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Niacin For High Blood Pressure

What Are The Pros And Cons Of Taking 500 Mg Of Niacin

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Niacin, which is also referred to as vitamin B-3, is one of eight B vitamins that plays a role in converting the calories you eat into usable energy. Niacin is also responsible for the production of stress and sex hormones and can help to improve circulation.

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According to the National Institutes of Health, you can consume all the niacin you need though diet, which makes niacin deficiency very uncommon in developed countries. While high doses of niacin present a number of serious risks, they may also be useful, under medical supervision, for treating high cholesterol. Consult with your doctor before adding supplements to your diet.

Tip

High doses of niacin are used as a treatment for lowering cholesterol. But consuming too much niacin in supplement form can cause side effects and be harmful to your health.

It May Help Manage Migraines

Although its unclear how niacin achieves therapeutic effects, it could be beneficial for migraine and tension-type headaches and the prevention of these headaches. Niacin may prevent migraine symptoms by widening the intracranial vessels and following contractions of the extracranial vessels.

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It Helps Control Cholesterol Levels

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Sometimes niacin is prescribed alongside cholesterol-lowering medications like statins to help normalize blood lipid levels. It can increase high-density lipoprotein cholesterol, which is the healthy kind of cholesterol, by 15% to 35%. And it can decrease low-density lipoprotein , the bad cholesterol, by 5% to 25%.

Other evidence indicates that niacin is good for people with an increased risk of heart attacks and heart disease because it not only lowers LDL cholesterol but also triglycerides. Niacin can decrease triglyceride levels by 20% to 50%. The prescription formulations Niaspan and Niacor have FDA approval to treat dyslipidemia .

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Niacin Can Cause Serious Side Effects In Heart

The vitamin niacin can cause significant side effects and offers no benefits for patients at high risk of heart disease who are taking cholesterol-lowering statin drugs.

Oxford University scientists presented results of the largest randomised clinical trial of niacin at the American College of Cardiology conference in San Francisco on Saturday.

The HPS2-THRIVE study found that adding extended release niacin to statin treatment made no difference to the chances of high-risk patients having a heart attack or stroke.

In addition, the researchers reported that niacin caused a significant number of different types of serious side effect. Some of the side effects of niacin were already known, but some of them were unexpected.

The use of niacin for the prevention of cardiovascular events should now be reconsidered, said principal investigator Professor Jane Armitage from Oxford Universitys Clinical Trial Service Unit. The HPS2-THRIVE trial shows that niacin causes significant hazards and does not reduce the number of people suffering heart attacks and strokes when added to treatments, such as cholesterol-lowering statin therapy, which are known to be safe and effective.

Its only by carrying out very large clinical trials that we can get clear answers on treatments like this, she added.

All trial participants were all given a statin drug called simvastatin as background treatment to reduce their initial cholesterol level.

May Improve Inflammatory Bowel Disease

Niacin has benefited some patients with ulcerative colitis, an inflammatory bowel disease. It is believed niacin helps in mucosal healing, leading to a remission of symptoms. The mucosal lining is the lining of body organs and cavities in this case, it is referred to as the inner lining of the gastrointestinal tracts.

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How To Follow A Niacin Flush

If youre wondering how long or how often to do a niacin flush as well proper dosage, always speak to your health care provider. Typically, doctors advise taking niacin with food and gradually increasing niacin dosage over the course of several weeks. Niacin extended-release supplements are often recommended. This version of niacin is designed to reduce the chance of skin flushing.

Heres an example of recommended dosing for a niacin flush with an extended-release niacin supplement:

  • Weeks 14: Daily dose of 500 milligrams of niacin extended-release taken at bedtime
  • Weeks 58: Daily dose of 1,000 milligrams of niacin extended-release taken at bedtime

After eight weeks, a doctor will typically evaluate the patients response to the niacin. Female patients have been known to require lower doses than male patients to see a desirable response. If the response to 1,000 milligrams is not adequate, the dosage may be increased to 1,500 milligrams and then 2,000 milligrams each day if needed. Niacin doses over 2,000 milligrams daily are usually not recommended. Its also recommended not to raise niacin dosage more than 500 milligrams over the course of four weeks.

May Reduce Blood Pressure

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One role of niacin is to release prostaglandins, or chemicals that help your blood vessels widen improving blood flow and reducing blood pressure. For this reason, niacin may play a role in the prevention or treatment of high blood pressure .

In one observational study of over 12,000 adults, researchers found that each 1 mg increase in daily niacin intake was associated with a 2% decrease in high blood pressure risk with the lowest overall high blood pressure risk seen at a daily niacin intake of 14.3 to 16.7 mg per day .

A high quality study also noted that single doses of 100 mg and 500 mg of niacin slightly reduced right ventricular systolic pressure (

However, more research is needed to confirm these effects.

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Usual Adult Dose For Hyperlipoproteinemia Type Iv

Immediate-release:

  • Initial dose: 250 mg orally once a day following the evening meal increase frequency and/or dose every 4 to 7 days to the desired effect or first-level therapeutic dose if the response is inadequate after 2 months, the dose can be increased at 2 to 4 week intervals to 1
  • Maintenance dose: 1 to 2 g orally 2 to 3 times a day
  • Maximum dose: 6 g/day

Sustained-release:

  • Weeks 1 to 4: 500 mg orally at bedtime
  • Weeks 5 to 8: 1000 mg orally at bedtime
  • After week 8: Titrate to patient response and tolerance if response to 1000 mg a day is inadequate, increase to 1500 mg a day may subsequently increase to 2000 mg a day: daily dose should not be increased more than 500 mg in a 4-week period
  • Maintenance dose: 1000 to 2000 mg orally at bedtime
  • Maximum dose: 2000 mg/day

How Much Niacin Should You Take

Since niacin can be used in different ways, talk to your health care provider about the best dosage for you.

Everyone needs a certain amount of niacin — from food or supplements — for the body to function normally. This amount is called the dietary reference intake , a term that is replacing the older and more familiar RDA . For niacin, the DRIs vary with age and other factors and are given in milligrams of niacin equivalents:

  • Children: between 2-16 milligrams daily, depending on age
  • Men: 16 milligrams daily
  • Women : 18 milligrams daily
  • Women : 17 milligrams daily
  • Maximum daily intake for adults of all ages: 35 milligrams daily

Most people can get the amount of niacin they need by eating a healthy diet.

If your doctor prescribes niacin, you might want to take it with food. This can prevent upset stomach. To reduce flushing — a harmless but uncomfortable side effect of niacin that describes redness and warmth in the face and neck — your health care provider might recommend taking niacin along with aspirin and avoiding alcohol and spicy foods.

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What Should I Know About Storage And Disposal Of This Medication

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture .

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.

What Other Information Should I Know

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Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to niacin.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking niacin.

Only use the brand and type of niacin that your doctor prescribed. Do not use another brand of niacin or switch between products without talking to your doctor. If you switch to a different brand or type of niacin, your dose may need to be changed.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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How Much Do You Need

The Recommended Daily Allowance for niacin depends on your age and gender. For ages 7 months and older, it is expressed as mg niacin equivalents . One NE is equal to 1 mg of niacin or 60 mg of tryptophan (

Summary

The recommended amount of niacin depends on your age and gender. Men need 16 mg NE per day, while women who are not pregnant or breastfeeding need 14 mg NE per day.

Niacin Benefits And Its Side Effects

Niacin, or vitamin B3, is one of the essential B-complex water-soluble vitamins that the body needs to turn food into energy. All of the vitamins and minerals are important for optimal health, but niacin is especially good for the nervous and digestive systems. Lets take a more in-depth look to better understand niacin benefits and its side effects.

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Message For The Clinic

Nicotinic acid is a well-known lipid-altering drug. The improved cardiovascular outcomes with nicotinic acid therapy are thought to be related to its favourable lipid effects. However, less known is that nicotinic acid may also lower blood pressure, particularly at higher doses administered over a longer period of time. It is possible that some of nicotinic acids cardiovascular outcome benefits may be related to an improvement in high blood pressure, which is a major cardiovascular disease risk factor.

May Help Treat Type 1 Diabetes

What is Vitamin B6

Type 1 diabetes is an autoimmune disease in which your body attacks and destroys insulin-creating cells in your pancreas.

Theres research to suggest that niacin could help protect those cells and possibly even lower the risk of type 1 diabetes in children who have a higher chance of developing this condition .

However, for people with type 2 diabetes, the role of niacin is more complicated.

On one hand, it can help lower the high cholesterol levels that are often seen in people with type 2 diabetes. On the other, it has the potential to increase blood sugar levels. As a result, people with diabetes who take niacin to treat high cholesterol also need to monitor their blood sugar carefully .

Fortunately, a more recent review of studies found that niacin did not have significant negative effects on blood sugar management in people with type 2 diabetes .

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How To Take Niacin

Use Niacin exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Niacin can cause flushing . These effects should disappear over time as you keep taking the medicine. Flushing may be worse if you drink alcohol or hot beverages shortly after taking niacin.

Your dose needs may change if you switch to a different brand, strength, or form of this medicine. Avoid medication errors by using only the form and strength your doctor prescribes.

If you stop taking niacin for any length of time, talk with your doctor before starting the medication again. You may need to restart the medication at a lower dose.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using niacin.

Niacin is only part of a complete treatment program that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely.

Your doctor may recommend you take aspirin or an NSAID to help prevent flushing. Keep using these medicines for as long as your doctor has prescribed.

Swallow the capsule or tablet whole and do not crush, chew, break, or open it.

Store at room temperature away from moisture and heat.

What Are The Risks Of Taking Niacin

  • Side effects. Niacin can cause flushing, especially when you first begin taking it. Your health care provider will probably suggest increasing the dose slowly to reduce this problem. They might also offer a time-release prescription formulation to control flushing. Niacin can cause upset stomach and diarrhea. However, all of these side effects tend to fade over time.
  • Risks. Niacin does have risks. It can cause liver problems, stomach ulcers, changes to glucose levels, muscle damage, low blood pressure, heart rhythm changes, and other issues. People with any health condition including liver or kidney disease, diabetes, high blood pressure, or cardiovascular problems need to talk to a doctor before using niacin supplements. Do not treat high cholesterol on your own with over-the-counter niacin supplements.
  • Interactions. If you take any medicines or supplements regularly, talk to your doctor before you start using niacin supplements. They could interact with medicines like diabetes drugs, blood thinners, anticonvulsants, blood pressure medicines, thyroid hormones, and antibiotics as well as supplements like ginkgo biloba and some antioxidants. Alcohol might increase the risk of liver problems. Though niacin is often used along with statins for high cholesterol, this combination may increase the risk for side effects. Get advice from your healthcare provider.

People with uncontrolled gout should also not take niacin supplements.

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It Promotes Joint Health

Vitamin B3 in the form of niacinamide has been shown to increase joint mobility and decrease joint pain, inflammation, and swelling. Because of its anti-inflammatory effect on joints, niacin may serve as a good treatment option for people with arthritis.

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