Niacin has a long and established history in the management of cholesterol problems, bringing down the bad LDL cholesterol. In addition, it can also INCREASE the HDL fraction which is very often low in people with HIV. HIV infection without antiviral therapy can cause this; add the antivirals, and you may see increasing cholesterol and triglycerides. Niacin is a much less costly and most likely more effective and less dangerous approach than over priced statin drugs. However, it can cause a flushing and itching sensation that many find unpleasant. Brining the dose up gradually over a few days and weeks can greatly reduce these side effects.
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