If the above fail to raise HDL to our desired target (but be patient!), then niacin is worth considering. For raising HDL, I find that a dose of 1000 mg per day yields maximal effect. (I use the non-prescription preparation, Sloniacin, made by Upsher Smith, exclusively. It has a proven track record of safety and is widely available in the vitamin aisle of drugstores and some department stores. I advise patients to begin with 500 mg at dinner for four weeks, then increase to 1000 mg.) Work with your doctor with niacin, but generous hydration (e.g., 2 big glasses of water) helps turn off the hot flush common with niacin.

Using the above approach in our program, HDLs of 60, 70, 80 mg/dl and higher are commonplace.