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OMG, I sure wouldn't have wanted to try it with 500mg twice a day right off! I'm taking an OTC sustained-release niacin. The company that makes it recommended starting out with only 250 mg and taking it with meals, then building up from there. Doing it that way, I had only minor flushing the first week, and none thereafter. I am now taking 750 mg, in a divided dose, 250mg 3x daily with meals. I know most people on Niaspan seem to take it at bedtime. That would never work for me, as I am a very light sleeper, and having "night sweats" from the niacin would wake me up for sure. The meals buffer the flush effect, and at least it is in the daytime. Maybe now that I've been taking it for a year, I could handle it, but I doubt that I could have at first.

I've had good results with my niacin. My TC went from 247 to 190, before I did my little egg experiment where I was eating two eggs a day. Then, of course, it went back up again. But HDL went up with the LDL, so I'm not going to get too worried about it.
[QUOTE=JJ]It also says to start at about 500 mgs. at night after a small fatty snack, and if your dr. wants to increase your dose, it still should be taken ONLY once a day, at bedtime. [/QUOTE]I'd be curious to know WHY it should be taken only once a day at bedtime. Sounds like a good way to get big-time night sweats to me. If there really is a reason for it, then I'd say that's a good reason to take an OTC product that can be taken with meals instead. (The fact that my Enduracin is costing me less than five dollars a month is another one for me!)

BTW, if you decide to consider an OTC sustained-release product instead, some are safer than others with regard to liver toxicity. There is information about the clinical studies done at Harvard and U of Minn of the Endurance Products website, so I felt fairly comfortable with their version. There may be other sustained-release products out there as good, but I'd like to see their research on it before I considered a switch.
[QUOTE=Uff-Da!]I'd be curious to know WHY it should be taken only once a day at bedtime. Sounds like a good way to get big-time night sweats to me. If there really is a reason for it, then I'd say that's a good reason to take an OTC product that can be taken with meals instead. (The fact that my Enduracin is costing me less than five dollars a month is another one for me!)

BTW, if you decide to consider an OTC sustained-release product instead, some are safer than others with regard to liver toxicity. There is information about the clinical studies done at Harvard and U of Minn of the Endurance Products website, so I felt fairly comfortable with their version. There may be other sustained-release products out there as good, but I'd like to see their research on it before I considered a switch.[/QUOTE]

I just took this tonight and I am as red as a lobster!! :eek: My husband says it will go away but my whole body is red and tingly. I don't think I'm going to like this. :nono:
[QUOTE=Uff-Da!]I'd be curious to know WHY it should be taken only once a day at bedtime. Sounds like a good way to get big-time night sweats to me. If there really is a reason for it, then I'd say that's a good reason to take an OTC product that can be taken with meals instead. (The fact that my Enduracin is costing me less than five dollars a month is another one for me!)

BTW, if you decide to consider an OTC sustained-release product instead, some are safer than others with regard to liver toxicity. There is information about the clinical studies done at Harvard and U of Minn of the Endurance Products website, so I felt fairly comfortable with their version. There may be other sustained-release products out there as good, but I'd like to see their research on it before I considered a switch.[/QUOTE]

Maybe they figure it won't bother U at nite??? I have NO idea, as my hubby never took it. He said he had his fill of statins and side effects and was in no mood for anything else to aggravate him.

I tried the stinking 100 mgs. and look what happened to me. I was really annoyed, as I figured that amount shouldn't have any affect. Oh well, guess I have a really weird system.... :confused: Stayed on it for over a week, but it never got any better, then I stopped it for a week and tried going back, and it just did the same thing, I itched like a fool for hrs. Somedays I just QUIT!!
[QUOTE=babydog]Hi Everybody,

Looks like I have given up the ship. My doctor has given me a prescription for Niacin which I began today. I will have my numbers checked again in 3 months.

Here are the current numbers:
TC 227
HDL 54 (down from 64!)
LDL 164 (up from 148!)
Trigs 65 (down from 76 - but so what)

I am 49. Also going thru menopause. I think menopause is affecting my numbers right now despite my best efforts with diet. :rolleyes:
I have to admit I have been a little remiss with exercise except for walking and housework.

Has anyone had a positive result from Niacin?
I am taking Niaspan 500mg 2x a day.

Best wishes to all my cholesterol fighting friends. :wave:[/QUOTE]


Yes,

I've been taking Niacin for approx. 3 years. Niacin corrects all lipid abnormalities. (No other prescription drug can make this claim). It raises HDL,
lowers LDL, lowers trigs, lowers total cholesterol, and improves LP(a). It also improves circulation, and removes arterial plaque.

I take a prescription niacin called "NIACOR" this is not an Extended release formula. NIASPAN is an extended release formula. The dose allowed is much less then an immediate release niacin. NIASPAN is an excellent niacin formulation and probably the most researched. With doctor supervision
it is a very safe and effective choice. I purchase NIACOR through my prescription plan (which is cheaper than OTC). The NIACIN flush will be much less with NIASPAN.

Note: The flush is very beneficial (It's both a cleansing reaction and a circulation enhancer) The flush will be much less when taken with food.
My numbers with my current dosage of niacin are approx :

Total = 195
LDL = 120
TRIGS =110
HDL = 52
CRP 0.7

(Not too bad considering I am not strict on diet and exercise) I hope this info helped.
[QUOTE=ACE28]Yes,

I've been taking Niacin for approx. 3 years. Niacin corrects all lipid abnormalities. (No other prescription drug can make this claim). It raises HDL,
lowers LDL, lowers trigs, lowers total cholesterol, and improves LP(a). It also improves circulation, and removes arterial plaque.

I take a prescription niacin called "NIACOR" this is not an Extended release formula. NIASPAN is an extended release formula. The dose allowed is much less then an immediate release niacin. NIASPAN is an excellent niacin formulation and probably the most researched. With doctor supervision
it is a very safe and effective choice. I purchase NIACOR through my prescription plan (which is cheaper than OTC). The NIACIN flush will be much less with NIASPAN.

Note: The flush is very beneficial (It's both a cleansing reaction and a circulation enhancer) The flush will be much less when taken with food.
My numbers with my current dosage of niacin are approx :

Total = 195
LDL = 120
TRIGS =110
HDL = 52
CRP 0.7

(Not too bad considering I am not strict on diet and exercise) I hope this info helped.[/QUOTE]

Hello
Yes! this is very helpful! Can you tell me what your numbers were before starting on niacin??

Thanks. :wave:
Hi Babydog,

About 3 years ago I tried Lipitor. (My numbers were great but the side effects were awful). I then began to experiment with niacin (approx 500 - 1000 mg immediate release a day) At this time my doctor took me off the lipitor (due to neck and shoulder aches) My numbers about 4 years ago were approx:

TOTAL = 250
LDL = 150
HDL = 45
TRIGS = 370

6 months after 10 mg lipitor:

TOTAL = 170
LDL = 95
HDL = 41
TRIGS = 125

After lipitor my doctor switched me to 10mg of pravachol and approx.1000 mg of OTC niacin

TOTAL = 190
LDL = 110
HDL = 53
TRIG = 170

My doctor was fairly pleased with these results.

P.S As I mentioned NIASPAN is a very good choice. (listen to your doctor on this one) The Sustained Release (OTC) has caused liver failure in most of the cases of Niacin use. NIASPAN is also FDA approved (MD prescribed) Why take chances with your liver on unregulated OTC Niacin products.

Just my opinion...
[QUOTE=ACE28]As I mentioned NIASPAN is a very good choice. (listen to your doctor on this one) [B]The Sustained Release (OTC) has caused liver failure in most of the cases of Niacin use.[/B] NIASPAN is also FDA approved (MD prescribed) Why take chances with your liver on unregulated OTC Niacin products.[/QUOTE](bolding above mine)I think your statement might be easily misinterpreted. There have been more cases of liver damage with sustained release formulas than with the other formulas. But problems still affect only a very small proportion of users. And if they'd had their liver enzymes checked as they should, problems would be caught before they become irreversible. Also, from what I've read, one case resulted in needing a liver transplant when a doctor recommended a specific dosage immediate release and the patient, without conferring with the doctor, substituted an equal dosage sustained-release. Duh! The amount he took was, as I recall, about twice the maximum strength recommended by the manufacturer of that product!

I suspect the majority of problems are when people take an OTC product without being under supervision of a doctor at all, or who just don't go in for liver enzyme checks when they should. People who are heavy drinkers or who have other liver problems, for example, should not be taking niacin of any kind.

You might be interesting in reading this research abstract: [I]Varying Cost and Free Nicotinic Acid Content in Over-the-Counter Niacin Preparations for Dyslipidemia[/I]. You'll find it at
http://www.annals.org/cgi/content/abstract/139/12/996

For the 500 mg OTC products tested the research found:[quote]The average content of free nicotinic acid was 520.4 mg for immediate-release niacin, 502.6 mg for sustained-release niacin, and 0 for no-flush niacin.[/quote]I don't know about you, but I don't think if I get an average of 502.6 mg instead of 500, it is going to make much difference in my lipids or in risk.

Also, note that the lead author has financial ties to the maker of Niaspan. They state the toxicity risk this way:
[quote] Over-the-counter sustained-release niacin contains free nicotinic acid, but [B]some brands [/B] are hepatotoxic.[/quote](bolding mine) Unfortunately, they gave no indication of how many brands.

I've been taking Enduracin for about 21 months now. My liver enzymes in that time changed as follows:

AST - from 21 to 23 (reference range 5-40)
ALT - from 16 to 19 (reference range 5-50)

So for me, liver toxicity is not something I'm likely to have to worry about. However, though the greatest likelihood of problems is initially, problems can occur later, so I'd still encourage anyone taking niacin and getting good liver enzyme reports to continue getting checked out every six months or as directed by your doctor.

With all that said, [B]I would agree that if the cost of Niaspan is covered by insurance or if the cost out of pocket is not a major concern, by all means, go with the Niaspan.[/B] But for those like me who have to watch money carefully in retirement and whose every prescription dollar comes out of pocket, I see the OTC products as an easy way to save a bundle with relatively little extra risk, provided you take appropriate precautions.
[QUOTE=Uff-Da!](bolding above mine)I think your statement might be easily misinterpreted. There have been more cases of liver damage with sustained release formulas than with the other formulas. But problems still affect only a very small proportion of users. And if they'd had their liver enzymes checked as they should, problems would be caught before they become irreversible. Also, from what I've read, one case resulted in needing a liver transplant when a doctor recommended a specific dosage immediate release and the patient, without conferring with the doctor, substituted an equal dosage sustained-release. Duh! The amount he took was, as I recall, about twice the maximum strength recommended by the manufacturer of that product!

I suspect the majority of problems are when people take an OTC product without being under supervision of a doctor at all, or who just don't go in for liver enzyme checks when they should. People who are heavy drinkers or who have other liver problems, for example, should not be taking niacin of any kind.

You might be interesting in reading this research abstract: [I]Varying Cost and Free Nicotinic Acid Content in Over-the-Counter Niacin Preparations for Dyslipidemia[/I]. You'll find it at
http://www.annals.org/cgi/content/abstract/139/12/996

For the 500 mg OTC products tested the research found:I don't know about you, but I don't think if I get an average of 502.6 mg instead of 500, it is going to make much difference in my lipids or in risk.

Also, note that the lead author has financial ties to the maker of Niaspan. They state the toxicity risk this way:
(bolding mine) Unfortunately, they gave no indication of how many brands.

I've been taking Enduracin for about 21 months now. My liver enzymes in that time changed as follows:

AST - from 21 to 23 (reference range 5-40)
ALT - from 16 to 19 (reference range 5-50)

So for me, liver toxicity is not something I'm likely to have to worry about. However, though the greatest likelihood of problems is initially, problems can occur later, so I'd still encourage anyone taking niacin and getting good liver enzyme reports to continue getting checked out every six months or as directed by your doctor.

With all that said, [B]I would agree that if the cost of Niaspan is covered by insurance or if the cost out of pocket is not a major concern, by all means, go with the Niaspan.[/B] But for those like me who have to watch money carefully in retirement and whose every prescription dollar comes out of pocket, I see the OTC products as an easy way to save a bundle with relatively little extra risk, provided you take appropriate precautions.[/QUOTE]


Hi Uff-Da

Sorry for the mis-interpretation..

To clarify "my opinion". If a choice were given by my MD, for NIASPAN a researched and tested (FDA approved) Extended release Niacin formula with excellent and proven results with a very low insurance co-pay or; OTC (questionable non-consistent ingredients) sustained release NIACIN, I would choose the NIASPAN. (Just my opinion..) There is also a difference between Extended Release formulas versus Suspended release formulas. Oddly the NIASPAN Extended release has proven extremely safe even with statin use.
I choose the Immediate release because even at 20,000 - 30,000 mg a day (as was used at psych clinics for different ailments) there were very few cases of elevated enzymes, which reversed quickly after lowering the dose.
Extended Release/Sustained Release warn not to exceed 2,000 - 3,000 mg a day. I once took several OTC niacin products with very poor blood test results. Some products gave me no flush at all. The prescription NIACOR gave me better and more consistent results. The best OTC Niacins which helped my numbers were CARLSON(500 mg) PURITAN'S (250 mg) and CVS (100mg).

Note: I agree, the most important thing is to be monitored by your MD, regardless of the type or brand of Niacin used.
[QUOTE=ACE28]Hi Babydog,

About 3 years ago I tried Lipitor. (My numbers were great but the side effects were awful). I then began to experiment with niacin (approx 500 - 1000 mg immediate release a day) At this time my doctor took me off the lipitor (due to neck and shoulder aches) My numbers about 4 years ago were approx:

[B]After lipitor my doctor switched me to 10mg of pravachol[/B] and approx.1000 mg of OTC niacin

TOTAL = 190
LDL = 110
HDL = 53
TRIG = 170

Just my opinion...[/QUOTE]
ACE28,
Are you saying that you have also been on Pravachol for the past 3 years, along with the niacin? Pravachol lowered my numbers about 6 years ago until I could hardly walk from the leg weakness and stopped taking it.





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