Co-administration of equimolar doses of betaine may alleviate the hepatotoxic risk associated with niacin therapy.

@article{Mccarty2000CoadministrationOE,
  title={Co-administration of equimolar doses of betaine may alleviate the hepatotoxic risk associated with niacin therapy.},
  author={Mark F. Mccarty},
  journal={Medical hypotheses},
  year={2000},
  volume={55 3},
  pages={
          189-94
        }
}
  • M. Mccarty
  • Published 1 September 2000
  • Medicine
  • Medical hypotheses
High-dose niacin has versatile and substantial efficacy for the treatment of hyperlipidemias, but its utility is compromised by various side effects, the most serious of which is liver damage. It is proposed that this hepatotoxicity reflects the high demand for methyl groups imposed by niacin catabolism, leading to a reduction in hepatic levels of S-adenosylmethionine (SAM). Depletion of the hepatic SAM pool has likewise been shown to mediate, at least in part, the hepatotoxic effects of… 
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TLDR
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