Red yeast rice really works—but it isn’t risk-free

Q: I have always been suspicious of statins, so when I could not get my cholesterol levels under control with diet and exercise, I turned to red yeast rice. Based on reading your articles I am inclined to stop even that, but what feedback do you have on using it?

Dr. Fred: I use red yeast rice in my practice for those patients with stubborn cholesterol issues and a strong family history of heart disease and adverse cardiovascular events, like stroke and heart attack.

If you fall under this umbrella, taking red yeast rice might be a good option for you. I tend to think of it almost as a super low-dose statin, because it features the same active compounds as these drugs. (Albeit in a more natural form.)

Red yeast rice really does work. And as cholesterol treatments go, red yeast rice is a better choice than statin drugs. But it’s not a completely risk-free alternative. Unsurprisingly, I have seen a few patients experience side effects similar to what you’d encounter with statin use—like muscle issues, erectile dysfunction, and brain fog.

That’s why, as I mentioned above, I reserve it only for the patients who really need it and for whom the benefits will outweigh any potential risks.

In these cases, I recommend taking 600 mg twice per day, with close monitoring of blood cholesterol levels.