It Helps Control Cholesterol Levels
Sometimes niacin is prescribed alongside cholesterol-lowering medications like statins to help normalize blood lipid levels. It can increase high-density lipoprotein cholesterol, which is the healthy kind of cholesterol, by 15% to 35%. And it can decrease low-density lipoprotein , the bad cholesterol, by 5% to 25%.
Other evidence indicates that niacin is good for people with an increased risk of heart attacks and heart disease because it not only lowers LDL cholesterol but also triglycerides. Niacin can decrease triglyceride levels by 20% to 50%. The prescription formulations Niaspan and Niacor have FDA approval to treat dyslipidemia .
Understanding How You Measure Up
Too much LDL cholesterol can increase your risk for heart disease. At the same time, too little HDL cholesterol can lead to the same effect. This is because HDL is responsible for removing the bad cholesterol from the blood and taking it back to the liver to be disposed, preventing the buildup of plaque in the arteries.
According to the National Institutes of Health, your ideal cholesterol levels are:
- Total cholesterol: less than 200 mg/dL
- LDL cholesterol:less than 100 mg/dL
- HDL cholesterol: 60 mg/dL or higher
What Impact Does Niacin Have On Cholesterol
- If your HDL cholesterol is too low, niacin may help to increase it.
- If your LDL cholesterol is too high, niacin may help to decrease it.
- Niacin can also help decrease triglycerides.
Niacin is able to reduce cholesterol because it drops the number of fatty acids being activated from tissue storage and decreases how much LDL is synthesized.
It increases HDL by preventing the removal of it by liver cells, allowing the body to retain more.
While these are impressive benefits, niacin does not erase all risk for cardiovascular disease, even if it helps to normalize lipid levels.
This is because even as it helps to balance lipids, it may increase insulin resistance and contribute to potential blood glucose imbalance.
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Dosage Of Niacin Required To Lower Cholesterol
This effect is dose related. The dosage required is 1 to 4 gms per day. Immediate release and long acting formulations are available OTC. Sustained release niacin 500 mg tablets are available. See my article best niacin 500 mg tablets on the best brands available in the market.
Do not use nicotinamide in place of niacin because it is ineffective.
Niacin Too Dangerous For Routine Cholesterol Therapy
Mainstay drug now linked to death risk, dangerous side effects and no benefits
CHICAGO — After 50 years of being a mainstay cholesterol therapy, niacin should no longer be prescribed for most patients due to potential increased risk of death, dangerous side effects and no benefit in reducing heart attacks and strokes, writes Northwestern Medicine® preventive cardiologist Donald Lloyd-Jones, M.D., in a New England Journal of Medicine editorial published July 16.
Lloyd-Joness editorial is based on a large new study published in the journal that looked at adults, ages 50 to 80, with cardiovascular disease who took extended-release niacin and laropiprant to see if it reduced heart attack and stroke compared to a placebo over four years. All patients in the trial were already being treated with a statin medication.
Niacin did not reduce heart attacks and stroke rates compared with a placebo. More concerning, niacin was associated with an increased trend toward death from all causes as well as significant increases in serious side effects: liver problems, excess infections, excess bleeding, gout, loss of control of blood sugar for diabetics and the development of diabetes in people who didnt have it when the study began.
There might be one excess death for every 200 people we put on niacin, said Lloyd-Jones,
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More Common Side Effects
Some of the more common side effects of niacin can include:
- reddening and warming of your face
- dark-colored urine
- yellowing of your skin or the whites of your eyes
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
It May Improve Mental Health
Dietary habits have a significant influence on many mental disorders including depression, anxiety, schizophrenia, and bipolar disorder. This has led to the development of nutritional guidelines to help manage these conditions. Niacin deficiency has shown a possible link to some mental disorders.
Studies have documented reduced cerebral blood flow in depressed patients and improved cerebral blood flow following antidepressant treatment. Niacin is believed to increase cerebral blood flow, so there is potential to use niacin supplementation along with prescription antidepressants.
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It May Help Manage Migraines
Although its unclear how niacin achieves therapeutic effects, it could be beneficial for migraine and tension-type headaches and the prevention of these headaches. Niacin may prevent migraine symptoms by widening the intracranial vessels and following contractions of the extracranial vessels.
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Can Niacin Help Control Your Cholesterol
Not all cholesterol is bad. High-density lipoprotein, or HDL, is considered good cholesterol.
Higher levels of HDL are associated with lower risks of heart disease and stroke.
Certain foods, like those high in fiber, can help boost your HDL numbers.
Niacin, a B vitamin, has been shown to help increase HDL and lower both the bad LDL cholesterol in your blood and triglyceride levels.
In this article, Ill talk more about what niacin is and its impact on cholesterol, as well as other benefits and risks from supplementing niacin.
Ill also outline when you should talk to your doctor about niacin and your cholesterol levels.
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An Overly Ambitious Goal
In the Aim-High study, all participants were given Zocor, also known as simvastatin, while some were given a second cholesterol-lowering drug, Zetia, to make sure their bad LDL cholesterol stayed at very low levels. More than half of the patients had suffered a heart attack prior to the trial.
The National Heart, Lung, and Blood Institute , part of the National Institutes of Health, announced in May it had stopped the Aim-High study early. An independent panel looked at the interim results and concluded niacin offered no benefits beyond statins, even though it significantly increased HDL and cut triglycerides.
In criticizing the study, Barter said researchers were being incredibly ambitious in setting a goal of 25 percent reduction in cardiac events including stroke and heart attack.
Given the studys design, Barter said it would have taken 15 to 20 years to draw any such conclusions.
In response to Barters criticism, Dr. Michael Lauer of the NHBLI said the issue of what goal the trial set out to achieve was moot, as what we saw was no benefit at all.
Based on the Aim-High study, niacin offers no clinical benefit after 32 months of follow-up to patients similar to those enrolled in the study, Lauer said in a statement.
The results also may have been confounded by the fact that patients in the control group saw their good cholesterol rise, limiting the difference with the niacin group.
Other cardiologists also took issue with the study.
It May Protect Against Alzheimers Disease
In a study published by the Journal of Neurology, Neurosurgery, and Psychiatry, dietary niacin was concluded to be a possible protector against Alzheimers disease and age-related cognitive decline. A higher intake of niacin may be associated with a slower rate of cognitive decline over time.
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Drink Alcohol In Moderation
Moderate alcohol consumption has been shown to increase your levels of good cholesterol, which, in turn, can reduce your levels of bad cholesterol.
The effects arent enough to encourage people to start drinking, but it does mean that perhaps its a good idea not to cut all alcohol from your diet just for the sake of reducing calories.
Niacin Recommendations And Dietary Sources
Niacin is present in a number of foods, including eggs, lean meats, nuts, poultry, dairy products, enriched breads and cereals, legumes and fish. The recommended daily allowance of niacin for adults is 14 to 16 milligrams per day an amount more than 30 times less than a 500-milligram dose.
You can easily meet this daily requirement by consuming niacin-rich foods, such as chicken, with 7.3 to 11.7 milligrams per serving tuna, 8.6 to 11.3 milligrams per serving fortified breakfast cereal, 20 to 27 milligrams per serving salmon, 8.5 milligrams per serving and lentils, 2.1 milligrams per serving.
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Niacin And Other B Vitamins In Cardiovascular Risk
Niacin is used in a variety of multivitamin supplements together with other vitamins of class B, such as thiamine , riboflavin , and pyridoxine . According to the National Institutes of Health , the U.S. Recommended Daily Allowance for adults ranges between 16 and 18 mg daily . Daily intake of niacin via multivitamin supplements maximally reaches tens of milligrams, which is far below the pharmacologically active hypolipidemic dosage . The main sources of dietary niacin are meat, fish, and nuts . Both experimental and clinical data provide evidence for the importance of B vitamins in the pathophysiology of metabolic syndrome and in the prevention of cardiovascular diseases. Recent studies have shown that low levels of thiamine, niacin, and pyridoxine are associated with increased insulin resistance, metabolic syndrome, diabetes, and cardiovascular disease .
Furthermore, pyridoxine influences the metabolism of fatty acids. The study on volunteers with marginal nutritional deficiency of vitamin B6 showed decreased plasma concentrations of polyunsaturated fatty acids of the n6 and n3 families, whereas the levels of TC, LDL-C, HDL-C, and TAG did not change . Altered synthesis of unsaturated, particularly n6 and n3 PUFA, was proved in cultured human hepatoma cells under the condition of vitamin B-6 restriction . These changes could participate in mechanisms by which vitamin B-6 inadequacy influences cardiovascular risk .
I Heard Taking Niacin For Cholesterol Was Dangerous Didnt They Stop A Drugs Trial
You are thinking about the US study called AIM-HIGH, , which was sponsored by the National Heart, Lung and Blood Institute .
In this study the researchers were looking to see whether raising HDL with a drug based on niacin, while at the same time lowering LDL with a statin drug could prevent more instances of heart disease than by just taking the statin by itself.
This is an ongoing study that started in 2006 and was due to finish in 2012, but it was halted eighteen months early.
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Niacin Its Hypolipidemic Effects And Cardiovascular Risk
Despite the substantial improvement in medical care for patients suffering from cardiovascular disease , this condition contributes to about 50% of deaths in Europe . Treatment of hyperlipoproteinemia, especially of elevated LDL-cholesterol and treatment of arterial hypertension, which decreases the risk of thrombotic events, are among the main therapeutic targets. It has been proved that intensive hypolipidemic treatment targeting recommended goals, of which statins are the most powerful LDL-C decreasing drug, significantly decreases cardiovascular risk . Moreover, statins favorably influence other parameters of lipoprotein metabolism, such as triacylglycerols and HDL-cholesterol . Nevertheless, even if the target goals of LDL-C are achieved, the risk of cardiovascular events during the following five years remains high ranging from about 6575% . This risk, known as residual cardiovascular risk, is probably particularly high in patients with manifest coronary heart disease or diabetes mellitus. Decrease of HDL-C, elevation of serum TAG, apolipoprotein B, small dense LDL particles, lipoprotein concentrations and some other factors significantly contribute to residual cardiovascular risk. In order to reduce residual risk, a combination of statins with fibrates, niacin or n3 polyunsaturated fatty acids is usually recommended .
Lowering Cholesterol With Niacin Or Nicotinic Acid
Last Editorial Review: 12/30/2004niacin
There are two types of nicotinic acid: immediate release and timed release. Most experts recommend starting with the immediate-release form discuss with your doctor which type is best for you.
Nicotinic acid is inexpensive and widely accessible to patients without a prescription but must not be used for cholesterol lowering without the monitoring of a physician because of the potential side effects.
All patients taking nicotinic acid to lower serum cholesterol should be closely monitored by their doctor to avoid complications from this medication. Self-medication with nicotinic acid should definitely be avoided because of the possibility of missing a serious side effect if not under a doctor’s care.
Patients on nicotinic acid are usually started on low daily doses and gradually increased to an average daily dose of 1.5 to 3 grams per day.
Nicotinic acid reduces LDL-cholesterol levels by 10 to 20 percent, reduces triglycerides by 20 to 50 percent, and raises HDL-cholesterol by 15 to 35 percent.
Three other major adverse effects include liver problems, gout, and high blood sugar. Risk of these three complications increases as the dose of nicotinic acid is increased. Your doctor will probably not prescribe this medicine for you if you have diabetes, because of the effect on your blood sugar.
Thank you for your question.
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How Low Should Your Ldl And Non
Numerous studies have found that an LDL level above 100, even in otherwise healthy patients, will lead to the growth of damaging plaques. Research suggests that LDL levels significantly lower than 100 are optimal. For example, one major study involving more than 8,800 European patients found that LDL cholesterol levels of 81 were even better than levels of 104 in preventing death, heart attacks, and other cardiovascular-related problems in people with heart disease. 2
And recently, a six-year study involving 18,000 people with heart disease affirmed that for reducing LDL levels, the lower, the better. The study was reported at the annual meeting of the American Heart Association.3 Half the subjects lowered their LDL, on average, to 69 the other half reduced LDL to 54. Both groups were rewarded with few heart events over the six-year period, but the group with the lower LDL, 54, ended up the winner. It had 6.4% fewer events heart attacks, heart disease deaths, strokes, bypass surgeries, stent procedures, and hospitalizations for severe chest pains than the group with the higher LDL.
For non-HDL, an optimal goal for people with clear evidence of heart disease is less than 80. A good goal for healthy individuals wanting to prevent heart disease is less than 100.
What Are The Side Effects Of Niacin
With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.
Contact your doctor immediately if you experience any of the following:
- Liver damage: severe abdominal pain, yellowing of the skin or whites of your eye, severe nausea, or vomiting
- Muscle pain : unexplained severe muscle pain, muscle tenderness, or weakness
The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time.
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Pharmacist Tips For Niacin
If you’re taking immediate-release form of niacin, take the medication after your evening meal. If youre taking the extended-release form of niacin, take the medication at bedtime after you eat a low-fat snack such as fruit, pretzels, or carrots. This lowers your risk of side effects like flushing and stomach upset.
Swallow the extended-release tablets whole. Don’t crush or chew them as too much medication might get released at once, which can cause side effects.
Don’t drink alcohol, hot beverages, or eat spicy food right before you take this medication as it might raise the chance of flushing and itching of the skin.
Niacin might make your skin feel hot and turn red . Typically, people get used to the medication and flushing can go away after several weeks. If youre taking the immediate-release form of niacin, your healthcare provider might recommend that you take an aspirin or non-steroidal anti-inflammatory drug before you take niacin to lower your risk of flushing.
Niacin might affect your blood sugar levels. If you have a history of diabetes or high blood sugar, your healthcare provider might have you monitor your blood sugars more closely. Be sure to tell your provider if you notice any changes in your sugar levels.
Niacin can raise uric acid levels, which can worsen your gout. Talk to your healthcare provider if you’re having more gout attacks.
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Who Can Take Supplements
Researchers are still seeking to confirm the benefits of supplements in treating high cholesterol. For this reason, it remains unclear who can or cannot take them. In general, they are considered safer to use in younger people with no history of serious heart-related illness or risk.
However, all people should speak to a healthcare provider before taking supplements.
One reason for this is because your own medical history may include other health conditions that may be affected by taking an herb or nutritional supplement.
Another concern may be the potential for interaction with any drugs you already take.
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Vitamin B3 For Lowering Cholesterol Safely
The finding that niacin lowered cholesterol was soon confirmed by Parsons, Achor, Berge, McKenzie and Barker and Parsons at the Mayo Clinic, which launched niacin on its way as a hypocholesterolemic substance. Since then it has been found to be a normalizing agent, meaning it elevates high density lipoprotein cholesterol, decreases low density and very low density lipoprotein cholesterol and lowers triglycerides. Grundy, Mok, Zechs and Berman found it lowered cholesterol by 22 percent and triglycerides by 52 percent and wrote, “To our knowledge, no other single agent has such potential for lowering both cholesterol and triglycerides.”
Elevated cholesterol levels are associated with increased risk of developing coronary disease. In addition to niacin, a typical diet generally recommended by orthomolecular physicians will tend to keep cholesterol levels down in most people. This diet can be described as a high fiber, sugar-free diet which is rich in complex polysaccharides such as vegetables and whole grains.
Niacin Combined With Other Drugs Which Lower Cholesterol
Fortunately, niacin does not decrease cholesterol to dangerously low levels. Cheraskin and Ringsdorf reviewed some of the evidence which links very low cholesterol levels to an increased incidence of cancer and greater mortality in general.
Continuous use of niacin can be expected to reliably decrease mortality and prolong life.