Q: My cholesterol is extremely high, but I don't want to take the medicine used in lowering it. I am trying a vegetarian diet, and walking four to eight miles a day. I was told that taking extra Niacin would also help bring down my cholesterol. Do you know if there is any scientific proof of this?

A:While Niacin can lower triglyceride levels, and may raise HDL (good cholesterol), it's important to talk with your doctor about prescription niacin, which is sometimes combined with other medications. Steer clear of over the counter niacin supplements to self-medicate without professional advice. While Niacin is in the B vitamin family, when used in high doses, it acts like a medicine. 

It's important that you know that cholesterol comes from two sources: what you eat and how much your liver produces. You only have control over what you eat - and you can't control, with diet, how much your liver is producing.

A vegetarian diet is a healthful one for a lot of reasons, and if you are controlling your saturated fat intake (limiting animal products, including full fat dairy and whole eggs) you are on the right track, from the dietary point of view. Many people cut way back on their dietary saturated fat and cholesterol, and still have elevated blood cholesterol.

Depending on your own numbers, I'd suggest talking to your doctor about non-prescription and prescription options. Some people respond to phytosterol treatment (plant compounds that can help lower cholesterol) found in pills, or "supershots" (a fortified yogurt drink), while others need a small dose of a prescription medication. Good luck - and let me know how you are doing!

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