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Home > Anti-aging Research > Niacin


The dreaded niacin “flush” | Track Your Plaque Blog - trackyourplaque.com, 5/18/07 - "a very simple maneuver can relieve the hot flush in over 90% of instances: Drink water. Let me explain ..."

Note:  I see a lot of orders for no-flush niacin.  I assume the reason people are buying this is to raise HDL cholesterol.  I couldn't find any research that no-flush niacin works to increase HDL.  It's probably a waste of money for the no-flush.  Just do a Medline search of  hexanicotinate HDL, hexaniacinate HDL or no-flush niacin.  Here are the the only studies I could find:

Accumulation of chylomicron remnants and impaired vascular reactivity occur in subjects with isolated low HDL cholesterol: effects of niacin treatment - Atherosclerosis. 2006 Jul;187(1):116-22 - "evaluation of no-flush niacin treatment ... Twenty-two low HDL subjects with reduced FMD were randomized into two groups, one given 1.5 g/day niacin and a placebo group. After 3-month treatment, plasma lipids and chylomicron kinetics were not changed by niacin treatment"

Varying cost and free nicotinic acid content in over-the-counter niacin preparations for dyslipidemia - Ann Intern Med. 2003 Dec 16;139(12):996-1002 - "Commonly used over-the-counter niacin preparations (500-mg tablets or capsules) from the 3 categories of immediate-release, sustained-release, and no-flush were purchased at health food stores and pharmacies and from Internet-based vitamin companies ... The average content of free nicotinic acid was 520.4 mg for immediate-release niacin, 502.6 mg for sustained-release niacin, and 0 for no-flush niacin ... No-flush preparations of over-the-counter niacin contain no free nicotinic acid and should not be used to treat dyslipidemia. Over-the-counter sustained-release niacin contains free nicotinic acid, but some brands are hepatotoxic. Immediate-release niacin contains free nicotinic acid and is the least expensive form of over-the-counter niacin"

http://www.lipidsonline.org/slides/slide01.cfm?tk=25&dpg=34 shows that with extended release niacin, HDL peaks out at 2,500 mg.  http://www.lipidsonline.org/slides/slide01.cfm?q=effect+of+niacin&dpg=7 hows immediate release crystalline niacin compared to Niaspan.  There isn't much gain in HDL with the immediate release crystalline niacin after 1,000 mg per day.  After seeing that, I'll probably cut down from 3,000 mg but from the slide it appears that there is a significant advantage to lowering triglycerides by going to 3,000 mg plus there is a linear decrease in LDL-C by going to 3,000 mg immediate release crystalline niacin.  This graph also shows that immediate release crystalline niacin is significantly better at raising HDL and lowering triglycerides compared to Niaspan.  Also see the slide titled CHD Risk According to HDL-C Levels.

I’ve never seen any studies on Niaspan and liver damage but it would seem like it would be similar to the slow release niacin. The only study I’ve seen on that is:

A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients - JAMA. 1994 Mar 2;271(9):672-7 - "None of the patients taking IR niacin developed hepatotoxic effects, while 12 (52%) of the 23 patients taking SR niacin did"

Be sure to see a doctor to have your liver enzymes checked before and after taking any niacin supplement.  See the bottom of http://www.lipidsonline.org/slides/ for some great slide shows on HDL.  The January 2007 Harvard Men's Health Newsletter has a good article on HDL cholesterol but it is a paid subscription.  See niacin at Amazon.com.

Related Topics:

Specific Recommendations:

Related products that also may increase HDL:

General Information:

  • Extended-Release Niacin and Hyperlipidemia Management - November 15, 2000 - American Academy of Family Physicians - aafp.org - "Niacin can lower LDL cholesterol by 10 to 25 percent and triglyceride levels by 20 to 50 percent, and can raise levels of high density lipoprotein (HDL) cholesterol by 15 to 35 percent ... The daily niacin dosage was started at 375 mg taken nightly and slowly increased, to a maximum of 3,000 mg per day, at four-week intervals for a total of 25 weeks. Patients were permitted to take 325 mg of aspirin before taking the study medication if they wished to prevent flushing ... The dose response demonstrates a linear effect, with maximal benefit at a dosage of approximately 2,500 mg, although the maximum recommended dosage of extended-release niacin is 2,000 mg"
  • Niacin - A New Look at an Old Drug - U.S. Pharmacist, 10/15/03 - "In one study, up to 53% of patients treated with IR niacin reported flushing, compared with 22% in the SR niacin group; four of the 23 IR-treated patients (17%) withdrew because of flushing. However, 67% of patients discontinued SR niacin therapy because of liver enzyme elevations (three times the upper limit of normal), and 52% of patients developed hepatotoxic symptoms; however, no patients treated with IR niacin developed significant changes in liver enzymes ... Because the incidence and severity of flushing often decreases with continued use—sometimes dissipating altogether—stress that any interruptions in therapy may lead to losing any tolerance" - Note:  I've been taking two grams of the TwinLab immediate release niacin for years and I don't get any flush from it if I take it with a little food. - Ben
  • A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients - JAMA. 1994 Mar 2;271(9):672-7 - "None of the patients taking IR niacin developed hepatotoxic effects, while 12 (52%) of the 23 patients taking SR niacin did"

News & Research:

  • Vitamin B3 revitalizes energy metabolism in muscle disease - Science Daily, 5/14/20 - "Vitamin B3 forms have recently emerged as potent boosters of energy metabolism in rodents. These vitamins are precursors for NAD+, a molecular switch of metabolism between fasting and growth modes ... niacin treatment efficiently increased blood NAD+ both in patients and healthy subjects. Niacin restored NAD+ in the muscle of the patients to the normal level and improved strength of large muscles and mitochondrial oxidative capacity. Overall metabolism shifted towards that of normal subjects ... The study is a significant leap in the development of targeted therapy options for energy metabolic diseases" - See niacin at Amazon.com.
  • Vitamin B Derivative (Nicotinamide) Appears to Reduce Skin Cancer Risk - Medscape, 10/16/17 - "Nicotinamide is a widely available, inexpensive and welltolerated agent. It has been reported in a small number of studies to be of benefit in a range of skin conditions, including acne, rosacea, immunobullous disease and photoaging. Recent studies show that it may also be an effective chemopreventive agent against skin cancer, possibly due to its ability to both augment cellular DNA-repair mechanisms and counteract UVinduced immunosuppression. Due to its favorable safety profile and demonstrated effectiveness, nicotinamide supplementation should be considered as an adjunctive chemopreventative treatment for patients at high risk of developing NMSC or AKs." - See nicotinamide at Amazon.com.
  • People with forms of early-onset Parkinson's disease may benefit from boosting niacin in diet, research suggests - Science Daily, 1/10/17 - "With this extra source of NAD, the flies had far fewer faulty mitochondria than their mutant peers on a regular diet ... The vitamin also prevented the flies from losing neurons ... The results suggest that in familial Parkinson's, available NAD is critical for keeping mitochondria in shape and the disease at bay. Drugs that block NAD-consuming DNA repair already exist to treat cancer. Loading up on niacin probably can't hurt either ... This study strengthens the therapeutic potential for Vitamin B3/niacin-based dietary interventions and PARP inhibition in the treatment of Parkinson's disease"
  • Study found high-risk patients who took nicotinamide daily developed fewer non-melanoma lesions - WebMD, 10/21/15 - "A form of vitamin B3 called nicotinamide appears to reduce non-melanoma skin cancers by 23 percent when taken twice daily ... The vitamin supplement also appeared to reduce the numbers of thick, scaly patches of skin that can become cancer. Those patches were reduced in the nicotinamide group by 11 percent at three months, and by 20 percent at nine months of treatment"
  • Surprising Result Shows Kidney, Mortality Benefits of Niacin - Medscape, 11/21/14 - "The proportion of patients experiencing a rapid decline in estimated glomerular filtration rate (eGFR) can be decreased significantly with niacin, as can all-cause mortality ... patients who took niacin had an 11% decreased risk of death ... Niacin has been shown to decrease reactive oxygen species, inflammation, hypertriglyceridemia, hyperphosphatemia, and endothelial dysfunction — all factors associated with a decline in eGFR" - See niacin at Amazon.com.
  • Niacin Doesn't Reduce Heart Problems, May Create Some, Research Finds - WebMD, 7/16/14 - "Half the patients received treatment with an extended-release pill containing niacin and laropiprant, while the other half received an inactive placebo. Laropiprant is a medication that treats flushed skin, which is a common side effect of niacin" - Note:  This has gone back and forth for years.  I'm still going to take my  1000 mg of immediate release niacin per day not only for the increased HDL but for a healthy skin.  For one thing, I don't see how they can reach that conclusion by saying that an extended-release pill containing niacin and laropiprant is the same as taking immediate release niacin along.  For one thing, see:
  • Mouse study offers new clues to cognitive decline - Science Daily, 5/8/14 - "The pathway begins with the B vitamin nicotinamide. Cells take dietary nicotinamide and, with a helper protein called Nampt, manufacture a molecule called NMN, which then is processed further to make NAD. When Stein eliminated Nampt from neural stem cells, several significant changes took place ... Levels of NAD dropped, and the neural stem cells stopped dividing; they stopped renewing themselves; and they stopped being able to create important cells that insulate axons, the "wires" that carry electrical signals throughout the brain. With less insulation, these signals slow down, impairing brain function"
  • Energizing sick mitochondria with vitamin B3: Effective treatment for mitochondrial disease - Science Daily, 4/7/14 - "Vitamins B have recently been turned out to be potent modifiers of energy metabolism, especially the function of mitochondria. Vitamin B3, (niacin) has been found to delay the signs of aging in animal models ... Mitochondria power up all cells in our bodies, by generating fuel, ATP, for all cellular functions ... feeding mice with food supplemented with B3 form, nicotinamide riboside, delayed their mitochondrial myopathy" - Note: It seems like you could kill two birds with one stone by taking niacin to raise the good cholesterol.
    • What Is the Difference Between Niacin & Niacinamide? - LiveStrong.com - "Your body can convert niacin into niacinamide ... Niacin and niacinamide have identical function when used as vitamins ... their pharmacologic properties differ. For example, high doses of niacin can cause skin flushing. Niacinamide, however, does not have the same vasodialating, or blood-vessel widening, effects, that niacin has, so it does not lead to skin flushing" - Note:  You'll find contradictory information on the Internet but niacinamide will not raise HDL and niacin will.  See niacin at Amazon.com.
  • 'Good' cholesterol controls blood glucose - Science Daily, 10/30/13 - "without ApoA-I, burning of calories is reduced in skeletal muscle resulting in increased blood glucose and weaker muscle function. The scientists then determined that HDL cholesterol and its protein ApoA-I both enhance usage of glucose and calories inside muscle cells. Raising HDL and ApoA-I levels in animal models resulted in protection against hyperglycemia and age-related symptoms such as decline of muscle performance or fat mass gain. Improved calorie burning in mitochondria (the "power plants" in each cell) was further indicated by a marked reduction of circulating Fibroblast Growth Factor 21, a novel biomarker for mitochondrial dysfunction ... Our results link for the first time low HDL-cholesterol with impaired use of glucose and burning of calories in type 2 diabetes" - See niacin at Amazon.com.
  • Niacin, the fountain of youth - Science Daily, 9/30/13 - "Vitamin B3 -- also known as niacin -- and its metabolite nicotinamide in the worms' diet caused them to live for about one tenth longer than usual" - See niacin at Amazon.com.
  • New research shows that while niacin added to statin therapy increases HDL cholesterol levels it does not improve HDL functionality - Science Daily, 3/10/13 - "While two large clinical trials recently showed that adding niacin to statin therapy failed to improve clinical outcomes despite a significant increase in HDL-C levels, little is known about exactly why the increased HDL-C levels did not reduce the risk of cardiovascular events ... We performed a small trial to examine how niacin modulated a classic function of HDL, namely its ability to promote cholesterol removal from cells ... As expected, they saw a 29 percent increase in HDL cholesterol with the addition of niacin to statin therapy, compared to a two percent increase in those treated with statin only. However, on the measures of cholesterol efflux capacity and the HDL inflammatory index, they saw no significant changes in HDL function"
  • Raising HDL Levels May Not Lower Heart Attack Risk - WebMD, 5/16/12 - "Many clinicians still prescribe the vitamin niacin to help raise HDL levels, even though a government-funded trial proved disappointing ... The trial was halted early a year ago when it was determined that people with heart disease who had low HDL levels did not benefit from the treatment ... The drug company Pfizer abandoned its experimental HDL-boosting drug torcetrapib in 2006 when trials showed an increase in heart attack and stroke risk among users ... the new research casts even more doubt on the strategy of raising HDL to lower heart and stroke risk ... HDL levels are related to risk, but that doesn't mean that raising HDL is beneficial ... What we do know is that lowering LDL has a big impact on risk, so the take-home message remains, 'Get those LDL numbers down'"
  • Niacin doesn't stop heart attacks, major study finds - Health - Heart health - msnbc.com - MSNBC, 5/26/11 - "The newest study tested Abbott Laboratories' Niaspan, an extended-release form of niacin that is a far higher dose than is found in dietary supplements ... the Niaspan users saw their HDL levels rise, and their levels of risky triglycerides drop, more than people who took a statin alone. But the combination treatment didn't reduce heart attacks, strokes or the need for artery-clearing procedures such as angioplasty ... That finding "is unexpected and a striking contrast to the results of previous trials," ... Also, there was a small increase in strokes in the high-dose niacin users — 28 among those 1,718 people given Niaspan compared with 12 among the 1,696 placebo users. The NIH said it was not clear if that small difference was merely a coincidence, as previous studies have shown no stroke risk from niacin. In fact, some of the strokes occurred after the Niaspan users quit taking that drug" - See my niacin and HDL pages for many more studies.  For one thing, there are waaaay more arguments for raising HDL than just heart disease.  Things such as centurions having unusually high HDL, prostate cancer, bowel cancer, impotence, Alzheimer's, etc., not to mention that it conflicts with other studies.
  • Evolving Concepts of the Role of High-Density Lipoprotein in Protection from Atherosclerosis - Curr Atheroscler Rep. 2011 Mar - "HDL is able to interact with and remove cholesterol from the lipid-laden foam cells in the peripheral vasculature with subsequent transportation to the liver for excretion. However, HDL has multiple other physiologic effects that may play a significant role in protection from atherosclerosis. HDL has been demonstrated to exhibit multiple beneficial effects on the coagulation system. Platelet function is improved by both direct and indirect mechanisms. HDL has a complex interaction with the protein C and protein S system. Thrombolytic balance is also improved by HDL. HDL has been demonstrated to have a significant natural antioxidant effect that inhibits the oxidative step required for low-density lipoprotein uptake by the macrophage. Additionally, HDL has also been demonstrated to exert multiple beneficial effects on endothelial function, including decreased apoptosis and endothelial repair" - See niacin at Amazon.com (niacin increases HDL).
  • Preventing heart problems while keeping a cool head: Cause of flushing effect arising from cholesterol treatment with nicotinic acid - Science Daily, 7/26/10 - "The opposite approach, which involves increasing the concentration of "good" HDL cholesterol using nicotinic acid, has proven unpopular among patients up to now. The reason for this is that treatment with nicotinic acid has an unpleasant but harmless side-effect: the drug makes patients turn quite red in the face ... the higher an individual's level of HDL cholesterol, the lower his or her risk of contracting these diseases. For this reason, the strategy of increasing HDL plasma concentration through medication has become more prevalent of late. The drug on which most hopes are pinned here is nicotinic acid ... The flushing phenomenon can be prevented by inhibiting prostaglandin formation or blocking the prostaglandin receptors in the skin, while the desired effects of the nicotinic acid on lipid metabolism remain unaffected"
  • Vitamin B3 shows early promise in treatment of stroke - Science Daily, 2/24/10 - "An early study suggests that vitamin B3 or niacin, a common water-soluble vitamin, may help improve neurological function after stroke ... Niacin is known to be the most effective medicine in current clinical use for increasing high-density lipoprotein cholesterol (HDL-C), which helps those fatty deposits ... Niacin essentially re-wires the brain which has very exciting potential for use in humans"
  • Quality of HDL Differs in Diabetics But Improves With Niacin Therapy - Medscape, 12/22/09 - "HDL cholesterol in individuals with diabetes has impaired endothelial protective functions compared with the HDL from healthy subjects, although treatment with extended-release niacin can improve these endothelial protective effects"
  • Adding Niacin Boosts Effectiveness of Simvastatin/ezetimibe - Medscape, 12/16/09 - "In high-risk patients with hyperlipidemia, the addition of extended-release niacin provides superior results to therapy with simvastatin and ezetimibe alone ... At 64 weeks, compared with simvastatin and ezetimibe alone, the triple combination significantly improved HDL cholesterol (+21.5%), triglycerides (-17.6%), non-HDL cholesterol (-7.3%), low-density lipoprotein cholesterol, apolipoprotein B and A-I, and lipoprotein ratios"
  • Vitamin B niacin offers no extra benefit to statin therapy in seniors already diagnosed with coronary artery disease, study suggests - Science Daily, 11/18/09 - "This does not mean that niacin therapy may not have other cardiovascular benefits, but any such benefits are independent of reducing the amount of plaque buildup and patients should be aware of that ... Lima cautions that an ongoing national study of the long-term vascular benefits of dual therapy and whether extended-release niacin, also known as nicotinic acid, lowers death rates from heart disease should provide more definitive data" - Note:  The article implies that prescription Niaspan works better than immediate release niacin.  See http://www.lipidsonline.org/slides/slide01.cfm?q=effect+of+niacin&dpg=7 which implies the opposite.  The prescription might have less flush but I couldn't tell the difference.  Like I've said in the past, the flush gets less the longer you use it and is practically non-existent after you taken it for several months if you take it with food.  Also, the slow release may produce liver damages.  See:

  • Niacin Tops Zetia in Cutting Artery Plaque - WebMD, 11/16/09 - "The question is whether ezetimibe works at all ... Niacin has been around for 50 years. It's a well-understood drug, and in this trial it was clearly superior ... Ultrasound images of neck arteries showed that Niaspan reduced artery plaque by about 2%. Zetia did not slow plaque buildup, although it did lower cholesterol"
  • ARBITER 6-HALTS: HDL Raising With Niacin Superior to Ezetimibe - Medscape, 11/16/09 - "Adding extended-release niacin (Niaspan, Abbott) to statin therapy results in a significant regression of atherosclerosis as measured by carotid intima-media thickness (IMT), whereas the addition of ezetimibe (Zetia, Merck/Schering-Plough) to statin therapy did not, according to an eagerly anticipated study"
  • Raising 'Good' Cholesterol Levels May Benefit Clogged Arteries - Science Daily, 11/6/09 - "Using MRI scans, we have shown a reduction in the size of artery walls in patients after a year of treatment with nicotinic acid ... Nicotinic acid, sometimes known as niacin, is one of the oldest drugs used for atherosclerosis and only fell out of favour as statins came to prominence. It is known to raise levels of good cholesterol in the blood"
  • MRI study: Reduced carotid wall area with Niaspan - theheart.org, 10/30/09 - "So, in terms of relieving a stenosis, for example, it is not clinically relevant. The point is the direction of change. Atherosclerosis has, for years, been considered a relentlessly progressive disease process. To bring about a demonstrable reversal, however small, in only 12 months is mechanistically significant," he said. "Furthermore, remember that the plaque is heterogeneous. We don't know what compositional changes have been induced, but if, for example, the lipid component had been reduced—and there are data from other studies to suggest this happens—then even a small change in total size could be very relevant to plaque behavior."
  • Ignored cholesterol blamed for heart attacks - MSNBC, 6/9/09 - "Statins — taken by millions to cut heart attack and stroke risk — do not affect lipoprotein (a) ... people with the highest liporotein (a) levels were two to three times more likely to have a heart attack than those with the lowest levels ... Niacin, a vitamin often prescribed generically to lower cholesterol, also lowers lipoprotein (a) levels. It can cause uncomfortable flushing, however. Aspirin can also lower lipoprotein (a) levels" - [WebMD]
  • Biology Of Flushing Could Renew Niacin As Cholesterol Drug - Science Daily, 4/6/09 - "Niacin, also known as nicotinic acid or vitamin B3, has long been regarded as one of the most effective weapons in managing cholesterol. It can lower levels of triglycerides, fatty acids and to a lesser extent, the "bad" kind of cholesterol (LDL) while at the same time powerfully increasing the "good" kind (HDL). But there's a catch – a big one. Patients don't like to take niacin because in most of them, it causes embarrassing, uncontrollable intense flushing, a rush of blood to the face and other skin surfaces accompanied by a prickling sensation ... One particular protein in that group, beta-arrestin1, was found to trigger the chemical reaction that led to flushing ... beta-arrestin1 plays no role whatsoever in niacin's ability to lower cholesterol and fatty acids ... the discovery opens the door to the possibility of developing a "biased ligand," a drug that would trigger GP109A, but not the beta-arrestins"
  • Low Levels Of Good Cholesterol Linked To Memory Loss, Dementia Risk - Science Daily, 6/30/08 - "Researchers defined low HDL as less than 40 mg/dL ... At age 60, participants with low HDL had a 53 percent increased risk of memory loss compared to the high HDL group" - [WebMD] - The best way to increase HDL is niacin.  See niacin at Amazon.com.  Start slow maybe even with the 100 mg capsules.  It took me about three months to get immune to the flush from 2000 mg per day.  Taking it with soup seems to be the best.
  • Niacin's Role In Maintaining Good Cholesterol - Science Daily, 6/5/08
  • Combination Niacin-Laropiprant Plus Simvastatin Reduces Cholesterol by Almost 50% - Doctor's Guide, 11/6/07 - "When patients with dyslipidemia added simvastatin to their experimental combination of extended-release niacin and laropiprant -- a novel anti-flushing agent -- they reported reductions in low density lipoprotein cholesterol (LDL-C) of as much as 48% from baseline ... high density liopoprotein cholesterol (HDL-C) was increased by 28% and triglycerides decreased by 33%"
  • New Combination Drug Improves Multiple Cholesterol Disorders in Single Pill - Doctor's Guide, 11/5/07 - "Simcor combines prescription niacin and simvastatin, two FDA-approved medications with established safety profiles, to target good cholesterol (HDL), bad cholesterol (LDL), and triglycerides in a single pill" - Sounds stupid to me.  Why would you pay prescription drug prices for something that is dirt cheap like niacin.  It is the Niaspan form of niacin, which they claim has less flush.  I tried Niaspan and couldn't tell any difference in the flush plus the flush eventually stopped even with immediate release niacin.  Plus I worry about increased liver damage with Niaspan.  Click here for the study that concerns me which was sustained release niacin, not Niaspan but it would seem to be similar.  Plus immediate release niacin is about 20% more effective at raising HDL than Niaspan.  Click here and note where Niaspan is on the graph.  I'm just eye balling the 20%.
  • Merck Niacin Drug Controls Cholesterol - Intelihealth, 9/5/07 - "The drug, called Cordaptive, can both raise good cholesterol and lower bad cholesterol. It combines an extended-release form of the B vitamin niacin with a chemical to inhibit an often intolerable niacin side effect called flushing -- redness, burning and tingling of the face ... compared with dummy pills, Cordaptive produced an 18 percent drop in levels of LDL-C, or "bad" cholesterol; a 26 percent drop in another type of blood fat called triglycerides, and a 20 percent increase in levels of HDL-C, or "good" cholesterol"
  • Niacin (Nicotinic Acid) -- The Old Drug Is Making a Comeback With A New Act - Medscape, 6/11/07 - "Niacin (nicotinic acid) is well known as the most effective drug currently available for raising levels of high-density lipoprotein (HDL) cholesterol, raising it by 25% to 35% at the highest doses"
  • FDA Approvals: Veramyst, Niaspan, and HepaGam B - Medscape, 5/9/07 - "Film-Coated Niacin Extended-Release Caplets (Niaspan) May Reduce Flushing ... use of the new orange-coated formulation significantly reduced the incidence of flushing by 9%"
  • Combining Agents Leads to Safe Treatment of Lipid Abnormalities - Physician's Weekly, 5/7/07 - "Combining the use of statins and niacin should be encouraged because it appears to safely treat multiple lipid abnormalities in appropriate high-risk patients"
  • Improving Outcomes With HDL Cholesterol - Physician's Weekly, 4/9/07 - "Patients who have high HDL levels appear to have better protection against vascular disease than others and some variants of HDL may actually reduce plaque in the coronary arteries. Essentially, HDL acts as a scavenger compound; it moves the lipids from the blood vessel to the liver, where they are then excreted from the body ... Currently, in the United States, the only medication other than statins designed specifically to help physicians raise the HDL cholesterol levels in their patients is niacin"
  • An Old Cholesterol Remedy Is New Again - New York Times, 1/23/07 - "In its therapeutic form, nicotinic acid, niacin can increase HDL as much as 35 percent when taken in high doses, usually about 2,000 milligrams per day. It also lowers LDL, though not as sharply as statins do, and it has been shown to reduce serum levels of artery-clogging triglycerides as much as 50 percent ... There’s a great unfilled need for something that raises HDL ... Right now, in the wake of the failure of torcetrapib, niacin is really it. Nothing else available is that effective" - See niacin at Amazon.com.
  • Gene Tied To Longevity Also Preserves Ability To Think Clearly - Science Daily, 12/26/06 - "Centenarians were three times likelier to possess CETP VV compared with a control group representative of the general population and also had significantly larger HDL and LDL lipoproteins than people in the control group ... Researchers believe that larger cholesterol particles are less likely to lodge themselves in blood vessels" - Could niacin do the same thing?  See:
  • Prolonged-Release Nicotinic Acid Combined With a Statin in NAUTILUS - Medscape, 10/19/06 - "The safety and tolerability profiles of prolonged-release nicotinic acid did not differ in patients who were and were not taking a statin. In particular, there was no sign of serious hepatic or muscle toxicity in patients receiving prolonged-release nicotinic acid with a statin. The addition of prolonged-release nicotinic acid to a statin raised levels of HDL cholesterol"
  • Comparative Effects on Lipid Levels of Niaspan and Statins - Medscape, 7/28/06 - "Niacin is the best HDL-cholesterol raising drug right now"
  • Niacin Extended-Release Tablets Combined With Low/Moderate Dosed Statin Achieves Better Total Lipid Control Versus Higher Dose Statin Monotherapy or Simvastatin and Ezetimibe - Doctor's Guide, 6/22/06 - "patients given Niaspan in combination with a low to moderate dose of Lipitor or Crestor achieved equivalent reduction in LDL-C (51-58%), 1.2 to 1.9-fold greater decreases in triglycerides and 2.5 to 3.5 fold greater increases in HDL-C, than patients who received high-dose Crestor or Zocor/Zetia"
  • Aspirin for Preventing Flushing from Niacin - Medscape, 6/13/06 - "the impact of flushing can be minimised by careful dose escalation, administering 'extended-release' NA at bedtime, administering ASA 30 min before 'extended-release' NA and avoiding alcohol or hot drinks near the timeof administration"
  • Hypertriglyceridemia - Medscape, 6/1/06 - "ER niacin has been shown to lower the triglyceride level by ~25% and raise the HDL level by almost 30%"
  • About 5% of Long-term Niacin Users Evolve Into HDL Hyperresponders - Doctor's Guide, 3/14/06 - "about 5% of patients on long-term therapy become hyperresponders, increasing their HDL levels by 50% or more ... Overall, these patients lost 4% of body weight while on niacin treatment"
  • Combination Treatment Shown for First Time to Cause Regression of Atherosclerosis - Doctor's Guide, 11/16/05 - "reversal of atherosclerosis - a primary cause of stroke and heart attacks - can be achieved with a combination of Niaspan (prolonged-release nicotinic acid) and a statin ... ARBITER 2 clearly showed that statins alone are not enough to halt the progression of atherosclerosis even when the LDL-C target is met. However, the addition of Niaspan 1000 mg stopped the progression of atherosclerosis in 12 months ... a further 12 months of treatment with Niaspan and a statin actually achieves regression of atherosclerosis"
  • Adding Niacin to Lovastatin Therapy Might Improve Efficacy for Dyslipidemia - Doctor's Guide, 10/5/05 - "Niacin has been shown to be one of the most effective drugs for improving levels of high-density lipoprotein (HDL) cholesterol, or good cholesterol ... Combining the best LDL lowering and best HDL raising drugs makes sense"
  • Can Niacin Slow the Development of Atherosclerosis - Medscape, 5/20/05 - "Extended-release niacin slowed the development of atherosclerosis in adults with coronary artery disease, independently from statin therapy"
  • The Effects of Niacin on Lipoprotein Subclass Distribution - Medscape, 1/19/05 - "the combination of niacin and a statin may be among the best available treatment options for many patients with complex forms of dyslipidemia ... Niacin effectively modifies all major lipids and lipoproteins with respect to both their quantity and quality. It is the most effective agent currently available for raising low levels of HDL cholesterol"
  • Two-Pronged Cholesterol Approach Works - HealthDay, 11/11/04 - "Niacin is the most effective treatment to treat low HDL ... Overall, combining niacin with a statin slowed disease progression 68 percent more than a statin alone. The combination treatment also resulted in a 60 percent reduction in heart attacks, deaths, strokes, and other coronary events"
  • Niacin in Diet May Prevent Alzheimer's - WebMD, 7/14/04 - "those who got the least niacin were 70% more likely to develop Alzheimer's disease than those who got higher amounts ... Those at the study's highest niacin level were getting 45 mg per day in diet and supplements"
  • Niacin Extended-Release/ Lovastatin Combination Effective in Patients with Multiple Lipid Disorders - Doctor's Guide, 4/23/03 - "Treatment by niacin ER/lovastatin was found to be more effective than each of its components, showing improved levels of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG)" - Note:  Niacin usually increases HDL (the good cholesterol) much more than statins.  From my own experience and from taking to others, it seems like many physician's may ignore low HDL.
  • Statins May Cut Alzheimer's Risk - HealthDay, 4/21/03 - "extended-release niacin reduced brain cholesterol levels by 10 percent" - Note: Red yeast rice is a non-prescription statin but you should still check with your physician.  See red yeast rice at Amazon.com.
  • Raising HDL-C Levels Slows CAD Progression and Reduces Mortality - Medscape, 4/3/04 - "Results of two studies of high-density lipoprotein cholesterol (HDL-C)-targeted therapies indicate that attacking heart disease by increasing HDL-C levels appears to slow progression of atherosclerosis and reduce mortality ... Although the protective effect of HDL-C is well known, "most researchers ignore this fact," said Henrietta Reicher-Reiss, MD, from Sheba Medical Center in Tel Hashomer, Israel. It is a costly oversight since "about half of heart attack victims have normal [low-density liprotein cholesterol (LDL-C) levels]," ... drugs designed to target HDL-C have a number of adverse effects. Niacin, for example, causes flushing, and fibrates are associated with gastrointestinal side effects. That side-effect profile might be a factor against this approach. Statins, on the other hand, tend to be very well tolerated"
  • Vitamin K and niacin good for complexion, experts say - HealthDay, 3/26/03 - "Vitamin K was found to be successful in treating dark circles under the eyes. It's also been found effective for treating bruising on the face following dermatologic procedures such as laser treatment for spider veins ... Niacin shows promise as an over-the-counter ingredient in anti-aging products"
  • Alzheimer's Disease and Dementia: Vitamins Can Help Prevent - WebMD, 2/28/03 - "High levels of a substance in the blood called homocysteine tops the list of potentially new risk factors for heart disease, stroke, and now dementia. A new study suggests that high homocysteine levels are linked with mental declines associated with Alzheimer's disease in elderly people ... High homocysteine levels can be treated very easily with vitamins, including folate, niacin, and B-12"
  • Statin-Niacin Combination Counters Dyslipidaemic Cardiovascular Risk - Doctor's Guide, 12/20/02 - "Combined statin-niacin is a safe, tolerated therapy that lowers low density lipoprotein cholesterol and raises high density lipoprotein cholesterol ... At niacin doses of at least 1000 (mean 1480) mg/day added to a constant statin regimen in 29 patients, high density lipoprotein cholesterol rose significantly (by 20 percent)"
  • Niacin Appears Safe for Treating Patients Who Have Diabetes and High Cholesterol - Doctor's Guide, 11/21/02
  • Extended-Release Niacin Safe, Effective in Type 2 Diabetes - Medscape, 7/26/02
  • Niacin May Be Effective Therapy For Broad Range Of Diabetes-Associated Dyslipidaemias - Doctor's Guide, 7/25/02 - "After niacin treatment, the patients' LDL peak particle diameter increased from 252 +/- 7 Å to 263 +/- 7, the researchers reported. Their small, dense LDLc particle mass decreased from 27 +/- 11 mg/dL to 15 +/- 4 mg/dL. Total HDLc increased from 39 +/- 7 mg/dL to 51 +/- 11 mg/dL. Their HDL2, as the percentage of total HDLc mass, increased from 29 +/- 8 percent to 45 +/- 10 percent, and their Lp(a) decreased from 43 +/- 17 mg/dL to 25 +/- 10 mg/dL ... Twenty-one percent of the patients were unable to tolerate niacin because of reversible adverse effects. Another 14 percent were unable to adhere to the niacin dosing regimen of three times daily"
  • 'Advent' Study Highlights Safety And Efficacy Of Niaspan (Niacin) In Diabetic Patients - Doctor's Guide, 7/22/02
  • Niacin Helps Hearts - Nutrition Science News, 11/01
  • question regarding your new cholesterol-lowering supplement, Policosanol - Life Extension Magazine, 11/01 - "Studies show that niacin (B3) in doses of 1.5 grams to 3 grams lower triglycerides levels and raise HDL concentrations. Those who tolerated higher doses of niacin (nicotinic acid) showed even more improvement in lipid levels. Some people taking just 1000 mg of flush-free niacin see an elevation in beneficial HDL. Green tea also has been shown to elevate levels of HDL while lowering serum triglyceride levels. In the Journal of Molecular Cell Biochemistry, curcumin has been demonstrated, in vivo, to decrease triglycerides and increase HDL. In a study published in 1989 by the Journal of Associated Physicians-India, 125 patients receiving gugulipid showed a drop of 16.8% in triglycerides, and a 60% increase in HDL cholesterol within three to four weeks. Make sure you are taking at least six Mega EPA fish oil capsules daily, as low dose fish oil may not adequately suppress triglycerides. Finally, there are some lifestyle changes you may wish to consider. If you are overweight, weight loss would be recommended, as it would help to lower triglycerides and raise HDL. Also, try reducing carbohydrates, which can raise triglycerides"
  • Laboratory Investigations of Erectile Dysfunction - WebMD - "men with erectile dysfunction frequently have low levels of high-density lipoproteins, the good form of cholesterol." (niacin raises HDL)
  • Antioxidant Supplements Lessen Response To Cholesterol Drugs - Doctor's Guide, 8/10/01
  • Baycol (Cerivastatin) Not To Be Used In Combination With Gemfibrozil, Says Bayer - Doctor's Guide, 7/25/01 - "Statins are known to cause a rare side effect of muscle breakdown ... In a very small percentage of patients, there is a risk of muscle breakdown resulting in kidney damage, which in rare instances can lead to life-threatening kidney failure ... The risk of muscle breakdown is greater in patients taking gemfibrozil as well as other fibric acid derivatives (a group of cholesterol-lowering drugs), cyclosporine (an immunosuppressant), erythromycin (an antibiotic), azole antifungals, or lipid-lowering doses of niacin (nicotinic acid) together with statins including cerivastatin."
  • Niaspan (Niacin Extended Release) Superior To Gemfibrozil in Raising "Good" Cholesterol - Doctor's Guide, 5/15/00
  • Integrated Health Care: Applying Best Practices From Two Medical Models - Nutrition Science News, 5/01 - "Many alternative care practitioners utilize a "non-flush" version of niacin, called inositol hexaniacinate, instead of regular niacin. This form of niacin does not have the flushing side effect of regular niacin (which can force patients to discontinue use) and is considered safer than niacin"
  • Parkinson's Defense - Nutrition Science News, 5/01
  • Niacin Reduces Triglycerides, Increases Good Cholesterol In Diabetics - Doctor's Guide, 3/20/01 - "There had been concern that niacin use in diabetic patients might increase blood sugar levels ... but we didn't see that in our study ... Patients were randomised to receive placebo, 1,000 mg of niacin or 1,500 mg of prescription niacin ... Patients taking the active agent increased high-density lipoprotein (HDL) cholesterol by 20 to 24 percent compared with a 4 percent increase among the placebo patients. At the same time, triglycerides were reduced 15 to 29 percent in the patients on niacin compared with a 5 percent reduction among patients taking placebo"
  • Nicostatin (Niacin/Lovastatin) Reduces Cholesterol, Triglyceride Levels - Doctor's Guide, 3/16/00
  • At the Counter with Dan Lukaczer, N.D., Niacin Good for Diabetics - Nutrition Science News, 3/01
  • Niaspan (Niacin Extended Release Tablets) Safe And Effective For Diabetics - Doctor's Guide, 11/14/00
  • Statin Plus Niacin Reduces Heart Attack Risk, Reverses Arterial Build-up - Doctor's Guide, 11/13/00
  • Research Reveals Soy, Niacin, and Tea Offer Protection From Heart Attack and Stroke - WebMD, 11/13/00
  • Niacin Safe And Effective For Cholesterol Lowering In Diabetics - Doctor's Guide, 9/14/00
  • Niacin Is Safe for Diabetics With High Cholesterol, Study Shows - WebMD, 9/12/00
  • Niaspan (Niacin Extended Release) Superior To Gemfibrozil in Raising "Good" Cholesterol - Doctor's Guide, 11/15/00
  • Nicostatin (Niacin/Lovastatin) Reduces Cholesterol, Triglyceride Levels - Doctor's Guide, 3/16/00
  • Niaspan (Niacin Extended-Release) Raises HDL Twice As Much as Gemfibrozil - Doctor's Guide, 3/14/00
  • Gemfibrozil-Niacin Combination Greatly Increases Good Cholesterol - Doctor's Guide, 3/10/00
  • Niacin for Achy Joints - Nutrition Science News, 11/99 - "niacinamide at 3 g/day reduced overall disease severity by 29 percent, inflammation by 22 percent and use of anti-inflammatory medication by 13 percent."
  • Sidestep Heart Disease - Nutrition Science News, 5/99