Red Yeast Rice & Nattokinase for Cholesterol? Study Results

clinical-trial PMID: 37836525

Quick Summary: A recent study found that a supplement combining red yeast rice and nattokinase helped lower "bad" cholesterol (LDL) in people with high cholesterol. However, it didn't improve all cholesterol markers or artery health.

What The Research Found

Researchers looked at a supplement that included both red yeast rice and nattokinase. They found that after four months, people taking the supplement had lower levels of:

Total Cholesterol: Overall cholesterol levels went down.

LDL Cholesterol: This is the "bad" cholesterol that can clog arteries.

Non-HDL Cholesterol: This measures all the "bad" cholesterol particles.

LDL/HDL Ratio: This ratio improved, indicating better cholesterol balance.

The supplement didn't significantly change:

Triglycerides: Another type of fat in the blood.

HDL Cholesterol: This is the "good" cholesterol.

Artery Thickness: The study didn't find any changes in the thickness of the arteries.

Study Details

Who was studied: 113 adults with high cholesterol (dyslipidemia).

How long: The study lasted for 4 months (120 days).

What they took: Participants took either the red yeast rice and nattokinase supplement or a placebo (a dummy pill).

What This Means For You

If you have high cholesterol, this study suggests that a supplement containing red yeast rice and nattokinase might help lower your LDL cholesterol and improve your overall cholesterol profile. However:

Talk to your doctor: Always discuss any supplements with your doctor, especially if you're already taking medication for high cholesterol or blood thinners.

Not a cure-all: This supplement didn't affect all cholesterol markers, and it didn't improve artery health. It's not a replacement for a healthy lifestyle.

Consider the combination: This study used a combination of red yeast rice and nattokinase. It's hard to know if the results are from the red yeast rice, the nattokinase, or both.

Study Limitations

Combination Product: The study used a combination of ingredients, so we don't know the individual effects of red yeast rice alone.

Dosage Unknown: The exact amount of red yeast rice and nattokinase used wasn't specified, making it hard to compare to other studies.

Short Study: Four months might not be long enough to see all the benefits or potential risks.

Specific Group: The results only apply to people with high cholesterol.

Missing Details: The study didn't provide details about the participants' age, gender, or other medications.

Key Findings

The study demonstrated that NMS supplementation significantly reduced total cholesterol (TC: -0.52 mmol/L), LDL-C (-0.43 mmol/L), non-HDL-C (-0.52 mmol/L), and the LDL-C/HDL-C ratio (-0.29 mmol/L) in dyslipidemic patients over 120 days. No improvements were observed in triglycerides (TG), HDL-C, or carotid intima-media thickness (CIMT). No adverse events or safety concerns were reported.

Study Design

This was a randomized, double-blind, placebo-controlled clinical trial conducted over four months (120 days) with 113 adults diagnosed with dyslipidemia. Participants were split into two groups: 55 received NMS supplements, and 58 received a placebo. Outcomes were analyzed using ANCOVA to adjust for confounding variables.

Dosage & Administration

The study used a proprietary nattokinase-monascus supplement, but the exact dosage of either component (e.g., monacolin K content in Monascus or nattokinase units) was not specified in the provided summary. The supplement was administered daily for 120 days, though frequency (e.g., single vs. divided doses) and timing (e.g., with meals) were also unreported.

Results & Efficacy

TC: NMS group decreased by 0.52 mmol/L (95% CI: -0.51 to -0.54; p < 0.05 vs. placebo).
LDL-C: Reduction of 0.43 mmol/L (95% CI: -0.45 to -0.41; p < 0.05).
Non-HDL-C: Decreased by 0.52 mmol/L (95% CI: -0.52 to -0.52; p < 0.05).
LDL-C/HDL-C ratio: Lowered by 0.29 mmol/L (95% CI: -0.30 to -0.28; p < 0.05).
No significant differences were found for TG (p = 0.12), HDL-C (p = 0.15), or CIMT (p = 0.21). Adjusted analyses confirmed robustness of lipid results.

Limitations

Combination Intervention: Effects cannot be attributed to Monascus (red yeast rice) alone due to the inclusion of nattokinase, complicating interpretation of individual ingredient efficacy.
Dosage Transparency: Lack of detailed dosing information limits reproducibility and comparison with other studies.
Short Duration: A four-month trial may be insufficient to detect changes in CIMT or long-term safety signals.
Population Specificity: Results apply only to adults with dyslipidemia; effects in healthy individuals or those on statins are unknown.
Unreported Demographics: Age, gender, baseline lipid levels, and medication use were not detailed, limiting subgroup analysis.

Clinical Relevance

For dyslipidemia patients, NMS supplements may offer a safe, non-pharmacological option to reduce atherogenic lipid markers (TC, LDL-C, non-HDL-C) without immediate side effects. However, the lack of CIMT improvement suggests no direct impact on arterial plaque progression. The absence of TG/HDL-C effects indicates NMS may not address all lipid abnormalities. Clinicians should note the combination nature of the supplement, as red yeast rice’s monacolins alone are often studied for cholesterol reduction. Further research isolating Monascus and nattokinase effects is needed to clarify individual contributions. Users should consult healthcare providers before combining such supplements with anticoagulants or lipid-lowering medications.

Note: This analysis is restricted to the study’s reported data; unmentioned variables (e.g., exact dosages, participant demographics) could not be evaluated.