More on Niacin and Cholesterol

Letter The cholesterol theory of cardiovascular disease erroneously supposes that dietary cholesterol is the cause of atherosclerosis. The pharmaceutical industry is interested in this theory because selling cholesterol lowering drugs is profitable. Most people who have not investigated the matter might assume that such medication is able to provide significant benefits to the health of patients. However, this is provably untrue and the reality of the situation is that drug companies have been distorting science and using propaganda to sell borderline worthless products in the name of profit and power. The absurdity of the whole process is illustrated nicely by the number of nutrients and dietary components that are as effective as the expensive pharmaceuticals at modifying plasma cholesterol levels. In fact, when the side effects of many of the drugs are considered, the nutrients are far more effective long term propositions compared to drugs.

One particularly effective cholesterol modulating nutrient is niacin (vitamin B3). At pharmacological levels niacin has been shown to increase levels of high density lipoprotein (HDL). For example, one double-blind placebo controlled study1 compared the effects of niacin (1000 to 2000 mg per day) against gemfibrozil (1200 mg per day) on the plasma lipoprotein levels in patients with low levels of HDL. The results showed that niacin was significantly more effective tham gemfibrozil at increasing plasma levels of HDL. While gemfibrozil increased plasma HDL by 21 %, niacin in the form of Niaspan increased in HDL by 26 %. This was reflected by an increase in apolipoprotein A-I levels that increased 11 % in the niacin group compared to 9 % in the gemfibrozil group. Interestingly, niacin also had a significantly greater effect on lipoprotein(a) levels, lowering them by 20%, compared to 7 % for gemfibrozil.

Vitamin B3 is therefore more effective at improving the total to HDL cholesterol ratios in patients with low HDL levels than the pharmaceutical drug gemfibrozil. More importantly, the niacin did not affect the low density lipoprotein levels, whereas the gemfibrozil caused a 9 % increase. Gemfibrozil also caused an increase in fibrinogen levels of 4 %, whereas niacin caused a decrease of 5 %. Lowering cholesterol in a pharmacological manner is controversial and does not necessarily improve patient health or mortality risk. However, even if it is believed to be beneficial, nutrients have been shown to be as effective or more effective than expensive pharmaceuticals. However, despite the increased efficacy of nutrients over some drugs, the best method of remaining healthy and maintaining correct lipoprotein ratios is to eat a healthy high quality diet, devoid of processed and adulterated foods such as sugars and processed meats.  


1Guyton, J. R., Blazing, M. A., Hagar, J., Kashyap, M. L., Knopp, R. H., McKenny, J. M., Nash, D. T. and Nash, S. D.2000. Extended-release niacin vs gemfibrozil for the treatment of low levels of high-density lipoprotein cholesterol. Archives of Internal Medicine. 160: 1177-1184

About Robert Barrington

Robert Barrington is a writer, nutritionist, lecturer and philosopher.
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