Niacin for Lowering Cholesterol and Triglycerides

Hi Dr. Dean,

I have been on a robust supplement program since 1975 (age 15). I’m an avid follower of you, Durk & Sandy, and the researchers/writers from Life Enhancement, Life Extension, and lately to a lesser degree, VRP. My question is, is there a way to measure if 40 years of heavy supplementation has preserved this 55 year old body as that of a 47-year old, a 45 year old, a 52 year old, etc.? Am I crazy with this regimen? I certainly think the science behind the supplements I take makes sense.

Extend Ultra and Advanced Essential minerals have been my base multi’s since they came out. In addition, I take 250 mg Resveratrol, 200 mg Ubiquinol, 75 mg DHEA, Inner Power, ThyroPlex, Insulife B, Potassium Basics, magnesium citrate, 3000 EPA/DHA, 5000 IU D3, L-Carnosine/benfotiamine , Propel, Pycnogenol, Andro Amp, Andro Prime and 1000 mg EDTA & Garlic daily. Stopped taking 1500 mg niacin, and now take red yeast rice and policosanol to see if they knock down my cholesterol and triglycerides numbers. All blood work numbers (male panel from are very good and below “normal” ranges, but cholesterol and triglycerides are high, hence the switch from niacin. On no meds, BP normal, exercise, very limited white flour/sugar. Lower carb/protein daily diet with a little cheating.

If I lived closer to Florida I’d become a patient. Thanks for all the great information you have provided over many years.

VIC, Greenwood, SC

Dear Vic,

That’s quite a comprehensive and commendable program. But I suggest you get back on the niacin. Make sure it’s just plain, quick-release “flush-producing” nicotinic acid. I’ve found the timed-release to be less effective and more toxic, and the flush-free Inositol Hexanicotinate to be next to worthless for normalizing your lipid levels.

Niacin will lower your total cholesterol, LDL, and triglycerides, and raise your HDL. You should be able to “fine-tune” your lipid profile by adjusting your niacin dose. Doses up to six grams are sometimes required—but usually an appropriate dose ranges between 1-2,000 mg per day.

The red yeast rice extract may help, but it’s just like taking a statin drug—it lowers your CoQ10 levels, and doesn’t affect the HDL level, as niacin does. Also, despite the positive literature articles on policosanol, I’ve never seen it have much effect on lipid levels in my patients. Niacin is the only lipid-lowering substance I recommend (see Fig.1).

Figure 1. Both niacin and EPs significantly improved serum lipoprotein profiles in patients with hyperlipidemia and angina pectoris, compared with pretreatment baseline levels. (Adapted from Klimov AN, Konstantinov VO, Lipovetsky BM, et al. “Essential” phospholipids versus nicotinic acid in the treatment of patients with type IIb hyperlipoproteinemia and ischemic heart disease. Cardiovasc Drugs Ther. 1995;9:779-84.
(click on thumbnail for full sized image)

Other supplements I recommend for you (and everyone) include Melatonin (5-10 mg an hour or so before bedtime) and the drug Metformin (500 mg two or three times/day with normal kidney function; less with severe kidney impairment). I think Metformin is beneficial for almost everyone (except those rare individuals who are allergic to it). Metformin is a multi-hormone receptor sensitizer, activates AMPK (to restore youthful cellular function), protects against cancer, and extends the lifespan of experimental animals (and presumably us, as well). It will also have beneficial effects on your elevated triglycerides. Another supplement to consider is Turmeric/Curcumin, as in Durk & Sandy’s Turmeric Root Power, with its multiplicity of anti-inflammatory, anti-cancer, anti-thrombotic and anti-aging properties.

With regard to your excellent question regarding biological age, and its potential delay using anti-aging drugs and nutrients…. That’s a subject I’ve been researching for over 30 years. My book on the subject (Biological Aging Measurement—Clinical Applications) was published in 1988. Unfortunately, it was done in the “pre-computer era,” and is somewhat out of date. Nevertheless, it remains one of the most comprehensive compendiums of “what goes up and what goes down” with aging.

As the Medical Director of AntiAging Systems, Inc (, we designed an excellent but short-lived computer-based system (unfortunately driven into bankruptcy by a frivolous lawsuit from a jealous, incompetent competitor).

An innovative approach to aging measurement are the tests of telomere length that are now available. Titanovo (, Life Length (, and ( are three of the many companies that specialize in this burgeoning, changing technology. The tests are relatively expensive, and there are questions as to which method will give the most accurate, usable information. If you choose to do this test, I recommend Life Length—although I would probably hold off for another year or two, while the science and data are being developed and refined.

The Life Extension test battery is one of the better ones for clinical chemistry, although I think True Health Diagnostics ( offers an even broader, more sophisticated battery of tests, focusing on Metabolic, Inflammatory, Cardiovascular and Endocrine hormone panels, depending on the ordering physician’s customized panel. If you can’t find a physician near you who offers this test, give my office a call and we can find a drawing station and arrange a telephone consultation follow-up.

Ward Dean, MD

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