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High Cholesterol Message Board

High Cholesterol Board Index

Well, I know that people here on the board think they've had success with the Inositol Hexanicotinate, but the research says it contains no free niacin, and the medical literature says it is worthless for cholesterol control. My own doctor emphasized that again the last time I saw her a couple of weeks ago. So frankly, I don't know if it works or not. I think there might be a possibility that the method used in that research just didn't find what they needed to find because it is so extremely slow-release or something. I just don't know enough about chemistry or how they test such things to know if that is a possibility or not, but that might explain why people say they get results when the research says it's impossible. Or they may have changed their diet or other things at the same time and they only think it is working when it really isn't. I guess if it were me, with as serious a family history as you have, I'd switch to a different type and see if you get much better results. That should tell you. You could always switch back later if it turns out you aren't getting better results.

Be aware that there are differences with the other types. The immediate release is the safest for long term high dose use, though you still need regular liver enzyme checks. But you are likely to get major flushing until you get used to it. Start with no more than 250 mg daily and take it with a meal. Gradually build up over a period of weeks. You'll probably have major flushing and itching at first, but it will diminish with time.

I use a sustained release, with the 750 mg split between three meals. Flushing and itching are minimized with it, though you may have a little at first. There have been more serious problems with this type, but research into the various types indicated "some brands are hepatotoxic." The editor in a note put it more positively, "some brands are safe." Unfortunately, we were not told what brands were safe. (Of course, since the lead author had financial ties to the maker of Niaspan, I guess that shouldn't come as a surprise!) Anyway, I take the brand Enduracin. I've taken it for almost two years, and I've been at the 750 mg daily dose for about a year and a half. My AST and ALT levels before I started on it in 2003 were 21 and 16 respectively. My AST and ALT levels a couple of weeks ago were 22 and 17. Reference is up to 40. (And I've also at least doubled my alcohol intake since then, too.) So the Enduracin has presented no problem for my liver - so far. But that doesn't mean it couldn't some day nor that it might not be a problem for someone else. But I'm comfortable with continuing to use it for myself.

Another alternative would be to ask your doctor about prescribing Niaspan, a prescription only niacin. It is extended-release, which is like a cross between immediate release and sustained release in terms of flushing and timing. As a prescription, it is more costly. (It would cost me about $50 a month, in contrast to the $5 or less a month I pay for the OTC Enduracin.) If you have good prescription insurance coverage or if the cost is not a major concern, I'd go with the Niaspan, since as a drug it is more highly regulated.

I brought my TC down from 247 to 190 and my LDL from 158 to 101 and raised my HDL from 62 to 72 on 750 mg Enduracin, plus making major dietary changes as I indicated in my previous post. My figures have since come up a lot after doing considerable experimenting with such things as two eggs a day, but that might give you an idea of what might be possible. Of course, each person responds differently, so who knows what yours might do.

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