Niacin (vitamin B3) and good HDL cholesterol

Question
Hi Dr Zilberter,

I have a question about taking Niacin to boost HDL cholesterol. I have heard that it is a safe supplement, vitamin B3. Do you know of any research that shows that it actually works? And in what doses? I am not interested in taking mega-doses of anything.

Thanks, Robert

Answer
Robert,

Low levels of "good" cholesterol or high density lipoprotein cholesterol (HDL) are known to be bad for your heart since 1950s and ever after the work of Altschul in 1955, niacin has been used to increase the HDL levels. The increase can be as high as 35 percents. What's more, this effect is parallel to _decreasing_  the "bad" cholesterol (LDL) up to 25 percent thus creating favorable lipid profile.

As to the doses, in clinical studies dosage was started with 375 mg/day, and then increased progressively, and were maintained at a level of 2,000 mg a day for 16 weeks. That high doses are considered safe, the only absolute contraindication is insulin-dependent diabetes.

It's important to keep in one's mind that, though efficient, niacin treatment is not the only one available. Among  non-pharmacological methods, weight loss and exercise helps increase the HDL levels without affecting LDL levels, in a kind of "doze-dependent" manner: 1 mg/dL increase for every 3 kg of lost weight or for every 5 miles run per week.

Other natural approaches proved to be efficient are Omega-3 fatty acids and alcohol in moderation ((1? alcoholic beverages several days a week) caused 0.133 mg/dL increase in HDL per gram of alcohol consumed per day, independently of alcohol source.

Read more on the topic:

HDL numbers and metabolic resistance
http://atkinszone-home.blogspot.com/2008/05/metabolic-syndrome.html

Best exercise to rise HDL
http://atkinszone-exercise.blogspot.com/2008/06/high-intensity-interval-training...

Megavitamins
http://atkinszone-did-you-know.blogspot.com/2006/10/megavitamins-may-be-useful-t...

Opinion: 95% supplements is a waste of money
http://atkinszone-exercise.blogspot.com/2008/08/opinion-95-supplements-is-waste-...


Tanya Zilberter

References

Guyton, John R., Blazing, Michael A., Hagar, James, et al. Extended-release niacin vs Gemfibrozil for the treatment of low levels of high density lipoprotein cholesterol. Arch Intern Med, 2000, 160: 1177-1184.

Altschul R, Hoffer A, Stephen JD. Influence of Nicotinic Acid on Serum Cholesterol in Man. Arch Biochem Biophys. 1955;54:558?.

Szapary PO, Rader DJ. The triglyceride-high-density lipoprotein axis: an important target of therapy? Am Heart J. 2004;148:211?1

Jin FY, Kamanna VS, Kashyap ML. Niacin decreases removal of high-density lipoprotein apolipoprotein A-I but not cholesterol ester by Hep G2 cells. Implication for reverse cholesterol transport. Arterioscler Thromb Vasc Biol. 1997;17:2020?

Ganji SH, Kamanna VS, Kashyap ML. Niacin and cholesterol: role in cardiovascular disease (review). J Nutr Biochem. 2003;14:298?05

Devine PJ, Turco MA, Taylor AJ. Design and Rationale of the ARBITER 6 Trial (Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol)-6-HDL and LDL Treatment Strategies in Atherosclerosis (HALTS). Cardiovasc Drugs Ther. 2007;21:221?.  

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