Don’t be fooled by no-flush niacin

Niacin can help you lower your levels of bad cholesterol while increasing good cholesterol. When used with lifestyle changes such as losing weight, eating healthy, and increasing physical activity, niacin helps to lower high cholesterol, Many doctors recommend their patients to take niacin in addition to their other cholesterol-lowering therapy. But beware – not all products that have the word “niacin” on their label will actually benefit your cholesterol health.

What is niacin?

Niacin (or nicotinic acid) is another name for vitamin B3, which is 1 of 8 B vitamins needed by the body to break down fats and proteins and to convert carbohydrates into energy. There are two other forms of niacin, nicotinamide (or niacinamide) and inositol hexanicotinate, which serve as sources of vitamin B3. This is why they can be referred to as “niacin.” What many people fail to realize, however, is that these forms of niacin do not work in the same way as niacin.

What’s the difference between regular niacin and “no-flush” niacin?

Products that are simply labelled as “niacin” contain nicotinic acid. This is the substance that, at doses higher than those needed for its vitamin effect, has been shown to have benefit in people with high cholesterol. Nicotinic acid is known to lower two types of “bad” cholesterol (LDL and VLDL) as well as increase levels of “good” cholesterol (HDL). In fact, it is able to increase HDL more than any other medication.

The nicotinic acid is the substance that causes the flushing side effect of niacin. The flush normally begins as a deep red in the face and then spreads to the rest of the body. Intense warmth and itching usually accompany the flush and this lasts for about 30 minutes. Other side effects of niacin include increased blood sugar levels, increased uric acid levels (which can affect people with gout), dry skin, stomach irritation, or heartburn.

Products labelled as “no-flush” niacin generally contain no nicotinic acid. The main component in these products is inositol hexanicotinate (a different form of vitamin B3 mentioned earlier). While inositol hexanicotinate works as other B vitamins work to promote energy metabolism and nervous system health, it has not been shown to have any effect on cholesterol levels. This product does not cause flushing because it does not work the same way as niacin.

How can “flushing” be avoided?

Unfortunately, if you want the cholesterol health benefits of niacin, a “no-flush” option does not exist. But there are some ways that you can prevent or minimize the flushing effects. Taking a dose of acetylsalicylic acid (ASA) 30 minutes before your niacin dose can minimize flushing. Flushing may also be reduced if niacin is taken after meals. Avoid hot drinks or alcohol before taking niacin, as this can add to the flushing.

If you are just starting to take niacin, begin at a low dose and gradually increase the dose as recommended by your health professional to help minimize flushing. The good news is that the flushing effect often decreases over time as you get used to taking niacin. In fact, many patients find that the flushing stops after 1 to 2 weeks of being on a stable dose of niacin.

There are some people who should not take niacin, such as those who have a history of stomach ulcers. Always speak to your doctor or pharmacist before starting a new medication.