Tag Archives: cholesterol

Niacin Outperforms Drug At Lowering Cholesterol

In a study published in the New England Journal of Medicine, a time release version of an inexpensive Vitamin B (Niacin- not niacinamide) was compared to a common cholesterol drug, ezetimibe (trade name Zetia), made by Merck.  The vitamin gave superior results.

In 2008, 9 million Americans were taking Zetia versus just 2.5 who were taking niacin, putting the majority at higher risk for stroke and spending more money for their treatment.

Niacin is easier on the blood vessel walls. Niacin had a beneficial effect on the plaque buildup in the walls of the arteries that supply blood to the brain, while Zetia caused a slight worsening.  Nine patients taking  Zetia had heart attacks, stroke, or died from heart disease, versus just two patients taking niacin.

Niaspan, the niacin used in the study is a prescription product that has a special timed-release formulation, which may cut down on the hot flashes that are associated with niacin use.  It does still cause flushing in some people however.

Zetia reduced LDL, the so-called bad cholesterol by 20%.  But unlike Zetia,  niacin boosts HDL, or good cholesterol by 20%, as well as reducing LDL by 16%, total cholesterol by 10% and triglycerides by 28%.

The prescription version of niacin is Niaspan, a 500mg-1000mg version taken at two tablets in the evening.  The vitamin does cause flushing, but less so than straight niacin.  Niacinamide (also called nicotinamide or “no flush niacin”) does not work the same way, although it is often used as a substitute for niacin in multivitamins.

Niacin can cause blood sugar to rise, may be contraindicated for people with gout, bleeding, stomach ulcers, liver disease, kidney problems and shouldn’t be taken by heavy drinkers or people on blood thinners. IT has not been studied on pregnant or nursing women but most likely does get into the breastmilk and should be monitored.  The most common side effects include flushing, headache, diarrhea, nausea, vomiting, increased cough, and itching.  It may interact with aspirin. I suspect that it may increase hot flashes for menopausal women due to the similarity of the symptoms and Chinese medicine interpretations, but Abbot has not mentioned that side effect.   If you take other cholesterol medication take it 4 hours apart.

While the form used in the study is only available by prescription, Natrol sells a 500mg time release niacin for $7.33 for 100 pills and there are likely many other vendors.  The Abbot Labs site says that there may be liver problems when changing to a long-term time release from a non or intermediate time release niacin, so if you are changing brands of niacin, spend a few days without it.  Start at 500mg once a day and go up slowly.  Do not exceed 2000mg.  Women may need lower doses than men.

If you are severely yin deficient this may make things worse and it should be combined with shatavari, or the Rhemannia 6 herbal formula (Liu wei di huang wan).  Speak with your acupuncturist or herbalist.

If you are on a statin, there is no extra benefit to taking niacin or vice versa.  Incidentally the anti-inflammatory effect of two cups of coffee a day or a half pint of blueberries is the same as a statin, but the latter do not deplete your muscles of Coenzyme Q10.

Sources:

http://abcnews.go.com/Health/HeartDiseaseNews/cheap-niacin-beats-pricier-zetia-heart-patients/story?id=9092855

http://blogs.healthfreedomalliance.org/blog/2010/02/05/vitamin-proves-better-then-big-pharma-drug/

http://rxabbott.com/pdf/niaspan.pdf

http://www.niaspan.com/AboutNiaspan/Default.aspx#isi

See Also:

Coffee Beats Statin in Reducing Diabetes Inflammation

Vitamin D, Niacin and Red Yeast Rice

Herbs and Hypertension

Vitamin D, Statins and Red Yeast Rice

red-yeast-rice-300x238As those of you who read my blog are aware, I am not a big fan of statins.  The first reason is that cholesterol is not really the problem. The second is that statins depress the body’s own anti-inflammatory compound CoQ10.  But recent research shows that, against our logical assumptions, Vitamin D levels may rise when statins are taken.

Cholesterol is good?  Yes.  Cholesterol is the building block of hormones, and it is the body’s own bandage for inflamed arteries.  When the inflammation is high, cholesterol rises and if it isn’t enough to lower you get cardiovascular disease.  It doesn’t get rid of the inflammation to remove the body’s bandage, you need to look at diet and stress and other causes of inflammation.  Besides if you block cholesterol with statins, you block the body’s formation of CoQ10 which is our natural antioxidant.  And that can cause a painful disease called rhabdomyolysis where the muscles ache and cramp.

But isn’t it helpful to prevent heart disease?  Sort of.  You are less likely to get a second heart attack, but not a first one.  You may be less likely to die from a heart attack but no less likely to die from other causes within a normal study period.  And it probably isn’t because it reduces cholesterol, but because it is anti-inflammatory (replacing your body’s own anti-inflammatory coenzyme with its own effect).

How about Red Yeast Rice?  Red Yeast Rice is a kind of statin, and is the source for lovastatin which it contains.  Red Yeast Rice is somewhat less dangerous- it spreads itself out among liver detoxification pathways without clogging a few important pathways.  And the dosage is lower, which is common in a whole herb and does not impair its action. But it still reduces CoQ10,  and adds some liver taxation  I use it rarely.

The information about Vitamin D and statins is a surprise.  Vitamin D and cholesterol have the same precursor, and those of us in the natural medicine field assumed that statins would reduce absorption of Vitamin D if you took a medication that reduced the precursor.  In a Turkish cardiology study, 91 patients with high blood lipids were tested before and after an eight week course of Rosuvastatin  (Crestor).  Their blood levels of Vitamin D (25 hydroxy D)  went from 14 to 36 on average, and a number of other measures of Vitamin D improved.  Why?  Well we don’t know, but it could have to do with the breakdown products of the drug and the precursor fitting into the receptors.

Do I recommend asking your doctor for Crestor to build Vitamin D?  No.  There are several formulations of high value D3 on the market, from drops to fast-dissolving dry pills.  They go from a tiny pill with 5000 iu to capsules of 50,000 iu.  If one doesn’t work well to increase your serum (25 Hydroxy D) Vitamin D levels to a level of 50, look at others.  You may build up your dose to a higher level.  And you should consider supplementing your D3 vitamins with even a little midday sun exposure without sunscreen because sunlight energy can’t be reduced to one isolated vitamin.  (Your body will not make too much.)

If all else fails, then I would try taking the Vitamin D with some Red Yeast Rice for a period of up to two months while you load Vitamin D.  Red Yeast Rice has not been studied like the Rosuvastatin so you are experimenting on yourself but chances are good that it will work.  Add extra Co-enzyme Q10 to protect your liver and your muscles.  And when you get your levels up, stop the Red Yeast Rice.