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Niacin & Gout ?


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#1 Morgan F

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Posted 23 June 2010 - 12:07 PM


Hey guys -

I take 2g of Niacin (flush!) daily. Just got my blood test results back and my cholesterol (HDL, LDL), glucose, etc numbers are through the roof amazing, magnitudes of order better than anything before. Yay! The primary reason I take niacin is that, I'm at high risk for heart disease and it seems to be one of the safest ways to significantly reduce my risk; furthermore, I take 2g daily because it seems like this is the largest recommended amount that doesn't risk serious side effects.

However: my uric acid level is now 9.8 mg/dl while they say the normal level is 3.4 to 7. I have been researching this and apparently this puts me at major risk for gout; and it also seems likely that this was caused by the niacin (the Interwebs indicate that niacin increases uric acid levels and the chance of getting gout).

I'm wondering if anyone has any data or analysis as to the benefits of niacin (lower chance of developing heart disease?) vs the negatives (chance of developing gout) - or any other analysis or information about how to balance these two, or how I should change my regimen in response to this data.

Thank you!
morgan

#2 pycnogenol

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Posted 23 June 2010 - 03:04 PM

Do you take 2 grams of niacin all at once daily or do you divide up the dose? Why 2 grams of niacin and not 1 gram (or less) daily? Just curious.


Ray Sahelian has some info on niacin:

http://www.raysahelian.com/niacin.html
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#3 mikeinnaples

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Posted 23 June 2010 - 03:30 PM

I take 2g / day as well ...

My understanding is that a single dose gives the best clinical effect. This has been proven true for me.
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#4 rwac

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Posted 23 June 2010 - 03:30 PM

There are better ways of improving your cholesterol levels.
You can start by cutting out the wheat and sugars.

Additionally Saturated fat will increase HDL.

http://heartscanblog...vs-complex.html
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#5 Morgan F

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Posted 23 June 2010 - 03:30 PM

I take it all together. 2g because, according to various (online) sources, that's the maximum amount most people can take daily before damage starts - and, with Niacin it seems, the more the better for reducing cardiovascular risk.

Any recommendations on what I should do differently?

The higher uric acid numbers worry me so, as of today, I'm reducing niacin to 1g/daily, although I'm not sure if I should reduce it by more or less, or not change it at all, or not do anything else differently, etc.

Thank you!
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#6 Morgan F

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Posted 23 June 2010 - 03:36 PM

There are better ways of improving your cholesterol levels.
You can start by cutting out the wheat and sugars.

Additionally Saturated fat will increase HDL.

http://heartscanblog...vs-complex.html


FYI -- I also eliminated 99% of wheat and 80% of sugar from my diet, too. I'm sure these contributed to my recent amazing cholesterol and glucose numbers., as well.
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#7 mikeinnaples

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Posted 23 June 2010 - 03:36 PM

There are better ways of improving your cholesterol levels.
You can start by cutting out the wheat and sugars.

Additionally Saturated fat will increase HDL.

http://heartscanblog...vs-complex.html


Unfortunateley diet can't overcome hereditary issue for all in a reasonable manner. Niaicn is the topic, not diet management. Niacin is also well tested and well tried and for the most part completely safe ...in addition, the way it acts, by increasing overall particle size accomplishes something diet does not.
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#8 Morgan F

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Posted 23 June 2010 - 03:36 PM

I take 2g / day as well ...

My understanding is that a single dose gives the best clinical effect. This has been proven true for me.


Mike, have you noticed your Uric Acid levels change significantly? Have you had or heard any guidance of what to do about this side effect of the niacin?

Thank you!

#9 mikeinnaples

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Posted 23 June 2010 - 03:38 PM

I take it all together. 2g because, according to various (online) sources, that's the maximum amount most people can take daily before damage starts - and, with Niacin it seems, the more the better for reducing cardiovascular risk.

Any recommendations on what I should do differently?

The higher uric acid numbers worry me so, as of today, I'm reducing niacin to 1g/daily, although I'm not sure if I should reduce it by more or less, or not change it at all, or not do anything else differently, etc.

Thank you!


Here is my suggestion:

1. Talk to your doctor about the Uric Acid numbers

2. Watch your glucose levels as Niacin can screw up insulin sensitivity at a clinical dose.

3. Continue taking Nicotnic Acid .....sustained release products can do more harm than good in regards to the liver and most flush free formulas wont help you cholesterol at all because it is the nicotinic acid conversion process that works the magic, not the metabolite.
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#10 mikeinnaples

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Posted 23 June 2010 - 03:40 PM

Mike, have you noticed your Uric Acid levels change significantly? Have you had or heard any guidance of what to do about this side effect of the niacin?

Thank you!


I wish I could comment on this is more detail, but my last labs had me within range. I supplement a lot of things, so I really can't offer any advice on yours.
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#11 SATANICAT

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Posted 23 June 2010 - 03:49 PM

I may be mistaken, but drinking water will help flush the uric acid out.
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#12 rwac

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Posted 23 June 2010 - 04:11 PM

Unfortunateley diet can't overcome hereditary issue for all in a reasonable manner. Niaicn is the topic, not diet management. Niacin is also well tested and well tried and for the most part completely safe ...in addition, the way it acts, by increasing overall particle size accomplishes something diet does not.


Just throwing ideas out there. It doesn't necessarily make sense to use niacin to lower lipids while eating a bad diet (not the case here).
It's also not completely safe, as your very next post demonstrates.

#13 mikeinnaples

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Posted 23 June 2010 - 04:30 PM

Unfortunateley diet can't overcome hereditary issue for all in a reasonable manner. Niaicn is the topic, not diet management. Niacin is also well tested and well tried and for the most part completely safe ...in addition, the way it acts, by increasing overall particle size accomplishes something diet does not.


Just throwing ideas out there. It doesn't necessarily make sense to use niacin to lower lipids while eating a bad diet (not the case here).
It's also not completely safe, as your very next post demonstrates.


As I said ...for the most part. Anything you ingest can be unsafe depending on circumstance, even water.

In terms of measuring risk, Niacin is pretty low especially when properly monitored.

Edited by mikeinnaples, 23 June 2010 - 04:32 PM.


#14 Logan

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Posted 23 June 2010 - 05:10 PM

I take it all together. 2g because, according to various (online) sources, that's the maximum amount most people can take daily before damage starts - and, with Niacin it seems, the more the better for reducing cardiovascular risk.

Any recommendations on what I should do differently?

The higher uric acid numbers worry me so, as of today, I'm reducing niacin to 1g/daily, although I'm not sure if I should reduce it by more or less, or not change it at all, or not do anything else differently, etc.

Thank you!


Here is my suggestion:

1. Talk to your doctor about the Uric Acid numbers

2. Watch your glucose levels as Niacin can screw up insulin sensitivity at a clinical dose.

3. Continue taking Nicotnic Acid .....sustained release products can do more harm than good in regards to the liver and most flush free formulas wont help you cholesterol at all because it is the nicotinic acid conversion process that works the magic, not the metabolite.


Oops, just bought some sustained release Niacin. Crap. I was even thinking I should get regular old nicotinic acid but I bought it any way. Dumb dumb:unsure:

#15 mikeinnaples

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Posted 23 June 2010 - 06:07 PM

My understanding of the research is that prolonged Niacin release increases liver risk especially in the SR formulas. I believe I read also that this applies to doing something such as taking a 2g Nicotnic Acid dose and taking it in 500mg doses throughout the day. I also read that more I gained from a spike than a sustained dose, at least clinically in regards to cholesterol. I wish I had sources handy to cite for you.

My take is this:

regular nicotnic acid > SR Nicotinic acid > Flush Free as Inositol Hexaniacinate > Flush Free as Niacinamide (in fact this one won't do anything for your profile)


Edit/Disclaimer: My suggestion is to read the research out there yourself and make your own informed decision. Don't rely on anonymous people on the internet like me, because I am not an expert. :)

Edited by mikeinnaples, 23 June 2010 - 06:10 PM.

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#16 krillin

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Posted 24 June 2010 - 04:56 AM

Curr Opin Rheumatol. 2010 Mar;22(2):165-72.
A prescription for lifestyle change in patients with hyperuricemia and gout.

Choi HK.

Section of Rheumatology and the Clinical Epidemiology Unit, Boston, Massachusetts 02118, USA. hchoius@bu.edu
Abstract

PURPOSE OF REVIEW: This review summarizes the recent data on lifestyle factors that influence serum uric acid levels and the risk of gout and attempts to provide holistic recommendations, considering both their impact on gout as well as on other health implications. RECENT FINDINGS: Large-scale studies have clarified a number of long-suspected relations between lifestyle factors, hyperuricemia, and gout, including purine-rich foods, dairy foods, various beverages, fructose, and vitamin C supplementation. Furthermore, recent studies have identified the substantial burden of comorbidities among patients with hyperuricemia and gout. SUMMARY: Lifestyle and dietary recommendations for gout patients should consider overall health benefits and risk, since gout is often associated with the metabolic syndrome and an increased future risk of cardiovascular disease (CVD) and mortality. Weight reduction with daily exercise and limiting intake of red meat and sugary beverages would help reduce uric acid levels, the risk of gout, insulin resistance, and comorbidities. Heavy drinking should be avoided, whereas moderate drinking, sweet fruits, and seafood intake, particularly oily fish, should be tailored to the individual, considering their anticipated health benefits against CVD. Dairy products, vegetables, nuts, legumes, fruits (less sugary ones), and whole grains are healthy choices for the comorbidities of gout and may also help prevent gout by reducing insulin resistance. Coffee and vitamin C supplementation could be considered as preventive measures as these can lower urate levels, as well as the risk of gout and some of its comorbidities.

PMID: 20035225

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#17 nameless

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Posted 24 June 2010 - 08:53 PM

What about cherries? That should lower uric acid somewhat.

Although eating too many cherries could be an issue due to fructose. Hmm... an extract, maybe?

And extended release niacin should still work, just not quite as well as IR. If you get your liver checked regularly, and take it under a doctor's care, I wouldn't be overly concerned. Although 2 grams is a pretty hefty dose... you may want to see if you can get by with less, like you are trying.




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