It’s turned up on pharmacy shelves only within the last few decades, but red yeast rice has been prized for its powerful medicinal properties for hundreds of years.

As one of the top natural remedies for high cholesterol levels, red yeast rice is one of the few natural supplements that contain active ingredients virtually identical to those found in prescription medications.

Plus, the benefits of red yeast rice extend beyond correcting cholesterol levels, with emerging research showing that it may also benefit inflammation, metabolic syndrome, blood sugar levels and more.

Here are the benefits, side effects and dosage recommendations for red yeast rice.

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Red yeast rice is a type of fermented rice that is produced using a specific species of mold.

It’s been used in traditional Chinese medicine for centuries for its powerful health-promoting properties.

Red yeast rice contains the compound monacolin K — the same active ingredient found in prescription cholesterol-lowering medications like lovastatin (1).

For this reason, it’s often used as a cost-effective alternative to pricey medications to help reduce cholesterol levels and support heart health.

Research has shown other beneficial effects as well, ranging from reduced cancer cell growth to improved blood sugar and insulin levels.

Today, red yeast rice is commonly sold as an over-the-counter supplement marketed to help manage cholesterol and improve overall health.

Summary Red yeast rice is produced by fermenting rice with a specific species of mold. It contains the same active ingredient as cholesterol-lowering medications and has been studied for other benefits as well.

Heart disease is a serious condition that affects millions and is estimated to account for 31.5% of deaths around the world (2).

High cholesterol — one of the main risk factors for heart disease — can cause arteries to narrow and stiffen, leading to an increased risk of heart attack and stroke (3).

Red yeast rice is commonly used as a natural remedy to help lower cholesterol levels and promote heart health, often with less adverse side effects than prescription drugs used to treat high cholesterol (4).

One study in 25 people showed that red yeast rice lowered total cholesterol by an average of 15% and “bad” LDL cholesterol by 21% over about two months of treatment (5).

Similarly, an eight-week study in 79 people reported that taking 600 mg of red yeast rice twice daily significantly reduced “bad” LDL cholesterol levels, compared to a control group (6).

What’s more, one review of 21 studies found that red yeast rice was effective at reducing levels of total and “bad” LDL cholesterol, as well as triglycerides and blood pressure, when combined with statin drugs (7).

Summary Studies show that red yeast rice may help lower cholesterol levels. It may also have the potential to reduce triglycerides and blood pressure when combined with statins.

Metabolic syndrome is a cluster of conditions that increase your risk of chronic conditions, such as heart disease, diabetes and stroke.

Some of the criteria for metabolic syndrome include high blood pressure, excess body fat, increased blood sugar and alterations in cholesterol or triglyceride levels (8).

Several studies have found that red yeast rice may help treat some of these risk factors and could be used as a natural treatment to aid in its prevention (9).

One of its most well-documented effects is its ability to lower cholesterol. Research shows that it can effectively reduce both total and LDL cholesterol levels (5, 6).

Another small, 18-week study found that a supplement containing red yeast rice was able to reduce blood sugar, insulin levels and systolic blood pressure (the top number of a reading) in people with metabolic syndrome (10).

Plus, an eight-week study looked at the effects of red yeast rice on mice fed a high-fat diet compared to a control group. It found that red yeast rice was able to prevent increases in cholesterol levels and body weight (11).

Summary Human and animal studies show that red yeast rice may help reduce several risk factors for metabolic syndrome, including high levels of cholesterol, blood pressure and blood sugar, as well as excess body weight.

Inflammation is a normal immune response designed to protect your body against acute infections and foreign invaders.

However, sustained inflammation is thought to contribute to chronic conditions like diabetes, cancer and heart disease (12).

Studies show that supplementing with red yeast rice may help reduce inflammation and promote better health in the long term.

For example, a study in 50 people with metabolic syndrome showed that taking a supplement containing red yeast rice and olive extract reduced levels of oxidative stress — a key cause of chronic inflammation — by up to 20% (13).

Similarly, one study found that giving red yeast extract to rats with kidney damage reduced levels of specific proteins involved in inflammation in the body (14).

Summary Human and animal studies show that red yeast rice may help decrease levels of oxidative stress and inflammation in the body.

Although current research is limited to animal and test-tube studies, some evidence suggests that red yeast rice may help reduce the growth and spread of cancer cells.

One study found that giving mice with prostate cancer red yeast rice powder significantly decreased tumor volume compared to a control group (15).

Similarly, a test-tube study showed that treating prostate cancer cells with red yeast rice was able to decrease cancer cell growth to a greater degree than lovastatin, a cholesterol-lowering medication with anticancer effects (16).

However, more research is needed to evaluate the effects of red yeast rice on other types of cancer in humans.

Specifically, further studies should be done to determine how the potential anticancer effects of red yeast rice may affect the general population.

Summary Animal and test-tube studies have found that red yeast rice may help reduce the growth and spread of prostate cancer cells, but human-based research is lacking to confirm these effects.

Monacolin K is the active compound found in red yeast rice that is commonly extracted and used in cholesterol-lowering statins and medications.

It’s typically credited with the majority of the health benefits attributed to red yeast rice, especially regarding its cholesterol-lowering properties.

According to the FDA, red yeast rice products that contain monacolin K should be considered a drug, subjecting them to stricter regulations than standard over-the-counter supplements (17).

Since 1998, the FDA has taken action against several companies selling red yeast rice extract, noting that it’s illegal to market these products as supplements in the US.

In recent years, a number of red yeast rice supplements have popped up, many of which evade FDA regulations by containing only trace amounts of monacolin K.

However, it remains unclear how effective these products really are and whether they have the same benefits on health as true red yeast rice (17).

Summary Many products marketed as red yeast rice contain minimal amounts of its active ingredient, monacolin K, to avoid strict FDA regulations.

Despite the long list of benefits associated with red yeast rice, supplementing with it may come with some adverse effects.

Gastrointestinal problems like bloating, gas and stomach pain are some of the most commonly reported side effects of red yeast rice.

In more extreme cases, it can also cause issues like muscle problems, liver toxicity and allergic reactions, similar to the side effects caused by prescription cholesterol-lowering medications (1).

For this reason, it’s important to stick to the recommended dosage and buy from a reputable retailer to ensure you’re getting the best quality possible.

Because research is still limited on the long-term safety of red yeast rice, it’s also not recommended for those currently taking statins or women who are pregnant or breastfeeding.

If you notice any adverse symptoms after taking red yeast rice, consider decreasing your dosage or discontinuing use and consult a trusted healthcare practitioner.

Summary Red yeast rice may cause gastrointestinal issues, allergic reactions, liver toxicity and muscle problems. It’s not recommended for people taking statins or women who are pregnant or breastfeeding.

Red yeast rice is available in capsule or tablet form and often formulated in combination with other ingredients, such as CoQ10, nattokinase or omega-3 fatty acids.

These supplements are widely available in health food stores, pharmacies and though online retailers.

Doses ranging from 200–4,800 mg have been studied in clinical trials, typically containing about 10 mg of total monacolin (18).

Most major supplement brands on the market generally recommend taking between 1,200–2,400 mg daily, divided into two to three doses.

However, given the risk of adverse side effects and safety concerns associated with red yeast rice extract, it’s best to speak with your doctor to determine the best dosage for you.

Summary Red yeast rice is widely available in both capsule and tablet form. It’s been studied in doses ranging from 200–4,800 mg, but most supplements recommend 1,200–2,400 mg daily for best results.

Red yeast rice may support heart health and reduce cholesterol levels, inflammation, cancer cell growth and risk factors of metabolic syndrome.

It can cause gastrointestinal issues, allergic reactions, liver toxicity and muscle problems and is not recommended for people taking statins or women who are pregnant or breastfeeding.

Most supplements recommend 1,200–2,400 mg daily. However, many products on the market today contain minimal amounts of its active ingredient, potentially negating any health benefits associated with red rice extract.

Working closely with your doctor and selecting a high-quality supplement from a reputable brand is the best way to take advantage of the unique benefits that this potent ingredient has to offer.