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High Cholesterol Message Board

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I'm starting to take OTC niacin and am looking for the most reliable OTC brand and type. As far as type, I bought two different kinds...time release that is plain niacin (nicotinic acid), and a flush-free one that is inositol hexanicotinate niacin. Is one of these any better than the other? Or is there something better than these?

I also keep reading that since the OTC niacin is not regulated, that it might not contain exactly the amount it says it does, which is why prescriptions like Niaspan are better. So, I want to make sure I'm using the most reputable makers. (I have some Niaspan that was prescribed about a year ago, but was stubborn and didn't take it, now it's expired!) Wanted to try it on my own OTC for a few months, and then go in to get the blood work done.

Also, do you have to take it at night? If the only reason for taking it at night is to avoid feeling the "flush," I'd rather have it during the day. I have a hard enough time sleeping well as it is. Only taking 250 mg, I don't flush at all, even w/o aspirin. I bumped up to 500 today--250 twice a day. See what happens. Is it okay to take lower dosages, and take them more than once a day, you know, spread it out?

What are the dosages that most people end up with (after starting low and moving up) that produces results, and about how long (six months or so?)?

Actually, I just found the answer to my one of my own questions! Seems the liver produces the most cholesterol at night, so taking niacin at night has the greatest effect.
Avoid inositol hexanicotinate, as it won't do anything for cholesterol.

OTC immediate or slow release should be okay though. When taking high dose niacin, you really should take it under the care of a doctor. He/she should check your liver enzymes, as high dose niacin can eventually affect your liver.

Slo-Niacin or Niaspan are two options which may help you avoid the flush. Ideally, take the niacin at bedtime, as it's more effective then. But you can take it after a meal (dinner) if the flush is too big of a problem. After taking niacin for a while, the flush should eventually minimize. And you should also titrate slowly. Start at a low dose (100mg), then eventually increase over the period of weeks/2-3 months. Again, best to talk to your doctor about dosing, lipid testing and which type of niacin to use (IR or slow release).
Niaspan and the 'flushing''ll still get it. Sometimes I have to get up out of bed and go stick my head in the freezer until the feeling subsides. Luckily the intense burning feeling only lasts a couple of minutes, and is usually only bad for the first two weeks of taking the pills if I have been off them for a bit.
started taking Immediate release niacin about 4 years ago. Started at 500mg a day (twice daily) use to look like a red lobster. Would last about 1 hr.
Now I take 3500mg daily divided into 3 dosages (1000mg, 1000mg and 1500mg at bed time) very little flushing now. Cholesterol numbers are fantastic!
An excellent over the counter Niacin is CARLSON Immediate release (500mg tab). Keep away from any timed release niacin (over the counter). Almost all cases of liver damage have occurred with timed/sustained release formulas. Of course NIASPAN which is Extended Release and Lab tested to precise standards has not caused these liver problems. NIASPAN is also very expensive. If you have Prescription Insurance this is not a concern. I take a prescription brand of niacin (Immediate release) called NIACOR (3,000 mg a day). It is much cheaper than Niaspan. One thing I can say about Niacin is do not self-treat yourself (especially with any time release verison). Your doctor will want to monitor your liver enzymes periodically as a pre-caution. A good way to start taking niacin (over the counter) is to start with a low dose about(50 mg. immediate release) then slowly increase till you reach about 500 to 1,000 mg a day. The CVS brand is a good choice. They sell a small bottle of100mg tablets (immediate release) which you can split in half. That is the way I started almost 6 years ago.

P.S Don't be afraid of the flush... The flush is great for your blood vessels. Niacin vasodilates, increases circulation and the flush cleans the dirt/impurities from your system. Many say that the flush is the healing power of niacin. We should seek that flush according to altrernative doctors.
I appreciate the good information from ACE28 and others. It is very helpful. I'm trying answer a couple of questions in my mind and sensing that there may be more than one answer to both.
Is the difference between Niaspan and OTC niacin products primiarily the flushing factor? Or, as has been suggested to me, the OTC's can be either impure or unreliable as to correct dosage?
I get the impression that different people react differently to niacin, but any help you can be on these two questions would be appreciated.
Thank you.

I have been taking 1500 mg of niacin in the morning and 1500 mg in the evening for about a year and a half now. Excellent cholesterol numbers especially the HDL which went up quite quite a bit after starting the niacin therapy. Started with 500 mg of niaspan ,then 1000 niaspan then 1500 plain niacin then up to the 3000. Very little flushing now . My latest numbers........Total cholesterol ,,,120,HDl....51,LDL....61,Triglycerides........18, Tot cholesterol/ HDL Ratio2.36
Thanks, JimmyDale, for the quick reply and good information.

I did a trial run with Niaspan and my number jumped from 40 to 58, so, common sense dictates I should continue it. My doc did not say "no" to trying non-Niaspan niacin (his recommended dosage was 1500 mg once a day), but was less than enthusiastic, citing the flushing factor. I'm considering giving the alternative a try and see what happens and your example is helpful.

Hi Chase 0737

Thank you for the reply. I first read about in Dr. Agatston's book "The South Beach Heart Program". I discussed it with my doctor and started on the niaspan. At the time he said that none of his patients were taking niaspan. I did try one niacin 500 mg tablet about three years ago and broke out in nasty red welts every where. It was quite scary. At the time I put niacin out of my mind until reading the doctors book. The niaspan was no problem with flushing and must have helped build up a tolerance for the regular niacin. I have a little flushing but hardly noticeable on the 3000 mg . a day. A word of caution. I am getting regular blood tests every three months..... cholesterol,and liver function. The liver function tests have always been normal so no problems there. All the Best.........

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