Red yeast rice and CoQ10 are often taken together to support cholesterol balance and heart health. While red yeast rice may help reduce LDL (“bad”) cholesterol, it can also deplete CoQ10 levels in the body, just like statins. Supplementing with CoQ10 alongside red yeast rice may help reduce common side effects such as muscle aches and fatigue, while also supporting energy production and cardiovascular function. In this guide, we explore how each supplement works, what the science says, and whether combining them is right for you.
What Is Red Yeast Rice?
Red yeast rice is a traditional Chinese fermented product made by culturing rice with the yeast Monascus purpureus. It contains a naturally occurring compound called monacolin K, which is chemically identical to lovastatin, a cholesterol-lowering statin drug.
Because of this, red yeast rice has become a popular natural alternative for those looking to manage their cholesterol levels. However, like statins, it may cause side effects such as muscle pain or fatigue due to its impact on mitochondrial function and CoQ10 levels in the body.
What Is CoQ10?
Coenzyme Q10 (CoQ10) is a substance naturally produced by the body that is essential for energy production in our cells. It plays a key role in mitochondrial function and acts as a powerful antioxidant, especially in high-energy-demanding organs like the heart and muscles.
Our natural levels of CoQ10 decline as we age and are further reduced by statin medications, including monacolin K in red yeast rice. This depletion is linked to muscle aches, tiredness, and low energy, common side effects reported by statin users.
Why Take Red Yeast Rice with CoQ10?
If you are taking red yeast rice to help support cholesterol levels, supplementing with CoQ10 may help maintain optimal CoQ10 levels in the body. This is especially useful for:
- Reducing muscle-related side effects such as cramping or weakness
- Supporting energy levels and reducing fatigue
- Promoting overall cardiovascular function and antioxidant protection
Some cholesterol support formulas now combine both ingredients into one supplement for convenience and better tolerability.
What Does the Research Say?
- A 2019 meta-analysis of 20 studies found that red yeast rice can significantly reduce LDL cholesterol by an average of 1.02 mmol/L [1].
- A 2020 clinical review reported that CoQ10 supplementation may help reduce statin-associated muscle symptoms (SAMS), making statin-like therapies more tolerable [2].
- A recent study suggested that combining red yeast rice with CoQ10 and other supplements such as grapeseed extract, improved adherence to treatment by reducing side effects while maintaining cholesterol-lowering effects [3].
However, it’s worth noting that red yeast rice is not suitable for everyone. Its active ingredient is considered pharmacologically active, and certain products may vary in monacolin K content, leading to inconsistent results or regulatory concerns.
Things to Consider Before Taking Red Yeast Rice with CoQ10
- Always check if the red yeast rice supplement specifies the amount of monacolin K it contains.
- If you are taking prescription statins, speak to your doctor before combining them with red yeast rice.
- CoQ10 is generally considered safe and well-tolerated, especially in its active ubiquinol form.
- Look for high-quality products that use Kaneka Ubiquinol or other clinically validated CoQ10 sources.
Choosing the Right Supplement
If you're considering a natural approach to cholesterol support, we recommend the following:
- Napiers Lowerol™ Red Rice Yeast Capsules – A food supplement containing red yeast rice (monacolin K), CoQ10, policosanol and grape seed extract. When used in conjunction with a low cholesterol diet, red yeast rice may contribute to the maintenance of normal blood cholesterol levels, especially as you get older.
- Napiers Japanese Energy CoQ10 – Provides Kaneka Ubiquinol, the highly bioavailable form of CoQ10. Supports normal energy production and protection of cells from oxidative stress, making it a good option for those seeking heart and vitality support.
We always recommend consulting with a GP or a herbalist before starting any new supplement routine. You can book a free 15 minute 1:1 consultation with a herbalist here.
Who Might Benefit from This Combination?
- Adults with borderline or high cholesterol looking for a natural support option
- People experiencing muscle discomfort while taking red yeast rice
- Individuals over 40 whose CoQ10 levels may already be in decline
- Those looking to support heart health, energy, and antioxidant status
As with any supplement, it’s best to seek personalised advice from a qualified healthcare practitioner or registered herbalist before starting a new regimen.
FAQs: Red Yeast Rice and CoQ10
Can you take red yeast rice and CoQ10 together?
Yes, many people take them together. CoQ10 may help offset muscle aches or fatigue associated with red yeast rice by replenishing depleted levels.
What is the best time to take red yeast rice and CoQ10?
Red yeast rice is often taken at night when the body produces more cholesterol. CoQ10 should be taken with food containing fat, ideally earlier in the day for energy support.
How much CoQ10 should I take with red yeast rice?
Doses between 100–200 mg of CoQ10 (preferably in ubiquinol form) are often used, but consult a practitioner for personalised advice.
Is red yeast rice safe to take long-term?
It can be, but only when used at appropriate doses and under supervision. Long-term use should be monitored due to its statin-like effects.
Can red yeast rice interact with medications?
Yes. Like statins, red yeast rice may interact with certain medications and may not be suitable for everyone. Always check with your healthcare provider.
This content is for educational purposes only and is not intended to diagnose, treat, or replace medical advice. Always consult a qualified healthcare professional before starting any new supplement.
References
- A FG Cicero, F Fogacci, M Banach (2019). Red Yeast Rice for Hypercholesterolemia. PubMed
- C Kennedy, Y Köller, E Surkova (2020). Effect of Coenzyme Q10 on statin-associated myalgia and adherence to statin therapy. ScienceDirect.
- N Angelopoulos, R D Paparodis, I Androulakis, A Boniakos, G Argyrakopoulou, S Livadas (2023). Low Dose Monacolin K Combined with Coenzyme Q10, Grape Seed, and Olive Leaf Extracts Lowers LDL Cholesterol in Patients with Mild Dyslipidemia: A Multicenter, Randomized Controlled Trial. PubMed
