The dark side of some cholesterol medication

We can add one more item to the list of things we thought were good for us and now know probably aren’t: niacin, aka vitamin B-3.

Many of us with troublesome cholesterol levels have been on statins to reduce the risk of stroke or heart attack. Niacin has been added to our list of go-to drugs for many years because when combined with statins, it is known to reduce bad (LDL) cholesterol and raise the level of the good (HDL) cholesterol. So far, so good.

However, new research reported in The New England Journal of Medicine has determined that: 1) statins alone do a good job of preventing strokes and heart attacks, and 2) just because niacin has helped folks achieve better LDL and HDL numbers doesn’t mean that it helps to prevent strokes and heart attacks.

Turns out it doesn’t.

Even worse, niacin can have its own set of side effects. Some are merely annoying (flushing, which can be offset by pairing niacin with laropiprant), while others are serious (gastrointestinal problems, bleeding, rashes and ulcers). Those in the study who took niacin were 32 percent more likely to be diagnosed with diabetes. One-third of participants dropped out because of problems caused by the niacin. An earlier clinical study was actually stopped when researchers found there was no difference between the niacin and a placebo, and discovered the same side effects.

If you’ve been prescribed niacin to go along with your statins for heart attack or stroke prevention, talk to your doctor about whether you should continue to use it. At the same time, don’t try this on your own! Get medical advice before either starting or stopping therapeutic doses of niacin.

Matilda Charles regrets that she cannot personally answer reader questions, but will incorporate them into her column whenever possible. Send email to [email protected]