How do niacin supplements improve HDL levels?

the doctor states having HDL = 27 with LDL = 112 is not a healthy ratio & wants to see this improve.

Niacin is supposed to help lower total cholesterol whilst raising HDL 'good' chlesterol, which it looks like you need to do. Here are a couple of links on that:

http://www.medterms.com/script/main/art....
http://www.medicalconsumers.org/pages/NI...

You can also increase your intake of foods/ herbs and other health supplements known to lower total cholesterol whilst at the same time raising HDL, such as:
garlic (in cooking or capsules), fish oil (capsules or oily fish such as sardines, mackeral, salmon and fresh tuna), pomegranate juice, grapefruit juice (its full of cholesterol-lowering pectin), globe artichoke extract, gum guggul, lecithin, Vitamin E, dandelion tea, ginger and chromium picolinate. These are just a few examples. Also: use cholesterol-lowering extra virgin olive oil in your cooking.

Here is a guide for more information:
http://www.herbal-supplements-guide.com/...

Hope this helps.
Best wishes.

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