NIACIN....WTF

[T TOTAL]

Well ive tried niacin in the past and get the real bad flush/burn feeling even at low dosages. Just couldnt tolerate it.


However due to the health benefits i researched some more and from what i learnt i the sustained release was the way to go as opposed to the non flush, as these apparantly don't benefit cholestral as much if at all...


The sustained release are 500mg and i took them at bed time to eliminate any flushing if any. Thankfully there wasnt any at all....Phew....


However i took my tablket as normal at bed time, and then after about 20mins or so i could feel my neck and cheeks burning/tingling. Then my arms....my chest....my back......infact all over. WTF!!!!!


Felt like someone had poured acid over me. Ran in to the bathroom looked in the mirror and i was BRIGHT RED all over and white patches in places!!!!


Just had to lie in bed and ride it out which lasted atleast half hour...Ivwe no idea why this would happen this time after a good few weeks using the same.

Any suggestions??

I don't really fancy taken tonights dose now!!!

 

[leegee38]

Do you take a baby aspirin each day? If so, try taking the aspirin about a half hour before taking the niacin.

 

[Quad-smack]

200 mg of Ibuprofen once a day will also decrease the flushing. Go with the immediate release - much better results & less risk of liver damage...
Pantethine is another good nutritional supplement for cholesterol reduction. It does not cause flushing at all. Its effect is more of lowering LDL than raising HDL, but it still raises HDL significantly. Niacin therapy has a greater effect on raising HDL levels. Best of luck on your project.

 

[LATS]

QUAD.. THAT IS INTERESTING.. my doc put me on sust released niacin a while back because he said it was more effective..i take 500 at breakfast and 500 at dinner..

 

[Quad-smack]

QUAD.. THAT IS INTERESTING.. my doc put me on sust released niacin a while back because he said it was more effective..i take 500 at breakfast and 500 at dinner..

Compliance is very low with most immediate release niacin - niaspan was developed as a prescription med to be better tolerated. I'll see if I can dig up some studies for you guys.

 

[Quad-smack]

A good quick read:
Lipids Online: Educational Resources in Atherosclerosis

I'll also post the speaker's notes:

Three niacin products are available: an over-the-counter immediate-release formulation, an extended-release prescription formulation (Niaspan), and several over-the-counter sustained-release preparations. The LDL-C-lowering and HDL-C-raising efficacy of the sustained-release products is modest compared with the immediate-release products. Niaspan at its maximum daily dose of 2 g/d reduces LDL-C by about 15%. These products also differ importantly in the side effects they can produce (see below).

Immediate-release niacin has been shown to reduce fatal and nonfatal myocardial infarction in the Coronary Drug Project, a 6-year, placebo-controlled, randomized clinical trial. Nine years later (15 years after initiating niacin therapy), total mortality in niacin-treated patients was found to be significantly lower. Additionally, niacin has been used in combination with a bile acid resin in several angiographic trials showing a slowed progression of atherosclerosis.

Niacin is the best agent available for raising HDL-C and, in patients with mixed hyperlipidemia, shifts cholesterol from small LDL particles to larger ones, thus converting patients from the atherogenic pattern B to a less-atherogenic pattern A.

Its primary limitation is side effects. Immediate-release niacin and Niaspan cause flushing, itching, and headache, which limit the number of people who are willing or able to tolerate therapy on a long-term basis. Niaspan is recommended to be dosed at bedtime to limit this side effect. Additionally, aspirin should be taken 30 minutes before the first daily dose of niacin to limit these symptoms. Patients should also take their niacin dose with food to limit the flushing side effect.

Daily doses of 2 g or more of sustained-release niacin can cause hepatotoxicity, which is manifest in its mildest form as asymptomatic increases in liver transaminases and in its severest form as malaise, lethargy, anorexia, and other symptoms of hepatitis. Because of this risk, daily doses of these products should not exceed 2 g, and close monitoring of liver function (i.e., at baseline, every 6-12 weeks for the first year, and approximately every 6 months thereafter) should accompany use of these products. Most authorities recommend that the immediate-release or extended-release dosage forms be given preference to sustained-release products to avoid this risk.

Other side effects include activation of peptic ulcer, hyperglycemia, and gout. Niacin reduces insulin sensitivity and often worsens hyperglycemia in persons with type 2 diabetes.


Coronary Drug Project Research Group. Clofibrate and niacin in coronary heart disease. JAMA 1975;231:360-381.
Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ, Friedewald W, for the Coronary Drug Project Research Group. Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. J Am Coll Cardiol 1986;8:1245-1255.

Also - IMO, Niaspan (extended release) is much better than OTC sustained released products...

 

[Dado5]

Take noncoated aspirin 10 min before niacin and you will be fine. My dr. put me on 1000mg ofenduracin (slow release niacin) and told me to take Aspiring with it.
No more flushes.
But yeah flushes are nasty, i get red, tight skin and my hart starts pounding, then legs gets so itchy..

 

[Conan21]

i normally take mine before I go to bed 1,250 mgs.

usually i just fall asleep before it hits me and I don't experience any discomfort. but it does make me turn beat red and hot.

Sometimes I wake up in the middle of the night and my skin is ITCHING terribly. Almost to the point of driving me mad. I have to get out of bed and go play on the internet or something just to take me mind off of it. The strange thing is, this only happens occasionally. But It has caused me to discontinue using it the last couple weeks. Have been afraid of having an Itch attack

I need to start taking it again.

 

[SOCOM]

Take it with a small meal.

 

[mad_dawg]

I used to take regular niacin a long time ago, but had to take small doses and built up a tolerance to it. Then I could take the full tab. The rushes and cramps were a real bitch when I tried to take a full dose before building up to it. Not sure if you tried that?

Now I just take a no-rush formula at night. It doesn't bother me, however the first time or two I did notice a very slight tingling, but not since. You must be real sensitive to niacin. I have never heard of the aspirin thing, but it seams like lots of folks are recommending that so give it a try.

Peace,
Mad_dawg

 

[mad_dawg]

Oh, or with a snack like SOCOM said above.

 

[dabeast75]

Its normal

Hey Brabus, its normal that you get that kind of reaction from niacin. Its a supplement which flushes out toxins in the body, so these reactions are NORMAL. You just took too much to start up with. Your body needs to adapt to the niacin. Take a lower dose until your body stops getting a reaction and then you up the dosage.

Also, take it AFTER a meal.

And my key advice is to stop trying to suppress the symptoms of the niacin with Ibuprofin, NSADs or aspirin. Just let your body adapt tp the substance and then the symptoms will subside or go away completely.

 

[T TOTAL]

Thanks for all the responses and advice..

A few points of note. I already take a hand full of supplements with my evening meal, and this also includes a baby aspirin.

I don't fancy taking an ibubrufen to mask the reddening to be honest.

One point to note, which a few have missed is that i had been taking the niacin at the same time, ie bedtime, for a few weeks with no flushing whatsoever...

Then it was just last night i had the flushing, real bad at that...No idea why as i said. The tablet is only 500mg sustained release...

To be fair, i don't have high cholestral. It was more of a preventative measure why i was taking it. Now im not so sure after it has been said it can be hepatoxic and that there is an alternative perhaps...Hmmmmmm..

Makes you think..you take a supplement as a benefit, then find its perhaps not so beneficial in other ways..

 

[myosin]

Immediate Release- Agree

The sustained release causes more liver damage (or more potential for so I should say).

Also, taking the immediate release split throughout the day is bad as well. You want to expose the liver to Niacin for as short amount of time as possible.

So, take the entire amount all at once... then with the others suggestions (with a meal, etc).

The amount also needs to increased slowly... 500mg for a couple months, then, increase to 1000.

 

[Massive G]

A good quick read:
Lipids Online: Educational Resources in Atherosclerosis

I'll also post the speaker's notes:

Three niacin products are available: an over-the-counter immediate-release formulation, an extended-release prescription formulation (Niaspan), and several over-the-counter sustained-release preparations. The LDL-C-lowering and HDL-C-raising efficacy of the sustained-release products is modest compared with the immediate-release products. Niaspan at its maximum daily dose of 2 g/d reduces LDL-C by about 15%. These products also differ importantly in the side effects they can produce (see below).

Immediate-release niacin has been shown to reduce fatal and nonfatal myocardial infarction in the Coronary Drug Project, a 6-year, placebo-controlled, randomized clinical trial. Nine years later (15 years after initiating niacin therapy), total mortality in niacin-treated patients was found to be significantly lower. Additionally, niacin has been used in combination with a bile acid resin in several angiographic trials showing a slowed progression of atherosclerosis.

Niacin is the best agent available for raising HDL-C and, in patients with mixed hyperlipidemia, shifts cholesterol from small LDL particles to larger ones, thus converting patients from the atherogenic pattern B to a less-atherogenic pattern A.

Its primary limitation is side effects. Immediate-release niacin and Niaspan cause flushing, itching, and headache, which limit the number of people who are willing or able to tolerate therapy on a long-term basis. Niaspan is recommended to be dosed at bedtime to limit this side effect. Additionally, aspirin should be taken 30 minutes before the first daily dose of niacin to limit these symptoms. Patients should also take their niacin dose with food to limit the flushing side effect.

Daily doses of 2 g or more of sustained-release niacin can cause hepatotoxicity, which is manifest in its mildest form as asymptomatic increases in liver transaminases and in its severest form as malaise, lethargy, anorexia, and other symptoms of hepatitis. Because of this risk, daily doses of these products should not exceed 2 g, and close monitoring of liver function (i.e., at baseline, every 6-12 weeks for the first year, and approximately every 6 months thereafter) should accompany use of these products. Most authorities recommend that the immediate-release or extended-release dosage forms be given preference to sustained-release products to avoid this risk.

Other side effects include activation of peptic ulcer, hyperglycemia, and gout. Niacin reduces insulin sensitivity and often worsens hyperglycemia in persons with type 2 diabetes.


Coronary Drug Project Research Group. Clofibrate and niacin in coronary heart disease. JAMA 1975;231:360-381.
Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ, Friedewald W, for the Coronary Drug Project Research Group. Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. J Am Coll Cardiol 1986;8:1245-1255.

Also - IMO, Niaspan (extended release) is much better than OTC sustained released products...

great post.

 

[Massive G]

i normally take mine before I go to bed 1,250 mgs.

usually i just fall asleep before it hits me and I don't experience any discomfort. but it does make me turn beat red and hot.

Sometimes I wake up in the middle of the night and my skin is ITCHING terribly. Almost to the point of driving me mad. I have to get out of bed and go play on the internet or something just to take me mind off of it. The strange thing is, this only happens occasionally. But It has caused me to discontinue using it the last couple weeks. Have been afraid of having an Itch attack

I need to start taking it again.

I have 2 unopened bottles on my nightstand-one isa bottle of regular niacin caps, and the other is a bottle of red yest rice no flush niacin COQ10 combo capsules and still am apprehensive of taking them I am going to try them over the holidays since I am off work and if it keeps me awake a bit it won't effect work.

My cardiac stack consists of Carlson's Very Finest Fish Oil and Cod Liver Oil D3 capsules Vitamin E Gems Magnesium and Hawthorne Berry.

My cholesterol is in the 150's but the LDL and HDL are always a bit borderline so it can't hurt-and as mentioned above the particle size is a big factor in the over all picture. I'll have to throw mt baby aspirin in the stack as well.

 

[BigMatt]

Niacin.

Panthotenic Acid

Vitamind D3

Fish oil.

They all help with Cholesterol.

 

[LATS]

just to throw this out there.. flush free is not touted as a good promoted of hdl.. this can be seen in more and more studies coming out.. i was experiencing back pain and it would not go away.. so yesterday i had my appointment with my gen pract.. he is in the same office as a cardiac surgeon.. he asked if i was taking anything different as standard protocol.. i told him niacin as usual with my fish oils ect.. he asked what kind.. i told him the slow release.. we talked a bit about that..

he ended it with saying "well, the flush free is worthless".. i said that i knew a few guys that take it and swear buy it... he said "hold on"... walked out for about 5 minutes and in came the "cardiac man".. he peeked his head in and said " stay away from it.. it does nothing.. complete gimmick.." i repeated what i said about knowing those who swore it worked.. he said "what else they taking?" and smiled and walked out..

since then and this thread i have read every web article i could about flush free compared to regular.. and more and more articles are saying it is worthless... i too have taken flush free and thought it worked based on the blood work i had.. but i was also on fish oils, red yeast rice, vit d3 ect ect.. so i guess i can rule out flush free niacin lol.. i am also going to get rid of slo niacin.. after reading the reports about liver issues.. no thanks.. ill just get red!!! and live with it..

 

[LATS]

look at this study..towards the bottom

No Flush Niacin - What You Need To Know About No Flush Niacin

 

[maldorf]

Compliance is very low with most immediate release niacin - niaspan was developed as a prescription med to be better tolerated. I'll see if I can dig up some studies for you guys.

Niaspan will do that to me too sometimes. There is no rhyme or reason to it. Id say I get the flush maybe once per week. I read somewhere that drinking a lot of water if one comes on will make it go away. I tried it and sure enough it worked for me. So next time you get one try lots of water.