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Does Red Yeast Rice Raise Blood Sugar Levels Like Statins?

Red yeast rice contains some statin-like compounds. Does that mean it can cause statin-like side effects? Will red yeast rice raise blood sugar levels?

Many people are reluctant to take statins because of side effects like muscle pain and weakness. But their doctors are often quite adamant that they need to lower their LDL cholesterol. Sometimes people may try red yeast rice as a different option. This ancient Chinese food product has been used for hundreds of years to flavor and color food. Chinese healers have traditionally used red yeast rice to enhance blood circulation. Because it also contains statin-type compounds related to lovastatin (Mevacor), it has been shown to lower cholesterol. Does red yeast rice (RYR) have statin-like side effects? In particular, some of our readers would like to know: does red yeast rice raise blood sugar?

Could Red Yeast Rice Affect Blood Sugar?

Q. What information do you have about natural statins, i.e., red yeast rice, and type 2 diabetes management? I’ve been taking a low dose of red yeast rice for more than twenty years.
For most of my adult life, I have been told I’m prediabetic. Over the last couple of years my numbers have risen (along with my weight) and now I am clearly in type 2 diabetic territory. As a result, I am wondering if I should stop taking red yeast rice.

A. We found your question fascinating. There is now considerable evidence that statin-type cholesterol-lowering drugs can indeed raise blood glucose and the risk of type 2 diabetes (JAMA Internal Medicine, Oct. 4, 2021).

There has not been as much research on red yeast rice (monacolin K), a natural statin. However, some small studies we found don’t indicate that red yeast rice raises the risk for diabetes significantly (Biomedicine & Pharmacotherapy, Sep. 2018; High Blood Pressure & Cardiovascular Prevention, Aug. 2019; Cardiovascular Therapeutics, April 2021). Of course, that doesn’t eliminate the possibility that your supplement might be contributing to your current situation. Keep reading for more information on this complex question.

To find out whether red yeast rice is actually affecting your blood sugar, you could do a trial without it. Do check with your doctor and monitor both cholesterol and blood sugar during that time. You may also find that losing weight, if you can, can also help bring your blood sugar down. We know that is easier said than done.

Another reader decided to do that experiment.

Did Red Yeast Rice Raise Blood Sugar?

Q. Late in 2016, I began taking red yeast rice (RYR) to lower my total cholesterol and LDL. My glucose level in March 2017 was 118. My doctor recommended nutritional counseling for a “pre-diabetic condition.”

When I told the counselor I was taking red yeast rice, she told me to stop taking it, as it can raise blood glucose levels. I did so, and the following year my blood glucose was 105. This year it was 95. Does red yeast rice raise blood sugar just like a statin drug?

I am a healthy 63-year-old who exercises daily. With no history of heart disease or stroke, I have a 4 percent lifetime risk of heart attack according to the ACC/AHA calculator. I would rather have high cholesterol than become a type 2 diabetic with all its attendant risks.

Red Yeast Rice and Statin-Like Side Effects:

A. Red yeast rice does contain statin compounds, and it therefore can produce some statin-like side effects. The best study we found to answer your question was conducted recently in Taiwan, where red yeast rice is a popular prescription remedy (Diabetes, Metabolic Syndrome and Obesity: Targets and Therapies, Jan. 9, 2020).

The researchers compared 34,000 people prescribed RYR to 34,000 prescribed lovastatin. None of these people had diabetes to start with. Those taking lovastatin were more than twice as likely as those on RYR to develop diabetes over the next five years.

A review in the journal Frontiers in Pharmacology (Dec. 2, 2019) suggests that red yeast rice may actually have anti-diabetic activity in diabetic rodents. The authors admit, though, that there are no clinical trials demonstrating such an effect in humans.

Can Red Yeast Rice Cause Statin Side Effects?

A “mini-review” published in the International Journal of General Medicine (April 30, 2019) concludes:

“The claim that red yeast rice ‘naturally’ lowers or maintains cholesterol levels without comparable side-effects to synthetic statins is untenable… It is recommended that red yeast rice products are only made available with appropriate warnings as they have the same clinically relevant risk potential as statins.”

Readers Share Their Red Yeast Rice Stories:

Did red yeast rice raise blood sugar for Ann?

“I am also interested in the red yeast rice and pre-diabetes relationship. I have been taking red yeast rice for eight years. It has kept my cholesterol level below 200, but my fasting blood sugar has risen gradually to 102 and HbA1C is now at 5.7.

“Seems that if one takes a “statin” even if it is non prescription, the side effects are the same”

Debbie has had a somewhat similar reaction:

“My MD has had me on red yeast rice for a number of years. Despite my not eating much sugar nor refined flour, my blood sugar is higher than seems reasonable (though not to the point of diabetes).”

P.A. experienced statin-like side effects while taking red yeast rice:

“I had taken red yeast rice for several years because of slightly elevated cholesterol (around 216). Over time, muscle aches and pain increased to the point that I thought I made a mistake moving to NC to play more golf, because I was so stiff and ached so much (I was 59 at the time).

“After deciding to stop taking red yeast rice for a little while to see if I noticed any difference in how I felt, I was amazed to find that physically I ached at least 70% less, and because I am physically very active, I was able to do so much more with way fewer anti-inflammatories. A side benefit is that I felt much more mentally alert.

“I was seeing both a massage therapist and physical therapist for back, knee, and hip pain and both commented on how much difference they saw in the rigidity of my muscles. In addition, I had been diagnosed with diabetes, which I now maintain with diet and exercise. Would I ever take any statin, prescribed or in a dietary supplement like red yeast rice? Emphatically no.”

There is not a lot of research on red yeast rice and blood glucose elevation. We suspect that diabetes is probably less common with red yeast rice than with statins. After all, the “dose” of statins is lower than with many of the more potent statins like atorvastatin, rosuvastatin or simvastatin. That does not mean the risk is zero. We think that anyone taking a statin or red yeast rice should monitor blood glucose levels carefully.

Please share your own red yeast rice story below in the comment section. Did red yeast rice raise blood sugar levels for you?

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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  • Mansi IA et al, "Association of statin therapy initiation with diabetes progression: A retrospective matched-cohort study." JAMA Internal Medicine, Oct. 4, 2021. DOI: 10.1001/jamainternmed.2021.5714
  • Mazza A et al, "Effect of Monacolin K and COQ10 supplementation in hypertensive and hypercholesterolemic subjects with metabolic syndrome." Biomedicine & Pharmacotherapy, Sep. 2018. DOI: 10.1016/j.biopha.2018.06.076
  • Mazza A et al, "The effects of a new generation of nutraceutical compounds on lipid profile and glycaemia in subjects with pre-hypertension." High Blood Pressure & Cardiovascular Prevention, Aug. 2019. DOI: 10.1007/s40292-019-00332-6
  • Puato M et al, "Lipid profile and vascular remodelling in young dyslipidemic subjects treated with nutraceuticals derived from red yeast rice." Cardiovascular Therapeutics, April 2021. DOI: 10.1155/2021/5546800
  • Chen, T. L., et al, "Evaluating Risk of Incident Diabetes Between Patients Who Used Lovastatin and Red Yeast Rice Prescriptions (LipoCol Forte): A Retrospective Cohort Study Based on a Real-World Database," Diabetes, Metabolic Syndrome and Obesity: Targets and Therapies, Jan. 9, 2020, DOI: 10.2147/DMSO.S223833
  • Zhu B et al, "Red yeast rice: A systematic review of the traditional uses, chemistry, pharmacology, and quality control of an important Chinese folk medicine." Frontiers in Pharmacology, Dec. 2, 2019. doi: 10.3389/fphar.2019.01449
  • Farkouh A & Baumgärtel C, "Mini-review: medication safety of red yeast rice products." International Journal of General Medicine, April 30, 2019. doi: 10.2147/IJGM.S202446
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