Niacin can be useful to raise HDL, reduce small LDL particles, and reduce triglycerides, but it’s not without its problems: higher blood sugars, higher uric acid and gout, the annoying “hot flush,” and—given its mixture of effects—failure to reduce risk for cardiovascular events.
I stopped using niacin altogether when it became clear that the strategies used in my Undoctored program achieved SUPERIOR improvements in cardiovascular risk factors than niacin:
- Increased HDL—often dramatic. (My personal HDL jumped from 27 mg/dl to 94 mg/dl—not an uncommon response and far in excess of the modest increase achieved by niacin.)
- Increased HDL size—making it presumptively more protective
- Reduction or elimination of small LDL particles
- Reduction of triglycerides
- Reduction of VLDL particles after meals—a huge effect in reducing cardiovascular risk
- Reduction in inflammatory measures such as C-reactive protein, CRP
- Reduction in insulin resistance, fasting glucose, fasting insulin, HbA1c
In other words, niacin can’t even begin to match the lipoprotein/metabolic/cardiovascular benefits of the strategies we follow in the Undoctored program.
Why I No Longer Use Niacin
Up till about eight or nine years ago, I used to use a lot of niacin (actually, slow-release niacin) in my practice, to prevent heart disease — coronary heart disease. But I stopped using it, when it became clear that the strategies we use in the Wheat Belly Total Health and Undoctored programs were much more effective, with a lot less problems.
So, in my programs, we eliminate wheat and grains (all wheat and grains) and cap our net carb intake to no more than 15 grams net carbs per meal. We supplement Vitamin D to achieve a 25-hydroxy Vitamin D level of 60 to 70 nanograms per milliliter. We supplement fish oil at a therapeutic dose; supplement iodine; achieve optimal thyroid status; supplement magnesium, and make efforts to cultivate bowel flora.
Well, I used to use niacin because it raised HDL, and made HDL a larger particle, and thereby presumptively more protective. It converted some small LDL particles (that cause heart disease) to large LDL particles. And it also reduced triglycerides modestly.
Well you know what? It did so, but had lots of problems. It also raised blood sugars substantially. It increased the uric acid that leads to gout and uric acid kidney stones. And it also was a source of a peculiar effect of red hot flushing — it was very annoying to many people.
The Wheat Belly Total Health and Undoctored strategies did all the same things: raise HDL, made HDL larger, reduced small LDL (magnificently by the way) and reduced triglycerides, and also reduced postprandial lipoproteins (after meal lipoproteins), that niacin does not do. In other words, the effects achieved by these basic efforts were far superior to what we achieved with niacin, with none of the problems. And we actually got lots of side benefits, not side-effects.
And so, I found that if we did all the strategies in these programs you don’t need niacin — even with lipoprotein(a). Lipoprotein(a) is a genetic pattern that is also reduced by niacin. I also found that if you follow the basic strategies of the Wheat Belly Total Health / Undoctored programs, that we could most carotid and coronary disease to a halt, even in people with lipoprotein(a) — without trying to reduce the lipoprotein(a) with niacin.
Bottom-line: these strategies put together, in the oddly named Wheat Belly Total Health and Undoctored programs, are far superior, far more effective than niacin ever was in achieving improvements in the factors that lead to heart disease — with none of the problems.
Now, if you like these kinds of ideas, I invite you to subscribe to my YouTube channel, or join my conversation my Wheat Belly Blog, my Undoctored Blog and the Wheat Belly and Undoctored social media.