Niacin, also known as vitamin B3 and prescribed by doctors since the 1950s, proves helpful in improving bloodstream levels of low-density lipoprotein, high-density lipoprotein and triglycerides. The amount of niacin prescribed for triglycerides depends on the severity of your current levels as well as your ability to tolerate side effects, including flushing of your skin. High doses of niacin may cause liver damage, and a recent clinical trial ended early when risks of taking niacin proved more harmful than helpful.
Cholesterol and Triglycerides
A cholesterol screening measures the amounts of three types of lipids in your bloodstream: low-density lipoprotein, high-density lipoprotein and triglycerides. LDL cholesterol, also known as "bad" cholesterol, and triglycerides tend to accumulate in your arteries, decreasing blood flow and increasing your risk of developing cardiovascular disease. HDL cholesterol, the "good" cholesterol, helps pull LDL cholesterol and triglycerides out of your body. If dietary changes prove ineffective in improving your triglycerides and cholesterol, medications such as statins and niacin may help.
A healthy diet includes about 14 to 16 mg of niacin from sources such as beef, tuna and peanuts. Doctors may prescribe mega-doses of niacin, ranging from about 100 mg to 2,000 mg daily, to reduce triglycerides. Niacin proves effective in lowering your triglyceride levels. Lower levels of triglycerides, a type of fat, should protect you against heart disease. But a U.S. government-funded study found that taking 2,000 mg of niacin daily did not reduce the risk of suffering heart attacks. The National Institutes of Health announced on May 26, 2011, a decision to end a niacin study 18 months earlier than planned because of disappointing results. About half of the 3,414 participants in the study took a combination of statins and niacin. The other half took statins and a placebo. Persons who took niacin enjoyed a reduction in their triglycerides, but did not suffer fewer heart attacks than persons who took the placebo.
Taking large doses of niacin may increase your risk of suffering a stroke. In the NIH study, persons who took niacin suffered more strokes – 28 compared to 12 – than persons who took the placebo.The findings in the NIH study were "unexpected and a striking contrast to the results of previous trials," Dr. Jeffrey Probstfield, a researcher at the University of Washington and a leader of the study, told CBC News. The NIH said in a statement that similar studies remain ongoing and may produce more positive results. If you currently take niacin to lower your triglycerides, do not stop taking it without consulting your physician. The higher incidence of strokes among niacin users in the NIH study does not necessarily indicate a risk to you.
Diet and Exercise
If you don't currently take niacin – or decide to stop – a scientific statement from the American Heart Association may provide incentive to try a prescription-free approach to lowering triglycerides. The AHA statement, released in April 2011, said you could lower your triglycerides by 50 percent through diet and exercise. Michael Miller, director of the Center of Preventive Cardiology at the University of Maryland School of Medicine, reviewed more than 500 studies before reaching the conclusion that you can reduce triglycerides by 20 percent by following a low-fat, low-sugar diet and another 20 to 30 percent by including at least 150 minutes of moderate exercise in your weekly routine. Miller published his research in the April 2011 issue of "Circulation," a publication of the American Heart Association.
Is This an Emergency?
- University of Maryland Medical Center: Vitamin B 3 (Niacin)
- CBC News; Niacin Trial For Heart Disease Stopped Early; May 27, 2011
- National Institutes of Health: NIH Halts Clinical Trial on Combination Cholesterol Treatment; May 26, 2011
- “Circulation: Journal of the American Heart Association”; Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association; Michael Miller et al; April 30 2011