Re: Hanna (information on niacin)

The Real Endpoint:
The real proof of niacin’s heart-healthy powers don’t rest with numbers on your blood test charts, but with real-world, life-and death results. Niacin is also the only true dietary supplement clearly proven to reduce heart attacks, strokes, and actual death rates. This proof was provided in a large trial in which 8341 men who had already suffered a heart attack were assigned to receive one of four different cholesterol drugs, or niacin, or a dummy pill. Three drugs were abandoned early due to their side effects. But niacin proved its heart-protecting powers clearly. Compared to dummy pills, niacin therapy cut the rate of nonfatal heart attacks by 27%, and stroke by 26%, over the course of the trial. And unlike any of the men given the various drugs tested in the study, men taking niacin supplements were 11% less likely to die from any cause compared to the placebo group. The reduction in risk was especially great in people who had the highest cholesterol levels to begin with.

The Stockholm Ischaemic Heart Disease Secondary Prevention Study, the Cholesterol-Lowering Atherosclerosis Study, the Familial Atherosclerosis Treatment Study, and the Harvard Atherosclerosis Reversibility Project further document niacin’s ability, as part of combination therapy, to reduce risk of heart disease, heart attacks, and strokes.

In the last few years, a host of studies have shown that niacin can be combined with statin drugs to improve the safety and overall effects of both. Statins are very effective at lowering total and LDL (“bad”) cholesterol, but have little effect on HDL and triglycerides, and no effect on Lp(a). So the effects of the combination can be very powerful. While we certainly don’t encourage people to rush out and ask their doctor for a statin prescription, people whose physicians want them on a statin may discuss the idea of combining a lower dose of statin with niacin as a way to maximize the benefits of both.

Safe for Diabetics
New research has dispelled an old myth about niacin. For a long time, it was believed that one drawback to the use of this vitamin for cholesterol balance was that it would raise the blood sugar levels of diabetics, thereby worsening their condition. This situation was ironic in the extreme, since diabetics typically have exactly the lipid imbalance combination that most closely match up with niacin’s beneficial properties as a dietary supplement: high LDL, low HDL, and – especially – high triglycerides. But the belief that niacin and diabetes don’t mix was based entirely on a handful of case reports and small-scale, poorly controlled experiments. Recently several large, well-controlled trials have found that niacin does not elevate blood sugar to a clinically significant degree in either diabetics or healthy individuals when administered on a long-term basis (60 weeks).

Guard Against Homocysteine
Some concern has been raised by a recent report, which found that niacin raises homocysteine levels. But in fact, this finding represents yet further proof of niacin’s benefits for heart health, and an opportunity to make them even stronger. That is, since persons taking niacin alone, even with this Hcy-raising effect, still end up with lower rates of both heart attack and death than those not receiving the supplement, it is reasonable to speculate that taking niacin with homocysteine-lowering nutrients may result in even greater reductions in risk. Hcy-lowering nutrients include the vitamins B6, B12, and folic acid, along with trimethylglycine (TMG) – and, to a lesser extent, B2 (riboflavin). Animal studies confirm that B vitamins lower Hcy without inhibiting niacin’s cholesterol-balancing function.

Peripheral Vascular Disease (PVD)

In addition to its ability to keep your arteries clean, IHN has been shown to be a highly effective therapy in the treatment of peripheral vascular diseases, including Raynaud’s syndrome and intermittent claudication. IHN increases blood flow and raised temperature in the hands and feet, while allowing necrotic areas to heal. A typical protocol used in clinical trials would be 4 000 mg per day for 12 weeks.

Of course, niacin – even in the form of IHN – will not help everyone. But given its safety, its orthomolecular status, and its remarkable range of cholesterol-balancing effects, and its proven track record in slashing death rates, it may be the best first choice for most people with concerns about their cholesterol balance.