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Niacin to Lower Cholesterol

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Q. What do doctors know about niacin?

Taking just one 500 mg niacin tablet daily (time-release type) has worked wonders for me in reducing my total cholesterol from more than 250 to 145 in just four weeks.

Of course, I have also been watching my diet and exercising a little. I've lost about 8 pounds (about 5 percent of my original body mass).

Why do doctors prefer costly statins over niacin for people with high cholesterol?

A. Niacin is a time-honored drug for lowering cholesterol, but you have had an exceptionally good response. Not everyone can lower his cholesterol that much with such a low dose.

Doctors sometimes assume that patients will experience flushing and tingling and refuse to take niacin. Your time-release formulation reduces that reaction, but does not protect the liver from possible harm. Make sure your doctor is monitoring your liver enzymes as well as your cholesterol.

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35 Comments

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I have been taking Niaspan for 10 years with good results. 3 years ago I developed type 2 diabetes. I have had a hard time controlling my blood sugar. 2 months ago I stopped taking the Niaspan and now I can control my blood sugar. High blood sugar is a side effect of niacin.

4/25/2011
This Niacin question in today's LA Times aroused my curiosity. I used to take slow release niacin years ago, but it eventually caught up with me. Severe flushing that baffled several dermatologists, but I soon noted a pattern and stopped.

Now, I find another product at Costco advertised as flush free, so I picked up a container. Reading the label at home, no mention whatsoever about cholesterol. The label claims are for nervous system, energy and heart. The form of nitrogen on the label is iniosterol hexanicotinate. Looked that up and found it is niacin in a long atomic chain that does not affect cholesterol. I then queried Costco who passed the buck to the manufacturer, Nature's Bounty, Inc. in Bohemia, NY.

A call back from them was revealing. They claimed to know nothing about the use of niacin with its use to control cholesterol. My comment to them was that the primary use people have for this mineral is for cholesterol. They persisted in their lack of knowledge on this subject with nothing more than what is on the package. I find this irresponsible on the part of both Costco and the manufacturer. Any comment?

I believe "flush free" niacin is niacinamide. It is a different chemical than niacin and does not effect your cholesterol. Niacinamide is usually marketed for enhanced joint and memory support. It is probably not a good idea to "mix and match" different forms...like, Niamax, Niaspan, Niacin, Niacinamide etc.

PEOPLE'S PHARMACY RESPONSE: IT IS CORRECT THAT NIACINAMIDE DOES NOT LOWER CHOLESTEROL. BUT NICOTINIC ACID, THE FORM OF NIACIN THAT LOWERS CHOLESTEROL, IS ALSO AVAILABLE IN TIMED-RELEASE FORMULATIONS THAT REDUCE THE LIKELIHOOD OF FLUSHING.

IT MAY RAISE LIVER ENZYMES AND IF IT DOES, IT WILL NEED TO BE DISCONTINUED. ANYONE TAKING NIACIN TO LOWER CHOLESTEROL SHOULD HAVE HIS/HER DOCTOR MONITORING BOTH CHOLESTEROL LEVELS AND LIVER ENZYMES.

I have been taking 1500 mg of Niacin for six months plus a krill oil capsule with no results in lowering my total cholesterol of 303. I have just added Red Yeast Rise 600 mg to see if that will help. I will have to wait several months to see if this is going to help. I do not want to go on statins as I have had side effect with several of them. I am an active senior an wonder what else I can do.

I take SIMCOR which is a combination of Simvasatin & Niacin--the only my doctor is having me take it is because my HDL is 5 points off. I have an appointment with him and I already got my lab test done yesterday. If they show no improvement or very little--I GETTING OFF THOSE SATINS-- to many bad stories out their to risk taking them especially in my case with just such a small problem.

I have given up on statins - tried them all. The ones that worked gave me muscle aches and sometimes memory problems. I continue on 1500 MG Niaspan to get my HDL to go from 30 to 60 to improve the ldl/hdl ratio it does not affect my ldl. Doctor says I could go up to 2000 mg, but I have not done it yet. The price is very high in my opinion for this med. Will go to medicare part D this year and see if that will help my overall drug costs.

4 grams of fish oil does help drop my triglycerides by about half.

I too have been fighting bad cholesterol for years. I have used diet, red yeast rice (too hard to get consistent results as contents seem to change), and several different statins. A cardiologist has now prescribed niacin (over the counter-not the time release formula) and Lipator and as the doctor described it "You are a new woman". Numbers are all what is recommended.

This whole cholesterol bruhaha is a boondoggle for the drug companies. I only worried about my hubby when his went over 300. I did a cupboard search and found some products we were buying that had some un-natural fats. The hydrogenated variety. We eliminated that and added in more natural saturated fats such as organic palm and coconut oil and now his level is in the low 200s, which is ideal.

Unfortunately mine is too low. I have read that a level of 150 is needed for the proper production of hormones in the body. The only time mine went up was with microwave popcorn about ten years ago. We eliminated that and got a Stir Crazy popper and use palm oil in the bottom and real butter melted over the top (with pressed garlic in it for flavor). I'd like to get my number up to 150 but will not eat the unhealthy fats to do it!

At age 65 neither of us have athlersclerosis and our Blood Pressures are good! A side benefit is really great skin. The massage therapist at my Dr's office is totally amazed with my skin. I use no commercial products-only coconut oil. Haven't done for over 20 years! Yes, I do go in the sun 3X a week during warm weather to try to get my D level up!

I was put on time-release niacin about 10 years ago. I developed an abdominal rash, which a dermatologist attributed to the niacin. Since then, I have been on lovastatin, then simvastatin, presently 10 mg/day. Cholesterol now under control.

I am pleased that a comment here shows true knowledge as well as common sense. fbl's comment is a good one.

I agree that this high cholesterol is just a scheme and is not related to heart disease or anything else. We need cholesterol for our hormone production. Mine is high, likely due to chronic stress and its production of cortisol, but that is my guess.

Remember when we were told to avoid eggs due to cholesterol? Finally it is admitted that dietary cholesterol does not raise cholesterol. Use common sense people. No fox raids my hen house and makes sure not to eat too many eggs! And no wolf counts his saturated fat levels when he eats an elk.

I've been taking niacin, slow release, for 20 years for hyperlipidemia, with good results. Take a baby aspirin with niacin and you won't get the flushing. It may take a few days for the aspirin to work for more than an hour, but it eventually works.

My husband was recently prescribed simvastatin and heart disease runs in his family. Should he be taking niacin and/or coQ10 in addition to this medication? He is very thin, but his LDL cholesterol is high.

PEOPLE'S PHARMACY RESPONSE: COQ10 IS AN EXCELLENT IDEA, BECAUSE SIMVASTATIN DEPLETES THE BODY OF THIS COMPOUND.

Anytime you take a pill with a SATIN in ---you should take CoQ10-- as the Satins deplete the CoQ10.

My husband has had success using Bragg's Organic Apple Cider Vinegar, just 1 tbls. in a little water. His doctor was amazed.

I have a liver test for Niaspan coming up in a month. I think I will give the TBLS Apple Cider Vinegar a try too. I am already eating the one avocado per week that I believe was mentioned by a reader in another news article on cholesterol by Joe and Terry. I would like to get my LDL down a bit.

send me information on cholesterol, what to eat a and what not to eat. This way I don't tico that my doctor prescribed I haven't started taking it yet. Can you give me this information or more?

My numbers are: Tri-58; HDL - 88; LDL - 90.... I am on Pravastatin but, have read too many negatives on statin drugs. Does my range necessitate my taking this drug or, do I have options? I walk 10,000 steps every day and go to the gym for weight lifting 3-4 times per week. I am slightly remiss in my diet as I probably eat too much sugar...

But your numbers are good because you are on a statin. If you were off the statin, your numbers may be significantly higher. How long have you been on it? Do you have cholesterol numbers when you were not on pravastatin?

There are a lot of unwanted side effects, but if you are not having any of the side effects, it may be better to continue with it. You need to consult with your doctor for sure before going off of the statin. I have two brothers and one tolerates a dose of statin 4 times what I tried to take and needs it because he already had 5 stents. He has none of the side effects. The other brother is like me and cannot tolerate them.

YOU NEED TO CONSULT YOUR DOCTOR BEFORE GETTING OFF PRAVASTATIN.

I have recently begun taking Simcor to lower triglycerides. Is there anything that counteracts the flushing sensation? I feel like I' have a severe sunburn.

Can you tell me if Niacin in the form of Inositol Hexanicotinate is the type that will help to lower cholesterol? The bottle says that it is flush free Niacin but I'm not able to tell if it is Nicotinic Acid or Niacinimide or neither. Thanks.

Is there a problem with using both Braggs Organic Cider Vinegar, 1 TAB with water daily AND taking Niacin 500 mg
daily?

Ken, take an Aspirin 1/2 before your take the Simcor and preferably right before you go to bed. That way if there is any flushing.

I have been taking Braggs Apple cider vinegar for almost 9 months with 1500 mg Niaspan. My last cholesterol & liver function tests 6 months were ok. I have my next tests coming up this week.

I believe anyone on large amounts of niacin should be getting liver function tests regularly.

I am also eating an avocado per week and am interested in how my reading will fare.

I mix 4 ounces with water in a 32 ounce container with 8 teaspoons of 50/50 splenda/sugar and refrigerate it. I take 4 ounces per day so each container lasts me 8 days and gives me a tablespoon per day.

Try adding dried blueberries (from trader joe's) to your diet, and see what this does to your numbers. I believe this has helped me raise my good numbers.

40 yo male with high LDL (as high as 300 at one point) numbers just started a niacin regime. I was taking simvastatin ( 20-40 mg every other day). I visited my doctor recently and told him I was discontinuing the statin due to a number of side effects I was experiencing, some that I originally didn't associate with the drug until I looked them up online.

The most prominent of those was aching knee pain. This lasted for over two weeks before I decided to investigate and was surprised to find simvastatin had joint pain associated with the medication... I sort of knew that piece from previous discussions with my doctor, but other side effects were a surprise especially since I'd been experiencing them without making the connection. These included: muscle fatigue (shaking hands), numbness in fingers (when waking in the morning), back pain (sort of a burning sensation near shoulder blades), and a chronic sore throat (that persisted at various degrees over 3-4 months).

I even received a scope on my throat to see if there was some darker reason for its persistence. My primary care physician never even mentioned the later could be related to the statin -- not sure if he didn't know or just didn't was to discourage my use of the statin. Long story short, I've discontinued the statin (3 weeks now) and began 500 mg of niacin a day. To date, my knees have no pain, sore throat is gone, no numbness in fingers, and muscle weakness is gone!

I haven't been tested for my levels yet (6 weeks), but I know I feel much better in terms of overall health. If you're having good results with statins and having no side effects, do what works best for you. If, however, you are experiencing any unusual health issues, do some research and make sure statins aren't to blame... I cannot stress how much better I feel after stopping the simvastatin. In my experience, it's side effects were far too many for me.

I am curious though, of those who have had positive results with niacin, what dosage have you used? I take 500mg. In the AM with breakfast. I do experience a flush (for about 20-30 min), but was told this is a common, even necessary, side effect in combating high LDL. I also take coQ10 daily. I'm willing to experiment with some holistic methods, but refuse to revisit statins. Any suggestions would be appreciated :0). Thanks in advance for any information.

I had an IMT of my carotid artery 1.5 yr ago.. Left artery 2mm plaque..
Went on Red yeast rice for 1 yr--had bad neck pain, muscle pain, and just lived with it. Everything went really low on 2 /day..Then, after 3 months stayed on 1 a day.. The LDL and TC went high. Tri stayed low. So got off RYR and fish oil after all the bad readings. Tri started going up too.

On Benecol chews for 3 weeks and the trig. went up and all Chol. readings went down. Now I have plaque (2nd IMT) in both arteries. Am on SimCor now for a 3 month check. Also take COQ10, It hasn't helped that I kept my Christmas 5 lbs on still.

Three months ago my doctor told me that my cholesterol levels were too high and that I should start on statins. No other advice to lower my cholesterol but just to take the drug, I declined and opted for another check up in three months time. After a lot of research I found that doctors in the UK especially are on a 'bonus/incentive' for prescribing statins, also recently in the news, they are trying to get everyone over 50 in the UK on them.

I thought this to be far too pushy and with zero other advice about diet or exercise, I thought this had to be a con.

Niacin initially helped me lower my cholesterol and reminded me to do something about it by giving me flushes. I have now (three months later) ceased the Niacin and hopefully along with increasing my physical exercise (nothing too strenuous longer walks etc) and improving my diet, more salads and veg, less fried foods, my cholesterol will stay down naturally. I will hopefully report back in another three months 'drug/herb free' with a static result.

After reading about all the negative side effects, I thought no chance to statin and started a 500mg of Niacin a day habit. Today my levels are fine, and I largely attribute my initial high cholesterol to a sedentary office job and poor diet. I think when doctors just tell you to pay for a drug without telling you how you can achieve normal levels, it's just not on.

My advice, get off your backside and make your blood work for you and don't eat too much junk if you're not going to burn it off.

I use 750mg of slow release niacin (Enduracin - wax matrix time release, about $50/year) with no flushing, increased HDLs by about 10% and lower LDL by about 10%. Numbers aren't where I'd like them but all very tolerable. Statins affected both my memory and muscles and I'd never take them again.

I am so glad that more and more people are questioning statins. I went to a new cardio and she almost flipped off her chair when I told her I do not want to take statins. I have taken them before. I take lots of medicine for DDD/back pain, prior heart attack, etc. Did any of you have the special Lipo-protein test aside from regular lipids? Supposed to be around 30... mine was 282!! It sounds terrible, but I read that researchers are still not sure how important that marker is overall.

My good cholesterol did come up some, since I have used coconut oil. I am starting a new regime with my already habit of flax, B6 and Folic help with Homosysteins, good B12 levels help everything, my D is up some, alfalfa seems to be good, also read about L-Lysine and L-Proline suggested by some Natural doctors.

Don't forget the salmon/fish or capsules with oil or largest meal of the day. My biggest problem overall, I think is sugar. I use Stevia sometimes, but I crave sweet things, and sugar (even unrefined and brown) are bad for cholesterol and lots of other issues.

Any cardiologist who "flips out of their chair" on statin pushback is disingenuous at best or not up on current research at worse. My cholesterol was at a record high in June. I thought about reasons why since I have kept weight off but have not been on statins for about 2 years. I took my Niaspan up to 2000 mg with my cardiologist OK. But sometime in the spring we quit eating oatmeal 3 times per week. Think I may start on a half to one cup of Cheerios as a snack and see what happens for my December checkup.

I may be a big outlier, but taking prescription-strength niacin caused my liver enzymes to go crazy, almost causing liver failure. Beginning the niacin was the only change; stopping the niacin, my LFTs returned to normal.

PEOPLE'S PHARMACY RESPONSE: something of an outlier, perhaps, but not completely. Niacin does raise liver enzymes in susceptible people.

People might try using more plant foods in your diet instead of niacin or statins-- I cut my LDL by 47 pts by switching to a plant based diet. http://nutritionfacts.org/video/how-fiber-lowers-cholesterol/

I was told by my MD to take Endua-Acin I read the label and found that it contains soy. I am allergic to soy. is there a comparable one that does not contain soy?

CK, read my email above to find out how to lower your cholesterol naturally.

My liver enzymes are elevated. I had been taking 2000mg niacin and red rice yeast 2400mg for approximately two years which totally turned around my cardiovascular health for the good. I can not take statins for cholesterol as they make me ill. Unfortunately I have become ill and may need a liver biopsy to determine if anything is wrong. I am wondering if the use of niacin has led to the enzyme levels being elevated? If so does anyone know how long it takes for the body to no longer be affected by the niacin once its use is discontinued?

I have discontinued the niacin and red rice yeast since my regular M.D.'s felt it was important to do so. This was back in December then another short stint of about a week back on niacin but came back off it, so have been off the niacin for at least three weeks. I do not believe the liver enzymes were elevated before beginning the niacin. Has anyone experienced this scenario as well? I had been under a doctor's care all along, but my Integrative M.D. passed away last July so until I became ill I didn't know there were any issues possibly connected to my continued use of the prescribed supplements.

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