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Niacin for Cholesterol

05/01/2022 | 4 min. read

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If I had to pick one nutrient I receive the most questions about, it’s niacin. That’s because many doctors, cardiologists included, are still in the dark about the benefits of niacin for cholesterol.

So, what is niacin? Simply put, it’s vitamin B3, which is one of the eight different types of B vitamins. It’s an essential nutrient, meaning your body can’t manufacture it, so you need to get niacin through foods and supplements.

Inside your body, niacin helps to convert the foods you eat into the energy your body needs. Niacin also supports your brain, central nervous system, and healthy cholesterol levels—which is why it’s a nutrient I’ve highly recommended for years.

Here’s how niacin impacts the different forms of cholesterol.

Niacin and HDL Cholesterol

Niacin is one of the best nutrients for raising high-density lipoprotein (HDL) cholesterol. HDL, which is often called the “good cholesterol,” helps to remove oxidized LDL cholesterol from your arteries. Plus, it helps to continuously repair the endothelium, which is the inner lining of your blood vessels.

A research roundup completed by an esteemed colleague of mine, Mark Houston, M.D. from the Vanderbilt University School of Medicine, revealed that niacin increased HDL levels by 10% to 30%. Higher HDL levels help to keep plaque from forming in your arteries and help to protect your blood vessels.

Is Niacin Good for Lowering LDL Cholesterol?

LDL cholesterol is sometimes referred to as “bad cholesterol,” but it’s not harmful unless it’s oxidized. In fact, driving LDL cholesterol levels too low with cholesterol-lowering statin drugs can harm your immune system, brain, and overall health.

What is a concern is oxidized LDL cholesterol. These small, “sticky” LDL particles can trigger inflammation in your body, affecting the walls of your arteries.

Niacin helps to lower oxidized LDL cholesterol that can clog your arteries. In his research, Dr. Houston also found that vitamin B3 benefits included reducing LDL cholesterol by 10-25%. Plus, niacin was shown to reduce triglycerides by 20-50%.

Niacin for Lowering Lp(a) Cholesterol

Lipoprotein A, or Lp(a) for short, is a highly inflammatory, dangerous form of cholesterol. Elevated levels can alter the “stickiness” of your blood, which can lead to clots that increase your risk of having a stroke or heart attack.

Niacin is one nutrient that decreases dangerous Lp(a) cholesterol particles. Fish oil, nattokinase, and lumbrokinase can also help to neutralize the pro-clotting influence of Lp(a). Plus, newer research has shown that coenzyme Q10 (CoQ10) can also have a favorable impact on Lp(a).

How Much Niacin to Take for Cholesterol

While you always want to work closely with your doctor, I recommend starting with 100 mg of niacin one time daily and slowly working up to 3 times daily, if you can tolerate the “niacin flush.”

What is the niacin flush? This tingly pins-and-needles sensation and sometimes hot flushing of the skin usually begins in the forehead and works its way down your arms and chest. It can occur initially at doses as low as 50 mg a day and typically lasts no more than a half-hour to an hour, then disappears.

The higher the initial dose of niacin that you take, the greater the initial flush. Fortunately, you can minimize the intensity of the flush by taking the pills after meals.

As you continue taking niacin, the niacin flush lessens, and it could vanish within a week or two. If you tolerate 300 mg with or without the flush, you can try going to higher doses working up to 1-1.5 grams a day.

Make sure you always work closely with your doctor since high-dose niacin can affect your liver and can interact with other medications you may be taking. Taking niacin can also cause dangerous drops in blood pressure for people with low blood pressure.

What Is the Best Time of Day to Take Niacin?

While you should always work closely with your doctor, in general, the best time of day to take niacin is in the evening, either after dinner or after a snack.

Taking niacin on an empty stomach can worsen the niacin flush and can upset your stomach.

Is No-flush Niacin a Good Option?

Some people use no-flush niacin because they are uncomfortable with the flushing effect. The problem with no-flush niacin is you don't get the same vascular benefits you would get with standard niacin.

Therefore, if you want reliable results you should only use the standard niacin for cholesterol. The good news is that it’s also the less expensive option.

Niacin-Rich Foods

In addition to taking supplements, there are several heart-healthy food sources of niacin, including:

  • Organic chicken and turkey
  • Tuna
  • Wild-Caught Salmon
  • Peanuts
  • Avocados
  • Brown Rice
  • Mushrooms
  • Peas
  • Potatoes

Some foods are fortified with niacin, including cereals and bread.

Bottom Line

Taking niacin for cholesterol can be beneficial. It can raise HDL cholesterol, as well as lowering oxidized LDL cholesterol, triglycerides, and Lp(a).

You want to take standard niacin, not no-flush niacin, since the no-flush form doesn’t have the same positive effects on cholesterol. You also want to take niacin after a meal, preferably in the evening.

It’s also important to work closely with your doctor to determine whether taking niacin for cholesterol is appropriate for your specific health needs.

Dr. Stephen Sinatra

Meet Dr. Stephen Sinatra

Dr. Stephen Sinatra is a highly respected and sought-after cardiologist and nutritionist with more than 30 years of clinical practice, research, and study. His integrative approach to heart health focuses on reducing inflammation in the body and maximizing the heart's ability to produce and use energy.

More About Dr. Stephen Sinatra