023 – Lowering Cholesterol with Red Yeast Rice

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My Interview with Gary Walker, manufacturer of American Made Red Yeast Rice

Red Yeast RiceRed Yeast Rice is a very popular supplement in America. Most people use it to help maintain a lower cholesterol. Red yeast rice is controversial for a couple of reasons. The first is that it is very effective at lowering cholesterol. It is effective because it contains compounds similar to statin drugs and it lowers cholesterol via the same metabolic pathway. This makes it very close to a drug in the mind of the FDA.  The second controversy is whether lowering cholesterol via these compounds is good medicine, regardless of whether it is natural or not.

The first controversy is really in the domain of the FDA and the companies it regulates. Currently the FDA allows red yeast rice products to be sold as long as they don’t contain the same statin compound as is found in the drug and don’t make medical claims. One  problem that affects red yeast rice is lack of standardization. Not all red yeast rice products are equally good. Some red yeast rice raw material coming from China is low potency and therefore not very effective, and some others are contaminated with unwanted compounds. Check out Consumer Labs to review their report on red yeast rice products. Seek out products from reliable companies and inquire about the source of their red yeast rice.

The second controversy is something the consumer is going to have to consider. Ask yourself these questions.  Do statin drugs help you live longer? How effective are statin drugs at preventing deaths due to heart attacks? This is where the truth begins to be revealed. The answer is that they are not very effective at all. It is not so simple as to suggest that everyone with high cholesterol is at risk and should be put on drugs. There are other factors you should consider such as blood pressure, triglyceride level, inflammation status, cholesterol ratio, and family history. If you don’t have these other risk factors then your risk may be much lower than the typical American. You may also be shocked to learn that if you put 100 people on statin drugs for 4 years, the number of heart attacks will be 2. In a no drug population, the number of heart attacks will be 3. You have to put 100 people on statin drugs for 4 years to stop 1 heart attack. Listen to my podcast with Dr. Michael Murray, What the Drug Companies Won’t Tell You and Your Doctor Doesn’t Know.

The other thing to consider is that there are many ways to support cardiovascular health and you may have much better results by applying principles of metabolic cardiology which can actually help strengthen the heart. (Listen to my podcast with Dr. Stephen Sinatra).

The typical dose of red yeast rice is 600 mg. taken two to four daily. The best time to take red yeast rice is at bedtime. The clinical studies have been done with 2400 mg. per day (4×600) of standardized extract.  Another consideration is that both statin drugs and red yeast rice inhibit CoQ10 production as well as cholesterol. So anyone using this strategy should supplement with at least 100 mg. of CoQ10. Because both statins and red yeast rice affect the liver, you should have liver function tests and take steps to protect liver function.

There are two companies that I recommend for red yeast rice. I’m sure there are other brands but I can’t confirm them for you. The first company is Doctor’s Best. They have both a 600 and a 1200 mg. formulas. The other is Nature’s Plus. They sell a 600 mg tablet and they also sell a 1 per day extended release tablet that is equal to four  600 mg. tablets. I prefer American made red yeast rice. I know what the source is.

Bottom line for me is that statin drugs should be a last resort unless you have cardiac issues. If you feel you must lower your cholesterol, then try a quality brand of red yeast rice along with CoQ10. Otherwise there are many ways to support healthy cholesterol, improve inflammation and nourish the cardiovascular system and you should include them as part of your health care plan. For the best long term results you must use nutrition. The consistent application of nutritional support will provide the building blocks of better health. No matter the health condition, a person who is well nourished will do better than one who isn’t.

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{ 71 comments… read them below or add one }

1 Gina April 23, 2017 at 12:41 pm

Why can’t I find any information about how much ubiquinol to take if I’m taking a 1200mg pill of red yeast rice? Is 200mg enough? Thank you.

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2 Steve Lankford April 23, 2017 at 1:48 pm

IMHO – 200 mg of ubiquinol is a good dose. You can take more if you want. There is no standard recommendation so your current dose is a reasonable amount.

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3 Terri Amend September 28, 2016 at 9:40 pm

I’m 55 and for the first time my bad cholesterol jumped up 20 points out of range. I go back in Dec to get rechecked. I take a thyroid pill first thing in morning, and take high blood pressure (low dosage) at bed time. When should I take red yeast rice, in afternoon? I can take blood pressure at 8:30 and rye at 11:30 – would that be ok? Please let me know. I don’t want to go on meds. Thanks.

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4 Steve Lankford September 28, 2016 at 9:49 pm

Sorry. I am not a doctor. You need to work with your health provider to developing a plan.

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5 Karen September 26, 2016 at 6:03 pm

I bought natures plus red yeast rice but not the extended release. It is called Natures plus Herbal actives red yeast rice 600 mg. It says to take one at bedtime. I always took one in the morning and one in the afternoon of other brands. Are these also stronger like the extended release ones.

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6 Steve Lankford September 26, 2016 at 6:36 pm

One Extended Release 600 mg is equal to 4 Herbal Actives. It comes down to the amount of monocolins per tablet. Extended Release = 1.7 mg per tablet. Herbal Actives =.4 mg per tablet. So I always recommend the extended release. It is fine to take the lower dose tablets. Maybe you can get good enough results with a more modest dose. Keep track and adjust as needed.

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7 Karen September 26, 2016 at 7:27 pm

So you are saying it is probably safe to take 2 of the natures plus herbal actives. If they have .4 mg of monocolins that would be .8 a day. I am hoping that will be enough.It had said to only take 1 on the bottle. I just bought a bottle and want to see if it works and then decide whether to try the extended release.

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8 Steve Lankford September 26, 2016 at 10:16 pm

That’s what I’m sayin’. Take a consistent dose for 2-3 months and then test. Then adjust if needed, go for 3 months and test again. That’s how you find the most effective dose.

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9 Karen September 27, 2016 at 4:14 am

Thank you very much for the information

10 Karen September 26, 2016 at 5:54 pm

I had been taking red yeast rice to lower my cholesterol for several years. My numbers went from around 257 down to 197. I also excercise 4 or 5 times a week and eat a low fat diet. I switched to a different brand and my cholesterol went over 300. I thought the test results were a mistake or the cheaper brand red yeast must not be any good. I went out and bought the Natures plus as you recommend. My question is that my doctor has told me to take a 600mg capsule twice a day. I bought the regular Natures plus(not the extended release) It says to take 1 at bedtime. Would it be safe to take 2 since the Natures plus is probably higher in the active ingredient than what I had taken. I continue to excercise and follow a healthy diet and hope my next numbers are better.

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11 Steve Lankford September 26, 2016 at 6:40 pm

Not all Red Yeast Rice products are equal. It is easy to purchase inferior products. Seek to find out the amount of monocolins in any product that you want to try. If a company does not declare the amount of monocolins per tablet then how do you know? That’s why I like Nature’s Plus. They have the two products and they work consistently. The amount in the Extended Release is the previously clinically studied dose. It always works.

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12 chris July 27, 2016 at 10:22 am

Hi there!!
I cant seem to find the NP RYR you recommend. Do you know where I can find the “one a day pill from NP”?
Background: 35 years old, super healthy, athletic, no smoke or drinking, no family history and somehow my panel went from normal to 243 being trig 151, hdl 57 and ldl 156. Dr recommended RYR, since I refused to go on statins. Just need to know where to find the ” one a day”. Thank you for your help.

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13 Steve Lankford July 27, 2016 at 10:55 am

Look to independent health food stores in your area. Or search online Nature’s Plus Red Yeast Rice Extended Release One per day There are many place to buy both retail and online. Just be sure to get Extended Release – One Per Day by Nature’s Plus. It is the only one I have found and have recommended to many users.

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14 chris August 2, 2016 at 9:17 am

Thank you. I ended up finding! One more question, do you know how long I should wait before taking another blood test to see if its working? Would 60 days be enough to see a change?

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15 Steve Lankford August 2, 2016 at 10:27 am

60 to 90 days would be sufficient. Good Luck. Let us know how you do.

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16 Katherine March 20, 2016 at 9:07 pm

I’m trying to research and find the product with the most quantity is RSY. It’s all so confusing because it’s not always revealed in the information. The 2 that seem to be the best from my search are Choleslo and Ativa RSY. Which brand would you take if it was you? I don’t have money to waste on useless pills. I tried Lipitor and my muscles and joints hurst so bad that I felt like I was 100 years old! Thank you for any advice. 😊

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17 Steve Lankford March 21, 2016 at 8:37 am

I recommend Nature’s Plus Extended Release One Per Day Red Yeast Rice. It is the only one I know of that has the full standardized dose of 1.7 mg. of monocolins. This is the dose you should seek. If you can discover the amount of monocolins per tablet in your RYR you can determine the most effect dose. Most tablets have around .4 mg of monocolins per tablet but this is not usually revealed by the company. You will have to do some inquiry to determine. Be sure to add CoQ10. Listen to my interview with Dr. Stephen Sinatra on The Great Cholesterol Myth.

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18 Gina March 15, 2016 at 12:51 pm

Hi Steve, I hope you can help with a question I have not seen asked in the past.
Can my body acclimate to RYR so I would need to increase the dosage?

I have been taking 1200 mg of RYR or over a year and was very pleased to see my total cholesterol fall from 245 to 175 in Nov 2015. Then, two weeks ago (less than five months later), I switched primary physicians and they performed another blood test. My total cholesterol went back up to 245!!!

I have been using RYR from a reputable source and staying with the same brand. I take it religiously, 600 mg in the AM, 600 mg in the evening along with CoQ10. I have reduced my carb intake in the past four months prior to this recent blood test. I am 60 years old, weigh 145 pounds. My physical activity is generally pretty good, running or jogging three times a week. The only thing that has changed is that I am currently separated from my husband, which of course is a great stress. Can stress cause this much of a change in my total cholesterol?

My Doc wants me to take a regular statin, I am declining and considering increasing my dosage to 2400 mg and to retest in 6 months

What are your thoughts?
Thanks so much!
Gina

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19 Steve Lankford March 15, 2016 at 9:34 pm

Ask the Dr. to retest, just to be sure. Sometimes test are not accurate.

2400 mg. of standardize red yeast rice is the clinically studies dose for RYR. So increasing is an option. Then retest until you figure out your current needs. Bodies change and sometimes doses need adjusting.

Take your RYR at night is the most effect time. You make your cholesterol at night when sleeping.

Listen to my podcast with Dr. Stephen Sinatra on The Great Cholesterol Myth. You might think differently about the role of cholesterol.

Can stress cause this jump? Don’t know, maybe. Stress makes many things worse.

If your current RYR fails then try Nature’s Plus Extended Release One Per Day Red Yeast Rice. 1 tablet is equal to 2400 mg. of standardized RYR.

Good luck and best wishes.

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20 Brittany August 27, 2014 at 11:46 am

Back in March- a friend had a TMI- 62 years old (no prior issues)
After multiple tests the prognosis was that it was a small blood clot or piece
of plaque had blocked oxygen to the brain, and then passed. Lasted about 30 minutes. There were no signs of permanent damage. The bad cholesterol was 120. They put me on blood thinners 75 mg, (plavix) and 10 mg of a statin cholesterol drug. His cholesterol has come down. His concern is his family history of alzheimers and the new research stating statin drugs can make this worse. His doctor told him that RYR is not tested or proven and not worth the risk of having another stroke. What would your opinion be? If you think the RYR is a good option, what dosage for a 250 pound man, and should he continue taking the statin at the same time or try going off of it? Thank you.

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21 Steve Lankford August 27, 2014 at 1:06 pm

It is very difficult to give advice because of the complexity of the situation. I am not his doctor, so I can’t advise you as to what he should do. There are so many issues.
There is the challenge of the statin drug. There is the challenge of finding a quality red yeast rice. There are many sub par products.
I would recommend that you get the book Metabolic Cardiology by Dr. Stephen Sinatra and read it carefully.
If it was me, here’s what I would consider:
Fish oil especially, DHA for the brain.
Nattokinase – enzymes that removes fibrin the source of clots.
Vitamin K-2 – Takes calcium out of the arteries and into the bone.
Ribose – for muscle energy, esp. cardiac.
Kyolic Aged Garlic Extract – clinically shown to reverse soft plaquing in the arteries, also lowers blood pressure.
Curcumin Extract – New studies showing beneficial effects for Alzheimers.
Vitamin D – It’s just important.

If you take red yeast rice, confirm that you have a good quality. I can recommend Nature’s Plus and Sylvan brands.

I hope this is helpful. Best wishes.

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22 Gracie Santanagelo June 15, 2014 at 5:09 pm

Hi, I have a family history of high cholesterol, diabetes & heart disease….I was on statins and I had horrible side effects & it did not lower my LDL much my triglycerides stayed the same …Total Cholesterol on statins: 188 , Triglicerides: 293. HDL 33, LDL 96 , VLDL: 59..,,.I am changing my diet to all natural ( clean) foods and trying to eliminate simple sugars /carbs….increasing my intake of veggies & lean protien/fish….

I am taking 2400 RYR
4 fish oils eph 270/dha 180
CoQ10 150mg
Drinking 3 -4 cups green tea

Do ypu think this will be affective in lowering my cholesterol & triglycerides & balancing my ratio better…
Thanks so much….

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23 Steve Lankford June 16, 2014 at 8:16 am

It could. Everyone is different and you have to measure the results that you receive and then adjust as needed. These are all important nutrients. Make sure you use high quality brands.

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24 Padin June 14, 2014 at 8:24 pm

Quick question…I am presently taking RYR 1200 w/CoQ10 and it is working! Can I also take a magnesium supplement (OptiMag 125) along with the RYR?

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25 Steve Lankford June 16, 2014 at 8:14 am

Yes. It’s likely to be a good idea as magnesium has many benefits.

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26 Cheryl Cloutier May 8, 2014 at 4:46 pm

I cannot take red yeast rice at night, it keeps me awake. It has helped lower my cholesterol but I have insomnia – I sleep well until about 2 a m then I’m up for about an hour – can I take this in the am?

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27 Steve Lankford May 9, 2014 at 8:24 am

You can take RYR in the morning and see how you do. Try it and monitor your results. It is usually taken at night because your liver makes cholesterol at night while you sleep. Track your cholesterol and see what happens.

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28 J T June 29, 2013 at 6:02 pm

I finished Checkup,blood work on May 2013 and realized that my cholesterol level is way than year before … total 254, and triglyceride is also high above 215.. blood pressure is normal as always.

Since then, I decided to exercise 20 mins a day (min) and take some supplements.
Btw, my doctor just told me to watch my diet, no drug prescribed for me.

Now my question is taking mixed supplements , harm or help?

I am currently taking…

garlic pill – 2 a day
fish oil (360 omega 3) – 3 to 4 day (depending on my meal.. if i have fish, i take less)
red yeast rice (1200 to 1800mg) a day
coq 10 -100mg one a day(take it with ryr 2 pills)
flax seed oil – one a day (skip weekend)
ginger root – 2 a day for digestion
green tea extract – one or two a day (skip weekend)

I don’t really feel any side effect now. Maybe because I didn’t the max as recommended .. for example 2400mg ryr , fish oil 1000 mg omega-3, flax seed oil – 4 a day.

I remembered years back, I just took one fish pill day and on and off, and I didn’t see any result back. This time I may be more diligent on taking supplements.

Will that be okay if I continue as I have scheduled above.. Your input? Will i see some effect on lowering my cholesterol?

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29 Steve Lankford June 30, 2013 at 3:41 pm

You may have smart doctor to hold off on the drugs.
Several points:
Consider you overall risk factors in addition to cholesterol and triglycerides. Normal blood pressure is a good factor. Consider lifestyle and family history and smoking as well.
You should also evaluate the quality of your supplements. Not all brands are equal.
Garlic: Aged garlic extract is my preferred form because it has over 600 clinical trials showing cardiovascular benefits.
Fish Oil: Good for triglycerides. Consider a more potent, therapeutic dose. 2000 to 4000 mg of combined EPA and DHA.
Red Yeast Rice. This dose up to 2400 mg. is useful. Make sure you have a quality product that is standardized. There are some which are not.
CoQ10: Consider using the ubiquinol form as this is better utilized.
You other supplements are fine, tho’ you should confirm that you have a quality brand that can be depended on for quality and potency. You will have to experiment to determine your individual effectiveness and adjust as needed.
Listen to the interview with Dr. Stephen Sinatra on metabolic cardiology.
I will soon be posting a new interview with Dr. Sinatra on his latest book “The Great Cholesterol Myth” which will be posted within the next several weeks. His contention is that cholesterol is not always a significant risk marker. You’ll hear more about that in his upcoming interview.
The only risk I see in your program is that red yeast rice lowers cholesterol by the same mechanism as statin drugs. For a few people this could be an issue. Not usual from my experience.

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30 J T May 27, 2014 at 10:57 am

Time flies… a year passed by and got another check up and got result
Only cut back on beef and eggs
No regular exercise done
got some improvement.. but not as great as I want..
still flag as board line high.

but RYR does not seem to help (been taking for the last two months)
Fish oils pills (been taking for whole year non-stop)

Here is the number

2013 – 2014

total 254 > 222
hdl 45 > 51
ldl 157 > 146
Tri. 260 > 123

That may just mean one thing… Fish oil does lower down Triglycerides
But RYR may not be working to me..

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31 Steve Lankford May 27, 2014 at 11:39 am

It is reasonable to question the quality of the RYR. Some products in the marketplace have low amounts of the monocolins. Some are just cheap products from China. Before you give up on RYR consider trying a different brand.

You should also consider your other risk factors. If you have no other risk factors then I would question the wisdom of trying to lower your cholesterol at all. If you do have additional risk factors then evaluate those risks and consider if your cholesterol is truly a risk for you. The less additional risk factors you have the better.

Risk Factors:
Do you smoke?
Do you have diabetes?
Do you have high blood pressure?
Do you have a family history?
Do you have a cardiac history?
What is your CrP?

Your numbers may be OK depending on the above risk factors. Check out the American Heart Asso risk brochure.
There are good things in your assessment.
Why do you think RYR is not working when your total is down and your HDL is up, your LDL is down and triglycerides are down. Your ratio of HDL to LDL is 1 to 3. That’s good. So maybe it is working. You’ve only been on two months. Seems OK to me.

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32 J T May 27, 2014 at 12:10 pm

Don’t smoke
Don’t have diabetes
Always normal in blood pressure
Family History? – high cholesterol is heritage I guess
Cardic History? – nope, no heart attack in family, nor myself
CRP? what is it, C-Reactive Protein? I don’t see it on my test result, I saw a couple of Protein, and they are normal, also everything else is normal
Except Total Cholesterol, LDL, and Non-LDL (shows up this year, but vldl not showing at all this year test.. not sure if they are they same thing) are flagged.

Also, the reason I think RYR is not working because all the statistic, review I read online, many people have successful rate to low their cholesterol in just 8 weeks.. Maybe my system takes longer? Anyway, I am adding Lecithin to my supplement selection this year because I heard this is good for liver, (I heard too much fish oil may be bad to liver due to toxic even my liver so far is normal, just don’t want to see it flagged)

33 Adam Smith May 26, 2013 at 6:19 pm

Steve: I have another question that I forgot to ask you. What is the impact of Bergamonte, if any, on one’s requirements for CoQ10? If one is taking Bergamonte for hyperlipidemia and other risks related to glucose and cholesterol regulation, what kind of dose of CoQ10 do you think would be advisable?

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34 Steve Lankford May 28, 2013 at 8:48 am

Bergamonte has been reported to lower cholesterol by reducing the HMG-CoA enzyme. This is the same manner in which statins and RYR lower cholesterol. The HMG-CoA enzyme is also involved in the body’s production of CoQ10. This suggests that one should add CoQ10 into their program for the same reason. Suggested dosage would be 100 to 300 mg. daily. I would prefer the ubiquinol in this case and whenever you are taking something that interferes with HMG-CoA such as statins, RYR, Pantithine, bergamonte, etc.

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35 Adam Smith May 25, 2013 at 6:35 pm

What do you think of the Xymogen brand of Red Yeast Rice?

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36 Steve Lankford May 26, 2013 at 7:39 am

I am not familiar with the brand. You could ask the company where does their RYR come from. You could also ask them if they have a third party certificate of analysis. A good company with a COA should be happy and able to provide this.

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37 Adam Smith May 26, 2013 at 6:17 pm

Thanks for the suggestion about Xymogen. That is exactly what I will do. I will post the results for others who may be considering the Xymogen product.

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38 teresa May 11, 2013 at 5:01 pm

I remember taking coq10 a few yrs ago and it really lowered my blood pressure and made me dizzy. I just bought Natures Plus Ryr extended release to lower my. Chol. I’m afraid to take the Q10, but you say I need it with the RYR. What should I do?
Here are my bloodwork numbers from last month. Dr wants me in statins but agreed toi RYR for 3 mos.
Total- 214
Hdl- 68
Ldl- 135
Trig- 57

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39 Steve Lankford May 11, 2013 at 7:37 pm

RYR lowers CoQ10 as well as cholesterol. Most experts suggest that CoQ10 is important to take with RYR and statins. You could start with a lower potency CoQ10 and work up to a recommended amount. I suggest you listen to the interview on CoQ10 with Carl Germano

You should also read all of the comments in the RYR interview. I have covered the important points in that comment thread. If I were you I would consider all of the risk factors as articulated by the American Heart Association. You may not need to lower your cholesterol if you other risk factors are low or non-existent. Other risk factors are smoking, blood pressure, family history and previous cardiac event. Please look into this so you can decide if you are a good candidate for avoiding statin and/or RYR

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40 teresa May 13, 2013 at 3:59 pm

I am a smoker. 1 pack a day. Always excellent blood pressure. My mom had cholesterol problems in her later yrs. She had heart problems also in her later yrs. She passed@ age 86. Since my hdl is so good ( 68), does that some how cancel out some of the ldl (135) ? Is 135 ldl really that bad? I take melatonin at night. Will this cause problems with taking RYR at night? Thank you so much!

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41 Steve Lankford May 13, 2013 at 5:10 pm

Let me state that this is only my opinion. I am not a doctor and I cannot evaluate your risk. You have three risk factors. Cholesterol, smoking and family history. Smoking is by far the worse because of the terrible effects that tobacco smoke has on your arteries. Without stopping the smoking, I think you will find in difficult improve your risk.
Your cholesterol is not that far out of range and your HDL to LDL ratio is 1 to 2, which is a good ratio. Don’t assume that a good ratio will offset the damage of smoking. This is your most dangerous risk factor.
As far as I know there is no problem taking melatonin with RYR.

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42 teresa May 13, 2013 at 6:10 pm

Thank you so much! I will continue to work on my smoking cessation. God bless.

43 Maya April 17, 2013 at 7:10 am

I am taking 1 tablet of Natures plus extended release RYR at night and 200 mg Ubiquonol in the morning for 3 weeks now. I am experiencing muscle pain in the upper thigh. It gets better when I stop RYR. So I a thinking of taking RYR every other night or take half the tablet every day. Also I read that RYR causes mucle problems, and since heart is a muscle one should not be using it. I am confused.
Please advice.

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44 Steve Lankford April 17, 2013 at 4:06 pm

RYR contain statin compounds that have similar actions to statin drugs. Typically people tolerate RYR much better than statin drugs. But not always. You seem to be one of those who are affected. The strategy of lowering your dose of RYR is reasonable as you may tolerate a lower dose. You might consider changing to a regular 600 mg RYR as you can adjust the dosage more effectively. Try to find the most effective but lowest dose without side effects.

For me, RYR is far preferable to statin drugs, but there are other ways to reduce cardiac risk. But I would also consider other possibilities to lower cardiac risk. I would consider whether lowering cholesterol by statins is actually a healthy way to lower cardiac risk or that it is even effective. But this is another story. I do not ascribe to the cholesterol theory of heart disease, so it would not be a personal strategy for me to use statin drugs.

That is a good amount of the right kind of CoQ10. You could try doubling up on this dose and see if it makes a difference, but I would target RYR first.

Good Luck.

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45 Maya March 27, 2013 at 5:18 pm

Hi,
I am 41 years old female. My total cholesterol level are always little above the normal range. And my LDL and TG are also little high. I am starting Natures plus extended release RYR. I understand that its best to take it at night. My question is :
1. Is it ok to take RYR along with Calcium Magneseium, because I usually take Calcium at bed time.

2. Is it ok to take CoQ10 along with other vitamins like a daily multivitamin, fishoil, etc

3. I am taking 100 mg CoQ10 daily. But I read that for every 600mg RYR take 60mg COQ10. But since Natures Plus ‘s 600mg tablet is equalent to 4 tablets , should I take 240 mg CoQ10 daily?

Thank you so much for the information.
Maya

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46 Steve Lankford March 27, 2013 at 5:48 pm

1. Yes, you can take with calcium / magnesium.
2. Yes, it is ok to take with other supplements.
3. Yes, you should probably take a higher potency. I would suggest taking the ubiquinol form of CoQ10. It is more easily absorbed and stays in your blood stream longer.

Good luck and best wishes.

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47 Richard Poor March 21, 2013 at 8:08 pm

Just read a fascinating NIH peer reviewed treatise on sympathetic nervous system over response to stressors causing chronic metabolic change resulting possibly in hypertension, elevated cholesterol and insulin resistance…initiation of these counter health responses can be initiated by a cortex to amyglada exchange just by “reliving” traumatic memories as in PTSD. One of the pleiotropic benefits of some statins or monacolins may be to mute these responses. This is aside from interference with liver function and unlike anti-hypertensives such as Ca blockade, ACE inhibition or ARB or even cardio-selective beta blockade. Therefore, I suspect a combination of non selective beta blockade (low dose Inderal effective to some extent in PTSD with Omega-3, CoQ-10 and RYR may be the best intervention in addition to exercise and mental therapy-stress reduction-weight loss. A good constellation to counter a bad constellation.

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48 Jessica March 12, 2013 at 8:54 pm

Hello,
I am a 43 year old woman with a family history of high cholesterol. I just got my lab results back and they are as follows:
Cholesterol: 245 LDL: 157 HDL: 54.9
Triglyceride: 167 Chol/HDL% 4.5

I exercise 3-5 times per week (running 3-5 miles). I do not smoke, no cardiac history and live a very active life. I could stand to lose 20 pounds. I am just beginning to research red yeast rice and coQ10 and wondering if you think I can benefit from this to lower my cholesterol. I would like to avoid taking a prescription drug at this point in my life.
I would greatly appreciate your thoughts.

Thanks!
Jessica

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49 Steve Lankford March 13, 2013 at 7:23 am

Hi Jessica,
There is no way to predict your future. You have to evaluate your particular risk factors and whether the statin drugs will be of benefit or not. When you look into the science of statin drugs you will discover that the actual risk reduction for statins is only about 1 in 100. This means that you have to give statin drugs to 100 people to reduce the number of heart attacks by 1. You may be better served by focusing on improving and maintaining cardiac health. These are some of the risk factors you should consider in addition to cholesterol number.

1. Blood Pressure
2. Family History
3. Your personal cardiac history
4. Do you smoke?
5. What is your CrP? This is a marker for inflammation. Some suggest that low or no inflammation equates to low risk of a cardiac event.
6. Do you take fish oil? Consumption of fish oil equates to lower inflammation and lower cardiac risk. Also known to lower triglycerides. Take 1 to 3 grams of Omega-3.

If you are taking a quality red yeast rice it can lower your cholesterol, similar to statins. You should take CoQ10 in that case.

The question to ask is: What is the best way to reduce the risk of a cardiac event? Taking statins, OR taking proactive care of your health. I favor the second. Some people may need to do both, but I consider the statins to only be a medical stop gap, because taking statins does not affect your other risk factors.
You should listen to the interview with Dr. Stephen Sinatra on Metabolic Cardiology and Dr. Doug Bibus on Omega-3. These two interviews will give you a good starting point.

After that, let me know if you have additional questions.

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50 Richard Poor March 21, 2013 at 8:21 pm

Good luck to you Jessica. Dropping the 20 lbs and avoiding simple carbs and artificial sweeteners will probably help you a lot. So also may adding weight training or body weight exercise (military approved calisthenics, etc.) help. Also, watch out for too much beer-wine, etc. Oily fish, squid and quality fish oil may help. BE SURE any fish product is highly purified and Mercury free. This will drop your TG and raise HDL. RYR may lower your LDL but be sure to do CO-Q-10 with it. Again, be careful about the brand and avoid brands with Titanium Dioxide as a filler. White Paint is NOT a nutraceutical and TiO2 is the “white” in paint. Don’t eat fried anything. Frying creates oxidized fat creates inflammation.

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51 Keri March 6, 2013 at 10:05 pm

My total Cholesterol is 334 HDL 89 Trig 66 and LDL 232 I’ve never smoked, eat right, and exercise, I can’t take statins what so ever so my Dr. suggested RYR. but didn’t say how much I should take. When I read about the side effects of RYR it seemed the same as taking a statin!

I’m not sure what to do.

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52 Steve Lankford March 9, 2013 at 7:22 pm

Please listen to the interview on Red Yeast Rice and read through the comments and questions as I answer your questions about how much to take.
While it is possible to have similar side effects as statins it seems that very few people have that as an issue. Everyone I know who has taken RYR has tolerated very well. Be sure to also take CoQ10. This is covered in detail in the commentary that follows the podcast page. If after reading through those, let me know if you still have questions. You should also consider family history as well and your own personal situation. If I had no other risk factors, RYR could be a valid choice.

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53 Lena Mares February 17, 2013 at 11:13 pm

I understand the extract form of Red Yeast Rice is better than the powder, and they should be citrinin free. Most bottles of Red Yeast Rice do not indicate whether they are extract or powder form, nor citrinin free. How can we know that what we are buying is good. Also, some that do indicate this have Coq10 in them. Is it safe to take as much as 200 mgs of Coq10 with 1200 mgs twice daily. My doctor has prescribed 1200 mgs twice daily. I’m having a hard time deciding what to buy, since like I say, they do not indicate if they are extract, powder, or citrinin free.

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54 Steve Lankford February 18, 2013 at 8:48 am

Basic RYR is low potency and subject to citrinin. Consumers Labs did a report on RYR a couple of years back and you could search for that. I don’t recommend non standardized RYR.

The extracts of RYR are standardized to 600 mg containing .4 mg of monocolins. It takes 4 of these to equal the clinically studied dose. 2400 mg per day. Your doctor is recommending the correct amount. You should take CoQ10. 100 to 200 mg. is also a reasonable dose. So this is good advice.

Some companies produce on 600 mg. doses so you take up to 4 per day. Some companies have a 1200 mg dose so you take two per day. Nature’s Plus is the only company that I know that produces an extended relaease RYR that 1 tablet is standardized to 1.7 monocolins per tablet. So 1 of these equals 2400 mg of regualar RYR. Nature’s Plus also sell a 600 mg dose that does require 4 per day so if you shop for this brand be sure to distinguish between the two. Some companies sell non standardized RYR in 600 mg dose and this can be confusing as these are the products that you don’t want. But they usually do not easily reveal that they are not using an effective dose. This is what you want to avoid.

I can recommend the Doctor’s Best brand for the regular standardized 600 and 1200 mg tablets. Nature’s Plus Extended Release is what I recommend for those who want 1 per day. I know these brands from experience and personal contact with the companies. I am sure there are other brands that are also suitable. I just don’t have personal knowledge of their brands.

If you want to consider a brand that you don’t know, there are several ways to get informed. Ask the company for their certificate of analysis for their RYR. If they won’t or can’t give this to you, then move on. Also ask them to confirm that their RYR is citrinin free. They should also be able to do this. If they won’t then move on. Good companies will know their products and can share that with you. They should be happy to do this as it reveals their intent to provide pure and tested ingredients.

All good company uses good raw materials, good manufacturing practices and disclosure. Their products will cost more than cheap products that do not conform so you must do due diligence. I would not give my business to a supplement company that will not reveal this to customers. If you find it impossible to call the company or walk in their front door, I would be concerned. Good companies have a physical address and a phone number. If this is not findable, then I would move on.

I hope this is useful. Let me know if you have more questions.

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55 Cynthia January 31, 2013 at 2:11 pm

Is it ok to take 1/2 of the Natures Plus extended release? Have you ever heard of it causing a bit of swelling of the feet and hands? Is Puritans Pride a good brand of RYR? Sorry for all of the questions.

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56 Steve Lankford January 31, 2013 at 3:01 pm

Don’t worry about asking questions. We encourage them. It should be OK to take half a tablet. It may effect the rate of release, but with RYR that should not be an issue. However, that is just an educated guess. You could contact Nature’s Plus and ask them. Let me know if you have any trouble getting a response.
I don’t know about Puritan’s Pride. You should be able to contact them and inquire who and/or where they get their RYR. Ask for the certificate of analysis. If they won’t supply those then that is suspect. If they are open and disclose this to you, that is a good sign. Good companies are always willing to answer consumer questions. I can only speak for the brands I am familiar with, so you will have to do due diligence. You cannot assume that any company, buys the highest quality ingredients. Companies who sell at the lowest prices, are often buying the cheapest raw materials. You need the advice or recommendation of someone you trust or you have to ask them directly.
I think that consumers who take aggressive actions to determine the quality of the supplements they take will get better results because of the distinctions between brands, products and raw materials. So I think you would do well to contact Puritan’s Pride and see what you can discover. It will either be a good experience and you will learn what you need to know, OR you will discover that not all companies do this. In either case it will tell you a lot about the company and it will help you be comfortable contacting companies and seeking information about their products.
Good Luck with that. Let me know how it goes.

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57 Gerry January 1, 2013 at 3:08 pm

Two questions: if taking coq10 separately from RYR, is it better to take the coq10 in the am and the RYR in the pm or together as in the Nature Plus brand?

Your advice to investigate the company is solid. When you said to ask the manufacturer what form of RYR they use, what response should we be looking for?

Thank you for providing helpful information.

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58 Steve Lankford January 1, 2013 at 7:02 pm

It does not matter when you take the CoQ10. It is a fat soluable nutrient so timing is not so critical. So take at the same time or not. It will help either way.

Ask them what is the country of origin for the RYR. US made is good.
Ask them if they have a certificate of analysis and will they send it to you.
Ask them what is the percentage of monocolins in the RYR. Should be at least .4%. This is the clinical dose at 600 mg per tablet, times %.4 times 4 tablets per day equals 9.6 mg.
Ask them if the RYR is free of citrinin which is a toxin found in some cheap RYR. http://www.taipeitimes.com/News/taiwan/archives/2010/09/24/2003483666

The NP extended release is equal to 4 of the regular 600 mg tablets. 600 mg. times 1.7% = 10.2 mg of monocolins per tablets. I tablet per day. This is my preferred product.
I suggest buying the CoQ10 separately as it is usually more cost effective. You can adjust the amount or type of CoQ10 to suit your needs.

Best wishes for 2013.
Steve

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59 Marguerite December 13, 2012 at 10:27 pm

At 54, this is my first rise in LDL – 125. Total Cholesterol 212. Triglyceride 52. HDL 77. My doctor gave me red yeast rice 1200 mg coq10 100 mg to take twice a day. Is this excessive?

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60 Steve Lankford December 14, 2012 at 4:57 pm

The dose that was recommended is right in line with the clinically studied dose, so you should be fine.

You might question if you actually need to lower your cholesterol. The American Heart Association actually has different recommended levels depending on various risk factors and you may be below the threshold. Look into that. The additional risk factors are:
1. Smoking
2. Previous cardiac event
3. Family History
4 Ratio LDL/HDL (Yours is better than ideal)
5. Triglycerides (Yours is very low)
6. High Blood Pressure.

Unless you have some of the other risk factors, you can justify a higher total cholesterol. This is what I would look at if I were you. If you decide to use Red Yeast Rice to lower your cholesterol your dose is good assuming you are using a trustworthy brand.

Good Luck

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61 D'anna November 16, 2012 at 11:46 pm

What about just eating red rice?

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62 Steve Lankford November 17, 2012 at 2:18 pm

Eating red rice will not do it. It is fermented red yeast rice that has the effective compounds.

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63 barry November 4, 2012 at 3:41 am

Thanks for answering my last question. I can’t find nature’s plus 2400 extended release pills. I see that they have a 600mg extended release version. Would I take four of these at night then? For the last 4 years I have been taking red yeast rice, coq10, fish oil, and flax oil daily. My cholesterol for the most part is under control but I really don’t control my diet well and I had been buying all my pills at various stores so there was no standardization. The only thing I kept in common was I would take them morning and night with the only variation being I would take 600mg of red yeast in the morning and 1200 at night. I want to get the most out of this so I have been researching.

Also Nature’s plus makes an extended red yeast with coq 10. Should I take that or would that be too much coq10?

Any info is appreciated.

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64 Steve Lankford November 4, 2012 at 2:15 pm

The Nature’s Plus is a standardized extract and you only need one tablet. It equals 4 of the regular 600 mg tablets. So take one at night. You should take CoQ10 but you can usually do better both cost and potency by taking a separate CoQ10, but it is fine to take the combo if you want the convenience.

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65 barry November 4, 2012 at 2:52 pm

Are you saying one 600mg extended release pill is the equivalent of taking 2400 of taking 2400 non extended release pills?

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66 Steve Lankford November 4, 2012 at 3:43 pm

Yes, I did not make that clear. Here are the choices in the marketplace
Non-standardized red yeast rice. Usually not very effective. Examples are Solaray and Kal. these have only trace amounts of monocolins.
Standardized Red Yeast Rice. The studied form. Dosage was 4 6oo mg tablets. Each tablet equals .4 mg. of monocolin. 4 tablets = 1.6 mg of monocolin which is the most active compoound.
Nature’s Plus Extended Release Red Yeast Rice. This has a higher percentage of monocolin per tablet. One table = 1.7 mg. It is still 600 mg. but at a 4 times greater concentration. So 1 tablet = 4 of any other standardized red yeast rice.
One brand that I know uses the standardized red yeast rice is Doctor’s Best. They have a 600 and 1200 mg tablet so you can dose between 600 and 2400 mg. You can experiment with the dose and find the effective dose for you.
There are other good brands and poor brands. You should enquire with the company to discover what form of red yeast rice they use. The company knows and should be able to answer your question. If they won’t answer then I would not buy that brand. A good company should be willing to disclose what is in their product. If not go elsewhere.

I know a store that sells the nature’s Plus Extended Release Red Yeast Rice at 20% off. You can call them at 920-432-6886. They do mail order so tell them Steve told you to call and they will help you. Best wishes.

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67 barry November 2, 2012 at 3:18 am

If you do the extended release pill, should you take it in the morning or night?

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68 Steve Lankford November 2, 2012 at 1:29 pm

Take at night before going to bed.

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69 Cynthia Elterman August 27, 2012 at 5:45 pm

I have read the above, please let me know if their are other companies that make RYR.

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70 Steve Lankford August 28, 2012 at 2:20 am

You could contact the raw material supplier and inquire about the brands that use this raw material. Otherwise you could inquire with any company you are interested in and request the test data for their red yeast rice and ask about their source. A company that uses American red yeast rice will usually be proud to announce that fact.

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71 Steve Lankford May 27, 2014 at 1:00 pm

CrP is C-Reactive Protein. It is a measure on systemic inflammation. If inflammation is low then risk is also low. You may have to ask for this test.

Your numbers and history suggest low risk. I would re-consider trying to lower cholesterol, especially if CrP is normal. Listen to my two interviews with Dr. Stephen Sinatra on Metabolic Cardiology and The Great Cholesterol Myth.

So you have a family history of high cholesterol but no family history of cardiac disease. That should be a huge clue for you. Cholesterol and heart disease are not your issues. That would be my take away and I personally would focus on maintaining health, and not on artificially lowering cholesterol, even with RYR.

Just my opinion.

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