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Hello Mike George,   For all that you do, your HDL is surprizingly low.   I can understand your and your doctor's concern.   If your doctor thinks that treatment with niacin and statins are a good option for your health, I would take them.  The concerns about statins hurting the liver are fairly overblown.  Yes, you should get liver function tests(LFTs) 2 months after treatment starts, yearly afterwards, and 2 months after any dosage increases, the relatively few people that get increased LFTs return to completely normal after stopping taking the medication.  These drugs RARELY  ( I mean less than 1/20,000 patients) get a condition called rhabdomyolysis which can hurt your kidneys.  Niacin definately raises HDL, but is not terribly well tolerated in patients because of a sensation of flushing (harmless, but irritating) that a lot of people seem to get.    Be sure to discuss with your doctor if your take your medications at your next visit!   To your health, Neil MD