Niacin, also known as niacinamide and vitamin B3, is an FDA-approved treatment for elevated cholesterol. Niacin affects all aspects of cholesterol: it lowers LDL, or bad, cholesterol; it lowers the triglycerides, or fats, in the blood; and it increases HDL, or good, cholesterol. It is always important to consult your physician before starting any natural or herbal medication due to possible adverse side effects or interactions with other medications.
Proof Niacin Works
A study from the American Journal of Cardiology revealed that when an average dose of 2,000 mg was admininstered to patients with high cholesterol, total cholesterol was lowered by 11 percent, LDL by 18 percent, triglycerides by 24 percent and increased HDL by 29 percent. (These healthy outcomes were further improved when combined with traditional statin therapy, like Lipitor.
How Much Niacin is Effective
The average over-the-counter dose of niacin is 50 to 100 mg, and prescription strength is 500 mg. Therapeutic doses are in the range of 1,500 to 3,000 mg per day, depending on the formulation, which includes immediate release, timed released, controlled release and extended release. An Archives of Internal Medicine study found 1500 mg per day improved HDL and triglycerides, where 2,000 to 3,000 mg were required to decrease LDL.
Niacin and Flushing
The most common side effect of niacin is flushing, which primarily occurs at the higher dosages that are required to treat elevated cholesterol. Flushing consists of redness, burning and tingling of the face, arms and chest. This occurs because niacin causes vasodilatation of the surface blood vessels in the face, neck and chest. This usually improves after a few weeks of treatment, when the blood levels have stabilized, but can reoccur with increases of niacin or if a dose is missed. Flushing can be improved by taking aspirin 325 mg prior to taking the niacin, or using the extended-release formulation.
Niacin Side Effects
Niacin can have additional adverse reactions, including elevations in liver enzymes, nausea, vomiting, diarrhea, mildly elevated blood sugars in diabetics, exacerbated gout symptoms, dizziness, low blood pressure, rashes and itching. The majority of these symptoms are dose-dependent, and are another reason why a physician should be consulted before starting niacin.
When You Should Avoid Niacin
Niacin can improve total cholesterol, LDL, HDL and triglycerides, but in certain cases should be avoided. Niacin can worsen diabetes, low blood pressure, Crohn's disease, peptic ulcer disease, liver disease, kidney disease, and gout. Always be cautious before beginning a natural medication and talk to your doctor.
References
- "Archives of Internal Medicine"; New perspectives on the use of niacin in the treatment of lipid disorders; McKenney J; 2004;164:697-705.
- "American Journal of Cardiology"; Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia; Guyton JR, Goldberg AC, Kreisberg RA; 1998;82:737-43.
- "American Journal of Cardiology"; Treatment of hyperlipidemia with combined niacin-statin regimens; Guyton, JR, Capuzzi, DM; 1998 Dec 17;82(12A):82U-84U
- UpToDate
- "Food and Nutrition Board, Institute of Medicine"; Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline; 2000.
- "Journal of Family Practice"; The effect of aspirin on niacin-induced cutaneous reactions; Whelan AM, Price SO, Fowler SF, Hainer BL; 1992;34:165-8.
