An Old Cholesterol Remedy Is New Again (Niacin) - NYT

[MattSh]

***** Please help keep this bumped..... *****

Many scientists still believe that a statin combined with a drug that raises HDL would mark a significant advance in the treatment of heart disease. But for patients now at high risk of heart attack or stroke, the news is better than it sounds. An effective HDL booster already exists.

It is niacin, the ordinary B vitamin.

<and>

In 1975, long before statins, a landmark study of 8,341 men who had suffered heart attacks found that niacin was the only treatment among five tested that prevented second heart attacks. Compared with men on placebos, those on niacin had a 26 percent reduction in heart attacks and a 27 percent reduction in strokes. Fifteen years later, the mortality rate among the men on niacin was 11 percent lower than among those who had received placebos.

“Here you have a drug that was about as effective as the early statins, and it just never caught on,” said Dr. B. Greg Brown, professor of medicine at the University of Washington in Seattle. “It’s a mystery to me. But if you’re a drug company, I guess you can’t make money on a vitamin.”

<and>

WARNING: Many cardiologists see no reason to wait for the results. But niacin can be a bitter pill; in rare instances, the vitamin can cause liver damage and can impair the body’s use of glucose. High doses should be taken only under a doctor’s supervision.

From http://www.nytimes.com/2007/01/23/health/23consume.html?_r=1&oref=slogin

>> Problem is, of course, most doctors will look at you real weird-like when you try to suggest a vitamin instead of a miracle drug. <<

[magellan]

1. Upcoming Lancet article suggests cholesterol hysteria is a scam

Have we been conned about cholesterol? | the Daily Mail

snip...

"Nearly everybody is in agreement about the need to lower your cholesterol level. The NHS spends nearly £1 billion a year on prescriptions for statins and possibly the same amount administering the cholesterol tests, surgery visits and the rest.

But is it all worth it? According to an article being published in the medical journal The Lancet this week, the answer is probably no.

A leading researcher at Harvard Medical School has found that women don't benefit from taking statins at all, nor do men over 69 who haven't already had a heart attack.

There is a very faint benefit if you are a younger man who also hasn't had a heart attack - out of 50 men who take the drug for five years, one will benefit.

Nor is this the first study to suggest that fighting cholesterol with statins is bunk. Indeed, there are hundreds of doctors and researchers who agree that the cholesterol hypothesis itself is nonsense."

more... http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=430682&in_page_id=1774

[Porcupine]

4. Yep, and they make your willie wilt.

Google: statins and impotence.

[magellan]

5. My husband was on statins for a while

And although he didn't experience impotence, he had other worrying side effects. They basically made him sick as a dog unless he took them before bed; then he slept through the worst of it. But we both worried about it and he no longer takes them. We can't afford them anyway, nor doctor visits.

We manage his cholesterol through diet and exercise and get his labs done at a clinic every six months for $30. There's no history of heart disease in his family, and his BMI is in normal range. I watch over him like a hawk!

He found this article today. We're both more convinced than ever that the statin thing is a $$-making scam by the pharmas.

[SOS]

31. A couple of thoughts

If your husband has elevated LDL cholesterol, you may want to research the following:

Policosanol, a sterol derived from sugar cane. Make sure it's sugar cane. No side effects and about $12 a month.
Beta-Sitosterol, also a plant sterol which works well with policosanol.
While taking the above, add 30-60 mg. of Co-Q 10.
And add the niacin as suggested in the OP article.

I've had success with this combination. My doctor wanted me on Lipitor, but I decided not to take it.
She says my test results are actually better than what she sees with statins. LDL down 30% HDL up slightly.
To top it off, no side effects and about $40 a month total as opposed to $110 a month for Lipitor.

[BigBearJohn]

6. THANK YOU so much for this. How do I get a copy of the Lancet article?

[magellan]

7. They may have it online when it appears

http://www.thelancet.com

It isn't showing yet. But it seems at least of some of their articles are free to view with a registration.

[MattSh]

10. Good article,

Though it does not address the role of cholesterol after you already have arterial plaque. My thoughts for a while have been that cholesterol is not a problem until you have this plaque. Then it can become one. But I have also found that the problem with cholesterol (if it is a problem) comes not from what you eat, but from what your body generates.

Back in September, I have some cholesterol tests, which while generally good, were a bit elevated. Right before my follow-up test, I went on my cholesterol lowering diet. Eat all the meat dairy and eggs I want, all the veggies I want, but restrict processed foods, starches and sugars (even those in fruit). My follow-up test meet all the recommended cholesterol numbers by a wide margin. And this was without statins.

I would be most interested in reading the whole Lancet article to see if they say anything about cholesterol when you already have arterial plaque.

Good find there, magellan.

Let's keep this kicked and recommended for all those who might benefit by this!

[magellan]

13. Thanks, MattSh

Great OP, welcome to DU!

Do you know if there's a test for arterial plaque? I mean, how do doctors know if you've got it? Besides keeling over in their office from a stroke or heart attack, I mean.

About B3 niacin (the nicotinic acid kind): I read about it recently. The problem as you suggested in your OP is that it needs to be taken in very high doses -- gradually working up to 1-2g two to three times a day (max recommended dosage is 6g per day) -- and that can cause liver damage. So can statins, but since you won't get an Rx for them without being under a doctor's care, at least your liver function is being monitored on statins.

B3 at high levels can also cause side effects like flushing, dizziness and nausea, and shouldn't be used by people with metabolism problems (like thyroid diseases). So I read; I'm not a doctor.

I'd recommend trying this only under a doctor's care.

[MattSh]

25. This is how.....

You notice chest pain or pain in the upper arms. You may not feel it during rest, but it's noticable during exercise. You go to your GP, who immediately refers you to a specialist. You get an appointment for a "thallium stress test". Here's a brief description from AHA.

When the patient reaches his or her maximum level of exercise, a small amount of a radioactive substance called thallium is injected into the bloodstream. Then the patient lies down on a special table under a camera ("gamma camera") that can see the thallium and make pictures. The thallium mixes with the blood in the bloodstream and heart's arteries and enters heart muscle cells. If a part of the heart muscle doesn't receive a normal blood supply, less than a normal amount of thallium will be in those heart muscle cells.

The first pictures are made shortly after the exercise test and show blood flow to the heart during exercise. The heart is "stressed" during the exercise test -- thus the name "stress test." The patient then lies quietly for 2-3 hours and another series of pictures is made. These show blood flow to the heart muscle during rest.

More http://www.americanheart.org/presenter.jhtml?identifier=4743

Keep in mind that if you feel pain and take this test, you might still come up normal. The pain might be something else, OR the blockage may be too small to show up. Under some conditions, a 70% blockage might not show.

Once you get a diagnosis of a blockage, it's a good sign of arterial plaque. From the above test, your doctor might say you have a 80% blockage. Then you'll have a catheterization, a (minimally) invasive procedure that will help your doctor pinpoint exactly where the blockage is, and the extent of the blockage. He might say instead of 80%, it's actually 95%. Then you go in for the angioplasty to roto-root the artery are insert a stent. In a small number of cases (< 2%)? there might be complications and your angioplasty becomes a bypass. Not good.

Then, you qualify for follow-up tests every six months, since you are at higher risk. You may be perfectly fine, no pain, but the test finds another blockage. This might be a new blockage, or one that was not picked up the first time around. Now, repeat the above process.

There is also something call the EBT Scan, or the Ultrafast CT Scan.

Here's some of the pluses and minuses of this. http://heartdisease.about.com/cs/cardiactests/a/ebtpos.htm

[magellan]

40. Thanks!

Hadn't heard of this test before. Lots of good information, I appreciate it. :hi:

[bananas]

2. There are two kinds of niacin - nicotinic acid and niacinamide

the one which causes a flush is effective (nicotinica acid).
aerobic exercise is also effective - it also causes a flush.
Capsaicin is also effective (hot red pepper) - it causes a flush.
Moderate alcohol is effective - it causes a flush.

[Jack from Charlotte]

27. I've been on Niacin for about 15 years................

I take an aspirin as soon as I awake. This aspirin eliminates the flushing the niacin causes. About 15 minutes later I take 1000 mg of Niacin and then another 1000 mg around supper time. When prescribed by my Doc my HDL (The Good Chol)_was in the 30's, which is too low. It went up to the 50's immediately with Niacin. Niacin also has another beneficial property in that it treats the Chol. particle size........ I can't recall which is more desirable small or large particle size.

The cost of my 2000 mg of niacin daily is about $45 per year. Check with your doc but if you can't afford Lipitor, aspirin + niacin may be as good and it might just be better than Lipitor or other statins.

[Eurobabe]

3. Ironic that my doc in Germany knew that my high cholesterol was a result of my thyroid levels

Most doctors NEVER check people's thyroid levels if they have high cholesterol, they just throw statins at them.

People must INSIST that doctors thoroughly test the thyroid function (TSH, free T4 and free T3 levels, simple blood test) before they put you on any cholesterol meds.

My doctor and I both know that as my TSH comes down, my cholesterol levels will come back into normal range. We've seen it before, we'll see it again.

But then, thyroid medication is a very cheap solution for alot of ills, big Pharma doesn't like that....

[Hekate]

8. There is no "one size fits all" unfortunately.Diet & exercise drove my cholesterol up to 350

Niacin made me miserable -- "flushing" doesn't do justice to the bright redness and all-over intense itching that lasted for 45 minutes at a time throughout the day. And my cholesterol only went down 10 points.

I went on a rigorous program of low-fat diet and walking exercise and got into wonderful shape. I looked fabulous. My cholesterol leapt to 350.

Only statins brought it down. I do feel lucky that I haven't had any bad side effects that I know of, because I've been on one or another of them for over 15 years.

:shrug:

Hekate

[magellan]

15. Wow

That's one perverse metabolic system you've got, Hekate! :)

[Hekate]

32. Yeah, I know. The doc said my liver kept checking my bloodstream to see if there was "enough"...

... cholesterol, and then made some more. So my instructions were to eat in moderation (as everyone should, in other words) but otherwise forget about trying to control this particular thing by diet alone.

There's other things coming down the turnpike -- bleah -- and this time I may or may not be able to healthy-diet my way out of it (although I'm going to give it my best shot -- and at least I'll fit my best clothes again.;-) ) My mom's side of the family is rife with things that for them turn up in middle age and late-middle age -- but that's a story for another time.

:hi:

Hekate

[HysteryDiagnosis]

9. Bumping this up and suggesting a book......

Oh heck, let's just list a few of them.

The Cholesterol Myths : Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease by MD, PhD, Uffe Ravnskov (Paperback - Oct 1, 2000)

The Myth of Cholesterol: Dispelling the Fear and Creating Real Heart Health by Paul, M.D. Dugliss and Sandra Fernandez (Paperback - April 2005)

Hidden Truth about Cholesterol-Lowering Drugs by Shane Ellison (Paperback - Nov 1, 2005)

Health Myths Exposed 2nd Edition by M.Sc. Shane Ellison (Paperback - Jun 1, 2006)

The Cholesterol Hoax: 101+ Lies by Sheldon Zerden (Paperback - Jun 1997)

Malignant Medical Myths: Why MEdical Treatment Causes 200,000 Deaths in the USA each Year, and How to Protect Yourself

The Heart Revolution: The Extraordinary Discovery That Finally Laid the Cholesterol Myth to Rest by Kilmer McCully and Martha McCully (Paperback - Mar 1, 2000)


http://www.lef.org/whatshot/index.html#nrlc
Nutritional regimen lowers coronary heart disease risk factors in heart attack patients

A report published in the January, 2007 issue of the Journal of Nutrition revealed the finding of researchers in Granada, Spain that providing patients enrolled in a cardiac rehabilitation program with a combination of nutrients abundant in the Mediterranean diet reduced total cholesterol, low density lipoprotein (LDL) cholesterol, apolipoprotein B, and high-sensitivity C-reactive protein after one year.

Forty male patients who had suffered a myocardial infarction (MI) and were attending exercise classes at a cardiac rehabilitation unit were divided to receive semi-skimmed milk fortified with vitamins A and D, or the same milk additionally fortified with EPA and DHA from fish oils, oleic acid, folic acid, vitamin B6 and vitamin E to be consumed twice per day. Blood samples were evaluated for plasma triglycerides, cholesterol, apolipoprotein B, homocysteine, high-sensitivity C-reactive protein and other factors at the beginning of the study and quarterly for one year.

[PADemD]

11. Renewed evidence suggests statin/Parkinson's link

There's also this from the recent news:

http://news.yahoo.com/s/nm/20070116/us_nm/statins_parkinsons_dc_2

[DemReadingDU]

12. A person's body also makes cholesterol

Everyone in my family has high cholesterol. However, we are active, exercise, eat healthy and low-fat foods. Because we ate so little 'fat' foods, our bodies went into overdrive and started making too much cholesterol.

We did an experiment by adding eggs, peanuts and more olive oil to our diets (the good kind of fats). Well, after a month, our cholesterol went down 20 points!

I have used niacin too, to lower the cholesterol even more.


Here are some additional good articles to read...

You walk into your doctor's office for a physical exam and step on the scale. Last year, the doctor said you were overweight. Now he says you are obese — at the same weight....A nurse takes your blood pressure. You have hypertension — with the same previously healthy reading you've had for years....The doctor scans your wrist bone. You have a condition called "osteopenia" — with the same bone density that was fine last time you were measured....

The drug companies & FDA are conspiring to make people think they are sick to sell us new drugs! click to read more, and there are links for additional articles - Hypertension, Obesity, Osteoporosis, etc.
http://seattletimes.nwsource.com/html/health/sickintro.html



...there is no credible science, and there never was, that offered proof that lowering cholesterol levels to physiologically abnormal levels reduced cardiovascular risk. Thus, basing a broad governmental public health recommendation on no solid science is flat our wrong.
http://www.newstarget.com/021147.html

[magellan]

14. Our bodies make all the cholesterol we need

Everything we add through food is superfluous. It's how efficiently our bodies treat (and as in your family's case, make) cholesterol that may be of concern.

More and more I believe that living and eating healthy is the best preventative medicine. But that can be expensive and time-consuming -- out of reach for many. So the pharmas provide us with expensive pills to let us continue abusing our bodies instead, while they and the health insurance companies get rich off our misery.

It really would help if we had national healthcare. I think we'd keep a better eye on what new "health crises" and "cures" were pushed on us then.

Thanks for the interesting links. :)

[DemReadingDU]

17. The Seattle Times had a series of health articles

interesting reading on all these links (upper right hand corner)
http://seattletimes.nwsource.com/news/health/suddenlysick/


I think there is a place for prescriptions. Everyone needs them occasionally. But I refuse to take those statin drugs, just because my cholesterol is 'high' according to the doctor/pharma companies latest charts.

[pecwae]

16. My VA doc actually just rxd

niacin for my cholesterol. It's only 500 mg, but causes intense flushing and itching. I may half it and start slowly. On statins my muscles became so sore and weak I literally had to crawl up stairs!

The advice upthread about thyroid testing is well worth taking.

[DemReadingDU]

19. There are non-flush niacin products available

check you PM

[hyphenate]

22. I've started to believe that

the weakness I have is also partially caused by the Lipitor I'm supposed to be taking--I, too, have great difficulty climbing the stairs and the frustration it causes makes me want to cry sometimes! They're testing for other potential problems for the weakness, but I'm not taking any chances, and will wait to see what happens with the current tests before I go ahead and put it back into my regimen. I've taken myself off the Rx and am going back to the niacin if necessary, because the side effects of the niacin are more tolerable than having no ability to climb the needed steps to my apartment.

[BlackVelvet04]

24. Muscle weakness is most definitely a side effect of

statin drugs and some hypertension drugs.

[pecwae]

34. I tried Lipitor and Zocor;

both left me weak as a kitten. A neighbor developed severe pancreatitis on Zocor. Yet, it seems like everyone I meet is on a statin. I hope you get some answers to your weakness. It's very frightening in addition to being frustrating. All the best to you.

[Jack from Charlotte]

28. Take a small dose of aspirin prior to your niacin........

It stops the flushing the niacin causes.

[pecwae]

33. I'll give that a try! nt

[Hobarticus]

35. I take Niaspan...

Do you take it before bed? If not, ask your doc if you can.

Also, try a single aspirin and a light low-fat snack like bread or crackers.

It'll pass as you getused to it. I started taking it before bed, and I'd be flushed first thing in the morning. Now, it ain't no thing. I take 1000 mgs, no sweat.

Good luck!

[pecwae]

38. Thanks for those tips! nt

[atommom]

18. My husband's doc prescribed niacin for him, so there are some savvy drs out there. nt

[Sgent]

20. My doctor prescribed this for me 3 years ago

its available as a prescription as well as a vitamin -- and is cheaper to buy (along with being guaranteed your getting what you think) via a script.

[hyphenate]

21. Niacin really does work

Back when my cholesterol reached 300, my doctor at the time and I talked about me trying out the Niacin. My cholesterol went from 300 to 256 in less than 4 months. However, the damage had already been done, and I ended up getting an angioplasty anyhow.

The major problems with Niacin are the side effects, which can be intolerable for many: it causes your entire body to flush red and you end up with an itch all over which can drive you nuts. It is supposedly preventable by taking an aspirin 1/2 hour before the niacin, however. You do need to build up to the proper dose--some people who are under doctor's supervision take as much as 2-3 grams a day, though for most people, 1 gram is enough. For an everyday dose, 500 mg is recommended, and you start out 1 week at 100 mg, 1 week at 250 mg, 1 week at 400 and then 500 mg. It can hurt your liver, so it is recommended that you be upfront about taking it with your doctor so you can periodic liver tests to make sure everything is working right.

[RedEarth]

23. CAUTION:,,,, Be Very Careful when using Niacin............

I know for a fact that some people don't react well when taking niacin. My lipid profile got screwed up after about two months of taking time-released niacin. This was about twenty years ago and since that time my blood work is fine and I've been able to get my cholesterol under control through diet and exercise. However, in all honesty, I would not take niacin unless I was under a doctors supervision and having regular blood work done.

[Jack from Charlotte]

30. I thought time-release niacin was shown to be............

less effective than regular niacin.

[Hobarticus]

36. Yes, doctor's supervision is a must...

Like anything, megadoses of niacin can be bad news.

[Stuckinthebush]

26. It didn't work for me

but my doc tried it anyway. Just make sure you get the no-flashing Niacin. Man those hot flashes can be brutal!

[laylah]

29. I have used garlic forever

for just this reason, as well as for upper respiratory system. Thanks for the new info tho', and a belated welcome to DU.

Jenn

[vireo]

37. I take "HDL Booster"

http://www.enzy.com/portal/go/Enzy/hdlHDLBooster.aspx?alias=Enzy&tabalias=hdlHDLBooster

[goclark]

39. I was so sick from those statins

My joints ached, I could hardly get out of the bed.

Cramps in my foot so bad I could not walk.

FINALLY, My Trainer looked at the blister on my foot and realized that it was not really a blister. it looked more like some type of allergy ---

So, I called the doctor and after the 3rd doctor, the Neurologist told me to get off of the cholesterol drug etc. and drink plenty of water immediately.

I was fine in 2 days.

I try my best to control it with Food intake and exercise.

If I gain a pound it goes up so I know that my weight has so much to do with it for me.

Best book ever for me is by Reader's Digest called, " Cut Your Cholesterol In 14 Days."

I follow it and it took it way down.]