Daily Column

DEAR DR. GOTT:
In a past column you recommended replacing Lipitor with either omega-3 fish oil capsules or niacin. I have elected to try the niacin. You said to START with 500 milligrams per day and I have done this for a couple of weeks. Now I want to increase the dosage but don’t know what to increase it to. Should I go to 1000, 1500 or 2000 mg? Maybe more? Also, how long should I stay on the niacin? I would also like to know your opinion on red yeast rice. I have noticed that you don’t mention it.

DEAR READER:
Niacin is an excellent alternative choice for lowering cholesterol levels. I often recommend patients to start with a relatively low-dose of 250-500 mg daily and then slowly work up to 1000-1500 mg daily, usually in increments of 250 mg. This is primarily to allow the body to become accustomed to the vitamin and reduce the chance of side effects, namely, flushing. [Read more...]

Daily Column

DEAR DR. GOTT:
What are statins and how do I know if the pills I take are statins? What are they for and what are the side effects?

DEAR READER:
Statin drugs are effective in lowering cholesterol levels and reducing the risk of heart attack and death in patients with known coronary artery disease. Lipitor (atorvastatin), Lescol (fluvastatin), Mevacor (lovastatin), Pravachol (pravastatin), Zocor (simvastatin), and Crestor (rosuvastatin) fall into the statin category. If you are on any of these medications, you are taking a statin.

The most common side effects are elevated liver enzymes and leg cramping. If you are on a statin, your doctor should schedule periodic laboratory testing to determine if your levels are within normal limits. If the cholesterol level remains high despite the medication or the liver enzymes start to rise to dangerous levels, he or she will likely make a determination [Read more...]