What Is Red Yeast Rice?
Red yeast rice is produced by fermentation of a fungus on rice. The fungus can enrich the rice with substances known as monacolins, including monacolin K which is structurally the same as the statin medicine Lovastatin. Statin medications like Lovastatin, reduce the production of cholesterol in the body in order to decrease the amount of cholesterol that may build up on the walls of arteries, as a part of the atherosclerotic process, interfering with blood flow to the heart, brain, and rest of the body. Studies have shown that statin drugs, used in conjunction with diet and weight loss, reduce the risk of heart attack and stroke. https://www.nccih.nih.gov/health/red-yeast-rice Red yeast rice is available as an over-the-counter dietary supplement.
How Much Monacolin K Is in Red Yeast Rice?
Red yeast rice contains trace monacolin K, the active ingredient which lowers cholesterol.
It is, however, generally not possible for consumers to know the amount of monacolin K in red yeast rice products because the levels of monacolin K are not included on product labels. A review published in 2017 analyzed 28 brands of red yeast rice products from major retailers, and none of them listed the amount of monacolin K on the label. Monacolin K was not even detected in two brands, highlighting the importance of purchasing over the counter products from reliable sources. Among the supplements which did contain Monacolin K, the amount contained varied greatly.
Many controlled clinical trials have confirmed the lipid-lowering effects of Red Yeast Rice. A meta-analysis of 20 studies showed that using doses which varied between 1,200 mg and 4,800 mg/day accomplished lowering LDL-Cholesterol by an average 39.4 mg/dL after 2 to 24 months of treatment compared to placebo. This effect on LDL lowering was similar to moderate-intensity statin therapy such as pravastatin. This study also found a small increase in HDL-Cholesterol and a decrease in triglycerides levels compared to placebo. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822657/ In looking at physiologic effects red yeast rice was shown to improve endothelial function which has been enhanced by adding 30mg of Coenzyme Q10 to the treatment regimen.16,17.
In one clinical trial, 50 patients with coronary heart disease were given 1,200 mg/day of Red Yeast Rice vs placebo for 6 weeks. Their lipid levels, and high sensitivity C-reactive protein (hsCRP) were measured. After 6 weeks those receiving RYR showed reductions in HsCRP. Red yeast rice has also been evaluated in long-term studies for its effect on cardiovascular disease outcomes.
One such study involved 1,445 patients between the ages of 65 and 75 years, who had all suffered a myocardial infarction. In this placebo-controlled study those who received Red Yeast Rice supplementation over a 4-year period, reduced their risk of Coronary Heart Disease by 31 %. Furthermore, they showed risk reductions for all-cause mortality (31.9%), stroke (44.1%), the need for coronary artery bypass graft or a percutaneous coronary intervention (48.6%), compared to placebo. Death from coronary heart disease was 6.4% in those receiving RYR and 9% in those receiving placebo, indicating that RYR significantly decreased the risk of CHD death by 29.2%. https://pubmed.ncbi.nlm.nih.gov/19602720/
Guggul
The resin of the Commiphora mukul tree has been used in Ayurvedic medicine for more than 2000 years. Studies in both animal models and humans have shown that this resin, termed gum guggul, can decrease elevated lipid levels. The evidence showed that these compounds are antagonist ligands for the bile acid receptor farnesoid X receptor, which is an important regulator of cholesterol homeostasis. This effect is what accounts for the lipid lowering activity of these plant compounds.
A National Library of Medicine Review was published, “To evaluate the scientific evidence on guggul for hyperlipidemia including, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.” https://pubmed.ncbi.nlm.nih.gov/12626688/
The information for this review was obtained by electronic searches in nine databases, 20 scientific journals and bibliographies from 50 selected scientific references. All literature collected pertained to efficacy in humans, dosing, precautions, adverse effects, interactions, and mechanism of action.
Surveying the scientific literature that existed before this review, it was reported that most scientific evidence suggested that guggulipid elicits significant reductions in serum total cholesterol, low-density lipoprotein (LDL), and triglycerides, as well as elevations in high-density lipoprotein. The studies referenced in this review included:
(HDL)J Res Indian Med Yoga Hom 1979;14(2):11-6; Kotiyal JP, Singh DS, Bisht DB.
Gum guggulu (Commiphora mukul) fraction ‘A’ in obesity-a double-blind clinical trial.
J Res Ayur Siddha 1985;6(1, 3, 4):20-35; Gaur SP, Garg RK, Kar AM, et al. Gugulipid, a new hypolipidaemic agent, in patients of acute ischaemic stroke: effect on clinical outcome, platelet function and serum lipids.
Asia Pacif J Pharm 1997; 12:65-9; Urizar NL, Liverman AB, Dodds DT, et al. Clinical trial of gugulipid-a new hypolipidemic agent of plant origin in primary hyperlipidemia. Indian J Med Res 1986; 84:626-34;
Verma SK, Bordia A. Effect of Commiphora mukul (gum guggulu) in patients of hyperlipidemia with special reference to HDL-cholesterol. Indian J Med Res 1988; 87:356-60;
Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther 1994;8(4):659-64; Ghorai M, Mandal SC, Pal M, et.
Conclusion
The effects of guggulipid in patients with high cholesterol was inconsistent, with some studies finding cholesterol-lowering effects, and other research not able to confirm that finding. Therapeutic effects of guggul and its constituent guggulsterone: cardiovascular benefits. Deng R. Cardiovasc Drug Rev. 2007 Winter;25(4):375-90. doi: 10.1111/j.1527-3466.2007.00023.x.PMID: 18078436 Review.
Oleogum resin (known as guggul) from the guggul tree, Commiphora mukul, has been used to treat various diseases including hyper-cholesterolemia, atherosclerosis, and arthritis. Guggulsterone. isolated from guggul, has been identified as the bioactive constituent responsible for its therapeutic effects. Guggulsterone is an antagonist at farnesoid x receptor (FXR), a key transcriptional regulator for the maintenance of cholesterol and bile acid homeostasis. The FXR antagonism is felt to be the mechanism for its hypolipidemic effect. Guggul has been found to potently inhibit the activation of NF-kappaB, a regulator of inflammatory responses. This repression of NF-kappaB activation by guggulsterone is the proposed mechanism of its antiinflammatory effect.
Effect of Commiphora mukul (gum guggulu) in patients of hyperlipidemia with special reference to HDL-cholesterol. Verma SK, Bordia A. Indian J Med Res. 1988 Apr;87:356-60.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671351/ Guggul for hyperlipidemia: a review by the Natural Standard Research Collaboration.Complement Ther Med. 2005 Dec;13(4):279-90. doi: 10.1016/j.ctim.2005.08.003. Epub 2005 Sep 23. PMID: 16338199 Review.
Guggul May Help Rheumatoid Arthritis
A Detailed Analysis was published with the title: Exploring the Promising Role of Guggulipid in Rheumatoid Arthritis Management: An In-depth Analysis Amit Sahu 1, Sunny Rathee 1, Sanjay Kumar Jain 1, Umesh Kumar Patil 1 PMID: 38284718 DOI: 10.2174/0115733971280984240101115203
Guggulipid is used widely in Ayurvedic medicine for treating various disorders including gout, arthritis, inflammation as wella s for lipid metabolism imbalances and obesity.
This comprehensive review elucidates the molecular targets of guggulipids and explores their cellular responses. It summarized the findings from clinical investigations related to arthritis and various inflammatory conditions. A number of possible mechanisms have been postulated for its effectiveness, such as cyclooxygenase-2 (COX-2), vascular endothelial growth factor (VEGF), nitric oxide synthase, and NFκB signaling pathways, as essential to its antiarthritic and anti-inflammatory effects.
This studies’ conclusion: “The collective evidence strongly supports the promising role of guggulipid as a therapeutic agent, encouraging further research and development in guggulipid-based treatments for these conditions.”
Other Natural Supplements Used for Lowering Lipids
Niacin
Niacin is a form of Vitamin B3 called nicotinic acid. It can raise the “good” cholesterol called HDL-Cholesterol while lowering the bad cholesterol -LDL Cholesterol. It also lowers triglyceride levels.
Omega-3 fatty acids found in fish and a variety of seafood, omega -3 fatty acids, reduce blood triglyceride levels, and may high-density lipoprotein (HDL) cholesterol.
Sterols
Sterols can reduce cholesterol absorption and thus lower bad cholesterol (LDL) levels.
Berberine
A compound that comes from several plants, berberine may help lower LDL cholesterol and triglycerides, and increase HDL Cholesterol
Garlic
Contains a component called allicin, which may lower total cholesterol, LDL cholesterol, and triglycerides.
Soluble fiber
May help to lower total cholesterol as well as LDL-Cholesterol
Soy
Contains isoflavones, which are believed to be soy’s main cholesterol-lowering ingredients.
