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High Cholesterol Message Board

High Cholesterol Board Index

Hello all,

Well, after approx. 6 months of niacin therapy, I got new blood results in. Somehow, my HDL has gone down on 500mg Niaspan daily.

HDL started off at a paltry 29. After around 3 months, it went up to 33-34 (forget exactly), and now 3 months later it reads 28.

My LDL is slightly worse too, at 132 (it's normally 110-120ish), but I chalk that up to increasing my fish oil to the 3.5-4 gram range as an experiment to lower triglycerides/improve LDL particle sizes. But neither budged and it seems instead all I did was add about 10 pts to my LDL. And my LDL size seems locked into the A/B pattern, no matter what diet/exercise/niacin/fish oil/vitamin D changes I made.

As to reasons why Niaspan didn't help... still a bit clueless. One possibility is that I recently started taking it around dinner time, instead of right before bed, as I felt I was having some sleeping problems. I recently found out I may have acid reflux, which could explain why niacin right before bed would be a bad idea.

Another possibility as to why my HDL went down is: the Niaspan didn't really help to begin with, and my temporary increase to the 33-34 range would have occurred with or without being on Niaspan. My HDL range tends to be 28-34ish, so there is no guarantee that Niaspan originally rose my HDL at all.

I speak with my cardio next week, and we'll have to go over new options. Perhaps raising Niaspan to the 750mg-1000mg range would work. If not, I'm sorta out of options for improving HDL (that I'm aware of). Low-dose statin might be a last resort, just to lower LDL as much as possible, since my HDL is so crummy.

I've also investigated other reasons for low HDL, such as hormone levels, thyroid, vitamin D (currently at a nice 56), but they all came back fine.

I'll also ask my cardio about Apo-A1 and perhaps get that tested separately. There is the rare chance it's not quite as terrible as my HDL is.

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