An active compound in the B vitamin niacin is a powerful cholesterol-lowering agent. Your doctor may prescribe nicotinic acid to improve your total blood lipid profile, meaning it can affect both forms of cholesterol and your triglyceride levels. It bears repeating that the form of niacin used to treat cholesterol comes from your doctor, and not the shelves of your drug store. Always seek the help of a qualified professional to use niacin for lowering your cholesterol.
How Niacin Affects Cholesterol
Niacin is especially helpful for patients who have low levels of the beneficial form of cholesterol, called high-density lipoprotein. The University of Maryland Medical Center says it raises HDL higher than any other cholesterol medication. The center says niacin is also effectively lowers your triglycerides and low-density lipoprotein, both of which are factors in your heart disease risk. Another benefit is that being a vitamin, treatment with niacin costs less than treatment with other cholesterol drugs.
There are a few pharmaceutical versions of niacin made by different companies. In its guidelines on evaluating and treating high cholesterol, the National Heart, Lung and Blood Institute, or NHLBI, said the standard doses of immediate-release tablets or capsules, such as Niacor and Nicolar, is between 1.5 g and 3 g. Each tablet of Upsher-Smith's Niacor contains 500 mg of niacin. The Cleveland Clinic says the usual prescription calls for patients to take the medication three times per day, with or after your meals. The NHLBI says that at 1.5 to 3 g dose, you could experience up to 25 percent reduction in LDL cholesterol, up to 50 percent reduction in triglycerides and up to a 35 percent increase in HDL cholesterol.
Niacin can cause uncomfortable side effects, such as intense skin flushing, itching, headache, blurred vision, dizziness and stomach upset. The University of Maryland says that because of these effects, one-quarter of people who take standard-release nicotinic acid stop taking it. An extended-release version is available to help mitigate discomfort. Sold under the brand name Niaspan, slow-release tablets can contain 375 mg, 500 mg, 750 mg or 1,000 mg doses. Your doctor may start you out on a trial basis, progressively increasing your dosage each week until you are ingesting the 1 g to 2 g dosage recommended by the NHLBI. The Cleveland Clinic says that your doctor may advise you to take aspirin a half-hour before taking Niaspan, and then taking the Niaspan with food to reduce the flushing and stomach problems. The University of Maryland Medical Center says some people are advised to take it at bedtime to reduce these issues.
Consult Your Doctor
Although niacin is a regular vitamin sold over the counter at your local pharmacy, it is not pharmaceutical grade. The doses of nicotinic acid prescribed by your doctor are far higher. Taking high doses of the over-the-counter dietary supplement is not how you treat high cholesterol and doing so could be dangerous. Always follow the advice of your health care provider when taking niacin or otherwise trying to lower your cholesterol.
- University of Maryland Medical Center; Cholesterol - Medications; Harvey Simon; May 5, 2009
- National Heart, Lung and Blood Institute: High Blood Cholesterol: Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III); May 2001
- National Cholesterol Education Program; Your Guide to Lower Cholesterol with TLC; December 2005
- Cleveland Clinic; About Cholesterol-Lowering Drugs