If your lipid profile comes back indicating that your low-density lipoprotein -- LDL or "bad" cholesterol -- is a bit high, and your high-density lipoprotein cholesterol -- also called HDL or "good" cholesterol -- is a bit low, your doctor may suggest a regimen of prescription medications to help rectify the situation. But in addition to the standard statin and similar drugs, he may suggest or prescribe niacin as well. Also called vitamin B-3, niacin has shown promise in helping regulate cholesterol levels in the body.
Niacin Overview
Niacin, or vitamin B-3, is one of eight B-complex vitamins used by the body to help metabolize carbohydrates fats, and proteins. Niacin also has a role in the production and regulation of stress and sex hormones produced by the adrenal glands, and is known to improve circulation. Niacin is water-soluble, which means that it cannot be stored in your body and must be frequently replenished. It is easy to get adequate vitamin B-3 by eating a varied diet, but in some cases, an additional supplement may be suggested. Niacin is found in lean meats and fish, eggs and dairy products, nuts and enriched grains like bread or cereal.
Niacin's Effects on Cholesterol
A number of empirical studies have focused on the use of niacin as a treatment for cardiovascular disease because of its seeming ability to help regulate lipid levels. A review of applicable evidence conducted by the Atherosclerosis Research Center in 2003 found that there was sufficient evidence to prescribe niacin as a cholesterol drug in its own right, not just as a helpful vitamin supplement. Niacin lowers LDL cholesterol and triglycerides by decreasing the body's ability to use triglycerides stored in its own fat and interrupting triglyceride synthesis, resulting in an overall reduction in both triglycerides and LDL in the bloodstream. What is even more notable than that, however, is niacin's role in increasing HDL or "good" cholesterol. Niacin is considered to be the most effective drug in raising HDL, as it can do so by between 15 and 35 percent. According to the June 2008 issue of the "Journal of Lipid Research," niacin accomplishes this by acting to prevent the liver from removing HDL in the bloodstream, which maintains higher HDL levels.
Why LDL and HDL Levels Matter
HDL helps remove LDL cholesterol from the bloodstream and take it to the liver for filtration and disposal. HDL also appears to have a role in fighting arterial inflammation and in acting as an antioxidant to prevent LDL cholesterol from oxidizing, a process that causes it to change and harm the arteries. High HDL levels in the bloodstream have been found to be as beneficial to the body as low LDL levels, and higher HDL levels are considered protective of the heart and cardiovascular system. Levels of HDL over 40 mg/dl are desired, while levels over 60 mg/dl are optimal and most beneficial. LDL cholesterol is responsible for transporting about 75 percent of the body's cholesterol to cells. On its own, LDL is relatively harmless. The process of oxidation, or exposure to unstable molecules that occur naturally in the body, is what causes LDL to become harmful. Once oxidation has occurred, LDL reacts with arterial walls, causing changes and oxidation. Levels of LDL under 200 mg/dl are considered desirable, and levels under 100 mg/dl are considered optimal.
Niacin Side Effects
While niacin is both a drug demonstrated to be helpful in treating cardiovascular disease and a vitamin necessary for the body to function, it can still cause undesirable side effects in some people. According to medication resource Drugs.com, you should avoid taking niacin with warm beverages because this will likely serve to exacerbate the "flushing" effect many people experience -- a warm, tingly, itchy feeling. Also avoid taking niacin with alcohol, which could increase the chances of liver damage and also serve to worsen the flushing effect. In some people, medication-sized doses of niacin may cause dizziness, a faint feeling, rapid heartbeat, muscle aches and flu-like symptoms, jaundice or a feeling of shortness of breath. Call your doctor if you experience any of those symptoms. Other less serious side effects that niacin may bring about include a tingly flushing feeling, gastronomic distress, muscle cramps and insomnia. Speak with your health-care provider before beginning any medication or supplement regimen.
References
- University of Maryland Medical Center: Vitamin B-3
- "Journal of Nutritional Biochemistry"; Niacin and Cholesterol: Role in Cardiovascular Disease; S.H. Ganji et al.; June 2003
- "Journal of Lipid Research"; Niacin Inhibits Surface Expression of ATP Synthase β Chain in HepG2 Cells: Implications for Raising HDL; Lin-Hua Zhang, et al.; June 2008
- New York Times: Cholesterol Overview
- Drugs.com: Niacin
