Fish oil, which contains essential omega-3 fatty acids, and niacin, a B-complex vitamin, are often used to manage elevated cholesterol levels and decrease risk for cardiovascular disease. These two nutrients work differently and offer slightly different benefits. Consult your doctor to determine the best therapy for your health needs before using fish oil or niacin to treat a health condition.
Supplementation with the fish oil component eicosapentanoic acid, or EPA, decreases heart attack risk by as much as 54 percent in high-risk individuals. However, overall, docosahexanoic acid, or DHA, the other essential fatty acid in fish oil, is associated with cholesterol-lowering and improving cell membrane fluidity, while EPA is known for it immune-modulating effects. Fish oils in high doses may cause a blood thinning effect. If you are taking blood thinning medications, consult your doctor before taking fish oils.
If you have high cholesterol and do not reach your goals on drug therapy, your doctor may recommend combination therapy using niacin and fish oil. Fish oils can lower triglycerides and may be used safely in doses up to 3 to 4 g. Doses as low as 1 g per day have been shown to reduce heart attack risk. EPA in fish oil might reduce coronary heart disease risk, particularly where triglycerides are high and HDL levels are low, according to Ernst Schaefer, author of the book "High Density Lipoproteins, Dyslipidemia, and Coronary Heart Disease."
Niacin is a safe and cost-effective means of managing cholesterol and the most effective substance available for raising levels of high-density lipoprotein, HDL, the good form of cholesterol, in some people, according to Joseph Loscalzo, author of the book "Harrison's Cardiovascular Medicine." Niacin can decrease triglycerides and works well in combination with statin drugs. It is particularly useful in people who have elevated total cholesterol and low HDL levels. This vitamin can raise your blood sugar, although it has been shown to cause only slight elevations in fasting glucose. If you have diabetes, your blood sugar levels should be under control before starting on niacin. Only use niacin with your doctor's consent and supervision.
Blood Sugar Control
To reduce impaired blood sugar from taking niacin a time-released niacin formula may help while still providing cholesterol-lowering benefits, according to Steven Marso, author of the book "Diabetes and Cardiovascular Disease: Integrating Science and Clinical Medicine." Marso recommends time-released niacin for those who need to increase HDL levels and immediate-release niacin when decreasing triglyceride levels is the main goal. Niacin can cause stress on your liver when used in high doses and your liver enzymes must be monitored when taking this supplement. Niacin can cause a facial flushing reaction. When using immediate-release niacin, start at a low dose of about 100 mg and increase slowly.