Niacin and fish oil are two once-alternative treatments for high cholesterol and triglycerides that have become mainstream. Fish oil is approved by the U.S. Food and Drug Administration to treat very high triglyceride levels, and niacin is approved to treat cholesterol. Prescription versions of both supplements are available in dosages and formulations appropriate to treat these conditions.
Niacin
Niacin is also known as vitamin B-3 and nicotinic acid. Scientists have known that niacin lowers cholesterol since 1955. An article in the December 1986 issue of the "Journal of the American College of Cardiology" reported on a 15-year study involving 8,341 men. Subjects who took 3 g of niacin per day reduced blood cholesterol by 10 percent and triglycerides by 26 percent compared with controls. Overall, subjects taking niacin had 27 percent fewer nonfatal heart attacks than the control group.
Niacin Side Effects
Niacin produces a very common side effect called "flushing." Patients often experience a prickly rash over their upper torso and head that lasts for approximately one hour. MayoClinic.com recommends taking niacin with food and not taking it with alcohol or hot beverages.
Another variant of niacin, called niacinamide, is often advertised as "flush free." Niacinamide has no effect on cholesterol levels. MayoClinic.com recommends sticking with the prescription version because it is more effective and easier on the liver.
Fish Oil
Fish oil contains eicosapentaenoic acid and docosahexaenoic acid, also called EPA and DHA. EPA and DHA are omega-3 fatty acids that lower triglyceride levels. An article in the June 2011 issue of "Journal of Pharmacy Practice" states that fish oil also has anti-platelet activity and improves vascular function in diabetic patients.
Prescription Fish Oil
Prescription fish oil has very high doses of EPA and DHA. Taking the prescription variety is better than taking over-the-counter varieties because patients have a clearer idea how much EPA and DHA they are getting. Over-the-counter varieties often fail to provide this information or provide it in an inflated manner, such as advertising the EPA and DHA content per serving -- and hiding the serving size in small print. The prescription variety is also a highly purified product regulated by the FDA.
References
- "The American Journal of Cardiology"; Evaluating Niacin in its Various Forms; R. H. Knopp; December 2000
- "Chicago Tribune"; Doctors Rethinking Prescribing Abbott's Niaspan; Bruce Japsen; May 2011|
- "Journal of the American College of Cardiology"; Fifteen Year Mortality in Coronary Drug Project Patients: Long-term Benefit With Niacin; P.L. Canner, et al.; December 1986
- "Journal of Pharmacy Practice"; Fish Oil: What Is the Role in Cardiovascular Health?; B.E. Brinson, et al.; June 2011
- Lovaza: Frequently Asked Questions About Very High Triglycerides
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