i can't take regular niacin because of the flush, but I take time release niacin before I go to bed. Many cholesterol meds have niacin.
Good article from Scientific American: Cholesterol and Controversy: Past, present and Future
Today, it is estimated that 50% of the American population have cholesterol levels that fall outside the accepted healthy range, and the prevalence of cardiovascular disease reflects this. However, the idea that cholesterol is a major risk factor for the development of heart attacks and strokes was one that was rejected by the scientific community for decades. Although high cholesterol is now a universally accepted warning sign, some medical professionals are starting to question the current standard of care when it comes to statin therapy, as these cholesterol-lowering medications may not benefit all patient populations equally. Will history repeat itself? Here I will present the story of cholesterol, and how it has – and continues to be - a controversial component of modern medical history............
and towards the end of the article..........
To date, niacin is the most effective FDA approved means of raising HDL-cholesterol. Interestingly, niacin also lowers LDL-cholesterol, as well as another type of blood lipid called triglycerides. Because of this, it is hard to tease out whether the protective effects of niacin are actually related to raising HDL levels. Fibrates, such as TriCor or Lopid, are another class of compounds that can significantly raise HDL levels, but, like niacin, these drugs also affect LDL and triglycerides.
All statins have been reported to be associated with adverse side effects, especially when administered at high doses2. These side effects include memory problems, sleeping issues, and, most commonly, that which is associated with muscle. For some, these muscle issues might just be minor. For others, however, statin use may come with more serious muscle problems, and this is catching some attention (see this post by Laura Newman). Based on this, as well as results published in November of 2010 in the Lancet, which reported a significant increase in the number of patients experiencing a muscle condition called myopathy as a result of high-dose statins (80mg per day), the FDA has issued the following safety announcement:
[06-08-2011] The U.S. Food and Drug Administration (FDA) is recommending limiting the use of the highest approved dose of the cholesterol-lowering medication, simvastatin (80 mg) because of increased risk of muscle damage. Simvastatin 80 mg should be used only in patients who have been taking this dose for 12 months or more without evidence of muscle injury (myopathy). Simvastatin 80 mg should not be started in new patients, including patients already taking lower doses of the drug. In addition to these new limitations, FDA is requiring changes to the simvastatin label to add new contraindications (should not be used with certain medications) and dose limitations for using simvastatin with certain medicines.
https://blogs.scientificamerican.com/guest-blog/cholesterol-confusion-and-why-we-should-rethink-our-approach-to-statin-therapy/
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