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Niacin to boost your HDL, 'good,' cholesterol
Niacin is an important B vitamin that may raise your HDL, "good," cholesterol. Find out if you should talk to your doctor about taking niacin alone or with cholesterol medications.By Mayo Clinic staff
Niacin, a B vitamin, has long been used to increase high-density lipoprotein (HDL), or the "good," cholesterol. HDL cholesterol helps sweep up low-density lipoprotein (LDL), or the "bad," cholesterol, in your bloodstream. Although niacin is readily available and effective, it hasn't gotten much attention compared to other cholesterol drugs.
Most discussion about cholesterol focuses on lowering your low-density lipoprotein (LDL), or "bad," cholesterol. That's still an important goal. But boosting your HDL level can be just as important as lowering your LDL cholesterol. Taking niacin — either by itself or along with other cholesterol-lowering medication — may help control your total cholesterol level.
What is niacin?
Niacin (nicotinic acid) is a B vitamin that's used by your body to turn carbohydrates into energy. Niacin also helps keep your nervous system, digestive system, skin, hair and eyes healthy. That's why niacin is often a part of a daily multivitamin, though most people get enough niacin from the food they eat.
You may see niacin labeled in different ways. As part of a multivitamin or supplement, it's often just referred to as niacin. When it's used as a treatment to increase your HDL cholesterol or correct a niacin deficiency, it's sold in higher doses that are prescribed by your doctor. It's not possible to get enough niacin from the food you eat to increase your HDL cholesterol. Some common brand names of prescription niacin include:
Niacin is also available as an over-the-counter (OTC) supplement. However, don't take niacin — even in the over-the-counter form — without discussing it with your doctor first because niacin can cause side effects when taken in high doses.
What impact does niacin have on cholesterol?
Niacin can raise HDL cholesterol — the "good" cholesterol — by 15 to 35 percent. This makes niacin the most effective drug available for raising HDL cholesterol. While niacin's effect on HDL is of most interest, it's worth noting that niacin also decreases your LDL and triglyceride levels. High levels of LDL and triglycerides are significant risk factors for heart disease.
You may have heard that a large study that examined the effect of niacin to raise HDL cholesterol was stopped early. This study examined how niacin worked when used with statin medications for people who have a history of heart disease. The trial was stopped because no difference was seen between people who took prescription-strength niacin and people who took a placebo. The study also found there may be a small increase in the risk of stroke for people who take niacin to increase their HDL cholesterol level. More research is necessary to see how effective niacin might be compared with other heart disease medications. You shouldn't stop taking niacin unless you get your doctor's OK. Talk to your doctor if you're concerned about taking niacin.
Why is having a high HDL cholesterol level important?
HDL, or "good," cholesterol picks up excess bad cholesterol in your blood and takes it back to your liver for disposal. The higher your HDL cholesterol, the less bad cholesterol you'll have in your blood.
Cholesterol levels are measured in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L):
- For men, HDL levels under 40 mg/dL or 1 mmol/L increase the risk of heart disease.
- For women, HDL levels under 50 mg/dL or 1.3 mmol/L increase the risk of heart disease.
- An HDL level above 60 mg/dL or 1.6 mmol/L is considered ideal for men or women.
Having a low HDL level by itself is a risk factor for developing heart disease. That means even if your LDL and other risk factors are normal, having a low HDL level still increases your risk of heart disease.Next page
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- Grover SA, et al. Evaluating the incremental benefits of raising high-density lipoprotein cholesterol levels during lipid therapy after adjustment for the reductions in other blood lipid levels. Archives of Internal Medicine. 2009;169:1775.
- Singh IM, et al. High-density lipoprotein as a therapeutic target: A systematic review. Journal of the American Medical Association. 2007;298:786.
- Cholesterol-lowering drugs. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=163. Accessed Feb. 21, 2011.
- Guyton JR, et al. Safety considerations with niacin therapy. American Journal of Cardiology. 2007;6:S22.
- FDA statement on the AIM-HIGH trial. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm256841.htm. Accessed May 27, 2011.