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Glucose & metabolicLowers LDL cholesterol via natural monacolin K · 4-8 weeks
Too few graded studies1 study
Liver health
Too few graded studies1 study
By the numbers
Pulled from 35 studies with measurable effects
Likely real effects
83%
across studies
People studied
46k
typical study: 143 people
Strongest designs
33
16 pooled, 17 randomised
Showed benefit
100%
15/15 studies
How long studies ran
1–3 months
2
3+ months
3
Populations Studied
Patients with hyperlipidemia2
Patients with hypercholesterolemia2
Statin-intolerant patients2
Hypercholesterolemic patients2
Active research area
20 studies in the last 5 years · Latest meta-analysis: 2026
200820172026
1Total cholesterol reductionMeta-AnalysisCited 6×n=4,838 · very large study2024
Berberine, alone or with other nutraceuticals, can provide a modest positive impact on lipid concentrations.
Hernandez AV et al. · Journal of dietary supplements (2024)
Noticeable benefit
← WorseNo effectBetter →
Products with berberine alone had less robust effects on TC (MD -12.08 mg/dL [95%CI: -21.79 to -2.37]), LDL (MD -9.26 mg/dL [95%CI: -20.31 to 1.78]), and HDL (MD 1.38 mg/dL [95%CI: -1.27 to 4.03]) but TG effects were similar (MD -17.40 mg/dL [95%CI: -32.57 to -2.23]).
Berberine, alone or with other nutraceuticals, can provide a modest positive impact on lipid concentrations.
3Serum lipids, glucose, and hs-CRP improvementMeta-AnalysisCited 15×n=1,050 · large study2021
These changes are consistent with improved cardiometabolic health.
Cicero AFG et al. · Nutrients (2021)
Armolipid Plus® was well tolerated.
This meta-analysis demonstrates that dietary supplementation with Armolipid Plus® is associated with clinically meaningful improvements in serum lipids, glucose, and hs-CRP.
These changes are consistent with improved cardiometabolic health.
5Plasma lipid and glucose levelsMeta-AnalysisCited 80×n=1,670 · large study2016
Inverse variance-weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated for net changes in lipid and glucose levels using a random-effects model.
Pirro M et al. · Pharmacological research (2016)
Noticeable benefit
← WorseNo effectBetter →
Likely real
Inverse variance-weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated for net changes in lipid and glucose levels using a random-effects model.
Overall, WMDs were significant for the impact of NComb supplementation on plasma levels of total cholesterol (-26.15mg/dL, p<0.001), LDL-cholesterol (-23.85mg/dL, p<0.001), HDL-cholesterol (2.53mg/dL, p<0.001), triglycerides (-13.83mg/dL, p<0.001) and glucose (-2.59mg/dL, p=0.010).
NComb-induced amelioration of lipid profile was not affected by duration of supplementation nor by baseline lipid levels; conversely, a greater glucose-lowering effect of NComb was found with higher baseline glucose levels and longer durations of supplementation.
6LDL cholesterol and total cholesterol levelsMeta-AnalysisCited 20×n=1,246 · large study2017
Although RYR appears to be a safe and effective lipid-lowering agent, there is insufficient evidence to support the recommendation of RYR supplementation to patients.
Peng D et al. · The American journal of nursing (2017)
Significant reductions in low-density lipoprotein cholesterol and total cholesterol levels with RYR supplementation were observed in all trials.
Although RYR appears to be a safe and effective lipid-lowering agent, there is insufficient evidence to support the recommendation of RYR supplementation to patients.
Further research is needed, including long-term studies, studies that include participants with comorbidities and complex medical histories, and studies that take into account the variability of formulation and dosage of RYR in the marketplace.
8LDL-C reductionMeta-AnalysisCited 119×n=1,012 · large study2019
Red yeast rice effectively lowered LDL-C in statin-intolerant patients with significantly better tolerability than statins.
Fogacci F et al. · American Journal of Cardiology (2019)
Large benefit
← WorseNo effectBetter →
LDL-C was reduced by 22-30% in statin-intolerant patients
Muscle-related adverse events were significantly lower than with statin therapy
Red yeast rice containing monacolin K at 3-10 mg/day was most effective
9Dyslipidemia managementMeta-AnalysisCited 84×n=804 · large study2014
The meta-analysis suggests that red yeast rice is an effective and relatively safe approach for dyslipidemia.
Li Y et al. · PloS one (2014)
The meta-analysis suggests that red yeast rice is an effective and relatively safe approach for dyslipidemia.
However, further long-term, rigorously designed randomized controlled trials are still warranted before red yeast rice could be recommended to patients with dyslipidemia, especially as an alternative to statins.
10Safety outcomesMeta-AnalysisCited 2×n=61 · small study2024
The evidence examined in this study suggests that RYR preparations are safe; however, the credibility of the evidence was not high.
Ma ZY et al. · Journal of integrative medicine (2024)
Based on A MeaSurement Tool to Assess Systematic Reviews version 2, 3 (20%) and 12 (80%) of these meta-analyses had low and critically low confidence, respectively.
The other 46 (75.4%) associations showed no significant difference between the use of RYR preparations and control treatments.
Regarding the credibility of the evidence, 21 (34.4%), 34 (55.7%) and 6 (9.8%) associations showed moderate, low and very low credibility, respectively.
11Total cholesterol and LDL-C reductionMeta-AnalysisCited 10×2024
Further research on specific subpopulations and outcomes could establish a consensus on determining the clinical benefits and potential risks, if any, of this nutraceutical.
Trogkanis E et al. · Nutrients (2024)
The consumption of RYR extract by people with hypercholesterolemia was associated with statistically significant reduction in total cholesterol and LDL-C, whereas it was not associated with an increase in life-threatening side effects.
As regards the safety, RYR extract was considered a safe choice with neither threatening nor frequent side effects.
Further research on specific subpopulations and outcomes could establish a consensus on determining the clinical benefits and potential risks, if any, of this nutraceutical.
13Cholesterol and triglyceride reductionMeta-AnalysisCited 13×2022
Xuezhikang was found to have the highest probability of being the most effective formulation for reducing total cholesterol and low-density lipoprotein cholesterol levels, while Zhibituo had the highest probability of being the most effective for controlling triglyceride and high-density lipoprotein cholesterol levels.
Xu G et al. · Endocrinology, diabetes & metabolism (2022)
In terms of reduced total cholesterol levels, Xuezhikang (SUCRA: 84.5%) had the highest probability of being the most effective formulation, with Simvastatin (66.4%) and Zhibitai (65.4%) ranked second and third, respectively.
Xuezhikang also had the highest probability of reducing low-density lipoprotein cholesterol levels to the greatest extent (SUCRA: 82.6%) with Simvastatin (SUCRA: 74.9%) and Zhibituo (SUCRA: 52.8%) being the second and third choices, respectively.
For reduced triglyceride levels, Zhibituo (SUCRA: 80.2%) exhibited the highest probability of being the most effective, with Xuezhikang (SUCRA: 63.4%) and Simvastatin (SUCRA: 57.6%) in second and third places, respectively.
Various MediterrAsian diet products or natural extracts may represent a potential intervention treatment to raise HDL-C in dyslipidemic subjects.
Rondanelli M et al. · BioMed research international (2016)
The results of this systematic review indicate that the dietary supplementation with red yeast rice, bergamot, artichoke, and virgin olive oil has promising effects on the increase of HDL-C serum levels.
Various MediterrAsian diet products or natural extracts may represent a potential intervention treatment to raise HDL-C in dyslipidemic subjects.
This meta-analysis confirms that the nutraceutical combination containing berberine, policosanol, and red yeast rice has shown to be an effective product for the improvement of the lipid profile.
Millán J et al. · Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis (2016)
Barely noticeable benefit
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The effect size (relative change from baseline (%)) was -1.3 (9.9%) for total cholesterol, -1.17 (-13.7%) for LDL-c, +0.17 (+3.7%) for HDL-c and -0.24 (-7.0%) for Triglycerides.
This meta-analysis confirms that the nutraceutical combination containing berberine, policosanol, and red yeast rice has shown to be an effective product for the improvement of the lipid profile.
This meta-analysis indicated that RYR extract in MI patients with borderline hypercholesterolemia is associated with improved cardiovascular outcomes and lipid profiles.
Sungthong B et al. · Scientific reports (2020)
Huge benefit
← WorseNo effectBetter →
RYR extract (1,200 mg/day) reduced nonfatal MI (risk ratio (RR) = 0.42, 95% CI 0.34 to 0.52), revascularization (RR = 0.58, 95% CI 0.48 to 0.71), and sudden death (RR = 0.71, 95% CI 0.53 to 0.94).
Follow-up periods ranged from 4 weeks - 4.5 years and the studies were overall of high quality with low risk of bias.
This meta-analysis indicated that RYR extract in MI patients with borderline hypercholesterolemia is associated with improved cardiovascular outcomes and lipid profiles.