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Q. I've been reading about a study of niacin for cholesterol. The study was stopped after several people had strokes. I could not find out what dose was given.
I take 1500 mg daily of non-flush over-the-counter niacin. Should I stop taking it? Any information you have would be extremely helpful.
A. The study you refer to was called AIM-HIGH. It involved roughly 3,500 people with heart disease who had high levels of triglycerides (bad blood fats) and low levels of good HDL cholesterol.
All the subjects in the trial were taking simvastatin (up to 80 mg) to lower their cholesterol. About half also received extended-release niacin at a dose of either 1,500 or 2,000 mg/day. There was no benefit from adding niacin to simvastatin, and there was a slightly increased risk of stroke. Since you are not taking a statin, the findings of this study may not apply to you.
We understand your confusion, so we are sending you our Guide to Cholesterol Control and Heart Health for more information about niacin, other medications and non-drug approaches to getting blood lipids down. The investigators emphasize that people taking niacin should not stop without consulting their physicians. The findings of this study were announced before the FDA warned against 80-mg doses of simvastatin.
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My sister was told by cardiologist to take the flush type because the non flush doesn't work!
Treatments for medical conditions are often quoted in the press along the lines ... "New treatment reduces your risk of X disease by 25%". However, although this sounds good, it usually refers to the relative risk. But, the benefit really depends on how common or rare the disease is. A large reduction of relative risk for a rare disease might not mean much reduction in the absolute risk. For example, a 75% reduction in relative risk for something that has a 4 in a million absolute risk of happening brings the absolute risk down to 1 in a million.
When deciding on whether to take a treatment, ideally you should decide with your doctor if the reduction in the ABSOLUTE risk outweighs the risks, side-effects and costs of treatment.
My doctor has recently put me on 1,000 mg of FLUSH FREE (over the counter) niacin for slightly high cholesterol. I do not take a statin. My 1st liver blood test check this past April, 2011, was fine after taking 1,000 mg of FF niacin. I take 5mg of lisinopril for high blood pressure. I take 1+1/4 gr. of NatureThroid for low thyroid.
I take RX Women's Intl. Pharmacy made hormones from soy & wild yam after a total hysterectomy 25 yrs ago. And I take 2+1/2mg of diazepam for anxiety 3 times a day.
And my doctor put me on 40mg of LUMBROKINASE (over the counter) as a blood thinner after a very minor TIA at 70yrs old. I could not tolerate PLAVIX. I am now 74yrs. I am very sensitive to most drugs.
I am now concerned after reading this about a slightly increase in strokes after adding niacin. Is it the niacin or the combination simvastatin & niacin?
I would like to know if I should continue with the niacin?
Two pharmacists both told in I wanted to raise my HDL and could not afford NIASPAN to use the immediate release Niacin not the slow release.