I was researching the effects of adding Niacin to my statin which I'm managing in vanishly small increments...up to 250mg. X 3 taken on a full stomach.
I want to keep my HDL as high as I can get it because it tends to be low.
I know that niacin will raise the HDL but I wanted to see more specifics regarding which fraction would be raised most, HDL2 (larger lighter particles) being more beneficial than the small dense HDL3.
I stumbled on an NIH sponsored study throwing antioxidant vitamins into the mix.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11498460&dopt=Abstract

As I had hoped, niacin doubly helps the picture by creatingmore HDL and mayby more importantly, more light HDL and lighter LDL (beneficial Pattern A) but the startling data suggests strongly that the benefits are prevented by the addition of Vitamin C, E, A and selenium. In fact the rather wonderful 42% increase in HDL2 for the statin + niacin group was reduced to ZERO when antioxidants were added.

Good Lord, the ramifications of this are really worrisome. Thank God the full text of this article is available FREE! It's a nice service that our taxes are paying for!:D:D

As I had hoped, niacin doubly helps the picture by creating more light HDL and lighter LDL (beneficial Pattern A) but the startling data suggests strongly that the benefits are prevented by the addition of Vitamin C, E, A and selenium.


Studies have proven that people who take too much supplemental vitamins over a period of time have a larger risk of developing cancer and heart disease. This is why I always only take half of the recommended dose suggested on the vitamin package labels.

I posted this on another thread recently. You may want to add this to your research on Niacin & Statin.

Please take a look at this link to check on drug interaction.
http://www.drugdigest.org/DD/Interaction/ChooseDrugs/1,4109,,00.html

I entered ZOCOR and NIACIN, this is what it says,

NIACIN may interact with SIMVASTATIN (in Zocor)

Although the cause of this potential interaction is not clearly understood, using niacin and simvastatin at the same time could cause a serious or potentially life-threatening side effect that involves the destruction of muscle tissue and could lead to kidney failure. These drugs should generally not be used together unless your doctor is monitoring you very closely. Promptly report any unexplained muscle pain, tenderness, or weakness to your doctor. Ask your healthcare provider about these drugs and this potential interaction as soon as possible.

This interaction is poorly documented and is considered major in severity.

SIMVASTATIN (in Zocor) may interact with GRAPEFRUIT JUICE

Grapefruit juice may block the breakdown of simvastatin in the intestines and thus more simvastatin may get absorbed into the bloodstream. Increased blood levels of simvastatin could cause a serious or potentially life-threatening side effect that involves the destruction of muscle tissue and could lead to kidney failure. Avoid taking simvastatin with any form of grapefruit, including the actual fruit as well as drinks and nutritional supplements that contain grapefruit juice. Discuss this potential interaction with your healthcare provider at your next appointment, or sooner if you think you are having problems.

This interaction is poorly documented and is considered major in severity.

Lenin,

Well, if they really wanted to do a thorough study, they should have included a third group. They only looked at two groups, those who took both niacin and a statin, and those who took niacin, statins, and antioxidants. They should also have included those who took only niacin and antioxidants. Wouldn't you agree?

I find it very hard to believe that antioxidants have a negative impact on HDL. In fact, nearly all of the antioxidants mentioned are supposed to have a favorable impact on HDL. I have personally taken niacin along with high doses of these antioxidants for many years, and my HDL has gone nowhere except up. Well, so much for their findings! If HDL was adversely impacted when antioxidants were added to the statin-niacin group, my guess would be that it was probably due to some kind of interaction with the statin, because antioxidants to not drive down HDL levels by themselves.

Linda,

Both are true with caveats. The liver stress is due to the fact that both niacin and statins are metabolized and do much of their work in the liver. Studies are shown that the concern may be overblown for lower dose statins and lower dose niacin, and a lot of doctors are recommending the combo it for their patients with persisten low HDL.

On the grapefruit issue, it takes a LOT of grapefruit juice to cause a problem, and is virtually impossible with the fruit...but a quart or more of juice might cause problems.

What should REALLY be warned about is the HORRIBLE interaction of statin + macrolide antibiotic...I thought I was in BIG trouble when last that was prescribed.

Perhaps you are right, ARIZONA, and the fourth group should have been used (one was placebo.)
But then, one cannot study everything with one study.
The implicit and almost articulated assumption of the authors (in the conclusion) is that the statin, from other studies, has only a small effect on HDL and NONE on Lp(a) and the beneficial effects seen in the S+N group on these two parameters was entirely due to the niacin addition. Thus, the addition of the antioxidants and the nullification of the beneficial effects seems to be caused by antioxidant blockage of niacin. That seems reasonable to me. It would seem DOUBLY reasonable if it was found that niacin acts beneficially as an OXIDIZER, and thus supplementation with reducing agents would then surely be contraindicated...but I don't really know the mode of action by which niacin increases HDL and HDL2.

I will see what I can dig up regarding Niacin and HDL2, with or without antioxidants.
For me though the study is uniquely interesting since I take Lipitor and Niacin AND Vitamin C, E, and A in rather large doses for decades...but never selenium.

Indeed, I will also see what has been done regarding statins and antioxidants <gosh, I hate that term...without oxidation, life would be snuffed out in the time it takes for me to type in this period <.>

Len,

I take ADE in a multi-vitamin supplement but I don't add additional amounts of those (supplement wise). I do take selenium. I don't take Lipitor, but I am experimenting with 1000 mg Niacin right now.

In the past, when I was on 1500-2000 mg Niacin (Niaspan), and taking the multi and Se, I did have a huge rise in HDL, and HDL2. However, keeping up the exercise and removing the niacin therapy did little to change the overall HDL levels, including the amounds of HDL2 and HDL3. What did happen is that my LDL rose just a bit to the point where the ratio of LDL: HDL was now about 1.2:1 vs. being on Niacin plus exercise, where it was 1:1.06 (LDL,HDL).

I don't know (offhand) what the mechanism of intereference is with antioxidants in the paper that you cited. I am curious about it, so if I have a chance, like you, I will try to find more info on it.

Lenin,


Well, as interesting as this study is, unfortunately it is incomplete, as they simply did not carry it far enough. They should have at least included a niacin-antioxidant group, and probably a niacin only group.

Nevertheless, I have a hard time believing that antioxidants can nullify the HDL-raising effects of niacin. I have certainly never experienced such an effect. It's my gut feeling that it's the statin interacting somehow with the other antioxidants. In any case, do you by any chance know what dosages of these antioxidants were used? In many cases, they often use low doses, and the vitamin E they use often turns out to be synthetic. I have always used selenium along with natural vitamin E. There is a synergistic effect between these two supplements.



Anyway, it's just too bad they didn't go far enough with this study. But let me ask you a hypothetical question. I am taking niacin and relatively high doses of these antioxidants, and my HDL is around 100. Now suppose I began taking a statin, and the next time I get my cholesterol checked I learn that my HDL has dropped. To what would you possibly attribute that to?

Considering the obvious shortcomings of this study, I am surprised that they have prematurely concluded that the favorable effects on HDL were blunted by the antioxidants. How can they say that when there were no subjects given only niacin and antioxidants? For all we know, it may have been the statin that blunted the favorable effects on HDL.

Arizona,
They used "1 Gram BID niacin, as tolerated." I haven't a clue whether they used "natural", "organic", "chelated", or "l, DL, or mixed tocopherols" as the Vitamin E, 400 IU BID. Same with Vitamin C, not a clue whether they used orotate or ascobate but they used 500 mg. Vitamin C.

If you added a statin to your dosage and dropped your HDL, I'd attribute the drop to the statin.

But:
For all we know, it may have been the statin that blunted the favorable effects on HDL.
That strikes me as inconceivable because the statin + niacin gave superb results, so it's not the statin or the niacin that's causing the drop! It's like saying that my bacon and eggs are delicious together but when I added motor oil the taste was AWFUL...must have been bad bacon!:D

Oh, there's another study (Harvard) that used the same protocols but angiographically measured PLAQUE accumulation on the 3 regimens...the most plaque was accumulated when antioxidant vitamins were added to the niacin + statin!

On my thought that it's possible that Niacin needs to act as an oxizer to do its work and that interference with reducing agents (antioxidants) might mess up its normal activity, here's some evidence of plausibility:
With the help of tryptophan, niacin forms NAD (nicotinamide adenine dinacleotide), which is an enzyme required by the brain to perform several vital tasks. NAD also functions as an oxidizing agent used in processes that burn fuels (glucose and fatty acids) producing energy in cells.

Lenin,
I am taking niacin and relatively high doses of these antioxidants, and my HDL is around 100.

Arizona,

A 100 HDL reading is astounding!!! Wish I could do half as good. I'm beginning to believe that the HDL rating is hereditary and there's not a great deal one can do to boost it significantly.

What do you think?

Have you always had a high HDL count?

Or can you attribute an increase in you HDL level from niacin, exercise, Omega-3 Fish oils or some other lifestyle change?

Just curious...

HubbleRules
:cool:

Well, if antioxidants have a major effect in reducing the effect of niacin on cholesterol, I'd think I would have had a smaller impact than I did with my niacin therapy. I reduced my LDL from 247 to 190 and increased my HDL from 62 to 72 with just 750 mg of a sustained-release niacin. Usually 1000-2000 is considered a therapeutic dose. And during that time I was taking 575 mg vitamin C, 460 mg vitamin E, 3500 IU vitamin A, and 200 mcg selinium. I do not take a statin.

Lenin,

Maybe it's true that statins and niacin both increase HDL. But when you include antioxidants, and the HDL goes down, why do you blame antioxidants? That's my point. How do you know that it wasn't the statin that played a part in this drop? Why point the finger at antioxidants, when it could be the other way around? But that's typical of practically all of these studies that are portrayed in the mainstream media. Portray antioxidants, and every other beneficial supplement as the villain, and make a case that only drugs are beneficial! That's ridiculous! But they do it again and again and again! That's pure propaganda, and it's disgusting. But it's the drug companies who have all the power and influence, and they will stop at nothing to use every means possible to brainwash and steer people away from using beneficial supplements. This is nothing new. I've seen this going on for the past 25 or 30 years already. Well, I refused to believe it then, and I refuse to believe it now.

Hubble,


My HDL has never really been that bad. Fortunately, I have saved my records throughout the past 20 years. Sixteen years ago my HDL was 68, and my most recent test registered 107. And I've NEVER taken statins. The only changes I have made were to take high doses of antioxidants, garlic, and niacin. So, so much for all this anti-antioxidant bias.

Far be it from me to deny anyone his niacin and antioxidants. The STUDY points to the fact that anyone taking niacin and a statin (as I am) to try to get superb bloodwork might be wise to avoid high dose antioxidants, since the niacin and statin work together MUCH better without the addition of Vitamins A, C, and E!
Of course one is free to accept or reject any study based on merit, prejudice, relious belief, brainwashing or whatever.

It's clear to me that the antioxidant is interfering with the niacin but absent a good study showing that, I would never promulagate that as theory only the most rational hypothesis.

I think the brainwashing works both ways but the difference seems to be that the drugs brainwash more with STUDIES and the vitamins do it with anecdote and overblown, untested claims in paperbacks...and outright lies!
After all, only one camp is required to actually produce EVIDENCE to the FDA of safety and efficacy before sale or even health claims.


Notice how Niacin and Folic Acid are well accepted in both camps because they both actually seems to work well and pass muster in reputable studies, even though they are mega-doses of vitamins!
Funny the "horrible conspiracy" doesn't apply to them?

In my opinion, the amount of brainwashing for Vitamin C claims has overwhelmed the brainwashing for the most popular drugs in history (like Lipitor and Valium) by ORDERS of MAGNITUDE over 40 years...without a single GRAIN of evidence! Now THAT'S brainwashing!

And to anyone who has whined over the years that "boo, hoo, they never perform studies of 'natural' methods because of a medical conspiracy," here's a study that tests niacin, Vitamin C, selenium and Vitamin E for efficacy in dealing with blood cholesterol.
See, no conspiracy, no fiendish plot, just evidence. If you judge it as contrary to the divine word (Pauling-Rath), then perhaps you can print it out and burn the sheet of paper at the stake as a HERETIC!

Lenin,

That study is garbage, just like so many of their others. You cannot draw any conclusion from this statin, niacin, antioxidant fiasco because it was poorly carried out and woefully incomplete. A bunch of half-baked high school dropouts can do better than that. If I was asked to rate this study, I would give it a D-. On top of that, no dosages were specified. They probably didn't even use a quality vitamin E product. More than likely, they used synthetic vitamin E, which is pure garbage. That's what they used in that last vitamin E study (fiasco is more like it) that hit the streets.

The problem with studies involving supplements such as vitamin E and vitamin C is that far too often the dosages used were either much too low, or else the product was of an inferior quality. It's almost as if they were purposely set up and designed to fail right from the start. And of course you have to follow the money, and find out who is actually behind the study and providing the funding. And do you remember that last fiasco, in which a panel of so-called "experts" recommended changing the guidelines so that millions of more people would end up taking statins? It turned out that virtually every one of those panel members had direct financial ties to major drug companies.

Arizona

Some people have violent reactions to any posts about any natural remedies.

Some of the replies you and I and others get are so emotionally charged and sarcastic that they come across completely ridiculous - more of what I'd expect from a 5 year old than an adult.

Some people have a strong emotional need to win an arguement - and are obsessed with winning.

Keep up the good fight, but don't expect to win any converts.

Best of luck,

HubbleRules





:cool:

Arizona,

By the way, I totally agree with your position. I'm continuing with my natural regimen.

I don't object to medications - obviously they help lots of people. But I also think there's lots of merit to taking the supplements that you, I and a host of others take.

I'm free of CHD and want to stay that way, and I think having taken supplements for many years has been part of the reason I don't have CHD.

HubbleRules
:cool:

On top of that, no dosages were specified. They probably didn't even use a quality vitamin E productOn top of that, no dosages were specified.
My goodness, ARIZONA...the dosages WERE clearly specified and I repeated them for you after I looked it up. Did you even READ the whole study (the little box upper left)? It sounds like you didn't read more than the title, or maybe the few line abstract before grading the paper. That's a poor way to grade papers even in elementary school.

Of course when studies turn against vitamin "cures" there's always the yammering about "synthetic" vitamins, or not using the chelate, or the orotate, or the L- form or using too little or using too much. For Vitamin C when 50 grams a day doesn't "cure" the quack always says that 120 grams intravenously is needed...for CANCER to be "cured!"
How do you tell the "inferior" Vitamin C...is it clearly marked that way in the health food store. Or is it judged "inferior quality" because it didn't cure a cold, stop atherosclerosis in its tracks or cure AIDS (yep, that's RATH'S new yammer in Africa...but yah gota take Lysine with it...sound familiar?) Only the "superior" quality effect a cure?
I guess "superior" quality vitamins are always the ones that are sold with the name of the guy who claimed the cure.

That's the way snake oil is usually sold.

Lenin,

I have been taking Vytorin for six weeks now. So far, so good. No side effects. The medication instruction is to take it in the evening. The reason is that the liver releases cholesterol around one or two in the morning... something like that. Since Niacin has to do with the liver function, do you take it in the morning or evening? My husband also has high cholesterol. He refuses medication. I hope to convince him to take some Niacin. Any thoughts?

Blessings,
Linda

Lenin,

My apologies about the doses used. I found them, but it still leaves some unanswered questions. As expected, the vitamin C dose (500mg) was relatively small. In order to maintain high blood levels of vitamin C, it must be taken in divided doses every 4-6 hours throughout the day. If the 500mg was taken all at once, blood levels will return to baseline after a period of 4-6 hours, and will remain low for the next 20 hours or so, until the next dose is taken.

The amount of selenium used (50mcg) was a rather piddling amount as well. You would think that they would have used at least 200mcg.

They state that 400 IU vitamin E was used, but they never said whether it was the cheap, ineffective synthetic version (which is what they probably used), or a natural full spectrum vitamin E. This is what I mean by quality. If you want to conduct a study using vitamin E, at least use a quality product. Vitamin E, as it naturally occurs, consists of alpha, beta, gamma, and delta tocopherols, as well as alpha, beta, gamma, and delta tocotrienols. That's the form of vitamin E they should be using.

The same holds true for beta-carotene. They specify an amount (12.5mg), but never say whether it was synthetic or natural beta-carotene. Was it natural beta-carotene derived from Dunaliella salina algae or the worthless synthetic version?

For as long as I can remember, mainstream medicine has demonstrated a vendetta against nutritional supplements, and they have always been particularly harsh and critical in their attacks on vitamin C and E. I do not understand, nor can I explain why the S-N-antioxidant group failed to demonstrate the same favorable effect on HDL as did the S-N group. However, I do not believe that antioxidants blunt niacin's favorable impact on HDL. If there is such an effect, then I think the presence of the statin had something to do with it. But since there is no available information on the effects of a niacin-antioxidant regimen, you cannot automatically say that in the absence of a statin that the effect would be the same. Personally, I have not found that to be the case. But my father is an even better example. He had at one time been taking Zocor, niacin, selenium, vitamin C, E, and beta-carotene, and his HDL was up in the 70s. He has since quit taking Zocor, but has continued taking antioxidants and niacin. The only marked change is that his LDL went back up, as expected. But his HDL has remained virtually the same as it had been while he was taking the Zocor. It is still up in the high 70s, and he has been off Zocor for three or four years already.

ARIZONA,

Though one cannot be absolutely certain, I think one might hypothesize with confidence that if small doses of antioxidants (though many times the RDA) lower the effects of statin + niacin, more antioxidants are apt to lower the effect even more, or at least as much, and is unlikely to show any kind of J-curve result with sudden improvement at mega-mega dosage (though it DOES happen rarely). So I don't think the dosing argument carries much weight. Sort of like being rather sure that two aspirin will likely to cause tinnitus if one has been shown to do so.
And you know as well as I that WHATEVER dosage of these 3 vitaminerals were added, or WHATEVER brand, in whatever dosing schedule, SOMEONE was going to say either too little, too much, or wrong kind (to touch the TIP of the iceberg.) I wish I had a quarter for every time I heard lines like "Oh, you should have taken THE OROTATE" on Natural Living...yeah right, it COSTS more and allows the proponent a chance to dodge the issue.

What was your father's starting point on HDL with any dietary and lifestyle intervention but absent the drugs or the vitamins. Without that number, no conclusion can be drawn...with it some limited information pertinent to the study can be gained.

Since it is clear that most benefit to HDL is from niacin, your father has removed the wrong variable to shed any light on the STUDY...the statin. Try removing the ANTIOXIDANTS for a month and see if the niacin raises his HDL further! Test also for HDL2 because it is at the HEART:D of HDL's benefits.

Since the study compares two situations with placebo...2 drugs PLUS antioxidants and 2 drugs MINUS antioxidants. The only variable is the antioxidant administration!

I doubt that anyone will ever dispute that statins are relatively innocuous influencers of HDL, certainly not this study and I would not have expected your dad's HDL to change by removing Zocor.
That problem, I think, is the precise reason for the study...to work towards a dosing schedule that will lower the LDL as much as possible and maximizie HDL...I really think the researchers hoped to show INCREASED benefit from the antioxidants added to the niacin and statin but got the reverse.

The study addresses the issue specifically: should a person who is taking statins and niacin take large doses of these three vitaminerals. The answer seems a clear NO...and I am going to evaluate my vitamins (I've never taken SE...I'm very leery of elemental dosing)
Unanswered is the question WHICH of the three supplements caused the conflict? Probably not all three...but that's another study. (I have my hunch)

Lenin,

I've looked up my father's records which date back to 1990. Unfortunately, I don't have lab reports which date back to a time when he was not taking antioxidants. I wish I did. But he has been taking antioxidants for over 20 years.

Anyway, for what it's worth, the following numbers are from March, 1990. My father was not taking a statin or niacin at this time.

TC.........247
HDL.........48
LDL.........181
Trig.........115



Fast forward to February, 1999. At this time he was on 40mg Zocor, but no niacin:


TC.........208
HDL.........70
LDL........125
Trig.........66


Now fast forward to March, 2002. He is still on 40mg Zocor, but has added 1500mg inositol hexanicotinate:


TC.........203
HDL.........84
LDL........106
Trig.........66


His last blood test was in March, 2005. He is still taking the niacin and antioxidants, but is not longer on Zocor:


TC........244
HDL........81
LDL.......151
Trig........61


I don't know if you can make any more sense out of this than I can. But I find it very odd that the study would suggest that antioxidants would negatively effect HDL. From all that I've ever read about them, antioxidants such as vitamin C, E, and even beta-carotene should have a positive impact on HDL, not a negative one. Unfortunately, my father's doctor never measures HDL-2. But if there is one thing we should keep in mind about antioxidants, especially vitamin E, it is that they can help prevent or reduce the oxidation of LDL, which is also important, and should be taken into consideration. And statins do deplete the LDL molecule of vitamin E, making it more susceptible to oxidation even though LDL is reduced.

Sorry ARIZONA,
I can't get much more out of your father's numbers either. It is quite possible that LOTS of intervening diet changes have occured since the numbers 15 years ago.
Such a nice response from the Zocor in the HDL's. I got 7 points from my statin (+25%) and I though I was at the rather high end...he got a 22 point jump (+46 %), though with a 9 year intervention, a lot of other changes occur.

Net seems to be he is holding his nice HDL's. If I was FORCED to come to a conclusion, I would venture to guess that the niacin hexanicotinoate isn't doing much here...certainly NOTHING for his LDL. Has he tried the quick-hit niacin?

I think maybe that ancient test doesn't reflect his status quo without any drugs, Perhaps testing of HDL was less refined or a lab fluke occurred. Perhaps he just has good HDL levels now for whatever reason (diet?). Is he restricting carbs and fat...his triglycerides look so good.

Lenin,

It's true that my father has made other changes in his diet and lifestyle, so therefore it is extremely difficult to point to any single factor as being key to his HDL being as high as it is today. From other blood tests taken back in 1990 and 1991, his HDL had always been in the 47-55 range.

When I became interested via Atkins' books about the effects of carbohydrates on triglycerides and HDL, I naturally passed this information along to my father. You see, my father is also diabetic, so I figured that this information would be of particular interest to him. He used to snack more often than he does now, and usually ate pretzels every night. He is much more careful about carbohydrates now than he was back then.

My father also quit smoking in 1991 after a 40 year habit, and has since been using snuff. So maybe the fact that he stopped smoking also had a positive effect on his HDL.

I don't know how much of an effect inositol hexanicotinate had on his HDL. I suppose the only way he would find that out would be if he stopped taking it. No, he has never used regular nicotinic acid. I suggested the flush-free niacin because it is supposed to have a negligible impact on blood sugar. I'm not sure if he can tolerate regular niacin or not. I'll ask him to mention it to his doctor and see what he says.

A couple of other supplements that he has added over the last 5 years or so are fish oil and pantethine. He has been taking lecithin for a long time, even prior to 1990.

Judging by his lab reports, my biggest concern when he quit taking Zocor was that his HDL may drop back down to 1990 levels. Naturally I expected the LDL to go back up. But the fact that his HDL has remained near 80 has surprised even me. I thought that the niacin may have had some effect, but considering other variables and changes that were made, I find it impossible to conclude that it was any one thing. I wish I knew the answer.

Does anyone have an opinion about what may be going on here? I know that it's good that his HDL has remained quite high, even after discontinuing the Zocor. At this point in time, I think it's reasonable to assume that it really wasn't the Zocor that was maintaining the high HDL. It has to be something else. But what? And all the while, my father has continued to take both antioxidants and niacin, and there hasn't been any blunting of the HDL by antioxidant supplementation in combination with niacin. Hey, for someone who for years had an average HDL of anywhere between 47-55, and is now consistently maintaining that level at close to 80, well, I'd say that is remarkable, especially since my father has been diabetic for 40 years. Diabetics are known to have elevated triglycerides and less than optimal HDL. Perhaps I should give credit to Dr. Robert Atkins, my father's lifestyle changes, and the supplements he is currently taking. What else is there?

Arizona..I have no idea what actually helped your dad, diet, supplements or the whole combination, but whatever he is doing have him keep it up. Your right, usually diabetics have high Trigs. and low HDL, as does my husband, but your dad seems to be doing fine. It looks to me like he always had an above average HDL, and possibley the non flush Niacin and his supplements just pushed it up more. Being off the meds. I also would expect his TC & LDL to go up. Usually when U go off a statin your numbers do go up, mine did, but leveled off after about a year.

I don't know how long he has been off the Zocor, but maybe if he continues with the supplements and niacin he may even level off his TC and LDL, but only time will tell. All I can say, is God bless him, and may his numbers continue to improve.

Some of us would kill for HDL that high... :wave:

Arizona,

I would imagine it was the cutting back on carbs/snacks, plus taking fish oil, and the inositol hexanicotinate that's helping him maintain his high HDL level.

I've read that fish oil will increase HDL, and of course niacin will also.

Stopping smoking is supposed to help increase HDL also.

Could be a combination of all the above...

Did he lose weight also? That always has a beneficial effect on lipid blood levels.

HubbleRules

Hubble,

Yes, I also think it's probably a combination of different things. Weight was never really an issue. In fact, if anything, my father is underweight right now. I think he only weighs about 130 pounds. He's 76 years old. When we get old, all sorts of screwy things start happening. We begin to shrink, lose our appetites, spend half our time visiting doctors, and are forever complaining about aches and pains. And they call these the golden years? Some joke.