Niacin pin prickles. Bad? Worth it?

Question

I was taking 1500 mg of Slo-Niacin a day on the advice of my nurse practitioner for cholesterol. Due to a rash, I reduced ithe time-released niacin to 1000 mg. After a month of that dosage, I stopped it, due to rash and skin tingling like pin pricks. I can't take Lipitor or Lescol XL due to extreme effects, like a bad case of flu & muscle achiness & dizziness, etc. I take fish oil capsules daily, and I have 1/4 cup flax seeds, which I grind and put into water with Crystal Light. I have cut out margarine and butter for the most part. I exercise pretty regularly. But I still have bad cholesterol numbers. I was hoping that niacin would help. But I am now off niacin completely. Is it bad for me, like the cholesterol RX's were?

Answer 1

Your NP could use a lesson in treatment of cholesterol. The only good long acting niacin product on the market @ this time is Niaspan. It is a pelleted form of immediate release niacin that is realeased over ~ 12 hours. Niacin is primarily used for treating hypertryglycidemia, elevations in triglycerides, not generally for elevated cholesterol. Slow release preparations of niacin have been shown to be potentially dangerous and may increase cardiovascular problems!
Niacin itself is a drug that you need to work up to the proper dose slowly, because the #1 reason for stopping it is flushing and itching. The usual starting dose of Niaspan is only 500 mgs and it is suggested that you stay on it until all flushing stops. It is also suggested that you take Ibuprofen or benedryl about 15 minutes before you take the niacin, in order to stop flushing. It is also recommended that you take it at bedtime so that the flushing will occur while you are sleeping.
There are several anti-cholesterol medications that may help that are unrelated to lipitor and lescol. Zetia is one of them, and it works by reducing absorption of cholesterol from the GI tract.
There is a super concentrated form of fish oil called Omacor that has also been shown to be of benefit in reducing cholesterol. The daily dose of Omacor is 800 mg. twice daily and is equivalent to taking 12-14 fish oil caplets at a time.
Plant sterols and stanols have been shown to help lower cholesterol in low doses, but can cause a stanol overdose syndrome if overdone, So the dose is 1 or 2 tablets twice a day. Use Cholest-off by Nature Made!
It is not recommended that you stop Niacin the way you did, because to restart it, you will have to endure several days of flushing.
Niacin can have side effects of elevating your Uric Acid levels which can lead to Gout. It can also elevate you blood sugar and cause a syndrome indistinguishable from type 2 diabetes mellitus, therefore your NP should monitor both your blood glucose and uric acid levels as well as your kidney function.
The prime goal in lowering your cholesterol is to get your LDL cholesterol below 70 (new value) or 100 (old value). You should increase your HDL to over 55 and preferably over 60. This can be done by exercising, not smoking, and being female.
Your total cholesterol should be below 130 (new value) and 150 (old value). Tryglycerides (circulating fats) should be below 150.
There is some evidence that triglycerides are nearly as important as cholesterol in developing vascular disease and should be treated aggressively if necessary. Besides niacin, a drug called Tricor has been used to treat this.
Exercise, Diet and Weight Loss are also important factors in controlling triglycerides and cholesterol. Do not smoke as this raises your bad cholesterol (LDL and VLDL) levels and lowers your good cholesterol levels (HDL).
There are some familial diseases known as hyperlipidemias which are inherited problems with handling cholesterol and/or triglycerides that may make you problem worse if you have one of them.
I suggest you sit down, talk to your NP and have her explain exactly what your condition is and ask why you are on Niacin and not Niaspan and ask what her plans are with you. Also I feel that you should begin Omacor and Zetia if necessary to lower cholesterol and Tricor if necessary to lower triglycerides.
Flax seeds are good unless you have diverticulosis. Margarine is probably not safe at all, stick with olive oil, peanut oil, canola oil, and other monosaturated oils or small amounts of butter
Good Luck

Answer 2

The fact that we are living and breathing and able to do all these things. The fact that we are not rocks and some divine coincidence made use who we are instead of some inorganic atom. The fact we can give things worth. We can categorise. Its all beautiful, the sight, the sound, the feel, the emotion, the taste. Even pain. We can feel that not many other things can. Pain may be painful, but we can feel it just as we can feel happy. Its amazing really that out of all of this we can do these things. Although it seems to suck sometimes its still wonderful. random fact: if you shoot a rabbit, it doesnt know why it feels pain, it doesn't register that there is an explanation, it just knows it feels pain and as a reaction will run away, even if its dying. Shoot a human (even if they did not know what a gun was) it would realise its something launched, have some sort or knowledge of what to do and so on. I dont think this was relevant but its written now... But if youre looking for one reason it would definitely be pie.