For the past several decades, cholesterol has been the major focus of efforts to combat heart disease. The emphasis has been on happinesslifetime.com low cholesterol diets and potent anti-cholesterol drugs, despite intrinsic adverse side effects and significant risks.
It was believed that elevated cholesterol was the main reason for arterial plaque formation, otherwise called atherosclerosis. And it has been accepted that atheromatous plaque reduces blood flow through affected arteries, resulting in strokes, heart attacks and PAD (peripheral artery disease)-which are all manifestations of the same disease, just affecting different end organs.
But there is a single vitamin that can rapidly lower your cholesterol level. And compared with the cost of one of the statin drugs, like Lipitor, or Crestor, it costs only pennies. This wonder vitamin is Vitamin B-3, otherwise called niacin, or nicotinic acid.
Niacin tends to lower cholesterol levels rapidly and significantly. It is, without question, the champion of natural cholesterol combating compounds. Three grams (3000mg) a day of standard niacin can lower your total cholesterol levels by 25% within two weeks!
But, this comes at a price: niacin causes a very pronounced "flush," an erythema of the skin that looks like a sunburn and lasts for about 20-30 minutes. This is accompanied by a tingling or burning sensation. Both the characteristic flush and the tingling sensation are products of histamine release, a chemical that mediates inflammation in the body and the same substance that causes your nose to fill up and run, when you have allergies, or a cold.
Personally, I always liked this flush, because I could feel it and see it, knew it was working and I could visualize it cleaning out my arteries. But some people are frightened. The first time they feel it, they're afraid they're having a stroke.
Because of this niacin flush, you can't just start taking niacin in these mega doses, right away. You have to start with a much lower dose and gradually build up your tolerance to the higher doses. Some people never learn to tolerate this side effect.
Fortunately, there are alternatives to standard niacin. You can take a flush-free form of niacin (inositol hexanicotinate), or do what I've found works best for me: a sustained release form of niacin.
The sustained release formulation minimizes the flush, so it's no longer a problem. You can enjoy the benefits, but avoid (or at least minimize) that annoying, problematic flush.
However, if you use a sustained release form, never take more than two grams a day, even if you found that you could tolerate up to three grams of standard, short acting niacin. Exceeding this two gram limit (three grams, with standard niacin) can result in a chemical hepatitis and liver damage.
If you are already on a prescription statin drug, do not take niacin on your own, without the consent of your doctor. This is extremely important.
Although it can boost the LDL and total cholesterol lowering and HDL raising effects of those drugs, it can also increase the risk of very serious adverse effects, like muscle aches and cramps, and even worse, muscle lysis (muscle cell dissolution-called "rhabdomyolysis"). This complication can be life threatening because muscle lysis releases a pigment from the cells, called myoglobin, into the blood stream, which clogs up and damages the kidneys, causing potentially fatal renal failure.
This is also a risk if you take another natural cholesterol lowering compound, called red yeast rice, which works by the very same pathway, blocking the same cholesterol synthesizing enzyme as the prescription medications.
If you are new to niacin, you can start with 100mg, once a day, from a drug store brand of standard niacin. Despite the low dose, you will feel the characteristic flush. With time, the sensation and the actual flush become less pronounced.
Each week, increase the dose by another 100mg, as tolerated, until you can approach the maximum dose of 3000mg a day (in divided doses, like 1000mg three times a day). The gradual increase helps you to accommodate to the niacin flush.
If you start with a sustained release form, begin with a single 500mg capsule, or tablet, just once a day (do not chew or break the capsule or tablet, which would defeat the time release mechanism, releasing all the niacin at once). In a week or so, add another dose in the evening, so you're taking one 500mg dose, twice a day. In another week or so, add another 500mg dose in the morning. Eventually, you should be able to tolerate the full dose of two caps/tabs (1000mg) twice a day. Remember that with a sustained, or time release formula, you must NEVER exceed 2000mg in a day.
It's a good idea to get a baseline blood level of your cholesterol levels, called a lipid profile, before you begin using niacin. You should also get your liver functions checked at the same time and repeat these every 3-4 months, while using niacin, to be sure it is not causing any liver damage (which would show up as an elevation of liver enzymes, called transaminases). Just ask your doctor, who should be suggesting this kind of testing anyway.
After you've been on niacin at the maximal dose for at least a month, check your cholesterol levels again. I think you'll be very pleasantly surprised: your total cholesterol and your LDL ("bad" cholesterol) will be much lower and your HDL ("good" cholesterol) will be significantly higher. Not bad for a mere "vitamin."
Of course, for best results, you might want to invest in a pharmaceutical grade niacin, or get the prescription form (Nicobid, or Niaspan), if you have a prescription option with your health insurance. These forms are more expensive, but they are more likely to be pure, devoid of contaminants and be certified for consistent levels of niacin in each capsule or tablet.
Just remember, start with a low dose, advance slowly and ask your doctor to monitor your progress, with periodic lab tests. If you do this correctly, you will help to keep your cholesterol levels lower, despite your diet, and reduce your risk of atherosclerosis and all its attendant diseases.
Dr. Bill is the on-line handle for William Thomas Stillwell, MD, FACS, FICS, FAAOS, FAANAOS, FAAPGS, board certified orthopaedic specialist, Chairman Emeritus, Department of Orthopaedic Surgery, St. Catherine of Siena Medical Center, Smithtown, NY and formerly Associate Professor of Clinical Orthopaedic Surgery, SUNY at Stony Brook, NY; currently President & CEO of Dr. Bill's Clinic, Inc. and author of DR. BILL'S LITTLE GREEN BOOK FOR ELIMINATING KNEE PAIN, DR. BILL'S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN and HOW TO AVOID KNEE SURGERY. For a FREE report: SECRETS TO RELIEVING KNEE PAIN, go to drbillsclinic.com drbillsclinic.com/. He is also Medical Director of Dr. Bill's Favorite Formulas, Inc., a source for pharmaceutical grade fish oil and other premium quality supplements favoriteformulas.com favoriteformulas.com/.
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