Long-term niacin treatment induces insulin resistance and adrenergic responsiveness in adipocytes by adaptive downregulation of phosphodiest

[Bolt_Upright]

2014 - Long-term niacin treatment induces insulin resistance and adrenergic responsiveness in adipocytes by adaptive downregulation of phosphodiesterase 3B ncbi.nlm.nih.gov/pmc/articl...

Re-thinking Niacin.

[eschneid]

Hoffer was talking of real people, some were his patients. These were mice and iffy results imho.

[Bolt_Upright in reply to eschneid]

Agreed. And this is 7 years old too. There's been a lot of pro-Niacin research in the last 7 years. And the PD protocol is low dose.

[eschneid in reply to Bolt_Upright]

I actually was taking the slow release you recommended but stopped to clear things out....will niacin up again in some form soon.

[MarionP in reply to eschneid]

Hope it is iffy results, I don't know where you get that idea though . But you also should know that hope is not a plan, and insulin resistance is not something to get. This is not real heavy evidence indicting niacin, but you don't want to discount it just because of that. I would not, will not, drop niacin on this not-heavy evidence, the benefit outweighs the risk at this point, but more research is justified.

[eschneid in reply to MarionP]

I believe we agree that this is not an indictment of niacin and us few on this post are not dropping it based on these studies mentioned. As with anything we try here, you have to get your physicals/bloodwork done, know your body-monitor things constantly and bounce things off your primary dr.

What dose are people taking of niacin. I believe Bolt/I take 250 mg slow release and Despe does 50 mg sublingual.

Sorry for the confusion, I did combine Despe's niacin post with this one. Probably cousins of the other transgenic mice.

[Bolt_Upright]

heart.bmj.com/content/102/3...

Conclusions Niacin therapy is associated with a moderately increased risk of developing diabetes regardless of background statin or combination laropiprant therapy.

[park_bear in reply to Bolt_Upright]

"725/13 121 assigned niacin; 646/13 219 assigned control) were diagnosed with diabetes during a weighted mean follow-up of 3.6 years. Niacin therapy was associated with a RR of 1.34"

If niacin offers significant benefits, relative risk of 1.34 is not a showstopper. It is important to consider increase of absolute risk rather than just relative risk in isolation: Using the above numbers 5.5 percent of people in the niacin arm acquired diabetes versus 4.9 percent of the control arm. Without using any weighting factors that is relative risk of 1.12.

This study was weighted at 64 percent in the meta-analysis, so accounted for most of the result:

nejm.org/doi/full/10.1056/N...

Note that this was not a straight study of niacin, it included:

" Laropiprant (INN) was a drug used in combination with niacin to reduce blood cholesterol (LDL and VLDL) that is no longer sold, due to increases in side-effects with no cardiovascular benefit. Laropiprant itself has no cholesterol lowering effect, but it reduces facial flushes induced by niacin."

Although in fairness the meta-analysis would have arrived at a similar result without this study with regard to diabetes.

(Side note - niacin did raise HDL and lower LDL, but had no effect on vascular events. Not the only study with this result)

Here are the results from this study:

Niacin plus laropripant adverse effects

[eschneid in reply to park_bear]

PB.....thanks for going above and beyond as usual. I'm sure I am not alone in that thinking

[park_bear in reply to eschneid]

Thanks for kind words!

[Bolt_Upright]

But! If Niacin works to slow or stop PD progression, the risk may be worth it? It's a big "if" though.