Increasing HDL Cholesterol

Patients often ask how to increase their HDL cholesterol. The current theory is that the higher your HDL the less likely you are to have heart disease.

Lifestyle changes work best. For example, exercise raises HDL by 5% to 30%, weight loss 5% to 20% and smoking cessation about 5%. Niacin is the most effective in that it increases HDL up to 35%.

What type of Niacin is best. Evidence indicate that immediate release niacin is the most effective and less toxic to the liver. It has to be taken 3 times a day and will typically cause flushing. By taking 325mg aspirin 30 minutes before the niacin helps to decrease the flushing.

Inositol hexanicinate (“no-flush” niacin) is expensive and there is not much evidence that it works as well as regular niacin.

Terry Pfau, D.O., H.M.D.

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