Niacin: A Comeback for the Happy Cholesterol Vitamin

Juvenon Health Journal volume 7 number 6 june 2008
By Benjamin V. Treadwell, Ph.D.

Cholesterol. Do you associate the word with poor health? Not surprising when you consider the pervasive advertising for an ever-growing list of drugs developed to reduce its levels in our blood. What may surprise you? The cells of our body actually require a certain amount of this lipid for the production of components that regulate multiple biochemical pathways to keep us healthy. (See Juvenon Health Journal Volume 4, No. 12, December 2005, Cholesterol, High Blood Pressure, Diseased Arteries: Making the Connection.) In other words…

Cholesterol Isn’t All Bad
Although it’s carried in the blood stream in several different particle forms, for simplicity, let’s look at the two primary types: high density lipoprotein cholesterol (HDLc) and its counterpart, low density lipoprotein cholesterol (LDLc).

HDLc is composed of specific proteins and lipids designed to transport cholesterol away from the peripheral tissues (including the delicate endothelial cells that line the insides of our vessels) and back to the liver. The cholesterol is processed there, and removed from the body.

If you think of the HDLc particle as a packhorse that is trained to only travel in one direction, to the liver, the other form, LDLc, is trained to go in the opposite direction. It carries cholesterol from the liver and intestine, delivering it to various cells of the body, including those vessel-lining endothelial cells.

“HDLc is also called “happy” cholesterol; LDLc “lousy” cholesterol.”

For reasons related to their “training” (and their abbreviations), HDLc is often called “good” or  “happy” cholesterol. LDLc, on the other hand, is known as disease-associated or “lousy” cholesterol.

Past and Present
The pathways leading to cholesterol synthesis, as well as the construction of the cholesterol-carrying “packhorses,” evolved over millions of years. Man was subsisting on plant roots, wild fruits, vegetables and berries, as well as insects, fish, and a variety of other animals. The amount of fat, including cholesterol, was minimal with this diet.

In direct contrast, today’s diet is packed with calories from “fast food” and the sugar-laden cakes, candies, soft drinks, and other “junk food” available at convenience stores. The results?
• a super-increase in the level of total cholesterol
• an imbalance of lower HDLc to higher LDLc
• eventual LDLc-saturation of the endothelial cells lining the blood vessels

Inflammatory Reaction
LDLc at this level has a tendency to become oxidized, the beginning of a kind of chain reaction in the endothelial cell. The oxidation causes inflammation that leads to the production of plaque, a form of scar tissue, which can calcify and decrease the size of the blood vessel opening as well as create a rough surface on the vessel lining.

The rough surface is eventually recognized by blood-clotting platelets and factors that initiate the development of a clot. A blood clot can lead to serious tissue damage as it shuts off the supply of nutrients and oxygen carried by the blood vessels to our organs.

So, how can we break the chain?

Niacin to the Rescue

“Niacin was the first successful agent for treating high levels of fat.”

Over 50 years ago, studies showed that vitamin B3 – A.K.A. nicotinic acid or niacin – was useful in treating people with high blood levels of cholesterol and triglycerides (fat). In fact, niacin was also the first successful agent for treating hyperlipidemia (high levels of fat) in humans.

Subsequent research with human subjects indicated the vitamin did more than just lower the levels of fat and cholesterol. An oral dose of 500 mg to 2,000 mg per day not only reduced LDLc, the lousy cholesterol, but it also increased HDLc, the happy cholesterol.

Unfortunately, these results were inconclusive as subject compliance was not consistent due to side effects – flushing and itchiness – associated with niacin. Today, niacin is available in compounds with substances that produce a slow release of the vitamin, largely eliminating the side effects.

How It Works
Recent work (See this issue’s “Research Update.”) has upheld the early observations about niacin’s effect on LDLc and HDLc. It has also uncovered the probable mechanism involved in improving blood-fat profiles. The machine that makes our cellular energy,ATP, seems to play a major role.

A structural part of this machine, the beta subunit, binds to the surface of specific cells in the body, one being the liver cell. The liver cell-bound beta subunit acts like a magnet. Any HDLc in the vicinity is attracted, taken up by the liver cell, digested, and eliminated in the bile, lowering the blood levels of happy cholesterol.

Niacin however, inhibits the beta subunit from binding to the liver cell, disabling the HDLc “magnet.” The net effect? Niacin can increase blood levels of HDLc by up to 35%.

More HDLc Benefits

“HDLc has anti-oxidant, anti-clot and anti-inflammatory properties.”

Besides transporting cholesterol for removal from the body, research indicates that HDLc has other health-promoting functions. It seems to improve the condition of the endothelial cells lining blood vessels, thanks to anti-oxidant, anti-clot and anti-inflammatory properties. These HDLc characteristics may also help minimize the likelihood of cardiovascular disease and associated conditions (dementia, hypertension, etc).

Re-discovering Niacin
As the results of several recent clinical trials have been published, many health professionals have re-discovered niacin and its health-promoting properties. They are prescribing 500 mg to 2 or more grams per day for patients taking the statin class of cholesterol-lowering drugs.

Because the statins lower both lousy and happy cholesterol, niacin can help restore and improve HDLc levels and their associated health benefits. However, since niacin, itself, is processed by the liver, it can be toxic in high doses. Regular checkups by a health professional are important to measure blood levels of specific liver enzymes, indicators of the organ’s health.

For over 50 years, researchers have been aware of niacin’s capacity to promote a healthy blood-lipid profile. In an article, published in the June issue of theJournal of Lipid Research, a team from the University of California, Irvine, and the VA Healthcare System in Long Beach, California, confirms that knowledge as well as the vitamin’s (also known as B3) dramatic effect on improving levels of HDLc, our good cholesterol, by up to 35%.

Perhaps most interesting, however, are theinvestigators’ findings about a piece of the puzzle that has eluded scientists until now: the mechanism involved in niacin’s HDLc-boosting ability.

Briefly, the researchers found that one of the subunits, comprising the mitochondrial ATP-producing machine, appears to bind to the surface of specific cells, including hepatocytes. Once bound to the hepatocyte cell membrane, the subunit acts as a receptor for HDLc. The subunit binds the HDLc to the hepatocyte, which is activated to engulf and digest the particle, eliminating it from the body.

When the investigators added niacin to hepatocytes in culture, however, they discovered it interfered with the expression of the ATP subunit on the hepatocyte, preventing the uptake of HDLc. As a consequence, the HDLc was not eliminated. In other words, niacin effectively increased the level of good cholesterol.

This Research Update column highlights articles related to recent scientific inquiry into the process of human aging. It is not intended to promote any specific ingredient, regimen, or use and should not be construed as evidence of the safety, effectiveness, or intended uses of the Juvenon product. The Juvenon label should be consulted for intended uses and appropriate directions for use of the product.

Dr. Treadwell answers your questions about Juvenon™ Cellular Health Supplement

QUESTION: I’ve been taking Juvenon for three years and feel that my energy level is improved. (I’ll be 65 years old soon.) But last fall, I found out that I have blood sugar concerns. My blood sugar level is essentially normal now with daily exercise and a low-carb diet. I recently read that alpha lipoic acid and evening primrose oil act like insulin in the body. So, I take evening primrose oil, as well as Juvenon, to help maintain my blood sugar level. Do you think this works? – J

ANSWER: There is significant evidence that alpha lipoic acid does improve the sensitivity of cells to insulin. In fact, for many years, lipoic acid has been used in Europe for people with blood sugar concerns. However, we have no clinical evidence that Juvenon will help promote insulin sensitivity.

I think you are doing the right thing by combining taking Juvenon with exercise and a low-carbohydrate diet. The evening primrose may be of help, too. Another substance that may also help is cinnamon, I like to put a teaspoon on the fruit I have for breakfast each day.

Benjamin V. Treadwell, Ph.D, is a former Harvard Medical School associate professor.