per day would range more than a hundred-fold. In the United States, manufacturers don’t list the amount, but in Europe, where they do, not a single supplement matched what it said on the label. Nine were lower, 24 were higher, and three basically had nothing. So, in other words, Buyer Beware!

An independent U.S. laboratory recently analyzed ten popular red yeast rice products, and most didn’t contain any, and those results were even worse than previous years.

But wait, what’s this about 30% being contaminated with a kidney toxin called citrinin, exceeding the allowable safety limit by 65-fold?

The U.S. Food and Drug Administration has been warning consumers for years to avoid red yeast rice products because they contain kidney toxins, including citrinin, a type of mold toxin, which is considered toxic to the kidneys, liver, and fetus, found at high levels contaminating up to 80% of red yeast rice products. Given that it’s also classified as a DNA-damaging compound, Europe dropped the maximum amount permitted in food supplements down to 100 μg/kg. Thirty-seven red yeast rice supplements were screened. Guess how many exceeded the safety limit: 97%! 36 out of 37. Only a single product was compliant. And all of them contained the toxin, even though four of the products swore they were “citrinin free.” Liars. The bottom line is this toxin is almost always present and above safety limits.

In Japan, there was an outbreak of serious kidney problems linked to red yeast rice supplements causing hundreds of hospitalizations and five deaths, which is particularly alarming because the supplement company had evidently addressed the known citrinin concern by using a mold strain reportedly incapable of producing citrinin. It turns out the batch was contaminated by another type of mold that made a different kind of kidney toxin. So, as far as I’m concerned, if you want to take a statin drug, just take a statin drug; so, by law you know exactly how much you’re getting, and you don’t have to worry about mold toxin contamination issues. Modern medicine contains lots of examples of natural substances whose active ingredients were identified, isolated, studied, standardized, and regulated to create a product whose net benefits outweigh the harms. Without these steps, we are left relying on anecdotes, hearsay, and blind faith that a substance will have its desired effect.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Doctor's Note

This is the 10th video in an extended series on the critically important topic of how to lower LDL cholesterol, the primary driver of our primary killer. In this series, we take a deep dive into ways we may lower our cholesterol through diet. We’ll explore the Portfolio Diet, plant sterols, and cholesterol-lowering supplements, foods, herbs, and spices, before concluding with my Portfolio Plus Powder recipe “cooking” video.

If you don’t want to wait for all the videos to be released over time, we’ve compiled all the information into my latest book, Lower LDL Cholesterol Naturally with Food, available as a softcover, ebook, and audiobook.

If you missed the previous videos in this series, see:

If you haven't yet, you can subscribe to our free newsletter. With your subscription, you'll also get notifications for just-released blogs and videos. Check out our information page about our translated resources.

Subscribe to our free newsletter and receive the the Maximally LDL-Lowering Daily Dozen checklist from Dr. Greger's Lower LDL Cholesterol Naturally with Food book.

Previous Video

Why I Don’t Recommend Policosanol Cholesterol-Lowering Supplements

Next Video

Friday Favorites: Dietary Cholesterol and Inflammation from Abdominal Obesity

Pin It on Pinterest

Share This