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Old 01-26-2005, 04:15 PM   #1
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Niaspan - No Benefit

I have been taking Niaspan for about five years. I have put up with flushing that almost drove me insane. About four months ago my new MD told me to drop the Niaspan. I have a lipid profile from October 2004 and now one from January 2005. My tests results show there was absolutely no benefit from taking the Niaspan.
Additionally, about two years ago I started a fish oil therapy of 3000mg daily. My new MD told me to increase that to 6000mg daily. I have had a 25 % increase in my HDL but it appears that the fish oil is totally responsible and not the Niaspan.
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Old 01-26-2005, 04:29 PM   #2
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Re: Niaspan - No Benefit

MY GOD,

How did you ever tolerate 5 years of flushing. I have tried niacin for a month trying to tolerate incredibly small doses and increase gradually. I get to 100 mg. and that's my limit.
My one bout with 500 mg. had me scared to death of choking or anaphylaxis (my first bout with angioedema.)
There's no way I can tolerate even 250 mg. even with 650 mg. taken beforehand.

So, you are holding the 25% increase in your HDL even with the cessation of the Niaspan? That's encouraging, I think I'll up my fish oil dose too.

 
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Old 01-26-2005, 06:30 PM   #3
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Re: Niaspan - No Benefit

Lenin,
I started with 500mg Niaspan and ended with a dosage of 750mg.
Most nights I would fall asleep before the flushing began, but there were
many nights, too many, that I went through some real agony.
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Old 01-27-2005, 06:18 AM   #4
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Re: Niaspan - No Benefit

Donsabi,

I understand about the flushing. It is/was worse for me when I was dehydrated. I found that I could keep my HDL high by daily exercise, but after two years of being off Niaspan, I just requested to go back on it (1000 mg). It wasn't that my ratios were bad (my results from my blood draw 2 weeks ago were, in mg/dL, Total 133, LDL 74, HDL 57, TG 42, VLDL 2). All of these were measured due to it being a VAP test. What had changed is that my Lp(a) crept up a bit, my hs-CRP, although somewhat low (0.49) also increased from 0.18 before. On niacin, my HDL>LDL, however, that is not why I requested to go back on it. What niacin does to the size of the LDLs and HDLs in your bloodstream is the benefit that I want back; it shifts the distribution to a more buoyant form. My LDL density pattern was flagged for being in between A/B and I want that back to A. Also, my HDL-2 dropped a bit (the more protective HDL type) and HDL-3 rose a bit (less protective). So, even though my HDL remained high, I tend to shift into a "less protective" distribution of those HDLs.

Where niacin won't help much is with VLDLs. The exercise and weight seems to keep the large buoyant (VLDL1 and VLDL2) at 2.3 mg/dL, while the small remnant VLDL3 was at 0.0 mg/dL. The low levels of circulating VLDLs give rise to the low levels of TG in the bloodstream and it seems the best way to keep those in check (provided no other disorder in TGs exist) is to keep exercise up and weight down.

Anyway, I am off on a tangent there, but I just wanted to point out that not all benefits of niacin are tested for routinely and there are some things that a superb diet, and 2 hrs of daily exercise won't do for someone that niacin might.

Last edited by ubernier; 01-27-2005 at 06:47 AM.

 
Old 01-27-2005, 07:41 AM   #5
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Re: Niaspan - No Benefit

Ubie,
Thanks for that thorough breakdown. You ALMOST make me want to pull out the bottle of niacin and try again...OY!

 
Old 01-27-2005, 01:09 PM   #6
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Re: Niaspan - No Benefit

Quote:
Originally Posted by ubernier
Donsabi,
What had changed is that my Lp(a) crept up a bit, my hs-CRP, although somewhat low (0.49) also increased from 0.18 before. On niacin, my HDL>LDL, however, that is not why I requested to go back on it. What niacin does to the size of the LDLs and HDLs in your bloodstream is the benefit that I want back; it shifts the distribution to a more buoyant form. My LDL density pattern was flagged for being in between A/B and I want that back to A. Also, my HDL-2 dropped a bit (the more protective HDL type) and HDL-3 rose a bit (less protective). So, even though my HDL remained high, I tend to shift into a "less protective" distribution of those HDLs.

Where niacin won't help much is with VLDLs. The exercise and weight seems to keep the large buoyant (VLDL1 and VLDL2) at 2.3 mg/dL, while the small remnant VLDL3 was at 0.0 mg/dL. The low levels of circulating VLDLs give rise to the low levels of TG in the bloodstream and it seems the best way to keep those in check (provided no other disorder in TGs exist) is to keep exercise up and weight down.

Anyway, I am off on a tangent there, but I just wanted to point out that not all benefits of niacin are tested for routinely and there are some things that a superb diet, and 2 hrs of daily exercise won't do for someone that niacin might.
Just when I thought I was getting the hang of the numbers and their meaning! You are referencing things I have not come across before. Could you please explain how and why you have what appears to be a much more detailed profile of your cholesterol levels? Many thanks.

 
Old 01-27-2005, 03:12 PM   #7
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Re: Niaspan - No Benefit

I just started taking the niaspan 500 prescribed by my cardio. She advised me to take an adult asprin 30 mins b4 taking the niaspan. I am very sensitive to meds so i halfed the dosage to 250mg instead of the 500. I will increase it once i know who the med will affect me.

I was soooooo scared to try it, but i have no choice at this time.

 
Old 01-28-2005, 05:35 AM   #8
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Re: Niaspan - No Benefit

jtu91952,
If you are considering dividing a 500mg tablet to reduce your dosage please check with your pharmacist first. I think that dividing Niaspan tab's is not recommended.
Some people are not bothered by this med, so give it a try. If you do experience flushing it is uncomfortable but lasts only about 30 minutes.
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Old 01-28-2005, 05:38 AM   #9
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Re: Niaspan - No Benefit

Quote:
Originally Posted by Lenin
Ubie,
Thanks for that thorough breakdown. You ALMOST make me want to pull out the bottle of niacin and try again...OY!
Ah Lenin, the reason I sound so "aggressive" about this is that I had a heart attack at age 35. Granted my cholesterol was 162 (total) just before the MI, but my HDL seems to be the major problem. Of course, I was doing everything wrong (no exercise, way too many calories, tobacco, etc.). I am weighing out my MI/near death experiences vs. flushing and that makes the choice pretty clear. Without an MI, I know I wouldn't even push for niacin again.

On a side note, I think I am not bothered as much as others by niacin. I do remember one night that my legs were itching so bad that I had to hop out of bed at 3:30 am and do my morning run at that time to make my mind off of it. I was scratching my quads every 5 sec and my skin was turning a nice shade of pink. I just took a 1000 mg dose last night about 2 hrs before bedtime and never even noticed the flush or warmth. I can't predict when it happens. I did note that I had no wine last night, and had consumed >108 oz of fluid by bedtime.

Last edited by ubernier; 01-28-2005 at 05:52 AM.

 
Old 01-28-2005, 05:48 AM   #10
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Re: Niaspan - No Benefit

Quote:
Originally Posted by Ward
Just when I thought I was getting the hang of the numbers and their meaning! You are referencing things I have not come across before. Could you please explain how and why you have what appears to be a much more detailed profile of your cholesterol levels? Many thanks.
Ward:

There are companies (more now) that look at additional factors that might be causing the premature development of CHD, which afflicted me. A few years back, I had mine done by NMR lipoprofile analysis, and there was a company in NC that would do the breakdown. More companines now have labs that will do the VAP (stands for Vertial Auto Profile). It allows quantitation of the lipoprotein subclasses. The whole reason that they started to do this analysis on my plasma is to try to identify additional risk factors to explain my early development of CHD because my total cholesterol was not really all that high, nor was my LDL. My HDL was low but still, there was more to the picture--my particle size of LDLs, IDLs, HDLs, VLDLs were all weighted heavily toward the small and dense type. I just happend to reread a manuscript on all these novel risk factors this morning, and will try to remember to get the link and post it in here. I might have done so a while back? In any case, I think its an article in the Journal "Circulation." It's not too difficult to understand.

I found the NMR lipoprofile report easier to interpret than the VAP report. The company that produces it displays in a more understandable format. Unfortunately, the cost is higher to have them do it. (With insurance I pay around $250).

 
Old 01-28-2005, 06:07 AM   #11
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Re: Niaspan - No Benefit

ubernier,
Your numbers are fantastic! Thanks for the info.
My tests have been limited to TC, HDL, LDL, Triglycerides, and ratio. I have one of the best BCBS plans available and more recently they won’t even allow a complete test but limit it to, i.e., TC and HDL.
To be more specific, for more than ten years my HDL was 28 and nothing I did would improve it. However, during the time I was taking Niaspan my HDL began to increase and Niaspan was credited for the improvement, but during the same period I added fish oil, 3000mg daily. Four months ago, with a new doctor, he told me to stop the Niaspan. He did a brief lipid profile and the HDL was 43. Four months without Niaspan I was retested and my HDL was 45. He also had me increase the fish oil to 6000mg daily at our first meeting.
I met with my cardiologist yesterday and mention some of what you pointed out. Needless to say, he dismissed it as being internet babble as most doctors do. Regardless, I will continue to look into the Niaspan benefits as you mentioned. Thanks again!
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Old 01-28-2005, 07:05 AM   #12
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Re: Niaspan - No Benefit

Donsabi,

My HDL was in the 25-30 range. Getting it to 43 was great work! My GP doubted I could ever raise it to even 40, with Niacin. However, a lot of exercise (I run and bike, now, daily), gets me to those numbers. With niacin though, I had an LDL of 67 and HDL of 70. I was floored because I didn't think I could get my HDL higher than my LDL, ever. Without niacin, the best I can do is about a 4:3 ratio (aboud 80 LDL and 60 LDL). I just am worried about that HDL component, because I know that even with two stents, I had some areas in the circumflex (LCA) that had visible plaque buildup during my angiograms. If there is any chance to reverse it, I want that to happen. Perhaps one day I will have another angiogram, and then will be able to compare it to what it looked like in 2002?

I do wish you good luck. Coming from where you are, I remember the frustration of trying to get my HDL higher...

Oh, I have BCBS federal. I think they limit the total lipoprofiles to once every 4 months with the proper diagnosis codes? Not sure on that though, but they paid mine at that frequency a few years back. Right now, I have it done twice per year on that plan, plus once for free for my yearly work physical.

I almost forgot, fish oil. I do take additional omega-3s in capsules, two per day. I eat fish (usually salmon) 2-3 x per week, 4-6 oz per serving.

As for babble, I do that at times too However, most of what we are discussing is in the literature, and supported by different studies. I don't want to give away too much info, but I suppose that is one aspect (finding this info) that comes easy to me, since writing manuscripts and reading/researching literature is something I do all the time in the publish or perish nature of my profession--although the subject we are discussing is outside of my field. <--My disclaimer

Last edited by ubernier; 01-28-2005 at 07:14 AM.

 
Old 01-28-2005, 08:00 AM   #13
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Re: Niaspan - No Benefit

Uberiner,
Everytime I talk with any health professional and mention anything I have
found on the internet the they immediately label it as usless information.
My feeling is that most people come to these boards beacause they are having some kind of problem with maladies, treatments or medications.
I find sharing this information very helpful even if a post is simply supportive. The medical profession wants us to take an active part in our treatment but don't dare question their direction or one is labeled a troublesome patient. Needless to say, I am a troublesome patient because I question. I hope there are more of us doing the same.
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Old 01-28-2005, 05:29 PM   #14
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Re: Niaspan - No Benefit

I had a decent LDL level (112) and great Trig(52) but my hdl was 36 at one point and the doctor immediatly threw 500mg tablets of Niaspan at me. I was quick to learn about the horrific flushing that people experience prior to starting the regimine so instead of using Niapan, I cleaned up my diet with soluable and insoluable fiber, started taking flax oil tablets and increased my exersise regimine and now I'm fine. Exersise is shown to increase HDL but only after about 6 months of a daily cardio routine (about 45 minutes a day). Only then do you usually see a marked increase in HDL.

After disucssing Niaspan with some college friends of mine who are now doctor's, they were suprised my doctor gave me synthetic Naicin (or any at all) since I'm only 29 and there are other options to explore.

It's completly possible to raise HDL without Niaspan, but when you're in to see a doctor, it's the easier option to just prescribe something they know should statistically be a sure fire winner, even if the side effects could be unbearable. It's always wise for everyone to look at ALL thier options and understand them prior to enganging in a synthetic regimine of some kind.

 
Old 01-28-2005, 06:30 PM   #15
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Re: Niaspan - No Benefit

Quote:
Originally Posted by donsabi
Uberiner,
Everytime I talk with any health professional and mention anything I have
found on the internet the they immediately label it as usless information.
My feeling is that most people come to these boards beacause they are having some kind of problem with maladies, treatments or medications.
I find sharing this information very helpful even if a post is simply supportive. The medical profession wants us to take an active part in our treatment but don't dare question their direction or one is labeled a troublesome patient. Needless to say, I am a troublesome patient because I question. I hope there are more of us doing the same.

I agree 100%! All the regulars on this board know my story. For about a yr(maybe two) ihave been complaining about hbp & high choleterol caused by diuretics. Well, i was on lipitor for three yrs(messed up my liver) and finally got off it in the ER. I kept pushing and refusing all statins until i found a cardiologist that would work with me. She prescribed niaspan 500mgs.

At first i was afraid to take it bcuz of the other posting i had read. Plus niaspan can affect diabetes. I am finally taking the niaspan(30mins after adult asprin) so far w/o side effects.

I appreciate all the info i can get on this board. All my drs had considered me a nut or troublemaker. This is my body and should be able to get straight answers to make an intelligent decision.Since i can't trust the drs, i do my own research.

 
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