Advise Please

[pcovers]

Originally Posted by RMiller

You can start with a small dosage of 100mg a day and then have your cholesterol rechecked in a few weeks.
According to one recent study, people have taken 1000-2000 mg. daily with no adverse effects

I read a metadata study on clinical trials using Niacin and it reported a greater than 50% dropout rate due to unacceptable levels of flushing. While niacin does work well, it is not well tolerated to quite a large population. However one may say that the flushing goes away or you get used to it, the numbers don't lie and over 50% is a huge dropout rate compared to the norm.

Probably a lot like Atkins. It may work. But only if you stay with it, and most people don’t.

[RMiller]

Originally Posted by pcovers

I read a metadata study on clinical trials using Niacin and it reported a greater than 50% dropout rate due to unacceptable levels of flushing. While niacin does work well, it is not well tolerated to quite a large population. However one may say that the flushing goes away or you get used to it, the numbers don't lie and over 50% is a huge dropout rate compared to the norm.

Probably a lot like Atkins. It may work. But only if you stay with it, and most people don’t.

The study you are referring to was published in the American Journal of Medicine in Oct. 1995. Lead researcher was L.W. Gibbons.

Niacin was originally treated as a drug and was overprescriibed at times in excess of 3 grams. This caused liver problems, increased uric acid, blood sugar elevations, and the flushing problem.

Another study published in the Archives of Family Medicine, 1996 showed that the newer sustained release Niacin improved HDL cholesterol levels by 20% when given in a dose of 1500-2000 mg. which is far lower than the original dosages.
that is why I suggested a starting dose of 100mg which is less than 1/10 the dose used in the 1996 study.

The idea is to determine the level of Niacin needed to make the desired change.

A just-published study in Archives of Internal Medicine (Guyton, et al, 2000) confirms my long-held belief in the superiority of niacin (vitamin B3) as a lipid-lowering agent. A proprietary timed-release version of niacin (Niaspan) was compared to the pharmaceutical drug gemfibrozil (Lopid).

The study involved 399 male and female subjects ranging in age from 21 to 75, all of whom had low levels of HDL (high density lipoproteins—“good cholesterol”) less than 40 mg/l. Other criteria for inclusion in this study were triglycerides less than 400 mg/l, and LDL (low density lipoproteins—“bad cholesterol”) less than 260 mg/l. Niacin was administered once daily at bedtime. The niacin dosage was begun at 375 mg/day, and then increased progressively over the course of the study, and maintained at a level of 2,000 mg nightly for 8 weeks. The duration of the study was 16 weeks. Subjects took an aspirin as-needed to prevent flushing. Gemfibrozil 600 mg was administered twice daily over the entire 16 weeks.

Niacin increased HDL levels over 25%, compared to an increase of 13.3% due to gemfibrozil. Gemfibrozil actually raised LDL (the “bad” cholesterol, remember?), while niacin slightly lowered this fraction. Gemfibrozil lowered triglyceride levels by 40%, compared to a 30% decrease from niacin. Thus, niacin resulted in an overall improvement in the lipid profile which exceeded that induced by gemfibrozil.

[zip2play]

RMiller,

Have you ever taken niacin?
I have tried it several times. I bought a bottle of 300 tabs of 500 mg. niacin. I took one.....I thought I was going to die. The term "flush" is, for me, a good synonym for "auto da fe." I have rarely suffered so much.

I tried the gradual tolerance doses starting at 25 mg. I found that by 250 mg the symptoms were always unbearable. I tried all kinds of "tolerance regimens."

Believe me the term "flush" is understated for those who experience it!

Of course, I always assumed it was I who was the anomaly and I've passed the bottle of niacin to several friends who eventually came down with "high cholesterol"
with only one stipulation: Return the bottle if the flush is unbearable.....I STILL have the bottle with the old yellowed label....do you want it?

I really am beginning to think that the niacin cure for high cholesterol is about as useful as the Vitamin C cure for the common cold!

[pcovers]

Originally Posted by RMiller

Subjects took an aspirin as-needed to prevent flushing.

In many people, aspirin prevents flushing.....not! Bottom line is that a few people can take effective doses of niacin with little or no problem. Some more can tolerate the side effects well enough to continue taking it, and still more can take all the aspirin Bayer manufactures in a day and still cannot live with the flush caused by niacin.

It is a great tool if you can take it. I have never read a clinical study that indicated anything less than a gram to be effective.

[RMiller]

I am sure that some are more tolerant of Niacin than others.
However, statin drugs and their known side effects and long term damage are not a viable option in my opinion.