Niacin Expert needed please!

[MEKoan]

I am a long term ME patient who has elevated cholesterol - something I seem to remember reading, decades ago, was not uncommon in ME - and I am trying niacin rather than cholesterol lowering drugs.

The Niacin I purchased is Inositol Hexanicotinate which, I discovered only after opening, may not be as effective as Niacin in lowering cholesterol. Oy.

I feel like I've just entered a degree level course of study and it's more than I can seem to handle with the cognitive abilities I have at the moment. I thought I'd see if there were any Niacin experts who might take pity on me, and where better to look than here :0)

Many thanks in advance!

 

[tumbleweed]

Something else for you to consider...

Having an underactive thyroid raises cholesterol. In fact, a few decades ago, before the awful modern blood tests were invented people were diagnosed with hypothyroidism based on their cholesterol level and symptoms. Many, many people would prefer it if this was still true. Doctors love to tell patients that their thyroid function tests are normal when they often only test a pituitary hormone called TSH (Thyroid Stimulating Hormone) and ignore the thyroid hormone levels altogether!

Another thing to be aware of is that the body doesn't trust people to eat enough cholesterol - it is so vitally important for health that the liver makes it if we don't eat enough of it.

https://health.howstuffworks.com/di...cholesterol/how-the-body-uses-cholesterol.htm

Sorry, I can't help you with info on niacin.

 

[pamojja]

The Niacin I purchased is Inositol Hexanicotinate which, I discovered only after opening, may not be as effective as Niacin in lowering cholesterol.

For cholesterol, especially the dangerous but difficult to lower like Lp(a) or for raising HDL, only the Nicotinic acid works. Not Niacinamide, flush free Niacin, or the Inositol Hexanicotinate. There are also extented release or slow release Nicotinic acid preparations, which are better to be avoided because they can harm the liver. Still worthwhile to check liver enymes even on immediate release Nicotinic acid regularly.

Start with a very low dose, because Nicotinic acid can cause a strong flash where some already panicked and went to the ER. Beside the possible panic, the flush itself (strong burning sensations and red skin for about 20 minutes) is harmless.

Inexpensive examples:
http://www.lifeextension.com/Vitamins-Supplements/item00372/Vitamin-B3-Niacin
https://www.swansonvitamins.com/swanson-premium-niacin-vitamin-b-3-500-mg-250-caps

In the beginning open such a 500 mg capsule and take only 1/5, if that doesn't cause too much of a flush you can increase to a 1/4 the next day, next 1/3 and so gradually more. If at any point the flush gets to much, decrease the dose again and get used to the flushing at a level you can handle, before increasing further again.

 

[Stretched]

‘Not sure if you’re concerned about the cardiovascular benefits... .

If so, there’s a ‘famous’ heart study I read about 10 years ago weighing the effect of statins and their efficacy. (I can’t quite recall it’s
name but you could likely google it...maybe Framingham Sudy?). IAE, it covers the statistics of these various cardiovascular drugs
vs various alternatives to heart health and it’s components.

I don’t know about ‘expert’ but I read and debated the medical literature relative to the rxs and NOT going to more extreme
measures to reduce high levels x,y,z. At the time I was resisting Statins and could argue a pretty good case against them in favor of supplements and Niacin.

In the end, after several debates with cardiologists I ended up with 2 heart stents, on Statins AND supplements, including Niacin, 1 gram x 2/day.

I stopped Niacin after a couple of years due to the hot flush which pharmaceutical grade niacin brought on. I switched to the niacinimde grade w/o the flush. My cardio approved as he said the Niacin was extra insurance to then lowered chol and triglycerides...that neither variety of Niacin would do the job alone (which heart drugs do).

I’ve since gone w/o either as my #’s are good. My point is that the Niacin was not adequate on its own, nor with a mixture of supplements to keep the ‘bad’ numbers at bay.

 

[pamojja]

If at any point the flush gets to much, decrease the dose again and get used to the flushing at a level you can handle, before increasing further again.

By the way, after years of taking 3 g of Nicotinic acid per day myself I don't feel the flush anymore. Sort of miss it.

 

[Mary]

@MEKoan, I started taking niacin (nicotinic acid) a few years ago at night for sleep. It helped a lot. After taking it for maybe 2 years I found that my cholesterol for the first time in ages was in the normal range. I got used to the flush and actually began to look forward to it, because it meant that I would be falling asleep soon.

I take it at night with no problem However I don't take it during the day because it makes me tired then. It can slow down methylation, which I don't want, but at night it's fine for me. It also does something to GABA receptors which is why it's helpful for sleep.

and @pamojja is right - don't get the extended or time release, it has been associated with liver damage, and the non-flushing kind won't work either.

 

[MEKoan]

Hi everyone and BIG thanks to you! Looks like I got the wrong kind. It says right on the front label: Healthy cholesterol Levels. And the manufacturer sent me the response quoted below in answer to my questions: "Is this product IP6? Can you point to any research comparing Inositol to Niacin for cholesterol lowing effects?"

I asked about IP6 because many good things have been attributed to it even if not lipid lowering.

Many thanks!

Dear Christina,

Thank you for your interest in Natural Factors Niacin Inositol Hexanicotinate 500 mg (SKU 1223); we appreciate you taking the time to contact us.

Both of these products contain Inositol, which by itself can be used therapeutically to reduce cholesterol, but IP6 is Inositol Hexaphosphate, which is different from Inositol Hexanicotinate. Studies show that IP6 helps to prevent disease, improves cellular communication and inhibits abnormal cell division. Whereas niacin offers support for the cardiovascular system by having a positive effect on cholesterol levels by reducing LDL and triglycerides, while raising levels of HDL – the good cholesterol.

Niacin Inositol Hexanicotinate Flush Free delivers niacin in the form of inositol hexanicotinate, which minimizes the side effects associated with other forms of niacin in high doses, such as flushing of the skin and upset stomach. When ingested, inositol nicotinate hydrolyzes in the body to free niacin and inositol, allowing both to function in reducing cholesterol levels in the body. It acts as a slow-release supply of niacin; hence, the flushing effect is not a likely event when ingested.

We have attached a copy of our research information sheet for your perusal. Please understand that as a manufacturer we are not able to offer medical advice or suggest treatment; certain prescription drugs may interact with herbal medicines and supplements, therefore we always recommend consulting with your physician or a qualified healthcare practitioner concerning all matters of health.

We hope you find this helpful. Please find attached a virtual coupon that you may print and redeem at your local health food store. We wish you the best in your search for optimum health and well-being.

Kindest regards,

Michele Gurney, R.H.N. | Customer Service SpecialistNatural Factors Nutritional Products Ltd.1550 United Blvd, Coquitlam, BC V3K 6Y2T 800 663.8900 | F 800 663.2115 | custservice@naturalfactors.com
naturalfactors.com
​

I'm confused by this answer. But very impressed that they got back to me so swiftly. I want to follow up with them with a question that settles the matter but I'm still somewhat confused re "free niacin".

They also linked:
http://www.efsa.europa.eu/sites/default/files/scientific_output/files/main_documents/949.pdf
http://www.ajconline.org/article/S0002-9149(06)01067-8/abstract
and a couple of others that were just about niacin with no mention of inositol or extended release

I will be back to go over each of these posts tomorrow when I hope to have better braining going on.

Again: BIG thanks! BIG!

:0)

 

[MEKoan]

Thanks to all of you and your excellent advice, things are going well :0)

Tumbleweed, What you say about the thyroid is very interesting. Only THS was tested. Thanks very much for the helpful link, too! I will look into this further when I have adequate steam. No need to not have niacin info when you had this helpful stuff!

Pamojja, I got some Nicotinic Acid. Thank you much for your detailed response re various types of Niacin. While I waited out the flush, I read some accounts in Niacin message boards of people totally freaking out. I could kind of see how that happens but it seemed to happen more often with pharmaceutical/prescription Niacin than good old nicotinic acid. There does seem to be a subtle (for some, not so subtle) uptick in arousal when you suddenly get hot and itch all over. I can see how that could lead to anxiety and a cascade of unhelpful responses and reactions. Thanks for preparing me ;0)

Stretched, I hear your warning and I'm sorry you have had such a difficult time with this issue. I am heartened to hear you now have good numbers off all. I wonder why that happened. I will be aggressive with Niacin, porridge ;0), cutting out sugar :0( and see how I go before taking the meds. My LDL is high normal WITHOUT fasting and my HDL is fine. It's only the triglycerides that are a problem and I understand they respond to sugar more than anything else and I'm generally careless about that. Also, I'm vegan which can easily lead to too many carbs - which I love.

Mary, Your experience of enjoying the flush is a big help! I took have a tablet 250 mg first, along with a baby aspirin as is advised various places online, and the flush was no big deal. Last night I took the whole 500 mg and it was a bit more intense. It's the itching that I find most annoying but I reminded myself that it's possible to find the flush pleasant and I committed to that. I also googled how long it lasted and the combo of that info and your account made it totally fine.

Thanks much!

:0)

 

[MEKoan]

Oh, one more thing. I seemed to feel a pretty powerful sense of well-being when the flush stopped but I don't know if that was because I was happy the itch was subsiding; I was reacting in some way to the niacin; or I had totally convinced myself that the flush was a wonderful thing and all was right in the world. Or the aspirin, maybe ;0)

 

[Learner1]

Hi everyone and BIG thanks to you! Looks like I got the wrong kind. It says right on the front label: Healthy cholesterol Levels. And the manufacturer sent me the response quoted below in answer to my questions: "Is this product IP6? Can you point to any research comparing Inositol to Niacin for cholesterol lowing effects?"

I asked about IP6 because many good things have been attributed to it even if not lipid lowering.

Many thanks!

Dear Christina,

Thank you for your interest in Natural Factors Niacin Inositol Hexanicotinate 500 mg (SKU 1223); we appreciate you taking the time to contact us.

Both of these products contain Inositol, which by itself can be used therapeutically to reduce cholesterol, but IP6 is Inositol Hexaphosphate, which is different from Inositol Hexanicotinate. Studies show that IP6 helps to prevent disease, improves cellular communication and inhibits abnormal cell division. Whereas niacin offers support for the cardiovascular system by having a positive effect on cholesterol levels by reducing LDL and triglycerides, while raising levels of HDL – the good cholesterol.

Niacin Inositol Hexanicotinate Flush Free delivers niacin in the form of inositol hexanicotinate, which minimizes the side effects associated with other forms of niacin in high doses, such as flushing of the skin and upset stomach. When ingested, inositol nicotinate hydrolyzes in the body to free niacin and inositol, allowing both to function in reducing cholesterol levels in the body. It acts as a slow-release supply of niacin; hence, the flushing effect is not a likely event when ingested.

We have attached a copy of our research information sheet for your perusal. Please understand that as a manufacturer we are not able to offer medical advice or suggest treatment; certain prescription drugs may interact with herbal medicines and supplements, therefore we always recommend consulting with your physician or a qualified healthcare practitioner concerning all matters of health.

We hope you find this helpful. Please find attached a virtual coupon that you may print and redeem at your local health food store. We wish you the best in your search for optimum health and well-being.

Kindest regards,

Michele Gurney, R.H.N. | Customer Service SpecialistNatural Factors Nutritional Products Ltd.1550 United Blvd, Coquitlam, BC V3K 6Y2T 800 663.8900 | F 800 663.2115 | custservice@naturalfactors.com
naturalfactors.com
​

I'm confused by this answer. But very impressed that they got back to me so swiftly. I want to follow up with them with a question that settles the matter but I'm still somewhat confused re "free niacin".

They also linked:
http://www.efsa.europa.eu/sites/default/files/scientific_output/files/main_documents/949.pdf
http://www.ajconline.org/article/S0002-9149(06)01067-8/abstract
and a couple of others that were just about niacin with no mention of inositol or extended release

I will be back to go over each of these posts tomorrow when I hope to have better braining going on.

Again: BIG thanks! BIG!

:0)

It doesn't look like they answered your question. A quick Google search turned up conflicting information on whether or not
Inositol Hexanicotinate reduces cholesterol.

However, have you thought about manipulating the ratios of micronutrients in your diet or looking at your gut health? People have made dramatic changes in cholesterol numbers with both.

 

[MEKoan]

Hi Learner1,
Yea, my googling resulted in the same conflicting results. I've decided that I don't need to understand whether or not Inositol Hexanicotinate works so long as the niacin I use does.

I have not considered "manipulating the ratios of micronutrients" because that phrase makes me want to crawl under the furniture and weep. It's enough already that I'm vegan (ethical, not health) and now going to drastically cut down on the refined sugars. I don't think I can take on anything more. ;0) But thanks for the suggestion. :0)

 

[pamojja]

It's enough already that I'm vegan (ethical, not health) and now going to drastically cut down on the refined sugars.

Been vegan and very low fat from age 10 to 41 too. Then a serious PAD (with a 60% walking disabilty), COPD1, T2D diagnosis. Enough is enough and changed my diet to high fat (mainly from nuts, coconut, olive, fish, avocado..), added daily eggs. Absolutely no sugar, grains or processed foods. Helped these conditions a lot. However, everyone responds a bid different to different macro-nutrient ratios.

 

[Learner1]

Hi Learner1,
Yea, my googling resulted in the same conflicting results. I've decided that I don't need to understand whether or not Inositol Hexanicotinate works so long as the niacin I use does.

I have not considered "manipulating the ratios of micronutrients" because that phrase makes me want to crawl under the furniture and weep. It's enough already that I'm vegan (ethical, not health) and now going to drastically cut down on the refined sugars. I don't think I can take on anything more. ;0) But thanks for the suggestion. :0)

Cutting down on refined sugars sounds like a great idea, for many reasons.

As discussed elsewhere around here, many of us have issues with our ability to use carbohydrates, and several of us have been experimenting with low carbohydrate diets. Additionally, the metabalomics studies have been finding PWME to be low in B12 and amino acids, which tend to be lower on began diets.

While it may seem tremendously difficult to come to terms with, it may be essential for your health to reconsider your vegan diet. It is possible to have ethically raised animal proteins and you may find your health improves.

But I know its a big ask... Best wishes...

 

[MEKoan]

Hi Learner and Pamojja,

Yea, there are things to be mindful of on a vegan diet, for sure. And ME complicates everything... and we're guessing so much of the time. I was B12 deficient but overdid the supplements and raised my levels to crazy heights. ;0) Letting that settle down now. I use a good vegan protein supplement with all the necessary aminos including the elusive lysine. Aside from the vegan thing, I am quite careless about food. I have to make it easy for me to eat the right things or I won't. I know me ;0)

Were I to add animal products, I would probably add fish :0( and if I could find an ethical rescue hen situation, eggs, but that's hard to find. Eggs - even from backyard hens - are a real problem because male chicks are slaughtered as soon as they can be sexed, so any way you buy into the production of laying hens, you're paying for that. The only reason I feel relatively ok about fish is that fish eat fish with nary a backward glance ;0) but then the environmental cost has to be factored in and that's so complicated.

Anyway, we'll see how I go. Thanks again :0)

 

[MEKoan]

Pamojja,

You certainly had some back luck despite a good diet. We don't have nearly as much control over these things as we like to think, do we. I hope things go much better for you now. :0)

 

[Learner1]

I eat duck eggs from a local farm as I'm allergic to chicken eggs. And sheep yogurt and cheese. And organic, pastured pork, chicken, beef, and wild salmon.

I found my body needs as much protein as I can give it, based on my labs.

A ketogenic began diet is possible, but it takes careful planning and discipline. I know a patient who survived a glioblastoma on such a diet.

 

[MEKoan]

That wouldn't work for me. I'm happy for you if it works for you. I'm not doing ketogenic anything, either. I'm very happy for anyone who survived glioblastoma!

 

[MEKoan]

Just wanted to post an update re my Niacin adventures. I got some good old fashioned nicotinic acid tablets and started at half a tablet to get a sense of the flush. I didn't mind the warmth, at all, but was not wild about the itching.

I read online that if you take a regular aspirin 30 min. beforehand, along with at least 8 ounces of water, the flush should be very much diminished. (Actually, either/or aspirin/water may also work.) It works! It's been 10 days of upping the dose every few days, starting at 250 mg, and tonight I took a gram with no flush at all. I also take it on a fairly full stomach which was also recommended. I wish I could find tune it to get a lovely warm feeling without itching ;0)

Thanks again for all your help!