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Home > Anti-aging Research > Niacin
Niacin
Note: I see a lot of orders for no-flush niacin.
I assume the reason people are buying this is to raise HDL cholesterol. I
couldn't find any research that no-flush niacin works to increase HDL.
It's probably a waste of money for the no-flush. Just do a Medline search of
hexanicotinate HDL,
hexaniacinate HDL or
no-flush niacin. Here are the the only studies I could find:
Accumulation of chylomicron remnants and impaired vascular reactivity
occur in subjects with isolated low HDL cholesterol: effects of niacin
treatment - Atherosclerosis. 2006 Jul;187(1):116-22 -
"evaluation of no-flush niacin treatment ...
Twenty-two low HDL subjects with reduced FMD were randomized into two
groups, one given 1.5 g/day niacin and a placebo group. After 3-month
treatment, plasma lipids and chylomicron kinetics were not changed by
niacin treatment"
Varying cost and free nicotinic acid content in over-the-counter niacin
preparations for dyslipidemia - Ann Intern Med. 2003 Dec
16;139(12):996-1002 - "Commonly used
over-the-counter niacin preparations (500-mg tablets or capsules) from
the 3 categories of immediate-release, sustained-release, and no-flush
were purchased at health food stores and pharmacies and from
Internet-based vitamin companies ... The average content of free
nicotinic acid was 520.4 mg for immediate-release niacin, 502.6 mg for
sustained-release niacin, and 0 for no-flush niacin ... No-flush
preparations of over-the-counter niacin contain no free nicotinic acid
and should not be used to treat dyslipidemia. Over-the-counter
sustained-release niacin contains free nicotinic acid, but some brands
are hepatotoxic. Immediate-release niacin contains free nicotinic acid
and is the least expensive form of over-the-counter niacin"
http://www.lipidsonline.org/slides/slide01.cfm?tk=25&dpg=34 shows that
with extended release niacin, HDL
peaks out at 2,500 mg.
http://www.lipidsonline.org/slides/slide01.cfm?q=effect+of+niacin&dpg=4
shows immediate release crystalline niacin compared to Niaspan. There
isn't much gain in HDL with the immediate release crystalline niacin after 1,000
mg per day. After seeing that, I'll probably cut down from 3,000 mg but
from the slide it appears that there is a significant advantage to lowering
triglycerides by going to 3,000 mg plus there is a linear decrease in LDL-C by
going to 3,000 mg immediate release crystalline niacin. This graph also
shows that immediate release crystalline niacin is significantly better at
raising HDL and lowering triglycerides compared to Niaspan. Also see the
slide titled
CHD Risk
According to HDL-C Levels.
I’ve never seen any studies on Niaspan and liver damage
but it would seem like it would be similar to the slow release niacin.
The only study I’ve seen on that is:
A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients - JAMA. 1994 Mar 2;271(9):672-7 -
"None of the patients taking IR niacin developed hepatotoxic effects, while 12 (52%) of the 23 patients taking SR niacin did"
Be sure to see a doctor to have your liver enzymes checked before and
after taking any niacin supplement. See the bottom of
http://www.lipidsonline.org/slides/ for some great slide shows on HDL.
The
January 2007 Harvard Men's Health Newsletter has a good article on
HDL cholesterol but it is a paid subscription. See
Source Naturals 100 mg niacin at iHerb
and
Twinlab niacin 1000mg at iHerb.
Related Topics:
Specific Recommendations:
Related products that also may increase HDL:
General Information:
- Niacin - The Natural Pharmacist
- "When used as therapy for a
specific disease, niacin, niacinamide, and inositol hexaniacinate are taken
in dosages much higher than nutritional needs, about 1 to 4 g daily. Because
of the risk of liver inflammation at these doses, medical supervision is
essential"
-
Niacin (Vitamin B-3), Niacinamide - Intelihealth -
"Thyroid function may also be impaired while taking niacin. Periodic monitoring of thyroid
function is recommended ... Studies have used one to four grams of niacin
daily for treating clogged arteries or heart disease"
-
Extended-Release Niacin and Hyperlipidemia Management - November 15, 2000 -
American Academy of Family Physicians - aafp.org -
"Niacin can lower LDL cholesterol by
10 to 25 percent and triglyceride levels by 20 to 50 percent, and can raise
levels of high density lipoprotein (HDL) cholesterol by 15 to 35 percent ...
The daily niacin dosage was started at 375 mg taken nightly and slowly
increased, to a maximum of 3,000 mg per day, at four-week intervals for a
total of 25 weeks. Patients were permitted to take 325 mg of aspirin before
taking the study medication if they wished to prevent flushing ... The dose
response demonstrates a linear effect, with maximal benefit at a dosage of
approximately 2,500 mg, although the maximum recommended dosage of
extended-release niacin is 2,000 mg"
-
Niacin - A New Look at an Old Drug - U.S. Pharmacist, 10/15/03 -
"In one study, up to 53% of patients treated with IR
niacin reported flushing, compared with 22% in the SR niacin group; four of
the 23 IR-treated patients (17%) withdrew because of flushing. However, 67%
of patients discontinued SR niacin therapy because of liver enzyme
elevations (three times the upper limit of normal), and 52% of patients
developed hepatotoxic symptoms; however, no patients treated with IR niacin
developed significant changes in liver enzymes ... Because the incidence and
severity of flushing often decreases with continued use—sometimes
dissipating altogether—stress that any interruptions in therapy may lead to
losing any tolerance" - Note: I've been taking two grams of the
TwinLab immediate release niacin for years and I don't get any flush from it
if I take it with a little food. - Ben
-
A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients - JAMA. 1994 Mar 2;271(9):672-7 -
"None of the patients taking IR niacin developed hepatotoxic
effects, while 12 (52%) of the 23 patients taking SR niacin did"
News & Research:
-
Low
Levels Of Good Cholesterol Linked To Memory Loss, Dementia Risk - Science
Daily, 6/30/08 - "Researchers defined low HDL as less than 40 mg/dL ... At age
60, participants with low HDL had a 53 percent increased risk of memory loss
compared to the high HDL group" - [WebMD]
- The best way to increase HDL is niacin.
See
Twinlab niacin 1000mg at iHerb.
Start slow maybe even with the 100 mg capsules. It took me about three months to get immune to the flush from
2000 mg per day. Taking it with soup seems to be the best.
-
Niacin's Role In Maintaining Good Cholesterol - Science Daily, 6/5/08
-
Combination Niacin-Laropiprant Plus Simvastatin Reduces Cholesterol by
Almost 50% - Doctor's Guide, 11/6/07 - "When
patients with dyslipidemia added simvastatin to their experimental
combination of extended-release niacin and laropiprant -- a novel
anti-flushing agent -- they reported reductions in low density lipoprotein
cholesterol (LDL-C) of as much as 48% from baseline ... high density
liopoprotein cholesterol (HDL-C) was increased by 28% and triglycerides
decreased by 33%"
-
New Combination Drug Improves Multiple Cholesterol Disorders in Single Pill
- Doctor's Guide, 11/5/07 - "Simcor combines
prescription niacin and simvastatin, two FDA-approved medications with
established safety profiles, to target good cholesterol (HDL), bad
cholesterol (LDL), and triglycerides in a single pill" - Sounds
stupid to me. Why would you pay prescription drug prices for something
that is dirt cheap like niacin. It is the Niaspan form of niacin,
which they claim has less flush. I tried Niaspan and couldn't tell any
difference in the flush plus the flush eventually stopped even with
immediate release niacin. Plus I worry about increased liver damage
with Niaspan.
Click here for the study that concerns me which was sustained release
niacin, not Niaspan but it would seem to be similar. Plus immediate
release niacin is about 20% more effective at raising HDL than Niaspan.
Click here and note where Niaspan is on the graph. I'm just eye
balling the 20%.
-
Merck Niacin Drug Controls Cholesterol - Intelihealth, 9/5/07 -
"The drug, called Cordaptive, can both raise good
cholesterol and lower bad cholesterol. It combines an extended-release form
of the B vitamin niacin with a chemical to inhibit an often intolerable
niacin side effect called flushing -- redness, burning and tingling of the
face ... compared with dummy pills, Cordaptive produced an 18 percent drop
in levels of LDL-C, or "bad" cholesterol; a 26 percent drop in another type
of blood fat called triglycerides, and a 20 percent increase in levels of
HDL-C, or "good" cholesterol"
-
Niacin (Nicotinic
Acid) -- The Old Drug Is Making a Comeback With A New Act - Medscape,
6/11/07 - "Niacin (nicotinic acid) is well known as the
most effective drug currently available for raising levels of high-density
lipoprotein (HDL) cholesterol, raising it by 25% to 35% at the highest
doses"
-
FDA
Approvals: Veramyst, Niaspan, and HepaGam B - Medscape, 5/9/07 -
"Film-Coated Niacin Extended-Release
Caplets (Niaspan) May Reduce Flushing ... use of the new orange-coated
formulation significantly reduced the incidence of flushing by 9%"
-
Combining Agents Leads to Safe Treatment of Lipid Abnormalities -
Physician's Weekly, 5/7/07 - "Combining the use of statins and niacin should be encouraged because it
appears to safely treat multiple lipid abnormalities in appropriate
high-risk patients"
-
Improving Outcomes With HDL Cholesterol - Physician's Weekly, 4/9/07 -
"Patients who have high HDL levels
appear to have better protection against vascular disease than others and
some variants of HDL may actually reduce plaque in the coronary arteries.
Essentially, HDL acts as a scavenger compound; it moves the lipids from the
blood vessel to the liver, where they are then excreted from the body ...
Currently, in the United States, the only medication other than statins
designed specifically to help physicians raise the HDL cholesterol levels in
their patients is niacin"
-
An Old Cholesterol Remedy Is New Again - New York Times, 1/23/07 -
"In its therapeutic form, nicotinic
acid, niacin can increase HDL as much as 35 percent when taken in high
doses, usually about 2,000 milligrams per day. It also lowers LDL, though
not as sharply as statins do, and it has been shown to reduce serum levels
of artery-clogging triglycerides as much as 50 percent ... There’s a great
unfilled need for something that raises HDL ... Right now, in the wake of
the failure of torcetrapib, niacin is really it. Nothing else available is
that effective" - See
Twinlab niacin 1000mg
at iHerb
 .
-
Gene
Tied To Longevity Also Preserves Ability To Think Clearly - Science Daily,
12/26/06 - "Centenarians were three
times likelier to possess CETP VV compared with a control group representative
of the general population and also had significantly larger HDL and LDL
lipoproteins than people in the control group ... Researchers believe that
larger cholesterol particles are less likely to lodge themselves in blood
vessels" - Could niacin do the same thing? See:
-
Prolonged-Release Nicotinic Acid Combined With a Statin in NAUTILUS -
Medscape, 10/19/06 - "The safety and
tolerability profiles of prolonged-release nicotinic acid did not differ in
patients who were and were not taking a statin. In particular, there was no
sign of serious hepatic or muscle toxicity in patients receiving
prolonged-release nicotinic acid with a statin. The addition of
prolonged-release nicotinic acid to a statin raised levels of HDL
cholesterol"
-
Comparative Effects on Lipid Levels of Niaspan and Statins - Medscape,
7/28/06 - "Niacin is the best
HDL-cholesterol raising drug right now"
-
Niacin Extended-Release Tablets Combined With Low/Moderate Dosed Statin
Achieves Better Total Lipid Control Versus Higher Dose Statin Monotherapy or
Simvastatin and Ezetimibe - Doctor's Guide, 6/22/06 -
"patients given Niaspan in
combination with a low to moderate dose of Lipitor or Crestor achieved
equivalent reduction in LDL-C (51-58%), 1.2 to 1.9-fold greater decreases in
triglycerides and 2.5 to 3.5 fold greater increases in HDL-C, than patients
who received high-dose Crestor or Zocor/Zetia"
-
Aspirin for Preventing Flushing from Niacin - Medscape, 6/13/06 -
"the impact of flushing can be minimised by careful dose escalation, administering 'extended-release' NA at
bedtime, administering ASA 30 min before 'extended-release' NA and avoiding
alcohol or hot drinks near the timeof administration"
-
Hypertriglyceridemia - Medscape, 6/1/06 -
"ER niacin has been shown to lower
the triglyceride level by ~25% and raise the HDL level by almost 30%"
-
About 5% of Long-term Niacin Users Evolve Into HDL Hyperresponders -
Doctor's Guide, 3/14/06 - "about 5%
of patients on long-term therapy become hyperresponders, increasing their
HDL levels by 50% or more ... Overall, these patients lost 4% of body weight
while on niacin treatment"
-
Combination Treatment Shown for First Time to Cause Regression of
Atherosclerosis - Doctor's Guide, 11/16/05 -
"reversal of atherosclerosis - a
primary cause of stroke and heart attacks - can be achieved with a
combination of Niaspan (prolonged-release nicotinic acid) and a statin ...
ARBITER 2 clearly showed that statins alone are not enough to halt the
progression of atherosclerosis even when the LDL-C target is met. However,
the addition of Niaspan 1000 mg stopped the progression of atherosclerosis
in 12 months ... a further 12 months of treatment with Niaspan and a statin
actually achieves regression of atherosclerosis"
-
Adding Niacin to Lovastatin Therapy Might Improve Efficacy for Dyslipidemia
- Doctor's Guide, 10/5/05 - "Niacin
has been shown to be one of the most effective drugs for improving levels of
high-density lipoprotein (HDL) cholesterol, or good cholesterol ...
Combining the best LDL lowering and best HDL raising drugs makes sense"
-
Can
Niacin Slow the Development of Atherosclerosis - Medscape, 5/20/05 -
"Extended-release niacin slowed the
development of atherosclerosis in adults with coronary artery disease,
independently from statin therapy"
-
The Effects of Niacin on Lipoprotein Subclass Distribution - Medscape, 1/19/05 -
"the combination of niacin and a statin may be among the best available treatment
options for many patients with complex forms of dyslipidemia ... Niacin effectively modifies all major lipids and lipoproteins with respect to both their quantity and quality. It is the most effective
agent currently available for raising low levels of HDL cholesterol"
-
Two-Pronged Cholesterol Approach Works - HealthDay, 11/11/04 -
"Niacin is the most effective treatment to treat low HDL
... Overall, combining niacin with a statin slowed disease progression 68 percent more than a statin alone. The combination treatment also resulted in a 60 percent reduction in heart attacks, deaths, strokes, and other coronary events"
-
Niacin in Diet May Prevent Alzheimer's - WebMD, 7/14/04 -
"those who got the least niacin were 70% more likely to develop Alzheimer's
disease than those who got higher amounts ... Those at the study's highest niacin level were getting 45 mg per day in diet and supplements"
-
Niacin Extended-Release/ Lovastatin Combination Effective in Patients with Multiple Lipid Disorders - Doctor's Guide, 4/23/03 -
"Treatment by niacin ER/lovastatin was found to be more effective than each of its components, showing improved levels of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG)" - Note: Niacin usually increases HDL
(the good cholesterol) much more than statins. From my own experience and from taking to others, it seems like many physician's may ignore low HDL.
-
Statins May Cut Alzheimer's Risk - HealthDay, 4/21/03 -
"extended-release niacin reduced brain cholesterol levels by 10 percent" - Note: Red yeast rice
is a non-prescription statin but you should still check with your physician. See
iHerb
or
Vitacost
red yeast rice products.
- Raising HDL-C Levels Slows CAD Progression and Reduces Mortality - Medscape, 4/3/04 -
"Results of two studies of high-density lipoprotein
cholesterol (HDL-C)-targeted therapies indicate that attacking heart disease by increasing HDL-C levels appears to slow progression of atherosclerosis and reduce mortality ... Although the protective effect of HDL-C is well known, "most researchers ignore this fact," said Henrietta Reicher-Reiss, MD, from Sheba
Medical Center in Tel Hashomer, Israel. It is a costly oversight since "about half of heart attack victims have normal [low-density liprotein cholesterol (LDL-C) levels]," ... drugs designed to target HDL-C have a number of adverse effects. Niacin, for example, causes flushing, and fibrates are associated with
gastrointestinal side effects. That side-effect profile might be a factor against this approach. Statins, on the other hand, tend to be very well tolerated"
-
Vitamin K and niacin good for complexion, experts say - HealthDay, 3/26/03 -
"Vitamin K was found to be successful in treating dark circles under the eyes.
It's also been found effective for treating bruising on the face following dermatologic procedures such as laser treatment for spider veins ... Niacin shows promise as an over-the-counter ingredient in anti-aging products"
-
Alzheimer's Disease and Dementia: Vitamins Can Help Prevent - WebMD, 2/28/03 -
"High levels of a substance in the blood called
homocysteine tops the list of potentially new risk factors for heart disease, stroke, and now dementia. A new study suggests that high homocysteine levels are linked with mental
declines associated with Alzheimer's disease in elderly people ... High homocysteine levels can be treated very easily with vitamins, including folate, niacin, and B-12"
-
Statin-Niacin Combination Counters Dyslipidaemic Cardiovascular Risk - Doctor's Guide, 12/20/02 -
"Combined
statin-niacin is a safe, tolerated therapy that lowers low density lipoprotein cholesterol and raises high density lipoprotein cholesterol ... At niacin doses of at least 1000 (mean 1480) mg/day added to a constant statin regimen in 29 patients, high density
lipoprotein cholesterol rose significantly (by 20 percent)"
-
Niacin Appears Safe for Treating Patients Who Have Diabetes and High Cholesterol - Doctor's Guide, 11/21/02
- Extended-Release Niacin Safe, Effective in Type 2 Diabetes - Medscape, 7/26/02
-
Niacin May Be Effective Therapy For Broad Range Of Diabetes-Associated Dyslipidaemias - Doctor's Guide, 7/25/02 -
"After
niacin treatment, the patients' LDL peak particle diameter increased from 252 ± 7 Ĺ to 263 ± 7, the researchers reported. Their small, dense LDLc
particle mass decreased from 27 ± 11 mg/dL to 15 ± 4 mg/dL. Total
HDLc increased from 39 ± 7 mg/dL
to 51 ± 11 mg/dL. Their HDL2, as the percentage of total HDLc mass, increased from 29 ± 8 percent to 45 ± 10 percent, and their
Lp(a) decreased from 43 ± 17 mg/dL to 25 ± 10 mg/dL
... Twenty-one percent of the patients were unable to tolerate niacin because of reversible adverse effects. Another 14 percent were unable to adhere to the niacin dosing regimen of three times daily"
-
'Advent' Study Highlights Safety And Efficacy Of Niaspan (Niacin) In Diabetic Patients - Doctor's Guide, 7/22/02
-
Niacin Helps Hearts - Nutrition Science News, 11/01
-
question
regarding your new cholesterol-lowering supplement, Policosanol - Life Extension Magazine, 11/01 -
"Studies show that niacin (B3) in doses of 1.5 grams to 3 grams lower triglycerides levels and raise HDL
concentrations. Those who tolerated higher doses of niacin (nicotinic acid) showed even more improvement in lipid levels. Some people taking just 1000 mg of flush-free niacin see an elevation in beneficial HDL. Green tea also has been shown to elevate levels of HDL while
lowering serum triglyceride levels. In the Journal of Molecular Cell Biochemistry, curcumin has been demonstrated, in vivo, to decrease triglycerides and increase HDL. In a study published in 1989 by the Journal of Associated Physicians-India, 125 patients receiving
gugulipid showed a drop of 16.8% in triglycerides, and a 60% increase in HDL cholesterol within three to four weeks. Make sure you are taking at least six Mega EPA fish oil capsules daily, as low dose fish oil may not adequately suppress triglycerides.
Finally, there are some lifestyle changes you may wish to consider. If you are overweight, weight loss would be recommended, as it would help to lower triglycerides and raise HDL. Also, try reducing carbohydrates, which can raise triglycerides"
-
Laboratory Investigations of Erectile Dysfunction - WebMD -
"men with erectile dysfunction frequently have low levels of high-density lipoproteins, the good form of
cholesterol." (niacin raises HDL)
- Antioxidant Supplements Lessen Response To Cholesterol Drugs - Doctor's Guide, 8/10/01
- Baycol (Cerivastatin) Not To Be Used In Combination With Gemfibrozil, Says Bayer - Doctor's Guide, 7/25/01 -
"Statins are known to cause a rare side effect of muscle
breakdown ... In a very small percentage of patients, there is a risk of muscle breakdown resulting in kidney damage, which in rare instances can lead to life-threatening kidney failure ... The risk of muscle breakdown is greater in patients taking gemfibrozil as well as other fibric acid derivatives (a group of
cholesterol-lowering drugs), cyclosporine (an immunosuppressant), erythromycin (an antibiotic), azole antifungals, or lipid-lowering doses of niacin (nicotinic acid) together with statins including cerivastatin."
- Niaspan (Niacin Extended Release) Superior To Gemfibrozil in Raising "Good" Cholesterol - Doctor's Guide, 5/15/00
-
Integrated Health Care: Applying Best Practices From Two Medical Models - Nutrition Science News, 5/01 -
"Many alternative
care practitioners utilize a "non-flush" version of niacin, called inositol hexaniacinate, instead of regular
niacin. This form of niacin does not have the flushing side effect of regular niacin (which can force patients to discontinue use) and is considered safer than niacin"
-
Parkinson's Defense - Nutrition Science News, 5/01
- Niacin Reduces Triglycerides, Increases Good Cholesterol In Diabetics - Doctor's Guide, 3/20/01 -
"There had been concern that niacin use in diabetic patients might increase blood sugar
levels ... but we didn't see that in our study ... Patients were randomised to receive placebo, 1,000 mg of niacin or 1,500 mg of prescription niacin ... Patients taking the active agent increased high-density lipoprotein (HDL) cholesterol by 20 to 24 percent compared with a 4 percent increase among the placebo
patients. At the same time, triglycerides were reduced 15 to 29 percent in the patients on niacin compared with a 5 percent reduction among patients taking placebo"
- Nicostatin (Niacin/Lovastatin) Reduces Cholesterol, Triglyceride Levels - Doctor's Guide, 3/16/00
-
At the Counter with Dan Lukaczer, N.D., Niacin Good for Diabetics - Nutrition Science News, 3/01
- Niaspan (Niacin Extended Release Tablets) Safe And Effective For Diabetics - Doctor's Guide, 11/14/00
- Statin Plus Niacin Reduces Heart Attack Risk, Reverses Arterial Build-up - Doctor's Guide, 11/13/00
-
Research Reveals Soy, Niacin, and Tea Offer Protection From Heart Attack and Stroke - WebMD, 11/13/00
- Niacin Safe And Effective For Cholesterol Lowering In Diabetics - Doctor's Guide, 9/14/00
-
Niacin Is Safe for Diabetics With High Cholesterol, Study Shows - WebMD, 9/12/00
- Niaspan (Niacin Extended Release) Superior To Gemfibrozil in Raising "Good" Cholesterol - Doctor's Guide, 11/15/00
- Nicostatin (Niacin/Lovastatin) Reduces Cholesterol, Triglyceride Levels - Doctor's Guide, 3/16/00
- Niaspan (Niacin Extended-Release) Raises HDL Twice As Much as Gemfibrozil - Doctor's Guide, 3/14/00
- Gemfibrozil-Niacin Combination Greatly Increases Good Cholesterol - Doctor's Guide, 3/10/00
-
Niacin for Achy Joints - Nutrition Science News, 11/99 -
"niacinamide at 3 g/day reduced overall disease severity by 29 percent, inflammation by 22 percent
and use of anti-inflammatory medication by 13 percent."
-
Sidestep Heart Disease - Nutrition Science News, 5/99
Abstracts:
-
Comparison of the Safety and Efficacy of a Combination Tablet of Niacin
Extended Release and Simvastatin vs Simvastatin Monotherapy in Patients With
Increased Non-HDL Cholesterol (from the SEACOAST I Study) - Am J Cardiol.
2008 May 15;101(10):1428-36 - "The efficacy and
safety of 2 regimens of a combination of a proprietary niacin extended
release plus simvastatin (NER/S; 1,000/20 and 2,000/20 mg/day) were compared
with simvastatin monotherapy (20 mg/day) for 24 weeks ... The safety of
NER/S was consistent with the safety profile of each individual component.
In conclusion, this study showed that NER/S provided additional clinically
relevant improvements in multiple lipid parameters and was safe and well
tolerated"
-
Effects of niacin on glucose control in patients with dyslipidemia -
Mayo Clin Proc. 2008 Apr;83(4):470-8 - "the effects
of niacin (</=2.5 g/d), alone or in combination with statins, on fasting
glucose (an increase of 4%-5%) and hemoglobin A1c levels (an increase of
</=0.3%) are modest, transient or reversible, and typically amenable to
adjustments in oral hypoglycemic regimens without discontinuing niacin.
Niacin therapy was infrequently associated with incident diabetes or the
need for new insulin prescriptions. Studies showed important clinical
benefits of niacin or niacin-statin regimens despite modest effects on
glucose control. On a population basis, significant reductions in incidences
of cardiovascular events and the degree of atherosclerotic progression
associated with long-term niacin (or niacin-statin) therapy in patients with
diabetic dyslipidemia outweigh the typically mild effects of this therapy on
glycemic regulation"
-
The
flavonoid luteolin inhibits niacin-induced flush - Br J Pharmacol. 2008
Jan 28 - "Sustained release niacin effectively
lowers serum cholesterol, LDL and triglycerides, while raising HDL. However,
75% of patients experience cutaneous warmth and itching known as flush,
leading to discontinuation. Acetylsalicylic acid (aspirin) reduces this
flush only by about 30% ... Quercetin and luteolin (4.3 mg per rat; 1000 mg
per human), administered i.p. 45 min prior to niacin, inhibited the niacin
effect by 96 and 88%, respectively. Aspirin (1.22 mg per rat; 325 mg per
human) inhibited the niacin effect by only 30%. Niacin almost doubled plasma
PGD(2) and 5-HT, but aspirin reduced only PGD(2) by 86%. In contrast,
luteolin inhibited both plasma PGD(2) and 5-HT levels by 100 and 67%,
respectively" - See
quercetin products at iHerb.
-
Increased total and high-molecular weight adiponectin after extended-release
niacin - Metabolism. 2008 Mar;57(3):404-9 - "at
least part of the cardioprotective benefits of niacin may be attributed to a
shift in the HMW/LMW adiponectin ratio in
obese men with the metabolic syndrome"
-
Preferential increase in high-molecular weight adiponectin after niacin
- Atherosclerosis. 2007 Nov 7 - "treatment with
niacin raises adiponectin between 52% and 95% in patients with the metabolic
syndrome"
-
Adiponectin definition - medterms.com -
"High blood levels of adiponectin are associated with a reduced risk of
heart attack. Low levels of adiponectin are found in people who are
obese (and who are at increased risk of a heart attack)."
-
The effects of extended-release niacin on carotid intimal media thickness,
endothelial function and inflammatory markers in patients with the metabolic
syndrome - Int J Clin Pract. 2007 Nov;61(11):1942-8 - "After
52 weeks of treatment, there was a change of carotid IMT of +0.009 +/- 0.003
mm in the placebo group and -0.005 +/- 0.002 mm in the niacin group (p =
0.021 between groups). Endothelial function improved by 22% in the group
treated with niacin (p < 0.001), whereas no significant changes were seen in
the placebo group. High sensitivity C-reactive protein decreased by 20% in
the group treated with niacin for 52 weeks (p = 0.013). Niacin increased
HDL-C (p < 0.001) and decreased low-density lipoprotein cholesterol and
triglycerides (p < 0.001) significantly, and there were no adverse effects
on fasting glucose levels after 52 weeks of treatment" - See
Twinlab niacin 1000mg at iHerb
or
Source Naturals 100 mg niacin at iHerb.
-
Safety considerations with niacin therapy - Am J Cardiol. 2007 Mar
19;99(6A):S22-31 - "Overall, the
perception of niacin side effects is often greater than the reality. As a
result, a valuable medication for cardiovascular risk is underused"
-
Aspirin reduces cutaneous flushing after administration of an optimized
extended-release niacin formulation - Int J Clin Pharmacol Ther. 2007
Feb;45(2):78-88 - "Aspirin
significantly reduced the incidence, intensity and duration of flushing
associated with reformulated niacin ER"
-
Effects of extended-release niacin on lipoprotein particle size,
distribution, and inflammatory markers in patients with coronary artery
disease - Am J Cardiol. 2006 Sep 15;98(6):743-5 -
"Addition of niacin resulted in
a 32% increase in large-particle HDL (p <0.001), an 8% decrease in
small-particle HDL (p = 0.0032), an 82% increase in large-particle LDL
(p = 0.09), and a 12% decrease in small-particle LDL (p = 0.008)"
-
Benefits of Niacin in Patients With Versus Without the Metabolic Syndrome
and Healed Myocardial Infarction (from the Coronary Drug Project) - Am J
Cardiol. 2006 Feb 15;97(4):477-9 - "Niacin decreased the occurrence of 6-year MI and 15-year total mortality
similarly among patients with or without the MS. For example, in the total
population, 15-year total mortality rates were 60% and 64% (hazard ratio
0.86) in patients with the MS treated with niacin and placebo, respectively,
and 50% and 57% (hazard ratio 0.86) in those without the MS ... these
results support the use of niacin in postinfarction patients with and
without the MS"
-
Effect of niacin on lipid and lipoprotein levels and glycemic control in
patients with diabetes and peripheral arterial disease: the ADMIT study: A
randomized trial. Arterial Disease Multiple Intervention Trial - JAMA.
2000 Sep 13;284(10):1263-70 -
"After an active run-in period,
participants were randomly assigned to receive niacin (crystalline nicotinic
acid), 3000 mg/d or maximum tolerated dosage (n = 64 with diabetes; n = 173
without diabetes), or placebo ... Niacin use significantly increased HDL-C
by 29% and 29% and decreased triglycerides by 23% and 28% and low-density
lipoprotein cholesterol (LDL-C) by 8% and 9% ... Glucose levels were
modestly increased by niacin (8.7 and 6.3 mg/dL [0.4 and 0.3 mmol/L]; P =.04
and P<.001) in participants with and without diabetes, respectively ... Our
study suggests that lipid-modifying dosages of niacin can be safely used in
patients with diabetes"
-
New Perspectives on the Use of Niacin in the Treatment of Lipid Disorders - Arch Intern Med, 4/12/04
-
A randomized trial of the effects of atorvastatin and niacin in patients with combined hyperlipidemia or isolated hypertriglyceridemia - Am J Med. 1998
Feb;104(2):137-43
-
Prolonged treatment with slow release nicotinic acid in patients with type II hyperlipidemia - Pol Arch Med Wewn. 1997 Nov;98(11):391-9
-
Dose-response characteristics of cholesterol-lowering drug therapies: implications for treatment - Ann Intern Med. 1996 Dec 15;125(12):990-1000
-
The effect of long-term Enduracin monotherapy on the clinical and biochemical status of patients with ischemic heart disease - Ter Arkh. 1997;69(9):41-5
-
A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients - JAMA. 1994 Mar 2;271(9):672-7 -
"None of the patients taking IR niacin developed hepatotoxic effects, while 12 (52%) of the 23 patients taking SR niacin did. CONCLUSION--The SR form of niacin is hepatotoxic and should be restricted from use. The IR niacin is preferred for the management of
hypercholesterolemia but can also cause significant adverse effects and should be given only to patients who can be carefully monitored by experienced health professionals."
- Fifteen year
mortality in Coronary Drug Project patients: long-term benefit with niacin
- J Am Coll Cardiol. 1986 Dec;8(6):1245-55 -
"Mortality in the niacin group was 11% lower than in the placebo group"
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