High cholesterol levels are a growing American problem. In 2008, the American Heart Association reported that 106.7 million Americans over age 20 have cholesterol levels above 200 mg of cholesterol per deciliter of blood, or above the normal range. Niacin, also known as B3, can help lower cholesterol and triglyceride levels. Prescription niacin, not over-the-counter supplements, should be used to lower cholesterol levels unless your doctor suggests otherwise.
Forms of Niacin
Niacin comes in several forms. Nicotinic acid is the form of niacin known to be effective in lowering total cholesterol, triglyceride and low-density lipoprotein levels while raising high-density lipoprotein levels. In lowering cholesterol levels, nicotinic acid also lowers the risk of coronary artery disease, J. McKinney from the National Clinical Research and Virginia Commonwealth University reports in the April 2004 "Archives of Internal Medicine." Other forms of niacin, such as nicotinamide, niacinamide and inositol nicotinate, also called inositol hexaniacinate, do not have the same medicinal properties, eMedTV warns.
Dosages
Niacin can be given in immediate-release, extended-release and sustained-release form. Normally, the dose starts low and is increased over several weeks to allow for acclimation to side effects. The dose for IR starts at 100 mg three times a day for the first week, moves to 200 mg three times daily for the next week and increases slowly up to 1,000 mg three times daily by week 12. The ER forms starts with 500 mg once a day at bedtime for weeks 1 through 4, 1,000 mg once daily during weeks 5 through 8 and 1,500 mg per day thereafter, increasing to 2,000 mg if necessary. The SR form starts with 250 mg twice a day, increasing up to 500 mg twice a day during weeks 2 through 5 and advancing up to 1,000 mg twice a day by week 10.
Results
Niacin can lower triglycerides by as much as 20 to 50 percent and raise HDL, the "good" cholesterol, by 15 to 35 percent, according to eMedTV. Niacin can also lower LDL, the "bad" cholesterol by 5 to 25 percent. In addition, niacin in conjunction with a statin drug was found to lower the risk of heart attack by as much as 90 percent in the HDL-Atherosclerosis Treatment Study, cardiologist William Davis reports. The trial, conducted by the National Heart, Lung and Blood Institute, concluded in 2001.
Side Effects
Niacin can have side effects, most notably skin flushing that is annoying but not harmful, according to MayoClinic.com. Other side effects include dizziness, headache, stomach upset or diarrhea. Taking niacin with several glasses of water and with meals helps decrease flushing. Taking 325 mg of uncoated aspirin shortly before taking the drug can also help, the Mayo Clinic website reports. In rare cases, niacin can cause liver damage; tell your doctor immediately if you experience yellowing of the skin and whites of the eyes, fatigue, dark urine or upper right quadrant abdominal pain.
References
- HealthCentral; Niacin: Myths and Facts; William Davis, M.D.; December 2007
- eMedTV; Niacin Benefits; Kristi Monson, et al.; September 2008
- American Heart Assocation: Cholesterol Statistics; April 2008
- "Archives of Internal Medicine"; New Perspectives on the Use of Niacin in the Treatment of Lipid Disorders; J. McKinney; April 2004
- MayoClinic.com: Niacin to Boost Your HDL, "Good," Cholesterol
