Niacin to improve cholesterol numbers

Niacin is an important B vitamin that may raise levels of high-density lipoprotein — also called HDL — cholesterol, the "good" cholesterol, and lower triglycerides.

Niacin has long been used to lower triglycerides and to increase high-density lipoprotein, also called HDL, cholesterol. This "good" cholesterol helps remove low-density lipoprotein, also called LDL, cholesterol, the "bad" cholesterol, from the bloodstream.

But niacin isn't for everyone. People who take niacin in addition to common cholesterol medicines see very little additional benefit. And niacin can cause uncomfortable and sometimes dangerous side effects.

What is niacin?

Niacin, also called nicotinic acid, is a B vitamin that is used by the body to turn food into energy. Niacin also helps keep the nervous system, digestive system, and skin healthy. That's why niacin is often a part of a daily multivitamin, though most people get enough niacin from the food they eat.

When it's used as a treatment to improve cholesterol numbers or correct a vitamin deficiency, niacin is sold in higher doses available by prescription.

Niacin also is available as a supplement that can be bought without a prescription. These supplements are not regulated like prescription medicines. The ingredients, formulations, and effects of niacin supplements can vary widely.

Talk with your healthcare professional before you take niacin because it can cause serious side effects in high doses.

What impact does niacin have on cholesterol?

Triglycerides and cholesterol are different types of fats, also called lipids, that are found in the blood. Together, they make up your total blood cholesterol level, which affects heart health.

Niacin can lower triglycerides by 25% and raise HDL cholesterol by more than 30%.

Triglyceride levels over 150 milligrams per deciliter (mg/dL) or 1.7 millimoles per liter (mmol/L) have been associated with a higher risk of heart disease.

The risk of heart disease is also increased in men who have HDL cholesterol levels below 40 mg/dL (1.0 mmol/L) and in women who have HDL cholesterol levels below 50 mg/dL (1.3 mmol/L).

There's currently some debate about the exact role HDL cholesterol plays in the body and in the development of heart disease. But HDL cholesterol has generally been thought to pick up excess bad cholesterol in the blood and take it to the liver for disposal, which is why HDL cholesterol is dubbed the good cholesterol.

Despite niacin's ability to lower triglycerides and raise HDL cholesterol, research suggests that niacin therapy isn't linked to lower rates of death, heart attack or stroke in most people.

What side effects are associated with taking high doses of niacin?

High doses of niacin available by prescription can cause:

• Severe skin flushing combined with dizziness.
• Rapid heartbeat.
• Itching.
• Upset stomach, vomiting and loose stools.
• Gout.
• Liver damage.
• Diabetes.

Who might consider taking niacin?

In the past, experts thought that HDL cholesterol levels would increase even more if niacin were taken along with cholesterol-lowering medicines. These medicines, such as atorvastatin (Lipitor) and simvastatin (Zocor), are called statins. But newer studies indicate that niacin provides little additional benefit when compared with statins alone.

However, niacin may be helpful in people who can't tolerate statins or other cholesterol-lowering medicines. Some studies suggest that people with high triglycerides and low HDL cholesterol may benefit from niacin.

What else can be done to increase HDL cholesterol and lower triglycerides?

Lifestyle changes are helpful in boosting HDL cholesterol and lowering triglycerides. To improve your cholesterol numbers, try these heart-healthy suggestions:

• If you smoke, stop.
• Eat a healthy diet.
• Exercise regularly.
• Avoid consuming trans fats or partially hydrogenated oils.
• Limit the intake of highly refined carbohydrates, including sugars.