Niacin and Cholesterol

Niacin or Vitamin B3 is an effective way to lower cholesterol levels. Niacin doesn’t just lower total cholesterol but rather lowers the bad cholesterol (LDL) while increasing the good cholesterol (HDL). However, it is associated with the dreaded niacin flush in which the skin turns red and itchy. While this reaction occurs shortly after ingestion and wears off fairly rapidly it is disturbing enough to discontinue its use. Different forms of the vitamin have come to the market in order to reduce the flush effect. The consumer should be aware of these different forms and their benefits and drawbacks.

What is the Niacin Flush?

The niacin flush occurs because of histamine release. Histamine is the same substance that is released during an allergic reaction to something. Histamine causes the small blood vessels near the surface of the skin to dilate. This blood dilation causes an increased blood flow to the skin’s surface resulting in flushing. It is similar to “hot flashes” associated with menopause in women. The dosage at which niacin causes flushing will vary among individuals and will depend on a number of factors.

How Can I Reduce the Flushing?

The doses of niacin required to reduce cholesterol are unfortunately in the flush zone of 500 to 1,000 mg of niacin.

Here are some ways to reduce the flushing:

  • take 300 mg of aspirin 30 minutes before taking the niacin
  • or take 1 ibuprofen tablet 30 minutes before taking niacin
  • take the niacin with meals
  • start low and gradually increase dosage as tolerance to flushing develops
  • divide doses of niacin throughout the day with each meal
  • drink 2 glasses of water if flush coming on
  • eat a small handful of nuts with niacin
  • take extended-release formula NOT sustained-release formula

Are No-Flush Niacin Formulations Effective in Controlling Cholesterol?

In order to overcome the flushing involved with niacin several forms have come to market that avoid the flush.

  • Niacinamide is one form and appears in most multivitamins. It is however ineffective in controlling cholesterol and has liver toxicity problems.
  • Inositol Hexanicotinate also is ineffective in controlling cholesterol.
  • A  sustained-release form of niacin while effective in controlling cholesterol without the flush has liver toxicity problems.
  • An extended-release form of niacin is effective in controlling cholesterol and doesn’t exhibit the toxicity problems associate with the sustained-release form.

Do not confuse sustained-release with extended-release niacin! Always choose extended-release formulas.

Can I Combine Niacin with Statins?

Since statins show greater side effects with increasing doses and niacin causes flushing at higher doses then in may be possible to incorporate non-flushing doses of niacin with statins.

Better yet combine the little to no-flush toxicity-free extended-release formula with your statins

A study at the University of Maryland to determine the effectiveness of statins combined with niacin to control cholesterol gave promising results.