Bests & Worsts Reviews from Amazon

I am a physician, I take this Rugby niacin 1500mg a day, and have for over 15 years. Niacin does work to lower your cholesterol, I've proven it to myself by adjusting the dosage and watching my cholesterol levels go up and down depending on the dosage. Recently, there's been a lot of flack coming from alleged experts who are in fact nothing more than the usual Big Pharma shills, saying that niacin DOES NOT WORK. And unfortunately, they all point to this one recent study from the New England Journal of Medicine (NEJM): "Effects of Extended-Release Niacin with Laropiprant in High-Risk Patients", in the July 17, 2014 issue. I will post a direct link to this article in the comments so you can read it for yourself. I have written articles for refereed journals, I read lots of medical articles, I used to subscribe to the NEJM. And I am appalled that the NEJM published such an awful article like this one and then allowed the Big Pharma shills to twist the results around and say that this article showed that niacin did not work. So let's look at this article carefully. The first key line that ALL of you need to read in this article is the fine print buried at the end of the article, page 211, where it states: ---------------------------- Dr. Landray, Dr. Haynes, Dr. Hopewell, Dr. Parish, Dr. Aung, Dr. Tomson, Mr. Wallendszus, Dr. Craig, Dr. Jiang, Dr. Collins, and Dr. Armitage report receiving grant support from Merck. ---------------------------- Right, so these esteemed physicians were on Merck's PAYROLL. What exactly did the researchers study? What did they prove? Here's what they did: The first thing they did was to take their study population and put them on standard statins and make sure that their total cholesterol levels were well controlled (p. 204-205): ----------------------------- In a prerandomization run-in phase, each participant received simvastatin at a dose of 40 mg daily; if this dose was not as effective as their prior treatment or if their total cholesterol level was 135 mg per deciliter (3.50 mmol per liter) or higher after 4 weeks, ezetimibe at a dose of 10 mg daily was added. ----------------------------- And then they added Merck's own concoction of niacin on top of that: ----------------------------- After LDL cholesterol-lowering therapy had been standardized, participants received a combination tablet containing 1g of extended-release niacin and 20 mg of laropiprant daily for 4 weeks, followed by two tablets daily providing a total of 2 g of niacin and 40 mg of laropiprant for 3 to 6 weeks. ----------------------------- Laropripant has NO cholesterol lowering effects but does work as a prostaglandin D2 receptor antagonist, and was designed to lower the flushing effects even more than the extended release feature of the type of niacin used. Nobody has ever studied explicitly whether Laropripant totally makes niacin ineffective as a cholesterol lowering agent, but the results of this study would seem to point much more in that direction than proving that niacin does not work for lowering cholesterol. The study basically attempted to see whether a group of patients already on statins and with well controlled total cholesterol levels would receive any ADDITIONAL BENEFIT from a drug concoction that used an ineffective form of niacin (the extended release type) mixed with another drug designed to NEUTRALIZE one of niacin's side effects, without any clue as to whether this other drug would also neutralize niacin's cholesterol lowering effects. The only thing this study proved was that Merck's product Laropripant combined with extended release niacin (a mix trademarked as Cordaptive in the US, Tredaptive in Europe) had NO ADDED BENEFITS IF THE PATIENTS WERE ALREADY WELL CONTROLLED ON A STATIN MEDICATION. Merck did two things with this article. They immediately withdrew Cordaptive/Tredaptive from the market following the publication of the article. And then a whole slew of doctors and other wizened heads were recruited to trumpet the fact that research had now shown that niacin DID NOT WORK! But niacin works to lower cholesterol. There is a lot of research that proves that it works. And there are a lot of side effects to statins. Muscle aches, fatigue, and memory loss being the biggies. My father was put on statins and got the muscle aches. He didn't like the flushing sensation of niacin either, so I told him to take Guar gum capsules. That plus changes in diet has worked well for him. We've known for decades that taking stuff that will bind cholesterol from the bile in your gut and prevent it from being reabsorbed into your body will lower your cholesterol levels. Cholestyramine, a resin used in biochemistry exchange columns was one of the earliest cholesterol reducing agents used based on this principle. This is how oatmeal and psyllium seed husks (metamucil) work to reduce cholesterol levels. The water soluble fiber in guar gum is the most concentrated form you can take to take advantage of this effect to lower your cholesterol. There are lots of other such water soluble fibers, like xanthan gum, but guar gum can be found readily in capsules, making this easier to take (there are many other water soluble fibers now available in capsules, pectin, glucomannan, psyllium seed husks, etc). As for me, I not only have gotten used to the niacin flush, I actually like it. I take the niacin every day before I go to work, on an empty stomach, and believe me, it wakes you up with a real buzz, better than coffee in the morning. I also take the guar gum capsules, since I got tired of the whole mess of mixing and gulping down metamucil every morning. I would point out also that the extended release versions of niacin, besides being less effective at lowering cholesterol, are the MAIN CULPRITS in all the reported cases of liver failure caused by niacin. Basically, your liver was NOT designed to be exposed to high doses of niacin 24 hours a day, that will kill it. But, if you take smaller doses of the extended release niacin to prevent liver failure, niacin doesn't work nearly as well. It's really simple. That's why I don't take extended release niacin, would never recommend anybody to take it, and I've gotten used to the niacin flush. It's better than losing your memory or getting muscle aches and fatigue.