Lowering Cholesterol with Niacin - Vitamin B3
Lowering Cholesterol with Niacin - Vitamin B3
Niacin or nicotinic acid, one of the water-soluble B vitamins, improves all lipoproteins when given in doses well above the vitamin requirement. Nicotinic acid lowers the total cholesterol, "bad" LDL-cholesterol, and triglyceride levels, while raising the "good" HDL-cholesterol level.
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. When buying Vitamin B3 to lower your cholesterol, make sure you purchase Niacin, not Niacinamide. Niacinamide is not effective for lowering cholesterol
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.
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.
Studies of Niacin for lowering Cholesterol
A study in Archives of Internal Medicine (Guyton, et al, 2000) confirms the superiority of niacin (vitamin B3) as a lipid-lowering agent. A proprietary timed-release version of niacin (Niaspan) was compared to the pharmaceutical drug gemfibrozil (Lopid). The study involved 399 male and female subjects ranging in age from 21 to 75, all of whom had low levels of HDL (high density lipoproteins—“good cholesterol”) less than 40 mg/l. Other criteria for inclusion in this study were triglycerides less than 400 mg/l, and LDL (low density lipoproteins—“bad cholesterol”) less than 260 mg/l. Niacin was administered once daily at bedtime. The niacin dosage was begun at 375 mg/day, and then increased progressively over the course of the study, and maintained at a level of 2,000 mg nightly for 8 weeks. The duration of the study was 16 weeks. Subjects took an aspirin as-needed to prevent flushing. Gemfibrozil 600 mg was administered twice daily over the entire 16 weeks.
Niacin increased HDL levels over 25%, compared to an increase of 13.3% due to gemfibrozil. Gemfibrozil actually raised LDL (the “bad” cholesterol, remember?), while niacin slightly lowered this fraction. Gemfibrozil lowered triglyceride levels by 40%, compared to a 30% decrease from niacin. Thus, niacin resulted in an overall improvement in the lipid profile which exceeded that induced by gemfibrozil.
These results support many previous studies on the use of niacin as a lipid-lowering nutrient. For example, in the Coronary Drug Project, which enrolled men with a previous myocardial infarction, niacin use resulted in a 26% decrease in second non-fatal heart attacks over a six-year period, and an 11% decrease in total mortality after 15 years of followup (Canner, et al, 1986)
Side Effects
Niacin's most frequent “adverse effect” is a harmless flushing of the skin, accompanied by itching. This effect usually resolves over a few days or weeks of use. Taking an aspirin 30 minutes or so before the niacin also helps to reduce this effect. Another way to minimize the flushing is to start with low doses (50-100 mg) and gradually increase the dose as tolerated.
Another side effect is the potential for elevation of liver enzymes or liver toxicity. Liver toxicity is rare, and occurs most frequently with timed release preparations. Anyone contemplating high dose niacin therapy probably should have their liver enzymes checked within several months of achieving therapeutic levels (1,500-3,000 mg).
The only absolute contraindication to niacin therapy is insulin-dependent diabetes. Niacin aggravates blood sugar problems in insulin dependent diabetics, further worsening their lipid problems, usually causing their triglycerides to skyrocket. Alternatively, niacinamide can be taken in doses up to three grams daily for insulin dependent diabetics. Although niacinamide does not normally effect lipid levels in non-diabetics, because of its glucose-stabilizing effect in diabetics, it tends to normalize their blood lipids—especially, the triglycerides.
Articles about Niacin for lowering cholesterol
Medline Plus - U.S National Library of Medicine