Niacin for a Healthy Heart

Niacin for a Healthy Heart

Niacin (vitamin B3) offers good news to Americans, for whom cardiovascular disease is the leading cause of death and who continue to live at high risk because of high cholesterol levels. Research supports the use of niacin as a safe and possibly more effective alternative to conventional cholesterol-lowering medications. In addition, niacin is a very affordable option.

Cholesterol is an important part of a healthy body. The body uses it to make vitamin D (required for the normal growth of bones and teeth) and various hormones, including the sex hormones. There are two kinds of cholesterol in your body: low-density lipoprotein, or LDL cholesterol, and high-density lipoprotein, or HDL cholesterol. These two types are sometimes referred to as the "bad cholesterol" and the "good cholesterol," and here's why: high levels of LDL cholesterol in the blood contribute to the development of atherosclerosis, or hardening of the arteries, which kills approximately 1 million Americans each year. High levels of HDL cholesterol, on the other hand, appear to lower a person's risk for heart disease.

In clinical studies, niacin has been shown to both lower LDL cholesterol levels and increase HDL cholesterol levels. One trial compared the effectiveness of niacin to that of lovastatin (trade names Mevacor or Mevinolin), a commonly prescribed LDL cholesterol-lowering drug. In this study, 136 patients with high cholesterol received either lovastatin or niacin daily. After 26 weeks, LDL cholesterol levels were reduced more in the lovastatin group (32 versus 23 percent). However, HDL cholesterol levels were increased more in the niacin group (33 versus 7 percent). This is noteworthy because the risk for heart disease is reduced more by raising HDL cholesterol levels than by lowering LDL cholesterol levels.

However, there is a side effect from niacin use that discourages some people from taking it. High doses of niacin can cause flushing—a sudden tingling, itching, and reddening of the face, neck, and chest. This side effect is uncomfortable but not dangerous. Slow-release forms of niacin are available and may reduce this effect; however, these may also be harmful to your liver. One possible solution is to take niacin supplements that are in the form of inositol hexanicotinate (IHN). This form of niacin is metabolized slowly by your body, reducing the possibility of flushing. IHN has been used in Great Britain for years to lower cholesterol levels.

To get niacin's heart benefits you will need to supplement your diet with 1.5 to 4.0 grams daily, divided into two or three doses. While there are a number of dietary sources rich in niacin (such as foods high in protein, like meat, eggs, and peanuts), none of these contain more than about 20 mg of niacin per serving. As always, it is very important to work with your doctor to determine which cholesterol-lowering treatments are right for you. Some dietary supplements should not be taken if you have certain medical conditions or are taking particular prescription medications.


American Heart Association. Leading causes of death: 1996 Cardiovascular Disease. Accessed at on March 23, 2000.

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O'Connor PJ, Rush WA, Trence DL. Relative effectiveness of niacin and lovastatin for treatment of dyslipidemias in a health maintenance organization. J Fam Pract. 1997;44(5):462-467.

McKenney JM, Proctor JD, Harms S, Chinchili VM. A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients. JAMA. 1994;271(9):672-677.

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Review Date: June 2000
Reviewed By: Integrative Medicine editorial

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