Niacin & CV Disease: Why the Debate? (The Science)

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ABOUT THIS VIDEO:
I've done a couple of updates on this video. Please check them out.
- https://www.youtube.com/watch?v=9pvRzoRSpHI
- https://www.youtube.com/watch?v=UJzv0X4zRLY

Along with its partner chemical, nicotinamide, it is the B3 complex. Niacin is vitamin B3 - not D3. (Blooper alert - at 00:35, I mistakenly said D3. Not once, but several times). I would re-tape. But too many people continue to value it.) The clinical and research discussion starts at 3:39. I still plan to do an update soon.

Niacin was discovered in the late 1800s and confirmed in the early 1900s. It was originally called "PP" factor, for Pellagra Prevention factor. Pellagra can cause severe skin disease. It also can create black tongue. This is also cured by niacin.

Niacin was originally made by oxidizing NICOTINE. The similarities in these two molecules are shown in the video. It may have something to do with the far-reaching impact of nicotine.

Niacin is involved in more metabolic processes (over 450) than any other vitamin cofactor. And Niacin has been found to have a positive impact on more cholesterol, lipid, and cardiovascular problems than any other medicine.

Debate started in 2011 with 2 studies: HPS2-THRIVE and AIM HIGH. The problem with HP2-THRIVE was laropiprant. Lapopiprant was the popular medication used to stop niacin flush. Niacin flush is created by action on prostaglandin receptors. Laropiprant blocks those receptors. This receptor-blocking activity stopped the niacin flush. But it appears it also stopped the positive impact of niacin.

AIM HIGH was another study that failed to show positive impact by niacin. There is a lot of debate re: the reason. It ranges from the thought that niacin doesn't work to problems with the study design.

Does niacin help or not? It's still a debate. Many studies have shown that it does. Some have shown that it does not. What do I do? I take it. 2000 mg/day. Rugby or Enduracin brands (and I have no financial relationships) are extended-release versions. We'll cover the management of flush in another video.

Read more about niacin here: https://prevmedhealth.com/does-niacin-work-the-great-niacin-debate.
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🩺ABOUT DR. BREWER
Dr. Brewer started as an Emergency Doctor. After seeing too many preventable heart attacks, he went to Johns Hopkins to learn Preventive Medicine. While there, he went on the run the post-graduate training program (residency) in Preventive Medicine. From there, he made a career of practicing and managing preventive medicine and primary care clinics. His later role in this area was Chief Medical Officer for Premise, which has close to 1,000 primary care/prevention clinics. He was also the Chief Medical Officer for MDLIVE, the second largest telemedicine company. More recently, he founded PrevMed, a heart attack, and stroke prevention clinic.

At PrevMed, we focus on heart attack, stroke, and cognitive decline. We serve patients who have already experienced an event as well as those who have not developed a diagnosis or event. Dr. Brewer provides services via telemedicine or in-person if you're in the Lexington, KY area. We find a lot of undiagnosed prediabetes or insulin resistance. Treating unrecognized risk factors like prediabetes allows reduction of risk and prevention of disease.

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