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6 Benefits and Side Effects of Red Yeast Rice (Some Red Yeast Rice Brands to Avoid, Be Aware!) [Updated Dec/2022]

It’s turned up on pharmacy shelves only within the last few decades, but red yeast rice has been prized for its powerful medicinal properties for hundreds of years.

Red Yeast Rice is a traditional fermented product that has been used for centuries to brew rice wine, as a flavor enhancer, food coloring agent, and to promote digestion, blood circulation and metabolism , which can be traced back to the “Gutian Local Chronicles” in the Tang Dynasty (618-907 AD)

Modern medicine has found that red yeast rice extract has anti-inflammatory, anti-oxidant, and anti-tumor activities, and is potentially helpful for the prevention and improvement of some chronic diseases, including hypercholesterolemia, hypertension, diabetes, obesity, dementia, and cancer.

In empirical medicine, does red yeast rice really have these effects? What are red yeast rice side effects? See the article report for details.

What is Red Yeast Rice?

Red Yeast Rice is fermented from rice or yam colonized by Monascus fungus and has been used for a long time in Asian cuisine and traditional medicine.

During the fermentation process, a variety of secondary metabolites produced by red yeast rice are the key to its medical value, including monascin (red yeast element), ankaflavin (red yeast flavin), Monacolin K (monacolin), dimerumic acid, GABA.

The chemical composition of Monacolin K is similar to the cholesterol-lowering drug lovastatin, which can reduce the effect of HMG-CoA reductase inhibitors (a rate-determining step in cholesterol synthesis) and indirectly inhibit cholesterol synthesis.

What Are the Benefits of Red Yeast Rice?

  1. Red Yeast Rice Benefits People With Osteoporosis

Osteoporosis is the most common systemic bone disease affecting millions of people around the world, especially the elderly or postmenopausal women.

Up to one in four men and one in five women aged 50 and over will experience a minor traumatic fracture that can cause significant pain, disability, and reduced quality of life. Treatment options such as medications, exercise, and physical therapy modalities can prevent further osteoporotic fractures.

A systematic literature review and meta-analysis (Meta-Analysis, including 11 randomized controlled trials) pointed out that red yeast rice or its extracts can significantly improve the bone density of experimental mice, promote the proliferation of osteoblasts, and increase the expression of alkaline phosphatase . Note 1

*Conclusion: Animal experiments pointed out that red yeast rice or its extracts can promote bone formation and may be helpful for the treatment of osteoporosis, but further verification by human studies is still needed.

  1. Red Yeast Rice Benefits Peopel With Myocardial Infarction

Myocardial infarction is a heart attack in which blood flow to the heart is reduced due to plaque buildup in the inner walls of the arteries and damage to the heart muscle due to lack of oxygen supply.

Symptoms include chest pain from the left arm to the neck, shortness of breath, sweating, nausea, vomiting, abnormal heartbeat, anxiety, fatigue, weakness, stress, depression, etc.

These types of heart attacks can be prevented by taking early action to reduce these risks by controlling diet, fat, cholesterol, salt, smoking, nicotine, alcohol, medications, monitoring blood pressure, exercising daily, and losing weight.

A meta-analysis of 7 randomized controlled trials involving 10,699 participants with myocardial infarction with borderline hypercholesterolemia found that adjuvant treatment with red yeast rice extract (1200 mg daily) reduced non-fatal events related to acute myocardial infarction, revascularization, and sudden death . Note 2

In addition, red yeast rice extract also reduced LDL cholesterol, total cholesterol, and triglyceride levels, and increased HDL cholesterol levels.

*Conclusion: For patients with myocardial infarction accompanied by borderline hypercholesterolemia, adjuvant treatment with red yeast rice extract can improve cardiovascular outcomes and blood lipid levels.

  1. Red Yeast Rice Benefits People With Schizophrenia

Schizophrenia is a chronic mental illness that mainly includes symptoms such as hallucinations and delusions, also known as “positive” symptoms. In addition, individuals may experience “negative” symptoms, including loss of joy, social withdrawal, poverty of thought and language, and depressed affect.

Severe cognitive impairment is common in schizophrenia, affecting up to 75% of patients. Specifically memory, attention, motor skills, executive function, and intelligence.

A pilot study (12 weeks in 35 stable patients with schizophrenia who were treated with antipsychotic drugs) showed that supplementation with red yeast rice extract significantly improved the Wisconsin Card Sorting Test (WCST) Continuous error, total error and phonemic fluency test items . Note 3

In addition, positive improvement trends can be observed in other WCST items, such as non-persistent errors, persistent responses, and semantic fluency subtasks.

*Conclusion: For cognitive disorders related to schizophrenia, red yeast rice extract may be able to bring positive help, but it is limited by the lack of control group, short observation period, small sample size, etc., and more research is needed.

  1. Red Yeast Rice Benefits People With Cardiovascular Disease (Lowering Blood Lipid)

Although deaths from cardiovascular disease have fallen by 31% over the past decade, they still account for a third of all deaths and are considered the number one killer in the world.

Elevated lipids lead to a cascade of reactions in the vessel wall, including endothelial dysfunction, smooth muscle cell proliferation, lipid accumulation, foam cell formation, and ultimately necrosis and plaque formation.

Hyperlipidemia is a major risk factor for a variety of diseases, including cardiovascular disease, type 2 diabetes, Alzheimer’s disease, and Parkinson’s disease. Therefore, taking effective measures and treating dyslipidemia is the key to preventing cardiovascular and cerebrovascular diseases.

A literature meta-analysis (Meta-Analysis, including 15 randomized controlled trials, a total of 1,012 patients with dyslipidemia) pointed out that Note 1

Compared with statins, red yeast rice extract is more effective in lowering TG (total triglycerides), lowering LDL-C (low-density lipoprotein cholesterol) and raising HDL-C (high-density lipoprotein cholesterol) Comparable in terms of , but less effective in lowering TC (total cholesterol).

Compared with other nutritional supplements, red yeast rice extract significantly reduces TC and LDL-C, and increases HDL-C.

In addition, red yeast rice extract significantly reduced apoB (apolipoprotein B) without increasing the risk of adverse events in patients with hyperlipidemia, either alone or in combination.

*Conclusion: Red yeast rice extract (daily dose 200 to 4800 mg) is an effective and relatively safe method for the treatment of dyslipidemia, but due to the heterogeneity of the included studies, strictly designed randomized controlled trials are still required to confirm its efficacy Efficacy and safety of long-term medication.

  1. Red Yeast Rice Regulates Blood Pressure

Hypertension, defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, is one of the most common chronic diseases.

High blood pressure can cause stroke, heart disease, heart and kidney failure, in addition, it is also related to dementia and sexual dysfunction.

Common symptoms associated with high blood pressure are headache, dizziness, hot flashes and mood disorders (low mood, depression, irritability), chest tightness, palpitations, back pain, constipation, and decreased vision.

A systematic review (systematic review, including 21 randomized controlled trials, a total of 4558 patients with hypertension) pointed out: . Note 2

Compared with placebo + conventional treatment, red yeast rice + conventional treatment can significantly reduce serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and CRP, but has no effect on systolic blood pressure, diastolic blood pressure, triglycerides Ester (TG) and high-density lipoprotein cholesterol (HDL-C) had no significant effect.

Compared with conventional treatment, red yeast rice + conventional treatment had a significant reduction effect on systolic blood pressure, TC, LDL-C, and CRP, but had no effect on diastolic blood pressure, TG, and HDL-C.

There was no significant difference in the improvement of blood pressure and blood lipids between red yeast rice + conventional treatment and statins + conventional treatment.

*Conclusion: Oral red yeast rice extract may have a positive effect on blood pressure control, but due to the heterogeneity and biases between studies, more rigorous trials are still needed to confirm its clinical benefits.

  1. Red Yeast Rice Regulates Blood Sugar Level

Diabetes is a growing public health problem affecting nearly one-third of U.S. adults over the age of 60, about half of whom are undiagnosed and another third have prediabetes.

Symptoms include periodic rises in blood sugar levels because the body does not produce enough insulin or the tissues resist the effects of insulin.

Poor blood sugar control can lead to short-term severe shock and a variety of long-term complications, including stroke, neuropathy, kidney disease and vision problems.

A randomized, double-blind clinical study (16 weeks in 39 diabetic patients) showed that the use of red yeast rice extract (fermented from the Monascus purpureus NTU 568 strain of red yeast rice) can help improve fasting blood sugar, low-density lipoprotein Cholesterol, total cholesterol levels . Note 3

*Conclusion: For diabetic patients, oral red yeast rice extract may be helpful for blood sugar regulation, but it is limited by the small number of samples, and more large-scale trials are needed to support it.

How to Eat Red Yeast Rice Supplements? What is the Recommended Dosage?

It’s better to take red yeast rice with CoQ10 (coenzyme Q10) or other supplements, such as nattokinase, or fish oil/omega-3 fatty acids.

Depending on the purity and form of the supplement, the optimal dosage varies, most clinical trial studies have used dosages from 200 to 4800 mg, and the optimal time is after meals

However, considering the risk of side effects and safety concerns associated with red yeast rice extract, it is best to check with your doctor about your physical condition before use to ensure safety.

What Are the Red Yeast Rice Side Effects?

Red yeast rice contains chemicals (monacolin K) that are similar to prescription statins, so the side effects may be similar.

Possible red yeast rice side effects that have been reported include: unexplained muscle pain and weakness, unusual fatigue, upper abdominal pain, liver injury, nausea, heartburn, headache, memory loss, constipation, loss of appetite, dark urine, gray stools , yellow skin or eyes… etc.

Red Yeast Rice Safety Precautions

  1. Do not use if you suffer from muscle and nerve-related diseases, such as Myasthenia Gravis (may cause symptoms to worsen).
  1. Improperly fermented red yeast rice may contain citrinin. Long-term exposure to citrinin can cause damage to the heart, liver, kidneys and reproductive system. Please choose the brand carefully before buying.
  1. Pregnant women should not use it as it may cause birth defects.
  1. Do not use for breastfeeding women, children, and those with poor liver and kidney function, because the relevant safety is unknown.
  1. Do not use if you have ever been allergic to red yeast rice products . There have been reports of severe allergic reactions caused by eating red yeast rice. Symptoms related to allergies include: difficulty breathing, swelling of the face/lips/tongue or throat, sneezing, rhinitis, Conjunctivitis, generalized itching. Note 4
  1. The metabolites in red yeast rice are the same as statin drugs, which will also hinder the synthesis of CoQ10 (coenzyme Q10) in the body, resulting in a decrease in the concentration of CoQ10 (coenzyme Q10). Note 5
  1. CoQ10 (coenzyme Q10) is an important enzyme in cells, which can help synthesize energy. If it is deficient, it will cause symptoms such as fatigue, muscle pain damage, heart failure, etc., and even rhabdomyolysis in severe cases (so if you take red yeast rice with CoQ10 (coenzyme Q10) , or add the compound ingredients of CoQ10, which can reduce the occurrence of such side effects).
  1. Do not use in combination with alcoholic beverages, which may increase the risk of liver damage.
  1. Do not use with Cyclosporine, Niacin and Gemfibrozil, which may increase the incidence of muscle lesions.
  1. Do not use it in combination with hepatotoxic drugs, which may increase the incidence of liver damage. Related drugs include: acetaminophen, amiodarone, carbamazepine, isoniazid, methotrexate, methyldopa, fluconazole, itraconazole, erythromycin, phenytoin, lovastatin, pravastatin, simvastatin.
  1. Do not use it in combination with cholesterol-lowering drugs (Statins), which may increase the incidence of side effects. Related drugs are: cerivastatin, atorvastatin, lovastatin, pravastatin, simvastatin.
  1. Do not use with drugs and herbs that need to be metabolized by the liver cytochrome P450 enzyme system, which may affect the efficacy of the drug. Common related drugs include: amiodarone, clarithromycin, diltiazem, erythromycin, indinavir, ritonavir, saquinavir.

Where to Buy the Most Reliable Red Yeast Rice Supplements?

In recent years, food safety problems in many countries have exploded, and what people spend money on is not health, but unscrupulous products. Therefore, European and American products with relatively strict quality control have become popular products. You can buy red yeast rice supplements and other supplemets such as CoQ10 in Costco and pharmaceutical stores.

There are some of the red yeast rice brands to avoid when purchasing, based on customer review and feedback, such as Thorne, Spring Valley, Solaray, 21st Century, Only Natural, Nature’s Plus.

Where can I buy the highest quality Red Yeast Rice that is recommended by most people?

Thorne, Choleast-900, 120 Capsules

(Direct shipping from the United States / Worldwide delivery)

Product Tips

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Product Features:

Thorne Research is a top health care brand originating from the United States that has been established for more than 30 years, and its products are widely praised by natural medicine clinics, and the main feature is Magnesium Stearate, which does not contain excipients.


Each capsule contains 900 mg of natural red yeast yeast extract, in addition to the active ingredient monacolins, there are also native substances such as plant sterols, isoflavones and trace minerals for optimal synergistic effects.

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