Red yeast rice is a supplement that is used to lower cholesterol and improve heart health.
It’s derived from traditional Chinese herbal medicine practices: freshly harvested rice is left to soak in water, and is inoculated with a specific kind of yeast that turns the surface of the rice a deep red and produces a number of biologically active compounds.
These compounds appear to manipulate the same biological pathways as statins, which are prescription medications that lower cholesterol.
Red yeast rice can be remarkably effective at improving heart health, but there are a lot of concerns about quality control during the manufacturing process.
If you want a high-quality red yeast rice product that’s both pure and effective, our researchers have investigated the top brands and ranked the best red yeast supplements for improving heart health.
1. BioScience Nutrition Red Yeast Rice
BioScience Nutrition Red Yeast Rice is an excellent option when it comes to both purity and potency.
Tested with strict standards for the presence of toxins, you can be assured that this red yeast rice supplement is both safe and effective.
It’s got 600 mg of red yeast rice per capsule, making it very easy to follow the usual clinical trial protocols for heart health. In terms of all-around utility for heart health, it’s our top pick.
2. Solaray Red Yeast Rice
Solaray Red Yeast Rice Provides the standard 600 mg dosage used often in clinical trials, and it’s one of the few red yeast rice supplements that’s been independently tested for purity and strength.
A study published in the Journal of the American Medical Association Internal Medicine included this supplement in a paper assessing the quality of red yeast rice supplements and noted that it had zero micrograms of the kidney toxin citrinin, while other red yeast rice supplements had up to 228 mcg per dose.
The purity guarantee, combined with a fairly low monacolin K content, make this a good choice for those who are safety conscious.
3. Solgar Red Yeast Rice
Solgar doesn’t get very fancy with their supplements, but with a red yeast rice product, that’s precisely what you are looking for.
It’s tested and certified free of the kidney toxin citrinin, and while there are a few extra binders and fillers, the real priority with a supplement like this is purity, not minimalist supplement design. It’s a very solid choice for a no-nonsense red yeast rice supplement.
4. Bluebonnet Red Yeast Rice
Bluebonnet is a reliable brand when it comes to pure ingredients and high quality supplements.
Their red yeast rice supplement is popular for this exact reason, though their product is also tested in-house and not by a third-party independent lab.
5. aSquared Nutrition Red Yeast Rice
aSquared Nutrition Red Yeast Rice advertises itself as high-dose, but it contains the same 600 mg dosage of red yeast rice you’ll find in just about any similar product.
Where this red yeast rice supplement shines is in its clean supplement design: with only red yeast rice, rice flour, and gelatin, its ingredients list is incredibly simple, making it a good choice for the purists out there.
6. Sundown Naturals Red Yeast Rice
Sundown Naturals makes a red yeast rice supplement that’s tested (albeit in-house, not by an independent lab) for purity and potency, and delivers the usual dosage.
With 240 capsules per bottle, it’ll last quite a while, making this a solid choice for long term use.
7. Pure Naturals Red Yeast Rice Pure
Pure Naturals Red Yeast Rice Pure has the expected 600 mg dosage of red yeast rice, and a gelatin capsule with a few more binders and fillers than you’d find in some of the top ranked supplements.
While pure is in the brand name, the company doesn’t specifically mention any independent third-party testing for purity.
8. Amazing Nutrition Red Yeast Rice
Amazing Nutrition has a solid red yeast rice supplement that’s got the usual 600 mg dosage of red yeast rice, though its gelatin capsule has a few too many binders and additives for the purists out there.
9. Puritan's Pride Red Yeast Rice
Puritan's Pride Red Yeast Rice has the usual 600 mg dosage of red yeast rice, but there’s no mention of independent lab testing or a certification that this supplement is citrin-free. While it’s popular, other supplements beat it out when it comes to purity and quality.
10. Thorne Research Choleast
Thorne Research Choleast uses a combination of red yeast rice and CoQ10 to specifically target cholesterol.
Though the supplement design is pretty clean, it might not be a good pick purely because it may not be available indefinitely: given its name and advertising, it’s flirting with strict FDA regulations on how red yeast rice can be marketed.
Red yeast rice benefits and side effects
Red yeast rice is a supplement with a very focused purpose—it is used to improve heart health, particularly by lowering your LDL (“bad”) cholesterol levels in a manner similar to that of statins, which are prescription cholesterol lowering drugs (this category includes medications like Lipitor and Zocor).
It’s been used in China for cooking and for traditional herbal medicine for thousands of years, but the potential health benefits of the active ingredients in red yeast rice weren’t recognized until a few decades ago.
Today, it’s a popular but contentious supplement, specifically because it is so effective when it comes to lowering cholesterol.
Red yeast rice has been shown to lower cholesterol levels in clinical studies. The heart health benefits of red yeast rice go beyond just theoretical and anecdotal evidence: it’s been tested directly in placebo-controlled trials.
One such study was published in the American Journal of Clinical Nutrition by researchers at the UCLA School of Medicine (1).
This experiment involved over 80 subjects with high cholesterol, who were divided up into two groups. One group received 2400 mg of red yeast rice per day, while the other group received a placebo. Both groups were given dietary advice for lowering cholesterol levels.
After 12 weeks of follow-up, the researchers found that the red yeast rice group experienced a significant decrease in LDL cholesterol and total cholesterol levels compared to the placebo group, but did not experience any decrease in HDL (“good”) cholesterol levels.
Other clinical trials have confirmed the effects of red yeast rice on LDL cholesterol; a systematic review published in 2014 found that there is a consistent benefit to taking red yeast rice when it comes to lowering LDL cholesterol levels and improving heart health (2).
Red yeast rice exploits the same mechanism to lower cholesterol as statins. The active ingredient in red yeast rice is a category of compounds called monacolins, and one of these—monacolin K—is chemically identical to lovastatin, which is the active ingredient in statin drugs for lowering LDL cholesterol.
However, the cholesterol lowering ability of red yeast rice seems to be due to more than just its monacolin K content, because it appears to be effective even at lower equivalent doses compared to statins, if you only consider its monacolin K content.
One meta-analysis of several clinical trials on red yeast rice for lowering cholesterol noted that the typical amount of monacolin K contained in red yeast rice supplements is lower than the equivalent amount of lovastatin which would create a similar decrease in LDL cholesterol (3).
You won’t find red yeast rice supplements that advertise their monacolin K content. One outcome of the research into red yeast rice was a series of court battles in the late 1990s over whether red yeast rice should be considered a supplement or a drug.
Initially, red yeast rice products were pulled from the market, because they made specific claims about cholesterol and listed their monacolin K (lovastatin) content (4).
When red yeast rice was reintroduced, all claims regarding monacolins had disappeared, which puts consumers in limbo—many red yeast rice supplements still have monacolin K in them, but levels from supplement to supplement vary widely.
One study published in 2010 in the Journal of the American Medical Association Internal Medicine looked at the content of several leading red yeast rice supplements and found that the monacolin K levels per 600mg serving ranged from 0.2 to 20.8 mg, a 100-fold difference in dosage (5).
While the rate of side effects in studies on red yeast rice is low, there is still some concern about similar side effects to those encountered with statins.
One review noted no serious side effects across 13 trials which included over 800 participants (6), and another trial of almost 5,000 people in China reported no difference in the incidence of side effects between the red yeast rice group and a placebo group (7).
However, some evidence from European countries indicates that there may the possibility for red yeast rice to cause muscle damage and liver injury (8).
These incidents happened outside of clinical trials, so it’s harder to establish causality, but these side effects mirror those of statins.
Beyond the effects of the active ingredients, scientists have raised the alarm about contamination by a compound called citrinin, a naturally occurring toxin that can cause kidney damage.
One study published in 2010 noted that four out of twelve red yeast rice supplements that the researchers tested contained some amount of citrinin (9).
The best red yeast rice supplement brands will test their product for citrinin, or even better, hire an independent third party laboratory to conduct citrinin testing.
Since red yeast rice can contain the same active ingredients as statins, all of the same possible medication interactions apply.
People who take statins or other prescription medications already should definitely talk to their doctor first before taking a red yeast rice supplement.
Most clinical trials use a daily dosage of 1200 to 2400 mg of red yeast rice per day. This is easy to achieve with two to four 600 mg capsules taken throughout the day.
The real challenge is that the level of monacolins can vary substantially from one supplement to another, and unfortunately, there’s no good way to asses monacolin levels aside from trial and error. The best you can do is stick to recommended dosages from a high-quality manufacturer.
Red yeast rice is a reliable way to lower LDL cholesterol, and at least in part, this appears to be due to the effects of the biologically active compound monacolin K.
It’s been demonstrated as an effective method to improve heart health in a number of clinical studies, though given the current regulatory environment, it’s difficult to figure out which brands have the most effective dosage.
The primary thing to watch out for is purity testing—less reputable brands have been known to be contaminated by the kidney-damaging toxin citrinin, so make sure you get a top-ranked red yeast rice supplement for optimal purity and safety.
Red yeast rice can have some of the same side effects as statins, though the risk is low: these can include muscle damage and liver injury, thous none of these effects have occurred in clinical studies.
People who are taking prescription medication should talk to their doctor before taking red yeast rice, since it could cause some adverse effects by interacting with drugs that you are taking.
With the above caveats, the scientific research says that red yeast rice is a powerful and effective way to improve your heart health by lowering your cholesterol levels. It might be worth considering if high cholesterol is a problem that you know that you face.