Many in the health care profession have forgotten about the positive relationship between niacin and cholesterol. 
Instead they have promoted statin drugs to control cholesterol levels. That’s unfortunate because niacin can be just as effective.
What is Niacin?
Niacin is a member of the vitamin B family. Specifically it is vitamin B3 or nicotinic acid. Because it’s a water soluble vitamin it needs to be replenished on a daily basis. The recommended daily allowance (RDA) of niacin is 2-12 mg/day for children, 14 mg/day for women and 16 mg/day for men. This RDA is the minimum required to prevent niacin deficiency which can be characterized by the following conditions:
- Slow metabolism
- Decreased tolerance to the cold
- Irritability
- Poor concentration
- Anxiety
- Fatigue
- Restlessness
- Depression
- Dementia
Niacin can be obtained through your dietary intake of the following foods: liver, heart, kidney, chicken, beef, tuna, salmon, milk, eggs, avocados, dates, tomatoes, leaf vegetables, broccoli, carrots, sweet potatoes, asparagus, nuts, whole grain products, legumes, mushrooms, and brewer’s yeast.
Cooking preparation is important since niacin is readily lost when food is cooked in water. Coupled with poor eating habits and foods depleted of their essential nutrients, many people insure their niacin RDA through vitamin supplements. If you choose a vitamin supplement then it is recommended that niacin is best taken with the other B vitamins and vitamin C.
Niacin is used by your body to help turn carbohydrates into energy. Niacin also aids your nervous system, digestive system, skin, hair and eyes. Niacin is also needed to help metabolize fats, which brings us to its ability to reduce cholesterol levels.
Niacin and Cholesterol Levels
To positively affect cholesterol levels, your niacin intake must be substantially greater than the RDA. As reported in the November 1998 American Journal of Cardiology, therapeutic levels of niacin have been clearly shown to:
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Lower LDL (BAD) and total cholesterol levels.
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Raise HDL (GOOD) cholesterol levels.
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Lower triglyceride (fat) levels.
Not only does niacin lower the “Bad” LDL cholesterol but it also substantially increases the “Good” HDL cholesterol. Many feel that increasing HDL cholesterol is more important than lowering LDL cholesterol. This is because the high-density lipoproteins (HDL) will sweep up the low-density lipoproteins (LDL) in your blood stream to keep them from damaging your endothelial cells.
Niacin can raise the HDL “Good” cholesterol by 15 to 35 percent. The Mayo Clinic estimates that for every 1 milligram per deciliter increase in HDL cholesterol you reduce your risk for heart attack by 3 percent. This means that the proper therapeutic use of niacin can lower the risks for atherosclerosis and other cardiovascular diseases.
Warning! If you are going to substantial increase your niacin intake above RDA levels then you should always discuss it first with your doctor. The reason why is that niacin can cause side effects when taken in high doses. This brings us to the reason why niacin has fallen out of favor in the treatment of cholesterol?
Flushing and Other Niacin Side Effects!
From over-the-counter supplements to prescription formulations, niacin comes in a variety of forms. Some are fast-acting and others are designed to act over a long period thru time-released encapsulation.
For therapeutic use to positively affecting your cholesterol levels, usually high doses of niacin (1000 milligrams or more) are administered. At this level most people will experience a “niacin flush” which is a temporary shunting (or vasodilation) of blood to the skin surface. The flush usually lasts for 15 to 30 minutes and will cause the skin to redden, feel warm to the touch, and may cause you to perspire. Although annoying, the “niacin flush” isn’t harmful. Some have found that taking an aspirin shortly before you take your niacin can help to alleviate this flushing effect. Hot drinks and alcohol can increase this flushing so it’s recommended that you avoid them when taking niacin.
To reduce the potential for flushing, some people will take a time-released niacin formulation. While this may help reduce the non-threatening, but inconvenient flushing, it increases the risk of harmful liver enzyme elevation. The continuous release of niacin into the liver can disrupt healthy methylation reactions that are essential to liver health. Fast acting niacin supplements do not usually present this problem.
It’s also important to note that therapeutic use of niacin does not mean taking 1000 milligrams at one time. Usually the total intake recommended by a qualified health practitioner is divided throughout the day in levels of 300 to 600 mg of niacin taken twice per day, and with a meal to help offset potential side effects.
Other potential side effects from therapeutic levels of niacin can include upset stomach, headache, dizziness from a drop in blood pressure, itching, increased blood sugar levels, and elevated liver enzymes. Thus, people with liver or kidney problems and diabetics need to take extra precaution. Working with a qualified health professional can help you find the right dose and form of niacin to help minimize these side effects.
Niacin, Statin Drugs and Current Research!
Niacin, like nitric oxide, seems to help statin drugs work more effectively. Research has shown that niacin, when used with some statins, can increase HDL “Good” cholesterol by 50 percent or more. Additionally, this combination also reduces LDL “Bad” cholesterol levels more than when statins are used by themselves.
Statin drugs have some very specific and dangerous side effects so utilizing other natural methods to help lower, and potentially eliminate statin usage can be beneficial for long term heart health. However, it is always best to check with your doctor and pharmacist before taking niacin with another medication to avoid any potential and dangerous drug interactions.
It’s also important to note that researchers are coming close to finding a niacin formulation that helps to prevent the dreaded niacin flush. Much of this research is at Duke University Medical Center and concentrates on G proteins. According to Robert Walters, M.D.,
“Niacin stimulates production of a vasodilator that dramatically increases blood flow to the face, causing the flush and the hot, prickly sensation – and beta-arrestin 1 is the culprit that enables that to happen. Interestingly, however, beta-arrestin 1 plays no role whatsoever in niacin’s ability to lower cholesterol and fatty acids. The G proteins do that.”
There is also a growing body of work looking at how flavonols – a class of plant-derived polyphenols – could inhibit this niacin flush. The two flavonoids that have shown the greatest potential are quercetin and luteolin. Quercetin is a compound that has been shown to promote endothelial function while supporting healthy blood glucose levels. Luteolin seems to suppress dangerous cytokines that are associated with flushing and other inflammatory reactions. A small human clinical trial used a combination of niacin, quercetin and luteolin to reduce the unpleasant side effects of niacin supplementation by an estimated 70 percent. This trial needs to be tested on a larger population base to confirm these findings.
Because over-the-counter niacin supplements can be just as good as prescription niacin in helping to increase your HDL cholesterol and lower your LDL cholesterol many people are opting for this method in their cholesterol reduction battle. Just make sure that it’s a reputable company that standardizes its ingredients and formulations. And, it’s important to note that if you choose to use dosages of niacin higher than the standard RDA, please consult with a qualified medical practitioner so that a proper program can be developed to your specific health goals.
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