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  #1   ^
Old Thu, Apr-10-14, 05:13
Lesliean Lesliean is offline
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Default Effects of Niacin on Ketones

Hi all,
Did a little experiment worth passing on. My ketones have been around .6 in the morning. They were higher but I'd been reducing my hormones and this apparently has had an effect on muscle mass and protein requirements.

Anyway, took 500mg of Niacin last night before bed as an idea to bring down LDL and total cholesterol. Your thoughts appreciated on Niacin as an aid to cholesterol numbers or side effects. I know it can take a toll on the liver but how long does this take and how much Niacin does it take to damage the liver?

The flushing was almost unbearable and that is a problem in itself. But, my morning ketone number was 2.1! This after three days of .6. Could it be the Niacin? Is Niacin a ketogenic aid? Does it have a downside?
Leslie
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  #2   ^
Old Thu, Apr-10-14, 07:01
teaser's Avatar
teaser teaser is online now
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Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
Default

Niacin shuts down lipolysis, but only temporarily. So you get a decrease in free fatty acids, and then a counter-regulatory hormonal response that results in higher free fatty acids than you started with--and yeah, if your liver's adapted to ketosis in the first place, the increase in free fatty acids can cause an increase in ketosis.

It also has the effect of forcing the liver and other tissues, while lipolysis is reduced to run through their glycogen stores etc., since free fatty acids are temporarily short.

The damaging effects of niacin on the liver have been reported with certain slow-release types of niacin. You can see how that could be a problem--shutting down lipolysis chronically, for one thing, rather than for a short period as with the more rapidly metabolized flush niacin. It's a chronic vs. acute stress thing. Your liver also has to work at removing niacin from the system, like with a toxin, this is another thing where the effect of a chronic steady release vs an acute dose could make the difference.

In the context of a high carb diet, niacin can raise fasting blood glucose. I've never caught it doing that to me on a low carb diet, though.

I had a day in November where I ate too much of a Coconut /butter/cocoa fat bomb thingy (about 2000 calories worth) in the morning, and then wasn't hungry all day, so didn't eat much else. Then in the afternoon, I took some niacin--only to get a call from a friend who was hunting in the woods, and had got his first deer, and needed help carrying it out. Took us a few hours to carry the deer out, and me with no free fatty acids to speak of. My blood sugar ended up in the 60s for the next few days, but I felt great.
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  #3   ^
Old Thu, Apr-10-14, 12:05
Lesliean Lesliean is offline
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Plan: Rosedale
Stats: 129/125/122 Female 5.5
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Default

Thanks teaser. I had to read your respose twice to get it all and still the concepts are a bit foggy.

Can I ask you how much niacin you take and whether you know of a downside to taking it for help with total cholesterol, LDL even though it's almost all large type, and non HDL?
Leslie
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  #4   ^
Old Thu, Apr-10-14, 12:31
Nancy LC's Avatar
Nancy LC Nancy LC is online now
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Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
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Location: San Diego, CA
Default

In spite of all the evidence to the contrary about LDL cholesterol and heart disease in women you're still trying to lower your cholesterol? Can I ask why?
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  #5   ^
Old Thu, Apr-10-14, 13:29
teaser's Avatar
teaser teaser is online now
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Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
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Location: Ontario
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I agree with Nancy here. I took niacin originally for cholesterol (without even knowing my cholesterol numbers, lol). I read about it on Dr. Davis's site. But I wouldn't bother taking it for that reason now.

I kept taking it for years because it had an unexpected therapeutic effect on an old shoulder injury.

I don't really know any downsides... but unless you get some obvious benefit from the stuff, it's probably better to be careful. If you do continue taking the stuff, if you let your Dr. know, they'll probably want to check for liver enzymes etc.

I'm not taking Niacin right now. After years of trouble, the shoulder problem finally resolved itself, so I stopped taking it. I worked up to three grams a day. I seem to work up a resistance to the stuff pretty quickly.
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  #6   ^
Old Thu, Apr-10-14, 14:31
teaser's Avatar
teaser teaser is online now
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Posts: 14,284
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
Default

http://www.ncbi.nlm.nih.gov/pubmed/7029504

Quote:
Severe hypertriglyceridaemia responding to insulin and nicotinic acid therapy.

Smith SR.

Abstract

A patient with unusually severe hypertriglyceridaemia (serum concentration initially 258 mmol/l or 22600 mg/dl) and hypercholesterolaemia is reported and discussed. The triglyceride elevation was found to reside within the very low density lipoprotein fraction and was probably attributable to the combination of diabetes mellitus and familial hypertriglyceridaemia. Treatment with insulin and restriction of dietary carbohydrate led to a 50% reduction in the triglyceride concentration, and the addition of nicotinic acid in modest doses led ultimately to a complete normalization of the patient's lipid values. A close correlation was noted between the falling triglyceride concentration and the rising serum sodium concentration during the course of successful therapy. Overall, it is felt likely that this patient's severe and reversible hypertriglyceridaemia was on the basis of excessively rapid lipolysis leading to high concentrations of very low density lipoprotein production. Combined therapy with insulin and nicotinic acid is recommended for other patients of this nature.


Just stumbled on this... maybe a place for niacin in extreme cases of dyslipidemia.
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  #7   ^
Old Thu, Apr-10-14, 14:48
Lesliean Lesliean is offline
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Plan: Rosedale
Stats: 129/125/122 Female 5.5
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Default

Thanks for the response. Such educated people!

I was thinking niacin for the balance of cholesterol components and trig. Trig was 128 and I'd like to see it lower. Spectracell had my HDL on the borderline so low considering my total cholesterol was 311. LDL small was on the borderline too even though most of the LDL was large. All inflammatory markers were extremely low except APO B.

I'll see the hormone and nutrient doctor on the 30th for the results of the nutrient profile which should be very interesting. She has deep knowledge from A4M and Spectracell on vitamins, minerals, amino acids and their balance and deficiencies. She's fine with me eating ketogenic and was not alarmed by my cholesterol numbers.

This will be a good question for her and I'll post the answer here.
Leslie
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  #8   ^
Old Thu, Apr-10-14, 14:49
teaser's Avatar
teaser teaser is online now
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Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
Default

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC407905/

This study has the effect of suppression of free fatty acids through niacin on gluconeogenesis and ketones. If you look at figure one, you can see where once the niacin has worn off and free fatty acids rise above basal, ketones rise sharply as well.
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  #9   ^
Old Thu, Apr-10-14, 15:43
Nancy LC's Avatar
Nancy LC Nancy LC is online now
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Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
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Progress: 80%
Location: San Diego, CA
Default

How long have you been LC this time around (assuming there's more than one)?

It takes a while but triglycerides will continue to lower for some time to come and HDL will raise slowly and surely. Mine was 85 last time. Started around 40, but I've been LC for many years.
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  #10   ^
Old Fri, Apr-11-14, 06:37
Lesliean Lesliean is offline
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Plan: Rosedale
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Very interesting study article Teaser, thanks for finding it, and passing it on. Nancy, I've been ketogenic for almost a year after years of fasting glucose numbers trending towards or just over 100. I'm an athlete and doing everything I can to maintain excellent health but have only been keto for a year.

I like doing experiments and might keep up the niacin if my doctor recommends it to see if it changes my numbers on next year's particle panel. Unless you have a reason why niacin should not be taken?

I'm really interested in the return and advising on the nutrient panel. This is a new and exciting area.
Leslie
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  #11   ^
Old Fri, Apr-11-14, 08:32
Nancy LC's Avatar
Nancy LC Nancy LC is online now
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Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
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Progress: 80%
Location: San Diego, CA
Default

You might want to tune into Dr. Davis. He's a cardiologist that writes, blogs, etc about Low Carb. His web sites are (you can google them) Track Your Plaque and Wheat Belly.

I bet he'd tell you to take fish oil to improve your lipid profile. He used to promote niacin (not the no-flush kind), but I'm not sure he does any longer.

IMHO doctors have fallen in love with numbers at the expense of outcomes.
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  #12   ^
Old Fri, Apr-11-14, 09:32
CristiVlad's Avatar
CristiVlad CristiVlad is offline
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Plan: Ketogenic
Stats: 174/157/157 Male 173 cm
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Teaser, the story with the carrying the deer around in the woods it's quite interesting. I'd also be interested in seeing the metabolic pathway of niacin as it gets into the body as well as its mechanism on influencing free fatty acids
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  #13   ^
Old Sat, Apr-12-14, 08:58
Neanderpam's Avatar
Neanderpam Neanderpam is offline
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Plan: Ketogenic now
Stats: 277/121/125 Female 61 inches
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Location: NE Indiana
Default

And you may be 'missing' part of the 'cholesterol and tri gly' mystery.

My cholesterol total was almost 423, and my tri glys were over 230...guess what I had??? Hypothyroidism. Yep.

TSH doesn't 'catch it' or mean much to a good thyroid doctor. My TSH was very VERY low (no, not hyPERthyroid, TSH doesn't test that...actually it doesn't test thyroid either...it tests pituitary action and is CHEAP to do and sounds' good, lol).

My actual thyroid hormones (Free T4, Free T3) were..um..almost none.

High cholesterol and tri glys in WOMEN especially (yes, men can have hypothyroidism too, but women are more apt to)...can signify thyroid disease, particularly Hashimoto's autoimmune Hypothyroidism (two out of every ten women, and of alllll the types of thyroid disease...this one is 98% of all hypothyroidism).

So...you're more apt to lower your cholesterol and try glys over time with a low carb diet (NO CHEATING though)...but if that's not doing it (test at the six month mark with NO cheating..not even a mouthful..otherwise, it can actually look 'higher' in the first few months of lowcarbing)...then get the proper tests for thyroid disease (Free T4, Free T3 (not T4, T3, those are totals), TPO AB for Hashimoto's..oh, and 'maybe' a TSH...

FT4 should be about midway of lab range or slightly UNDER to be normal, FT3 should be at LEAST midway of lab range, and some like it quite a bit higher and although TSH has a range of .23 to 5.5 (most labs) anything over a 2 is suspect...but like in MY case...my TSH was .32..but I wasn't making any hormones.
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  #14   ^
Old Sun, Apr-13-14, 06:55
Lesliean Lesliean is offline
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Posts: 170
 
Plan: Rosedale
Stats: 129/125/122 Female 5.5
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Default

Just an update. Pam, I totally get what you are saying. I love the website: http://www.stopthethyroidmadness.com/ I find it the must read for all with concerns about thyroid function. For me, my reverse T3 was high and my ferritin was almost out of range low so I might be feeling better because of iron supplementation which reverses reverse T3 and thereby increases usefulness of my thyroid supplement (am hypo).

I've continued to take 500mg niacin before falling asleep and this avoids feeling the flush. I don't even know if I'm still having it because I'm asleep.

This morning ketones were 2.5, a new high. Must be the niacin. And my blood sugar was the lowest ever, 83 (was running 103-107). Again, this just has to be the niacin.

I know the research shows high fbg and postprandial bg with niacin (although not high enough to not recommend to diabetics), but maybe this is different for those eating a ketogenic diet?

What do you think?
Leslie
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  #15   ^
Old Sun, Apr-13-14, 09:08
teaser's Avatar
teaser teaser is online now
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Posts: 14,284
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
Default

I've never noticed any long term effect of niacin with elevation of blood glucose, but I've always taken it with a reasonably strict low-carb diet.

Short-term, niacin gives a decrease in lipolysis, with a rebound in free fatty acids a few hours later. Long term, there's a certain degree of tolerance that builds up. So basal free fatty acids can increase--this might be a big part of what causes niacin's effect on fasting and postprandial blood glucose, physiological insulin resistance from the elevation in free fatty acids. Niacin was actually involved in sorting out physiological insulin resistance from free fatty acids in the first place. Researchers wanted to see if the free fatty acids were responsible for the insulin resistance/glucose intolerance that happens in most animals during an extended fast. Starve a rat, and time the dose of niacin just right, and when the animal is refed carbohydrate, the glucose intolerance is gone. Pair this with an infusion of free fatty acids, so that the decrease in lipolysis doesn't affect blood levels of free fatty acids, and the glucose intolerance returns. Since a ketogenic diet or starvation itself are already high free fatty acid states, the long term increase in free fatty acids that comes with niacin tolerance should have less of an effect on blood glucose in those states. All I have to back this up is plausibility and personal experience, so I don't really know if this is generally true or not.

http://en.wikipedia.org/wiki/Niacin_receptor_1

Quote:
GPR109A is believed to be an important biomolecular target of niacin which is a widely prescribed drug for the treatment of dyslipidemia and to increase HDL cholesterol but whose therapeutic use is limited by flushing.[5] In GPR109A knockout mice, the effects of niacin on both lipids[6] and flushing[7] is eliminated. Furthermore, in arrestin beta 1 knockout mice, niacin's effect on flushing is greatly reduced while the lipid modifying effects are maintained.[8]

The precise mechanism of action of niacin therapeutic effects has not been fully elucidated, but appears to work in part through activation of GPR109A which reduces the levels of intracellular cAMP thereby inhibiting lipolysis in adipocytes.[9] In contrast, the flushing effect is due to GPR109A activation of ERK 1/2 MAP kinase[10] mediated by arrestin beta 1.[8] Activation of MAP kinase in turn causes release of prostaglandin D2 from Langerhans cells in the skin


The blue is interesting. I tend to build up tolerance to the flushing effect of niacin fairly quickly. I've seen it suggested that schizophrenics and family members of schizophrenics are more tolerant of the flushing. Maybe for the blood lipid effects, I don't have to be chasing the flush so much.


I found the Hyperlipid blog when Peter left a comment on Dr. Davis's blog years ago about how ketones are ligands for some nicotinic acid receptor or other--I'm not sure if it's the one above. But ketones, like niacin, are also insulin mimetics in certain respects, promoting sparing of protein and also regulate lipolysis--which makes sense, if ketones are high enough, probably lipolysis is already sufficient to provide ketones where they're needed.
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