Doc wants me to take Niaspan

[bunnylady]

His nurse called me today- my Chol is 338, Trig 348 and LDL 204

I'm still suffering greatly- don't really care if I have a heart attack 10 years from now- I just want to get through this- they ask if I exercise? huh! what's that!

[Darrell]

The Niaspan side effects literature mentions flushing, itching, tingling, headache, stomach upset, heartburn, nausea, vomiting, diarrhea, vision problems, dark urine, stomach (abdominal) pain, yellowing eyes or skin, irregular heartbeat, black stools, increased urination, muscle aches/pain, rash, swelling, dizziness or fainting, and trouble breathing. Look to the bright side -- you already have lots of experience with some of these!

[Darrell]

Sorry, I couldn't resist. Try this: "Seriously, doc, could we fix some of the problems I already have before we work on my heart attack? Lowering my stress might be more effective than lowering my cholesterol."

[sos_group_owner]

Hi BunnyLady,

Re: His nurse called me today- my Chol is 338, Trig 348 and LDL 204

Would have been nice if they told you your HDL was excellent.
HDL of 64 is very good.

Eating low carb and supplementing with cinnamon can cut your triglycerides in half.
Lowering your cholesterol is only going to make your Dr happy and you more miserable. The problem with Niaspan (niacin) is that it can cause elevated homocysteine, especially if you don't supplement with the B vitamins... and the long list of adverse effects. Elevated homocysteine is one of the factors that leads to oxidized LDL.

Fran

[bunnylady]

Thanks- that's what I thought- I did have good HDL she said

I'll print this out and take it in

[sos_group_owner]

Hi BunnyLady,

Below is an abstract of a study published in the American Heart Journal.
Print this for your doctor.

Fran

Niacin treatment increases plasma homocyst(e)ine levels
Volume 138, Issue 6, Pages 1082-1087 (December 1999)

Rekha Garg MD, MSaa, M. Malinow MDba, Mary Pettinger MSca, Barbara Upson BSba, Donald Hunninghake MDda and On behalf of the ADMIT Investigators
Received 10 August 1998; accepted 16 December 1998.

Abstract
Background Studies have reported high levels of plasma homocyst(e)ine as an independent risk factor for arterial occlusive disease. The Cholesterol Lowering Atherosclerosis Study reported an increase in plasma homocyst(e)ine levels in patients receiving both colestipol and niacin compared with placebo. Thus the objective of this study was to examine the effect of niacin treatment on plasma homocyst(e)ine levels.

Methods
The Arterial Disease Multiple Intervention Trial, a multicenter randomized, placebo-controlled trial, examined the effect of niacin compared with placebo on homocyst(e)ine in a subset of 52 participants with peripheral arterial disease.

Results
During the screening phase, titration of niacin dose from 100 mg to 1000 mg daily resulted in a 17% increase in mean plasma homocyst(e)ine level from 13.1 ± 4.4 μmol/L to 15.3 ± 5.6 μmol/L (P < .0001). At 18 weeks after randomization, there was an absolute 55% increase from baseline in mean plasma homocyst(e)ine levels in the niacin group and a 7% decrease in the placebo group (P = .0001). This difference remained statistically significant at the end of follow-up at 48 weeks.

Conclusions
Niacin substantially increased plasma homocyst(e)ine levels, which could potentially reduce the expected benefits of niacin associated with lipoprotein modification. However, plasma homocyst(e)ine levels can be decreased by folic acid supplementation. Thus further studies are needed to determine whether B vitamin supplementation to patients undergoing long-term niacin treatment would be beneficial.

(Am Heart J 1999;138:1082-7.)

[CatMom]

niaspan.com

Have you read their sight, especially the part where it says this,"NIASPAN has not been shown to prevent the development of heart disease."

(2nd paragraph, last sentence.)

[bunnylady]

that figures- he told me if I didn't take it that I should forget getting knee replacement- if I died of heart attack I didn't need to fix my knee in other words- cause it will happen tomorrow

[garlicprincess]

Yikes, just got back from dr visit

As I thought, he was not happy with my no more Zocor no more Zetia cholesterol numbers:

Tri's 104
Chol 308
LDL 235
HDL 52
VLDL 21
TC HDL 5.9

Pretty ugly numbers if you read the cholesterol charts.

He wanted me to go on Vytorin!!!!!! Then he said Zetia!!!!!! No, no, no. Then he said Welchol.....then Niaspan! Said my LDL needs to decrease fast by at least 60% and that I am going to have a MI or cardiac related event if I don't do something fast to get my numbers down. Was very upset that my PCP took me off Zocor and Zetia. (did he not read the letter I sent to his office outlining all drug changes and events I had gone through, including all the tests, scopes, symptoms etc) So I have an RX for Niaspan and briefly reading about it is scary - warnings about liver and also reading about the increase in homocysteine levels.

Tried to tell him how rotten I felt all those years on the drugs, and that when stopping, some of the symptoms abated quickly - was told that if I don't take the Niaspan and don't get my numbers down, I would have to take statins and just accept what they do to my body and live with it!!!

I am so disappointed and wished I would have had articles and studies with me to show him. I needed to be so much more articulate than I was.
Obviously my memory issues or lack of still plague me - left my housekeys and umbrella at my last stop after my drs appt.

Sarah

[Darrell]

You said no more Zocor (simvastatin) and no more Zetia (ezetimibe) and he said Vytorin (simvastatin plus ezetimibe)! I would have walked out right then and there. Leaving your housekeys and umbrella was not a sign of memory problems -- it was a sign of being justifiably upset after being steamrollered by a doctor.

[garlicprincess]

Darrell,

Thanks for your comments - the last thing I want to start again is Zocor, Zetia, Vytorin or any of the other statins. Was just horrified that there had been such a lack of communication between all my health care providers, even when numerous letters, faxes etc had been sent from me to them in order to keep everyone on the same page, with copies of test results, blah blah.

Thought about walking out but tried to sit there and convey the events that had occurred since the last visit, the UCSD Statin Study etc., what effect the drugs had on me, the unneccessary tests, biopsies, scopes+ that I had to go through, the visits to Cleveland Clinic...

Frustrating. Yep, steamrollered for sure and I guess still venting.

Sarah

[sos_group_owner]

Hi Sarah,

Tri's 104 - Excellent
Chol 308
LDL 235 (so this is your doctors major concern?)
HDL 52 - Excellent
VLDL 21 - Excellent (calculated by dividing trig's by 5)
TC HDL 5.9

Your numbers are NOT ugly!

Do you have any history of:
Heart Disease?
Heart Attack?
Angina?
Diabetes?
High Blood Pressure?

Has your doctor checked for an underactive thyroid?
Tested your homocystiene levels?
Lp(a) - Lipoprotein (a)?
Oxidized LDL?

You've learned a vital lesson. Take a list of all your concerns so you can refer to it while you are seeing the doctor. And bring copies of tests with you rather than relying on the office staff to place test results in your file.

If your doctor is focusing only on elevated LDL and not paying any attention to your adverse reactions to statins and other lipid lowering drugs, it's time for you to start looking for another doctor.

Fran

[garlicprincess]

Hi Fran,

Thanks for your thoughts and comments. Although usually better prepared for drs appts, yesterday I was not! Appreciate your questions in regard to testing for homocystiene (asked that yesterday, he said homocystiene was not as much of a concern now as it was a few years ago..his current thinking). It appears his major concern is my LDL. He did mention that he could send me for a stress test but that was not ordered at this time. There are lots of options and I need to get one dr out of my team on the same page so that they will work with me. Reviewing recent labs again today and ones that were just ordered for 7 weeks out to see if homocystiene, Lp(a) and Oxidized LDL were ordered, if not will see if they can be added. Yes, my adverse reactions were totally dismissed in this case.

"Do you have any history of:
Heart Disease? Family history yes, personal no
Heart Attack? Family history yes, personal no
Angina? Family history yes, personal yes from Mitral Valve prolapse sometimes
Diabetes? Family history yes, pegged by same dr as "borderline diabetic" 12/2005 - 102 FBS asked about that yesterday..FBS now 82. Statin related perhaps??? No statins, better FBS!
High Blood Pressure?" Family history yes, personal: borderline high sometimes when stressed

Has your doctor checked for an underactive thyroid? - currently being treated for underactive thyroid
Tested your homocystiene levels? -Not recently
Lp(a) - Lipoprotein (a)? Going to check and ask
Oxidized LDL?" Going to check and ask

It's amazing how the medical thinking goes, used to be they wanted cholesterol level under 200, now I am told total needs to be under 170. Used to say take Vitamin E, that changes based on studies, glucosamine, coffee --- like marketing. No wonder it's so easy for a patient to get confused. As a consumer/patient, one wants to make the best choices and not inflict further harm upon the body.

Sarah

[bunnylady]

I took mine and threw it in the trash (the Zetia and Niaspan) I want to be rid of all side effects and pains before I worry about cholesterol- Fran I ordered the Cinnamon- how much should I take for the tri's?

Patty

[garlicprincess]

Hi Bunnylady

I am not filling my Niaspan RX yet, as it will most likely end up in the trash after reading about it.

Cinnamon Cassia - 500 mg capsule, 1 per day

Got some today at GNC $7.19 a bottle for 100 capsules

Interesting article re: cinnamon and benefits from 2003
ww.newscientist.com/article.ns?id=dn4413

Also good article Dr. Weil from 2004
ww.drweil.com/u/QA/QA346983/

I hope you start to feel better!

Best,
Sarah

[tex62]

Sarah (garlicprincess),

I don't think your experience with your doctor is very different than many others. How frustrating!!! It is enough to drive our blood pressure sky high in addition to the other problems we are already dealing with.

Dr. Graveline's September Statin Newsletter arrived today. There is a wonderful article about Permanent Side Effects from Statins that all of us who have experienced statin side effects should take along on our doctor visits in case they try to push another similar drug. In case you haven't gotton your newsletter yet, the article is at
http://www.spacedoc.net/statins_permane ... fects.html

Best wishes to you.

[sos_group_owner]

Re: Fran I ordered the Cinnamon- how much should I take for the tri's?

Hi Patty,

Start with one 500mg capsule. If that lowers your trig's enough, that's all you need. I think the most anyone should take is three 500mg capsule. Watch your carbs too, especially the white foods.

Fran