I take 200mg 4x a day of plain old Kroger brand niacin together with Lipitor 20mg. Flushing is minor but I built up the dose over time.

When I first started taking niacin I seem to remember reading that the plain was much more effective.

Would some one please explain the differences between plain niacin, flush free niacin and extended or time release niacin?

What is Slo-niacin?

Many thanks,
Tina

Tina,


I think it would be more effective for you to take the 4 pills at one time. THat would give you a more effective anti-cholesterol walllop while minimizing the time your liver is exposed to niacin.

Basically, the terminology (slow release, sustained, long acting) differences are a gray area that represent different rates at which the niacin is absorbed. Most actually use nicotinic acid in various formulations to slow down delivery and thus mitigate flushing. The stuff sold as "flush free" can be one of these or else, more commonly inositol hexanicotinoate where the nicotinic acid molecules are slowly peeled off the inolsitol portion of the molecule.

THen there's the prescription version sold as "extended release" called NIASPAN. Same nicotinic acid time release but at a MUCH higher price.

Thinking is that straight stuff in high doses (like 2 grams) is best for cholesterol and liver but causes huge flushing problems. I don't know ANYONE who can take 2 grams straight-up without major flushing so most of us take some sort of time release formulation in much smaller dosages.

Slo-Niacin is an extended release, over-the-counter version of Niacan. It's claim to fame is it's manufactured with polygel so that the niacin is delivered in a gradual and measured release. The result is less flushing and itching which are problems with Niacin. Slo-Niacin comes in 250, 500 and 750 mg tablets. Check a thread started by me (but with input from others) which shows some studies involving slo-niacin. Niaspan is prescription, as Lenin explained, but it has the side effects for many (including yours truly:mad: ) especially when the doses are increased to 1000 mg and above. Probably, Slo-Niacin (and other forms for that matter) are most effective at boosting HDL (good) cholesterol but may have mild effects in decreasing Total and LDL cholesterol. Certainly, Niacin works best when coupled with a statin, however, most caution against using 1000 mg or greater, due to potential liver toxicity, along with statin therapy (without doctor advise, of course).

Tina, I read in a study that plain Niacin is the least toxic of all the forms, including time-release. Individuals were less likely to suffer damage to the liver.

Judgejkh, why do you think that Niacin is more effective at raising HDL than lowering tc or LDL? Did you read that in the literature? Does it help to have high HDL if the total cholesterol is still too high?

Tina,

I think it would be more effective for you to take the 4 pills at one time. THat would give you a more effective anti-cholesterol walllop while minimizing the time your liver is exposed to niacin.

Thinking is that straight stuff in high doses (like 2 grams) is best for cholesterol and liver but causes huge flushing problems. I don't know ANYONE who can take 2 grams straight-up without major flushing so most of us take some sort of time release formulation in much smaller dosages.

Lenin, I guess my spreading my dose out to 4xs a day for a total of 800mg was just my DIY, cheap-skate form of time-release! I increased my dose incrementally so that my body could adjust and hopefully avoid the flushing. But, it seems I should continue to increase the dose to 2g.

Is the flush-free formulation the one that has been shown to be much less effective? I was wondering which to avoid. Many years ago I read that timed release formulations of vitamins and also prescription drugs could not equal the continual slow dose of a manual approach. If the timed-release version is as effective as plain niacin I will switch to that for simplicity's sake.

Many thanks, Tina

Certainly, Niacin works best when coupled with a statin, however, most caution against using 1000 mg or greater, due to potential liver toxicity, along with statin therapy (without doctor advise, of course).

I will schedule a visit with my Dr. before I up my dose past 1g. I take Lipitor, a much lower dose of which I need since I added niacin, from 80mg down to 20mg. This has made my ratio 2.9. Tri's-117, Total-195, HDL-67, LDL-105. My CRP was 0.6 and ALT 20. What numbers should I be aiming for. Both my parents died from heart disease with first heart attacks in their 60's. I'm 55, healthy, fit.

Many thanks, Tina

Tina,

I can't say that your numbers are bad. If you're getting an HDL of 67, WOW! Plus, your total and LDL are not that bad. As you indicate, your ratio is 2.9 which is well below 3.5 (the last target that I heard). I don't know. It looks to me like you're getting a good combo effect with what you're doing. Of course, only you know your comfort level, especially by taking Lipitor at 20 mg. Personally, I would love to have your HDL with my untreated numbers. I would be able to forget the Vytorin :). Plus, your ALT seems to show you're tolerating the Niacin and Statin well. Mine usually stays in the mid 50s which causes concern.

Catherine,

I think it's fairly common knowledge that Niacin is the best available HDL booster but doesn't lower total and LDL as well. Otherwise, we wouldn't have our statin concerns (we would just take Niacin :). Plus, the studies do show better HDL results than Total and LDL reduction with Niacin.

The other part of your question, I lack the knowledge to answer. Personally, if I could get my HDL above 50 I doubt I would feel the need to take a statin with untreated Total of 250. If my total and LDL were much higher then it would likely change my feelings. I guess each of us just has to know our own situation the best.

Yina,

IF you are taking Lipitor, I think you should be content with taking the 800 mg. niacin, especially in light of your superb HDL's. We niacin takers suffer with niacin only becasue of miserable HDL's...niacin isn't very good at lowering total cholesterol or LDL.
In fact, why not see what kind of numbers you get with JUST the Lipitor...perhaps you don't need the niacin at all.

But give a try at 800 mg. in ONE dose and see how it and see if you get a super-flush. It will be good to know for the future.

Yes, it WOULD seem that 200 x 4 is fairly equivalent to a time-release formulation.