Niacin scams

24. April 2007 William Davis (11)
As most of you know, niacin (vitamin B3) is an important tool for many in the Track Your Plaque program.

Niacin:

--raises HDL cholesterol
--reduces small LDL
--reduces lipoprotein(a)

And it's the most potent agent we have for all three patterns, despite just being a vitamin. Niacin also reduces LDL cholesterol, VLDL, IDL, triglycerides; reduces heart attack risk dramatically either alone or in combination with other agents.

Unfortunately, some people who are either afraid of the "hot flush" side effect, or experience excessive degrees of it, have resorted to two preparations sold in stores that have none of these effects.

Most notorious is "No-flush" niacin, also known as inositol hexaniacinate. This compound is an inositol sugar molecule complexed with 6 ("hexa-") niacin molecules. Unfortunately, it exerts none of niacin's effects in the human body. No-flush niacin has no effect on HDL, small LDL, or Lp(a), nor on LDL or heart attack.

In short, no-flush niacin is a scam. It's also not cheap. I've met people who have spent hundreds of dollars on this agent before they realize that nothing is happening, including a flush.

Likewise, nicotinamide does not work. It sounds awfully close to the other name for niacin, nicotinic acid. But they are two different things. Like no-flush niacin, nicotinamide has no effect on HDL, small LDL, Lp(a), etc.

Though I've discussed this issue in past, somehow these two "supplements" seem to sneak back into people's consciousness. You walk down the health food store aisle and spy that bottle of X-brand No-flush niacin, promising all the benefits of niacin with none of the bother. Then you remember that rough night you spent a few months back when the hot flush lasted longer than usual. That's when some people end up buying this agent making extravagant--and false--promises.

For now, for all its imperfections, niacin is still a pretty darn good agent for these patterns. Remember that the best strategy to minimize the hot flush effect is to drink plenty of water. We generally recommend taking the dose at dinner along with water. If the hot flush occurs, drink two large glasses of water (total volume 16-24 oz). Nine times out of ten, the flush is gone. It also dissipates the longer you take niacin.
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Comments (11) -

  • auntulna

    1/12/2009 11:06:00 PM |

    I've been taking Slo-niacin for more than six months, and about three times it must have broken down too fast. That is an intense hot pins and needles rush! Anyone else had that happen?

  • Grandma S.

    1/13/2009 2:37:00 PM |

    Dr. Davis,
    I do appreciate your blog and the information you provide. I am switching to SloNiacin!

  • stern

    1/13/2009 7:54:00 PM |

    it appears to me that the only    final decisive enemy for the heart is the LA sort LDL,all other are the indicators that your body inclines forward to get that enemy .all other encompassess high tryglicerides ,high ldl,low small hdl,c reactive proyien ,am i wright ?

  • Anonymous

    1/13/2009 9:46:00 PM |

    Niamax is also a slow release niacin.

    Is Niamax acceptable or does it also fall into the scam group?

  • Anonymous

    1/14/2009 12:27:00 AM |

    Please comment on a niacin product I have been using for years by Endurance Products,a sustained form of nicotinic acid that causes no flush (1000 mg daily) plus their regular version of immediate release (250 mg daily). Thanks...

  • martha

    2/4/2009 4:06:00 PM |

    Hi—
    My name is Martha and I am  a  writer working on a story about niacin for Better Homes & Gardens' Heart-Healthy Living magazine. I hope to interview Dr. Davis but also wanted to talk to people who are taking niacin for my story. If you are interested, please email me at marthajmiller@hotmail.com. My deadline is Feb. 16. Thanks
    -martha miller

  • IggyDalrymple

    2/28/2009 2:37:00 AM |

    My VA doc has been prodding me for years to take statins for my bad LDL/HDL ratio.  I finally took Dr Davis' advice and starting taking niacin and it worked.  My doc is now happy.

  • SES

    3/3/2009 10:29:00 PM |

    There are so many people commenting on the side effects of statins I wonder if there are side effects to something like Niaspan. Hot flashes are not what I am talking about.

  • Mary P

    4/28/2009 6:23:00 AM |

    I was talking to a dietitian friend about your strong feelings about no-flush niacin. I'm confused because she pointed me towards a recent European Food Standards Agency report that states that inositol hexanicotinate is bioavailable to humans and a source of niacin (they say, on average, 70% of an oral dose is absorbed into the blood stream).

  • buy jeans

    11/2/2010 7:40:15 PM |

    Nicotinamide--Also called niacinamide. While the nicotinamide/niacinamide forms of vitamin B3 can be used to treat B3 deficiency ("pellagra"), they do not reproduce the lipid and lipoprotein effects of niacin. For our purposes, they are useless.

  • Troy Honaker

    1/4/2011 5:00:05 AM |

    Niacin does have a tendency to have a prickly flushing effect on the skin.  This is normal to my knowledge.  It's not really a "side effect," it's just niacin doing its job.  I have never known it to be dangerous.  It is temporary.

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Heart scan gone wrong

Heart scan gone wrong

6. February 2010 William Davis (9)
Those of you reading the Heart Scan Blog, I hope, have come to appreciate the power in measuring atherosclerotic plaque, the stuff of coronary artery disease, and not relying on indirect potential "risk factors," especially the fictitious LDL cholesterol.

However, like all things, even a great thing like heart scans can be misused. Here's a story of how a heart scan should NOT be used, submitted by a reader.


Dr. Davis,

First of all, let me start out by commending you on all of the work you are doing with your website, blogs, etc. You are truly a breath of fresh air at a time when conventional medicine is no longer making any sense. In the last 3 years or so, I have spent a lot of time using the internet to try and find answers . . . and just about every time, when I find things that make "sense," it coincides which the recommendations you provide. Thank You!!

I am 56 years old, and roughly 5 years ago I bought your book, Track Your Plaque, primarily because I had asked my then Internal Medicine physician about why we weren't more "proactive" about determining the state of our cardiovascular health...since the means to do so existed (scans). He was trying to get me to go on a statin because my cholesterol #'s were a little high and at the time I smoked. Other than that, I was in perfectly good health with no side effects or issues. The following year at my annual physical, we again discussed this and he gave me a few options and I ended up having a calcium score done, which showed some blockage, but again, I never had any pains, sweats, or any other symptoms whatsoever, and I am a very active former athlete. This is when I bought your book to try and set a course of plan that wouldn't just include pharmaceuticals.

At the same time, my father was in his last months of life dealing with prostate cancer and the multiple radiation and chemo treatments, so I was making many trips from my home to be with him . . . a 4 hour drive, and very disruptive to family, as I still have 3 kids at home. At what I thought was going to be my last visit with him, I stopped at the cemetery he had planned on being buried to confirm details and such and then started home.

As I was driving, a symptom hit me which I was unfamiliar with (pretty sure it was an anxiety attack now) and I stopped at a friend's house in Chicago, as I didn't want this to be a heart attack while I was driving. This is when I began thinking about the heart scan and the blockage, and ended up driving back later that night and went right to the ER....not because I had any chest pains, but thought it best to be checked out because I did not want to go before my dad did. I ended up staying the night. In the morning the cardiologist PA [physician's assistant] came in with a copy of my calcium scoring and said it was best to have a heart cath...which I was in total agreement with since it would definitively tell me the current condition of my coronary vessels. As I was getting ready to be wheeled into the cath lab, they approached me with a form that would allow them to treat (stent). This is where I became very uncomfortable, in that I had never even met the cardiologist . . . and I didn't like this. No one ever had asked if I was experiencing pains or anything else . . . but I buckled and signed the form.

Before you knew it, I was awake watching my heart being cathed and the cardiologist angry because they did not have all the right sizes of stents, so he had to use a couple extra and I ended up w/5 total . . . and my life changed forever! In looking back, I can't necessarily argue the need for intervention, but in hindsight, it would have been nice to have tried an alternative method of reversing my plaque, especially since I had never experienced any symptoms and didn't appear to be in any imminent danger.

Upon release from the hospital I was put on a cocktail of drugs that typically follow and I then began to search and research. No one talked to me about lifestyle changes other that smoking....but nothing on diet or other means of cholesterol control, etc....in fact, when I had to pick out my meals in the hospital, they wouldn't let me have cheese....but the rice crispy treat was fine....how stupid! They originally told me the Plavix had to last 6 months....and then 12....and then 2 years....I stayed on it for 1-1/2 years and it was the only thing other than a baby aspirin. I went to another cardiologist out of town and he wanted me back on 5 or 6 medications and said that now I had the stents....I would have to be on these for life.....and he was the expert that talked at several main conferences.....my last trip to him.

Now, fast forward to about 6 months ago: I was participating in a father-son soccer scrimmage and was playing goalie. It was wet out and I couldn't catch very well. So being the competitive person I am, I resorted to using my chest on several of the saves and also took a direct blow to my eye ( I wear glasses) and the eye started swelling up pretty good. We then finished and went inside to have pizza and everyone was concerned about my eye. About 30 minutes later I excused myself as i felt some pretty significant sweats and subsequently a pretty severe pain directly in the middle of my chest....I was having a heart attack! Called 911 and went to hospital (2-1/2 years since original stents) and my local cardiologist removed the blockage that was at the anterior portion of my 1st stent causing the blockage. The huge disappointment to me is that I had taken many steps to improve my overall health. But now that I have foreign bodies in my vessels, the chance of further clotting is something that i will most likely always have to live with.

BU, Michigan



This is an example of how heart scans should NOT be used. They should NEVER be used to justify a procedure, no matter how high the score or where the plaque is located. The "need" for procedures is determined by symptoms (BU's symptoms were hardly representative of heart disease), blood findings, EKG, stress testing, and perhaps CT coronary angiography. "Need" for procedures can never be justified simply on the basis of the presence of plaque by a heart scan calcium score.

Unnecessary procedures like the one BU underwent are not entirely benign, as his experience at the soccer game demonstrated.

Heart scans are truly helpful things. But, like many good things, they are subject to misuse in the hands of the uncaring or greedy.
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Comments (9) -

  • jcj - mich

    2/6/2010 6:22:47 PM |

    My father had hardening of the arteries when he was 56 years old. My doctor put me on statins when I turned 50 because of high numbers . I am on a low-carb diet now and I have lost about 10 lbs ( I am only alitte over weight ).  My thought is, shouldn't the doctor consider taking my off the statins for a while to see if my numbers will be fine now ?  I am afraid of having the same problem as my father .

  • pmpctek

    2/6/2010 7:06:32 PM |

    This is an example of how heart scans should NOT be used. They should NEVER be used to justify a procedure, no matter how high the score or where the plaque is located. - Dr. Davis

    This is exactly the reason why my primary care physician says a heart scan is pointless, because the diagnoses of high coronary calcium leads to no accepted procedure/treatment protocol (other than a statin prescription) and may lead to nothing more than anxiety for the patient.  

    If only the AMA/AHA/ACC made Dr. Davis' book, website, and blog mandatory reading.

  • osusana

    2/7/2010 6:06:42 AM |

    Can the K2 vitamin promote clotting and lead to a thrombus?

  • Anonymous

    2/7/2010 5:17:00 PM |

    Reading this blog was eerie for me, as I suffered a similar experience.  I am 56.  2 1/2 years ago an unscrupulous cardiologist put 5 stents in my arteries after a nuclear stress test revealed some impaired blood flow. Subsequent reviews by other cardiologists showed that my arteries were not sufficiently blocked to justify placement of the stents.  I will now likely be on Plavix for the rest of my life but, even more importantly, have an increased risk of future problems because of these stents.  Although I was somewhat knowledgeable about prevention at the time, as a Trackyourplaque member, I did not suspect that there were cardiologists out there in established clinics who were so interested in making money at the risk of others' health.  Dr. Davis' program has helped me gain confidence that I will overcome this.

  • Nigel Kinbrum

    2/8/2010 12:18:45 AM |

    @osusana
    Vitamin K deficiency results in slow/no clotting. Vitamin K sufficiency results in normal clotting.
    Nige.

  • Selena

    2/8/2010 2:09:32 AM |

    I'm wondering if you're against all types of wheat. I found this:

    http://www.quakeroats.com/products/more-products-from-quaker/content/cereals/unprocessed-bran.aspx

    For 35 calories, it has 11g of carbohydrates, 8 of which is fiber...It also has very impressive mineral composition. What do you think?

  • Anonymous

    2/8/2010 2:24:20 PM |

    "No one talked to me about lifestyle changes other that smoking....but nothing on diet or other means of cholesterol control, etc."

    I find it so hard to believe that this person has absolutely no idea about basic food nutrition. With public libraries everywhere, and the internet it is easy to access food nutrition information. Please do not blame doctors for your ignorance about nutrition.

  • garval

    3/1/2010 8:07:24 PM |

    I would appreciate your help with the following: can coronary artery stenosis of between 70-80% be reduced by non invasive means for instance, by a combination of a healthy diet, exercise and medication or is it bypass surgery the only course of action?

  • buy jeans

    11/3/2010 3:04:09 PM |

    This is an example of how heart scans should NOT be used. They should NEVER be used to justify a procedure, no matter how high the score or where the plaque is located. The "need" for procedures is determined by symptoms (BU's symptoms were hardly representative of heart disease), blood findings, EKG, stress testing, and perhaps CT coronary angiography. "Need" for procedures can never be justified simply on the basis of the presence of plaque by a heart scan calcium score.

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