What Happens When Big Pharma Tries to Re-Invent a Vitamin

Doctor Sears is one of my favorite medical writers. He has a big South Florida practice and is an adventurous world traveler. He proves a point here that we have been teaching for about three years but he says it so much better. He explains why Niacin sometimes fails. He explains how to make it work to better your cholesterol profile. He is a provocateur which I like. -Garey

Big Pharma’s Phony Heart Drug Failure

Dear Reader,

Get this: Big Pharma giant Merck has been trying to re-package one of Nature’s most potent heart health allies and sell it to you as a heart “drug.”

They heavily lobbied the FDA to get it approved in the U.S. But a few weeks ago they had to pull it from the approval process.1

Why? Because their drug didn’t quite have the effect they wanted it to.

In a clinical trial, they gave half the people this new drug – a combination of a synthetic form of a vitamin and a synthetic molecule that reduces facial “flushing.” The other half got only a statin drug.

They wanted the combination of statins and their new drug to work … but it didn’t go so well. In fact, Merck suggested the side effects were worse than expected.

I’ll say.

What they don’t tell you in any of their press releases is that people taking only the new “drug” had skin and stomach side effects and experienced flushing.

On top of that, when they added a statin to the mix, people got myopathy which is nonfunctional and painful muscles, and rhabdomyolysis which is the painful disintegration of muscles.2 These are typical statin side effects.

So what was in the new “drug” Merck was trying to create? It was a synthetic form of good old fashioned vitamin B3.

It’s also called niacin. You can remember it with a handy phrase I developed to help my fellow medical students remember the names for all the B vitamins. I also used it to teach nutrition to my students at Barry University: “Teddy Roosevelt Never Painted Pyramids Blue in Fancy Clothes.”

This contains the first letter of all the B vitamins in numerical order: thiamin, riboflavin, niacin, pantothenic acid, pyridoxine, biotin, inositol, folic acid and cyanocobalamin.

I can see why Merck wants to patent niacin. It’s an amazing nutrient. And now that raising HDL has become such a big topic in the heart health world, they’re trying to capitalize on a proven, safe, inexpensive solution that’s been around for years by making a drug out of it.

Well I’m glad their drug failed. You can get all the benefits of niacin safely… without lining Big Pharma’s pockets.

I’ve been prescribing niacin for years. I have tested its effectiveness in thousands of patients in my 25 years practicing medicine. And as usual, standard medicine has forgotten just how effective a natural solution can be at improving heart health.

One study gave over 1,000 people either niacin or a placebo and followed them for 15 years. It found that niacin did reduce heart attacks. But what’s really incredible is that 10 years after the end of the trial, doctors followed up and found that niacin was still working. It had reduced the people’s chance of dying from any cause by 11%.3

And in a breakthrough study from the prestigious journal Atherosclerosis, niacin improved heart health markers across the board, including:

  • 24% increase in HDL—the heart-healthy “good” cholesterol
  • 35% increase in adiponectin, the hormone that melts fat away
  • 12% decrease in triglycerides, the real culprit behind clogged arteries

Niacin also improves nitric oxide activity. Nitric oxide release causes the linings of your blood vessels to relax and open up, improving circulation, and helping your body to deliver oxygen in the blood more efficiently.

The key to niacin is using the right amount and the right kind.

Unfortunately, 20 to 30 years ago, very slow-release niacin was used and caused liver toxicity in some people. This scared some doctors away from it, and most never learned how to administer niacin properly so they are afraid to recommend it.

I use sustained release niacin (sometimes referred to as extended release). It doesn’t act as slow as slow-release niacin which makes it much safer.

First, start by eating foods that boost your intake of natural vitamin B3. As always, stick with grass-fed meat, free-range chicken, and organic produce and nuts.

Here are some foods rich in B3 (niacin).4

Food Source
Mg of Niacin
Beef Liver 3.5 oz
14.4
Chicken White Meat 3.5 oz
13.4
Peanuts (1/2 cup)
10.5
Salmon 3.5 oz
8.0
Ground Beef 3.5 oz
5.3
Mushrooms – raw (1/2 cup)
1.7
Barley – cooked (1/2 cup)
1.6
Lentils – cooked (1/2 cup)
1.4
Almonds (1/2 cup)
1.4

Second, supplements are a great way to go. In this case, it’s crucial you take the right dose – and limit how much is in your body at any given time. I recommend taking 500 mg of “sustained release” niacin. Start by taking it every other day and slowly work up. In my clinic, I often gradually increase to up to 2 grams per day.

(Garey: We have recently changed our Niacin product over to Doctors Best Extended Release, 500 mg tablets.)

And, if you want to make niacin work even better, add a potent omega-3 supplement  in phospholipid form. This will work with niacin to help reduce Lp(a), a dangerous marker for heart disease and heart attacks.5

Phospholipid Based Omega-3 Choices

To Your Good Health,
Al Sears, MD
Al Sears, MD


1. “Merck Provides Update on Next Steps for TREDAPTIVE.” January 11, 2013. Retrieved Aug 2, 2013.
2. “HPS2-THRIVE randomized placebo-controlled trial in 25 673 high-risk patients of ER niacin/laropiprant: trial design, pre-specified muscle and liver outcomes, and reasons for stopping study treatment.” Eur Heart J. 2013 May;34(17):1279-91.
3. Canner P, Berge K, Wenger N, Stamler J, Friedman L, Prineas R, Friedewald W. “Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin.” J Am Coll Cardiol. 1986;8(6):1245-55.
4. “Nutrition Fact Sheet – B3”, Northwestern University Department of Preventative Medicine. www.feinberg.northwestern.edu. Retrieved Dec 9, 2013.
5. Helmbold A, Slim J, Morgan J, Castillo-Rojas L, Shry E, Slim A. “The Effects of Extended Release Niacin in Combination with Omega 3 Fatty Acid Supplements in the Treatment of Elevated Lipoprotein (a).” Cholesterol. 2010;2010:306147.

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