Mr. Dave: what are the side effects of niacin? The biggest and most common one
is flushing. I actually got a little flushing today from my own niacin drug.
Back in the days, when you just took regular niacin then, some people still
do that. I tried it for a while, and I remember I felt like I was a scalping
victim, felt like my whole head was blowing off with just this intense fire.
And I had to stop. I mean I could not take it. That is the most common thing.
Now you'll see YouTube comments on this channel and other places where people
say, oh, I love that flush. Well, if you love it and you can do it, that's great.
So there's been a lot of focus on trying to decrease that flushing. One of them
was a chemical called Laropiprant. LAROPIPRANT. Laropiprant. I'm
blanking on the name of the drug company (it's Merck). There was a drug company on their base
on 42nd Street in Manhattan. One of the well-known names. They had a Laropiprant-
niacin combination. And they did a world-class trial on it and expected to
just you know do the victory lap with a whole bunch of new sales. And it blew up.
It didn't work at all. And what actually happened was it appears that
Laropiprant, when it decreases the... when it does away with the flush from niacin,
also did away with whatever was helping decrease the cardiovascular risk.
So that didn't work. So what did the medical community do? Well, in America, the
response of the medical community was just to throw the baby out with the
bathwater. They said, well, niacin doesn't work. No, it wasn't that niacin
doesn't work. It was that niacin treated with and combined with Laropiprant
doesn't work. There are a couple of versions of niacin that we know does
work. I've got financial arrangements with either one of these groups. One of
them is Rugby. RUGBY. And the other one is Enduracin. ENDURACIN.
We're trying to develop something with Enduracin because they have been the
best tolerated product where we can make it more easily available. You can get it
right now on Amazon. The thing about Enduracin is they have
wax matrix process. So you get a wax matrix within the pill, and you've got
the little pockets of niacin within it. So it slows that down. What happens?
Reliably, you still get the niacin impact, but it slows down the release. And I'm
like all the other patients that I've dealt with so far are using it except a
few a few will still get intolerable flushes. But the vast majority of them do
like I do you get sort of a little flush and tingle. Not much of a bad when it all
happens every month or two and lasts about five minutes and then you never
notice it again. So that's the big thing. You can also get some gastrointestinal
problems with niacin. One of my family members had that problem, had to stop it.
Robert Pinsky: does long-term use of niacin caused liver damage?
There's a lot of focus on liver damage and there it has been reported. Yes, you
can't see it, and yes, it's more associated with niacin where other
chemicals have been added. Bottom line: at the end of the day, it's sort of like
statins, it's sort of like aspirin when indicated. It's sort of like driving a
car, sort of like flying in an airplane. You pay your money, you take your risks.
If you don't have any cardiovascular risk, I don't recommend thinking niacin
because there are some problems associated with it. But if you have
significant Lp(a), I clearly would recommend it. A lot of folks that have
low HDL. Obviously, we want to focus on the carbs in the diet. But niacin is the
only thing that's been shown... the only supplement or there's been no medication
that increases HDL. But again niacin increases. There's nothing that has
such an impact on our cholesterol panel like as a supplement like niacin.
So we use it a lot. I personally use it.
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