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    Old 04-07-2005, 06:42 PM   #1
    momcat1
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    what exactly is niacin supposed to do

    I've been reading about niacin here and elsewhere. Decided I would try to add the niacin, in the hopes that it might help my TC situation. I started with 1000mg after dinner (my only full meal of the day), And I did buy non-flush. At some point should there be anything I notice? It's been almost two full weeks and not only have I not had any side effects, I don't notice anything else different either.

     
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    Old 04-07-2005, 07:28 PM   #2
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    Re: what exactly is niacin supposed to do

    That was 1000 mg? Not 100 mg? Just wanting to make sure that wasn't a typo.

    If there wasn't a flush, you probably won't get a flush, nor will you have any idea whether or not it is doing anything for your cholesterol until your next blood test.

    Keep in mind that most "authorities" here say that the non-flush is useless for cholesterol control. There was at least one research study showing that it had "no free niacin," which is apparently needed for it to do any good for cholesterol. Yet a few doctors here are recommending it and it is apparently being used quite a bit in Europe. I'm personally wondering if there isn't something about the particular design of that study that just isn't finding how it works. But then, maybe it doesn't work. It just has been far less studied than either the immediate release or the sustained release, both of which have been shown to lower cholesterol levels.

    I'm personally using a sustained release, Enduracin, which was studied at both the U. of Minnesota and at Harvard. It was shown to be effective and safe for the length of the trial. But who knows about most anything long term? I started slowly, just 250 mg. a day, and had very minor flushing for a few days. Over a period of months, I increased that to 500 mg, then to 750 mg. I got no flushing with the increases, my liver enzymes are well within the normal range, and my lipid panel was much improved. Some brands of sustained release have had lower safety levels, so you'll want to check that out, should you decide to switch types.

    Did you have a lipid panel done shortly before you started? If you had no reason to believe your liver enzymes were out of whack before, I would personally continue with the non-flush for a total of about three months, then go in for both a liver enzyme test and a lipid panel test. If you have made no other changes to your lifestyle, that may give you an idea of whether or not it is working for you, regardless of the rather limited research on it.

     
    Old 04-08-2005, 05:18 PM   #3
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    Re: what exactly is niacin supposed to do

    Yes, it is 1000mg, no typo there. I hadn't seen any negative postings on non-flush and after my nightmare with estrogen replacement therapy, could not stomach going through another bout remotely like it. I did have a lipid panel last time, and the doc is pestering me to come back this month. Gave me one month to decide to take statins, which I'm seriously nOT considering. He's going to have to wait a bit and then I'll have him run the blood tests again, and we'll see. But I really hate the current state of medical care, where I have to pay for a vist to have the lood drawn, then pay for another visit to find out what the results are. I'm certain we were all better off before the healthcar industry's takeover of our care.

     
    Old 04-08-2005, 07:17 PM   #4
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    Re: what exactly is niacin supposed to do

    Gave you only one month to decide to take statins or not? I'd be inclined to tell him I'll take just as long as I please! (Can you say I'm just a bit on the independent side?)

    How bad were your numbers?

    Did you read the thread in which we discussed the JAMA article about the studies of women and lipid-lowering drugs? If not, you'll want to do so! Most of the subjects in the research on statins was done on middle age men. But an analysis of those women who were included in the studies was done, which indicated that, while women had fewer CHD deaths on the drugs, they had more deaths from other causes. So my opinion is that unless one has a preference about the cause of one's demise, what's the point in taking high-risk drugs? It is possible that a longer study might show greater benefit, but I personally don't think the research is there to justify the drugs use with women yet. You may want to look up the article and evaluate for yourself. Here is the link to our discussion. I think there is a link in it to the article.
    [url]http://www.healthboards.com/boards/showthread.php?t=268883&highlight=women+ statin[/url]

    I don't know how many older people were included in the statin tests, either. Also, from what I've read elsewhere, (can't remember where) there may be some advantage to having somewhat higher cholesterol for older people. How much higher, I don't know. They probably don't know, either. And does that apply equally to men and women? Who knows? Depending upon your age, that might be something else you'll want to research, too, before deciding.

    See, there is no way you are going to be able to do all the research you may want to do in one month unless that's all you do! Actually, one month isn't long enough to show much change in lipids from lifestyle changes, either. Three to six months would be more realistic.

     
    Old 04-08-2005, 08:38 PM   #5
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    Re: what exactly is niacin supposed to do

    momcat..if your dr. only gave U one month to make a choice of using statins or not, I would say he has already made up his mind U ARE going to take them. Like Uff said, no way are U going to get the results he wants in a month, it is usually a 4 to 6 month try of doing something natural to see any results.

    If he won't work with you, then he isn't worth the money U are paying him. I do hope your decision to take Niacin helps and gets this guy off your back, but if not, U need a good heart to heart talk with him. As far as the money thing, yes U pay to get the tests, but U should beable to call for the results.

    Don't know exactly how high your numbers are, but unless U have other risk factors like diabetes, overweight, or heart disease, a natural approach should be made to you, and definitely for longer then one month. Even with other risk factors, a good dr. would still give U some time to try the natural methods.

    I wish you luck, and hope things go well...

     
    Old 04-09-2005, 03:55 AM   #6
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    Re: what exactly is niacin supposed to do

    Why is everybody assuming that there is anything NATURAL about 1000 mg. nicotinic acid a day? There's certainly no way that anyone could get it in one's food. On top of that it's chemically compounded into a form to avoid the flush.
    Just because something is sold without a prescritiption doesn't in any way render it "natural."
    Niacin therapy is a very potent DRUG therapy, one among the choice of several drug therapies.

    I found this interesting and perhaps others will too (from the Linus Pauling Institute.):
    High cholesterol and cardiovascular diseases

    Quote:
    Pharmacologic doses of nicotinic acid, but not nicotinamide, have been known to reduce serum cholesterol since 1955 (22). Only one randomized placebo-controlled multicenter trial examined the effect of nicotinic acid therapy alone (3 grams daily) on outcomes of cardiovascular disease. The Coronary Drug Project (CDP) followed over 8,000 men with a previous myocardial infarction (heart attack) for 6 years (23). In the group that took 3 grams of nicotinic acid daily, total blood cholesterol decreased by an average of 10%, triglycerides decreased by 26%, recurrent nonfatal myocardial infarction decreased by 27%, and cerebrovascular events (stroke + transient ischemic attacks) decreased by 26% compared to the placebo group. Though nicotinic acid therapy did not decrease total deaths or deaths from cardiovascular disease during the 6-year study period, post-trial follow up 9 years later revealed a 10% reduction in total deaths. Four out of five major cardiovascular outcome trials found nicotinic acid in combination with other therapies to be of statistically significant benefit in men and women (24). Nicotinic acid therapy has been found to result in markedly increased HDL-cholesterol levels, as well as decreased serum Lp(a) lipoprotein concentrations, and a shift from small dense LDL particles to large, buoyant LDL particles, all of which are considered cardioprotective changes in blood lipid profiles. Because of the adverse side effects associated with high doses of nicotinic acid (see Safety), it has most recently been used in combination with other lipid-lowering medications in slightly lower doses (22). A recent randomized controlled trial found that a combination of nicotinic acid (2 to 3 grams/day) and a cholesterol-lowering drug (simvastatin) resulted in greater benefits on serum HDL levels and cardiovascular events, such as heart attack and stroke, than placebo in patients with coronary artery disease and low HDL levels (25, 26). However, an antioxidant combination (vitamin E, vitamin C, selenium, and b-carotene) appeared to blunt the beneficial effects of niacin plus simvastatin.

    Although it is a nutrient, at the pharmacologic dose required for cholesterol-lowering effects, the use of nicotinic acid should be approached as if it were a drug. Individuals should only undertake cholesterol-lowering therapy with nicotinic acid under the supervision of a qualified health care provider, so that the potential for adverse effects may be minimized and treatment benefit maximized.
    I'm doing Lipitor plus small doses (couple/three hundred mg./day) of niacin (for my HDL) and I guess I should discontinue my Vit.C and Vit. E til I find out if there's an adverse interaction.
    I cannot BELIEVE they tested 8300 men for 9 YEARS and didn't bother to measure their HDL levels...I guess because there wasn't much thinking about HDL and heart disease in the '60's and '70's? (I VAGUELY recall only total cholesterol being of much interest.)

    Last edited by Lenin; 04-09-2005 at 05:06 AM.

     
    Old 04-09-2005, 07:46 AM   #7
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    Re: what exactly is niacin supposed to do

    Your right about the Niacin, as I read that article also, but I think most people take lower doses to help with their cholesterol problems. I also believe the person should be given the chance to lower their numbers with diet, exercise and suppliments if they choose, NOT be told they have one month to decide to take a statin or not. JMHO

    I'm not saying Niacin is for everyone, but there are other things to try, and I don't think momcat was given any choices by her dr. A good dr. will have a talk with you and at least try something more "natural" before trying to push a statin on you, but her dr. gives me the impression he has already made up his mind to go the statin route. Not a very good attitude in my opinion, unless there is an underlining problem we don't know about.

    Have a nice day...

     
    Old 04-09-2005, 08:33 AM   #8
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    Re: what exactly is niacin supposed to do

    Quote:
    Originally Posted by Lenin
    Why is everybody assuming that there is anything NATURAL about 1000 mg. nicotinic acid a day?
    Well, I guess I'm not part of "everybody." I believe in approaching use of niacin with extreme caution. Here is the approach I took:

    When the doctor started getting concerned that my risk ratio was the highest it had ever been (4.0 with LDL 158) and mentioned statins, I said I wanted to try to get it down with diet first. She gave me three months. But we'd been this route a couple of years earlier, and though I got it down some then, after doing a lot of reading on the web, I decided on my own to try niacin in addition to being more careful about diet this time. I wanted to be extremely cautious, so took only 250 mg. for about two months before I went back to her for that 3-month checkup.

    She expressed concern about using an OTC product, but I had read the research on the particular one I was taking and was satisfied that it was probably no more dangerous than a statin in terms of liver toxicity. She reluctantly agreed to let me try 500 mg, since my liver enzymes showed zero problems at the 250 mg level. After another three months, I had another lipid panel and liver enzyme test. At this point, my doctor was so excited about my results, that she asked me to get her the address of where I ordered that particular OTC niacin, so she could give it to others. However, the results (TC=202, LDL=115, HDL=60, trigs=83) were still not good enough for her, so she recommended increasing the niacin to 750 mg, which is the level I'm still at.

    In my book, even 750 mg, though lower than most therapeutic doses, is still not natural. But it allows me to do some experimenting with diet to see if I can find some combination which will allow me to back off and lower that niacin dosage. The lower I can make it, the lower the risk.

    I liked the assertive approach I used, though. By starting the OTC on my own at a low dose and getting back a very favorable liver enzyme test the first time, my doctor, though still concerned, was probably less adamently against continuing on an OTC than she might have been otherwise. I simply cannot see paying ten times the price for Niaspan, when the research on the one I'm using seems to indicate a high level of safety.

     
    Old 04-09-2005, 08:36 AM   #9
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    Re: what exactly is niacin supposed to do

    Quote:
    Originally Posted by JJ
    A good dr. will have a talk with you and at least try something more "natural" before trying to push a statin on you. . .
    More natural and also less expensive, I might add. Some of us are on limited incomes and don't have insurance which covers meds.

     
    Old 04-09-2005, 09:01 AM   #10
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    Re: what exactly is niacin supposed to do

    I hear ya Uff. Niacin may not be for everyone, but if folks can try it and get results like U did, why not. My dr. told me I could try it, and also suggested green tea, but not together, as we wouldn't know which one was working. At least she is willing to try and work with me, some drs. won't. I also am on a limited income, so if I can get decent results without a prescription, plus I tried statins and they didn't agree with me, I'm all for it.

    So far I have been to 3 different stores and can't find any of the Niacin under 500 mgs., and I want to try a small dose. I'm reluctant to order over the net, never tried it before, and not enthused about givng any credit card info. on the net. Glad U were able to do so well and your dr. is in your corner.

    Enjoy your day......

     
    Old 04-09-2005, 10:37 AM   #11
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    Re: what exactly is niacin supposed to do

    JJ - I wouldn't give my credit card info over the net at first, either, but several years ago had to give it to sell on eBay. At the time, I had an extra credit card I really wasn't using, so I decreased the limit on it to the minimum and use that card exclusively on the net. If anyone ever did get the cc information, they wouldn't be able to do much damage. Some credit card companies now allow very low maximums with cards for that very reason. I've since done a lot of ordering online, as one can get many things much cheaper than here in a rural community. Just an idea you might want to check into.

     
    Old 04-09-2005, 11:41 AM   #12
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    Re: what exactly is niacin supposed to do

    JJJJ,

    Puritan Pride (mail order) is selling 250 mg. regular niacin at 3 bottles of 500 (total 1500) for $18.90 or
    3 bottles of 100 mg. X 500 (total 1500)tabs for a total of $12.95.

    I'm pretty sure these are the lowest prices current unfortunately it's a 3 for 1 sale so you've got to buy a LOT but you can't beat around a penny apiece!

    I ordered the 250's and split them for the best best price.

    I wasn't able to find small tablets anywhere else either.

    Vitamin Shoppe does
    250 mg. also but only as capsules (that can't be broken) and at a nickel apiece.

    Last edited by Lenin; 04-09-2005 at 11:43 AM.

     
    Old 04-09-2005, 12:23 PM   #13
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    Re: what exactly is niacin supposed to do

    Wal-Mart carries Spring Valley regular niacin, 100mg x 100 for 2.97, about 3 cents a dose.
    -Tina

     
    Old 04-09-2005, 01:44 PM   #14
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    Re: what exactly is niacin supposed to do

    Thanx to all for your responses. I had thought of buying the 500 and splitting it, but read somewhere that U shouldn't. I do believe it said the extended release isn't to be split, not totally sure.

    Ward, I was at Wally world, and couldn't find it there either, but I will try again. Only other place I didn't try was Rite Aid, so will try Walmart again and Rite Aid. I know my vitaminc C is Spring Valley from Walmart, so sooner or later it has to show up.

    As always, I really do appreciate your input folks.....

     
    Old 04-10-2005, 05:55 AM   #15
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    Re: what exactly is niacin supposed to do

    Oops,

    a mispost !

    Last edited by Lenin; 04-10-2005 at 05:56 AM.

     
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