Understanding Red Yeast Rice: Benefits, Risks, and Safe Usage Guidelines

Kobayashi Pharmaceutical embroiled in health product safety controversy, how should red yeast rice be used?

The controversy over the safety of health products involving Kobayashi Pharmaceutical has led to 2 deaths and 106 hospitalizations.

What is red yeast rice? What are its effects? What precautions should be taken when using red yeast rice?

What is red yeast rice?

According to publicly available information from the Guangdong Administration of Traditional Chinese Medicine, domestically produced red yeast rice can be categorized into three types: brewing red yeast rice, pigment red yeast rice, and functional red yeast rice.

Brewing red yeast rice has high saccharification and esterification abilities and a unique aroma, and is widely used in the production of various types of yellow wine, white wine, vinegar, and sauce.

Pigment red yeast rice has a high color value and is a pure natural food coloring agent, commonly used in coloring meat products, fermented bean curd, and other foods.

Functional red yeast rice refers to red yeast rice produced from rice as the raw material, fermented by pure-cultured red yeast bacteria to produce biologically active substances such as monacolin K (also known as lovastatin), commonly used as a raw material for health products and medicines for the prevention and treatment of cardiovascular diseases.

Ms. Liu Fang, Deputy Chief Pharmacist of the Sino-Japanese Friendship Hospital and Clinical Pharmacist of Traditional Chinese Medicine, stated in an interview with China News Service that modern research has shown that red yeast rice has pharmacological effects such as regulating blood lipids, reducing blood viscosity, anti-inflammatory properties, promoting stable blood pressure reduction, lowering blood sugar, anti-tumor, anti-fatigue, and enhancing immunity. Clinically, red yeast rice is mainly used in combination with corresponding Chinese medicine to treat diseases such as food accumulation vomiting, damp-heat diarrhea, and other diseases. In addition, red yeast rice can promote blood circulation and remove blood stasis, and can be used for postpartum lochia retention, blood stasis abdominal pain, and bruises.

How should red yeast rice be used?

Xiao Xiaohe, Academic Director of the Department of Hepatology at the General Hospital of the People’s Liberation Army and Director of the Institute of Traditional Chinese Medicine of the People’s Liberation Army, stated in an interview with China News Service that as a traditional Chinese medicine product with the same origin of medicine and food, red yeast rice has a long history of use in China, and there have been no records or reports of liver and kidney damage cases to date. From the perspective of red yeast rice production technology, even if adverse mold growth occurs and toxic substances such as citrinin are produced, causing harm to organs such as the liver, it is often a relatively slow accumulation process.

Xiao Xiaohe said that it is difficult to determine the specific cause of the damage related to Kobayashi Pharmaceutical’s health products containing red yeast rice without disclosing the details of the products and patients involved. The possibility of other toxic and harmful substances being mixed into the products cannot be ruled out.

According to Japanese media reports, analysis results on the 16th of this month showed that some of the red yeast rice raw materials from Kobayashi Pharmaceutical may contain unknown ingredients.

Liu Fang stated that red yeast rice used by medical institutions is professionally prepared in accordance with relevant regulations and meets the required quality standards. When using red yeast rice, attention should be paid to the following: red yeast rice contains statin-like components, so the dosage should be carefully monitored when used in combination with lipid-lowering drugs, and liver and kidney function should be monitored. Attention should also be paid when red yeast rice is used in combination with drugs that interact with statins. Patients with deficiency of spleen yin and excess stomach fire should also be cautious when taking red yeast rice, and patients without food accumulation or blood stasis should preferably not take red yeast rice. In addition, pregnant women should also use red yeast rice with caution.

Liu Fang said that as a medicinal product, red yeast rice must be used by doctors based on the premise of understanding indications and differentiating diseases and syndromes, and appropriate doses should be selected. As a food ingredient, the amount of red yeast rice used is relatively low, so it is generally safe. Relevant contraindications should be noted, and long-term, excessive use should be avoided.

On July 20, 2022, in Zhongshan Village, Tuliang Village, Mazhai Town, Dongyang City, Zhejiang Province, a brewing master collected fermented red yeast rice, preparing to transport it to the drying field. (Photo by Hu Yanghui, Xinhua News Agency)

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