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Old 11-08-2006, 11:14 AM   #1
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Niacin Flush

I am 30 and have had high cholesterol numbers, which are now under control from Vytorin, but my last 2 VAP tests showed my lp(a) levels at 22, where normal is under 10. After the first high level results I began takin slow release niacin (inositol hexaniacinate) but after taking 500mg for 6 months it had no impact on the lp(a) numbers. My doctor now recommended that I take the regular B3 niacin starting at 25mg and working my way to 1000mg per day.

I have had panic anxiety for the past 5 years and do not do well with new medicines or weird feelings so am not looking forward to the flush. With the slo-release I would ocassionally get a slight tingle in my face, but nothing that I would say was a full on flush.

My doctor recommended taking an adult aspirin 1 hour in advance and then taking the niacin with a meal, and after that I could expect a 20 minute or so flush.

I am hoping someone can describe to me their experiences with starting with a low dose and working their way up. Also how long after taking the niacin does the flush start.. is it minutes later, or hours... I really just want to feel comfortable with taking it and understanding how I am going to feel and in what time frames.

Also if anyone else has had high lp(a) numbers, please let me know how niacin helped.

I appreciate any help.

 
Old 11-08-2006, 05:29 PM   #2
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Re: Niacin Flush

Hello,

I have been taking Niaspan 1000mg for 1 1/2 years now.
I too suffer from anxiety and panic and when I first took the medication I made the mistake of taking a hot bath afterwards.

I thought the hot bath would relax my nerves. Big mistatke. Because it made my first niacin flush worse than it would have been.

There are times when the flush is bad. But remember, for the most part the flush is perfectly harmless. You feel red and hot all over and you will feel itchy as well. It does not last long. for me sometimes about an hour and then it goes away as quickly as it came.

Believe it or not I have gotten to the point where I actually like it and find the sensation relaxing in and of itself. Just knowing that it is harmless helps a lot. An aspriin 1/2 hour before taking will prevent this from happening.

I too have a high lp(A), much higher than yours. I have not had it retested since there really is no help for it. Although I heard niacin is very helpful for lp(a). More imporantly, niacin will raise your hdl.

My hdl is currently 84. My ldl is 115. So far I am very happy with the results and have been able to avoid statins.

Gail

 
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Old 11-09-2006, 05:16 AM   #3
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Re: Niacin Flush

master,

I too suffer with a sky high genetic Lp(a). My experience is that NOTHING affects it much with the possible exception of HUGE quantities of booze and even then only slightly. Niacin works a bit but only a for few percent change.

I have tried at least 10 times to titrate my doseage of regular niacin up to therapeutic levels. By the time I reach 100 mg., the flush is very uncomfortable...at 250 it is nearly unbearable and at 500 mg, it is dangerous. I found NO effect from the gradually increasing dose...in no way did it help acclimate myself to it. I just CANNOT take this crap in anything approaching a therapeutic dose.

If the same happens to you, get back on the slow-release and give the leftover straight niacin to your doctor.
I take 500 mg. and occasionally 750 mg. of slow release before bedtime WITH 2 adult aspirin. The flush is very slight and only if I stay awake for an hour.


I won't comment much on your Lp(a) because there are at least 3 different standards of normalcy floating around. BUT if you got 12 on any standard that topped out at 10, you are pretty close to normal. I wish I could say that.

The way that I look at it is that I have the risk factor of high Lp(a) and there is bupkis that I can do about it. What I CAN do is minimize all the other risk factors...so the niacin is for raising my HDL and the Lipitor is for shrinking my LDL and triglycerides. Exercise for heart workouts, and weight control to minimize bodyfat, fish oils for whatever they do , and daily aspirin to prevent clots, and good BP control round out the picture.

All I can do is HOPE my genetic Lp(a) doesn't kill me all on its own.<fingers crossed aerobically! >

Last edited by Lenin; 11-09-2006 at 05:21 AM.

 
Old 11-09-2006, 10:00 AM   #4
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Re: Niacin Flush

Thanks for all your posts, but one last question... How long does it take for the flush niacin to cause the flush. Can I expect a flush a few minutes after taking it or does it usually come on later in the day?

 
Old 11-09-2006, 05:49 PM   #5
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Re: Niacin Flush

Quote:
Originally Posted by master44
I am 30 and have had high cholesterol numbers, which are now under control from Vytorin, but my last 2 VAP tests showed my lp(a) levels at 22, where normal is under 10. After the first high level results I began takin slow release niacin (inositol hexaniacinate) but after taking 500mg for 6 months it had no impact on the lp(a) numbers. My doctor now recommended that I take the regular B3 niacin starting at 25mg and working my way to 1000mg per day.

I have had panic anxiety for the past 5 years and do not do well with new medicines or weird feelings so am not looking forward to the flush. With the slo-release I would ocassionally get a slight tingle in my face, but nothing that I would say was a full on flush.

My doctor recommended taking an adult aspirin 1 hour in advance and then taking the niacin with a meal, and after that I could expect a 20 minute or so flush.

I am hoping someone can describe to me their experiences with starting with a low dose and working their way up. Also how long after taking the niacin does the flush start.. is it minutes later, or hours... I really just want to feel comfortable with taking it and understanding how I am going to feel and in what time frames.

Also if anyone else has had high lp(a) numbers, please let me know how niacin helped.

I appreciate any help.
There is a NO FLUSH NIACIN that can be purchased at your local health food stores or from Vitiman Co's.

This I have found to be excellant, No flush at all, It is compounded with a substance that eliminates the FLUSH. Don't even bother with the slow release, it isn't worth it. I have been on this for almost year with absolutely no --- none--- zero flushes.

What have you got to lose? Nothing !!!!

 
Old 11-09-2006, 06:29 PM   #6
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Re: Niacin Flush

Quote:
Originally Posted by master44
Thanks for all your posts, but one last question... How long does it take for the flush niacin to cause the flush. Can I expect a flush a few minutes after taking it or does it usually come on later in the day?
It varies. No 2 people have the same experience. And the experience varies in the same person from one dose to the next.

For example, I can go sometimes a week or 2 now without any flush symptoms then I will get it a few days in a row. Sometimes it is mild. Other times I can get hot and red from head to toe.

A lot of things cause the variation. What you ate before. Alcohol intake, stress, exercise, etc.

Sometimes it comes on within a half hour after taking it - other times there may be a delay of serveral hours.

It's mystery is pure.
Gail

 
Old 11-10-2006, 05:24 AM   #7
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Re: Niacin Flush

master,

I have taken both Upsher Smith's SLO-NIACIN and Dixon's TIME-RELEASED NIACIN (in those capsules filled with multicolored granules that dissolve at different rates.)
There is very rarely a flush of any kind from either of these two slow acting drugs but IF I feel a tingly face and forehead it is usually around the 90 minute mark or a little later.

With straight (flush) niacin the flush is pretty punctual for me at 20-30 minutes. It occurs with EVERY dose and is always a really HORRIBLE feeling with intense redness and pin *****s from mid chest to mid scalp. It lasts ablout a half hour.
With higher doses my lips and eyelids swell badly...at 500 mg. I begin to notice some slight difficulty breathing.
I really think that for me, a dose of 1000 mg. would be fatal or close to it.

 
Old 11-10-2006, 02:24 PM   #8
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Re: Niacin Flush

Lenin,

Can you please offer some insight on No-Flush vs. Niacin vs. Slo-Niacin (extended release)? I think there are those on the forum who believe No-FLush works just as well or better in lowering Total and increasing HDL. Although I have no basis to doubt their personal results, I was told by my doctor that he could not safely dose me with No-flush to an amount that would "do the job". I do know that I took 500 mg of No-Flush for 3 months and it had no effect (other than a mild elevation in HDL). Actually, I think my total went up .

I join Lenin in describing the Niacin flush and can vouch for the fact that Slo-Niacin rarely causes flushing with me and when it does, it is MUCH less severe than with Niacin or Niaspan (prescription, extended release). Also, with regular Niacin or Niaspan it typically occurs after about 1/2 hour from taking. If you've never experienced it, all I can say is hold on. You won't enjoy it. I've read others say "it's not so bad" and "I've gotten used to it" and "I kind of enjoy the sensation." All I can say about that is, it feels like your ears, face, neck and shoulders are going to come off your body. If that is a good thing, I guess I'm in the wrong body . I would imagine the flush sensation they are describing is the flush I've described with Slo-Niacin (mild).

I had my labs done today after 2 months of Slo-Niacin (1000 mg)/day and 3 grams fish oil. I will post my numbers on Monday.

 
Old 11-11-2006, 05:12 AM   #9
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Re: Niacin Flush

I look forward to seeing what HDL boost you got from the 1000 mg. dose of SLO-NIACIN...
My guess: 10 points over your baseline before any niacin; okay, make it 12!

Last edited by Lenin; 11-11-2006 at 05:20 AM.

 
Old 11-11-2006, 05:14 AM   #10
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Re: Niacin Flush

The good thing about the flushing is that it is not harmful and it is not permanent. It goes away as quickly as it came.

I'll take niacin flushing over the side effects of statins anyday.

I was give lipitor once and I lasted 1 month on it. Ended up with a pain in my leg that made my eyes nearly pop out of my head. My doctor said lipitor is famous for that. Took 4 weeks for the pain to gradually disappear.

Guess we all have to pick our poison.

 
Old 11-11-2006, 08:36 AM   #11
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Re: Niacin Flush

If my HDL goes up 10 to 12 points, I'm definitely nominating Lenin as the spokesperson for Slo-Niacin . I'm hoping my total comes down. and the HDL goes up so that my ratio is down towards 4 to 3.5 to 1 (from 7:1) Probably shouldn't have eaten the buffalo chicken sandwich and 3 cookies on Thursday (day before testing) though .

 
Old 11-11-2006, 09:24 AM   #12
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Re: Niacin Flush

Quote:
The good thing about the flushing is that it is not harmful and it is not permanent. It goes away as quickly as it came.
That's not quite true. There are two conditions, rosacea, and telangiectasia that may develop and worsen with repeated flushes. They are both disfiguring facial conditions that affect lots of people in later years.
Flushing is NOT totally benign.

 
Old 11-11-2006, 11:32 AM   #13
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Re: Niacin Flush

Quote:
Originally Posted by Lenin
That's not quite true. There are two conditions, rosacea, and telangiectasia that may develop and worsen with repeated flushes. They are both disfiguring facial conditions that affect lots of people in later years.
Flushing is NOT totally benign.
Where can I read up more about this? There is no mention of this risk on the niaspan website. When I looked up telangiectasia in google it spoke mostly of the disease as it occurs in children or in patients taking steroids.

Thanks.

 
Old 11-12-2006, 09:28 AM   #14
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Re: Niacin Flush

cook,

Here's a lengthy discussion by a Dr. Nasr at the Cleveland Clinic which addresses the issue of flushing and its dangers and causes.
[url]http://www.clevelandclinicmeded.com/diseasemanagement/endocrinology/flushing/flushing.htm[/url]

You will find it interesting.

Reading many references to Rosacea will show extensive connections with niacin.

Telangiectasias are more difficult to unravel because often the term is used to decribe purple birthmarks...but a frequent occurrence is an ACQUIRED telangiectasia from irritating or flushing agents. Even extensive use of topical steroids can cause them.

But repeated flushing is pretty well agreed to be causative and aggravative of both conditions.

Last edited by Lenin; 11-12-2006 at 09:38 AM.

 
Old 11-15-2006, 10:01 AM   #15
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Re: Niacin Flush

My Husband takes the 1000 mg of Niaspan before going to bed along with his aspirin and has not had any flushing problems or is asleep when it happens and it hasn't woken him. In the morning he takes Lipitor.

 
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