Red yeast rice extract: A possible natural supplement for high cholesterol levels.

At Metabolica Med Dietitians we are continually attempting to keep up with nutrition research to provide our clients with updated and scientific information. In the field of nutrition, nutritional supplements are a controversial subject because of possible unnecessary supplementation vs health benefits and the correct use in certain circumstances.

Red yeast rice extract (RYRE) is a supplement that has anecdotal evidence in our practice to improve high cholesterol levels. 

Red yeast rice is a type of fermented rice that is produced using specific species of mold, Monascus ruber or Monascus purpureus. It contains a component monacolin K — the same active ingredient found in prescription cholesterol-lowering medications like Lovastatin.

It has been used for many years in Asian cuisine and traditional Chinese medicine for its health-promoting properties [1]. 

Research has shown other potentially beneficial effects as well, ranging from heart health, reduced cancer cell growth, improved blood sugar and insulin levels, and reduced inflammation.

Heart health:

In a pilot, primary prevention study of dyslipidemic patients with low to moderate cardiovascular risk, red yeast rice induced fewer fatigue side effects and exerted comparable lipid-lowering effects when compared to Simvastatin a cholesterol-lowering drug [2].

Furthermore, several clinical trials have shown RYR to be effective in reducing cholesterol in those who are intolerant of statins because of statin-associated myalgias, gastrointestinal side effects, or elevated transaminase levels [3].

Metabolic syndrome:

It has been shown that red yeast rice extract was able to reduce blood sugar, systolic blood pressure, and insulin levels. All factors form part of metabolic syndrome [4].

Could reduce inflammation:

Inflammation is a normal response of the body to acute infection or foreign substances. When the inflammation becomes chronic or prolonged it affects one’s health and can contribute to diabetes, cancer, and heart disease.

Red yeast rice extract may lower inflammation [5].

May have anti-cancer properties:

Studies on red yeast rice and cancer have only been done on mice and that showed a positive correlation of red yeast rice and prostate cancer in mice [6].

Possible downsides:

Because RYR contains monacolin K, also used in cholesterol-lowering medication, it should be used under the supervision of a health care professional considering important health markers and the use of other medication.

RYR should not be used while being pregnant or breastfeeding.

Drug interactions should be considered.

RYR Should not be taken in addition to prescription statin drugs [7].


RYR is a possible natural supplement for hyperlipidemia, and it is important to discuss the use of it with your health care provider as additional complementing ingredients, such as folic acid, vitamin B6, vitamin B12, coenzyme Q10, inositol, and milk thistle might be considered as well.


1.  Nguyen T,  Karl M,  Santini A. Red yeast rice.Foods.2017;6:19.

2. Xue Y, Tao L, Wu S, Wang G, Qian L, Li J, Liao L, Tang J, Ji K. Red yeast rice induces less muscle fatigue symptom than simvastatin in dyslipidemic patients: a single-center randomized pilot trial.BMC Cardiovasc Discord.2017;17:127.

3. Burke FM. Red yeast rice for the treatment of dyslipidemia. Curr Atheroscler Rep. 2015 Apr;17(4):495. 

4. Affuso F, Mercurio V, Ruvolo A, Pirozzi C, Micillo F, Carlomagno G, Grieco F, Fazio S. A nutraceutical combination improves insulin sensitivity in patients with metabolic syndrome. World J Cardiol. 2012 Mar 26;4(3):77-83. Available from DOI: 10.4330/wjc.v4.i3.77. PMID: 22451856; PMCID: PMC3312235.

5. Patel S. Functional food red yeast rice (RYR) for metabolic syndrome amelioration: a review on pros and cons. World J Microbiol Biotechnol. 2016 May;32(5):87.Available from: DOI: 10.1007/s11274-016-2035-2. Epub 2016 Apr 2. PMID: 27038957.

6. Hong MY, Henning S, Moro A, Seeram NP, Zhang Y, Heber D. Chinese red yeast rice inhibition of prostate tumor growth in SCID mice. Cancer Prev Res (Phila). 2011;4(4):608-615. Available from:doi:10.1158/1940-6207.CAPR-10-0219

7. Klimek M, Wang S, Ogunkanmi A. Safety and efficacy of red yeast rice (Monascus purpureus) as an alternative therapy for hyperlipidemia. P T. 2009 Jun;34(6):313-27.

Author: Amanda Kotze – Registered Dietitian (RDSA)

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