Niacin (July 22, 2014)
Niacin has been used for decades in relation to heart disease to raise HDL and to decrease lipoprotein (a), triglycerides and LDL levels with few problems (and those few are readily reversible). Pretty good for a natural substance, huh? So when I noticed a headline recently which blared that a “new study” establishes that suddenly this B vitamin is actually VERY DANGEROUS, I wondered what the story was.
It seems that there IS indeed a newly published study that found a host of problems in people who took niacin compared to people who took an inactive placebo. However, when you get past the headline and introductory comments and start reading the story itself, you quickly find out that the study was not done with niacin. It was done with a niacin+laropiprant combination. "What the @#*&?! is laropiprant?", you may ask. And well you may. It is a PRESCRIPTION MEDICATION that is meant to reduce the mildly-irritating-but-not-at-all-dangerous flushing that frequently occurs when you first start taking high doses of niacin. Apparently someone thought that this flushing was such a big hairy deal that s/he tried to stop it by combining the niacin with a medication (probably the same person who invented thalidomide for morning sickness) and lo and behold, people start DYING when this happens. Ok. But why is it the fault of the niacin?
A couple of the news stories mentioned that there was an earlier study which found similar problems and "no apparent benefit" to taking the niacin. But when you look at THIS study, you find that the test group again did not receive niacin alone but was taking it with statins. Moreover, the control was also taking statins plus niacin -- what kind of difference did they think they would find, with their test group and their control groups both taking the same stuff?
As I said, niacin is a B vitamin. Using it alone raises good cholesterol and lowers triglycerides and bad cholesterol. Difficulties with its use are well known, and if any of those problems are too distressing to the patient s/he can quit taking it and the problems go away. So this is my suggestion. If you want to try niacin as a cholesterol-lowering medication, take it by itself (under medical supervision like any other medication) and monitor it according to its known rules. If you get annoying side effects, or if it doesn’t do what it's intended to, quit taking it. These two “important” studies don’t say anything about the usefulness of niacin alone.
What I take away from all this is NOT what the medical establishment is taking away. They are saying that using niacin with drugs can cause problems, so people should stop taking niacin. I’m suggesting that if using niacin with drugs can cause problems, that maybe people should stop taking the drugs instead.
Why combine niacin with other medications at all? Well, to try make it easier to take and to lower blood levels of the targeted substances even further, and I certainly don't object to anyone trying to do that safely. But part of the reason has to be that you can't patent niacin alone since it is a substance found in nature but you CAN patent a niacin+prescription combination. That is all well and good, but when this bright moneymaker idea doesn't work I don't see any reason to then blame the niacin for it. Sheesh.
--dr. diane holmes
Copyright © 2014
Niacin has been used for decades in relation to heart disease to raise HDL and to decrease lipoprotein (a), triglycerides and LDL levels with few problems (and those few are readily reversible). Pretty good for a natural substance, huh? So when I noticed a headline recently which blared that a “new study” establishes that suddenly this B vitamin is actually VERY DANGEROUS, I wondered what the story was.
It seems that there IS indeed a newly published study that found a host of problems in people who took niacin compared to people who took an inactive placebo. However, when you get past the headline and introductory comments and start reading the story itself, you quickly find out that the study was not done with niacin. It was done with a niacin+laropiprant combination. "What the @#*&?! is laropiprant?", you may ask. And well you may. It is a PRESCRIPTION MEDICATION that is meant to reduce the mildly-irritating-but-not-at-all-dangerous flushing that frequently occurs when you first start taking high doses of niacin. Apparently someone thought that this flushing was such a big hairy deal that s/he tried to stop it by combining the niacin with a medication (probably the same person who invented thalidomide for morning sickness) and lo and behold, people start DYING when this happens. Ok. But why is it the fault of the niacin?
A couple of the news stories mentioned that there was an earlier study which found similar problems and "no apparent benefit" to taking the niacin. But when you look at THIS study, you find that the test group again did not receive niacin alone but was taking it with statins. Moreover, the control was also taking statins plus niacin -- what kind of difference did they think they would find, with their test group and their control groups both taking the same stuff?
As I said, niacin is a B vitamin. Using it alone raises good cholesterol and lowers triglycerides and bad cholesterol. Difficulties with its use are well known, and if any of those problems are too distressing to the patient s/he can quit taking it and the problems go away. So this is my suggestion. If you want to try niacin as a cholesterol-lowering medication, take it by itself (under medical supervision like any other medication) and monitor it according to its known rules. If you get annoying side effects, or if it doesn’t do what it's intended to, quit taking it. These two “important” studies don’t say anything about the usefulness of niacin alone.
What I take away from all this is NOT what the medical establishment is taking away. They are saying that using niacin with drugs can cause problems, so people should stop taking niacin. I’m suggesting that if using niacin with drugs can cause problems, that maybe people should stop taking the drugs instead.
Why combine niacin with other medications at all? Well, to try make it easier to take and to lower blood levels of the targeted substances even further, and I certainly don't object to anyone trying to do that safely. But part of the reason has to be that you can't patent niacin alone since it is a substance found in nature but you CAN patent a niacin+prescription combination. That is all well and good, but when this bright moneymaker idea doesn't work I don't see any reason to then blame the niacin for it. Sheesh.
--dr. diane holmes
Copyright © 2014