High-dose immediate-release niacin for lipid management
The speaker contrasts the effects of niacin forms. Immediate-release nicotinic acid is effective and safe for the liver, while slow-release niacin, designed to avoid flush, concentrates in the liver and becomes toxic. He cites McKenney's 30-week trial where 0/23 patients on immediate-release had liver issues vs 52% on SR. He also mentions the UC Irvine experiment that illuminated the mechanism. He emphasizes that pharmaceutical companies created patented forms like inositol hexanicotinate to profit, but they are less effective or dangerous.
Niacin affects the liver's handling of lipoproteins. A study at UC Irvine showed that nicotinic acid prevents the re-uptake of HDL into liver cells, likely by inhibiting a surface receptor or pathway, resulting in higher circulating HDL and lower LDL/VLDL. This is independent of the flush, which is caused by release of prostaglandins from skin mast cells.
grupa doktora mckenia podawała przez 30 tygodni dawki od 500 do 3000 mg dziennie u żadnego z 23 pacjentów przyjmujących niacynę szybko działającą nie stwierdzono problemową wątrobowych natomiast aż 12 z 23 przyjmujących niacynę SR czyli 52% ucierpiało z powodu hepatotoksycznego działania preparatu

