Artificial statin versus niacin?

[maryclaire]

What does niacin do to lower cholesterol that makes it a natural process? I want to use it to lower my LDL but have a very low tolerance. I flush and break out with hives all over.

A couple of months ago when i was trying to take 1000 mg a day, I had vigorous vomiting of bile for at least 8-12 hours. I take at a maximum 250 mg at a time and still suffer flushing and itching and if I were to take 250 mg 4 times a day, I think I would spend another day vomiting. I really thought my liver or gallbladder or wherever green bile comes from was detoxing too rapidly. I didn't throw up much except bile.

Would like reassurance that what niacin does to lower cholesterol is good for me. Any help in dosing is welcome also. It just seems if I'm flushing/itching, my body doesn't want any more niacin. I would like to believe that flushing is also detoxing but have not read that.

Thanks!
Mary

[Dolev]

Hi Mary,

Why don't you try non-flush niacin, as inositol hexanicitonate. It's 6 niacins surrounding an inositol molecule, so it's released slower and doesn't cause flush in most people. It's probably not quite as effective as regular niacin, but it works. I've used it successfully to lower people's cholesterol.

[ofonorow]

Thank you Dolev.

What does niacin do to lower cholesterol that makes it a natural process? I want to use it to lower my LDL but have a very low tolerance. I flush and break out with hives all over.

Thanks!
Mary

I just want to question the premise that you really want to lower your LDL cholesterol (Lp(a) fraction of LDL yes).

Most fat soluble vitamins, such as Vitamin E and CoQ10 ride around the blood stream traveling on these so-called "bad" LDL molecules.

And even if LDL does rise in the face of heart disease (like firemen rushing to a fire) the way to make LDL drop "naturally" is to put out the fire (e.g. take vitamin C (and lysine).

Now if you LDL is above, say 280 mg/dl, then I am with you and a good form of niacin is an excellent choice, although the literature cited by Atherotech states that Vitamin C is roughly equivalent to Niacin for lowering cholesterol.

[maryclaire]

Thank you both very much. I was trying to understand the science of how the niacin lowers the cholesterol as getting sick really scared me. I've started both the flush free niacin and vitamin c. My doctor is definitely wanting me on statins and there is no way I would go on them. So I need to lower my readings so he'll get off my back. My last test (see below) was before any supplements. I've just upped my vit c to 18 grams. Niacin at 1000mg. Do you think this is enough? Thanks again!


Component Standard Range Your Value
Cholesterol <200 mg/dL 277
Triglycerides <150 mg/dL 85
VLDL Calc <31 mg/dL 17
Chol HDL >40 mg/dL 67
LDL Calc <160 mg/dL 193

[tjallen]

You want to have your liver enzymes monitored if you are taking a high enough dose of niacin to lower your cholesterol. Niacin at such large doses is toxic to the liver, especially time-release niacin. I'd say that niacin at pharmacological doses is something to argue with your doctor about, not take on your own. A reasonable doctor should agree to try niacin instead of a statin as niacin is a medically recognized therapy and there are prescription-only versions of niacin (which don't work any better than the supplements that you can buy without a prescription). A 1000 mg dose is nearing the range of effective doses but some need two or three times that much. If you do start niacin, you should start small and work up. A 1000 mg dose will likely cause severe (but harmless) flushing. It can be surprising and alarming if you are not prepared for it; some people forget that niacin can cause flushing and go to the emergency room!

I have read here that vitamin C, l-lysine, and l-proline together will, after a year or two, lower cholesterol. I have not verified that yet myself. I'd prefer vitamin C to niacin and certainly to a statin.

[ofonorow]

In my opinion there is both good (and bad) information in the previous post. To imply that high dose niacin is "toxic" flies in the face of the 50+-year Abrahm Hoffer, MD, PhD experience and writing. (In fact, it was Hoffer's book describing how his practice "cured" schizophrenics extremely w/ high dosages of niacon - without any toxicity - that fascinated Linus Pauling. He mentions this in HOW TO LIVE LONGER AND FEEL BETTER ( I think) and if not, it was his biography "in his own words" by Marinacci where Pauling credited Hoffer with starting his interest in orthomolecular medicine.

There are three standard forms of niacin (two are non-flush) but one or two has not been shown to lower cholesterol. I would refer to the Hoffer/Saul book NIACIN: THE REAL STORY for this information. I noticed that Hoffer's standard dosage recommendation for various conditions was 3,000 mg niacin daily (along with vitamin C.)

The assumption is the previous post is that raised levels of liver enzymes equates to "toxicity". The book that has a balanced discussion of these issues is by Parsons: http://www.amazon.com/CHOLESTEROL-CONTROL-WITHOUT-DIET-Paperback/dp/B00AUODALC/ref=sr_1_2?s=books&ie=UTF8&qid=1415206051&sr=1-2&keywords=parsons+cholesterol+control

To the original query..

Thank you both very much. I was trying to understand the science of how the niacin lowers the cholesterol as getting sick really scared me. I've started both the flush free niacin and vitamin c. My doctor is definitely wanting me on statins and there is no way I would go on them. So I need to lower my readings so he'll get off my back. My last test (see below) was before any supplements. I've just upped my vit c to 18 grams. Niacin at 1000mg. Do you think this is enough? Thanks again!


Component Standard Range Your Value
Cholesterol <200 mg/dL 277
Triglycerides <150 mg/dL 85
VLDL Calc <31 mg/dL 17
Chol HDL >40 mg/dL 67
LDL Calc <160 mg/dL 193

Unless you are an exceptional individual, meaning something is increasing your metabolic requirement for vitamin C, then I believe that 18,000 mg daily will normalize your "slightly" elevated cholesterol to 180 mg/dl, (and we await your report of how long this might take.) In other words, 18 g vitamin C without niacin should shave 100 points off your total cholesterol at the dosage you are taking, but niacin has its own set of distinct and important health benefits.

This 180 mg/dl total cholesterol is mentioned by Pauling in his book HOW TO LIVE LONGER AND FEEL BETTER where he discusses the work of Emil Ginter. (I am not alone in discovering that my own cholesterol was exactly 180 mg/dl after increasing my vitamin C from 3 grams daily to 18 grams daily. Good science is impressive.)

[tjallen]

I don't think that we have a large disagreement. Sure, elevated enzymes do not necessarily mean that one is in danger of liver failure, but there does appear to be a 1989 report of liver failure in someone who took a large dose of time-release niacin in the form of nicotinic acid. (Mullin GE, Greenson JK, Mitchell MC. Fulminant hepatic failure after ingestion of sustained-release nicotinic acid. Ann Intern Med. (1989); http://www.ncbi.nlm.nih.gov/pubmed/2665592) I wouldn't use niacin (and definitely not a statin!) myself for cholesterol in the range of 277 mg/dl, even though I'd want my number to be somewhat lower. I think the benefits of lowering cholesterol by niacin are small and the risks, small though they may be, are still greater than the benefit. Several grams of niacin a day is a supra-physiological dose -- a pharmacological dose, unlike a bowel-tolerance dose of vitamin C, which brings us to about the physiological level of an animal of our weight and size without the GULO mutation.

I would argue with my physician about these numbers. I would argue that, in particular, the ratio Trigs/HDL is 1.27, which means relatively low risk. (I'd have to dig up the study that showed that this ratio is more correlated to disease than the total level is.)

[ofonorow]

Per that case report, even if accurate, it tells me that something in the "sustained released" form of the vitamin that he purchased from a "health food store" caused the problem. He was on niacin for months without problems, and I think it mentioned 6 grams daily. Seems to be a strong argument that niacin per se was not harmful.

The problem with any case report is that you lose all perspective. Was this one person out of two or one person out of thousands or millions? And are there other, better explanations? I'd want to know what else may have changed in his medications, etc.

Repeating myself, the Parsons book on lowering cholesterol without diet has a balanced discussion of the pros and cons of niacin therapy for lowering cholesterol.