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High Cholesterol Message Board

High Cholesterol Board Index

Niacin (nicotinic acid) is used in cholesterol control, but not niacinamide. Before you start taking niacin, though, you really should read up some on it's use in cholesterol control. A therapeutic dose is usually considered 1000-2000 mg., but I would never consider a dose like that without having a liver enzyme test first (simple blood tests) and checking with a doctor about other conditions which might make niacin therapy inappropriate for him. Liver disease, heavy alcohol consumption, and diabetes, for example, are all contra-indications.

What I personally did when I decided that diet alone wasn't going to do the trick, was to start with 250 mg. Endur-acin (a time-released niacin available online) daily for a couple of months before I was scheduled for my next doctor visit and lab work on my cholesterol. The doctor then added the liver enzyme tests to the lab order, and since they came back fine and my lipid profile had improved a bit but not enough, she had me increase my Endur-acin to 500 mg. daily. I'm now on 750 mg. Endur-acin, which is controlling my cholesterol adequately. I see on the Endurance Products website that maximum improvement in HDL will often occur at 500 - 1250mg for Endur-acin. You would want to check with the manufacturer of whatever brand you buy to see what the figures are for that brand, as they could differ. Frankly, it may be that niacin isn't even needed for your husband if you see several things you could change in his diet as I mentioned in my earlier post.

If he does decide to take niacin, you should be aware that it is available in immediate-release or sustained-release forms. Both will give a flush (like a major hot-flash) for half an hour or so after taking it until the body gets used to it, but the sustained release form has a much reduced flush. The sustained release form tends to be more toxic mg. for mg., though it usually takes less of it to get the same cholesterol-changing effect. But at the lower doses I expect your husband would be taking, that may not be a concern. The flush can also be reduced by (a) taking an aspirin half an hour before the niacin, (b) taking the niacin with meals (c) starting with a low dose and gradually building up over a period of weeks.

Even at relatively low doses, regular liver enzyme tests should be done to make sure it isn't negatively affecting the liver. (The doctor will recommend a timing, but initially after 6-8 weeks, then after 3-6 months seems to be pretty common.) Liver damage doesn't happen often, but in the few cases it does, catching it early can prevent permanent serious damage.

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