The Real Story On Niacin: Niacin associated with significant reductions in cardiovascular disease and mortality

You may have heard some recent reports on Niacin (one of the B-vitamins) that seemed to suggest it wasn’t of benefit for cardiovascular disease. Actually, the recent studies fueling these reports only looked at certain special forms of niacin taken together with a statin drug. These studies proved a disappointment to the statin drug makers, because the research didn’t show any additional benefit in adding the niacin. (By the way, some researchers have pointed out problems with the special forms of niacin used in these studies.)

Given the confusion in some news reports about Niacin, we at NYBC think it’s important to repeat what researchers stated about Niacin in a March 2014 article in the Journal of Cardiovascular Pharmacology and Therapeutics. This article reviewed the recent Niacin studies, and also reiterated the well-known and well-documented benefits of Niacin for cardiovascular health:

1. In a long-term study called the Coronary Drug Project, “niacin treatment was associated with significant reductions in cardiovascular events and long-term mortality, similar to the reductions seen in the statin monotherapy trials.”

2. “In combination trials, niacin plus a statin or bile acid sequestrant produces additive reductions in coronary heart disease morbidity and mortality and promotes regression of coronary atherosclerosis.”

3. Niacin is the “most powerful agent currently available” for RAISING levels of HDL-C (high-density lipoprotein cholesterol, the so-called “good cholesterol”); and it can also REDUCE levels of triglycerides and LDL-C (low-density lipoprotein cholesterol, the so-called “bad cholesterol”).

Here’s the reference for these three important points about Niacin:

Boden, W E, Sidhu M S, & Toth P P. The therapeutic role of niacin in dyslipidemia management. J Cardiovasc Pharmacol Ther. 2014 Mar;19(2):141-58. doi: 10.1177/1074248413514481.

NOTE: NYBC stocks Niacin No-Flush (Source Naturals): http://nybcsecure.org/product_info.php?cPath=50&products_id=439; Niacin TR Niatab 500mg (Douglas): http://nybcsecure.org/product_info.php?cPath=50&products_id=249; and
Niacin TR Niatab 100mg (Douglas) http://nybcsecure.org/product_info.php?cPath=50&products_id=252

As always, we strongly recommend that you consult your healthcare provider when using supplements.

Taking Vitamin D3 supplements for more than 3 years linked to lower mortality

We’ve heard a lot about Vitamin D in the past few years. There have been studies linking low Vitamin D levels to a host of health issues, from heightened risk of cardiovascular disease, to higher probability of developing the flu, especially during the winter season, when you get less exposure to the sunshine that allows the body to produce its own supply of the vitamin.

Now here’s an interesting meta-analysis (=review of previously published research) that looks at the connection between long-term use of Vitamin D3 supplements (“long-term” defined, in this case, as more than three years). Reviewing data from 42 earlier trials, this investigation found that those who supplemented with Vitamin D for longer than three years had a significant reduction in mortality. Specifically, this research found that the following groups showed a lower risk of death when supplementing with Vitamin D over a period longer than three years: women, people under the age of 80, those taking a daily dose of 800IU or less of Vitamin D, and those participants with vitamin D insufficiency (defined as a baseline 25-hydroxyvitamin D level less than 50 nmol/L).

Here’s the conclusion reached by the researchers:

The data suggest that supplementation of vitamin D is effective in preventing overall mortality in a long-term treatment, whereas it is not significantly effective in a treatment duration shorter than 3 years. Future studies are needed to identify the efficacy of vitamin D on specific mortality, such as cancer and cardiovascular disease mortality in a long-term treatment duration.

Our comment: We’re not surprised that supplementing over a period of years proves, in this review, to be more beneficial than briefer periods of supplementing. Vitamin D, like many supplements, shouldn’t be seen as treatment for an acute condition. It doesn’t act like an antibiotic, which may clear up an infection with a couple weeks of treatment. Instead, think of the body as having a long-term, continual need for Vitamin D; and note as well that seasonal change, or a particular health status (for example, being HIV+), may lead to deficiency and thus increase your need for supplementing. We were somewhat surprised to see that a significantly lowered risk of mortality was found even with a moderate rate of supplementation (800 IU daily dose). On this Blog you can read about other research that links decreased risk of flu, for example, with a daily Vitamin D dose of 2000IU. At any rate, there are no known “adverse events” at either of these doses of the vitamin, so not to worry, whether you’re following the lower or a higher recommendation.

See the NYBC catalog for Vitamin D3 offerings:

http://nybcsecure.org/index.php?cPath=25

Reference:
Zheng Y, et al. Meta-analysis of long-term vitamin D supplementation on overall mortality. PLoS One. 2013 Dec 3;8(12):e82109. doi: 10.1371/journal.pone.0082109.

CoQ 10, gum disease and cardiovascular health

Yes, your dentist is right: brushing with a good toothpaste (such as one with baking soda), flossing, and regular checkups can keep your smile bright–and also, very importantly, can help prevent gum disease. But did you know that the supplement CoQ 10 has also been found effective in fighting gum disease?

First, a few words about gum disease: the most widespread form, afflicting up to 30% of adults, is gingivitis, an inflammation and bleeding around the teeth that accompanies plaque buildup. If left unchecked, gingivitis can progress to periodontitis, which is characterized by more severe infection and abscesses around the teeth, and tooth loss.

As early as the 1970s it was recognized that CoQ10 could counteract gum disease, and quite quickly. Research found that CoQ10 doses of 50 mg – 75 mg a day halted deterioration of the gums and promoted healing, often within days of beginning therapy. In a carefully controlled trial, 50 mg per day of CoQ10 was notably more effective than placebo in reducing symptoms of gingivitis after three weeks of treatment (Wilkinson EG et al, 1976).

And there’s more: research from the just past few years has highlighted a surprising connection between gum disease and cardiovascular disease. One study found that 91% percent of patients with cardiovascular disease also suffered from moderate to severe gum disease (Geerts SO et al 2004). Researchers now believe that the inflammation associated with gum disease triggers the release of pro-inflammatory chemicals into the bloodstream, which provokes a systemic inflammatory response. It’s also very suggestive that many of the same factors that increase the risk for heart disease also increase the risk for periodontal disease, including C-reactive protein (CRP), fibrinogen, and cholesterol (Wu T et al 2000).

So here’s your bonus: CoQ 10 has a good track record of helping fight gingivitis and preventing the progression of gum disease. But, by fighting off gum disease with this supplement and all the other means mentioned above, you may also be reducing your cardiovascular risk. Isn’t that something to smile about?

NYBC stocks CoQ10 in several formats. See the entry below, which also provides detailed recommendations for use of this supplement:

COQ 10

Vitamin D, HIV, diabetes

A poster at the recent Conference on Retroviruses and Opportunistic Infections reported that Vitamin D supplementation decreases risk of diabetes and possibly cardiovascular complications for people with HIV. The study looked at data from 1574 patients over about 2 and half years. 61% of the patients were “undetectable” for HIV RNA, and at the start of the study, 14% showed evidence of “metabolic syndrome,” which generally points toward development of diabetes.

The study authors found that those patients who supplemented with 1000IU of Vitamin D per day had a substantially lower risk of developing full-blown Type 2 diabetes, which carries with it a higher risk of heart and blood vessel disease. However, they also found that this level of supplementation was not sufficient to completely make up for Vitamin D deficiencies in a significant number of the patients, and so they suggest that a higher dose could prove even more helpful for those with very low starting levels of the vitamin.

Reference: Guaraldi, G, et al. Vitamin D3 Supplementation Decreases The Risk of Diabetes Mellitus Among Patients with HIV Infection. CROI, 2011.

This study adds further evidence to NYBC’s conviction that Vitamin D supplementation, generally at 1000IU – 2000IU/daily (or, in case of substantial deficiency, even higher) is HIGHLY RECOMMENDED FOR PEOPLE WITH HIV. The expense is so low, the side effects basically nonexistent, and the health benefits so convincing that it doesn’t make sense for people with HIV not to supplement with this vitamin!

You can read more about current studies on the health benefits of Vitamin D on this blog.

A simple blood test for Vitamin D is available to check levels–ask your doctor.

Note that NYBC stocks:

Vitamin D – 1000IU

Vitamin D – 2500IU

Vitamin D- 5000IU

These Vitamin D formulations provide a convenient way to take the “sunshine vitamin” at the levels suggested by many recent studies.

Cardiovascular disease, Vitamin D & African-Americans

According to a study published in the Annals of Family Medicine in 2010, it looks increasingly clear that low levels of Vitamin D heighten the risk of cardiovascular disease. That fact could help explain why African-Americans, who have a higher rate of low Vitamin D, also have a much higher rate of heart and blood vessel disease than their white counterparts. (African-Americans have a 38% higher risk of dying of cardiovascular disease than whites do.) Why are African-Americans more likely to have low levels of Vitamin D? The researchers mention lower absorption of vitamin D due to darker skin, and lower dietary intake of Vitamin D among the most important factors. The study findings suggest that the rate of cardiovascular disease in African-Americans could potentially be reduced by as much as 60% through Vitamin D supplementation.

Reference: Fiscella, Kevin and Peter Franks. Vitamin D, Race, and Cardiovascular Mortality: Findings From a National US Sample Annals of Family Medicine 8:11-18 (2010)

You can read more about current studies on the health benefits of Vitamin D on this blog. A simple blood test for Vitamin D is available to check levels.
Note that NYBC stocks:
Vitamin D – 1000IU
And
Vitamin D – 2500IU
These Vitamin D formulations provide a convenient way to take the “sunshine vitamin” at the levels suggested by many recent studies.

Resveratrol again!

For a while it seemed like the excitement about resveratrol–the molecule famously found in red wine–had died down.

A few years ago widely publicized studies showed that resveratrol had potential as a life-extending supplement (it showed that capacity in lab animals). And there was buzz when companies raised hundreds of millions in venture capital to explore the possibilities further. One catch with that high-profile research was that it involved very high doses of resveratrol. (The equivalent of drinking hundreds of bottles of red wine a day!)

However, in just the past couple of years, scientific interest has come back to resveratrol, and this time it is pointing to substantial health benefits without those massive doses.

First, cardiovascular health. In 2009, a Univ. of Wisconsin research team reported that low doses of resveratrol in the diet of middle-aged mice could have many of the same effects as the high dose reseveratrol, especially in terms of protecting heart health. Second, in 2010, John Hopkins researchers reported on a mechanism by which resveratrol shielded mice from stroke damage to the brain. A single small dose of the compound increased levels of an enzyme that protects nerve cells in the brain from damage when blood flow is disrupted by stroke.

It’s also just been announced that the scientific research organization of Denmark will run a multi-year study of resveratrol for diabetes. This announcement follows the news from December 2010 that our hometown Albert Einstein Medical Center has been awarded an NIH grant, also for a study of resveratrol and diabetes.

All in all, resveratrol seems to remain a very promising research topic!

You can find resveratrol in two forms at the NYBC. (Resveratrol Synergy adds some of the additional parts of the grape that are thought to have health benefits, and combines those with green tea extract, another food extract that researchers believe may have health bnenefits.)

Resveratrol

Resveratrol Synergy

Acetylcarnitine for cardiovascular health

Acetylcarnitine (or acetyl-l-carnitine) has been studied in recent years for its neuroprotective effects. It is the subject, for example, of some good research on peripheral neuropathy (nerve damage leading to tingling, pain in the hands and feet) in people with HIV.

But we were interested to read about a 2009 report on acetylcarnitine used in a pilot study of people with elevated cardiovascular disease risk. The investigation, which involved 24 weeks of oral acetylcarnitine therapy (1 gram daily), found significant improvement in high blood pressure and glucose control among the study subjects. Since these improvements point to a decrease in cardiovascular disease risk, the investigators suggest that further research be done to see whether long-term acetylcarnitine supplementation can be a good cardioprotective strategy.

Here’s the abstract of the article:

Ameliorating Hypertension and Insulin Resistance in Subjects at Increased Cardiovascular Risk
Effects of Acetyl-L-Carnitine Therapy
Piero Ruggenenti; Dario Cattaneo; Giacomina Loriga; Franca Ledda; Nicola Motterlini; Giulia Gherardi; Silvia Orisio; Giuseppe Remuzzi

From the Unit of Nephrology (P.R., G.R.), Azienda Ospedaliera Ospedali Riuniti, Bergamo, Italy; Clinical Research Center for Rare Diseases “Aldo and Cele Daccò” (P.R., D.C., G.L., F.L., N.M., G.G., S.O., G.R.), Mario Negri Institute for Pharmacological Research, Bergamo, Italy; Institute of Special Medical Pathology (G.L., F.L.), Università degli Studi, Sassari, Italy.

Correspondence to Giuseppe Remuzzi, Mario Negri Institute for Pharmacological Research, Via Gavazzeni 11, 24125 Bergamo, Italy. E-mail gremuzzi@marionegri.it

Insulin resistance, a key component of the metabolic syndrome, is a risk factor for diabetes mellitus and cardiovascular disease. Acetyl-L-carnitine infusion acutely ameliorated insulin sensitivity in type 2 diabetics with insulin resistance. In this sequential off-on-off pilot study, we prospectively evaluated the effects of 24-week oral acetyl-L-carnitine (1 g twice daily) therapy on the glucose disposal rate (GDR), assessed by hyperinsulinemic euglycemic clamps, and components of the metabolic syndrome in nondiabetic subjects at increased cardiovascular risk a priori segregated into 2 groups with GDR 7.9 (n=16) or >7.9 (n=16) mg/kg per minute, respectively. Baseline GDR and systolic blood pressure were negatively correlated (n=32; P=0.001; r=–0.545), and patients with GDR 7.9 mg/kg per minute had higher systolic/diastolic blood pressure than those with higher GDR. Acetyl-L-carnitine increased GDR from 4.89±1.47 to 6.72±3.12 mg/kg per minute (P=0.003, Bonferroni-adjusted) and improved glucose tolerance in patients with GDR 7.9 mg/kg per minute, whereas it had no effects in those with higher GDRs. Changes in GDR were significantly different between groups (P=0.017, ANCOVA). Systolic blood pressure decreased from 144.0±13.6 to 135.1±8.4 mm Hg and from 130.8±12.4 to 123.8±10.8 mm Hg in the lower and higher GDR groups, respectively (P<0.05 for both; P<0.001 overall) and progressively recovered toward baseline over 8 weeks posttreatment. Total and high molecular weight adiponectin levels followed specular trends. Diastolic blood pressure significantly decreased only in those with higher GDRs. Treatment was well tolerated in all of the patients. Acetyl-L-carnitine safely ameliorated arterial hypertension, insulin resistance, impaired glucose tolerance, and hypoadiponectinemia in subjects at increased cardiovascular risk. Whether these effects may translate into long-term cardioprotection is worth investigating.

See the NYBC entry on acetylcarnitine for further information:
http://nybcsecure.org/product_info.php?products_id=118

and acetylcarnitine/Biosint (Italian source):
http://nybcsecure.org/product_info.php?cPath=50&products_id=320