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Red Yeast Rice |
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Red Yeast Rice (RYR) is a food herb made by fermenting a type of red yeast called Monascus purpureus over white rice. Other names used to refer to Red Yeast Rice include: red rice, red yeast, Choestin, monacolin K, lovastatin, Hong Qu, Zhi Tai, Xue Zhi Kang.
Red Yeast Rice contains naturally-occurring substances called monacolins – one of which, monacolin K - is chemically identical to lovastatin. Lovastatin is the active ingredient in prescription medications for high cholesterol (e.g. Mevacor). Researchers believe that the body converts monacolins to a substance which inhibits HMG-CoA reductase, an enzyme that triggers cholesterol production. This is the same mechanism by which popular statin medications work.
Different fermentation and production methods of Red Yeast Rice results in a variety of diverse Red Yeast Rice products, meaning the concentration and cholesterol lowering effects could vary greatly. Supplements have been found to contain a range of lovastatin, eight other possible monacolins, pigments, tannins, and other phytochemicals. Due to such variability, as well as the potency of the cholesterol-lowering effects of lovastatin in red yeast rice, the FDA has banned red yeast rice products containing lovastatin. All other non-lovastatin Red Yeast Rice products have been classified by the FDA as a dietary supplement.
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History of Red Yeast Rice: |
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The use of Red Yeast Rice has been documented as far back as the Tang Dynasty in China 800 A.D. Documentation of medicinal Red Yeast Rice usage appears in the ancient Chinese pharmacopoeia, Ben Cao Gang Mu-Dan Shi By Yi, published during the Ming Dynasty (1368-1644). This text proposed Red Yeast Rice as a mild aid to indigestion, diarrhea, blood circulation, and spleen and stomach health. Red Yeast Rice is still used today in traditional Chinese medicine for poor circulation, indigestion, and diarrhea.
In the late 1800s, Dutch scientists noticed the beneficial effects of Red Yeast Rice on the people of Java, Indonesia, and isolated the fungus Monascus from Red Yeast Rice, and eventually introduced the fungus to western society. Red Yeast Rice was later introduced in the United States in the late 1990s as a dietary supplement. Lovastatin was originally derived from another type of red yeast called Monascus ruber.
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Benefits of Red Yeast Rice: |
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One of the most studied benefits of Red Yeast Rice is its ability to lower cholesterol and triglyceride levels. Several studies in China have consistently shown that long-term therapy with Red Yeast Rice supplementation significantly decreased the recurrence of coronary events in those with a history of cardiovascular problems.
Red Yeast Rice was also shown to significantly reduce levels of total cholesterol, LDL ("bad") cholesterol, and total blood concentration of triglycerides. With lipid-modulating and anti-inflammatory effects, red yeast rice can improve endothelial function by increasing blood flow to the vital cells that line the heart, blood vessels, lymphatic, and various other cavities. Preliminary research has shown promising results in using Red Yeast Rice to treat Cancer (particularly colon and prostate cancer) and Diabetes.
Chang JC, Wu MC, Liu IM, Cheng JT. Plasma glucose-lowering action of Hon-Chi in striptozotocin-induced diabetic rats. Horm Metab Res. 2006 Feb;38(2):76-81.
Hong MY, Seeram P, Zhang Y, Heber D. Anticancer effects of Chinese red yeast rice versus monacolon K along on colon cancer cells. J Nutr Biochem. 2008 Jul;19(7):448-58.
Ye P, LU ZL, Du BM, et al. Effect of xuezhikang on cardiovascular events and mortality in elderly patients with a history of myocardial infarction: a subgroup analysis of elderly subjects from the China Coronary Secondary Prevention Study. J Am Geriatr Soc. 2007; 55:1015-1022.
Zhao SP, Liu L, Cheng YC, Shishehbor MH, et al. Xuezhikang, and extract of cholestin, protects endothelial function through anti-inflammatory and lipid-lowering mechanisms in patients with coronary heart disease. Circulation. 2004 Aug 24;110(8):915-20.
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Sources and Forms of Red Yeast Rice: |
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Red Yeast Rice is a product of the Monascus purpureus yeast grown on white rice. Its most common form is that of a dried, finely ground powder called Zhi Tai. When extracted with alcohol, it is called Xue Zhi Kang.
There are many ways of cultivating red yeast rice. In traditional production methods, the white rice is first soaked in water until the grains are fully saturated. The raw, soaked rice is then steamed for the purpose of sterilization, and then inoculated with yeast by mixing Monascus purpureus spores together with the processed rice. This mix is then incubated in room temperature for 3-6 days, during which time the rice will become fully cultured with M. pupureus, and each grain of rice turns reddish purple on the outside, with the color becoming increasingly red at the core of the rice grain.
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Recommended Dosage of Red Yeast Rice: |
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Currently, there is no established recommended dosage for Red Yeast Rice, however, some studies use a standardized commercial preparation, known as Xuezhikang, with 300mg tablets taken twice per day. Each 300mg capsule of xuezhikang contained monacolin K equivalent to lovastatin 2.5-3.2mg/capsule.
There is no scientific evidence available for recommending red yeast rice for children under 18, and as a precautionary measure, doctors advise against children under 20 and women who are pregnant or breastfeeding from taking red yeast rice. Due to the strong possibility that Red Yeast Rice may deplete CoQ10, an important nutrient in heart and muscle health, as well as energy production, it is recommended that anyone on a Red Yeast Rice regimen supplement their diet with 150-200mg of CoQ10 at night. Supplementation with CoQ10 should continue every day that you are on the Red Yeast Rice regimen, and for 4 weeks after you stop the regimen.
Langsjoen PH, Langsjoen AM. The clinical use of HMG CoA-reductase inhibitors and the associated depletion of coenzyme Q10. A review of animal and human publications. Biofactors. 2003;18:101-111.
Lu Z, Kou W, Du B, et al. Effect of xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction. Am J Cardiol. 2008;101:1689-1693.
Yang HT, Lin SH, Huang SY, et al. Acute administration of red yeast rice (Monascus purpureus) depletes tissue coenzyme Q(10) levels in ICR mice. Br J Nutr. 2005;93:131-135.
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Safety and Side Effects of Red Yeast Rice: |
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With the FDA ban on red yeast rice supplements containing lovastatin, the specific positive or negative side effects of Red Yeast Rice products in the United States are unknown. In red yeast rice products containing lovastatin, side effects mimic those of prescription statin drug.
Severe side effects include elevated liver enzymes , rhabdomyolysis (muscle wasting) leading to kidney impairment, liver inflammation, damage to peripheral nerves, muscle pain, and weakness. Other known side effects may include: anaphylaxis (allergic reactions), headache, indigestion, bloating and gas, dizziness, heartburn, and joint pain. Red yeast rice has also been found to obstruct the body’s ability to produce CoQ10, a coenzyme important to heart and muscle health, as well as in energy production.
Contraindicated medications (medication that should be avoided when taking Red Yeast Rice containing Lovastatin) include the antidepressant nefazodone, antibiotics, anti-fungal medicines, HIV medicines, and all other cholesterol-lowering medications.
Mueller PS. Symptomatic myopathy due to red yeast rice. Annals of Internal Medicine. 145.6(2006):474-5.
Prasad GV, Wong T, Meliton G, et al. Rhabdomyolysis due to red yeast rice (Monascus purpureus) in a renal transplant recipient. Transplantation. 2002;74:1200-1201.
Smith DJ, Olive KE. Chinese red rice-induced myopathy. Southern Medical Journal. 96.12(2003):1265-7.
Vercelli L, Mongini T, Olivero N, Rodolico C, Musumeci O, Palmucci L, Chinese red rice depletes muscle coenzyme Q10 and maintains muscle damage after discontinuation of statin treatment. Journal of the American Geriatrics Society. 54.4(2006):718-20.
Wigger-Alberti W, Bauer A, Hipler UC, Eisner P. Anaphylaxis due to Monascus purpureus-fermented rice (red yeast rice). Allergy. 1999 Dec;54(12):1330-1.
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Frequently Asked Questions on Red Yeast Rice: |
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Can Red Yeast Rice be used to treat heart-disease and other heart-related ailments?
Yes, Red yeast rice works similarly to prescription statin medications in lowering cholesterol, which can have a positive impact on those with coronary heart disease. Along with lowering cholesterol, studies have shown that Red Yeast Rice also lowers levels of triglycerides and lipids, has an anti-inflammatory effect, and has a protective effect on endothelial function.
A multi-center, randomized, double-blind study in China was conducted from approximately 5000 patients, age 18 to 70, over a 4-and-a-half year period. All patients in the study had suffered a previous heart attack in the year prior to the start of the study. Results were startling, with the risk of repeated heart attacks reduced by 45%. The need for revascularization (bypass surgery/angioplasty) was reduced by 30 %, and total mortality was reduced by 33%.
In another study, 50 cardiac heart disease patients were placed on a regimen of 1200mg/day of xuezhikang (RYR) or placebo. On the first day, the subjects were given a high fat meal (800 cal, 50g fat), and were found to have high post-meal flow-mediated vasodilation (blood pressure). When the high fat meal test was run again six weeks later, there was significant improvement in both pre-meal and post-meal blood pressure.
Other researchers determined that the cholesterol-lowering effect of the active ingredient of red yeast rice was dose-dependant, where the higher the dosage taken, the greater the decrease in cholesterol levels. This reduction was found to be a result of RYR inhibiting HMG-CoA reductase enzyme production – thus impeding the creation and secretion of cholesterol from the liver.
Man RY, Lynn EG, Cheung F, Tsang PS, et al. Cholestin inhibits cholesterol synthesis and secretion in hepatic cells (HepG2). Mol Cell Biochem. 2002 Apr;233(1-2):153-8.
Zhao SP, Liu L, Cheng YC, Shishehbor MH, et al. Xuezhikang, an extract of cholestin, protects endothelial function through anti-inflammatory and lipid-lowering mechanisms in patients with coronary heart disease. Circulation. 2004 Aug 24;110(8):915-20.
Can Red Yeast Rice supplementation be used in the treatment of Diabetes?
Animal studies into usage of red yeast rice for the treatment of diabetes has been positive. One study compared blood glucose levels of diabetic rats and normal rats after the oral administration of Hon-Qi, another form of red yeast rice. Results showed that blood glucose levels dropped in both the diabetic and normal rats, suggesting that red yeast rice could be successfully used as a treatment for diabetic rats lacking insulin.
Early human evidence suggests some potential for diabetes treatment, including reducing the macrovascular complications of type 2 diabetes. In a study of 591 patients with coronary heart disease and type 2 diabetes, a 4-year regimen of xuezhikang (RYR) reduced the risk of a coronary event by 50.8% over the placebo group.
Although additional study is needed before firm recommendations can be made regarding the use of red yeast rice in the treatment of diabetes – current research affirms that RYR therapy can be effective at preventing coronary events, while being safely tolerated by diabetic patients.
Chang JC, Wu MC, Liu IM, Cheng JT. Plasma glucose-lowering action of Hon-Chi in strptozotocin-induced diabetic rats. Horm Metab Res. 2006 Feb;38(2):76-81.
Zhao SP, Lu ZL, Du BM, et al. Xuezhikang, an extract of cholestin, reduces cardiovascular events in type 2 diabetes patients with coronary heart disease: subgroup analysis of patients with type 2 diabetes from China coronary secondary prevention study (CCSPS). J Cardiovasc Pharmacol. 2007;49:81-84.
Can Red Yeast Rice be used in the prevention or treatment of Cancer?
Since de novo cholesterogenesis, or the ongoing production of cholesterol by the liver, is critical to the growth of tumor cells, research into red yeast rice and its effects on cancer cells have been promising.
Studies clearly show that Red Yeast Rice inhibited the proliferation of prostate cancer cells and colon cancer cells. Additional animal and human studies must be conducted to determine the conclusive answers to Red Yeast Rice supplementation in the prevention and treatment of cancer.
Hong, MY, Seeram P, Zhang Y, Heber D. Anticancer effects of Chinese red yeast rice versus monacolin K alone on colon cancer cells. J Nutr Biochem. 2008 Jul;19(7):448-58.
Hong MY, Seeram P, Zhang Y, Heber D. Chinese red yeast rice versus lovastatin effects on prostate cancer cells with and without androgen receptor overexpression. J Med Food. 2008 Dec;11(4):657-66.
Why should I take Red Yeast Rice, when I can just take a prescription statin medication?
Much of the published literature shows the near-identical cholesterol-lowering effect of prescription statin medication (i.e. Mevacor) and Red Yeast Rice containing Lovastatin. There are many problems associated with the usage of Red Yeast Rice. Red Yeast Rice is a natural compound - with several different proprietary methods of production, more than one active ingredient, and may vary in efficacy from dose to dose.
Prescription statins are heavily regulated, and have precise amounts of active ingredient per dose. Additionally, patients who take prescribed medicines usually do so under the careful observation of a medical professional. There are still many reasons why Red Yeast Rice can be an excellent alternative to statins.
Cancer studies on the cellular level consistently show that RYR treatments were more effective than statins in preventing re-growth of tumors. Red Yeast Rice has a myriad of ingredients that work in a synergistic manner to provide antioxidant properties. As a natural substance, Red Yeast Rice is also easily tolerated very well by diabetic and post-chemotherapy patients. It is an effective substitute for those seeking cheaper health care, as well as those preferring a more natural and botanical solution.
Heber D, Lembertas A, Lu OY, Bowerman S, et al. An analysis of nine proprietary Chinese red yeast rice dietary supplements: implications of variability in chemical profile and contents. J Altern Complement Med. 2001 Apr;7(2):133-9.
Huang HN, Hua YY, Bao Gr, Xie LH. The quantification of monacolin K in some red yeast rice from Fujian province and the comparison of the other product. Chem Pharm Bull (Tokyo). 2006 May;54(5):687-9.
Huang Z, Xu Y, Li L, Li Y. Two new Monascus metabolites with strong blue fluorescence isolated from red yeast rice. J Agric Food Chem. 2008 Jan 9;56(1):112-8.
Li Z, Seeram NP, Lee R, Thames G, et al. Plasma clearance of lovastatin versus Chinese red yeast rice in healthy volunteers. J Altern Complement Med. 2005 Dec;11(6):1031-8.
Liu BH, Wu TS, Su MC, et al. Evaluation of citrinin occurrence and cytotoxicity in Monascus fermentation products. J Agric Food Chem. 2005;53:170-175.
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Additional Research on Red Yeast Rice: |
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Red Yeast Rice and Heart Disease
Ye P, Lu ZL, Du BM, et al. Effect of xuezhikang on cardiovascular events and mortality in elderly patients with a history of myocardial infarction: a subgroup analysis of elderly subjects from the China Coronary Secondary Prevention Study. J Am Geriatr Soc. 2007;55:1015-1022.
Red Yeast Rice and Cholesterol-Management
Du BM, Lu ZL, Chen Z, et al. The beneficial effects of lipid-lowering therapy with Xuezhikang on cardiac events and total mortality in coronary heart disease patients with or without hypertension: a random double-blinded, placebo controlled clinical trial. Zhonghua Xin Xue Guan Bing Za Zhi. 2006;34:890-894.
Heber D, Yip I, Ashley JM, et al. Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Am J Clin Nutr. 1999;69:231-236.
Huang CF, Li TC, Lin CC, et al. Efficacy of Monascus purpureus Went rice on lower lipid ratios in hypercholesterolemic patients. Eur J Cardiovasc Prev Rehabil. 2007;14:438-440.
Lin CC, Li TC, Lai MM, et al. Efficacy and safety of Monascus purpureus Went rice in subjects with hyperlipidemia. Eur J Endocrinol. 2005;153:679-686.
Liu J, Zhang J, Shi Y, et al. Chinese red yeast rice (Monascus purpureus) for primary hyperlipidemia: a meta-analysis of randomized controlled trials. Chin Med. 2006;1:4.
Silver MA, Langsjoen PH, Szabo S, et al. Effect of atorvastatin on left ventricular diastolic function and ability of coenzyme Q10 to reverse that dysfunction. Am J Cardiol. 2004;94:1306-1310.
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