You may have heard about the study published in The New England Journal of Medicine that concluded that niacin is not an effective therapy for managing cholesterol as once thought, and that it can actually do more harm than good. But Dr. Whitaker wants to assure you that this is just another example of the media skewing research results. Let me explain.
Previous Niacin Research
Niacin, or nicotinic acid, is a form of vitamin B3 that has been used to lower cholesterol and triglycerides since the late 1950s, decades before statin drugs came on the market.
The first large placebo-controlled trial of the effects of niacin on cardiovascular disease began in 1966. In this study, more than 8,000 men with a history of heart attack took 3,000 mg of niacin or a placebo daily. After six years, as compared to those taking a placebo, the average total cholesterol of the men taking niacin fell by 10 percent, triglycerides by 26 percent, recurrent heart attacks by 27 percent, and strokes by 26 percent. Although there was no difference in the death rate at that time, in a nine-year follow-up period there were 11 percent fewer deaths among those who took niacin.
Subsequent research found that niacin also raises “good” HDL cholesterol. A low HDL cholesterol level is an independent risk factor for heart disease, while a high level is protective, even if total cholesterol is above normal. In addition, niacin has been shown to favorably affect other blood lipids. It causes a shift away from small, dense LDL cholesterol particles to larger, more buoyant, and less damaging LDL particles. Moreover, it is one of the few proven therapies for lowering lipo-protein(a), another risk factor for cardiovascular disease.
The Latest Niacin Study
So what about the latest niacin study that “disproves” these previous findings and warns about a host of side effects, including gastrointestinal distress, skin problems, and blood sugar concerns?
For starters, the study examined the effects of prescription, extended-release niacin, which is not the same type of niacin used in the previous research. In fact, ever since Dr. Whitaker has been recommending niacin for its cardiovascular benefits Dr. Whitaker has been telling people about these potential side effects associated with extended-release niacin (and also when taking high doses of the regular form)—and, therefore, this type of niacin should be used with caution.
Second, the study participants were also taking statin drugs. The purpose of this study was to determine if extended-release niacin was a good adjunct therapy for people on statins since it has been shown to raise HDL, which is something statins cannot do. As Dr, Whitaker has said many times before, statins are some of the most dangerous drugs on the market because they deplete coenzyme Q10 and are associated with increased risk of memory loss and other cognitive problems, diabetes, heart failure, muscle pain and weakness, and liver damage.
Furthermore, along with the extended-release niacin, participants received another drug (laropiprant) designed to reduce the common, uncomfortable—but harmless—flushing that occurs when taking therapeutic doses of niacin. (Niacin dilates the blood vessels and promotes the release of histamine in the capillaries, resulting in a discomforting warm, tingly, itchy feeling.)
So, in actuality, the side effects the study subjects experienced very well could have been caused by one or both of these other drugs.
Don’t Shy Away From Niacin
The bottom line: niacin has its uses. Most of Dr. Whitaker’s patients see benefits with 1,000–2,000 mg daily. Start with a low dose and build up gradually over the course of a few weeks. Taking it in divided doses with meals reduces flushing. A baby aspirin (81 mg) half an hour before taking niacin and taking it at bedtime are helpful as well. And, as I’ve been saying for years, high-dose niacin is best taken under the supervision of a doctor, and if you have diabetes, gout, or liver problems, you should be especially cautious about taking higher doses. Please see a Doctor to determine what is correct for you.
If you decide niacin isn’t your best option, there are several other ways to naturally manage your cholesterol. They include berberine (500 mg twice a day), red-yeast rice (600–1,200 mg, taken with 100 mg of coenzyme Q10, two times a day), and ¼ cup of freshly ground flaxseed daily. Other measures that can help increase HDL cholesterol are eliminating trans fats, sugars, and starches from your diet and increasing your aerobic exercise. And remember, living a healthy lifestyle and optimizing your nutritional status are far more protective than chasing some arbitrary cholesterol goal.
Now it’s your turn: What do you think about this latest niacin study?