Hyperlipidemia

My cardiologist told me my lipids are 10 time higher than normal. I have CAD and had a MI in Jan.99. I have done very well with very little heart damage. I am followed closely by my MD. He is starting me on slow niacin 125mg  3 times a day for 2 weeks, 250mg 3 times a day for two weeks, and 500 mg 3 times a day for 2 weeks. Blood test will be done after the last 2 weeks.  He said we may have to go as high as 4000 mg. a day. This concerns me as niacin can affect the liver. I know I am at high risk for MI with these high lipids, but if I damage my liver to save my heart what is the use? I am already on Lipitor and I take Endolac for arthritis. All of these can affect the liver. Have you seen any studies on high dose nicain?

[Cleveland Clinic, MD]

Niacin is a good drug and usually well tolerated if started slowly.  There is a risk of increased liver enzymes and these must be monitored but they are reversible if detected and the dosage reduced.  Given your cholesterol profile it sounds like niacin is a good drug for you.