Heavyweights Battle over Cholesterol Dominance
A study published in the New England Journal of Medicine showed that the use of extended-release Niacin (vitamin B3, also known as nicotinic acid ) was “superior” to the popular drug Zetia (aka ezetimibe, a product of Merck and Schering-Plough) in preventing atherosclerosis, the build up of arterial plaque and a symptom of cardiovascular disease.
The researchers found that Zetia lowered people’s levels of LDL (‘bad’ cholesterol), but didn’t improve the narrowing in their arteries. However, people who took niacin, one of the oldest treatments for high cholesterol, had improvements in both their LDL and HDL (‘good’ cholesterol) cholesterol levels and their artery thickness. The researchers also found that people taking Zetia were more likely to die during the 14 month study, have a heart attack, or get serious problems related to heart disease. When researchers saw that people taking niacin had substantial improvement in their arteries while those taking Zetia did not, they decided to stop the study early.
“Niacin had a superior effect on the artery wall, so the take home message is clear: niacin should be the choice when considering an add-on therapy,” said Allen J. Taylor, MD, of the Walter Reed Army Medical Center and principal investigator of the ARBITER 6-HALTS trial.
This is not a surprise if you consider this information published in early 2008 that Zetia, a drug prescribed to about 1 million people each week, has no medical benefits. This was according to a clinical trial called Enhance that lasted two years, conducted by Merck and Schering-Plough, the very companies that make the product!
The clinical trial, which studied whether Zetia could reduce the growth of plaques, found that plaques grew nearly twice as fast in patients taking Zetia along with Zocor than in those taking Zocor alone. Patients who took both Zetia and Zocor received it in the form of Vytorin, a pill that combines the medications.
Dr. Steven Nissen, the chairman of cardiology at the Cleveland Clinic said, “The results were shocking. Patients should not be prescribed Zetia unless all other cholesterol drugs have failed. This is as bad a result for the drug as anybody could have feared. Millions of patients may be taking a drug that has no benefits for them, raising their risk of heart attacks and exposing them to potential side effects.” Still, patients who are taking Vytorin or Zetia should talk to their doctors if they are concerned and not discontinue taking the medicines on their own, Dr. Nissen said.
According to Dr. Joseph Mercola, “The answer is not to turn back to typical statin drugs to lower your cholesterol, as many of the so-called experts would have you believe. In fact, it is VERY rare for anyone to need cholesterol-lowering drugs. Among the more than 20,000 patients who have come to my clinic, only four or five of them truly needed these drugs, as they had genetic challenges that required it. If you or someone you know is taking them, odds are very high, greater than 100 to 1, that you or they don’t need it. Statin drugs can actually increase your risk of heart disease because they deplete your body of Coenzyme Q10 (CoQ10), which ironically, can lead to heart failure. It is also my experience that Niacin is not required for the vast majority of people with high cholesterol levels. First, realize that cholesterol is not the major culprit in heart disease, or any disease for that matter. Cholesterol is a necessary part of every cell in your body, and it is an essential ingredient for healthy hormones. Next, avoid getting caught up with the numbers. The guidelines that dictate what your cholesterol level “should” be are extremely biased, and have not been proven to be healthy. ”
Both Zetia and Vytorin cost about $3-4 a day and are inferior products. The time released niacin supplements cost less than $1 a day and are superior. Zetia and Vytorin are non-essential synthetic chemicals. Niacin is an essential vitamin for normal human function. Niacin can also be safely used in patients with diabetes and niacin therapy may be considered as an alternative to statin drugs or fibrates for patients with diabetes in whom these agents are not tolerated or fail to sufficiently correct hypertriglyceridemia or low HDL-C levels.
So which one are you going to choose?
The answer is neither. A balanced, healthy diet with reduced grains and sugars combined with adequate exercise is all that your body requires to balance your cholesterol levels. Although niacin supplementation can be effective, it can have side effects that can be avoided when consumed from food rather than supplement form. Do not take niacin supplements except under proper supervision.