Niacin to control cholesterol

[cacycle]

i have just begun to take Niacin to help control cholesterol. i was warned against the "Flush" feeling it gives you, but experiencing it firsthand was pretty interesting.

i tried taking 500 mg for the past mornings and have had quite a reaction to it. about 10 minutes after ingesting it, my skin begins to turn red and feels itchy & prickly. this sensation lasted about 20 - 30 minutes, then totally subsided.

i thought i would cut back to 250 mg and see what happens. has anyone else experienced this? if so, is it something you get used to ? or am is 500 mg too high of a dosage?

[eeso]

I got used to it.

Whatever u do tho, don't ever try a transdermal niacin (b3). Used that and got a foul rash with thousands of little blisters.

I don't particularly like the niacin rush. I think NOW foods make one which doesnt give a reaction....

[HeadDoc]

look for nonflush niacin. Here's a source from the Life Extension Foundation.

No Flush Niacin
800 mg, 100 capsules
Item Catalog Number: 373
No Flush Niacin contains a special form of niacin, inositol hexanicotinate, an ester compound formed from a six-to-one (6:1) molecular ratio (4:1 by weight) of niacin and inositol. Its unique properties allow for true niacin activity without niacin’s characteristic flush that is unacceptable to many people.



References
Supplement Facts
Serving Size 1 capsule

Servings Per Container 100

Amount Per Serving
Niacin (as inositol hexanicotinate)

640 mg

Inositol Hexanicotinate
800 mg

Inositol (as inositol hexanicotinate)
160 mg

Other ingredients: gelatin, microcrystalline cellulose, MCT (medium-chain triglycerides), and magnesium.

This product contains NO wheat, yeast, gluten, corn, or dairy. Contains NO sugar, artificial sweeteners, flavors, colors, or preservatives.


Dosage and Use
Take one capsule with meals or as recommended by a healthcare practitioner.


Caution
Do not take more than 500 mg of niacin per day except under supervision of a physician.

[cpeil2]

Originally Posted by HeadDoc

look for nonflush niacin. Here's a source from the Life Extension Foundation.

No Flush Niacin
800 mg, 100 capsules
Item Catalog Number: 373
No Flush Niacin contains a special form of niacin, inositol hexanicotinate, an ester compound formed from a six-to-one (6:1) molecular ratio (4:1 by weight) of niacin and inositol. Its unique properties allow for true niacin activity without niacin’s characteristic flush that is unacceptable to many people.



References
Supplement Facts
Serving Size 1 capsule

Servings Per Container 100

Amount Per Serving
Niacin (as inositol hexanicotinate)

640 mg

Inositol Hexanicotinate
800 mg

Inositol (as inositol hexanicotinate)
160 mg

Other ingredients: gelatin, microcrystalline cellulose, MCT (medium-chain triglycerides), and magnesium.

This product contains NO wheat, yeast, gluten, corn, or dairy. Contains NO sugar, artificial sweeteners, flavors, colors, or preservatives.


Dosage and Use
Take one capsule with meals or as recommended by a healthcare practitioner.


Caution
Do not take more than 500 mg of niacin per day except under supervision of a physician.

I have seen some studies that indicated that the no-flush formulation is not effective at lowing cholesterol.

[deadlifter405]

I tried the prescription brand Niaspan at 1 gram daily taken before bed and it was brutal.

I'd wake up completely drenched with my skin on fire about 2-3 in the morning and could not fall back asleep for a long time even after drinking a quart of water to rehydrate.

I gave up after 3 weeks so I didn't make it to a blood test to see what effect it had. In theory, it's supposed to drive HDL up and triglycerides down (or was it LDL?).

[hardasnails1973]

Fish oils 1 tsp 2 times a day will drop cholesterol make sure taking vitamin e 800 ius to prevent lipid perioxidation. Your insulin levels may be too high as well because insulin stimulates cholesterol production

[HeadDoc]

Originally Posted by cpeil2

I have seen some studies that indicated that the no-flush formulation is not effective at lowing cholesterol.

Here's some info I took from the Health Library at Pure Encapsulations.

Physiology and Clinical Effects
The body uses the water-soluble vitamin B3 in the process of releasing energy from carbohydrates. It is needed to form fat from carbohydrates and to process alcohol. The niacin form of vitamin B3 also regulates cholesterol, though niacinamide does not.

Vitamin B3 comes in two basic forms—niacin (also called nicotinic acid) and niacinamide (also called nicotinamide). A variation on niacin, called inositol hexaniacinate, is also available in supplements. Since it has not been linked with any of the usual niacin toxicity in scientific research, some doctors recommend inositol hexaniacinate for people who need large amounts of niacin.

Food Sources
The best food sources of vitamin B3 are peanuts, brewer’s yeast, fish, and meat. Some vitamin B3 is also found in whole grains.



Risk Factors and Symptoms of Deficiency
Pellagra, the disease caused by a vitamin B3 deficiency, is rare in Western societies. Symptoms include loss of appetite, skin rash, diarrhea, mental changes, beefy tongue, and digestive and emotional disturbance.



Recommended Dosage
In part because it is added to white flour, most people generally get enough vitamin B3 from their diets to prevent a deficiency. However, 10–25 mg of the vitamin can be taken as part of a B-complex or multivitamin supplement. Larger amounts are used for the treatment of various health conditions.



Contraindications
Niacinamide is almost always safe to take, though rare liver problems have occurred at amounts in excess of 1,000 mg per day. Niacin, in amounts as low as 50–100 mg, may cause flushing, headache, and stomachache in some people. Doctors sometimes prescribe very high amounts of niacin (as much as 3,000 mg per day or more) for certain health problems. These large amounts can cause liver damage, diabetes, gastritis, damage to eyes, and elevated blood levels of uric acid (which can cause gout). Symptoms caused by niacin supplements, such as flushing, have been reduced with sustained-release (also called ‘time-release’) niacin products. However, sustained-release forms of niacin have caused significant liver toxicity and, rarely, liver failure.1 2 3 4 5 One partial time-release (intermediate-release) niacin product has demonstrated clinical efficacy without flushing, and also without the liver function abnormalities typically associated with sustained-release niacin formulations.6 However, this form of niacin is available by prescription only.

In a controlled clinical trial, 1,000 mg or more per day of niacin raised blood levels of homocysteine, a substance associated with increased risk of cardiovascular disease.7 Since other actions of niacin lower cardiovascular disease risk,8 9 the importance of this finding is unclear. Nonetheless, for all of the reasons discussed above, large amounts of niacin should never be taken without consulting a doctor.

The inositol hexaniacinate form of niacin has not been linked with the side effects associated with niacin supplementation. In a group of people being treated alternatively with niacin and inositol hexaniacinate for skin problems, niacin supplementation (50–100 mg per day) was associated with numerous side effects, including skin flushing, nausea, vomiting and agitation.10 In contrast, people taking inositol hexaniacinate experienced no complaints whatsoever, even at amounts two to five times higher than the previously used amounts of niacin. However, the amount of research studying the safety of inositol hexaniacinate remains quite limited. Therefore, people taking this supplement in large amounts (2,000 mg or more per day) should be under the care of a doctor.

Vitamin B3 works with vitamin B1 and vitamin B2 to release energy from carbohydrates. Therefore, these vitamins are often taken together in a B-complex or multivitamin supplement (although most B3 research uses niacin or niacinamide alone).

Are there any drug interactions?
Certain medicines may interact with vitamin B3. Refer to drug interactions for a list of those medicines.


References
(To view, roll mouse over heading; to hide, click on heading)

--------------------------------------------------------------------------------

1. McKenney JM, Proctor JD, Harris S, Chinchili VM. A comparison of the efficacy and toxic effects of sustained—vs immediate-release niacin in hypercholesterolemic patients. JAMA 1994;271:672–7.

2. Knopp RH, Ginsberg J, Albers JJ, et al. Contrasting effects of unmodified and time-release forms of niacin on lipoproteins in hyperlipidemic subjects: clues to mechanism of action of niacin. Metabolism 1985;34:642–50.

3. Gray DR, Morgan T, Chretien SD, Kashyap ML. Efficacy and safety of controlled-release niacin in dyslipoproteinemic veterans. Ann Intern Med 1994;121:252–8.

4. Rader JI, Calvert RJ, Hathcock JN. Hepatic toxicity of unmodified and time-release preparations of niacin. Am J Med 1992;92:77–81 [Review].

5. Knopp RH. Niacin and hepatic failure. Ann Intern Med 1989;111:769 [letter].

6. Goldberg A, Alagona P Jr, Capuzzi DM, et al. Multiple-dose efficacy and safety of an extended-release form of niacin in the management of hyperlipidemia. Am J Cardiol 2000;85:1100–5.

7. Garg R, Malinow M, Pettinger M, Upson B, Hunninghake D. Niacin treatment increases plasma homocyst(e)ine levels. Am Heart J 1999;138:1082–7.

8. Brown WV. Niacin for lipid disorders. Postgrad Med 1995;98:185–93 [review].

9. Guyton JR. Effect of niacin on atherosclerotic cardiovascular disease. Am J Cardiol 1998;82(12A):18U–23U [review].

10. Welsh AL, Ede M. Inositol hexanicotinate for improved nicotinic acid therapy. Int Record Med 1961;174:9–15.


--------------------------------------------------------------------------------

[cpeil2]

Originally Posted by HeadDoc

Here's some info I took from the Health Library at Pure Encapsulations.

Physiology and Clinical Effects
The body uses the water-soluble vitamin B3 in the process of releasing energy from carbohydrates. It is needed to form fat from carbohydrates and to process alcohol. The niacin form of vitamin B3 also regulates cholesterol, though niacinamide does not.

Vitamin B3 comes in two basic forms—niacin (also called nicotinic acid) and niacinamide (also called nicotinamide). A variation on niacin, called inositol hexaniacinate, is also available in supplements. Since it has not been linked with any of the usual niacin toxicity in scientific research, some doctors recommend inositol hexaniacinate for people who need large amounts of niacin.

Food Sources
The best food sources of vitamin B3 are peanuts, brewer’s yeast, fish, and meat. Some vitamin B3 is also found in whole grains.



Risk Factors and Symptoms of Deficiency
Pellagra, the disease caused by a vitamin B3 deficiency, is rare in Western societies. Symptoms include loss of appetite, skin rash, diarrhea, mental changes, beefy tongue, and digestive and emotional disturbance.



Recommended Dosage
In part because it is added to white flour, most people generally get enough vitamin B3 from their diets to prevent a deficiency. However, 10–25 mg of the vitamin can be taken as part of a B-complex or multivitamin supplement. Larger amounts are used for the treatment of various health conditions.



Contraindications
Niacinamide is almost always safe to take, though rare liver problems have occurred at amounts in excess of 1,000 mg per day. Niacin, in amounts as low as 50–100 mg, may cause flushing, headache, and stomachache in some people. Doctors sometimes prescribe very high amounts of niacin (as much as 3,000 mg per day or more) for certain health problems. These large amounts can cause liver damage, diabetes, gastritis, damage to eyes, and elevated blood levels of uric acid (which can cause gout). Symptoms caused by niacin supplements, such as flushing, have been reduced with sustained-release (also called ‘time-release’) niacin products. However, sustained-release forms of niacin have caused significant liver toxicity and, rarely, liver failure.1 2 3 4 5 One partial time-release (intermediate-release) niacin product has demonstrated clinical efficacy without flushing, and also without the liver function abnormalities typically associated with sustained-release niacin formulations.6 However, this form of niacin is available by prescription only.

In a controlled clinical trial, 1,000 mg or more per day of niacin raised blood levels of homocysteine, a substance associated with increased risk of cardiovascular disease.7 Since other actions of niacin lower cardiovascular disease risk,8 9 the importance of this finding is unclear. Nonetheless, for all of the reasons discussed above, large amounts of niacin should never be taken without consulting a doctor.

The inositol hexaniacinate form of niacin has not been linked with the side effects associated with niacin supplementation. In a group of people being treated alternatively with niacin and inositol hexaniacinate for skin problems, niacin supplementation (50–100 mg per day) was associated with numerous side effects, including skin flushing, nausea, vomiting and agitation.10 In contrast, people taking inositol hexaniacinate experienced no complaints whatsoever, even at amounts two to five times higher than the previously used amounts of niacin. However, the amount of research studying the safety of inositol hexaniacinate remains quite limited. Therefore, people taking this supplement in large amounts (2,000 mg or more per day) should be under the care of a doctor.

Vitamin B3 works with vitamin B1 and vitamin B2 to release energy from carbohydrates. Therefore, these vitamins are often taken together in a B-complex or multivitamin supplement (although most B3 research uses niacin or niacinamide alone).

Are there any drug interactions?
Certain medicines may interact with vitamin B3. Refer to drug interactions for a list of those medicines.


References
(To view, roll mouse over heading; to hide, click on heading)

--------------------------------------------------------------------------------

1. McKenney JM, Proctor JD, Harris S, Chinchili VM. A comparison of the efficacy and toxic effects of sustained—vs immediate-release niacin in hypercholesterolemic patients. JAMA 1994;271:672–7.

2. Knopp RH, Ginsberg J, Albers JJ, et al. Contrasting effects of unmodified and time-release forms of niacin on lipoproteins in hyperlipidemic subjects: clues to mechanism of action of niacin. Metabolism 1985;34:642–50.

3. Gray DR, Morgan T, Chretien SD, Kashyap ML. Efficacy and safety of controlled-release niacin in dyslipoproteinemic veterans. Ann Intern Med 1994;121:252–8.

4. Rader JI, Calvert RJ, Hathcock JN. Hepatic toxicity of unmodified and time-release preparations of niacin. Am J Med 1992;92:77–81 [Review].

5. Knopp RH. Niacin and hepatic failure. Ann Intern Med 1989;111:769 [letter].

6. Goldberg A, Alagona P Jr, Capuzzi DM, et al. Multiple-dose efficacy and safety of an extended-release form of niacin in the management of hyperlipidemia. Am J Cardiol 2000;85:1100–5.

7. Garg R, Malinow M, Pettinger M, Upson B, Hunninghake D. Niacin treatment increases plasma homocyst(e)ine levels. Am Heart J 1999;138:1082–7.

8. Brown WV. Niacin for lipid disorders. Postgrad Med 1995;98:185–93 [review].

9. Guyton JR. Effect of niacin on atherosclerotic cardiovascular disease. Am J Cardiol 1998;82(12A):18U–23U [review].

10. Welsh AL, Ede M. Inositol hexanicotinate for improved nicotinic acid therapy. Int Record Med 1961;174:9–15.


--------------------------------------------------------------------------------

Durn, I can't find the studies anymore. Nearly everything in MEDLINE for inositol hexanicotinate is absolutely ancient and no abstracts. This was the only one I found, which reported that the effect of inosital hexanicotinate on blood lipids is slight.


Arch Sci Med (Torino). 1977 Oct-Dec;134(4):359-94. Links
[Comparative studies of the response of normolipemic and dyslipemic aged subjects to 2 forms of delayed-action nicotinic acid polyesters. Pentaerythrotol tetranicotinate and inositol hexanicotinate. Results of a controlled cross-over trial][Article in Italian]
Ziliotto GR, Lamberti G, Wagner A, Cima L, Genco G.
A cross-over trial was run to compare the effects of two delayed-action nicotinic acid polyesters (pentaerythritol-tetranticotinate, PETN, and inositol-hexanicotinate, MIEN) in 59 aged normo- and dyslipaemic subjects. PETN tended to normalise the lipid picture in much the same way as nicotin acid, without a drastic effect on circulating lipids and lipoproteins. MIEN, on the other hand, had only a slight effect on total blood lipids, and appeared to be ineffective or negative with respect to the other lipid parameters. PETN proved capable of releasing active concentrations of nicotinic acid in vivo for a period of time that was sufficient to correct hyperlipaemia in age subjects. The side-effects were slight, infrequent and quickly reversible.

PMID: 345998 [PubMed - indexed for MEDLINE]


There were other hits that report a combination of two compounds, one of which was inositol-hexanicotinate had a dramatic effect on blood lipids.



There doesn't appear to have been any serious research on the compound in nearly thirty years.

[greatgro]

Yes use inositol hexanicotinate. There are actually many companies who make this now including the big companies like Twin Lab. Regular Niacin can be toxic to the liver in very high dosages (the kind that you need for cholesterol reduction).

esso - you may not get flushing from your Niacin b/c NOW, IMO, is a very suspect company. There may not be Niacin in there! There's a reason why their products are half price. I saw a report a few years back where their supplements were extremely underdosed. I haven't purchased a NOW product since....

[Ozzie]

I too, use the Inositol Hexaniacinate from either Twinlab or Enzymatic Theryapy. I also use policosanol, pantethine, and LDL Protect (a product of Dr. Fuhrman's which contains some tocotrienols, policosanol, vegetable sterols, and pomegranate extract). I've also used guggul extract as well in the past although i've discontinued it of late given conflicting reports concerning its efficacy. I may restart.

While hardly a controlled experiment, i was able to bring my total cholesterol down from 243 (both LDLs and triglycerides were through the roof) three years ago to 97 total a year later. At that particular time, i was using the niacin, guggul, pantethine, and tamoxifen. A year after that, I still tested at 126 total.

Admittedly -- given the aforementioned shotgun approach with all its variables, it's hard to determine what's doing what. The point i'm merely trying to make is there are alternatives out there besides Lipitor and drugs of a similar ilk which are presumably healthier (especially the tocotrienols, pomegranate, and vegetable sterols).

[jimevans_2000]

I wouldn't use any non-flushing version of niacin, as I, too, have read studies saying that they just don't work, or not as well, at lowering bad cholesterol.

I have been taking niacin for years. Best thing to do is to
1) start at a low dose like 50mg and work your way up.
2) take it on a full stomach
3) take it when you're going to bed. Some studies showed it to be a GH releaser
4) take it before sex. As long as you've built up a tolerance, the flushing won't be painful like it can be if you take more than you're used to, and it actually seems to increase pleasure and accentuate orgasm
5) don't take time-release niacin. This is what was indicated as being hepotoxic.
6) learn to enjoy the flush. I find that it relaxes me and gives me a good body buzz.
7) aspirin can reduce the flushing if you take it a half-hour prior to the niacin.


I usually take one gram at bedtime and rarely wake up with a flush. I recall Durk Pearson and Sandy Shaw saying that they were taking 11 grams shortly after the Life Extension book was published.

Jim

[cacycle]

i just got some Niaspan and a 500 mg tablet broken in half causes no flushing. i was getting flushing with GNC's 250 mg tablet. problem is Niaspan is VERY expensive !!

[MrT]

Originally Posted by deadlifter405

I tried the prescription brand Niaspan at 1 gram daily taken before bed and it was brutal.

I'd wake up completely drenched with my skin on fire about 2-3 in the morning and could not fall back asleep for a long time even after drinking a quart of water to rehydrate.

I gave up after 3 weeks so I didn't make it to a blood test to see what effect it had. In theory, it's supposed to drive HDL up and triglycerides down (or was it LDL?).

Under my Doctors request (and close monitoring) I've worked my way up to 6 gms daily. *No, not a typo. This raises the good cholesterol. It takes a long time to work your way up to this level. And yes, I've also heard that the kimd that doesn't cause hot flashes doesn't work.

Ditto for Keto DHEA which appears to do nothing! I think its unbearable the things we are sold. At least you could cook with snake oil.