Need help about niacin

juststeveok

New Member
I'm 44 and in good shape. I have good cardio stamina and my weight is good. However, I had a heart attack 2 years ago (I was in even better shape with very little body fat and great strength and endurance) and had 6 stents placed in my coronary arteries. I was on bp medicine (even though it was never high)for a short time and i am still taking plavix. I REFUSE to ever put a statin drug into my body. I've been on niacin 3000mg since my MI. It hasn't really lowered my total cholesterol(which is usually around 215-225, but has lowered ldl 20pts, while raising hdl 20 points. My ldl used to be about 160 and Hdl 35. Now, on niacin, Ldl is 135 and hdl 55. It has also changed the particle size of the ldl from small dense to large, more buoyant ldl. It has also reduced my Lpa into normal ranges. The only negative thing is my liver enzymes are elevated. I hadn't had them checked in a while and last week I did. My alt was 90 and ast was 48. I take regular, instant release niacin 1000mg 3xday. Should I continue and not worry about the liver enzymes, or should I reduce? also, does red yeast rice have the same side effect potential as a statin? Any feedback would be appreciated.
p.s. the allopathic Drs. I see keep wanting me to take a statin if I want to "survive" for more than 7 years.
 
I don't know the answers to your questions,but I'm interested to know what the hypothesized reason for your heart attack was.
Elevated cholesterol is what I gather from your post.Is this correct?
 
Well I will try to answer some of your questions... In regards to your LDL and HDL, your HDL is your "good" cholesterol and the fact that it has gone up 20 points should be considered a good thing. This along with the decrease in your "bad" cholesterol means that something is working. I cant be sure about which one is working, I'm sure there are a number of variables that you have changed in your life which has led to the decrease in your cholesterol. As far as the liver values are concerned I would definately say that it has something to do with the niacin. The timed release or slow release niacins have been linked to liver toxicity and ultimately could be the reason for your high liver values. I would look into maybe taking the fast relaese niacin at a lower dose.. Also I would add some additional supplements into your diet; what I would recommend would be GLA, fish oil, B6, B-complex, and some Choline Phosphatidyl.. These will address the liver issues and attempt to lower the cholesterol a little more. As far as the plavix is concerned, I am definately not an advocate of taking pharmaceutical drugs. But in your situation I could not tell you one way or the other. I hope this helps.. Oh also one more supplement- milk thistle. And ONE more thing... you are spot on to not take the statin pharmacolgy. I my opinion they are doing more harm than good.
 
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Well I'll just give you some info
niacin is good for lowering cholesterol and statins do work very well, but they have some bad consequences and actually current research doesn't really support it either way. Actually the professor in one of my classes who is a cardiologist actually stopped taking statins because of a recent article that I can't find. Either way I'll just cut and paste some of my notes from a class to hopefully help you, but let met just say ldl is an ldl or low density lipoprotein and hdl's are high density. the difference is that hdl's are smaller so they're higher density since they're composed of a coat that's more dense than the containing cholesterol and become ldl's when they're larger. The hdl's scavenge the body for ldl's, when there's tons of hdl's, to help shrink the size.


Lack of fat in diets of rats
Scaly skin, kidney damage, impaired fertility, lived poorly, and died early
Later they gave them some vegetable oil and found out about essential fatty acids

Fatty Acids
? C (then a number) ; (another number) w-(a number) or n-(a number)
? Example C18;0 18 carbons 0 double bonds
? Example: monounsaturated MUFA
? Example: saturated fatty acids SFA
? Example: polyunsaturated PUFA
? Know how to use this so how to draw given something like CX;X w-X
? The number is where the first double bond starts
? i.e. Linoleic acid C18:2(w-6) the w-6 means it starts at the 6 position
? Know alpha-linolenic acid C18:3(w-3) aka omega 3 aka ALA
? Chains
Long chain >11 carbons
Medium chain 6-10 carbons
Short chain <6 carbons
The shorter the chain or more saturation, the lower the melting point
Animal fat: more saturated and so solid at room temp
Vegetable oil: more polyunsaturated fats and is liquid at room temp
? Metabolism
Triglycerides>(lipases)> fatty acids & glycerol
Fatty acid goes into cytosol and goes into mitochondria for fatty acid oxidation which requires carnitine (shoves it through membrane of mitochondria)
Broken down by beta oxidation which requires vitamin B2 (flavin)
? Introduces a double bond - dehydrogenation with B2 aka FAD
? Hydration with water which adds a hydroxyl group basically
? Oxidize it with NAD+ to a ketone NAD+ is niacin vitamin B3
? Thiolysis (using SCoA) so you have acetyl CoA
? Acetyl CoA goes to TCA cycle
? Synthesis
Occurs in the cytosol 2 carbons at a time
It usually finishes with palmitic acid C16:0 then it's ready to be modified
The cell uses enlongases and desaturases to change up the fatty acids ready for the body to use
Linoleic Acid C18:2(w-6) omega 6 fatty acid aka LA
We can't make double bonds in the fatty acids before alpha 9 carbon so if we need it, we have to eat it. Thus they are essential fatty acids
? Omega fats
Omega 6 is common in seed vegetable oils
Omega 3 has high concentration in plant leaves, which we don't make oil out of, and not common in seed oil except flax seed oil, hemp seed, walnut, canol
Hemp seed oil is 3:1 omega 3 to omega 6 which is ideal for health
Omega 6 - linoleic acid - makes arachidonic acid C20:4(w-6)
Omega 3 - alpha-linolenic acid - goes to EPA, C20:5(w-3), then further converted to DHA C22:6(w-3) which are precursors to eicosanoids (prostaglandins) which are key signaling molecules in our bodies.
Eicosanoids - do pain inflamation, digestion, etc etc
Arachidonic acids (from w-6) uses cyclooxygenases (COX) and LOX
? COX inhibitors, NSAIDS, block the formation of these
Group 2: AA (w-6) promote inflammation and blood clotting. Too much can causes hardening of arteries and such
Group 3: are competitive inhibitors of group 2. Dampen inflammation and thin blood. Beneficial for cardiovascular diseases. Too much leads to hemorrhagic strokes. You need some coagulation to control bleeding, or whatever which causes the strokes.
Thus eating omega-3 will lessen cancer, cardiovascular diseases, arthritis, etc.
W-3 tend to inhibit W-6's conversion and vice versa
DHA - found in the retina and the brain and is the last lipids the body will let go of. Good for heart function, brain function, and eye sight. It slows memory loss and increase I.Q. (6 points higher on average) Also linked with better social behavior. This was done in pregnant mothers for 15 years.
Ratio of w-6 to w-3 has decreased significantly over the years (w-6:w-3)
? Pre-ag times: about 1:1
? Currently: 10-15:1
? Recommended is like 2-3:1
? The more double bonds the more unstable so manufactures try to eliminate it (more prone to becoming rancid)
Conversion of w-3 to EPA and DHA is really inefficient
? Seafood is a good source of EPA and DHA hence seafood diets
Omega-3 in fish
? Problems with fish
Mercury, pollutants
The highest pollutants are the ones at the highest level of the food chains
High levels found in swordfish, shark,
Highest levels of omega-3 (don't need to know, just nice to have)
? Atlamtic salmon
1.8
? Anchovy
1.7
? Sardines
1.4
? Rainbow trout
1.0
? Coho salmon
.9
? Bluefish
.8
? Striped bass
.8
? Tuna, white, canned
.7
? Halibut
.4
? Catfish, channel
.2

Niacin
Know it's structure it's NAD(P)+ and NAD(P)H
It's a pyridine derivative
Deficiencies- pellegra (skin was broken), dementia, dermatitis, diarrhea
Takes 50-60 days
Lime (CaOH) is needed to make niacin available from corn since it's normally bound by protein
Main food sources in the south: corn, salted pork, black-eyed peas.
Niacin was unavailable in the corn, the salted pork was mostly fat, and the black-eyed peas had low niacin. (many people died from this).
More modern usage is to treat atherosclerosis at high levels of 1.5-2.0 g/day
This raises HDL and lowers LDL
Side affects include flushing, G.I. problems, and liver damage
normally RDA is 14-19 mg/day and UL 35 mg/day

have fun.
doctors are usually correct though, but do make mistakes
(I'm currently a med student)
hope this helps
 
Well I'll just give you some info
niacin is good for lowering cholesterol and statins do work very well, but they have some bad consequences and actually current research doesn't really support it either way. Actually the professor in one of my classes who is a cardiologist actually stopped taking statins because of a recent article that I can't find. Either way I'll just cut and paste some of my notes from a class to hopefully help you, but let met just say ldl is an ldl or low density lipoprotein and hdl's are high density. the difference is that hdl's are smaller so they're higher density since they're composed of a coat that's more dense than the containing cholesterol and become ldl's when they're larger. The hdl's scavenge the body for ldl's, when there's tons of hdl's, to help shrink the size.


Lack of fat in diets of rats
Scaly skin, kidney damage, impaired fertility, lived poorly, and died early
Later they gave them some vegetable oil and found out about essential fatty acids

Fatty Acids
? C (then a number) ; (another number) w-(a number) or n-(a number)
? Example C18;0 18 carbons 0 double bonds
? Example: monounsaturated MUFA
? Example: saturated fatty acids SFA
? Example: polyunsaturated PUFA
? Know how to use this so how to draw given something like CX;X w-X
? The number is where the first double bond starts
? i.e. Linoleic acid C18:2(w-6) the w-6 means it starts at the 6 position
? Know alpha-linolenic acid C18:3(w-3) aka omega 3 aka ALA
? Chains
Long chain >11 carbons
Medium chain 6-10 carbons
Short chain <6 carbons
The shorter the chain or more saturation, the lower the melting point
Animal fat: more saturated and so solid at room temp
Vegetable oil: more polyunsaturated fats and is liquid at room temp
? Metabolism
Triglycerides>(lipases)> fatty acids & glycerol
Fatty acid goes into cytosol and goes into mitochondria for fatty acid oxidation which requires carnitine (shoves it through membrane of mitochondria)
Broken down by beta oxidation which requires vitamin B2 (flavin)
? Introduces a double bond - dehydrogenation with B2 aka FAD
? Hydration with water which adds a hydroxyl group basically
? Oxidize it with NAD+ to a ketone NAD+ is niacin vitamin B3
? Thiolysis (using SCoA) so you have acetyl CoA
? Acetyl CoA goes to TCA cycle
? Synthesis
Occurs in the cytosol 2 carbons at a time
It usually finishes with palmitic acid C16:0 then it's ready to be modified
The cell uses enlongases and desaturases to change up the fatty acids ready for the body to use
Linoleic Acid C18:2(w-6) omega 6 fatty acid aka LA
We can't make double bonds in the fatty acids before alpha 9 carbon so if we need it, we have to eat it. Thus they are essential fatty acids
? Omega fats
Omega 6 is common in seed vegetable oils
Omega 3 has high concentration in plant leaves, which we don't make oil out of, and not common in seed oil except flax seed oil, hemp seed, walnut, canol
Hemp seed oil is 3:1 omega 3 to omega 6 which is ideal for health
Omega 6 - linoleic acid - makes arachidonic acid C20:4(w-6)
Omega 3 - alpha-linolenic acid - goes to EPA, C20:5(w-3), then further converted to DHA C22:6(w-3) which are precursors to eicosanoids (prostaglandins) which are key signaling molecules in our bodies.
Eicosanoids - do pain inflamation, digestion, etc etc
Arachidonic acids (from w-6) uses cyclooxygenases (COX) and LOX
? COX inhibitors, NSAIDS, block the formation of these
Group 2: AA (w-6) promote inflammation and blood clotting. Too much can causes hardening of arteries and such
Group 3: are competitive inhibitors of group 2. Dampen inflammation and thin blood. Beneficial for cardiovascular diseases. Too much leads to hemorrhagic strokes. You need some coagulation to control bleeding, or whatever which causes the strokes.
Thus eating omega-3 will lessen cancer, cardiovascular diseases, arthritis, etc.
W-3 tend to inhibit W-6's conversion and vice versa
DHA - found in the retina and the brain and is the last lipids the body will let go of. Good for heart function, brain function, and eye sight. It slows memory loss and increase I.Q. (6 points higher on average) Also linked with better social behavior. This was done in pregnant mothers for 15 years.
Ratio of w-6 to w-3 has decreased significantly over the years (w-6:w-3)
? Pre-ag times: about 1:1
? Currently: 10-15:1
? Recommended is like 2-3:1
? The more double bonds the more unstable so manufactures try to eliminate it (more prone to becoming rancid)
Conversion of w-3 to EPA and DHA is really inefficient
? Seafood is a good source of EPA and DHA hence seafood diets
Omega-3 in fish
? Problems with fish
Mercury, pollutants
The highest pollutants are the ones at the highest level of the food chains
High levels found in swordfish, shark,
Highest levels of omega-3 (don't need to know, just nice to have)
? Atlamtic salmon
1.8
? Anchovy
1.7
? Sardines
1.4
? Rainbow trout
1.0
? Coho salmon
.9
? Bluefish
.8
? Striped bass
.8
? Tuna, white, canned
.7
? Halibut
.4
? Catfish, channel
.2

Niacin
Know it's structure it's NAD(P)+ and NAD(P)H
It's a pyridine derivative
Deficiencies- pellegra (skin was broken), dementia, dermatitis, diarrhea
Takes 50-60 days
Lime (CaOH) is needed to make niacin available from corn since it's normally bound by protein
Main food sources in the south: corn, salted pork, black-eyed peas.
Niacin was unavailable in the corn, the salted pork was mostly fat, and the black-eyed peas had low niacin. (many people died from this).
More modern usage is to treat atherosclerosis at high levels of 1.5-2.0 g/day
This raises HDL and lowers LDL
Side affects include flushing, G.I. problems, and liver damage
normally RDA is 14-19 mg/day and UL 35 mg/day

have fun.
doctors are usually correct though, but do make mistakes
(I'm currently a med student)
hope this helps

Your class is wrong... currently in the literature it is speculated that the omega 6:omega 3 ratio is near 30:1. Are you taking nutrition class? Only reason I am asking is because I have to sit through the same classes... Dont worry it will get easier.
 
I'm 44 and in good shape. I have good cardio stamina and my weight is good. However, I had a heart attack 2 years ago (I was in even better shape with very little body fat and great strength and endurance) and had 6 stents placed in my coronary arteries. I was on bp medicine (even though it was never high)for a short time and i am still taking plavix. I REFUSE to ever put a statin drug into my body. I've been on niacin 3000mg since my MI. It hasn't really lowered my total cholesterol(which is usually around 215-225, but has lowered ldl 20pts, while raising hdl 20 points. My ldl used to be about 160 and Hdl 35. Now, on niacin, Ldl is 135 and hdl 55. It has also changed the particle size of the ldl from small dense to large, more buoyant ldl. It has also reduced my Lpa into normal ranges. The only negative thing is my liver enzymes are elevated. I hadn't had them checked in a while and last week I did. My alt was 90 and ast was 48. I take regular, instant release niacin 1000mg 3xday. Should I continue and not worry about the liver enzymes, or should I reduce? also, does red yeast rice have the same side effect potential as a statin? Any feedback would be appreciated.
p.s. the allopathic Drs. I see keep wanting me to take a statin if I want to "survive" for more than 7 years.

You are an idiot. Everything has a price. Whatever damage statins might do is greatly outweighed by the benefits. You should do everything possible to get your ldl as low as possible and hdl as high as possible. I has a stroke 5 years ago and spent a lot of time studying this during my recovery.
Crestor- start with 20mg/d
niacin slow release- 1000mg 2x/d with meals
gemfiprozil 600mg 2x/d
the three above work together to lower ldl and triglycerides and raise hdl.
my ldl=80
hdl=65
Zetia will lower dietary cholesterol by as nuch as 20%. You might add it too.

plavix 1/d forever
if your BP is high- control it
aerobic exercise if you can
dont smoke
eat sensibly. dont pig out and avoid lots of sugar. It readily metabolizes to triglycerides and then to ldl.
your ldl is way too high. In cases like yours ldl needs to be <100.
 
I'm 44 and in good shape. I have good cardio stamina and my weight is good. However, I had a heart attack 2 years ago (I was in even better shape with very little body fat and great strength and endurance) and had 6 stents placed in my coronary arteries. I was on bp medicine (even though it was never high)for a short time and i am still taking plavix. I REFUSE to ever put a statin drug into my body. I've been on niacin 3000mg since my MI. It hasn't really lowered my total cholesterol(which is usually around 215-225, but has lowered ldl 20pts, while raising hdl 20 points. My ldl used to be about 160 and Hdl 35. Now, on niacin, Ldl is 135 and hdl 55. It has also changed the particle size of the ldl from small dense to large, more buoyant ldl. It has also reduced my Lpa into normal ranges. The only negative thing is my liver enzymes are elevated. I hadn't had them checked in a while and last week I did. My alt was 90 and ast was 48. I take regular, instant release niacin 1000mg 3xday. Should I continue and not worry about the liver enzymes, or should I reduce? also, does red yeast rice have the same side effect potential as a statin? Any feedback would be appreciated.
p.s. the allopathic Drs. I see keep wanting me to take a statin if I want to "survive" for more than 7 years.

It sounds to me that benefits of what you are doing out weight the danger. I am particularly interested in the change in particle size of the ldl from small denise to the more bouyant ldl. That is awesome. Do you artibute that change in density to the NIacin only? I have read the dense particle ldl was the only true risk factor. If the ldl is bouyant then higher cholesterol is acceptable. I supplement Nician because it is suppose to help regulate blood sugar. Read Good Calorie Bad Calorie by Gary Taubes
 
It sounds to me that benefits of what you are doing out weight the danger. I am particularly interested in the change in particle size of the ldl from small denise to the more bouyant ldl. That is awesome. Do you artibute that change in density to the NIacin only? I have read the dense particle ldl was the only true risk factor. If the ldl is bouyant then higher cholesterol is acceptable. I supplement Nician because it is suppose to help regulate blood sugar. Read Good Calorie Bad Calorie by Gary Taubes


The problem with LDL is that it has a long half life in the bloodstream and that it is susceptable to damage from circulating free-radicles and toxins. When it becomes damaged. circulating macrophages no longer recognise and ignore it. The macrophages gourge themselves on the damaged LDL and assume a light, fluffy appearance and are known as foam cells. Foam cells have an affinity for the endotheilal lining of artery walls- especially so if there already exists an abnormality such as a roughness in the arterial lining, and congregate in masses in the artery.
Statins work by inhibiting the HMGcoA enzyme which is involved in the body`s cholesterol sensing mechanism and causing an increase in the number of LDL receptors. Now the LDL molecules have more places to dock and so the blood level is reduced.
 
The research on statins does not support their use. The advertsing has it in the small print. They reduce cardiovascular events by 36%. Sounds good but that means they treat 100 people with statins and instead of three events with statins there are only two events. What the statistics really say is that you need to treat 100 people for one to benefit while risking side effects like muscle pain, depression, dementia etc. The important number is NNT number needed to treat ( for one to benefit). For statins that is 100. Effective drugs should be no higher than 50 and preferably lower, one would be ideal. This is all from MDs who know how to interpret statistics that the drug companies misrepresent.
Other things would lower cholesterol, each a little bit. Like cayenne, ginger, garlic., CoQ10, flax seed (not oil), fish oil Etc. The Rx niacin is Niaspan and it has fewest side effects. You need to look at other factors also like CRP for inflammation, homocysteine, Triglyceride:HDL ratio (best under two), LDL:HDL (good under 5 best under two), heavy metal burden etc.. Vitamin C and lysine will reduce LpA
 
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