From: dyer@spdcc.com (Steve Dyer)
Newsgroups: sci.med.nutrition
Subject: Re: niacin and the NIH
Date: 6 Nov 92 07:35:18 GMT
Article-I.D.: spdcc.1992Nov6.073518.18479
Organization: S.P. Dyer Computer Consulting, Cambridge MA

In article <1992Nov5.101327.1@skcla.monsanto.com> mpmena@skcla.monsanto.com writes:
>>>"NIACIN IS "A FIRST CHOICE DRUG" FOR PREVENTION OF CORONARY HEART DISEASE,
>>>NIH PANEL SAYS;..."
>> 
>> So, where's the word "BEST"?   Simple, it wasn't mentioned.
>> 
>What does FIRST CHOICE mean to YOU????
>"Any moron" would understant that the term first choice doesn't mean "worst"

That wasn't the assertion.  You're unfamiliar with the phrase "a first choice
drug", which is a bit of medical jargon.  It means that it should be one of
the first drugs considered in treating hyperlipidemias, depending that is,
on the particular lipid disorder.  It does not mean that it is the "BEST"
in any sense of the word.

>> You're a fool if you're treating yourself with niacin without it being
>> prescribed by a physician and having periodic checkups.  It is not a
>> drug suitable for self-administration.
>
>Although any compound, be it a nutrient of pharmacologic agent, can have some
>side effects, a recognized panel of national experts feel strongly about the
>relative value of niacin, compared to other hypolipemic and bile-sequestiering
>agents.  Mr. Dyer seems to glibly ignore their combined experience and
>recommendations in this area.

This panel was most definitely not recommending self-medication with niacin!
You were taking something stronger than niacin if you could come to THAT
conclusion.  Crackpots like you are a dime a dozen.

>One other question... How much nutrition is taught at medical schools these
>days?  A recent study (no, I don't have it at my fingertips; if you can't find
>it on Medline like any other "moron" tough luck) decried to lack of adequate
>training by physicians not only in the area of basic and clinical/critical care
>nutrition and metabolism, but also in disease prevention.  My regular
>interaction with the faculty of these institutions in the US and other
>countries hasn't revealed any changes in these areas.
 
Yeah, yeah, blather, blather.  Niacin is acting like a drug, not a vitamin
in its effects on blood lipids.  This is not a matter of knowing "nutrition".
(I'm going to leave that dumb metadiscussion for someone else; it's not
worth my time.)  Niacin taken in such large doses as are needed to have an
effect on blood lipids can have any of a number of side effects, including
liver dysfunction, GI distress, possibly proceeding to peptic ulcer, it can
cause hyperglycemia, especially in individuals with poorly controlled or
borderline diabetes.  It has caused frank jaundice and hepatitis.  This
is not an innocuous drug.

Niacin regimens frequently include bile acid sequestering resins in the
treatment of certain hyperlipidemias, because they complement each other
and allow lower doses of both drugs to be administered.  But as I said
before, it all depends on what kind of lipid abnormality the individual has.

>In this area, Steve is absolutely right.  Anyone can get access to Medline...So
>why have the vast majority of physicians consistently failed to access
>peer-reviewed information relevant to nutrition for so many years... Is it that
>all too many physicians don't have the intelligence to gain the knowledge to
>put the raw information to use...(maybe they just don't understand
>metabolism...) or that they're too busy making money pumping patients through
>the disease-oriented system they created to be concerned about the health and
>well-being of their patients?  (My apologies to the few physicians who DO care,
>and make the effort to know what they're talking about!)

Duh.

>Wake up, Steve, and smell the vitamins!

Boy, they've got all kinds at Monsanto, don't they?

-- 
Steve Dyer
dyer@ursa-major.spdcc.com aka {ima,harvard,rayssd,linus,m2c}!spdcc!dyer