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Ageless Forever Anti-Aging News Blog

The “good” HDL cholesterol under attack! - Defending Niacin, aka vitamin B3

Niacin confers tremendous beneficial effects on both lipids, inflammation and endothelial function. For more, see my previous article:
 
 
 
Despite this, two media attention grabbing studies - AIM-HIGH and HPS2-THRIVE - did not find any benefits of niacin supplementation in heart disease patients who were already on intensive statin treatment. 
 
Here I will summarize these studies and expose their multiple flaws, which never made it to the headlines...
 
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Niacin, aka vitamin B3 – what you need to know about potential side effects

In previous articles I have talked about the multiple beneficial effects of niacin supplementation – on both lipids (blood fats and cholesterol) and non-lipid outcomes.
 
While flushing is often reported to be the main side-effect of niacin supplementation, the flush is a natural reaction to high-dose niacin, and is not dangerous. Thus, while some people may find it uncomfortable, it is not a harmful side-effect. For more on that, see “Niacin - How to Beat the Flush
 
Other, potentially harmful side effects, are liver strain/damage, insulin resistance and blood glucose elevations, and uric acid elevations.[1] Here I will summarize what research shows on the severity of these side effects, and whether it is something you should worry about… 
 
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Niacin - How to Beat the Flush

In a previous articles I covered the tremendous health benefits of niacin supplementation, mediated via both lipid (cholesterol and blood fat) and non-lipid mechanisms, and what you need to know about niacin products:
 
Here I will explain what the notorious niacin flush is all about, and give you hands-on practical tips on how to beat it.
 
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Niacin Supplements - what you need to know about niacin products

In a previous article I presented the wide array of health benefit of niacin – a.k.a vitamin B3 – supplementation, related to both its lipid and non-lipid effects "Niacin – a.k.a vitamin B3 – the Neglected Broad Spectrum Cholesterol Drug! "
 
In this article you will get critical information about the different niacin products and names, and what to look for when shopping niacin supplements…
 
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Niacin - vitamin B3 - elevates HDL levels (the "good" cholesterol) more than popular medications

Low HDL-C levels are an independent risk factor for development of coronary heart disease (CHD).[1] At all levels of total cholesterol, HDL-C shows a strong inverse association with incidence of CHD. Every 1 mg/dl increase in HDL is associated with a 2-3% decrease cardiovascular risk.[1]

Among men and women aged 49-82 years, who were free of CHD at baseline, after a follow up of 12 yr, the participants with high HDL-C levels (over 60 mg/dL) had half the risk of cardiovascular events compared with participants with low HDL-C levels (below 40 mg/dL).[2] Another large study of 4,500 subjects aged 16-65 years, found after a follow-up of 6 years that individuals with HDL-C levels below <35 mg/dl were at 4 times higher heart disease risk than those with HDL-C levels over 35 mg/dl.[3]

The prevalence of low HDL levels in apparently healthy US adults is 35% in men (defined as below 40 mg/dL or 1.03 mmol/) and 39% of women (below 50 mg/dL or 1.29 mmol/L).[4] Among patients with established cardiovascular disease, 20% to 60% have low HDL levels.[5-7] Furthermore, low HDL levels are part of the criteria for the metabolic syndrome [8] and are highly prevalent among patients with diabetes, affecting more than 50% of men and 66% of women who are diabetic.[9, 10]

Statins are the most commonly used medications for heart disease. However, while statin is the most effective medication to reduce LDL (the "bad" cholesterol) levels, there remains an unacceptably high residual risk in patients who have been on statin treatment. Even after intensive statin treatment that has achieved very low LDL levels, morbidity and mortality rates among statin-treated patients still remain approximately two thirds to three quarters of those found in patients who were getting placebo.[11, 12] This large residual risk clearly indicates that LDL only modestly impacts atherosclerosis at best. Therefore, medical research is investigating HDL elevating treatments with the aim to reduce residual risk, and prevent development of cardiovascular diesase in the first place.

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