Red yeast rice is created by fermenting rice using the particular yeast strain, monascus purpureus. This can be done by soaking rice until fully saturated and introducing the yeast spores or a powder made from red yeast rice to the mix. Culturing takes between 3 and 6 days at room temperature. When the rice is fully cultured, the grains will become bright red on the inside and purplish red on the outside. Marketed as a dietary supplement in many parts of the world, there is a correlation between red yeast rice and cholesterol.
Red yeast rice is cooked and eaten much the same way one prepares white rice throughout Asia. It is also used for its bright color in many Asian dishes. In addition to this, it has been used in traditional Chinese medicine since at least the Tang dynasty (circa AD 800).
RYR contains chemical substances identified as monacolins. These chemicals work in the body to block the action of HMG-CoA reductase, an enzyme associated with the production of cholesterol in the body. In fact, one, monacolin K, is chemically identical to the cholesterol lowering drug, lovastatin, marketed as the prescription drug, Mevacor. This has lead to a great deal of controversy over whether red yeast rice products should be sold as dietary supplements or considered drugs.
This controversy has raged around the world, but nowhere as much as in the US. The US FDA has taken the stand that any red yeast rice products containing monacolin K are a drug (lovastatin) and subject to regulation as such. For many years, products containing red yeast rice were banned in the US for this reason.
Today, there are approximately 30 different brands of RYR products that are sold in the US as dietary supplements. They accomplish this by either eliminating the monacolin K completely or limiting to a level well below the threshold considered to be a minimum dose of lovastatin if taken as directed. Some, however, carry warning labels similar to those required by the FDA for statin drugs and couple the RYR with Coenzyme Q10, a supplement that doctors often recommend for those taking statins.
There is still a great deal of debate about the safety of products containing RYR. Statin drugs have been shown to cause liver damage as well as muscle damage and possible renal failure. Doctors who have prescribed statins for their patients normally schedule routine tests of liver function to limit the occurrence of such damage.
The FDA fears that individuals may not realize that the monacolin content of products containing RYR can cause the same types of damage as the statin drugs. This is especially compounded by the fact that the monacolin content of RYR products can vary from a negligible amount to almost pure monacolin K (lovastatin).
One thing that has been shown is that, even though labels make no claims to cure or treat cholesterol or any other condition, there is a correlation between the use of red yeast rice and cholesterol. Even taken as dietary supplements, it can lower cholesterol in the same way that statin drugs work.