The safest, most effective, and cheapest treatment for high
cholesterol is a vitamin that costs 7 cents per pill, according to a new report
from Orthomolecular Medicine News Service (OMNS), a nonprofit research group in
Wichita, Kansas.
Vitamin B3—also called niacin or nicotinic acid—has been
safely used for 60 years to control cholesterol, with some 42,000 scientific
papers in PubMed describing its benefits and effects.
“Unlike statin drugs, which mainly reduce LDL cholesterol,
niacin is a very safe, effective treatment for
all lipid issues, improving levels of both good and bad cholesterol
and triglycerides, ” says
Bradley
Bale, MD, medical director of the Heart Health Program for Grace Clinic in
Lubbock, Texas.
One landmark study published in
Journal of the American
College of Cardiology found that at therapeutic doses, niacin boosted HDL
by up to 35 percent and cut triglycerides by as much as 50 percent.
Most remarkably, when the researchers tracked the 8,431
participants—all of whom had suffered heart attacks prior to enrolling in the
study—for 15 years, those on niacin had a 26 percent lower risk for both heart
attacks and strokes, even after treatment was discontinued, compared to those taking
a placebo.
Highly Effective, But
Often Overlooked
Despite some 42,000 scientific papers in PubMed describing niacin’s
effectiveness and medical uses, it’s remained the ugly duckling of heart
medicines, for a variety of reasons.
“The simple answer
is to follow the money,” contends OMNS. “Cholesterol-controlling drugs [such as
statins] are cash cows for the trillion-dollar-per-year pharmaceutical
industry,” while there’s no marketing push to persuade medical providers to
recommend a cheap, OTC remedy like niacin.
In his practice,
Dr. Bale typically recommends niacin for the following patients, if medically
appropriate:
- People
with high cholesterol who can’t tolerate statin drugs. About 20 percent of
statin users quit taking their medication due to side effects.
- Patients
with complex lipid issues, such as low levels of heart-protective HDL (good)
cholesterol and high triglycerides (a type of blood fat).
- People
with inherited cholesterol disorders, such as elevated levels of lipoprotein
(a), a type of cholesterol that triples heart attack risk and does not respond
to statins. Taking niacin can reduce lipoprotein (a) levels by up to 40
percent, according to the European Atherosclerosis Society.
- Patients
whose cholesterol problems aren’t responding to statins. Several studies show
that statins plus niacin is more effective than statins alone.
A Guide to Cholesterol-Free Foods
Side Effects of Niacin
In doses typically
used to control cholesterol the vitamin can have an annoying side effect known
as “the niacin flush,” a temporary and sometimes itchy or tingling redness of
the skin that lasts about 30 to 60 minutes.
“Doctors know that
if they advise niacin, they get calls from patients complaining about flushing,
particularly at first,” says Dr. Bale. “However, this problem is harmless and
can often be avoided by starting with a low dose that’s gradually increased.”
Patients who experience flushing initially will typically find that the problem
disappears or greatly diminishes over time.
While “non-flush” and
extended-release forms of niacin are available, they appear to be less
effective or may even have dangerous side effects, Dr. Bale adds. “There are
two pathways through which the body can metabolize niacin, and the one that
doesn’t cause flushing is more likely to harm the liver.”
Dr. Bale advises
avoiding non-flush or extended-release formulations. In addition, niacin should
only be used under the supervision of a healthcare provider, after a full
discussion of the potential risks and benefits.
Like statins,
niacin can cause muscle problems in some patients. It can also spark flare-ups
in people with gout, and may contribute to GI bleeding in patients with ulcers,
cautions Dr. Bale. “Any cholesterol treatment can cause side effects, but
compared to statins, niacin is relatively safe.”
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A Controversial Niacin
Study
In March, results of a highly publicized study of Tredaptive, an experimental drug containing extended-release
niacin plus an anti-flushing drug called laropiprant, were interpreted by the
media as showing that niacin may have dangerous side effects.
In the study, 25,673
patients who were already being treated with statins were randomly divided into
2 groups. One group took a statin drug plus Tredaptive and the other group
received the same dose of statin along with a placebo.
Patients taking
Treadaptive had higher rates of bleeding (2.5 percent vs. 1.9 percent) and
infections (8 percent vs. 6.6 percent), as well as higher rates of new onset
diabetes (9.1 percent vs. 7.3 percent). Nor did the patients on the
experimental drug have lower rates of heart attack or stroke.
The study was
halted prematurely, after four years, due to these problems and the maker of
the experimental drug, Merck, announced that it wouldn’t be seeking FDA
approval.
While media reports
blamed these problems on niacin, Dr. Bale and other experts point out these
adverse effects haven’t been seen in numerous previous studies of the vitamin
on its own, so the anti-flushing drug is the likely culprit.
“Niacin is being
thrown under the bus when it’s an inexpensive, effective treatment that’s been
used very safely for decades,” says Dr. Bale. “What this study is telling us is
that this particular no-flush combination drug doesn’t work and can have significant side
effects.”
Bisphenol
A (BPA) is a chemical that is used in the manufacture of polycarbonate
plastics and epoxy resins. It is ubiquitous in the environment, found in
common, everyday products. BPA is used in food and beverage containers
and packaging, and the chemical leaches into the products. That means
your canned beans, peas, soups, and chili have likely been exposed to
BPA, as well as milk cartons and foods in plastic containers.
