Niacin: An Unheralded Secret

February 02, 2007

Niacin: An Unheralded Secret.  

Competency # 15 Vitamins                          ReferenceMed Hypotheses. 2007; 69 (1):90-4

There has been a flood of news recently about the fats in our blood and how we have to alter them.  In part, those stories are driven by recent loss of Big Pharma pipeline drugs.  When potential blockbusters go belly up, the stock market talks about it.  And no one ever talks about the cheap stuff.  Niacin is a vitamin that’s generic, cheap, and effective.  This may be something we should all be on? The story is all about the fats in your blood.   We have total cholesterol, that doesn’t really tell us much.  Cholesterol is really split into a couple of different kinds.  The bad kind is called LDLs, or Low-Density Lipoproteins.  They pick up cholesterol and take it out and bury it in our blood vessels.  And there are HDLs, High-Density Lipoproteins.  They are your body’s garbage trucks.  They pick the cholesterol back up out of your vessels and bring it back to your liver.  

The trick is to have a low LDL and a high HDL.  If you can get your LDL below a 100, you are in great shape.  If you can get your HDL above 40, and better yet, in the range of 60, you are in great shape.   You can raise your HDLs with exercise.  And the less saturated fat, less sugar, and fewer transfats you eat, the better your LDLs get.  So, I can change my diet a little.  But I’m already pretty good, well, except when I’m watching CSI, or the Superbowl, or… Since 1975, we’ve known that Niacin reduces the risk of a heart attack AND stroke by some 25% in those who’ve just had a heart attack, or stroke.  That’s an amazing number.  

How come it didn’t catch on?  It’s just a vitamin.  A simple cheap vitamin you can buy over the counter.  Help me with this!  What’s the deal?  If it’s good for you AFTER you’ve had a heart attack, and 50% of us are dying from heart attacks, why isn’t it better for us before the heart attack?  Well, the money was on statins.  We can sell you statins for about $ 100 a month.  They work too, but only a tiny bit.   Not as well as niacin! 

 This is how niacin works.  It’s called B3 and its deficiency disease is called pellagra.  Your liver can make it from the amino acid tryptophan if you have enough tryptophan, but it’s slow.  To get deficient, you really should eat only a pure corn diet, so pellagra is rare.  Very low doses are all that’s needed to prevent pellagra.  But in higher doses, it starts to raise your HDL and lower your LDLs.  You put out less garbage into your blood, and send out more garbage trucks.  Your streets are cleaner.  Doctors prescribe 2000 mg a day in a sustained-release form.  But you can buy 100 mg over the counter. The bad part about niacin is that it has a few side effects.  You can flush and have your skin get all hot and itchy if you start too fast.  But if you start slowly, say with just 100 mg three times a day and build up to 500 mg three times a day, you can lower your LDLs and raise your HDLs dramatically.  For cheap.  Or, you can buy  NMN or Nicotinamide-riboside and get no flushing.   A very few people get into liver trouble.  It’s probably well advised to ask your doctor about it and have one check on your liver to make sure it’s healthy. 

 But 50% of us are sitting out there, with silent quite little plaques building up in our blood vessels.  And we don’t think we’re too bad off until that humbling, terrifying first symptom happens.  Well, the people I’m writing this for (you) are each and every one of you important to me, and I’m sort of interested in your hanging out a little longer. 

 WWW:  What will work for me?  What doesn’t work is my HDL.  Mine is 29.  That’s a lot below 60.   Just got my HDLs measured.  Bummer.  Holly is right.  I need to exercise more.  Hard to do when it’s -8 degrees.  And I’m already pretty good on my diet.  Either I take $ 100 a month of statins, which my doctor says isn’t really all that necessary, yet.   My health insurance deductible kicks in only after I get to about the 10-month mark, before that, I’m paying that bill.  Or, I just get in the habit of a bit of niacin.  I’m starting this week.  Why don’t you join me?  Add a few pills to the morning wad.  It’s probably a good idea.

This column was written by Dr. John E. Whitcomb, MD. Brookfield Longevity, Brookfield, WI. (262-784-5300)