The niacin flush, the redness, the itching.
This is how to use niacin for cholesterol
without the flushing.
Hi. I'm Dr. Chris Masterjohn of
chrismasterjohnphd.com.
And this is Chris Masterjohn Lite,
where the name of the game is
"Details? Shmeetails. Just tell me what works!"
And today we're going to talk
about how to use niacin to lower
cholesterol without that red and itching
flushing response. So, first of all I'm
not a huge fan of using niacin to lower
cholesterol. I've done several episodes
on this topic, and several episodes ago,
I'll link to the episode in the
description of this one, I explained the
rationale for why I don't recommend
niacin as an approach to lower
cholesterol in most people, but sometimes
when diet and lifestyle won't cut it,
it does make sense, and I know that people
are going to be using it no matter what
I say. So if you do use it, here are some
tips on the form to take and how to take
it and what to take it with to minimize
that flushing response. First of all,
let's talk about a couple things not to do.
So first of all, don't take
nicotinamide or niacinamide, those two
things are the same chemical compound.
Don't take niacinamide because
niacinamide doesn't have the positive
effects on blood lipids. So it defeats
the purpose. Second of all, don't take
slow-release niacin or inositol hexanicotinate
because even though this
does come with less flushing, it comes
with a greater potential to do harm to
your liver. I'm going to talk about that in
the next episode. Here are the things
that you can do. First of all, taking
aspirin at 325 milligrams 20 to 30
minutes before the dose of niacin will
reduce or eliminate the flushing. I don't
think this is a great idea even though
it's effective because I think the
potential risk of side effects from
chronic aspirin use are too great. So I
would not recommend that even though it
works. The second thing you can do is
wait it out. If you're using the
fast-release niacin, then even though the
flushing response will accompany it at
first, it will eventually go away if you
stick to your guns. The third thing that you can
do is you can take extended-release
niacin. You may find this
over-the-counter in the form of a wax-matrix niacin
such as Endura-Acin, or you
might find it with a prescription as in
the case of Niaspan. The
extended-release niacin, meaning the
wax matrix and the Niaspan, they will
slow the rate that niacin goes into your
bloodstream in a way that will reduce or
eliminate the flushing, but they will not
make it so slow that it increases the
risk of liver toxicity. I'm not saying
the risk of liver toxicity is zero, it's
not, but it doesn't raise the risk of
liver toxicity as much as the
slow-release or inositol hexanicotinate forms do.
Now, with that said, no matter
what form of niacin we take, we do have
potential concerns about liver toxicity
at high doses, and I'm going to address
how to protect your liver when you're
using niacin in the next episode.
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