High Blood Cholesterol And Triglyceride Levels

• 1 500-2000 mg pure crystalline niacin (nicotinic acid) daily — this level should be reached gradually over a period of 4-6 weeks.

• 1 500-2000 mg taken once daily for extended-release preparations (best taken at night).

• Inositol hexaniacinate is often associated with less flushing (Rakel 2003).

Clinical note— Differences between major forms of niacin supplements

Three main forms of niacin supplements are produced, each with their own set of safety issues. Immediate-release niacin is associated with increased incidence of flushing and other adverse reactions, whereas sustained-release forms have been

associated with potential liver damage (Henkin et al 1990, McKenney 2004). In comparison, extended-release niacin has been found to have similar efficacy to immediate-release forms but results in minimal flushing, myopathy or hepatotoxicity (Guyton 2004, McKenney 2004, Pieper 2002, Yim & Chong 2003).

No-flush preparations of OTC niacin contain no free nicotinic acid and are unlikely to be effective in treating dyslipidaemia (Meyers et al 2003).

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