Wax-Matrix Extended Release Niacin and Lipid Management

by Dr. Greg Fors, DC - Board Certified Neurologist DIBCN

Heart disease and strokes are now at epidemic levels throughout the Western world. Heart disease is the leading cause of death in the United States and a major cause of disability. Every 25 seconds, an American will have a heart attack, and every minute someone dies from it (Circulation 2011; 123). Heart disease is the leading cause of death in men and the first symptom of any heart disease in over half of these men is death itself. Combined, heart attacks and strokes are responsible for nearly one half of all US deaths.

Over ¾ of a million Americans will suffer a stroke this year. Most of these strokes could be prevented through proper risk factor identification and management.

Are you supporting healthy lipid metabolism in your patients? Over 1 in 5 adults have blood cholesterol levels above normal; nearly 40% of those individuals have levels that are considered high risk. The American Heart Association estimates that over 102 million American adults have total blood cholesterol values above 200 mg/dL (i.e. higher than desirable), while about 35 million American adults have total cholesterol levels of 240 mg/dL or above, a level considered too high.

"No-Flush" Inositol Hexanicotinate (IHN) Does Not Work
The most under utilized and misunderstood nutraceutical for lipid management is also one of the most effective. Red rice yeast has dominated the popular press for lowering cholesterol. However, recent studies show that proper niacin therapy can outperform red rice yeast and Statin drugs in their ability to lower LDL cholesterol and properly manage dyslipidemia.* There have been numerous studies on the utilization of niacin therapy, but one of the most compelling studies was recently published in the January 2013 issue of Journal of Clinical Lipidology, Volume 7, Issue 1.

This study exposed one of the mistakes many doctors make when utilizing niacin therapy. For nearly 30 years, based on poorly designed European studies, many doctors have utilized the "no-flush" inositol hexanicotinate (IHN) form of niacin. "This study concluded that the nicotinic acid in IHN is not bio-available, and there is no evidence that it reaches the therapeutic levels needed to alter lipids. Therefore it has no place in the management of high cholesterol. In fact, this study raises the ethical issue of whether IHN has any benefit at all even as a vitamin supplement." according to the study's author Joseph M. Keenan, MD. 

Wax-Matrix Niacin Works
The results of this study showed that wax-matrix niacin, demonstrated very positive lipid benefits, reducing total cholesterol 11 percent, LDL cholesterol 18 percent, non- HDL cholesterol 15 percent and triglycerides nine percent. It also promoted an increase in HDL cholesterol by 12 percent. These are very impressive results for any research on lipid management.

Then there is the poorly recognized risk factor of a high Lp(a) level (more than 30 mg/dl). This high Lp(a) level carries a 10 times greater risk for heart disease than an elevated LDL cholesterol level. Studies have also shown that Lp(a) sticks to damaged blood vessels, attracting other Lp(a) molecules, and finally creating the damaging atherosclerotic plaques. Furthermore, artery blockage or plaque is composed mainly of Lp (a) and not of ordinary cholesterol. This has been well established by research, yet very few physicians check for it in their patients. What is convenient about this risk factor is that it is very responsive to proper dietary intervention and supplementation with niacin.* WMER-niacin remains the only agent effective for lowering Lp(a) cholesterol and the best agent for raising low HDL, both of which are primary independent risk factors for vascular disease.* The National Lipid Association, the nation's largest organization of lipidology experts, recently went on record with a statement reaffirming niacin's role in lipid management.

Niacin lowers LDL indirectly by decreasing production of its precursor, very low- density lipoprotein (VLDL).* Niacin reduces mobilization of free fatty acids from adipose tissue which results in decreased triglyceride levels.* Niacin also assists in maintaining HDL levels and increasing transport of cholesterol back to the liver.* Niacin achieves this by reducing the amount of apo A-I taken and broken down from HDL during the liver uptake of cholesterol.* This maintains the structural and functional integrity of HDL particles.

Lipid Management Support with Wax-Matrix Niacin
Niacin is one of the most useful agents available for overall lipid management.* It is the best choice for mild-to-moderate dyslipidemias, especially in individuals with metabolic syndrome.* With one agent you are targeting many lipid variables, LDL, HDL, triglycerides, Lp(a), and LDL particle size. This is not possible with any other nutraceutical. It is usually best to start patients on 500 mg/d for 5 to 7 days and then increase the dose over 1-2 weeks to 1500 mg/d. When starting therapy, have patients take their dose with meals or at least 2-3 glasses of water. They can take a 325 mg aspirin with each dose if they experience flushing. Most individuals do not flush with a 500 mg dose of WMER- niacin so flushing is rare if dosed at 500 mg 3 times-a-day. As with any metabolic lipid therapy it is best to start with a baseline measurement of lipids as well as glucose, liver function, creatine phosphokinase, and uric acid blood chemistries. At the end of 6 weeks improvement in lipids should be obtained with the 1500 mg dose. If you haven't reached your LDL goal and blood chemistries are normal, you can increase the dose to 2000 mg /d. 

The dose response range for WMER-niacin is from 250 mg per day to 2000 mg per day. For most individuals, reduction in LDL usually increases with increasing doses of WMER-niacin to a maximum of 2000 mg per day. The optimal dose for overall lipid benefits with the least side effects for most individuals is 1500 mg per day. Many people can tolerate 2000 mg per day well, but the slight lipid benefit is usually modest. If your primary lipid goal is to raise HDL, the dose response peaks at about 1000 mg and then plateaus or drops. Some individuals appear intolerant of niacin at the usual therapeutic doses, but may experience lipid lowering effects at substantially lower doses (250-1000 mg/day). You should be aware of this and offer a patient who appears intolerant of niacin an opportunity for trial at a lower dose. Also, doctors should be aware that niacin can aggravate gout even at lower doses.


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BIOSPEC's CLINICAL UPDATES
with Dr. Greg Fors

Biospec Nutritionals has been in business for 15 years and is dedicated to bringing physicians premium quality formulations at prices their patients can afford. Biospec Nutritionals is committed to providing doctors with quality information and education, including this issue of Biospec's Nutritional updates. Find us at www.biospecnutritionals.com or call us at 800.825.7921

Dr. Greg Fors, D.C. is the Chief Science Consultant for Biospec Nutritionals, a Board-certified Neurologist (IBCN), certified in Applied Herbal Sciences (NWHSU) and acupuncture. Trained through the Autism Research Institute he is a registered 'Defeat Autism Now!' Doctor. As the clinic director of the Pain and Brain Healing Center in Blaine Minnesota he specializes in a natural biomedical approach to fibromyalgia, fatigue, depression, autism and ADHD. He is a sought after international lecturer for various post graduate departments and state associations. Dr. Fors is the author of the highly acclaimed book, "Why We Hurt" available through booksellers everywhere.