It has been hypothesized that wild yam ( Dioscorea villosa  and other  Dioscorea  species) possesses dehydroepiandrosterone (DHEA)-like properties and acts as a precursor to human sex hormones such as estrogen and progesterone. Based on this proposed mechanism, extracts of the plant have been used to treat painful menstruation, hot flashes, and headaches associated with menopause.

However, these uses are based on a misconception that wild yam contains hormones or hormonal precursors - largely due to the historical fact that progesterone, androgens, and cortisone were chemically manufactured from Mexican wild yam in the 1960s. It is unlikely that this chemical conversion to progesterone occurs in the human body. The hormonal activity of some topical wild yam preparations has been attributed to adulteration with synthetic progesterone by manufacturers, although there is limited evidence in this area.

The effects of the wild yam saponin constituent “diosgenin” on lipid metabolism are well documented in animal models and are possibly due to impaired intestinal cholesterol absorption. However, its purported hypocholesterolemic effect in humans and the feasibility of long-term use warrant further investigation.

There are few reported contraindications to the use of wild yam in adults. However, there are no reliable safety or toxicity studies during pregnancy, lactation, or childhood.

Atlantic yam, barbasco, batata silvestre, black yam, China root, colic root, devil’s bones,  Dioscorea ,  Dioscorea barbasco ,  Dioscorea hypoglauca ,  Dioscorea macrostachya ,  Dioscorea opposita ,  Dioscorea villosa , Dioscoreae (family), diosgenin, Mexican yam, natural DHEA, phytoestrogen, potassium, rheumatism root, shan yao, white yam, wild yam root, yam, yellow yam, yuma.

Note: “Yams” sold in the supermarket are members of the sweet potato family and are not true yams.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

High cholesterol

Animal studies have shown that wild yam can reduce the absorption of cholesterol from the gut. Early studies in humans have shown changes in the levels of certain sub-types of cholesterol, including decreases in low-density lipoprotein (LDL, or “bad cholesterol”) and triglycerides and increases in high-density lipoprotein (HDL, or “good cholesterol”). However, no changes in the total amount of blood cholesterol have been found. More studies are needed in this area.

Menopausal symptoms

Most studies have not shown a benefit from wild yam given by mouth or used as a vaginal cream in reducing menopausal symptoms. However, replacing two thirds of staple food with yam for 30 days was shown to improve the status of sex hormones, lipids, and antioxidants in a recent study in postmenopausal women. The authors suggest that these effects might reduce the risk of breast cancer and cardiovascular diseases in postmenopausal women. Further research is needed before a recommendation can be made.        C

Hormonal properties (to mimic estrogen, progesterone, or DHEA)

Despite popular belief, no natural progestins, estrogens, or other reproductive hormones are found in wild yam. Its active ingredient, diosgenin, is not converted to hormones in the human body. Artificial progesterone has been added to some wild yam products. The belief that there are hormones in wild yam may be due to the historical fact that progesterone, androgens, and cortisone were chemically manufactured from Mexican wild yam in the 1960s.          

Antifungal, anti-inflammatory, antiviral, asthma, bile flow improvement, biliary colic, breast cancer, breast enlargement, cancer prevention, cardiovascular disease, carminative (prevents gas), childbirth, cramps, croup, decreased perspiration, diverticulitis, energy improvement, excessive perspiration, expectorant, intestinal spasm, irritable bowel syndrome, joint pain, libido, liver protection, low blood sugar, menstrual pain or irregularities, morning sickness, nerve pain, osteoporosis, pancreatic enzyme inhibitor, pelvic cramps, postmenopausal vaginal dryness, premenstrual syndrome (PMS), rash, rheumatic pain, spasms, urinary tract disorders, uterus contraction, vomiting.

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

Allergies

Rubbing the skin with  Dioscorea batatas  (a yam species related to  Dioscorea villosa ) has been reported to cause allergic rash. Workers exposed to  Dioscorea batatas  in large amounts and for a prolonged time have developed asthma that is made worse by exposure to the yam. A person who is known to have an allergy to  Dioscorea batatas  may also be allergic to other  Dioscorea  types.

Side Effects and Warnings

Rubbing the skin with  Dioscorea batatas , a related yam species, has been reported to cause a rash at the site of contact. Wild yam cream caused no rash in 23 healthy women in one reported study. In another study, wild yam given by mouth was reported to cause stomach upset at high doses.

Wild yam was believed in the past to have properties similar to the reproductive hormone progesterone, but this has not been supported by scientific studies. It has been suggested that some wild yam creams might be tainted with artificial progesterone. Based on theoretical hormonal properties and possible progesterone contamination, people with hormone-sensitive conditions should use wild yam products with caution. This caution applies to people who have had blood clots or strokes and to women who take hormone replacement therapy or birth control pills. In addition, women with fibroids, endometriosis, or cancer of the breast, uterus, or ovary should be aware that these are hormone-sensitive conditions that may be affected by agents with hormonal properties.

Caution is advised in patients with diabetes or low blood sugar and in those taking drugs, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a healthcare provider and medication adjustments may be necessary.

Pregnancy and Breastfeeding

Use of wild yam is not recommended during pregnancy or breastfeeding due to a lack of safety information. Wild yam is believed to cause uterine contractions and therefore use is discouraged during pregnancy. Wild yam was once thought to have effects similar to those of reproductive hormones, although this has not been proven in scientific studies. Artificial progesterone may be added to some products.

InteractionsReturn to top

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

It is not clear whether blood sugar is lowered by  Dioscorea villosa  (wild yam). Dioscoretine, a compound found in the related species  Dioscorea dumentorum  (bitter or African yam), has been shown to lower blood sugar levels, but this has not been shown for  Dioscorea villosa . Effects on blood sugar in humans have not been reported. Nonetheless, caution is advised when using medications that may also lower blood sugar. People taking diabetes drugs by mouth or insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.

Early evidence suggests that wild yam lowers blood levels of indomethacin, a non-steroidal anti-inflammatory drug, and reduces irritation of the intestine caused by indomethacin. Human studies have not been reported in this area and it is not clear if wild yam affects the blood levels of other anti-inflammatory drugs such as ibuprofen (Advil®, Motrin®).

Diosgenin, thought to be the active substance in wild yam, has been found in animals to reduce absorption of cholesterol from the intestine and to lower total cholesterol levels in the blood. Studies in humans show no change in the total amount of cholesterol in the blood, although the amounts of specific types of cholesterol in the blood may be changed; low-density lipoprotein (LDL, or “bad cholesterol”) and triglycerides may be lowered and high-density lipoprotein (HDL, or “good cholesterol”) may be increased. It is thought that wild yam may enhance the effects of other cholesterol-lowering medications, including fibric acid derivatives such as clofibrate (Questran®), gemfibrozil (Lopid®), and fenofibrate (Tricor®). In animals, wild yam has been found to improve the effect of clofibrate in lowering cholesterol levels.

Tinctures of wild yam may contain high amounts of alcohol and may lead to vomiting if taken with disulfiram (Antabuse®) or metronidazole (Flagyl®).

An early study suggests that wild yam may interfere with the body’s ability to control levels of the reproductive hormone progesterone. Progesterone is a key ingredient in some hormone replacement and birth control pills. There are reports that some wild yam products may be tainted with artificial progesterone. Women taking birth control pills or hormone replacement therapy should speak with a licensed healthcare provider before taking wild yam.

Wild yam may also interact with steroids, although human evidence is lacking.

Interactions with Herbs and Dietary Supplements

It is not clear whether  Dioscorea villosa  (wild yam) lowers blood sugar levels. Although dioscoretine, produced by the related species  Dioscorea dumentorum  (bitter or African yam), has been shown to lower blood sugar, this reaction has not been seen with  Dioscorea villosa  and has not been reported in humans. Nonetheless, caution is advised when using herbs or supplements that may also lower blood glucose. Blood glucose levels may require monitoring and doses may need adjustment.

Diosgenin, thought to be the active substance in wild yam, has been found in animals to reduce absorption of cholesterol from the intestine and to lower total cholesterol levels in the blood. Studies in humans show no change in the total amount of cholesterol in the blood, although the amounts of specific types of cholesterol in the blood may be changed; low-density lipoprotein (LDL, or “bad cholesterol”) and triglycerides may be lowered and high-density lipoprotein (HDL, or “good cholesterol”) appears to be increased.

In an early study, a wild yam preparation was reported to block the body’s natural production of progesterone. However, this finding was not supported by later research. There have been several reports that some wild yam products are tainted with synthetic progesterone. Because wild yam may contain progesterone-like chemicals, the effects of other agents believed to have hormone-like properties, in particular those with estrogen-like properties, may be altered.

Wild yam may also interact with potassium vitamin C or steroids, although human evidence is lacking.

ROCHESTER - Vitamin D deficiency may contribute to a higher number of heart and stroke-related deaths among black Americans compared to whites, according to a University of Rochester Medical Center study.

The journal Annals of Family Medicine is publishing the study in the January-February edition, which goes online Jan. 11, 2010.

Researchers sought to understand the well-documented disparity between blacks and whites in cardiovascular deaths. They turned to vitamin D because growing evidence links low serum levels of D to many serious illnesses including diabetes, hypertension, kidney and heart disease.

Lead author Kevin Fiscella, M.D., said a complex host of genetic and lifestyle factors among blacks may explain why this population group has lower vitamin D levels across the lifespan than other races.

People get vitamin D through their diets, sun exposure, and oral supplements. Genetic factors common to blacks sometimes preclude vitamin D absorption, such as a higher incidence of lactose intolerance, which can eliminate vitamin-D fortified milk from the diet, and darker skin pigment that significantly reduces vitamin D synthesis.

“Therefore, our study suggests that the next step would be to intervene to boost vitamin D levels safely, with supplements,” said Fiscella, a national expert on disparities in health care and a professor of Family Medicine and Community and Preventive Medicine at URMC.

With funding through the National Heart Lung and Blood Institute, Fiscella and colleagues studied a sample of more than 15,000 American adults. The data included measurements of blood levels of vitamin D and death rates due to cardiovascular disease. Researchers also looked at other factors that contribute to heart health, such as body mass index, smoking status and levels of C-reactive protein.

Overall, the analysis showed that, as expected, a vitamin D deficiency was associated with higher rates of death among all people in the sample. In fact, those adults with the worst deficiency had a 40 percent higher risk of death from cardiac illness. This suggests that vitamin D may be a modifiable, independent risk factor for heart disease, Fiscella said.

Most striking, however, was that when researchers adjusted the statistics to look at race, blacks had a 38 percent higher risk of death than whites. As vitamin D levels rose, however, the risk of death was reduced. The same was true when researchers analyzed the effect of poverty on cardiovascular death rates among blacks, which suggests that vitamin D deficiency and poverty each exert separate risk factors, the study said.

A review article published in September 2009 in The American Journal of Medicine, noted that Vitamin D deficiency is a worldwide health problem. In the U.S., inadequate Vitamin D has been reported in about 36 percent of otherwise healthy young adults and about 57 percent of general medicine hospitalized patients.

Vitamin D is metabolized in the liver and converted to 25 hydroxyvitamin D or 25(OH) D, the form used to determine a person’s status through a blood test. Deficiency is usually defined by levels of less than 20 nanograms per milliliter; 30 ng/ml is viewed as sufficient. The mean blood level in the study sample was 29.5 ng/ml.

Most of the body’s tissues and cells have vitamin D receptors, making it a potent regulator of cell activity and growth. A deficiency contributes to inflammation associated with heart disease, many cancers and poor bone health.

Fiscella cautions, however, that not all observational studies of vitamin deficiency are borne out by subsequent clinical trials. For example, previous observational studies of vitamin E and beta-carotene that were associated with poor heart health did not hold up in later clinical studies. The need to further assess the vitamin D connection to heart disease is convincing, however, particularly among blacks, he added.

Other at-risk people include the obese and the elderly, (particularly housebound or nursing home residents), because vitamin D levels decline with age. And although more sun exposure can boost levels of D, skin cancer is also an increasing risk to many people. Therefore, medical authorities usually recommend increased dietary intake and/or supplementation as the best way to correct a deficiency.

BEVERLY HILLS - Quality vitamins for women should perform important functions such as slowing the aging process, strengthening the immune system, increasing energy levels and supporting the balancing of the female hormones.

When considering which daily vitamins for women to take, keep in mind that the least costly ingredients are the vitamins and minerals. A woman’s body also needs a variety of anti-aging natural substances that are proven by clinical studies to provide specific health benefits.

Taking a high-quality anti-aging daily supplement helps fill in the dietary gaps that every woman will have. What woman really consumes the recommended 5-9 daily servings of vegetables and fruits each day? It’s difficult for anyone to do…

For example, your body will use nutrients such as amino acids, antioxidants, bioflavanoids, neuronutrients, enzymes and specialized substances such as L-Carnosine, alpha lipoic acid, acetyl L-Carnitine and so on.

And women have the need for certain nutrients that are different than men, nutrients that help support the balancing of the female hormones so necessary for good health.

Every woman in her 30’s and over MUST be providing her body with certain nutrients to be healthy. And taking one-a-day drugstore or supermarket vitamins for women is probably a waste of time and money.

Today’s women have special concerns when looking to find vitamins for women that help provide needed protection from illness.

For example, osteoporosis affects a large percentage of older women, and this condition typically begins in a woman’s 30’s. Daily dietary calcium and magnesium supplementation along with other nutrients that assist in absorption should be considered essential for any woman over 40.

Heart health has to be considered vital for a woman as she ages - and essential fatty acids are needed on a regular basis for a healthy heart. The need for women to have a healthy dietary balance of the Omega-3 and Omega-6 fatty acids is well-documented in clinical trials.

Breast health and reproductive system health must be considered a high priority for today’s woman. Providing your body with nutrients that support the body’s immune system function and healthy tissue is essential when looking to find vitamins for women. These vitamins for women will provide the nutrients essential for good health.

PHILADELPHIA - Red yeast rice supplements may offer a cholesterol-lowering alternative to people who’ve suffered muscle pain as a side effect of statins, a small study suggests.

Researchers found that among 43 people who’d stopped using statins due to muscle pain, most were able to use either red yeast rice or the cholesterol drug pravastatin (Pravachol) for 12 weeks without suffering the side effect again.

The supplement and the statin were also similarly effective at lowering “bad” LDL cholesterol, the researchers report in the American Journal of Cardiology.

Used for centuries in parts of Asia as a medicine and food garnish, red yeast rice has become an increasingly popular over-the-counter supplement in the U.S. in the past few years.

The product, which is made by fermenting red yeast over rice, contains statin-like compounds called monacolins — including one, monacolin K, which is structurally identical to the cholesterol drug lovastatin (Mevacor).

Studies have long suggested that red yeast rice extracts can lower cholesterol. These latest findings suggest that both the supplement and pravastatin are potential options for people who have suffered muscle pain from statin use, senior researcher Dr. David J. Becker told Reuters Health.

However, while red yeast rice is available over-the-counter, patients should still talk with their doctors before using it, according to Becker, a cardiologist at Chestnut Hill Hospital and the University of Pennsylvania Health System in Philadelphia.

Nor should people with existing heart disease swap their statins for red yeast rice, he advised. Statins have been shown to lower the risks of heart attack, stroke and death from heart disease; the benefits of red yeast rice beyond lowering cholesterol are not yet clear.

For their study, Becker and his colleagues randomly assigned 43 patients with high cholesterol to take either red yeast rice capsules or pravastatin every day for 12 weeks. The supplement group took four 600-milligram capsules twice per day, while the pravastatin group took 40 mg a day.

Both groups also attended a program on lifestyle change.

By the end of the study, 1 of 21 patients on red yeast rice had stopped the treatment due to muscle pain, as had 2 of 22 patients on pravastatin. LDL levels fell by an average of 30 percent among supplement users, and by 27 percent among pravastatin users.

According to Becker, the low rate of muscle side effects in the pravastatin group is in line with other research showing that among statins, pravastatin and fluvastatin (Lescol) tend to be better tolerated.

When it comes to using red yeast rice for lowering cholesterol, the researcher noted that a continuing obstacle is the lack of regulation.

The Food and Drug Administration does not regulate dietary supplements as it does drugs, and consumers cannot be sure of what they are getting when they buy an herbal remedy.

A 2008 study by ConsumerLab, an independent testing company, found that 10 brands of red yeast rice supplements varied widely in their potency, and four were contaminated with citrinin, a potentially kidney-damaging substance that can form as a byproduct of the fermentation process.

SOURCE: American Journal of Cardiology.

PLEASE SEE OUR POST ON “POLICOSANOL” AS A EXCELLENT STATIN ALTERNATIVE

They have discovered that an enzyme called matrix metalloproteinase-8 that raises blood pressure and causes abnormal build-up of cells in the arteries - both of which increase the risk of heart disease.

“Our research tells us that this enzyme plays a crucial role in the build-up of fatty deposits in the arteries which causes heart disease,” said lead researcher Shu Ye, Professor of Molecular Medicine and Genetics at Queen Mary, University of London.

“Many patients with high blood pressure or heart failure are currently treated with ACE inhibitor drugs. However, some patients do not respond sufficiently to ACE inhibitors alone.

“We hope that what we’ve found here could be the basis for new drugs that can enhance the effects of ACE inhibitors, which would reduce deaths from heart disease,” Ye added.

During the study, researchers genetically engineered mice to lack the MMP8 enzyme.

The mice were fed on a Western-style diet high in fat and cholesterol and compared to normal mice fed on the same diet.

The mice, which lacked the enzyme, had clearer arteries and lower blood pressure.

The researchers also studied 2,000 patients who were being tested for clogs in arteries leading to their hearts with a test called a coronary angiogram.

They found that around 25 per cent of these patients had a slightly different version of the gene for MMP8 and their arteries were more clogged than other patients.

TO REDUCE CHOLESTEROL NATURALLY SEE THE POST ON “POLICOSANOL”

Policosanol, a dietary supplement, is a mixture of alcohols isolated from Cuban sugarcane wax. It contains about 60% octacosanol.

Because patent issue and the US trade embargo against Cuba, sugarcane policosanol is not widely available in the United States. Instead, policosanol products sold in the US are generally derived from beeswax and wheat germ.

Why People Use Policosanol

    * To Lower Total and LDL Cholesterol

    * To Raise HDL Cholesterol

What is the Evidence for Policosanol?

Policosanol has been touted as a dietary supplement that can lower cholesterol as well as statin drugs, without the side effects. Studies indicate that it works by inhibiting cholesterol formation in the liver.

However, almost all of the 80+ double-blind studies on sugarcane policosanol were conducted by a single research group in Cuba that owns the policosanol patent.

An independent study published in the Journal of the American Medical Association in 2006 did not find any benefit of policosanol, even at high doses, on cholesterol profile. This finding has casted some doubt on the reliability of the Cuban research on policosanol.

Dosage Information

A typical dosage of policosanol used in studies has been 5 to 10 mg two times a day. Studies generally found that it can take up to two months to notice benefits.

Side Effects of Policosanol

Although the reliability of the Cuban studies has been questioned, side effects of policosanol reported in the trials have generally been mild and short-term. They have included indigestion, skin rash, headache, insomnia, and weight loss.

Possible Drug Interactions

Policosanol may increase the effect of medications that interfere with blood clotting or anti-platelet drugs, such as aspirin, warfarin (Coumadin), heparin, clopidogrel (Plavix), ticlopidine (Ticlid), or pentoxifylline (Trental), or supplements such as garlic, ginkgo, or high-dose vitamin E.

Policosanol may increase the effects and side effects of levodopa, a medication used for Parkinson’s disease.

Overview:

Vitamin B3 is one of 8 B vitamins. It is also known as niacin (nicotinic acid) and has 2 other forms, niacinamide (nicotinamide) and inositol hexanicotinate, which have different effects from niacin.

All B vitamins help the body to convert food (carbohydrates) into fuel (glucose), which is “burned” to produce energy. These B vitamins, often referred to as B complex vitamins, also help the body metabolize fats and protein. B complex vitamins are necessary for healthy skin, hair, eyes, and liver. They also help the nervous system function properly.

Niacin also helps the body make various sex and stress-related hormones in the adrenal glands and other parts of the body. Niacin is effective in improving circulation and reducing cholesterol levels in the blood.

All the B vitamins are water-soluble, meaning that the body does not store them.

The body’s needs for B3 can usually be met through diet; it is rare for anyone in the developed world to have a B3 deficiency. In the United States alcoholism is the prime cause of vitamin B3 deficiency.

Symptoms of mild deficiency include indigestion, fatigue, canker sores, vomiting, and depression. Severe deficiency can cause a condition known as pellagra. Pellagra is characterized by cracked, scaly skin, dementia, and diarrhea. It is generally treated with a nutritionally balanced diet and niacin supplements. Niacin deficiency also results in burning in the mouth and a swollen, bright red tongue

Very high doses of B3 (available by prescription) have been shown to prevent or improve symptoms of the following conditions. However, taken at high doses niacin can be toxic, so you should take doses higher than the Recommended Daily Allowance only under your doctor’s supervision. Researchers are trying to determine if inositol hexanicotinate has similar benefits without serious side effects, but so far results are preliminary.

High Cholesterol

Niacin (but not niacinamide) has been used since the 1950s to lower elevated LDL (”bad”) cholesterol and triglyceride (fat) levels in the blood and is more effective in increasing HDL (”good”) cholesterol levels than other cholesterol-lowering medications. However, side effects can be unpleasant and even dangerous. High doses of niacin cause flushing of the skin (which can be reduced by taking aspirin 30 minutes before the niacin), stomach upset (which usually subsides in a few weeks), headache, dizziness, and blurred vision. There is an increased risk of liver damage. A time-release form of niacin reduces flushing, but its long-term use is associated with liver damage. In addition, niacin can interact with other cholesterol-lowering drugs (see “Possible Interactions”). You should not take niacin at high doses without your doctor’s supervision.

Atherosclerosis

Because niacin lowers LDL and triglycerides in the blood, it may help prevent atherosclerosis (hardening of the arteries) and is sometimes prescribed along with other medications. However, niacin also increases levels of homocysteine levels in the blood, which is associated with an increased risk of heart disease. This is another reason you should not take high doses of niacin without your doctor’s supervision.

Diabetes

Some evidence suggests that niacinamide (but not niacin) might help delay the onset of insulin dependence (in other words, delay the time that you would need to take insulin) in type 1 diabetes. In type 1 diabetes, the body’s immune system mistakenly attacks the cells in the pancreas that make insulin, eventually destroying them. Niacinamide may help protect those cells for a time, but more research is needed to tell for sure.

The effect of niacin on type 2 diabetes is more complicated. People with type 2 diabetes often have high levels of fats and cholesterol in the blood, and niacin, often in conjunction with other drugs, can lower those levels. However, niacin can also raise blood sugar levels, resulting in hyperglycemia — particularly dangerous for someone with diabetes. For that reason, anyone with diabetes should take niacin only when directed to do so by their doctor, and should be carefully monitored for hyperglycemia.

Osteoarthritis

One preliminary study suggested that niacinamide may improve arthritis symptoms, including increasing joint mobility and reducing the amount of nonsteroidal anti-inflammatory drugs (NSAIDs) needed. But more research is needed to determine whether there is any real benefit.

Alzheimer’s disease

Population studies show that people who get higher levels of niacin in their diet have a lower risk of Alzheimer’s disease. No studies have evaluated niacin supplements, however.

Skin conditions

Topical forms of niacin are being studied as treatments for acne, aging, and prevention of skin cancer, although results are too early to know whether it is effective.

Dietary Sources:

The best dietary sources of vitamin B3 are found in beets, brewer’s yeast, beef liver, beef kidney, fish, salmon, swordfish, tuna, sunflower seeds, and peanuts. Bread and cereals are usually fortified with niacin. In addition, foods that contain tryptophan, an amino acid the body coverts into niacin, include poultry, red meat, eggs, and dairy products.

Available Forms:

Vitamin B3 is available in several different supplement forms: niacinamide, niacin, and inositol hexaniacinate. Niacin is available as a tablet or capsule in both regular and timed-release forms. The timed-release tablets and capsules may have fewer side effects than the regular niacin; however, the timed-release versions are more likely to cause liver damage. Regardless of the form of niacin being used, periodic checking of liver function tests is recommended when high doses (above 100 mg per day) of niacin are used.

How to Take It:

Daily recommendations for niacin in the diet of healthy individuals are listed below.

Generally, high doses of niacin are used to control specific diseases, such as high cholesterol. Such high doses are considered “pharmacologic” and must be prescribed by a doctor, who will have you increase the amount of niacin slowly, over the course of 4 - 6 weeks, and take the medicine with meals to avoid stomach irritation.

Pediatric

    * Infants birth to 6 months: 2 mg (adequate intake)

    * Infants 7 months to 1 year: 4 mg (adequate intake)

    * Children 1- 3 years: 6 mg (RDA)

    * Children 4 - 8 years: 8 mg (RDA)

    * Children 9 - 13 years: 12 mg (RDA)

    * Males 14 - 18 years: 16 mg (RDA)

    * Females 14 - 18 years: 14 mg (RDA)

Adult

    * Males 19 years and older: 16 mg (RDA)

    * Females 19 years and older: 14 mg (RDA)

    * Pregnant females: 18 mg (RDA)

    * Breastfeeding females: 17 mg (RDA)

Precautions:

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable health care provider.

High doses (50 mg or more) of niacin can cause side effects. The most common side effect is called “niacin flush,” which is a burning, tingling sensation in the face and chest, and red or “flushed” skin. Taking an aspirin 30 minutes prior to the niacin may help reduce this symptom.

At the very high doses used to lower cholesterol and treat other conditions, liver damage and stomach ulcers can occur. Your health care provider will periodically check your liver function through a blood test.

People with a history of liver disease or stomach ulcers should not take niacin supplements. Those with diabetes or gallbladder disease should do so only under the close supervision of their doctor.

Niacin should not be used if you have gout.

Taking any one of the B complex vitamins for a long period of time can result in an imbalance of other important B vitamins. For this reason, it is generally important to take a B complex vitamin with any single B vitamin.

Possible Interactions:

If you are currently being treated with any of the following medications, you should not use niacin without first talking to your healthcare provider.

Antibiotics, Tetracycline — Niacin should not be taken at the same time as the antibiotic tetracycline because it interferes with the absorption and effectiveness of this medication. (All vitamin B complex supplements act in this way and should therefore be taken at different times from tetracycline.)

Aspirin — Taking aspirin before taking niacin may reduce flushing associated with this vitamin, but should only be done under your doctor’s supervision.

Anticoagulants (blood thinners) — Niacin may make the effects of these medications stronger, increasing the risk of bleeding.

Blood Pressure Medications, Alpha-blockers — Niacin can make the effects of medications taken to lower blood pressure stronger, leading to the risk of low blood pressure.

Cholesterol-lowering Medications — Niacin binds bile-acid sequestrants (cholesterol-lowering medications such as colestipol, colesevelam, and cholestyramine) and may decrease their effectiveness. For this reason, niacin and these medications should be taken at different times of the day.

Recent scientific evidence suggests that taking niacin with simvastatin (a drug that belongs to a class of cholesterol-lowering medications known as HMG-CoA reductase inhibitors, or statins), appears to slow down the progression of heart disease. However, the combination may also increase the likelihood for serious side effects, such as muscle inflammation or liver damage.

Diabetes Medications — Niacin may increase blood glucose (sugar) levels. People taking insulin, metformin, glyburide, glipizide, or other medications used to treat high blood sugar levels should monitor their blood sugar levels closely when taking niacin supplements.

Isoniazid (INH) — INH, a medication used to treat tuberculosis, may lower levels of niacin in the body and cause a deficiency.

Nicotine Patches — Using nicotine patches with niacin may worsen or increase the risk of flushing associated with niacin.

Alternative Names:

Inositol hexaniacinate; Niacin; Niacinamide; Nicotinamide; Nicotinic acid

BEVERLY HILLS - The levels of LDL cholesterol are determined by risk for cardiovascular disease and risk for links to family history, to gender, to age, to smoking, to high blood pressure. So if you’ve got few risks, meaning zero or one, your LDL cholesterol should be under 160 milligrams per deciliter. If, in fact, you have two or more risk factors for heart disease, it’s recommended your LDL cholesterol be under 130 milligrams per deciliter. If you have heart disease or stroke or some other form of vascular disease or diabetes, it’s recommended that your LDL cholesterol be treated to levels under 100 milligrams per deciliter.

Finally, if you have known heart disease and continue to have undue risk such as continue to smoke, are overweight, have low HDL cholesterol, or in fact have other risk factors that add to your risk, then it’s recommended that, by many, that you get the LDL cholesterol even lower to levels under 70 milligrams per deciliter.

For HDL cholesterol, a risk factor for heart disease is determined by an HDL cholesterol under 40 milligrams per deciliter. And then there’s a new condition which is driven by the metabolic syndrome categorization. The metabolic syndrome typically occurs in people with obesity who have big waist circumferences. Here we have a different stratification of HDL cholesterol levels. For women now, you get a point for the metabolic syndrome if your HDL is less than 50 milligrams per deciliter. And for men, it’s still at the level of 40 milligrams per deciliter.

CHICAGO - Fasting every other day can help obese people lose weight, a small study hints.

Even though the study participants ate whatever they wanted on their non-fasting days, they lost an average of 5.6 kilograms (about 12 pounds) after eight weeks, Dr. Krista A. Varady of the University of Illinois at Chicago and her colleagues found.

What’s more, their total and “bad” LDL cholesterol levels dropped, and their blood pressure fell.

“People lost anywhere from about 7 pounds to about 30 pounds and that was in a very short amount of time,” Varady said. And, she added, the program was pretty easy for the study participants to follow.

People typically try to lose weight by cutting their calorie intake every day, Varady and her team note in the American Journal of Clinical Nutrition. A much rarer approach, they add, is to have people alternate “feed days” with “fast days.” Studies in normal and overweight people have shown that this strategy can indeed help people lose weight and improve their cholesterol levels.

To test alternate-day fasting in obese adults, Varady and her colleagues had 12 obese women and 4 obese men begin by eating normally for a two-week control period. Then, for eight weeks, they ate just 25 percent of the calories they needed to maintain their weight, between noon and 2 p.m., every other day.

For the first four weeks, the researchers provided study participants with their fasting day meal, while for the next four, study participants met with a dietitian every week and prepared the meal themselves.

Study participants lost about 0.7 kilograms (1.5 pounds) every week. At the end of the eight-week diet, their total cholesterol had dropped by 21 percent, on average, while their LDL cholesterol had dropped 25 percent. Moreover, their systolic blood pressure (the upper number in a blood pressure reading) had fallen by an average of five points.

While Varady and her team had thought people might overeat on their non-fasting day in order to compensate, this turned out not to be true; people typically ate between 100 percent or 125 percent of their calorie needs on their all-you-can eat days.

“I think it’s probably because their stomachs kind of shrunk,” she said.

The next step, the researcher said, will be to figure out if people can maintain the on-off approach for a longer period of time, to continue to lose weight or to maintain a healthy weight.

Anyone who wants to give the diet a try, she added, should meet with their doctor or a dietitian first.

SOURCE: American Journal of Clinical Nutrition, November 2009.