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High Cholesterol Message Board

High Cholesterol Board Index

Virtual drinks are on me in celebration! (Maybe we had better make it V-8 juice with no salt added, however.) I just got back the results of my blood test. Results from this week are in black, those from 9/30/2003 are in blue, and my highest recorded is in red.

Total cholesterol 190 [COLOR=Blue](247)[/COLOR] [COLOR=Red](275)[/COLOR]
LDL 101 [COLOR=Blue](158)[/COLOR] [COLOR=Red](159)[/COLOR]
HDL 72 [COLOR=Blue](62)[/COLOR] [COLOR=Red](83)[/COLOR]
Trigs 87 [COLOR=Blue](133)[/COLOR] [COLOR=Red](214)[/COLOR]

I've been on an OTC Niacin (Enduracin) since November 2003. I started out with just 250 mg., when results weren't good enough judging by the next blood test, I increased it to 500 mg., and in June increased it again to 750 mg. Therapeutic dose for most people is considered 1000 to 2000 mg. My liver enzymes are way under the maximum normal level, so I'm fine there. And my Niacin therapy is costing me less than five dollars a month. My doctor was initially very cautious and concerned about me taking an OTC Niacin, but when liver enzymes came back hardly changed, she is now quite excited about it.

I've been pretty good about my diet, though, eating few saturated fats, and a lot of vegetables and soluble fiber. I'm trying hard to behave myself there, as I want to keep the amount of Niacin I have to take to a minimum. The lower the dosage, the lower the risk, I reason.

There is a strong history on the Norsk side of my family of strokes and heart attacks. None before age 70, and some in the late 70s, 80s or 90s, but it was stroke or heart attack, nonetheless. And since I'm now 63, I decided that "in the 70s" doesn't sound so far off any more and I had better get more serious about my health.

Anyway, I'm celebrating the results! :bouncing: :bouncing: :bouncing: :bouncing: :bouncing:
I might add a word of caution to anyone who reads this and is tempted to self-treat. Niacin is available OTC, so you don't need a prescription. But please, please, please check with your doctor and have a liver enzyme test before beginning therapy. There are a number of conditions (including heavy alcohol use) which are contra-indications for niacin therapy and your doctor will be able to tell you if it is a poor choice for you because of your other conditions. You will need regular liver enzyme tests after you begin therapy. Although there has been a problem in a very small percent of cases, you wouldn't want to be one of them, and a liver enzyme test done at regular intervals could catch any problem before it became serious. It can be used by diabetics only with VERY close doctor supervision, as it can tend to raise glucose levels in some people.

If you should go to your doctor with the idea, be prepared for him or her to discourage it. Mine did. Now after a few blood tests, she is sufficiently impressed with the results that she asked me where I get the particular one I am using, so she can suggest it to other patients.

If you are considering it, read up about niacin therapy on the net. Many of the doctors don't think to suggest starting at very low doses and building up slowly, or to suggest taking with meals, for example.
The sustained release form does seem to be more toxic than the immediate release form on a mg. for mg. basis. at least in some formulations. Whether it is more toxic on an amount-needed-to-do-the-same-job basis, though, I'm not so sure.

A lower amount of the sustained release is typically needed to get the same lipid lowering result. From what I read, some of the problems resulted when a doctor prescribed, for example, 3000 mg. daily of an immediate release niacin. The patient substituted 3000 mg. sustained release, which would have roughly the same effectiveness as 6000 mg. immediate release. (The one I'm taking 2000 mg. is considered the maximum recommended dose; I don't know about other brands.) And then the patient didn't bother to get a liver enzyme test. No wonder he ends up in trouble! Had he had regular tests, even taking this large amount, it probably would have been caught before he got in such serious trouble.

If someone were taking two to three times the maximum recommended dose of a statin and didn't have regular liver enzyme tests, he'd end up in trouble, too.

I appreciate the ability to use an inexpensive OTC product for lipid lowering, and feel the risk is no greater than with that of prescriptions PROVIDED people get informed before they take it in mega doses.

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