Niacin question: how much is too much?
I want to start taking niacin for my cholesterol. My multi has like 30mg and the time released ones I saw had 150mg.
Is there such a thing as too much? And: what is considered a therapudic dose for lowering cholesterol?
I'm anxious to hear about this also. I have been on a quest to lower mine for nearly 4 months now. I tried niacin (500 mg) and had to stop because of flushing. I had never experienced anything like that :stars: I know that there are some brands that say they don't cause the 'flush' but am a little nervous about buying more. My doctor has recommended green tea 2x a day and Policosanol (20 mgs) daily. I go back in August for another blood test. I've already knocked off 30 points, but have 30 more to go.... I also scaled back on the red meat and dairy (which I enjoyed so much on this WOE)
Your right -it is 500 mgs no flush -My hubby takes it he had a heart attack 2 years ago- I take the green tea on a daily basis Rita
Every store was out of the "no flush" but I got a 500mg time released one that says it helps the flushing problem by being released slowly over the day.
My Dr. told me to take the timed release version and it gave me the most awful, painful flushing I had ever had. Thru them away. My DIL started taking the "no flush" version and said she didn't have any problems (I think hers was the 150mg) I decided to try again since my cholesterol is up a little and I sure don't want to go to Statins. I bought the 500mg no flush and have been able to take that. I go to the Dr. this month but do't know if I have been taking them long enough to do anything.
Hmm.. thanks for the warning, I'll be sure to watch for it. I tend to flush easily and I didn't notice it with the 150mg time released I took yesterday, but I wanted to take a more therapudic dose, so I picked up the 500mg today to try.
Ok I started the 500mg time released niacin yesterday and I took it before lunch. I had a South Beach turkey and bacon wrap meal and about 45 minutes later, I felt itchy and like I do before I get hives(I didn't "flush" or get hives, just had that itchy feeling -all over my face and upper chest).
So today I took one then had lunch which was Healthy Choice polish sausage, cabbage and sliced cucumbers and again, about 45 minutes later I had the same itchy feeling.
So I don't know if it's the Niacin or the processed meats!
Tomorrow I will skip ant processed meats and take the Niacin and see what happens...
My nutrition book from college says the RDA of niacin is 14-16 mg per day and daily value on food is 20 mg.
It also says niacin begins to become toxic at 35 mgs of the nicotinic acid form, especially when intakes are above 100 mg per day.
Every 60 mg of the amino acid tryptophan is metabolized into about 1 mg of niacin, so seems like 500 mg plus food sources would be a little on the high side. (30 mg synthsized plus food sources)
Turkey is one of the food sources for niacin with 5.4 mg per 3 oz
Other food sources of niacin:
tuna, roasted chicken, peanuts, salmon, ground beef, raw mushrooms, lean steak, chunky peanut butter, beef liver, raise nut brain cereal, tortilla, cod, potato, halibut
Thanks for the info, Peskie!
I read another article that said the itching is probably the niacin. It said that niacin is water soluable, but that the time released may build up in the liver.. so much confusing info! So you take high doses(1-1.5g) a day and it will help your cholesterol, but may cause liver problems... you can take the lower dose (150-500mg) and it *may* help cholesterol but may not harm your liver. :stars:
Definition of Niacin
Niacin is a water-soluble vitamin that is part of the B-vitamin family. It is found in nuts, eggs, dairy products, fish and enriched breads.
Description of Niacin
Nicotinic acid, the water-soluble vitamin also known as niacin, has been used for many years as a cholesterol-lowering drug. It is considered a drug of first choice because it is safe and effective and has been shown to reduce the risk of heart attack.
Niacin lowers total and LDL cholesterol, as well as triglycerides, and raises HDL-cholesterol as well. Niacin can lower LDL cholesterol levels as much as 30 percent. It is also the least expensive cholesterol-lowering drug.
To produce such lipid lowering, niacin is given in therapeutic doses of one and one half grams (1,500 mg) daily or more; doses of up to six grams have been used in clinical studies. Therapeutic doses usually do not exceed 3 grams daily.
Since niacin can cause severe redness and itching of the skin, therapy is usually begun with small doses and gradually increased. An aspirin given one half hour before the drug helps to reduce flushing. In addition, flushing and itching are lessened if the drug is taken on a full stomach, or if a timed-release preparation is used.
It is also helpful to begin the therapy on a non-working day to avoid any potential embarrassment that may occur from the flushing, which gradually diminishes as the body adjusts to the drug.
Dosage And Side Effects
One of the major disadvantages of niacin is that toxic effects may occur when the drug is given in therapeutic doses. These effects include:
Mild inflammation of the liver
High levels of blood sugar or uric acid (which causes gout)
A darkening of the skin
These effects are easily reversed when the dosage of the medication is lowered. Careful monitoring and supervision by a physician is therefore essential for patients who take niacin.
Although niacin is available in drug stores without a prescription, no one should ever take this drug in therapeutic doses without medical supervision.
Individuals who have had serious liver disease, gouty arthritis, peptic ulcer, gout or significant abnormalities of heart rhythm should not take niacin.
Sustained Release And Instant Release Niacin
The side effects of itching and flushing are minimized when taking sustained-release niacin, which allows the drug to enter the bloodstream more slowly.
However, a new study comparing two generic versions of niacin, a conventional immediate-release (IR) form and a sustained-release (SR) preparation showed that the lower rates of flushing for the SR preparation may be offset by its effect on liver function.
In the trial, 46 adults with elevated cholesterol levels were randomly assigned to take either IR or SR niacin in dosages that increased from 500 mg per day to 3 grams per day. In addition, they followed a diet that restricted saturated fat and cholesterol.
The good news for the SR niacin users was that their total cholesterol levels were lower than in patients who took the IR preparation. Also, at a dosage of 1,000 mg per day, only 22 percent had flushing, tingling, headache, warmth, or itching with SR niacin, versus 53 percent with the IR medication.
The bad news is that the patients who took the SR niacin were more likely to develop abnormalities of their liver function, which occurred with dosages as low as 1,000 mg per day. These abnormalities caused more than half of the patients taking the SR niacin to withdraw before completing the study. IR niacin did not appear to have any such effects, although other studies have shown that IR niacin can also cause serious liver-function abnormalities.
The results of this study should not lead people to discontinue taking an SR preparation that has been effective and is not causing side effects. There are a wide range of sustained-release preparations, with varying degrees of complications and effectiveness, and patients should not generalize about these agents.
Both SR and IR niacin preparations are available without prescription, and these data provide a reminder that over-the-counter drugs, like all drugs, can have side effects, and that niacin can cause liver abnormalities.
Patients taking niacin - whether IR or SR preparations - should undergo liver function tests. Before starting or stopping either form of niacin, patients should discuss the issue with their physicians.
Questions To Ask Your Doctor About Niacin
Do my cholesterol levels indicate a need for niacin?
What is the recommended dosage of niacin for me?
Should I take immediate-release (IR) or sustained-release (SR) niacin?
Will I experience side effects such as flushing and itching?
How can I cope with the discomfort?
Will you do periodic liver function tests?
What improvement in my lipids can I expect over a period of time?
Dottie, several things...
First of all, the timed release niacin I took (Niaspan) said in the directions to take right before bed. I think the goal is to delay the flush until you are asleep. What you described is definately the flush. That being said, here's my story.
In January, my doctor wanted to put me on Lipitor because of my high cholesterol. (Total ~270, LDL ~210). I said no and asked to try niacin instead. She prescribed Niaspan (a timed release). I was to start on 500 mg a day for a week. Then go to 1000 mg for a week. Then 1500 mg for a week. Somewhere in here I ran out of Niaspan and bought some flush-free niacin (500 mg). I continued the dosage from where I left off. I eventually worked up to 2000 mg a day.
My doctor monitored me the whole time for both cholesterol levels and a liver panel. At my last check, my cholesterol had improved dramatically. My doctor was VERY impressed. (Total ~ 170 and LDL ~120.) I don't have my lab results with me right now, but I will post the actual numbers when I get home.
I am currently continuing at 1500 mg of flush-free niacin a day. My doctor will continue to monitor my liver panel.
These are from December 2004
My last test in May, after 5 months on niacin:
I will say that the high December reading was much higher than normal for me and I have been wondering what caused it. The only thing I can really think of is I was on a course of perscription ibuprofen last sumer - which can be hard on the liver. I have to wonder if that helped cause the high reading and had to do with the dramatic drop.
Thanks for the info again:)
That's odd that you mention ibuprofen. For about the past 2 months before the blood works that showed my cholesterol high(and one of my liver panel numbers elevated), I had been taking probably 4-6 tylenol a day because of sinus/allergy problems (which were actually blood pressure headaches as I found out!).
Anyway, I mentioned it to the doctor when she said something about the liver test being elevated and she said yes, tylenol and other pain meds can cause the liver tests to be elevated. BUT, she never mentioned cholesterol(whch, ok -the liver produces and regulates cholesterol, right? So that would make sense if my liver was "off" because of the tylenol my cholesterol might be off too, right?).
More to think about. I go back next Monday for another round of blood tests.
3 months ago it was:
Much higher than the last blood test I had 2 years ago but my triglicerides have always been high. I remember going to the ER when I was 19 and it was over 400 way back when I was thin and could eat anything I wanted without gaining. Maybe some people are just genetically prone to high triglycerides?
Oh -I read that niacin can cause blood sugar to rise, too! LOL -it's like we just can't do anything anymore without a backfire somewhere else!
Here is a post about niacin I did over a year ago...hope it helps
The flushing caused by niacin has no bearing on it effectiveness to help reduce cholesterol levels. To be honest with you in order for niacin to be effective you generally have to take about 1.5g to 3g of niacin a day for it to be noticibly effective. Be VERY careful though as sustained release niacin has be linked very strongly to liver damage. This has been proven over and over, so do NOT buy sustained released niacin products, especially if your daily niacin intake exceeds 2 grams. Also for niacin to work, generally you start a step therapy where you begin at roughly 250 mg to 1 g a day and titrate up to 3 g a day (generally niacin therapy is undertaken for 6-8 weeks and then a fasting lipid profile is taken to gauge overall therapeutic efficacy). If you miss a dose, and this is very important, you must start your step therapy over again! You cannot just resume the normal dose where you were at. Talk to you md before starting a niacin regimen. Also you can combat the flush of niacin by taking an aspirin 30 minutes before the niacin.
Best of luck,
Doctor of Pharmacy (PharmD.) 2006
the itching are histamines. if you take every day , you body will aclimate.
Had a mini stroke, actually 5 of them, starting niacin
what does sustained release mean?
I know there is a flush with niacin and I believe it has to do with the niacin taking the toxins out of the body. It evens out after a while.
I took flush free niacin and it didn't help. I switched to slo-niacin but quit when I had a bad flush that woke me up (I took before bed). Scary way to wake up.
I gave up on niacin and started garlic capsules, cinnamon capsules, and eating lots of flax. Saw major improvement in triglycerides and increase in hdl.
I tried regular niacin as well but the flush was beyond ridiculous. My whole body would be beet red and my face would be squished as if I had pressed my face into a window. People could see it happen right in front of them. I stopped and was having flashback flushing even weeks after I stopped taking it.
I thought I was going to die! It has now been hours ago and my face is still burning. Glad you posted this as I thought I was going crazy.:mad:
Well I decided to give it ago again as the dr has now prescribed statins. I cut the pill in half and the flushing takes longer to start and but finishes faster now. Yesterday I overate on my evening meal and took the pill while eating. First time I didn't have any flushing. Noticed previously that if I took it with something light like soup the symptoms where overwhelming. Stuck between a rock and a hard place if I have to choose between overeating and taking niacin or suffering the flushing/squish.
I also do not want to take statin drugs :annoyed:
I took Slo-Niacin 750 mg, faithfully, for three months without having any flushes. No problems with it......
My brothers doctor advised him to take plain aspirin, and wait an hour, than take the Niacin. Its suppose to help with the flushes......
I take my BP, and BS meds, with plain aspirin at 8 pm each evening with food.
An hour later I take my vitamins, along with the Slo-Niacin......
One night I forgot to take my magnesium, and Slo-niacin.....I got up at midnight to get a drink of water, and saw the two sitting on top of the microwave, and I immediately down them with my drink of water, and went back to bed.....
I woke up at 7am the next morning.....I was thinking about how good I was feeling, losing this weight, and thinking I haven't felt this good in forever :clap:
Then it hit me :sick: The itching, the heat, the red face :o My face, lips, cheeks, all went numb and tinglely....I remember my brother telling me what happen to him, so I knew what was happening to me, and I didn't panic....
I then realize :confused: I took the Niacin without food, and without taking an aspirin in advance.....when I talked to my doctor about this, she said I was taking fish oil, and she told me, don't take the niacin....hmmm :rolleyes:
My next office visit will be in November for blood work.....We'll see just what my results will be :aprayer:
I also take my vitamins, meds with 2 slices rolled up turkey lunchmeat in the evenings.....as turkey helps with sleep, and is low in carbs :love:
Niacin and then some
You can take Niacin between 1 - 1.5 grams daily as a healthy way of helping regulate your cholesterol. I would also recommend some other items to consider either as alternatives or even in conjunction to the Niacin if you ware concerned about cholesterol and heart health. And yes, a dose of aspirin approx 1 hour before taking the Niacin often greatly reduces the flushing of higher doses of Niacin. Don't forget that Niacin should be increased over time. Do not just rush into 1.5 grams and think it won't flush you even with aspirin. Start at 500mg and work your way up over 6-8 weeks.
Here are some things to consider.
Red Rice Yeast 1200 - 2400mg daily
Red Rice Yeast is a statin rich supplement which can be an herbal jump starter to raise your HDL and/or lower your LDL numbers.
Co-enzyme Q10: 100 - 300mg daily
Co-enzyme Q10 or just "CoQ10" is an essential compound used in the electron-transport chain which is in the final step of ATP-synthesis following the Citric-Acid or TCA Cycle in the mitochondria of your cells. In other words, it's good for you! I have read studies that show that higher intake levels of Niacin can 'sometimes' have a slightly adverse effect on your levels of CoQ10 in the body. Supplementing your Niacin intake with 100 - 300mg of CoQ10 daily is not a bad thing. (Talk to your PCP)
Fish Oil: So much is often said about fish oil, I highly recommend Pharmax brand Fish Oil. You get a big dose of both EPA and DHA with a combined total of Omega-3's of 562mg per pill. (I take 5 daily)
Any combination of these is a great supplement to your daily diet. Always remember that supplementation, no matter how awesome it is, does not substitute good physical fitness and proper diet, the number one fixers for heart health. I am considering posting some fitness routines etc on another thread here for those who are interested.
This is getting long but one more thing to pass on here that I cannot stress enough. DRINK WATER! I pound down 2 - 3 Liters a day, and I always say, if you want to move fat, you gotta move water. Sometimes a high water intake with a healthy diet has such a profound effect on your weight alone it will shock you.
Long time User of Niacin
I have been taking niacin for many, many years with the approval of my doctor. I take a product called Endur-Acin that I buy on line. I have found it to be less expensive that other brands. It comes in different sized containers and dosage. I buy the 500 mg with 1000 in a bottle. I have always taken 2 tablets a day with what little breakfast I eat. Usually a cup of coffee, a breakfast roll and a banana. If you search the name Endur-Acin you will find the site. I have always taken a statin drug to aid in the cholestrol reduction and between the two, every test comes out great. However, I have been getting very tired while golfing and one of my friends said the statin drug I was taking was probably the reason. So, I am increasing the niacin to 2500 and eventualy 3000 mg per day and have dropped the statin. I have never felt a "flush" with this product except for one time I took it on an empty stomach and that was not really that bad and was finished in about 15 minutes. I have read that taking an asprin prior to the niacin is also helpful. But food in the stomach is the real answer. With each blood test I have always asked my doctor about the liver and kidney readings and they have always been good. Go for it! :jumpjoy:
Here is a niacin chlosterol study you may want to look at it seems taking niacin may not ne all that good after all.
Niacin Won't Help, May Harm Heart Patients: Study - Drugs.com MedNews
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