I keep seeing warnings to those on Niacin therapy for their cholesterol that they should use alcohol cautiously if at all. Does anyone know what the reasoning is behind this? Is it because Niacin therapy in high doses causes liver damage in a small percent of people and that alcoholism does, too, so the two combined could be disastrous quickly? Or does alcohol interfere with the absorption of the Niacin? Or is it that that Niacin taken with alcohol will increase the "flush" associated with large quantities of Niacin? Or is it something else?
I've just spent the last couple of hours researching the web looking for the answer, but haven't been successful. So I'm hoping maybe someone else frequenting these boards has come across the answer.
I'm not an alcoholic, no where near it, but I'd like to know just how cautious I need to be, and the reason for the warning would help me determine that.
Consumption of alcohol while taking large doses of niacin may also increase the flushing side effect of the niacin.
"The liver undergoes profound changes in both its endoplasmic reticula and its microsomal enzymes in order to detoxify alcohol. The unbalanced introduction of very large doses of niacin to an overloaded liver may well overtax an alcohol-strained system. This is likely where some changes in liver function tests come from (American Journal of Medicine, vol 86, April, 1989, page 431 and vol. 87, August 1989, page 248; American Journal of Cardiology, vol. 64, October 1, 1989 page 728).
Perhaps more caution is needed regarding alcohol while taking sustained or time-release niacin, since it is being processed in the liver for longer periods of time, as opposed to the immediate-release form. I'm not really sure. But I take my niacin in divided doses throughout the day (immediate-release), with my last 250mg tablet being taken around 7:00PM. But I love my beer, and usually drink 4 cans each night, and have been doing so for a great many years with no problem (knock on wood).
Both substances are hard to the liver thus more care is warranted when taking 2 than taking one. I imagine someone on statins-niacin-alcohol combination could be really placing his liver squarely behind the eight ball.
Isn't it also true that people who take statins are instructed to take them in the evening, shortly before going to bed? Boy, that can be a real bummer! That's about the same time most people settle down and have a couple of drinks.