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  • Niacin & Diabetes

    Hey there.

    Got a little bit of the scoop on niacin from Dr Brewer, and then read some studies on my own. As with so many americans, much of my family has both blood glucose & blood lipid issues. Based on what i've looked at, it seems that niacin would likely help at least by raising HDL for some of my family members.

    My concern w/ niacin has to do with its effects on blood glucose. I've read trials where ER niacin + crestor raised HDL (vs statin monotherapy), but also raised fasting glucose. The increase wasn't massive, but raising FPG certainly makes me concerned about what impact it would have on peak levels of blood glucose, which is where a lot of the damage is done.

    At this point, the two questions I have are about weighing benefits/risks: (1) is it advisable for someone w/ advanced prediabetes & already taking a statin (rosuvastatin/crestor) to take niacin? Is the blood sugar impact/liver worries/other potential side effects worth the benefit (probably a bump in HDL)? (2) My other lingering question was about why niacin isn't recommended for someone who isn't in 50+ range, but has elevated & slowly creeping blood lipid levels. Would someone like Dr Brewer recommend a lower dose (250-500mg ER?) of niacin daily for someone in that situation, to lower LDL and raise HDL?

    Thanks!

  • #2
    The initial increase in BG from niacin averages only around 5 points and is relatively insignificant. It usually dissipates after a few weeks to a month. The benefits of niacin FAR outweighs that effect. Just track your FBG and postprandial BG after you start and keep a BG log.

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    • #3
      Stop eating carbs and eat only one meal a day. Your BG will decrease. Then increase to two meals per day. Track your insulin. It's the real evil.

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      • Robin
        Robin commented
        Editing a comment
        Fatmax, Wish it was that simple. I eat very low carbs, two meals a day between the hours of 12 and 6. Insulin is low in perfect place every lab...but FBG is always around 90 something. Occasionally in the mid 80s and sometimes 104. My post meal glucose readings are good. It's just the FBG. I take full flush niacin 500mg 3 times a day. I was taking Enduricin 2000mg but my liver enzymes changed so I was switched and now they are back to normal.

    • #4
      Try metformin to decrease your BG.

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      • #5
        Originally posted by fatmax View Post
        Try metformin to decrease your BG.
        Doctor won't prescribe it. He's dense and sees no problems and says I'm healthier than most of his patients .... He's not up to date on glucose and inflammation it appears. Didn't know what Lp(a) was.

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        • #6
          Sounds like my VA doctor. Total waste of time to talk to him. He's done the same things since medical school and is not interested in new information. Fortunately I have an excellent GP outside who is knowledgeable and supportive.

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          • #7
            Take a look at your triglycerides level. People tending towards metabolic syndrome often have high triglycerides that tends to suppress HDL-C levels. Niacin will suppress triglyceride production and thus reduce the triglyceride-rich VLDL particles that eventually shrink down to the small dense LDL particles that are atherogenic. At the same time some of the HDL particles are delayed for uptake in the liver resulting in the higher HDL-C levels. If this sounds like your case, then yes niacin will help. Find a different doctor if you are pre-diabetic and your doctor won't prescribe metformin. Metformin is cheap enough that it might cost you more to go through your insurance company with a co-pay vs. just buying it over the counter yourself (with a prescription).

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            • #8
              Well that's the big question. Am I prediabetic? I have been taking niacin for a year. I think it HAS raised my A1C. Prior to taking it my A1C was 4.9 and a year later on low carb diet and same exercise (a lot) and niacin it's now 5.3.

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              • #9
                I have been taking niacin 2-3000 mg per day divided into 3 doses for more than 30 years, ever since reading the 8-week Cholesterol Cure book. I had triglycerides 1300 and TC 400 at that time. It is my understanding that nicotinamide and ER non-flush niacin is ineffective for cholesterol reduction &/or increasing HDL. You have to begin low & slow with niacin, starting 100 mg 3 times/day to diminish the flushing , and increase dosage 50-100 mg/day every third day until desired dose is reached. My CAC was 186 in 1999 & I haven't repeated because treatment is same. (I know I have plaque, just trying to keep it cool. Recently had 2hour OGTT & MACR (thank you for the info Dr Brewer) and both were optimal. I now take Twin Labs Niacin 1000 mg (Amazon) 3 times per day with normal liver enzymes & FBS + keto diet. I am 5'10, 215# (I know, working on it) No CV events so far, take no prescription meds but considering starting ramipril/rosuvastatin low dose

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                • #10
                  Sounds great Paul! I too switched from non flush to flush after my liver enzymes went high. Now they are back to normal. I take 500, 3 times a day. My CAC was zero. But I was started on it due to my Lpa....which is all over the place. I'm still trying to figure out if the niacin changed my A1c, because mine was good before I started taking it.

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                  • #11
                    According to the Bradley Bale/Amy Doneen Beat the Cardiac Gene book the HgbA1C is not a very reliable test. Can be normal range even when insulin levels & 2 hour OGTT are elevated indicating pre-diabetes & insulin resistance. I also take berberine 500 mg 3 times/day which is supposed to have a metformin-like effect on glucose

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                    • #12
                      I have been taking berberine for a year. Don't think it does anything positive for me.

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                      • #13
                        I agree with both. HgA1C is not enough. And Berberine tends to be a pea-shooter, underpowered.

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