From Richard N. Fogoros, M.D.,
Your Guide to Heart Disease.
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Red yeast rice in the past reduced cholesterol levels because it contained (among many other chemicals), one of the statin drugs, namely lovastatin. (The statin drugs are the most effective cholesterol-lowering agents used in medicine today. They were originally derived from yeast products.)

Studies using the "original" form of red yeast rice accordingly confirmed significant reductions in cholesterol levels.

However, the story does not stop there. In fact, the story became pretty confusing right after the clinicals studies confirming the efficacy of red yeast rice were published in 1999. First, because red yeast rice was found to contain lovastatin, the FDA made an administrative decision that this dietary supplement (often sold as Cholestin in earlier times) was a regulable drug, and thus removed it from the unregulated shelves of the health food store.

Then, in 1999, the FDA ruling on red rice yeast was overturned by the court of the District of Utah. But finally, in 2000, the 10th U.S. Circuit Court of Appeals ruled that red yeast rice IS subject to FDA regulation. Since then, the FDA has aggressively gone after companies selling red rice yeast containing lovastatin. While red rice yeast is still available on the grocer's shelf, the stuff that is out there now is apparently fermented using a different process, and apparently (I say "apparently" because it is in fact extraordinarily difficult to find out what dietary supplements do and do not contain) does NOT contain lovastatin. Therefore, (the active ingredient having been removed) its ability to lower cholesterol levels is probably nil. (This explains why the otherwise colorful labels no longer tout the cholesterol-lowering properties of the product.)

NOTE: Here's a bulletin from 8/10/07 on red yeast rice products that still contain lovastatin.

Reference: PDRhealth on red rice yeast

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