Before Statin Drugs there was - Niacin (Vitamin B3)

Before the introduction of statin drugs, niacin (vitamin B3) was used to control cholesterol. There are various forms of this natural vitamin and there are some minor side-effects with usage such as a warm flushing that starts about 10-15 minutes after taking it and lasts for 20-30 minutes before slowly dissipating and eventually going away after an hour.

I just started a 500 mg, once per day, regimen to see the effects on my cholesterol levels. Apparently your body is supposed to get used to it after a week and the flushing diminishes. I'm on day 2 so I'll update everyone in a separate post.

The optimal dosage according to what I have read is 1-2 grams per day, so with the 500 mg tablets I'm supposed to take between 2 and 4 doses. It is recommended to initiate with a small dosage until your body adjusts and then increase gradually. I'm going to stick with 500 mg. and see the impact on my next blood test before increasing dosage.

Other side effects include an increase in uric acid which increases the possibility of getting gout. That's another reason I'm sticking to the lower dosage.

There are extended release tablets but I understand they may cause liver toxicity after a while.

It is strongly suggested that you begin treatment under the supervision of a doctor.

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  • Several posts on here about niacin in the past.

    healthunlocked.com/search/n...

  • Thanks. I have read all the pros/cons of taking Niacin. I'm experimenting with 500 mg. once daily for 2 weeks when I'm scheduled for my next blood test. So far I'm on day 2 and have experienced the flush which is tolerable. I hesitate to increase the dosage in order to avoid gout issues and possible liver toxicity, although I have never before been susceptible to gout previously. I will note any impact on my blood tests. I intend to measure Uric Acid this time to monitor the risk of getting gout.

  • Watching with interest

    :)

  • Day 3 - flush significantly less intense than first two days and also delayed. Usually you feel it within 15 minutes of ingesting the vitamin. Today it took much longer. I took a baby aspirin 15 minutes before eating breakfast. Breakfast took me 10 minutes to complete and then I took the Niacin, so about a half hour passed between the baby aspirin and the Niacin. Plus I read eating helps to dissipate the effect. So far so good. Blood work scheduled for Feb 20th and I'll see the impact, if any, for this 500 mg daily dosage.

  • Day 4 - flush a little more than yesterday, but not as bad as day 1 and 2. I don't intend to increase dosage until I see my blood work results in 11 days.

  • Flush Update - Day 5 flush was almost un-noticeable. I took an 81 mg baby aspirin exactly 30 minutes before taking the Niacin tablet. I had breakfast immediately after taking the baby aspirin and also had a small handful of almonds just before taking the Niacin.

  • Flush update - Day 10 - I have continued to take the baby aspirin 30 minutes before taking the Niacin dosage, while having breakfast in between. This has resulted in a very minimal flush, barely noticeable about 90 to 100 minutes after the dosage. The other key item is to take the NIacin with a full glass of cold water, not with a hot beverage which I was doing originally. I find the handful of nuts moments before taking the Niacin dosage helps even more.

    Blood test is scheduled for February 21st, I will see how this 500 mg daily dosage has impacted my lipid profile. It will only have been 3 weeks of dosing and I've read it takes months to have an impact. We will see...

  • I take 750 mg of niacin 2x/day and must have periodic blood work. It has worked well for me. I occasionally get the 20 minute flush, but it's tolerable. It has lowered my cholesterol very well.

  • @ clajac - thanks for your reply - it is encouraging to hear about your success.

  • How many of those who find niacin works are confirmed Familial Hypercholesterolaemiacs? (Type IIa on en.wikipedia.org/wiki/Hyper... )

    My consulting physician thought it wouldn't work for me, but maybe I should ask more why not.

  • I've been taking niacin for many years. After the hospital found out about it they began giving it to me. MY GP (PCP) told me it doesn't help but I feel much better when I take it and one surgeon told me it helps with triglycerides and increasing HDL the good cholesterol. However, too much can damage the liver. That's why like when you take statins you need a blood test at least every 3 months if not 2 months to see how/ if the statin's working and to check your liver for any possible damage from the statins, niacin and anything else that sometimes happens. Several months ago I was taking high levels of niacin and found out from a test that one of my liver enzymes - AST - was high and had to cut back on it. Besides that, I believe it helps. Deceide for yourself, talk to your doctor and keep checking your liver. Good luck.

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  • UPDATE ON NIACIN

    I had my blood work done yesterday after being on Niancin for about 16 days.

    My LDL cholesterol dropped by 10% and my HDL increased by 15%. I monitor uric acid now as Niacin increases this which can cause gout. My uric acid level was within the normal range but at the upper end. Berries offset uric acid and I ensure I eat a bowl of fresh berries, primarily blueberries, blackberries and raspberries daily.

    My liver enzymes where all normal. My current dosage of Niacin is 500 mg, once daily in the morning. I usually eat a small handful of almonds or cashews just before taking the Niacin then drink a full glass of cold water with the pill. This has helped to mitigate the 'flushing effect' which by this point has become minimal and barely noticeable. I also make sure I have a baby aspirin 30 minutes prior to taking the Niacin. I take the baby aspirin after breakfast to protect my stomach.

    All of my lipid values including Apo B are in the 'normal' range and my protective lipid value such as HDL and ApoA-1 are extremely high, implying significant Reverse Cholesterol Transport (RCT) that balances the LDL and Apo B.

    I also tested my fibrinogen levels which measure platelet coagulation - often a precursor to a heart attack or stroke. My levels were in the normal range.

    In addition, I tested for homocysteine, Lp(a), and did the PLAC test (Lp-PLA2). These results are still pending. The PLAC test shows the stability of existing plaques and whether they are subject to imminent rupture that can trigger a heart attack or stroke.

    Homocysteine is an amino acid that when present in large quantities contributes to plaque formation by damaging the arterial wall.

    Lp(a) is a lipoprotein that carries oxidized phospholipids which damage the arterial wall. Niacin is known to help reduce Lp(a) by up to 30% according to some research.

    My next step is to see my doctor and discuss increasing the Niacin dosage.

    Stay tuned.

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  • sos007.....How about an update now that it's been 6 months? Hope you are doing well!

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