Apparently I need to quit the Niacin today!

[timo2]

I've had two different cardiologists over 5 years prescribe Niacin. Looks bad for that prescription.

Niacin doesn't help heart, may cause harm, study says

 

[grasshopper]

My neighbor is a retired Cardiothoracic Surgeon when ever I ask him about me taking red rice yeast, he always says, try niacin which he uses. The next time I see him I will ask.

 

[imoldernu]

Side effects vary.
After 3 months of going to the pool and beach, skin had tanned nicely. Taking the niacin turned this into an itchy red mess, after three days. Tummy wasn't too happy, either. Back to the Lipitor, until the muscle aches became too much to deal with. This, many years ago, before Lipitor ever had any known side effects. Ended up with Tricor, generic (Phenophedrine), with excellent results... Cholesterol and Triglycerides.

Looks to me, that most drugs that work, come after trial and error. This is definitely true for heart and epileptic and mental health drugs.

One size does not fit all, evidence the 45 second disclaimer in the one minute commercial for popular Pharma drugs.

Every suggestion that our DD (Dear Doctor) has ever made, has been prefaced with the word "try" for "(X) days"... with a nurse follow up call on the target date.

DW is on third part of 6 month trials for Prolia, with good results as far as we can see. (Thank you Amgen). Fifteen years ago, would never even consider this.

As before... this asperin-only younger person has morphed into a cautious but humble old patient who learned to appreciate advances in medicine.

 

[gerrym51]

every 5 years or so a new study of something says the opposite of what the last study said.

 

[ls99]

Would have been useful if author provided a link to the at least the abstract of the study. Maybe discussed the dosage and type ie. Niacin on Niaspan. There are differences in effects and sideffects of the two. As is the article is useless, except for hype purposes.

 

[Khufu]

Would have been useful if author provided a link to the at least the abstract of the study. Maybe discussed the dosage and type ie. Niacin on Niaspan. There are differences in effects and sideffects of the two. As is the article is useless, except for hype purposes.

The niacin formulation was a new drug called Tredaptive which is said to combine nicotinic acid with iaropripan, a drug to decrease the flushing effect. Previously, flush-free versions of niacin, such as inositol hexnicotinate have had mixed results at best at modifying lipid levels. Is this Tredaptive therefore similar to inositol hexanicotinate? Since Merck would not be able to patent niacin without some additive to make it unique is the effect due to the additive?

There have been many earlier studies that showed positive effects from niacin including reduced mortality. I will continue taking niacin and watch to see if the results from this test are corroborated.

 

[ls99]

The niacin formulation was a new drug called Tredaptive which is said to combine nicotinic acid with iaropripan, a drug to decrease the flushing effect. Previously, flush-free versions of niacin, such as inositol hexnicotinate have had mixed results at best at modifying lipid levels. Is this Tredaptive therefore similar to inositol hexanicotinate? Since Merck would not be able to patent niacin without some additive to make it unique is the effect due to the additive?

There have been many earlier studies that showed positive effects from niacin including reduced mortality. I will continue taking niacin and watch to see if the results from this test are corroborated.

Thanks for the details. I find it maximally asinine when a media article appears and bad mouths some item, yet fails to disclose the compounding with other stuff. Then claims damaging quality of the base item. I think that sort of "journalism" borders on criminal.

At this point i am not even interested in reading the abstract of the study.

 

[rbmrtn]

There was one back in 2011 that also reported something similar

http://www.nytimes.com/2011/05/27/health/policy/27heart.html?_r=0

And then a rebuttal

Niacin and Cholesterol -- Heart Health Newsletter

It seems niacin is doing exactly what it is supposed to do, alter the lipid profile. what may be questioned is cholesterol really understood.

 

[timo2]

I emailed a nurse practitioner at my cardiologists office about this, and below is her response, which I am quite happy with because it shows cognizance of the issues I'm concerned with.

"Hi Tim,

In general we usually feel the niacin has far greater benefit than risk. The recent studies have muddied the water a bit. However we have historical data to show benefits of niacin on improving your cholesterol - lowering LDL (bad cholesterol) and triglycerides, increasing HDL and making the cholesterol you have less likely to contribute to plaque build up. Also, niacin usually only effects the blood sugar when you first start taking it or increae the dose, especially with the immediate release formulations. Also looking back, your fasting blood sugar has not been in the diabetes range (126 or higher) and for anyone weight loss and exercise are the best ways to improve your blood sugar when its in the pre-diabetes range (100-125).

That being said, the more recent studies, like the one discussed in this article, focus more on evaluating niacin for improving HDL and so far increasing HDL with medications hasn't shown a significant improvement in outcomes (i.e. decrease in cardiovascular events like heart attacks and stroke or cardiovascular death). Also, the article you reference was evaluating a new combination medication with niacin and another medication used to reduce flushing so it is unclear if the side effects they found were related to the niacin or the other new medication. However, I think historically you have been taking niacin mostly for HDL, and it is unclear if this offers you additional benefit ,so if you want to try stopping it just let me know and we can monitor your lipids more closely."

 

[Felix Mulier]

The niacin formulation was a new drug called Tredaptive which is said to combine nicotinic acid with iaropripan, a drug to decrease the flushing effect... I will continue taking niacin and watch to see if the results from this test are corroborated.

I take 250mg of niacin (specifically, nicotinic acid) at bedtime. About 30 minutes beforehand, I take 1000mg of vitamin C. It controls flushing just fine (and it's really cheap!) I also take NAC (N-acetylcycsteine) to protect my liver (it's what they give people who od on tylenol).

My DD checks my liver every 6 months and I've been fine so far. So, +1 on sticking with the niacin. I won't go back to statins.

 

[Khufu]

Thanks for the details. I find it maximally asinine when a media article appears and bad mouths some item, yet fails to disclose the compounding with other stuff. Then claims damaging quality of the base item. I think that sort of "journalism" borders on criminal.

At this point i am not even interested in reading the abstract of the study.

Here are some more details. Lorapiprant, the additive in Tredaptive which is used to control the flushing (and enable patenting since niacin alone can't be patented) has apparently never been independently tested for safety and effectiveness, only in the study cited. So, it's possible that the results are due to the additive. Other flushing-free formulations of niacin, such as inositol hexanicotinate, have shown little effect on modifying lipids.

It's true that the media generally jumps to the wrong conclusions. The more disappointing part is that doctors will, too.

 

[Felix Mulier]

Just came across the MedWatch February 2013 Safety Labeling Changes posting which includes one for Niaspan.

Not taking this any more, so didn't read the Niaspan details - you can check it out here:
http://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm342027.htm
The following drugs had modifications to the CONTRAINDICATIONS, WARNINGS and PRECAUTIONS sections.

 

[Stanley]

Here is a comment on the niacin plus a drug pill that has been sold and now is pulled from the market.

Cholesterol-modifying drug that does more harm than good is withdrawn from sale | Dr Briffa's Blog - A Good Look at Good Health