FH and niacin

Hi all. I am new here so apologies if this has been asked before but does anyone have any positive experiences with the above and if so, where did you obtain the niacin from? I ask these questions because I had statins years ago but stopped taking them due to undesirable side effects (which many of you are familiar with) and also didnt really fully understand why i was prescribed them. I have also tried niacin from h+b more recently but not sure if helped, as awaiting blood results. Never knew i had FH until yesterday after GP requested lipids consultation at local hospital. Any info would be appreciated. Thanks.


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32 Replies

  • Hi,

    I'm curious to know which of your lipids etc were tested and what were the results and reference ranges? Hopefully, you got the printout of your lab results and reference ranges. You're entitled to them because they are your data.

    There are different types of Vitamin B3 but, as far as I know, the flushing Niacin and flushing Nicotinic Acid regulate cholesterol.

    I'm also interested to know what your cholesterol level was when your GP prescribed statins and what reason was given to you for having to take statins.

  • Hi, thanks for replying. Last test in march 2016 was total 7.3, ldl 5.01, hdl 1.06, tri 2.7. Prior to this in 2007 my total was 6.9 but dont know the others and was prescribed simvastitin. As mentioned i had a blood test yesterday so awaiting results. My brother had a heart attack at 40, my dad and his brothers and sisters all had high cholesterol, his brother died of a heart attack at 50. Although FH hasnt been diagnosed, at 37 years old, the consultant thinks these numbers are high and considering i am fairly active and have a good diet, he believed it to be genetic. Hence i am trying to find alternatives to statins as when my results come through, he said he will be prescribing statins if the numbers are high 😫

  • It's your choice whether/not to take statins. As far as I know, there's a conflict of interests as doctors receive a financial bonus for each person they put on statins.

  • I have heard/read about that somewhere before. Desperately looking into niacin but would have liked some testimonials from anyone who has had good results before i decide what to do...

  • I'd be interested in knowing which tests you had and the results and reference ranges, when you receive them. 🖖🏻

  • Heart UK was set to help people with FH.

    Please Google Heart UK to get an email address and a phone number, there are medically qualified people at Heart UK who can help you with your questions.

  • Brilliant, thank you, i will contact them and ask 🙂

  • I am currently taking 500 mg of Niacin (nicotinic acid). This is below the recommended dosage of 1-2 grams to effectively reduce LDL cholesterol and increase HDL cholesterol.

    I purposefully started with a low dose to see the impact. I started in January and it has had a beneficial impact. It takes time to build up so you won't see the full benefit for a few months. I plan to increase by 100 mg so my new dosage will be 600 mg/day, still well below the 1-2 gram recommendation. However since I"m having success at current levels, I don't see the need to increase dramatically.

    I'm also hesitant to rapidly increase dosage as Niacin tends to increase urea (uric acid) in the blood. Excessive uric acid can cause gout. To offset this risk, I religiously drink a 4 oz serving of tart cherry juice daily as well as eating a bowl with a blend of blueberries, raspberries and blackberries, on a daily basis. I monitor my blood-work every 3 months to keep an eye on uric acid and other cardiovascular risk metrics, most notably ApoB and ApoA1 which are more pertinent than measures of LDL. You can learn why here:


    The only annoying side-effect of Niacin is a hot flush which usually starts 30-60 minutes after dosage. This dissipates after the first week of use and is milder if you take your dose with a little food and a full glass of COLD water.

    I wrote a post on Niacin a few months ago which you may read here:


    Keep in mind that I also exercise daily and am on a primarily plant-based diet. I will have chicken on occasion (once every week or two), but have fish 3-4 days per week. I am also on a no sugar, low simple carb diet which means I avoid white bread, pasta, pizza, rice and potatoes. I will eat brown rice, whole grain bread, whole grain pizza dough, and whole grain pasta.

    Without lifestyle and dietary changes, you can not expect optimal solutions from drugs alone.

    Good luck.

  • FH is far more rare than doctors diagnose. To know this definitively you can do a blood test called 'Lp(a)'. You can learn more here: docsopinion.com/health-and-...

    Furthermore, you can get a genetic test to determine your ApoE Geno-type. This will determine your optimal diet as the current avalanche of dietary advice does not consider individuality of genes. There is no one-size-fits-all diet out there. The closest thing to such an overall simple dietary solution is the need to avoid sugar in any form, including simple carbohydrates.

    You can learn more about Geno-types here:


    Good luck.

  • From what I have read it is necessary for vitamin B test to be carried out for any niacin medication.

    "Did you do any blood test for Vitamin B?"

  • There are various forms of vitamin B, so I'm not sure which B vitamin you are referring to. I routinely measure B12 to ensure that I'm getting enough nutrients. However, Niacin is available as an over-the-counter vitamin supplement here in Canada and does not require a prescription, therefore I did not conduct a blood test specifically to determine my need for Niacin.

    After conducting my own research on natural remedies for lowering LDL cholesterol I decided to start on a low dose of the Niacin as noted in my post. So far it has been effective and I've kept my blood urea levels under control by eating berries on a daily basis as well as consuming a small quantity of tart cherry juice daily.

  • Thank you for your input. I am still waiting for my test results and will post on here when they come through. I have found niacin (swanson brand) which has good reviews and plan to purchase these if i need to.

  • Please take a look at the BBC1 doctor in the house programme on I player as the programme was shown at 9 PM this evening.

    Blood test for homocysteine was discussed, an elevated level was controlled by strong dose of vitamin B supplement!!!

    Goole has a lot of information.

  • I check my homocysteine level during each blood test. Mine has been within the safe range, but above the 'ideal' range. I started taking Folic Acid (a.k.a. vitamin B9) to help lower it after my last blood test. I'll see the impact at my next test due at the end of July.

  • This is a reply i did for someone else, thought you might be interested,

    I tried loads of items OTC even the margarines and yogurts etc, non lowered mine significantly so at 8.2

    I decided to go on low dose simvastatin, with diet changes which included swapping from so called healthier spreads to butter and only good oils, like good quality extra virgin oil and watching what I eat I have lost about 4/5 lbs in weight and after 2 months it went down to 5.5 but they made me ache so moved over to atorvastatin, had non fasting bloods last Tuesday after having fish and chips as a treat the night before and my Horlicks before bed,actually forgot about tests and really thought it would go up again, got results this morning 5.2 so with a low enough dose that is not going to cause any major problems I'm happy.

    Also its nuts but my LFTs are all normal, the hematologist I saw 2 years ago said it was probably caused by fatty liver and to change diet, I have and normal, well I'm not normal but results are.

  • Thats brilliant! What strength were the first and subsequent statins? I am still waiting for my results, was a fasting one so fingers crossed. Once i get the results i will decide what i need to do but thank you for your input, much appreciated 😊

  • I just did a really long answer and my Internet went off, so annoying, its the same 10 mg and I do make sure I get omega 3 as well and I mix olive oil, freshly ground black pepper with tumeric, its good for inflammation, I have RA and thanking God I have never had to take the nasty drugs they prescribed for it.

    I asked my GP if they got paid for prescribing drugs, he said absolutely not, they get ticked off if they over prescribe though.

    My partner has been on statins for 18 years and about 3/4 years ago he swapped to atorvastatin and aches went away after a couple of months, try not to get too hooked into the statin debate, you have to do what's best for you.

    If you had high BP or another medical condition that needed meds you wouldnt think twice if nothing else would control it , PS I don't work for a statins company LOL

    I hope yours is low though

  • Lol i didnt think that! And my BP is normal, always has been 😊

  • When will you get your results, I can normally get mine within 4/5 days but left it a bit longer, was scared of results LOL

  • It has been just over a week now so hoping they come through soon.

  • Yes I take high dose os sustained release niacin up to 1400 mg. And it has lowered my chol by 40 pnts and raised my hdl. I also have FH so in same boat. Mine has been high since 1st time ever checked in my 20's.(iam 45 now and active with good diet) I also refuse take statins. Recently had a heart scan done which resulted in zero plaque score and the physician actually advised not to take statin as would do more harm than good. Especially not beneficial for woman.

  • Hey thanks for your input, very encouraging! Still waiting for my results but if I do decide to get some niacin, would you mind letting me know what brand you use and the dosage you take? Many thanks

  • Hey all. I'm sorry this is a blast from the past but i am now armed with alot more info which i wanted to share with you all especially the members who have heaps of knowledge. Hopefully you can advise/guide me 🙂

    So first i will start with my blood results which i will copy and paste from my notes app:

    Mar 2016/Dec 2016/May 2017/Aug 2017

    7.0 total / 7.3 total /7.5 total / 7.8 total

    1.15 hdl / 1.06 hdl / 1.03 hdl / 1.46 hdl

    5.07 ldl / 5.01 ldl / 5.79 ldl / 5.75 ldl

    No info / 2.7 t / 1.7 t / 1.3 t

    Along with my recent results, i was informed i have elevated LP(a) at 128 and normal is 30 or below! 😱

    It has been suggested that the lp(a) levels are down to genetics so environmental factors, dietary changes, etc will not reduce the levels. In fact, as it is a relatively new area, they dont really have any confirmed studies whereby a treatment has been identified.

    In between may 2017 and aug 2017, i started niacin, dosage was 500mg starting beginning june then i upped it by 500mg every week up to 2000mg. You can see that hdl increased but i also stopped smoking a month prior to the august results too so that probably also played a part (used to smoke around 5 a day)

    So diagnosis is: familial hypercholesterolemia and elevated lp(a)

    As mentioned in previous posts, i really dont want to take statins but after finding niacin didnt really improve overall cholesterol, i had to face defeat and agreed to 20mg atorvastatin. But in light of elevated lp(a), the consultant added 75mg aspirin. I was told that in "some" studies, aspirin was found to reduce lp(a) levels.

    I have the prescriptions since this morning but have still not got the medicines as i am certain i can avoid pharmaceutical meds and have been exploring vitamins.

    I am considering the following for the next 3 months before my next appt and wanted some advice on whether you think it is the best approach:

    Vit k2

    Vit d


    Vit c


    Omega 3 fish oils

    Does anyone think the above is too much?

    I do feel all these will definitely help based on the googling i have done (and the results of some studies out there) specifically relating to arterial plaque as this is my biggest concern especially in light of my elevated lp(a) levels. I have a exercise stress test in a couple of weeks and will see what the results indicate.

    So there you have it! Sorry for the loooong post but i have tried to put EVERYTHING down but if there is anything else that anyone needs to know, please feel free to ask!

    I hope my post helps others out there too, mainly if, like me, you want to avoid big pharma and stick to natural healing.

    Sorry i need to add that i think im in peri-menopause (i am 37!) as i keep suffering significant hot flashes day and night, sleep disturbances and no period for 2 months. I have read that declining levels of estrogen contribute to cardiovascular issues so cant help but think the two are linked but I could be wrong. I am adding vitabiotics menopace night supplements to the above too.

    Thank you 😊

  • If I were you I would give the niacin a bit longer to settle in. I've been taking similar amounts since February and have brought my total number down from 10.6 to 5.36.

    I get my official results today or tomorrow but had a prick cholesterol test yesterday and got that number. I just posted a long post about it yesterday.

    I also take 2-3 g niacin per day, flax oil supplements 1000mg, magnesium citrate 250mg, vitamin C daily.

    If you can't see my post let me know and I'll share my fill results with you.


  • By the way, after doing a fair amount of research, I decided to take flax oil because it contains 3,6 and 9 omega which creates a balance rather than overloading on omega 3. Plus, because of the radiation leaking from Japan's nuclear disaster,I don't feel confident enough in fish oil to be safe. Flax oil is excellent, I also use cold pressed flax oil on salads and cold dishes.

  • Right. So here's my Niacin for cholesterol journey so far:

    I have FH. It runs in the family on my father's side (littered with heart attacks and strokes).

    My initial blood test revealed cholesterol of 12.6. I managed to get it down to 10.6 making lifestyle changes. After trying lots of different statins and having terrible side effects with each (each statin comes with its own version of hell for me), I took nothing for some time. In February I spotted a bottle of inositol hexanicotinate in a health shop and bought it. A month later I switched to plain niacin. I began with 500mg and titrated up to 2g per day by June and then began moving it up to 3g per day. At the moment I'm hovering between 2.5-3g p/day.

    February 8th test results using nothing

    Feb total 10.6 = 409.89

    Feb LDL 5.1 = 197.2

    Feb Triglycerides 5.1 = 451.72

    Feb HDL 1.14 = 44.08

    Feb serum cholesterol / HDL ratio 9.3=359.07

    Feb serum cholesterol total 10.6=409.89

    I began taking 500mg per day on inositol hexanicotinate Feb 18

    Feb 20 1g p/day, 500mg every 12 hours

    Mar 6 1.5g, 500mg every 8 hours

    --total cholesterol 8.1= 312.74 --

    Mar 13 began 500mg plain niacin p/day

    Mar 25 1g p/day

    Mar 31 1.5g p/day

    Jun 5 2g p/day (500mg every 6 hours)

    June results taking 2g plain niacin per day:

    Jun total 7.1 = 274.5

    Jun LDL 3.7= 143.07

    Jun Triglycerides 3.7= 327.72

    Jun HDL 1.73= 66.89

    Jun serum cholesterol / HDL ratio 4.1= 158.30

    Jun serum cholesterol total 7.1= 274.5

    I've begun taking 2.5-3 g per day over the last month and a half, and

    I had a proper blood test yesterday (I should receive the full picture tomorrow or Thursday), but on Sunday I joined a gym and they gave me a prick test for total cholesterol and guess what the number was??

    5.63 mmol/L!!!!!!!!! (217.71 mg/dL)

    YAAAAAAY!!!!!! Cannot wait to see the full breakdown.

    Niacin rocks.

  • I'm confused. Are you taking the flushing Niacin AND Inositol Hexanicotinate?

  • Yay! So pleased you got your numbers down 😊 I havent gone above 2000mg niacin, think im scared it may do more harm than good if i take more than that. Plus having taken for over 2 months, was disappointed with the little impact it did have. However, i will continue on the same dose and see what the next set of results bring in 3 months time.

  • Where do you buy it and how much does it cost

  • Hi. I just found them online. They are sold by many companies although mine have been from america.

  • Hi.

    I have FH and cannot tolerate statins. I began using Niacin in February this year. I started with no flush but moved to plain niacin in March (test results in both UK and USA measurements:

    February 8th test results using nothing

    Feb total 10.6 = 409.89

    Feb LDL 5.1 = 197.2

    Feb Triglycerides 5.1 = 451.72

    Feb HDL 1.14 = 44.08

    Feb serum cholesterol / HDL ratio 9.3=359.07

    Feb serum cholesterol total 10.6=409.89

    I began taking 500mg per day on inositol hexanicotinate Feb 18

    Feb 20 1g p/day, 500mg every 12 hours

    Mar 6 1.5g, 500mg every 8 hours

    --total cholesterol 8.1= 312.74 --

    Mar 13 began 500mg plain niacin p/day

    Mar 25 1g p/day

    Mar 31 1.5g p/day

    Jun 5 2g p/day (500mg every 6 hours)

    Jun total 7.1 = 274.5

    Jun LDL 3.7= 143.07

    Jun Triglycerides 3.7= 327.72

    Jun HDL 1.73= 66.89

    Jun serum cholesterol / HDL ratio 4.1= 158.30

    Jun serum cholesterol total 7.1= 274.5

    Just had a prick test at my gym and total cholesterol was 5.63.

    However, august blood test showed total down to 6.4.

    But yes, it's very effective...

    it definitely works.

    Take it slow in increasing your dosage. I began on a high dosage and increased in 500mg increments but it is possible to get lower dosages and titrate up more slowly.

    Take niacin after food and a small aspirin will help with the flush until you're used to it, at which point you can do the aspirin. I only took one 75mg aspirin in the morning until the flushing stopped (roughly a week or so).

    Good luck, let us know how you get on.

  • Thank you. First 3 months of just niacin (starting at 500mg and building up to 2000mg at 500mg increments weekly) had minimal effect on total and ldl, however an improvement in hdl and tri was seen. I shall now see what another 3 months on 2000mg brings. Although i will be adding vit k2, vit d3, coq10 and omega fish. Will post results when i hav my next test. Fingers crossed 😊

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