Managing Cholesterol: What is Niacin?

Niacin, also known as nicotinic acid or vitamin B3, is a water soluble vitamin, meaning that it is not stored in the body like fat soluble vitamins are. Niacin should be replaced daily through diet or supplements. It is broken down into nicotinamide coenzymes which are used by the body in many energy-producing reactions and syntheses. Although they may sound ominous, these are in no way related to nicotine or harmful tobacco compounds.

Nicotinic acid in its common form has been used to lower serum cholesterol since 1955. It is often prescribed for patients to take along with modern cholesterol drugs. Nicotinic acid studies have shown marked reductions in total blood cholesterol and in trigycerides, and a reduction in strokes, TIAs and in recurrent heart attacks. Controlled studies using thousands of patients and following their health for many years have provided this valuable information.

Niacin therapy increases HDL levels ("good" cholesterol) and it causes changes in LDL ("bad" cholesterol) by altering the smaller dense LDL particles in the bloodstream into larger particles that are more buoyant. The more bouyant particles will not collect as readily to form arterial plaque.

The adult RDA of niacin has been set at 14-16 mg per day. If niacin is prescribed by your doctor, it will be in a much higher dose, usually 2 - 3 grams (that's grams vs milligrams). Even though it is cheap and available over the counter, niacin should be considered a very potent drug. It can have dangerous side effects, and you need to be monitored by your doctor if you are taking it. With small doses it is very common to have flushing, itchy skin, and nausea/vomiting. You should take niacin with a glass of cool water; hot beverages can exaggerate the common flushing and itching reaction.

Niacin doses at higher levels, but as low as 1 or 1.5 gram (well below a commonly prescribed dose) can cause liver problems, severe headache, skin rashes and dermatitis, and can cause severely impaired glucose tolerance. Make sure that your doctor is aware of any history you have with liver function, diabetes, gout, peptic ulcer, inflammatory bowel, migraine, or heart arrhythmia. Alcohol should not be consumed when you are taking niacin.

Healthy individuals can get adequate niacin by eating a balanced diet. Good food sources of niacin are chicken, beef, pork, eggs, milk, wheat flour and corn/maize flour. Niacin is one of the ingredients added to fortified cereals and breads, usually by means of enriched flour. Those on a gluten-free diet may want to take a daily supplement that includes niacin.

Sources:
http://www.drugs.com/niacin.html

http://lpi.oregonstate.edu/infocenter/vitamins/niacin/