RED YEAST BENEFITS AND SIDE EFFECTS September 22, 2011
Red yeast rice Red Yeast Rice is a unique natural product native to China that's been used in Asian traditional medical systems since approximately 800 A.D. It is produced by the fermentation of red yeast (Monascus purpureus) with white rice. However, manufacturers need to carefully produce the product to avoid the presence of citrinin, a toxic by-product of the fermentation process. According to Sloan-Kettering, red yeast rice contains lovastatin, fatty acids, starch, fiber, protein, water, magnesium, calcium and other minerals.
Red yeast rice has been shown to have the benefits of cholesterol-lowering activities, as it contains lovastatin (a HMG-CoA reductase inhibitor which inhibits cholesterol synthesis in the body) as well as other cholesterol-lowering compounds.  Red yeast rice is likely to be able to directly impact the process of atherosclerosis consequently, it may carry the benefits of cardiovascular diseases.  _______________________________________________________________________________
Red yeast rice benefit - Cholesterol-Lowering and anti-atherosclerosis effects
Hyperlipidemia is a well-known risk factor for atherosclerosis and statins are widely used to treat patients with elevated levels of lipids in their plasma. Notwithstanding the proven benefits of statin drugs on both primary and secondary prevention of heart disease, the high cost of statin treatment, in addition to possible side effects such as liver function abnormalities, may limit their widespread use.
Researchers have studied the tong-term effects of red yeast rice extract on serum lipids and severity of atherosclerosis in rabbits. In the study, the researchers fed the rabbit with the extract together with 0.25% cholesterol for 200 days. They found 25% and 40% reductions in total cholesterol with respect to doses of 0.4 and 1.35 g/kg/day of the red yeast rice. They also observed a reduction of serum LDL cholesterol, triglycerides and atherosclerotic index. 
There are a few clinical studies about the benefits offered by red yeast rice on cholesterol levels. Most of the subjects are either patients suffered from hyperlipidermia or coronary artery disease. All studies reviewed show the efficacy of red yeast rice on cholesterol-lowering.
A recent clinical study has demonstrated that ingestion of a red yeast rice extract (Xuezhikang) led to rapid reduction of C-reactive protein levels within 24 h and lipid profile within 2 weeks. In the study, they randomly assigned 48 consecutive patients with stable angina to 1200 or 2400 mg/day of a red yeast rice extract (Xuezhikang). They found that the red yeast rice extract Xuezhikang reduced total cholesterol, low-density lipoprotein (LDL) cholesterol, median plasma C-reactive protein levels and in mean plasma C-reactive protein levels significantly. The higher dose of the red yeast rice extract Xuezhikang (2400 mg/day) resulted in significantly greater reductions in total cholesterol TC and low-density lipoprotein LDL cholesterol compared with 1200 mg/day group (p<0.05, p<0.01, respectively. While, they observed a less reduction in triglycerides (TG) levels and no significant difference in mean high-density lipoprotein (HDL) cholesterol levels compared with baseline. 
In another study of patients with coronary heart disease at dose of 1200 mg/d for 6 weeks, researchers also observed the reduction of lipid levels and improvement of inflammation after the administration of the red yeast rice extracts.  According to University of Maryland, the dosage of supplemental red yeast rice is 6,000 - 9,000 mg per day, however, it also depends on the physical properties of the users.
Researchers conducted a study on a natural product as an alternative to statin treatment. Cholestin, a dietary supplement, is prepared from rice fermented with red yeast (Monascus purpureus), which has been shown to significantly decrease total cholesterol levels in hyperlipidemic subjects.
A recent study of 62 people who stopped taking statins because of side effects, reported a significant cholesterol-lowering effect of a commercially available nonprescription red yeast rice product. The average drop in cholesterol was 43 points at 12 weeks. The participants took three 600-milligram vials of red yeast rice twice a day. Each vial had only one milligram of lovastatin, so they took about 6 mg a day. The participants also followed a lifestyle change program, including education on nutrition, exercise and relaxation techniques. [AA1]
Supplements of fish oil and red yeast rice, coupled with lifestyle changes in diet and exercise habits, are able to reduce cholesterol as much as standard cholesterol- lowering medications known as statins, according to a new study. [AA2]
Mechanism A red yeast extract was found to have a direct inhibitory effect on HMG-CoA reductase activity (78-69% of control). In the study, researchers found this red yeast extract (25-100 microg/mL) were significantly reduced cholesterol levels in human hepatic cells HepG2in a dose-dependent manner (81-45% of control, respectively). They found an association of this reduction with the decreased synthesis and secretion of both unesterified cholesterol (54-31 and 33-14% of control, respectively) and cholesteryl ester (18-6 and 37-19% of control, respectively). Thus, one of the anti-hyperlipidemic actions of the red yeast rice in the study was a consequence of an inhibitory effect on cholesterol biosynthesis in hepatic cells.  _____________________________________________________________________________
RED YEAST RICE BENEFITS OTHER THAN CHOLESTEROL-LOWERING ACTIVITIES According to the website of Mayo Clinic, red yeast rice may improve blood flow and benefit cardiovascular system. It may further offer benefits to people at risk of diabetes. However, more studies are needed to support this claim. _____________________________________________________________________________
RED YEAST RICE SIDE EFFECTS Red yeast rice side effect can be serious; it may cause damage in liver, kidney, muscles and joints. For details, please, click Red Yeast Rice Side Effects. _____________________________________________________________________________
Discussion Red yeast rice is available in commercial preparations, and Cholestin has been studied extensively. Moreover, FDA required the manufacturer to remove the product from the market. The current formulation, according to the website of The University of Maryland, doe not contain red yeast rice.
Clinical studies show the benefits of red yeast rice on cholesterol levels, while it is unclear whether it is safe to use red yeast rice for long term. Further, do not take red yeast rice together with other cholesterol-lowering agents, anticoagulants, and grapefruit juice.
Please, also note that red yeast is the product of rice fermented with Monascus purpureus yeast. Red yeast supplements are different from red yeast rice sold in Chinese grocery stores. [MedlinePlus, 09-23-2012] _____________________________________________________________________________
Reference  Patrick L and Uzick M Cardiovascular disease: C-reactive protein and the inflammatory disease paradigm: HMG-CoA reductase inhibitors, alpha-tocopherol, red yeast rice, and olive oil polyphenols. A review of the literature. Altern Med Rev. 2001 Jun;6(3):248-71.  Herbs and atherosclerosis. Curr Atheroscler Rep. 2001 Jan;3(1):93-6.  Li JJ et al, Effects of xuezhikang, an extract of cholestin, on lipid profile and C-reactive protein: a short-term time course study in patients with stable angina. Clin Chim Acta. 2005 Feb;352(1-2):217-24.  Wei W et al, Hypolipidemic and anti-atherogenic effects of long-term Cholestin (Monascus purpureus-fermented rice, red yeast rice) in cholesterol fed rabbits. J Nutr Biochem. 2003 Jun;14(6):314-8.  Zhao SP et al, Xuezhikang, an extract of cholestin, protects endothelial function through antiinflammatory and lipid-lowering mechanisms in patients with coronary heart disease. Circulation. 2004 Aug 24;110(8):915-20. Epub 2004 Aug 16.  Man RY et al, Cholestin inhibits cholesterol synthesis and secretion in hepatic cells (HepG2). Mol Cell Biochem. 2002 Apr;233(1-2):153-8. [AA1] A Substitute for Those Who Can't Take Statins? HealthDay Mon Jun 15, 2009 [AA2] Fish Oil, Red Yeast Rice Cut Cholesterol WebMed July 23, 2008 [AA3] Grieco A, Miele L, Pompili M, Biolato M, Vecchio FM, Grattagliano I, Gasbarrini G.Acute hepatitis caused by a natural lipid-lowering product: when "alternative" medicine is no "alternative" at all J Hepatol. 2009 Jun;50(6):1273-7. Epub 2009 Mar 31 [AA4] Prasad GV, Wong T, Meliton G, Bhaloo S. Rhabdomyolysis due to red yeast rice (Monascus purpureus) in a renal transplant recipient.Transplantation. 2002 Oct 27;74(8):1200-1
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