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Glob Adv Health Med. 2012 Sep;1(4):84-91. doi: 10.7453/gahmj.2012.1.4.012.

The Effects of Tetrahydro-iso-alpha Acids and Niacin on Monocyte-Edothelial Cell Interactions and Flow-mediated Vasodilation.

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Joseph Lamb, MD, is director, Intramural Clinical Research at Metagenics, Gig Harbor, Washington; adjunct faculty, Institute for Functional Medicine, Gig Harbor; and medical director, KinDex Therapeutics, Seattle, Washington.


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Niacin favorably modifies cardiovascular risk factors but is associated with flushing and shows limited benefit in improving endothelial function. We investigated whether combining anti-inflammatory tetrahydro-iso-alpha acids (THIAA) from hops with niacin would improve endothelial function. We hypothesized that the THIAA+niacin combination would demonstrate benefits not seen with niacin alone. In an in vitro model, a THIAA+niacin mixture inhibited several TNF-α-induced cytokines in human aortic endothelial cells and in human monocytic cells and was significantly more efficacious than niacin alone. Subsequently, the effect of 125 mg THIAA and 500 mg niacin on endothelial-regulated flow-mediated vasodilation (FMD) was explored in a pilot study of 11 dyslipidemic volunteers. The 12-week treatment (2 tablets/day) resulted in a clinically relevant FMD increase compared to a trend toward an FMD decrease with placebo; the between-arm difference was statistically significant. THIAA+niacin treatment also improved total cholesterol, low-density lipoprotein cholesterol, and uric acid. No significant improvement in these parameters was observed with placebo. High-sensitivity C-reactive protein was significantly increased only in the placebo arm. Nutritional support with a THIAA+niacin combination may provide benefits for endothelial function in those with dyslipidemia.


Endothelial function; clinical trial; flow-mediated vasodilation; hops; niacin

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