In previous articles I have talked about the multiple beneficial effects of niacin supplementation – on both lipids (blood fats and cholesterol) and non-lipid outcomes.

 

While flushing is often reported to be the main side-effect of niacin supplementation, the flush is a natural reaction to high-dose niacin, and is not dangerous. Thus, while some people may find it uncomfortable, it is not a harmful side-effect. For more on that, see “Niacin - How to Beat the Flush”

 

Other, potentially harmful side effects, are liver strain/damage, insulin resistance and blood glucose elevations, and uric acid elevations.[1] Here I will summarize what research shows on the severity of these side effects, and whether it is something you should worry about… 

 

It is well documented that obesity may cause hypogonadism, and that hypogonadism may cause obesity [1-4] This has generated debate about what condition comes first; obesity or hypogonadism? And what should be the first point of intervention?

 

In this article I will summarize data from several reviews on the associations of hypogonadism and obesity [1-4], and make the case that these conditions create a self-perpetuating vicious circle. Once a vicious circle has been established, it doesn’t matter where one intervenes; one can either treat the obese condition or treat hypogonadism first. The critical issue is to break the vicious circle as soon as possible before irreversible health damage arises. 

 

Nevertheless, as I will explain here, treating hypogonadism first with testosterone replacement therapy may prove to be a more effective strategy because it to a large extent “automatically” takes care of the excess body fat and metabolic derangements. In addition, treating hypogonadism first also confers psychological benefits that will help obese men become and stay more physically active.