Triglycerides to HDL ratio on keto

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No-flush niacin (inositol hexaniacinate) has no effect on HDL cholesterol

Niacin, also known as vitamin B3, comes in two forms — nicotinic acid and nicotinamide. Both boost protective HDL and lower harmful LDL and triglycerides. Most people who take the high doses of standard, immediate-release niacin that are needed to improve HDL experience a feeling of flushing or itching, usually in the face. It starts within 30 minutes of taking the medication, and lasts for an hour or so.

No-flush niacin doesn't contain either nicotinic acid or nicotinamide. Instead, it contains inositol hexaniacinate. In theory, the body should slowly convert this into nicotinic acid. In reality, it doesn't. An excellent study by researchers at the University of Washington School of Medicine showed that taking no-flush niacin generates virtually no free nicotinic acid, and has little or no effect on HDL. No-flush niacin lives up to the no-flush part of its name because it isn't providing the body with any niacin.

I also recommend staying away from extended-release niacin. Instead of delivering a big bolus of niacin, it generates a lower, steady dose of the medication for hours. Although this eases flushing, it keeps blood levels of niacin high all day. The liver never gets a break from processing niacin, which has led to cases of severe liver damage.

more at:

• https://www.health.harvard.edu/newsletter_article/is-no-flush-niacin-as-effective-as-other-kinds-of-niacin

Can your HDL or ‘good cholesterol' be too high?

High levels of HDL, or “good” cholesterol, are generally considered healthy. But can you have too much of a good thing?

Possibly so, a study in the European Heart Journal found. Danish researchers tracked more than 116,508 men and women, average age 57, for an average of six years. There were 10,678 deaths.

After adjusting for other factors, an HDL of 73 milligrams per deciliter in men and 93 in women was associated with the lowest all-cause mortality. Compared with that, men with HDL levels of 97 to 115 had a 36 percent increased risk for death, and twice the risk above 116. Women at greater than 135 had a 68 percent increased risk. (Only 2.3 percent of men had levels above 97, and 0.3 percent of women had levels above 135.)

Low HDL, too, was tied to higher mortality risk, consistent with other studies. At levels under 39, the lower the HDL, the greater the increased risk for death.
The senior author, Dr. Borge G. Nordestgaard, a clinical professor at the University of Copenhagen, said that until now, he would “congratulate” patients with very high HDL. “The higher the better!”

“But now we know that’s not so. These people should protect themselves — exercise, stop smoking, eat a healthy diet and so on.”