Archive for the 'Niacin' Category

Jun 10 2008

Scientists Propose Mechanism Behind Niacin’s Ability to Raise “Good” Cholesterol Breaking News

A new study investigating the mechanism by which niacin is able to raise HDL, the “good” cholesterol, has found that the B vitamin may exert its effects on the liver by inhibiting the excretion of HDL.

Niacin is known to increase plasma HDL levels, but the mechanism by which niacin exerts its action is not clearly understood. Therefore, scientists undertook a new study to clarify exactly how niacin is able to raise HDL.

In the body, a substance called “a beta chain” takes up HDL and therefore reduces the level of good cholesterol. Researchers investigated niacin’s effects on beta-chain’s ability to uptake HDL, by incubating human liver cells with niacin. When they did this a 27 percent reduction in the presence of beta chains on the cell surface was observed. Furthermore, the scientists observed a 35 percent reduction in the uptake of HDL in cells treated with niacin.

The results of the in vitro study suggested that niacin stops the liver from removing HDL from the blood, allowing the body to preserve its high plasma HDL levels.

Griffin Medical Group prescribes pharmaceutical sustained release niacin (generic Niaspan) to raise HDL levels. Starting dose is 500mg each day with food. This product may cause a flushing episode that can last up to 30 minutes. This flushing will subside over time with continued use. You may want to take SR Niacin with ½ an aspirin to control the flushing during the initial phase of treatment.

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Zhang LH, Kamanna VS, Zhang MC, Kashyap ML. Niacin inhibits surface expression of ATP synthase {beta} chain in HepG2 cells: implications for raising HDL. J Lipid Res. 2008 Jun;49(6):1195-201.

Yours in health,

Griffin Medical Group

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Nov 08 2007

Description of Niacin – Sustained Vs. Immediate Release…

Published by under Niacin

Nicotinic acid, the water-soluble vitamin also known as niacin, has been used for many years as a cholesterol-lowering drug. It is considered a drug of first choice because it is safe and effective and has been shown to reduce the risk of heart attack.Niacin lowers total and LDL cholesterol, as well as triglycerides, and raises HDL-cholesterol as well. Niacin can lower LDL cholesterol levels as much as 30 percent. It is also the least expensive cholesterol-lowering drug.

To produce such lipid lowering, niacin is given in therapeutic doses of one and one half grams (1,500 mg) daily or more; doses of up to six grams have been used in clinical studies. Therapeutic doses usually do not exceed 3 grams daily.

Since niacin can cause severe redness and itching of the skin, therapy is usually begun with small doses and gradually increased. An aspirin given one half hour before the drug helps to reduce flushing. In addition, flushing and itching are lessened if the drug is taken on a full stomach, or if a timed-release preparation is used.

It is also helpful to begin the therapy on a non-working day to avoid any potential embarrassment that may occur from the flushing, which gradually diminishes as the body adjusts to the drug.

Sustained Release And Instant Release Niacin

The side effects of itching and flushing are minimized when taking sustained-release niacin, which allows the drug to enter the bloodstream more slowly.

However, a new study comparing two generic versions of niacin, a conventional immediate-release (IR) form and a sustained-release (SR) preparation showed that the lower rates of flushing for the SR preparation may be offset by its effect on liver function.

In the trial, 46 adults with elevated cholesterol levels were randomly assigned to take either IR or SR niacin in dosages that increased from 500 mg per day to 3 grams per day. In addition, they followed a diet that restricted saturated fat and cholesterol.

The good news for the SR niacin users was that their total cholesterol levels were lower than in patients who took the IR preparation. Also, at a dosage of 1,000 mg per day, only 22 percent had flushing, tingling, headache, warmth, or itching with SR niacin, versus 53 percent with the IR medication.

The bad news is that the patients who took the SR niacin were more likely to develop abnormalities of their liver function, which occurred with dosages as low as 1,000 mg per day. These abnormalities caused more than half of the patients taking the SR niacin to withdraw before completing the study. IR niacin did not appear to have any such effects, although other studies have shown that IR niacin can also cause serious liver-function abnormalities.

The results of this study should not lead people to discontinue taking an SR preparation that has been effective and is not causing side effects. There are a wide range of sustained-release preparations, with varying degrees of complications and effectiveness, and patients should not generalize about these agents.

Both SR and IR niacin preparations are available without prescription, and these data provide a reminder that over-the-counter drugs, like all drugs, can have side effects, and that niacin can cause liver abnormalities.

Patients taking niacin – whether IR or SR preparations – should undergo liver function tests. Before starting or stopping either form of niacin, patients should discuss the issue with their physicians.

Griffin Medical Group – Center for Anti-Aging & Aesthetics  (714) 549-6550

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Nov 08 2007

HDL and risk reduction – Sustained release niacin

Published by under Niacin

Higher HDL cholesterol for lower health risk

Many studies point to the important role of HDL cholesterol in lowering the risk of heart disease. Here are some facts from major studies:

  • For every additional point you increase HDL cholesterol, there is a 2-3 percent decrease in heart disease risk.
  • For every 10 point increase in HDL cholesterol, there is about a 50% reduction in heart disease risk

HDL cholesterol is protective.

Having high HDL cholesterol (>60) is so good for you that it can even minimize other risk factors (like high LDL cholesterol). That’s why, if your HDL level is low, your doctor will try to get it higher. (niacin sustained-release tablets) can help.

Sustained-release niacin raises HDL to lower risk

There are several kinds of cholesterol in your bloodstream.

  • LDL cholesterol carries cholesterol into your arteries, where it can form plaques that clog the flow of blood.
  • HDL takes the “bad” cholesterol out of your body.

By helping to keep plaques from forming, HDL cholesterol helps keep your blood flowing and reduces the risk of major problems like heart attack. Sustained-release niacin can help lower your risk by raising your HDL cholesterol levels.

Ask Griffin Medical Group whether sustained-release niacin may be right for you, based on your cholesterol levels and personal risk factors

(714) 549 -6550 ask for Alan

Judi Goldstone, M.D.

Alvin Yee, M.D.

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Nov 08 2007

Coenzyme Q10, Riboflavin, and Niacin Supplementation May Reduce the Risk of Cancer Recurrence and Metastases in Breast Cancer Patients

Published by under Niacin

In a study involving 84 breast cancer patients, supplementation with coenzyme Q10 (100 mg/d), riboflavin (10 mg/d), and niacin (50 mg/d), in addition to the drug, tamoxifen (10 mg/twice a day), was found to reduce circulating breast cancer markers, indicating a reduced risk of relapse. The authors point out that it is metastases at distant sites rather than the primary tumor that are the main cause of death among breast cancer patients. Levels of CEA (carcinoembryonic antigen) and CA 15-3 (carbohydrate antigen 15-3) – circulating breast cancer tumor markers – were elevated among breast cancer patients who remained untreated. After one year of treatment with tamoxifen (a drug which interferes with estrogen activity – acting against estrogen in breast tissue and acting like estrogen in other tissues), levels of circulating tumor markers decreased. When patients received supplementation with coenzyme Q10, riboflavin, and niacin, along with tamoxifen for 45 days or for 90 days (two groups), significant reductions in CEA and CA 15-3 were found. This study suggests that breast cancer patients may reduce the risk of relapse – as suggested by reduced circulating tumor markers – by adding coenzyme Q10, riboflavin, and niacin supplementation to standard tamoxifen therapy.

Reference:”Effect of coenzyme Q10, riboflavin and niacin on serum CEA and CA 15-3 levels in breast cancer patients undergoing tamoxifen therapy,” Premkumar VG, Yuvaraj S, et al, Biol Pharm Bull, 2007; 30(2): 367-70. (Address: Department of Medical Biochemistry, Dr. ALMP-GIBMS, University of Madras, Taramani Campus, and Department of Medical Oncology, Government Royapettah Hospital, Tamilnadu, India).

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