How Much Niacin To Lower Cholesterol

How To Take B Vitamins Together

For most people, vitamin B3 can usually be obtained through a healthy diet in high enough amounts to meet your daily needs. However, if you are considering supplementation for a quick and easy way to bump up your intake, be sure to look for a high-quality supplement that is made using whole food sources. Not only does this allow your body to better absorb and utilize these nutrients, but it can also reduce the risk of unwanted vitamin B complex side effects.

Taking a B complex is a great option to ensure youre meeting your needs for the entire array of B vitamins that your body needs. Consuming B vitamins together in a quality B vitamin complex supplement also allows them to work better in the body, since the B vitamins interact with one another to help optimize digestion and absorption.

B vitamins can be beneficial in supporting metabolism and promoting heart, brain, muscle and joint health, but remember that its always preferable to consume plenty of whole foods that naturally contain all the vitamins and minerals you need instead. Try enjoying high-quality cuts of meat, including free-range and grass-fed poultry and beef, fish, beans, nuts and seeds, in order to make sure youre getting your daily fix of B vitamins. Unlike supplementation, eating plenty of foods that contain niacin should not result in levels high enough to cause any harmful niacin side effects.

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.

Supplements For A Healthy Heart

Supplements can help patients meet nutritional needs when no other option is readily available. Healthy lifestyle choices are the best way to maintain cholesterol levels. Furthermore, quitting smoking and maintaining a healthy weight can help lower LDL cholesterol. For more information about supplements to lower cholesterol, speak with a pharmacist or healthcare provider.

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Are There Any Other Useful Measures Of Hdl

While doubt has been cast on the role of HDL-C as a target for therapy, there is growing evidence that there are other measures of HDL that may be more closely linked with cardiovascular events.

The biochemical mechanisms underlying the relationships between HDL and cardiovascular risk are complex. The primary atheroprotective role of HDL is in reverse cholesterol transport , which allows for the excretion of excess cholesterol from peripheral tissues via the bile and feces . Cholesterol efflux is the first critical step of the RCT pathway and is the mechanism by which macrophages in the vessel wall secrete cholesterol outside cells . Lipid-poor apolipoprotein A-1 is secreted from the liver and intestine and interacts with ATP-binding cassette transporter A-1 on hepatocytes and macrophage foam cells in atheromatous plaques, leading to efflux of free cholesterol and phospholipids. Free cholesterol in the resulting nascent HDL is esterified in the presence of lecithin/cholesterol acyltransferase , leading to the formation of mature HDL. Mature HDL then acts as an acceptor for ABCG-1-mediated cholesterol efflux from macrophages. Cholesteryl ester transfer protein mediates the exchange of HDL cholesteryl ester for triglycerides in Apo-B-containing lipoproteins such as LDL. Mature HDL particles can deliver cholesterol to the liver by the hepatic scavenger receptor type B1 which can then be secreted into bile, completing the RCT pathway .

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 .

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What You Are Hearing

“HPS2-THRIVE: No Benefit, Signal of Harm for Niacin Therapy” – Forbes

“ACC: HPS2-THRIVE May Signal the End for Niacin” – Medpage

“Niacin Causes Serious Unexpected Side-effects, but no Worthwhile Benefits, for Patients who are at Increased Risk of Heart Attacks and Strokes’ – Sacramento Bee

“Niacin Therapy Unhelpful, Occasionally Harmful” – Naharnet

“Niacin doesn’t help heart may cause harm, study says” – USA Today

Sadly, these headlines ignore the full story, and are incorrect because they place the blame on niacin while ignoring the adverse effects of laropiprant and statins. Although statins are widely used, they have serious side effects in some people, and will not help most who take them.

“Niacin is really it. Nothing else available is that effective.”

Taking Niacin For Cholesterol And Triglycerides May Be The Answer

Whether or not niacin for cholesterol reduction is a good idea has been the topic of much research over the past few decades.

The link has been clearly established, and studies show that it may help reduce your chances of developing heart disease, as well as help treat an existing heart condition. As such its worth looking into as an option for you.

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What Life Extension Says About Walnuts And Heart Health

In the August 2011 issue of Life Extension, William Faloon discusses the health impact of walnuts in his editorial entitledFDA Says Walnuts Are Illegal Drugs!Specific to walnuts and heart health, William Faloon had this to say:

The March 4, 1993, issue of theNew England Journal of Medicinepublished the first clinical study showing significant reductions in dangerousLDLand improvement in the lipoprotein profile in response to moderate consumption of walnuts. Later studies revealed that walnuts improveendothelial functionin ways that are independent of cholesterol reduction.

One study published by theAmerican Heart AssociationjournalCirculationon April 6, 2004, showed a64%improvementin a measurement ofendothelial functionwhen walnuts were substituted for other fats in a Mediterranean diet.

As mostLife Extensionmembers are aware, the underlying cause of atherosclerosis is progressiveendothelial dysfunction. Walnuts contain a variety of nutrients including arginine, polyphenols, and omega-3s that support the inner arterial lining and guard against abnormal platelet aggregation. These favorable biological effects explain why walnut consumption confers protection against coronary artery disease.

The US National Library of Medicine database contains no fewer than 35 peer-reviewed published papers supporting a claim that ingesting walnuts improves vascular health and may reduce heart attack risk.

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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Which Is The Culprit: The Drug Or The Vitamin

Which component of the tredaptive drug trial should be blamed for causing problems? Apparently the headlines have implicated niacin by default. After all, it can cause flushes! Well, niacin, an essential nutrient, has been used very safely at very high doses for over 60 years. It has been shown to reduce mortalities due to cardiovascular disease, even 10 years after patients stop taking it. The effect of niacin in preventing dyslipidemia is known to occur through PGD1 pathways. In contrast, laropiprant is a relatively new drug that blocks PDG1 pathways. It was included in the compound drug tredaptive to prevent the niacin flush side effect that sometimes occurs in some patients. However, it was not included for any clinically beneficial effect on cardiovascular disease, and it may have have even blocked the desired effects of niacin. The prostaglandin pathways inside cells are complex, and they are a current topic of intense research. In some studies, laropiprant showed a side effect on platelet DP1 receptors, which suggests that it may have adverse side effects on other receptors than on blood vessels within the skin, for example, in lung tissue and in the brain.

Dosage For Lowering Cholesterol And Triglyceride Levels And Reducing Risk Of A Heart Attack

Adult dosage

• Extended-release tablet: The starting dosage is 500 mg taken by mouth once per day at bedtime. After 4 weeks, your doctor may increase your dosage by up to 500 mg. The standard maintenance dosage is 1,0002,000 mg taken once daily at bedtime.
• Oral tablet: The initial dosage is 250 mg taken by mouth once per day following your evening meal. Your doctor may gradually increase your dosage to a maximum of 6 grams per day. The standard dosage is 12 grams taken 23 times per day.

Child dosage

• Extended-release tablet: The starting dosage is 500 mg taken by mouth once per day at bedtime. After 4 weeks, your doctor may increase your childs dosage by up to 500 mg. The standard maintenance dosage is 1,0002,000 mg taken once daily at bedtime.
• Oral tablet: The initial dosage is 250 mg taken by mouth once per day following the evening meal. Your doctor may gradually increase your childs dosage to a maximum of 6 grams per day. The standard dosage is 12 grams taken 23 times per day.

Child dosage

This medication hasnt been studied in children and shouldnt be used in children younger than 16 years.

Senior dosage

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects.

Dosage warnings

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Deficiency Symptoms And Causes

A deficiency in niacin is generally uncommon in developed countries where malnutrition is rare. Some of the most common causes of deficiency include alcoholism, malnutrition, digestive disorders and prolonged use of certain medications that interfere with absorption.

Clinical symptoms of a vitamin B3 deficiency are usually categorized as the 4 Ds: dermatitis , diarrhea, dementia and death. Diagnosis is usually clinical, and dietary supplementation with high doses of niacin is generally successful is resolving symptoms.

When a niacin deficiency is seen, the following are some of the most common signs and symptoms:

• Pellagra characterized by skin inflammation, hallucinations, digestive distress. Usually occurs in malnourished people or those with alcoholism and can include rash, stomatitis, diarrhea and mental problems.
• Mucous membrane swelling symptoms that affect the mouth, vagina and urethra tongue can cause pain in the mouth, increased salivation, swelling of the tongue and ulcers.
• Skin symptoms, including several types of lesions.
• Digestive disturbances symptoms include burning in the pharynx and esophagus, stomach discomfort, constipation, nausea, vomiting and diarrhea.
• Brain impairment and psychosis some studies have found a link between niacin and depression, impaired consciousness, cognitive decline, disorientation, confusion, mania or paranoia.

What You Need To Know

Niacin is the most important vitamin for maintaining a healthy lipid profile. Due to a lack of keeping up with new published literature, physicians have been slow to recommend it. The recommended dietary allowance of niacin only serves to prevent pellagra. However, dosages much higher produce significant reductions in more harmful forms of cholesterol and triglycerides with increases in more beneficial cholesterol. Results from a clinical trial with 160 participants reveal that niacin combined with a statin drug reduces heart attack occurrence and death by 90 percent. Niacin can exist in an immediate-release and extended-release form. An immediate-release form may provoke a harmless hot flush that is generally well tolerated. The extended-release form offers fewer hot flushes. This article will discuss the research on niacin and its optimal use.

The recommended dietary allowance of niacin to prevent pellagra is 16 mg a day for males and 14 mg for females. Pellagra induced by niacin deficiency was widespread in the United States during the nineteenth century, but is now long forgotten and rarely seen.

When taken at doses greater than the RDA, niacin confers an array of health benefits. Niacin:

• Increases high-density lipoprotein by 20-35%. No other available over-the-counter treatments, and very few drugs, are as effective.

There are two safe forms of niacin:

You can employ several strategies to greatly minimize or even eliminate niacin-induced hot flushes:

Health & Wellness

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Niacin Vs Niacinamide Vs Nicotinamide

Niacin is found in three different forms, including:

• Nicotinic acid
• Nicotinamide/niacinamide
• Inositol hexaniacinate

Nicotinamide, also sometimes called niacinamide, is one of the most common forms of vitamin B3, found in both food and supplement sources. Nicotinamide is often preferred over other supplemental forms of niacin because its less likely to cause flushing and can be used for a wide variety of purposes, including treating pellagra, acne and arthritis. However, unlike niacin, nicotinamide is not as effective at lowering cholesterol levels and improving heart health.

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Forms And Benefits Of Niacin

Niacin comes in several forms, including niacinamide and standard “fast-release” niacin. They both help to increase cellular NAD, an essential metabolic molecule for all life, but significantly, only niacin can raise HDL more than any statin while simultaneously lowering VLDL , triglycerides , and total cholesterol. These outcomes are commonly desirable in most high risk cardiovascular disease patients. However, niacin has also been shown to elevate NAD more than niacinamide in many cell types, making niacin superior to niacinamide for helping to prevent disease.

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When To See A Doctor

If you are interested in using niacin to decrease cholesterol levels, speak to your health care provider.

They will be able to help you determine whether niacin or a different lipid-lowering approach will work for you.

You should also speak with your provider if you are taking niacin and experiencing adverse side effects.

How To Take Niacin

Niacin is typically taken once or twice per day.

Niacin doses are measured in mg NE, which stands for niacin equivalents.

The recommended daily intake for niacin varies based on age:

• Males 14 and older: 16 mg NE
• Females 14 and older: 14 mg NE
• Pregnant females: 18 mg NE
• Lactating females: 17 mg NE

The tolerable upper limit for all adults is 35 mg NE.

If you are taking niacin to support balanced cholesterol levels, the dosage may be higher. Niacin is available as a prescription, which allows for a verified way to regulate dose.

Supplemental niacin is also available, but the FDA does not regulate supplements in the same way that pharmaceuticals are managed.

Dosages can vary, and taking higher doses of dietary supplements could result in accidental overdose.

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Supplements To Lower Cholesterol And Live A Happy Life

High cholesterol is hard to treat because symptoms are often invisible. The human liver can produce cholesterol fat. Humans can also get cholesterol from food sources such as dairy, meat, and fish. While a little cholesterol is good, too much can cause a stiffening, narrowing, and clogging of blood vessels that can lead to a heart attack or stroke. Some supplements like niacin, bergamot, and omega-3 fatty acids can aid in lowering cholesterol.

Drug Raised Hdl As Expected

The study, called the AIM-HIGH trial, enrolled 3,414 volunteers in the United States and Canada who were taking a statin to keep their LDL cholesterol low. More than half had suffered a heart attack before entering the trial.

All volunteers were given Zocor, and 515 participants were given a second LDL cholesterol-lowering drug, Mercks Zetia, or ezetimibe, to make sure their LDL stayed in the target range of 40 to 80 milligrams per deciliter, which are very low levels.

Researchers said the drug performed as expected, raising HDL by about 28 percent and lowering triglycerides by about 25 percent, in keeping with other studies.

Late last month, an independent panel looked at the interim results of the study and concluded that high-dose niacin offered no benefits beyond statins alone in reducing heart complications, prompting the decision to end the study early.

There was also a slightly higher rate of strokes among patients who took niacin, but the overall rate of strokes in both groups was low.

Abbott, which reported Niaspan sales rose 8.4 percent to $927 million last year, said the relevance of the findings outside the type of patients in the study is currently unknown and it would be premature to extrapolate these results to a broader patient population at this time.

Wells Fargo Securities analyst Larry Biegelsen said the surprise findings could cut Niaspan sales by 20 to 30 percent.

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