Risks of Red Yeast Rice

In order to avoid certain complications, you should understand certain red yeast rice risks. Before taking it, tell your healthcare provider if you have liver disease, a history of any problems with "statin" medications, or any allergies. It is also important to understand that the FDA considers red yeast rice supplements that contain lovastatin to be "unapproved drugs," not dietary supplements.

What Are the Risks of Red Yeast Rice?

Red yeast rice is a popular but controversial dietary supplement, usually used for treating high cholesterol. You should talk with your healthcare provider prior to taking it if you have:
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
In addition, tell your healthcare provider about any other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Red Yeast Rice Risks

Warnings and precautions to be aware of concerning the safety of red yeast rice include the following:
  • Some supplements contain lovastatin (Mevacor®), a prescription "statin" cholesterol medication. Lovastatin is not physically added to these supplements; instead, it is produced naturally when red yeast rice is fermented. Not all products contain lovastatin. In fact, most red yeast rice that is used in food contains little or no lovastatin.
Red yeast rice is produced from the fermentation of rice using a certain type of yeast. If the fermentation conditions are carefully controlled and specific strains of yeast are used, the result can be made to contain high levels of lovastatin. This is how red yeast rice supplements that are designed to lower cholesterol are made. Supplements that do not contain lovastatin are probably not effective at lowering cholesterol.
  • The U.S. Food and Drug Administration (FDA) has taken action against several manufacturers of red yeast rice supplements that contain lovastatin. Because they contain lovastatin but have not been approved by the FDA, these supplements are considered "unapproved drugs," not dietary supplements. Currently, many red yeast rice supplements do not contain lovastatin in order to comply with the FDA requirements, but, as mentioned, these products are not likely to be effective at lowering cholesterol.
  • Many people take red yeast rice as a natural alternative to statin cholesterol medications, not realizing that it contains a statin. This product should be assumed to have all of the usual side effects and toxicities of statin medications. If you have had problems taking a statin in the past, do not take red yeast rice.
  • This supplement may cause an increase in liver enzymes, which can be a sign of liver damage. If you already have liver disease, you should not take red yeast rice. If you develop any signs of liver damage while taking it, including high liver enzymes, you should stop taking it.
  • Red yeast rice can cause rhabdomyolysis (the severe breakdown of muscles), which can cause serious kidney damage.
  • Reputable manufacturers make red yeast rice supplements that contain little or no lovastatin in order to comply with FDA regulations. Therefore, companies that make supplements that contain lovastatin are probably not reputable, as they are not following FDA rules and regulations. This creates a dilemma for consumers. Supplements that do not contain lovastatin probably don't work, and red yeast rice that does contain lovastatin is made by manufacturers that are not trustworthy.
  • This supplement can interact with some medications (see Red Yeast Rice Drug Interactions).
  • Pregnant or breastfeeding women should not take this supplement (see Pregnancy and Red Yeast Rice and Red Yeast Rice and Breastfeeding).
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