Presented By: Anthony W. Clay,
D.O., F.A.C.C.

You may have seen “niacin” on the side of your cereal box in the morning or your doctor may have prescribed it for your high cholesterol. Yes, it is the same thing. Niacin and its precursor tryptophan are contained in many foods we eat including soy, milk, poultry, fish, eggs as well as plant sources. Lack of dietary niacin can lead to a rare but potentially deadly disease called pellagra. Pellagra is still seen around the world especially when corn is the main staple of food source. Pellagra was seen in the poorer South in the past but not in native peoples in the U.S. or Mexico; that is because the natives prepare their corn meal with lime/alkali. This process makes it easier to grind and improves taste but changes niacin into its absorptive form thereby preventing pellagra.

The recommended daily allowance of niacin is about 20 mg. Most people get this in their daily diet or in their vitamin pill. The amount your doctor prescribes is more likely
500 to 2000 mg. Your doctor may have prescribed niacin alone or in combination with other medicines to lower your cholesterol. Niacin is one of the few cholesterol medicines we have that does “all the right things.” Niacin lowers the “bad cholesterol” (LDL), raises the “good cholesterol (HDL 20%) and also lowers triglycerides (TG 26%). The coronary drug project also showed a decrease of nonfatal heart attacks by 27% and a decrease in stroke and mini stroke by 26%. So why isn’t niacin in the drinking water!
Because in doses that we prescribe, it does have side effects and risks and should be treated like a drug – whether it is a prescription or over the counter. The major complaint from some patients is intense skin flushing. This effect will usually dissipate in two weeks but may recur if the dosage
is increased.
To minimize flushing:
•  Take at bedtime.
•  Take an aspirin one-half hour prior or ibuprofen any time.
•  No spicy food or alcohol close to bedtime.

Your doctor will monitor the situation as well, looking at blood tests (blood sugars, liver tests, uric acid and lipids). Niacin is an underutilized medicine in the treatment of cardiovascular disease and although not for everyone, you should feel free to discuss it with your doctor.

After practicing for seven years in Philadelphia, Dr. Anthony Clay joined Cardiology Physicians, P.A. in 2003. He is a clinical assistant professor of medicine at Hahnemann University and an Instructor of Medicine at Philadelphia College of Osteopathic Medicine. Dr. Clay received both his Bachelors and Masters Degrees from Villanova University. He then went on to attend medical school at the Philadelphia College of Osteopathic Medicine. He did his internal medicine training at Hahnemann University where he was awarded Resident of the Year. Dr. Clay then served as Chief Resident of the Internal Medicine Program. He remained at Hahnemann University for his Cardiology fellowship and served as chief cardiology fellow there.

Dr. Clay has strong interests in teaching. He has been a lecturer at national conventions regarding congestive heart failure and coronary artery disease. He continues to teach regularly at medical schools in Philadelphia and has been a preceptor for hundreds of medical students.

Dr. Clay has also served as chairman of the Physician’s Fund Raising Committee for the American Heart Association, Southeastern Pennsylvania Chapter. He is a member of Alpha Omega Alpha honorary medical society and the Pennsylvania and Delaware medical societies. He is also a member of the American College of Cardiology, American Heart Association and American Medical Association. Dr. Clay has a special interest in consultative cardiology, as well as echocardiography, nuclear cardiology, CT angiography, and congenital heart disease.

Dr. Clay was born in Delaware County, Pa., and is one of ten children. He was married in 1987 and lives with his wife Bernadette. They have three sons, Anthony, Luke, and Blaise. Dr. Clay enjoys all sports, especially coaching and playing basketball, rowing, and scuba-diving. Dr. Clay also enjoys reading, movies, and travel.

Cardiology Physicians, P.A.
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