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About Niacin

  

About Niacin

Also known as Vitamin B3, niacin has earned a reputation (in supplement form) as a natural cholesterol-lowering agent that often rivals prescription drugs in mild to moderate cases. It may also help to prevent or treat a number of other disorders, from arthritis and depression to diabetes. Three forms of niacin supplements--each with a specific therapeutic role--are commercially available: nicotinic acid (also called nicotinate), niacinamide and inositol hexaniacinate, a compound of niacin and inositol (another B-family vitamin). 

Normally, the body manages to absorb enough niacin from foods to carry out basic functions, working on the cellular level to keep the digestive system, skin and nerves healthy. This vitamin is also critical to releasing energy from carbohydrates and helping to control blood-sugar levels. Interestingly, the body also synthesizes niacin from tryptophan, an amino acid found in eggs, milk and poultry. 

Although few people in the industrialized world are actually deficient in niacin, many may benefit from additional amounts in supplement form to help treat assorted complaints. Keep in mind that each of the three forms of niacin affects the body differently. Niacinamide has notable anti-inflammatory properties, for example, while nicotinic acid and inositol hexaniacinate affect blood lipid levels and circulation.

Vitasunn Niacin is available here in 300mg 120 Vegetarian capsules
Specifically, niacin may help to:

  • Control cholesterol. Unlike most prescription cholesterol-lowering medications, which simply lower levels of LDL ("bad") cholesterol and triglycerides, niacin also raises levels of HDL ("good") cholesterol (1). As a result, this vitamin may prove more potent than conventional medicines in ultimately reducing the risk for a heart attack (and death from a heart attack). In a recent study of people with high cholesterol, niacin not only reduced LDL and triglycerides by 17% and 18%, respectively, but it also increased HDL by 16% (2). Although both nicotinic acid and inositol hexaniacinate have cholesterol-benefiting actions, inositol hexaniacinate is the preferred form--it doesn't cause skin flushing and poses much less risk of liver damage with long-term use.  
  • Prevent complications from heart disease. Niacin may not only lower cholesterol, it may thereby lower a persons risk of cardiac complication overall. As levels of LDL rise, so does a person’s chance of heart attack, stroke, and the disability caused as a result of these conditions. Niacin has been shown to reduce the risk of adverse cardiac event and mortality in patients who suffer from atherosclerosis (3, 4). In a study of 8, 341 men conducted from 1966-1974 niacin was the only lipid lowering agent shown to reduce the rate of cardiac event and mortality (5). Niacin has also been shown to work effectively with statin drugs commonly prescribed for this condition (6, 7, 8). Findings have also shown niacin to reduce the risk of cardiovascular disease when combined with exercise and a low-Fat diet in an at risk population (9). 
  • Combat Raynaud's disease and other circulatory problems. Niacin improves circulation by relaxing arteries and veins, and disorders characterized by circulation difficulties may benefit as a result. In those suffering from Raynaud's disease, for example, niacin's ability to improve blood flow to the extremities may counter the numbness and pain in the hands and feet that occurs when blood vessels overreact to cold temperatures (10). The calf-cramping and other painful symptoms of Intermittent claudication, another circulation disorder, may lessen under the vessel-relaxing influence of niacin as well. The inositol hexaniacinate form of niacin works best for circulation-related discomforts.  
  • Fight depression. Based on niacin's well-recognized role in promoting the sound functioning of nerve cells, some experts recommend the vitamin for relieving depression as well as for soothing feelings of anxiety and panic. Most B-vitamin complexes contain sufficient amounts of niacin for this purpose; as an added plus, the complexes also offer the mood-enhancing benefits of other B vitamins. 
  • Ease symptoms of arthritis and rheumatoid arthritis. The anti-inflammatory properties associated with niacinamide may help in calming joint Inflammation, a frequent cause of rheumatoid arthritis pain. In a double-blind, 12-week study, osteoarthritis sufferers who received niacinamide supplements reported less inflammation and greater joint flexibility than other participants who were given a Placebo. The niacinamide group also required less conventional anti-inflammatory medication to relieve their customary pain and swelling.  
  • Slow progression of type 1 diabetes. High doses of niacinamide, if given at the first signs of the disease, appear to help prevent complications of insulin-dependent diabetes and may even help reverse its development. This complementary supplement treatment should only be undertaken with careful medical supervision, however.  
  • Treat the conditions that contribute to type 2 diabetes. Type 2 diabetes is often a condition that also effects those with high cholesterol and heart disease. Until recently, researchers were not certain if niacin was safe for use by those with type 2 diabetes. Current results confirm that niacin is a safe and effective treatment that may benefit the conditions, like high cholesterol and heart disease that exacerbates type 2 diabetes (11, 12).  
  • Prevent and treat Alzheimer’s disease and age-related decline. A study of 6, 158 participants conducted between 1993 and 2002 showed that dietary intake of niacin may help stave off the ravaging effects of Alzheimer’s disease and dementia (13). More research needs to be done to assess what dosage and length of supplementation are necessary to beat this debilitating condition (14).
     
  • Treat tinnitus. The persistent ringing, humming and buzzing in the ears associated with this condition has been linked to poor blood circulation. By widening blood vessels in the brain, inositol hexaniacinate may help to relieve these and other tinnitus symptoms.  
  • Relieve migraine headaches. A meta-analysis of 9 trials concluded that niacin may be effective in the treatment of migraine headaches (15). While scientists are uncertain as to the direct mechanism of relief, they postulate that the vasodilatory properties may benefit this painful condition.  

The RDA for niacin is 14 mg for women and 16 mg for men. Specific disorders usually require higher doses. 

A deficiency in niacin can result in pellagra, a skin disorder characterized by small patches of dry, scaly irritated skin in sunlight-exposed areas. Other symptoms include loss of appetite and strength, and digestive complaints. Severe cases can involve headache, memory loss and depression. Pellagra is now quite rare in the industrialized world.

It's nearly impossible to get too much niacin from foods. This is not the case with supplements, however. Keep in mind that megadoses can cause serious side effects, such as abdominal cramping, nausea, and vomiting; lightheadedness; ulcers; and skin rashes, flushing or itching. Liver damage is also a risk with long-term use of niacinamide and nicotinic acid. Inositol hexaniacinate in doses higher than 2,000 mg a day may have a blood-thinning effect.

Special tips:
 Most multivitamins and B-complex supplements provide the RDA for niacin. Dosages adequate for treating specific ailments are typically found in individual niacin supplements, however.

--In general, niacin in the form of inositol hexaniacinate and niacinamide tends to cause fewer side effects than nicotinic acid. 

  • For treating high cholesterol, Raynaud's disease, intermittent claudication or tinnitus: Take 500 mg of inositol hexaniacinate three times a day. Continue for two months if your goal is to lower cholesterol. Stop at this point if cholesterol levels haven't improved. 
  • For anxiety or depression: A vitamin B-complex supplement will typically provide the amount of niacin (50 mg a day) necessary for treating these conditions. 
  • For arthritis: Take 1,000 mg of niacinamide three times a day. 

Be sure to check out the Dosage Recommendations Chart for Niacin below, which lists therapeutic dosages for specific ailments at a glance. 

  • Take niacin supplements with meals or a glass of milk to prevent stomach discomfort.
  • Niacin acts like a drug when taken in high doses (1.5 to 6 grams a day). If you're contemplating using niacin in this dosage range, consult a doctor for supervision. 
  • When possible, substitute inositol hexaniacinate for niacinamide and nicotinic acid. Inositol hexaniacinate is the safest form available, causing no skin flushing and posing considerably less risk of liver damage. 
  • Use caution when taking large, therapeutic doses of niacin--in any form--if you're already on one of the cholesterol-lowering prescription drugs known as statins. Muscle pain and inflammation, and even kidney failure, are a risk if you mix niacin with any of the statins. Stop taking the drug and call your doctor immediately if any of the above symptoms occur. 

Note: For information on interactions with specific generic drugs, see our WholeHealthMD Drug/Nutrient Interactions Chart. 

  • Check with your doctor before taking niacin if you suffer from diabetes, low blood pressure, glaucoma, gout, liver disease, ulcers or a bleeding disorder. Niacin supplements may aggravate these conditions.
  • Have your doctor schedule blood tests every three months to check liver function if you take any form of niacin in amounts of 1,000 mg or more daily.
  • Don't take timed-release niacin, an over-the-counter cholesterol drug designed specifically not to cause nicotinic acid-related skin flushing. Research indicates it may cause liver damage. 
  • Stick to recommended doses; excessive amounts can cause serious health problems.
  • Administration of niacin has been shown to cause ocular damage. Check with your ophthalmologist if you notice any changes in your vision while taking niacin (16).

    References:

Backes JM, Gibson CA. Effect of Lipid-Lowering Drug Therapy on Small-Dense Low-Density Lipoprotein (March). Ann Pharmacother. 2005 Jan 25; [Epub ahead of print] 

  1. Birjmohun RS, Hutten BA, Kastelein JJ, Stroes ES. Efficacy and safety of high-density lipoprotein cholesterol-increasing compounds: a meta-analysis of randomized controlled trials. J Am Coll Cardiol. 2005 Jan 18;45(2):185-97. 
  2. Hexeberg S, Retterstol K. Hypertriglyceridemia--diagnostics, risk and treatment. Tidsskr Nor Laegeforen. 2004 Nov 4;124(21):2746-9. 
  3. Veverka A, Jolly JL. Recent advances in the secondary prevention of coronary heart disease. Expert Rev Cardiovasc Ther. 2004 Nov;2(6):877-89.
  4. Canner PL, Furberg CD, Terrin ML, McGovern ME. Benefits of niacin by glycemic status in patients with healed myocardial infarction (from the Coronary Drug Project). Am J Cardiol. 2005 Jan 15;95(2):254-7. 
  5. Taylor AJ, Sullenberger LE, Lee HJ, Lee JK, Grace KA. Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol (ARBITER) 2: a double-blind, placebo-controlled study of extended-release niacin on atherosclerosis progression in secondary prevention patients treated with statins. Circulation. 2004 Dec 7;110(23):3512-7. Epub 2004 Nov 10. 
  6. Meyers CD, Kamanna VS, Kashyap ML. Niacin therapy in atherosclerosis. Niacin therapy in atherosclerosis.
  7. Spratt KA, Denke MA. Utility of currently available modes of therapy in reaching lipid goals. J Am Osteopath Assoc. 2004 Sep;104(9 Suppl 7):S14-6. 
  8. Whitney EJ, Krasuski RA, Personius BE, Michalek JE, Maranian AM, Kolasa MW, Monick E, Brown BG, Gotto AM Jr. A randomized trial of a strategy for increasing high-density lipoprotein cholesterol levels: effects on progression of coronary heart disease and clinical events. Ann Intern Med. 2005 Jan 18;142(2):95-104. 
  9. Fiske S, Fox LP, Cavusoglu M. Beneficial effects of vitamin A niacin and riboflavin in the management of certain types of vascular conditions. Med Times. 1962 Oct;90:1055-64. 
  10. Birjmohun RS, Hutten BA, Kastelein JJ, Stroes ES. Increasing HDL cholesterol with extended-release nicotinic acid: from promise to practice. Neth J Med. 2004 Jul-Aug;62(7):229-34. 
  11. Rosenson RS, Reasner CA. Therapeutic approaches in the prevention of cardiovascular disease in metabolic syndrome and in patients with type 2 diabetes. Curr Opin Cardiol. 2004 Sep;19(5):480-7. 
  12. Morris MC, Evans DA, Bienias JL, Scherr PA, Tangney CC, Hebert LE, Bennett DA, Wilson RS, Aggarwal N. Dietary niacin and the risk of incident Alzheimer's disease and of cognitive decline. J Neurol Neurosurg Psychiatry. 2004 Aug;75(8):1093-9 
  13. Researchers study effect of niacin on Alzheimer's disease. Mayo Clin Womens Healthsource. 2005 Jan;9(1):3. 
  14. Prousky J, Seely D. The treatment of migraines and tension-type headaches with intravenous and oral niacin (nicotinic acid): systematic review of the literature. Nutr J. 2005 Jan 26;4(1):3. 
  15. Fraunfelder FW. Ocular side effects from herbal medicines and nutritional supplements. Am J Ophthalmol. 2004 Oct;138(4):639-47.

 


Niacin:

 

Ailments

Dosage

High Cholesterol

500 mg 3 times a day

Raynaud's Disease

500 mg 3 times a day

Tinnitus

500 mg inositol hexaniacinate 3 times a day

 

Drug/Nutrient Interactions

Simvastatin:If taken together, may cause myositis, which is characterized by muscle pain and inflammation. In severe cases, kidney failure may occur. Consult your doctor if any muscle pain develops.

Pravastatin:

If taken together, may cause myositis, which is characterized by muscle pain and inflammation. In severe cases, kidney failure may occur. Consult your doctor if any muscle pain develops.

Atorvastatin

If taken together, may cause myositis, which is characterized by muscle pain and inflammation. In severe cases, kidney failure may occur. Consult your doctor if any muscle pain develops.

Cerivastatin
If taken together, may cause myositis, which is characterized by muscle pain and inflammation. In severe cases, kidney failure may occur. Consult your doctor if any muscle pain develops.

Fluvastatin
If taken together, may cause myositis, which is characterized by muscle pain and inflammation. In severe cases, kidney failure may occur. Consult your doctor if any muscle pain develops.

Lovastatin

If taken together, may cause myositis, which is characterized by muscle pain and inflammation. In severe cases, kidney failure may occur. Consult your doctor if any muscle pain develops.