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Medical Forum / General / Nutrition / December 2003

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Low HDL - Niacin - Gout?

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Sully - 20 Dec 2003 17:00 GMT
Hi All,

I have been on 2 g Niaspan daily for 2 years with an increase in HDL
from 32 to 48. Quarterly blood checks have shown no adverse effects.
Recently I have been diagnosed with Gout. I have discussed options
with my Physician but I believe in studying many opinions. What is
your opinion on treatment for the low HDL in view of the Gout, and
what treatment would you recommend for the Gout?

I appreciate the opinions.

Mike Sullivan
John 'the Man' - 21 Dec 2003 02:37 GMT
Once upon a time, our fellow Sully
  rambled on about "Low HDL - Niacin - Gout?."
Our champion De-Medicalizing in sci.med.nutrition retorts, thusly ...

>I have been on 2 g Niaspan daily for 2 years with an increase in HDL
>from 32 to 48. Quarterly blood checks have shown no adverse effects.
>Recently I have been diagnosed with Gout. I have discussed options
>with my Physician but I believe in studying many opinions. What is
>your opinion on treatment for the low HDL in view of the Gout, and
>what treatment would you recommend for the Gout?

I hate to break the new to you, but your usage of Niaspan caused the
Gout!

Just my opinion.  But, I am *right* as usual!
--
John Gohde,
  Feeling Great and Better than Ever!

Natural health is an eclectic self-care system of natural therapies
that builds and restores health by working with the natural
recuperative powers of the human body.
http://tutorials.naturalhealthperspective.com/definition.html
Sully - 21 Dec 2003 12:26 GMT
I am aware the Niacin caused the Gout. My question is what are your
opinions on treatment of both - low HDL AND Gout?

Thanks

>Once upon a time, our fellow Sully
>   rambled on about "Low HDL - Niacin - Gout?."
[quoted text clipped - 11 lines]
>
>Just my opinion.  But, I am *right* as usual!
John 'the Man' - 21 Dec 2003 14:07 GMT
Once upon a time, our fellow Sully
  rambled on about "Re: Low HDL - Niacin - Gout?."
Our champion De-Medicalizing in sci.med.nutrition retorts, thusly ...

>I am aware the Niacin caused the Gout. My question is what are your
>opinions on treatment of both - low HDL AND Gout?

You treat Gout by stopping the cause which is in this case is Niaspan.
In other words, discontinue your use of Niaspan.

You treat low HDL the natural way:  Exercise!
--
John Gohde,
  Feeling Great and Better than Ever!
   
Alternative medicine was yesterday's quackery, is today's
complementary medicine, and will be tomorrow's new branch of medicine.
http://tutorials.naturalhealthperspective.com/glossary.html
Sully - 21 Dec 2003 22:32 GMT
I run 30 miles a week and weight train 3x week. In view of that  my
Physician perscribed Niacin. I am asking for advice of anyone who has
had sucess with other meds since exercize does not raise the HDL of
some people enough to be safe.

>Once upon a time, our fellow Sully
>   rambled on about "Re: Low HDL - Niacin - Gout?."
[quoted text clipped - 7 lines]
>
>You treat low HDL the natural way:  Exercise!
John 'the Man' - 22 Dec 2003 11:31 GMT
Once upon a time, our fellow Sully
  rambled on about "Re: Low HDL - Niacin - Gout?."
Our champion De-Medicalizing in sci.med.nutrition retorts, thusly ...

>I run 30 miles a week and weight train 3x week. In view of that  my
>Physician perscribed Niacin. I am asking for advice of anyone who has
>had sucess with other meds since exercize does not raise the HDL of
>some people enough to be safe.

Exercise works plain and simple.  But, there may be other factors.

Other factors known to lower HDL are:
- Smoking
- excessive amounts of trans-fatty acids (ie, partially
 hydrogenated oils)
- Excessive zinc
- and "Glycaemic Index as a Determinant of Serum HDL-Cholesterol
 Concentration"  (ie, too many refined grains and starchy foods)
http://atkinscenter.com/Archive/2002/1/11-160950.html
"Results indicated that among the 1,420 participants with complete
data, there was a negative relationship between HDL-cholesterol
concentration and the glycemic index of the diet for both men and
women."

Other factors known to increase HDL levels are:
1)500 mg a day of curcumin
2)Fat in your diet

The following is all the info that I have on the subject of increasing
hdl.

Subject: Exercise: How to Raise Good Hdl Cholesterol
Date: Sun, 25 Aug 2002 22:45:09 +0000

"Exercise before you eat fat. A study at the University of
Missouri shows that exercising regularly before eating high-fat
meals raises HDL cholesterol considerably."

To get the maximum effect from exercise on HDL you should always
exercise at least one hour before consuming a meal with fat.  This
effect depends a lot on the intensity of the exercise performed,
but low-intersenty exercises, like fast-walking, will work
provided you exercise for long periods of time.

And, if you engage in intense aerobic exercise you can effective
use this technique to cheat on your low-fat diet, with an
occasional high-fat meal.  Further, the high-fat meal can be
consumed up to 12 hours after exercising.

"The purpose of this study was to examine the optimal time to
exercise (before or after a fat meal) to magnify the effect of
exercise on postprandial TG and HDL responses."

"At 24 h, HDL2-Ch concentrations in both the 1 h-Pre and 12 h-Pre
trials were significantly higher than in Control."

"The TG-lowering effect in the premeal-exercise trials is
accompanied by elevation of HDLtot-Ch and HDL2-Ch. These findings
suggest that the detrimental effects of eating fat during a meal
can be decreased by exercise before the meal. Furthermore,
exercising 12 h before a fat-rich meal intake may magnify this
beneficial effect on the TG response and HDL metabolism, which may
more efficiently blunt the postprandial-induced atherosclerotic
process."

How to Raise Good Hdl Cholesterol
http://www.drmirkin.com/heart/8756.html
"Gabe Mirkin, M.D.

If your good HDL cholesterol is below 35, you are at increased
risk for heart attacks. You can reduce chances of suffering a
heart attack by two percent for every mg/dl rise in HDL.

To raise HDL cholesterol, run at least seven miles a week or burn
at least 1200 calories with exercise per week. Lose weight. For
every pound of fat lost, expect a one percent rise in HDL (1).

Exercise before you eat fat. A study at the University of Missouri
shows that exercising regularly before eating high-fat meals
raises HDL cholesterol considerably (2). Exercise stimulates the
fat-clearing enzyme, lipoprotein lipase, which drops triglycerides
to produce more HDL cholesterol."

Zhang JQ, Thomas TR, Ball SD.
Effect of exercise timing on postprandial lipemia and HDL
cholesterol subfractions.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9
760349&dopt=Abstract

J Appl Physiol. 1998 Oct;85(4):1516-22.
PMID: 9760349

FREE Full Text of article at Journal of Applied Physiology Online:
http://jap.physiology.org/cgi/content/full/85/4/1516

"Fig. 3.   A: effect of acute exercise on plasma total
high-density lipoprotein-cholesterol"
http://jap.physiology.org/content/vol85/issue4/images/large/japp06053003x.jpeg

Aldred HE, Perry IC, Hardman AE.
The effect of a single bout of brisk walking on postprandial
lipemia in normolipidemic young adults.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8
028506&dopt=Abstract

Metabolism. 1994 Jul;43(7):836-41.
PMID: 8028506

Avoid taking 100 mg or more Zinc a day.  I would not supplement
with more than 50 mg a day of Zinc.

Freeland-Graves JH, Friedman BJ, Han WH.
Effect of zinc supplementation on plasma high-density lipoprotein
cholesterol and zinc.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7
081096&dopt=Abstract

Am J Clin Nutr. 1982 May;35(5):988-92.
PMID: 7081096

Hooper PL, Visconti L, Garry PJ.
Zinc lowers high-density lipoprotein-cholesterol levels.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7
420708&dopt=Abstract

JAMA. 1980 Oct 24-31;244(17):1960-1.
PMID: 7420708

http://www.smartbodyz.com/herbal-cardiovascular-formula-Text.htm
"When 500 mg a day of curcumin was given to ten volunteers, there
was a 29% increase in beneficial HDL cholesterol after only 7
days.  Total cholesterol was reduced by 11.6% and lipid
peroxidation was by 33% (Indian Journal of Physiology
36(4):273-275 1992)."

Soni KB, Kuttan R.
Effect of oral curcumin administration on serum peroxides and
cholesterol levels in human volunteers.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1
291482&dopt=Abstract

Indian J Physiol Pharmacol. 1992 Oct;36(4):273-5.
PMID: 1291482
--
John Gohde,
  Feeling Great and Better than Ever!

Healers who believe in the healing power of nature,
Vis Mediatix Naturae, worship Hygeia and the vital force.
http://tutorials.naturalhealthperspective.com/history.html
John Applebaum - 22 Dec 2003 23:58 GMT
I am just curious what levels have you achieved yourself?  If you gave
us the starting points on your lipids and how they have changed over
time, along with other numbers that you changed.  The reason I'm curious
is that you really do seem to use a strong holistic approach and you are
very optimistic about always improving on your health.
Sully - 23 Dec 2003 15:48 GMT
3 years ago when I thought I could improve my colestrol with exercize
I was 260lbs at 6'3 and my HDL was at 30. Total colestrol was at 200.
I started a weight management and exercize program and in a year I had
lost 45lbs and raised my HDL by 2 to a whopping 32. Since starting the
Niaspan I have raised it to 48, total colestrol is 150, and I have
maintained my weight loss. I would still like to drop 20lbs.

Idealy I would like to achieve my health goals without high doses of
anything, however I'm not willing to risk a heart attack to do it.
Since the Gout, I have been searching for ways to manage all of these
issues with the least side effects.

I appreciate everyone's input and value each suggestion. Knowledge is
so powerful!

Mike Sullivan

>I am just curious what levels have you achieved yourself?  If you gave
>us the starting points on your lipids and how they have changed over
>time, along with other numbers that you changed.  The reason I'm curious
>is that you really do seem to use a strong holistic approach and you are
>very optimistic about always improving on your health.
John 'the Man' - 23 Dec 2003 19:12 GMT
Once upon a time, our fellow Sully
  rambled on about "Re: Low HDL - Niacin - Gout?."
Our champion De-Medicalizing in sci.med.nutrition retorts, thusly ...

>Since starting the
>Niaspan I have raised it to 48

A HDL of 48 is pretty bad.

Just thought that you might want to know. :)

Ha, ... Hah, Ha!
eldred30 - 24 Dec 2003 18:38 GMT
> 3 years ago when I thought I could improve my colestrol with exercize
> I was 260lbs at 6'3 and my HDL was at 30. Total colestrol was at 200.
[quoted text clipped - 12 lines]
>
> Mike Sullivan

I have used 300mg of allopurinol daily for the last 20 years to
successfully control gout. No side effects noted. Relatively
inexpensive.

eldred30
Frank Roy - 26 Dec 2003 02:01 GMT
> > 3 years ago when I thought I could improve my colestrol with exercize
> > I was 260lbs at 6'3 and my HDL was at 30. Total colestrol was at 200.
[quoted text clipped - 18 lines]
>
> eldred30

I have been taking the same dosage of allopurinol as yours since 1964.
Likewise, no side effects noted. My HDL is in the 60s and total
cholesterol is in the 150s while triglycerides are less than HDL.

Frank
John Applebaum - 25 Dec 2003 06:12 GMT
> I am just curious what levels have you achieved yourself?  If you gave
> us the starting points on your lipids and how they have changed over
> time, along with other numbers that you changed.  The reason I'm curious
> is that you really do seem to use a strong holistic approach and you are
> very optimistic about always improving on your health.

Does anyone think John the Mam is a self-centered dork for not answering
this question?  Anyone think it cause swallowing problems for him for a
few minutes?
John 'the Man' - 25 Dec 2003 07:53 GMT
Once upon a time, our fellow John Applebaum
  rambled on about "Re: Low HDL - Niacin - Gout?."
Our champion De-Medicalizing in sci.med.nutrition retorts, thusly ...

>> I am just curious what levels have you achieved yourself?  If you gave
>> us the starting points on your lipids and how they have changed over
[quoted text clipped - 5 lines]
>this question?  Anyone think it cause swallowing problems for him for a
>few minutes?

Merry X-Mas, dork!

Just thought that you might want to know. :)
John Applebaum - 25 Dec 2003 20:10 GMT
> Once upon a time, our fellow John Applebaum
>    rambled on about "Re: Low HDL - Niacin - Gout?."
[quoted text clipped - 13 lines]
>
> Just thought that you might want to know. :)

You couldn't even answer the simplest of questions.  It's hard to let
yourself be pinned down when you insist on being King in an imaginary
castle in the sky.  I predict a bunch of lurkers are really getting
impressed with your contributions over time and are going to push your
website over the top.  People from everywhere will be looking for your
detailed and rich understanding of nutrition and health...... .
John 'the Man' - 25 Dec 2003 20:46 GMT
Once upon a time, our fellow John Applebaum
  rambled on about "Re: Low HDL - Niacin - Gout?."
Our champion De-Medicalizing in sci.med.nutrition retorts, thusly ...

>> >> I am just curious what levels have you achieved yourself?  If you gave
>> >> us the starting points on your lipids and how they have changed over
[quoted text clipped - 16 lines]
>website over the top.  People from everywhere will be looking for your
>detailed and rich understanding of nutrition and health...... .

This THREAD is a good commentary on the differences between Treating
the Patient and Treating the Disease.  It also explains why physicians
prefer treating the disease.  :)

When Treating the Patient you have to figure out what the patient has
been doing W-R-O-N-G!  One could easily speculate that Sully has been
doing a number of things wrong.   Engaging in abusive forms of
exercise would certainly be one possibility.  Certainly, runners
suffer from a common form of mental illness:  namely that their chosen
form of abuse is healthy.  Ha, ... Hah, Ha!  Taking excessive amounts
of Zinc would be another possibility.  And, a lack of adequate amounts
of fat in the diet would certainly be another possiblity.

Naturally, an obviously problem with treating the patient is that you
have to deal with the mental problems of the patient:  D-E-N-I-A-L!
And, I am not talking about the Nile.  Ha, ... Hah, Ha!  Sully
obviously could write a book on his denial and his other mental
problems. :(

John Applebaum is the type of patient who is likely to become verbally
abusive.  :(

John Applebaum wants answers.  The problem is that John Applebaum
cannot even deal with a factual presentation of the facts, let alone
an exposé on where John Applebaum has failed in life, let alone in the
exercise department.  Ha, ... Hah, Ha!

John Applebaum is obviously another HDL failure, still walking.  Ha,
... Hah, Ha!  Maybe that is why you have failed?  Ha, ... Hah, Ha!

Just my opinion.  But, I am *right* as usual!

Ha, ... Hah, Ha!  X-Mas, Dorks!
markd@toad-net.com - 23 Dec 2003 22:05 GMT
Current guidlines for those at risk are 40 for m and 45 for w.  Each
percent of increase has a decrease of risk for cvd. If one is starting at
a much lower level, getting it that high is good, good/bad being relative
to some goal; one might have thought you know this already.

>>Since starting the
>>Niaspan I have raised it to 48
>
>A HDL of 48 is pretty bad.
John 'the Man' - 24 Dec 2003 07:51 GMT
Once upon a time, our fellow markd@toad-net.com
  rambled on about "Re: Low HDL - Niacin - Gout?."
Our champion De-Medicalizing in sci.med.nutrition retorts, thusly ...

>Current guidlines for those at risk are 40 for m and 45 for w.  Each
>percent of increase has a decrease of risk for cvd. If one is starting at
>a much lower level, getting it that high is good, good/bad being relative
>to some goal; one might have thought you know this already.

HDL doesn't become a negative risk factor until it is in the 60+
range.

Cheers ...
--
John Gohde,
  Feeling Great and Better than Ever!

Healers who believe in the healing power of nature,
Vis Mediatix Naturae, worship Hygeia and the vital force.
http://tutorials.naturalhealthperspective.com/history.html
John 'the Man' - 24 Dec 2003 08:09 GMT
Once upon a time, our fellow markd@toad-net.com
  rambled on about "Re: Low HDL - Niacin - Gout?."
Our champion De-Medicalizing in sci.med.nutrition retorts, thusly ...

>Current guidlines for those at risk are 40 for m and 45 for w.

Ha, ... Hah, Ha!

Whose guidelines?

Yeah, ... Sure, Right!   Those doctors who don't care if you live or
die because the HMO is the bill payor.

Ha, ... Hah, Ha!

>one might have thought you know this already.

One might have thought that Geeks had a brain, too.  But, I guess not!

Ha, ... Hah, Ha!

"... you have my sympathies"
Science Officer Ash to Ripley, in the movie ALIEN.
markd@toad-net.com - 24 Dec 2003 18:18 GMT
"Whose guidelines?"

Do a bit of google, it goes a long way.  There is much discussion about
what the hdl number indicates.  One idea has it that hdl appears in
responce to small particle ldl, such that if ldl is under control hdl is
not likely to be very high.  In any case, do your own homework, we thought
you need to know.
 
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