Using niacin without rinsing to lower cholesterol

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Niacin is a form of vitamin B, specifically B3 (niacin). It is a water- soluble vitamin that is essential for the proper functioning of the body's cells. Niacin has been studied for its ability to treat a variety of conditions, including Alzheimer's, cataracts, erectile dysfunction, and sickle cell anemia, but without much success.

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At one time, health professionals prescribed niacin to control cholesterol levels in people with cardiovascular disease. However, after a 2011 study published in the New England Journal of Medicine showed that niacin was not beneficial for people with high cholesterol, the practice was discontinued.

Today, niacin is used primarily to treat niacin deficiency, which in severe cases can lead to pellagra , a disease characterized by diarrhea, skin lesions, and dementia. Niacin deficiency most often develops as a result of chronic malnutrition, poverty, or alcoholism.

Most people get enough niacin in their diet to prevent a deficiency, especially from foods like yeast, meat, fish, milk, eggs, green vegetables, and fortified grains. However, if your healthcare professional or dietitian tells you that you need more vitamin B3 in your diet, there are things to consider in choosing the right niacin supplement.

The US Department of Health and Human Services recommends 14 milligrams (mg) of niacin per day for women and 16 mg of niacin per day for men from all sources .

Niacin immediate release

Immediate-release (IR) niacin, also known as "rapid-release" niacin, releases the full dose into the bloodstream as soon as it is ingested. For this reason, IR niacin is more likely to cause side effects than other forms of the vitamin .

Some nicotinic acid vials may not indicate whether they contain an 'immediate release' or 'sustained release' product (see below). If the label does not indicate what form of niacin is in the bottle, it is safe to assume that it is an IR product.

Sustained Release Nicotinic Acid

This form of niacin is available by prescription under the brand names Niaspan or Niacor, as well as generics. There is also a controlled-release version called Slo-Niacin, which is available without a prescription and can be less expensive.

Time-release (ER) nicotinic acid is released into the body more slowly than IR nicotinic acid. Sustained-release niacin can cause side effects, but they are likely to be less serious than those associated with the IR form .

Sustained Release Nicotinic Acid

Sustained-release (SR) niacin, also known as "sustained-release" niacin, releases niacin into the body over a period of time rather than immediately. It can still cause side effects, but they are likely weaker than immediate-release supplements.

A niacin SR supplement will take longer to detoxify the body than an IR form or an extended release (ER) form. For this reason, SR nicotinic acid is associated with a risk of liver toxicity.

If you have liver disease, such as cirrhosis or chronic hepatitis B or C infection , it is best not to take sustained-release niacin and to opt for an immediate or extended-release formulation.

Possible side effects.

Niacin supplements are safe for most people, but there are some potential side effects to be aware of. Most of the time it is redness: warmth, tingling, itching, and redness of the face, arms, and chest. This symptom may be accompanied by a headache, dizziness, a rash, and / or low blood pressure .

Niacin side effects can be severe and, in some cases, intolerable, but they usually go away after a couple of weeks. Until then, there are ways to mitigate them.

  • Ease in full dose. For example, if you must take 500 mg per day, take 250 mg for the first few days and gradually increase the dose to the full dose as tolerated.
  • Change the wording. If immediate-release niacin is causing problems, you may be better able to tolerate OTC extended-release or extended-release medications because niacin is given gradually rather than immediately.
  • Divide the dose. Instead of taking the entire dose at once, take half in the morning and half in the evening. (Although you can physically split an immediate-release niacin tablet in two, never cut, chew, or dissolve an extended-release or sustained-release tablet.)
  • Avoid alcohol and hot drinks. Both can aggravate side effects. Until they disappear completely, cut back on alcohol and coffee, tea, or other hot beverages or stop altogether.
  • Take aspirin. Studies have shown that taking aspirin 30 minutes before or at the same time as niacin can reduce the intensity and duration of hot flashes by 30-40% .
  • Do not try to rinse with niacin. This combination supplement contains nicotinamide and inositol hexaniacinate. Although niacin is better tolerated than other forms, research has shown that niacin without hot flashes is no better than placebo at improving cholesterol and other lipids .

High doses of niacin (more than 3 grams per day) can cause serious side effects, including liver damage, gout, gastrointestinal ulcers, vision loss, high blood sugar, irregular heartbeat, and other serious problems. High doses of niacin are also associated with an increased risk of stroke .

Dosage and preparation

There is insufficient scientific evidence to determine the recommended dose for niacin or niacin. If your healthcare provider prescribes nicotinic acid for you, they will base your dose on factors such as your age, gender, and medical history.

Before taking over-the-counter niacin, talk to your doctor to make sure it makes sense. Together, you can determine the optimal formula and dosage.

What to look for

Whether you buy niacin over the counter or intend to take it with a prescription, don't consider it "just a supplement." It is still a drug with risks and side effects. Report any serious side effects to your doctor immediately.

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