You can’t open a newspaper or magazine today without seeing the big ads hat trumpet statin drugs to treat high cholesterol.

The ads tell you how well the drugs work and how they help to prevent heart attacks. If you look more closely at the ads, though, you will see paragraphs after paragraphs of tiny type describing the side effects in scary detail.

The one thing that’s not mentioned in the ads is the cost. These drugs are expensive! A month’s supply of atorvastatin (Lipitor) cost about $90—and you’ll probably be taking it for the rest of your life. The generic versions of statin drugs are cheaper, but the cost still adds up.

For some people, there is a better and cheaper way to lower their cholesterol: That is with niacin. Doctors have known for many years that large doses of nicotinic acid—between 1 and 3 grams a day—lowers LDL (“bad”) cholesterol and raises HDL (“good”) cholesterol.

Lowering your LDL cholesterol and triglycerides, and raising your HDL cholesterol, definitely decreases your risk of a heart attack. In fact, a major study that went on for close to 16 years showed not only that the group who took niacin had lower cholesterol and less heart attacks, but they also had fewer deaths for any reason.

Niacin works for high cholesterol pretty well by itself. Many people need a combination of drugs to really make an impact in their cholesterol, though. Niacin can work well here too, when it’s combined with statin drugs such as Lipitor, Mevacor, Pravachol, or Zocor. Those combination can really bring your cholesterol way down.

Do not try Niacin supplement on your own to lower your cholesterol. The doses needed are so high that the niacin stops being a supplement that you take on a daily basis and becomes a drug. You must work with your doc and have your liver and cholesterol functions checked often. If you’re already taking a cholesterol drug, don’t stop taking it just to switch to niacin. Also, do not continuously take your cholesterol drug and then also start taking niacin supplements. Discuss you cholesterol and drugs you take with your doctor before starting niacin supplements.

Not everyone with high cholesterol should take niacin. If you have type 2 diabetes, extra niacin could cause your blood sugar to go up, but the benefits may outweigh the risks. If you have gout, extra niacin could trigger a severe attack. If you take medicine for high blood pressure, niacin could make your blood pressure decrease too low. And if you have liver disease or ulcers, niacin could make these problems to get worse.

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