Why are statins pushed when instead, it seems that the safer route is to just take high doses of niacin (vitamin B3) to lower cholesterol?

You may have read that niacin or niacinamide has a positive effect on cholesterol profile, and that some cholesterol drugs are “knockoffs” of vitamin B3.

“Although most people think of niacin as just a vitamin, if you give it in high enough doses (the doses you need to budge cholesterol levels), it actually becomes a drug,” explains Dr. Elizabeth Klodas, board certified cardiologist and co-founder of Step One Foods.

She continues: “And drugs have side effects.  High dose niacin can make blood sugar control worse in people with diabetes and prediabetes.  It can cause flushing and itching [though non-flush versions are available].”

Okay, so what if you have great blood sugar levels and use the non-flush version of niacin?

“It can affect liver function,” says Dr. Klodas.  “It can cause muscle achiness.  And if you take a look at the medical literature as a whole, niacin does not appear to be that effective in improving patient outcomes.

“So even though it may lower cholesterol, the net benefit is more neutral for niacin than for statins.

“The benefit data behind statins is actually quite strong, especially in individuals with heart disease, those with diabetes and those with persistently very high LDL (bad) cholesterol levels (over 190 mg/dL).

“I only use high dose niacin as a second-tier therapy in those patients with known heart disease who cannot tolerate statins and don’t recommend them for diabetics.

“Because the benefit data for primary prevention with statins (taking them as a purely precautionary step) is less robust, I always try to work hard with my patients to address their cholesterol profiles with lifestyle changes, especially diet.”

Diet for Improving Cholesterol, Rather than Statins and Niacin

The key is not letting your cholesterol profile become undesirable in the first place.

“If you take in enough food-based fiber, omega-3 fatty acids, antioxidants and plant sterols (and I have to emphasize that these nutrients need to come from REAL FOOD in its REAL FORM to be effective), chances are high that your cholesterol profile will improve,” says Dr. Klodas.

“Because my patients found it hard to modify their diet to get these nutrients in adequate amounts, I created Step One Foods to make it easy.”

Don’t let your cholesterol reach a point where you must decide between statins and niacin; practice preventive medicine via the right diet.

dr. klodas

Trained at Mayo Clinic and Johns Hopkins, Dr. Klodas believes in first changing the diet, rather than taking pills, to improve cholesterol profile.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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