If you want to raise your high-density lipoprotein -- HDL or "good" cholesterol -- levels, it helps to lose weight, exercise regularly and eat a healthy diet. If dietary and lifestyle changes prove inadequate, taking niacin may help. But don't self-medicate with niacin. Over-the-counter formulas of no-flush niacin may prove ineffective, and all forms of niacin -- vitamin B-3 -- carry serious health risks.
Healthy HDL Levels
Because of lower estrogen levels, post-menopausal women may find it difficult to keep their HDL levels at recommended levels of 60 mg/dl -- milligrams per deciliter -- of blood. Women whose HDL levels fall below 50 mg/dl and men whose HDL levels fall below 40 mg/dl face increased risk of developing cardiovascular disease. Niacin, prescribed since the 1950s to treat cholesterol, is more effective than other types of medicine for elevating HDL levels.
No-Flush Niacin
Niacin taken in large doses -- 100 mg a day or more -- often causes an uncomfortable side effect called skin flushes. Skin flushes make your face and chest turn red, and your skin may burn, tingle or itch. Doctors sometimes prescribe timed-release formulas of niacin to patients susceptible to skin flushes. You can purchase niacin without a prescription. Regular niacin, in both prescription and over-the-counter form, are pretty much the same. But no-flush niacin available at drugstores is chemically different from no-flush or timed-release niacin prescribed by your doctor. Over-the-counter no-flush niacin may not improve your HDL cholesterol levels.
Avoiding Skin Flushes
If you want to avoid skins flushes without taking no-flush niacin, two remedies exist. The first is to take an aspirin 30 minutes before your scheduled dose of niacin. The second is to begin taking niacin in small doses and gradually increasing the amount you take. Doctors may prescribe niacin in doses of 500 mg to 2,000 mg or more to treat HDL cholesterol. Over-the-counter niacin comes in strengths of up to 500 mg. All forms of niacin may cause liver damage, but taking regular niacin decreases your risk.
Niacin Risks
Ask your doctor about the risks and benefits of taking niacin. A National Institutes of Health Study raises doubts about the ability of niacin to protect you against heart disease. About half of the 3,414 persons in the study took statins, a commonly prescribed cholesterol-lowering drug, and about half took statins plus 2,000 mg of niacin daily. Persons who took both statins and niacin had higher HDL levels than persons who took only statins. But participants who took niacin suffered as many heart attacks -- and more than twice as many strokes -- as those who did not take niacin. The NIH ended the study early in May 2011.
References
- MayoClinic.com; High Cholesterol; June 24 2010
- University of Maryland Medical Center; Vitamin B 3 (Niacin); June 18, 2009
- MayoClinic.com; High Cholesterol: Niacin to Boost Your HDL, Good,' Cholesterol;June 6, 2009
- Medline Plus: Niacin and Niacinamide (Vitamin B3)
- National Institutes of Health: NIH Halts Clinical Trial on Combination Cholesterol Treatment; May 26, 2011
