What side effects are associated with taking high doses of niacin?
High-dose niacin can cause stomach upset and make your skin flush or itch. More importantly, niacin can increase your risk of:
- High blood sugar levels or type 2 diabetes
- Liver damage
Who might consider taking niacin?
In the past, it was thought that HDL levels would increase even more if niacin was added to cholesterol medications called statins, such as atorvastatin (Lipitor) and simvastatin (Zocor). But recent studies indicate that niacin provides little additional benefit when compared with statins alone, and may increase the risks of serious side effects.
Most doctors no longer recommend niacin for first line cholesterol control — except for people who can't tolerate statins. In those people, the benefits of niacin may outweigh the risk of potentially serious side effects.
What else can be done to increase HDL?
Lifestyle changes are helpful in boosting HDL:
April 15, 2017
- Stop smoking if you're a smoker.
- Eat a healthy diet.
- Start an exercise program, with your doctor's OK.
- Rosenson RS. Lipid lowering with drugs other than statins and fibrates. http://www.uptodate.com/home. Accessed Feb. 2, 2017.
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- What is cholesterol? National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/health-topics/topics/hbc#. Accessed Feb. 3, 2017.
- Silverman MG, et al. Association between lowering LDL-C and cardiovascular risk reduction among different therapeutic interventions. JAMA. 2016;316:1289.
- Niacin. Merck Manual Professional Version. http://www.merckmanuals.com/professional/nutritional-disorders/vitamin-deficiency%2c-dependency%2c-and-toxicity/niacin?qt=niacin&alt=sh. Accessed Feb. 3, 2017.
- Cholesterol medications. American Heart Association. http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Drug-Therapy-for-Cholesterol_UCM_305632_Article.jsp#.WJVUafImGLU. Accessed Feb. 3, 2017.
- Garg A, et al. Role of niacin in current clinical practice: A systematic review. American Journal of Medicine. 2017;130:173.
- Choi HY, et al. High-density lipoproteins: Biology, epidemiology, and clinical management. Canadian Journal of Cardiology. In press. Accessed Feb. 2, 2017.
- HDL cholesterol. Lab Tests Online. https://labtestsonline.org/understanding/analytes/hdl/tab/test/. Accessed Feb. 3, 2017.
- Rosenson RS. Clinical trials of cholesterol lowering in patients with cardiovascular disease or diabetes. http://www.uptodate.com/home. Accessed Feb. 2, 2017.