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Statin medications have become the treatment of choice for hyperlipidemia and lowering the risks of atherosclerotic cardiovascular disease. For this reason, clinical trials of nicotinic acid in the past several decades have examined whether it provides any additional cardiovascular protection to people taking statins [ 29].
For these reasons, niacin is not a primary treatment for high cholesterol. It’s primarily used to help improve blood fat levels in people who cannot tolerate statin drugs ( 5, 7). 2. May reduce blood pressure Niacin is available in multivitamin/mineral products, in supplements containing other B-complex vitamins, and in supplements containing niacin only. Nicotinic acid and nicotinamide are the two most common forms of niacin in supplements. Some niacin-only supplements contain 500 mg or more per serving, which is much higher than the RDA for this nutrient [ 11]. Blood pressure drugs, herbs and supplements. Niacin might have an additive effect when you take blood pressure drugs, herbs or supplements. This could increase your risk of low blood pressure (hypotension). A severe muscle problem (rhabdomyolysis) has happened when Niacin Flush Free (inositol niacinate) was used along with certain drugs for high cholesterol like This is a fact sheet intended for health professionals. For a general overview of Niacin, see our consumer fact sheet on Niacin. IntroductionThe U.S. Department of Agriculture's (USDA's) FoodData Central lists the nutrient content of many foods and provides a comprehensive list of foods containing niacin arranged by nutrient content . Dietary supplements
The flushing occurs with over-the-counter immediate-release niacin tablets. With this type of niacin the vitamin is delivered to the body in a short burst and the flushing reaction is more intense. At the low DRI doses, niacin is safe for everyone. However, at the higher amounts used to treat medical conditions, it can have risks. For that reason, children and women who are pregnant or breastfeeding should not take niacin supplements in excess of the DRI unless it's recommended by a doctor. There’s research to suggest that niacin could help protect those cells and possibly even lower the risk of type 1 diabetes in children who have a higher chance of developing this condition ( 10). According to a 2017 study, taking aspirin alongside niacin may help reduce the effects of flushing.
So, the next time you feel the warmth of your skin and you look as if you've run a marathon after you take your nicotinic acid, remember all the good it is doing for your body and try to embrace the discomfort—it's only temporary!
Ease into it. Some experts recommend starting with a smaller dose like 500 mg and then increasing to 1,000 mg gradually over the course of 2 months, before finally increasing to 2,000 mg. This strategy could bypass flush entirely ( 5).
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Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using Niacin Flush Free (inositol niacinate) Maki KC, et al. Triglyceride-lowering therapies reduce cardiovascular disease event risk in subjects with hypertriglyceridemia. Journal of Clinical Lipidology. 2016; doi:10.1016/j.jacl.2016.03.008. Vitamin B3 reacts with specific proteins in the skin and increases prostaglandins, a group of specialized compounds the body makes from fat that exert hormone-like effects, causing blood vessel dilation. As your blood vessels dilate, flushing spreads through your face and progresses to your arms and chest. This tingling may feel odd, but it's to be expected as part of a niacin-induced flush. How long does a niacin flush last? Most dietary niacin is in the form of nicotinic acid and nicotinamide, but some foods contain small amounts of NAD and NADP. The body also converts some tryptophan, an amino acid in protein, to NAD, so tryptophan is considered a dietary source of niacin.
In high doses, niacin also supports already-healthy cholesterol levels. It helps regulate the healthy ratio between low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Research has shown that high-dose nicotinic acid, at amounts that may cause flushing in some people, may help promote balance in already-healthy HDL and LDL cholesterol levels. So what is a niacin flush exactly? Let’s take a look at what it is, along with the possible benefits and serious risks of a niacin flush. The maximum daily intake of niacin for any person is 250 mg per day. The daily dosage may increase over time to up to 1000mg per day. It is possible to overdose. Overdose advice Niacin flushing indicates your body is receiving a large amount of vitamin B3. The flush means that blood vessels are dilating and increasing blood flow, which can be unpleasant but temporary. If you've been working on maintaining already-healthy cholesterol levels, and you haven't seen the results you were expecting, your doctor may recommend you take niacin in high doses. Not only is niacin a superstar at supporting cholesterol already within a healthy range, it's also good for your whole-body health. After all, every cell in your body uses vitamin B3 for every task that requires energy, aka everything your body does!
Usual Adult Dose for Vitamin/Mineral Supplementation
Severe niacin deficiency leads to pellagra, a disease characterized by a pigmented rash or brown discoloration on skin exposed to sunlight; the skin also develops a roughened, sunburned-like appearance [ 2, 4, 20, 21]. In addition, pellagra can cause a bright red tongue and changes in the digestive tract that lead to vomiting, constipation, or diarrhea. The neurological symptoms of pellagra can include depression; apathy; headache; fatigue; loss of memory that can progress to aggressive, paranoid, and suicidal behaviors; and auditory and visual hallucinations [ 2-4]. As pellagra progresses, anorexia develops, and the affected individual eventually dies [ 3]. Preliminary research shows that it could also help keep the brain healthy in cases of Alzheimer’s disease. However, results are mixed ( 15, 16). 5. Improves skin health Niacin. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed March 1, 2022. In one observational study of over 12,000 adults, researchers found that each 1 mg increase in daily niacin intake was associated with a 2% decrease in high blood pressure risk — with the lowest overall high blood pressure risk seen at a daily niacin intake of 14.3 to 16.7 mg per day ( 8).
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