Niacin - Better Than Your Statin?

can take nice and lower your cholesterol and maybe reduce the need for statins listen I'm no hero I'm no nutritionist I'm just an orthopedic surgeon but I do have elevated cholesterol right and I do take a Statin so this hit home for me so a few days ago before we started researching this in depth I started taking nasin because I heard it can lower your cholesterol stick around to the end to see if he's still taking n welcome to talking with docs I'm Dr bre what are you trying to say should I stop well we'll see okay so what is nasin okay nasin is vitamin B3 or most in the most common form is nicotinic acid nicotinic acid vitamin B3 it's water soluble water soluble water so you would think hey it's pretty safe to take cuz any excess you're going to pee it out right our bodies do up take a small amount into our red blood cells so it helps them circulating extra volume but most of it does get excreted it is primarily found in food so meat fish poultry nuts legumes it's very very common that's everywhere and in North America supplemented fortified cereals we could do a whole video and we should about the role of cereals why we eat so much cereal who told us to eat cereal maybe why it's not the best idea but North Americans typically get a lot of NYS and the other thing is we can make a very small amount of it from tryptophan commonly found in a bunch of things including turkey it's actually not the best source we have a video about that Who you calling turkey Who you calling turkey and in your body it plays a very important role in many many chemical processes that occur body sort of takes takes energy how it utilizes energy how it gets energy from food uh so it's crucial in those in those processes you need it 100% and the other key thing that's been a little more trendy is its role in making and repairing DNA so as an anti-aging molecule or something that has an antioxidant property and this is a very very common supplement that people that are super into anti-aging have been taking and now there's some question whether or not they should be taking it or not okay so let's look at the literature as we always do and both of you and I have reviewed bunch of papers on this what do you think one truth is now one thing is yes it seems to be proven well that taking an niin supplement so there's a difference here between getting niin from your food and taking niin supplement okay before we get there because that's actually a good point so is it is it Comon deficiency the first answer is no severe deficiency causes something called pellagra and this is uh not so uncomon in underdeveloped countries or people that have severe malnutrition so people have severe diseases causing malnutrition people that have anorexia people that are alcoholics unfortunately so those people but it's actually difficult to measure so if you measure n in your blood it's not a very reliable way to measure your total nin so the way that they do it is typically with some of the breakdown metabolites in your urine but this is just not commonly done okay okay that's the little side so your question is well yeah on that too and and and when you talk about deficiency as as with every deficiency it's a la it's a food source deficiency or a process in your body that's not metabolizing the food proper those are the two ways and so the food source deficiencies we often see in developing countries so yes it can you can have a deficiency however in developed countries very rare to have a deficiency so the question is should I take a nice and supplement right literally should I take a nice and supplement to help bring my cholesterol down right and that is what I was getting at before it seems to be a truism that if you go on a nice and supplement y your measured triglyceride level and LDL level and your blood will go down your HDL level will go up y okay that seems to be shown in the literat leave a comment if you're taking n in your cholesterol went down or what your thoughts are on this and that's even if you're on a Statin in addition to a Statin it will do that now the big question is will that help you in terms of reducing your chance of dying so your all cause mortality we call it or reducing your chance of a card cardiovascular event a cardiovascular event sounds like a fun thing with tents and balloons and a party but a B event is not a good thing it means a heart attack stroke or death yeah yeah death fall you mentioned that okay so so what does it show about that so there been a lot of clinical trials and they're they're all not exactly the same part of the trouble with some of these trials is that often it was comparing Statin to Statin plus NYS um and that was part of the trouble and some of them included NYS that had a slow release or another agent that helped reduce some of the side effects from the nice and so the it's not a totally homogeneous pool of participants or studies but the Met analyses have mostly concluded to say hey it will do all these things to your blood values but it does not necessarily translate into reduce cardiovascular events that is yet to be proven it does not appear to R and in fact I read an article that showed it might actually increase your cardiovas right so there's why how can this be it's raising your HDL it's lowering your LDL it's lowering your triglycerides how can it be not good for you in that sense right so one people that released a couple months ago talked about how maybe one of the metabolites something called 4py may be implicated in increased cardiovascular events this is a hypothesis it certainly has not been proven but this is maybe explaining why the events were not um seen to go down the studies another reason why these cardiovascular events all cause mortality death may not be reduced with n is because if you think of LL and triglycerides that's that's just just like one molecule they represent a bunch of different molecules h DL is not one molecule it's a bunch of different molecules although when you measure you're measuring an average of these in your blood the specific ones those are more sophisticated tests that are required to to measure the specific ones um and it turns out that maybe nasin increases the hdls that aren't actually good for you those sub molecules in the population of HDL that aren't good for you and that might be one of the reasons that we're not seeing the clinical results that should be expected from the blood results one of the other issues that the RDA for NY is in the 14 to 16 mgram area and the treatment in a lot of these studies is 500 to up to 3,000 milligrams we're talking like aund fold potentially to what your RDA is so that's part of the issue and you Al but you also got to think about where did the RDA come from RDA is just a man-made number that some people in an office somewhere figured was the right amount I think it was also B well I think it was based on the urine test of the metabolize to show that you're cuz if you're spilling lots of it that means you're receiving more than you can possibly use yeah yeah fair but I mean you can't hang your hat totally on rdas either I don't think okay because it's not a hook yeah all right so bottom line okay and what about the side effects because every time you do something there's a likely chance of side effects right we recently talked in our vitamin D and K video saying Vitamin K is pretty safe so if you take a whole bunch of it it's probably not we're not sure if it's going to do what you're hoping it's going to do but it's probably not going to hurt you with with n there are some very um predictable side effects so some gastrointestinal ones like nausea and vomiting the nce and flush they thought is related to high doses single doses where there's a rapid increase and prostaglandins are released that cause B basil dilation so you get a red face that is inconvenient and sometimes embarrassing for people sometimes it can be a little bit itchy sometimes can be associated with a headache and some little blood pressure because of that basil dilation so that was one big thing the another one is your blood sugars right this you could be a situation you're robbing Peter to pay Paul which normally I'm okay with but in this case if it's going to increase your blood sugars that carries with it a whole host of other risks of other diseases and other problems so you don't want doing that and especially you're on a Statin because the statins can also lead to diabetes ironically yeah and and those two big trials the aim trial and so the aim high trial and the Thrive trial also found yeah poorly controlled diabetes new onset diabetes high risk of infection as well as bleeding so these are these are things that are very real and have to be taken into consideration if you are going to consider a supplement always talk to your healthcare provider before you go on a supplement bottom line bottom line for me is first of all if someone writes that you guys are big Pharma shills that is irritating um because we're not telling we're not irrit we're not telling you to take a stat what we are saying is that we're just looking at the evidence we don't make the evidence we're just reporting it right so nin definitely lowers your cholesterol levels and uh raises your good cholesterol levels but it does not translate to reduceed cardiovascular vent so we would say proceed with caution do not stop your Statin based on this evidence in the video give it some consideration talk to your doctor and when you are taking it monitor it carefully that's a long bottom line that's that's your bottom paragraph so what's your bottom line so you started taking it a little while ago I'm not going to take it anymore okay there's six bucks I won't get back at the store where I bought it or I don't know how much it costs but I don't I don't think it's worth the risks f nison is in so many foods that I eat anyways I'm an omore eat a bu of those Foods so I think I'm going to get up nice in there I think always I think if you're considering taking a supplement look at the foods that have that supplement in it and choose those Foods instead of the supplement that's always been my go-to and for me what I really wish could be done would be a trial where they compared a a population that maybe is at risk of heart disease to take nothing versus nice and because now we have the gold standard is to lower your cholesterol with stattin so sometimes some people would argue that it's not ethical to prevent people from taking a stattin and just giving them nice and so it's a very hard study to do now cre study to do now for sure ethical issues with doing that kind of a study however my bottom line is nope there you go if you like this video please like it subscribe to our Channel and remember you are in charge of your own health we'll see you next time

Channel: Talking With Docs

Views: 167,361

Keywords: niacin, cholesterol, niacin benefits, hdl cholesterol, niacin cholesterol, ldl cholesterol, high cholesterol, niacin flush, how to lower cholesterol, niacin cholesterol lowering mechanism, niacin for cholesterol side effects, vitamin b3 niacin, how does niacin work, good cholesterol, niacin side effects, what is niacin, niacin health benefits, benefits of niacin, niacin cholesterol mechanism, bad cholesterol, lower cholesterol, niacin effects

Id: 4anTpm_9fHw

Length: 9min 54sec (594 seconds)

Published: Sun May 19 2024