Niacin: What forms are safe?

20. April 2011 William Davis (52)
Niacin, or vitamin B3, remains a confusing issue for many people. It shouldn't be.

It doesn't help that most physicians and many pharmacists also do not understand the basic issues surrounding niacin. The only reason why there is any level of prevailing knowledge about niacin is that Kos Pharmaceuticals managed to "pharmaceuticalize" a niacin preparation, prescription Niaspan, that provided the revenue to fund professional "education."

Niacin can be helpful to increase HDL, reduce small LDL particles and shift them towards the more benign large particles, reduce triglycerides, and reduce lipoprotein(a).

So here's a brief description of the various forms that you will find niacin:

Immediate-release niacin--Also called crystalline niacin or just niacin. This is the original niacin that releases within minutes of ingestion. Because it releases rapidly, it triggers the most intense "hot flush." While this form of niacin works wonderfully well, is the safest, and is dirt cheap, the majority of people are simply unable to tolerate the intense flush. It also works best taken twice a day, generating two intolerable flushes per day.

Slow-release niacin--These preparations were popular in the 1980s, since the slow 12 to 24 hour pattern of release minimized the annoying hot flush. But, with prolonged use, it also became apparent that an unnaceptable frequency of liver toxicity developed. Unfortunately, this means that any niacin preparation that trickles niacin out over an extended period, including many of the slow-release preparations now sold in health food stores and pharmacies, have potential for liver toxicity. These preparations should be avoided.

6-hour release niacin--Releasing niacin more slowly than immediate-release niacin but more rapidly than slow-release niacin, 6-hour release (or what the Niaspan people call "extended-release" niacin) is nearly as effective as immediate-release niacin with approximately the same low potential for liver toxicity. It is far less liver toxic than slow-release niacin. 6-hour release niacin therefore offers the best balance between effectiveness and safety. Preparations that show this pattern of release include Niaspan ($180 per month), the poorly-named Sloniacin (about $8 per month), and Enduracin (about $7 per month) for 1000 mg per day. (Some Track Your Plaque Members have also determined that several other over-the-counter preparations have been demonstrated to share a similar pattern of release.)

Then there are the scam products that have no useful effect at all:

Flush-free or no-flush niacin--Inositol hexaniacinate, or 6 niacin molecules bound to the sugar, inositol, has no effect in humans, at least not with the dozen or so preparations that I've seen used. Nor are there any data to document the effectiveness of flush-free niacin. It's also more expensive.

Nicotinamide--This niacin derivative likewise has no effect on the usual targets for niacin treatment.

While I used to prescribe Niaspan, the ridiculous pricing and aggressive marketing really turned me off. I now advise my patients and our online followers to use only Sloniacin or Enduracin, unless you can tolerate immediate-release niacin.
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Comments (52) -

  • Mikie

    4/19/2011 7:08:18 PM |

    How about this interesting source of Niacin ... drum roll please ....

    Food.

    Why the pills?  I guess to a hammer the whole world is a nail.

  • Anonymous

    4/19/2011 7:14:26 PM |

    Humans need about 20mg daily of Niacin, which can be met thru diet.
    Lipid modifying effects start to occur at levels above 1000 mg daily (sometimes not until 2000 mg).  It is essentially a type of over dose reaction.

    Tried niacin myself at only a few hundred mg daily.  Was able to tolerate the flushing, but then had the pleasure of passing 2 kidney stones.  Niacin has been given the boot ever since.

  • Anonymous

    4/19/2011 7:47:12 PM |

    Is there a relationship between niacin and kidney stones? I've had a kidney stone before and it isn't much fun.

    I tried Niacin several times, IR, Niaspan, and Enduracin. But I ended up getting heart palpitations on each. I also kinda felt weird, tired and generally lousy. And strangely enough, even though I toughed it out for several months, my HDL went down a point (at 500mg/daily -- Niaspan & Enduracin)

    Just wondering what can be done for those who are Niacin intolerant.

    And I tried the aspirin beforehand, taking with food, etc. Didn't matter in my case.

  • Anonymous

    4/19/2011 8:07:24 PM |

    Well, great...just great.  I've been taking NOW Foods Double Strength Flush-Free Niacin (500 mg) for a few months and now I'm told its for naught at best, and possibly damaging my liver.  There is a slight difference in the chemical name - Inositol Hexanicotinate.  I don't suppose that is significant?

    Anyway, I guess its back to the Sloniacin I took before.  At least that's considered safe.

    Regardless, I'm ever so grateful for this blog.  I learn something from most every post - even when it means I've been doing something wrong.

  • Daniel A. Clinton, RN, BSN

    4/19/2011 10:04:59 PM |

    I know Niacin has the power to make some numbers change, but is there any sort of credible evidence directly studying Niacin's effect on outcomes like heart attack and death? I am not comfortable inferring a benefit from alledged "cholesterol lowering."

  • Tara

    4/19/2011 10:12:41 PM |

    Good reminder post, Doc!  

    Mikie-
    I'm normally a proponent of getting your micronutrients from food, but in the case of therapeutic doses of niacin it's just not feasible.  1000mg of niacin= 19 pounds of yellowfin tuna, 17 lbs of chicken, or 500 cups of asparagus

  • Anonymous

    4/19/2011 10:45:33 PM |

    quote:
    .. but is there any sort of credible evidence directly studying Niacin's effect on outcomes like heart attack and death? I am not comfortable inferring a benefit from alleged "cholesterol lowering."

    It's interesting with niacin, even after discontinuation it seems to have an effect on mortality:

    http://www.ncbi.nlm.nih.gov/pubmed/3782631

  • Anonymous

    4/19/2011 11:09:27 PM |

    Daniel,

    It is my understanding that therapeutic doses of Niacin is VERY cardio-protective (assuming the person in question can tolerate it). Lookup the HATS, FATS & CLAS trials. Check out Dr. B G's blog for more info on this:

    http://drbganimalpharm.blogspot.com/2009/09/cardio-controversies-dr-superko-md.html

    John M.

  • Anonymous

    4/19/2011 11:16:17 PM |

    I've been taking SloNiacin at 1500 mg/day for quite some time. Recently my HDL went up to 60 mg/dl from 50. No problems with flushing or liver fuction or kidney stones. I've become interested in the use of Niacin plus bile acid binding resin (colestipol) to reduce plaque in arteries (PAD). The studies are old, 1980's and 1990's, and of limited number of patients. However on the Niaspan website they claim that Niaspan along with diet and a bile acid binding resin is FDA approved not only to slow down plaque buildup, but also to help reduce plaque that already exists. niaspan.com/heart-healthy/plaque-build-up.aspx  ...  They cite the old studies on the web page.

    I wonder if the claim is substantially true about plaque reduction and FDA approval.

  • steve

    4/19/2011 11:51:44 PM |

    interesting post.  My doctor said that Slo Niacin is less tolerated than Niaspan.  He does not care which you use.

    Separate question: what impact does Niacin have on blood sugars and homocysteine?

  • michael goroncy

    4/20/2011 12:21:50 AM |

    I have reason to treat aggressively this 'spooky' disease of the heart. The science and anecdotal experience of cardiologists (who stay on the 'cutting edge') like Dr Davis and a few others will attest to the overwhelming positive effects of NIACIN.
    I have titrated my Nicotinic Acid (OTC ..100 tabs..cost $11) up to a daily dose of 1.5gm.
    The intolerable flush I concluded is in the main...PSYCHOSOMATIC.
    At first I thought the uncomfortable feeling was unnatural and  possibly harmful but, the science convinced me that it was harmless. The tact I adopted was to enjoy the flush and look on it as a
    wonderful healing zooming through the body. The actual flush cannot harm...the liver is another story.
    Sheesh! The things you have to do to play mind games.
    The use and other add on supplements  have created excellent lipids (Iam thinking of entering them in the State Championships)
    Learn to love the flush..small discomfort-huge benefits.

  • Bobby

    4/20/2011 12:51:34 AM |

    I have been taking good old regular niacin and actually like the flush--it makes me feel like it is doing something. However, my blood glucose is somewhat elevated (104) over what I believe it should be. My doctor isn't concerned , but I'm not sure. Any feed back?

  • Dr. William Davis

    4/20/2011 2:22:21 AM |

    That's great, Tara!

    It would be a great episode of Man vs. Food.

  • Dr. William Davis

    4/20/2011 2:23:55 AM |

    A discussion of the downsides of niacin, even when done properly, sounds like it might be of help to many people.

    I'l put it on the "to-do" list.

  • Dymphna

    4/20/2011 2:29:15 AM |

    Did anyone have nausea with higher levels of niacin? I've tried it but it makes me somewhat sick-feeling.

    Any ideas?

  • Anonymous

    4/20/2011 12:09:20 PM |

    I'd second the notion to avoid real-slow release niacin...I looked in the mirror to see someone with yellow skin when taking some.

    So what are the available 6 hour release brands?

    And what about pomegranate extracts to help clear plaque buildup?

  • Renfrew

    4/20/2011 12:37:06 PM |

    Good thread.
    I am taking a form of niacin that has 1000 mg of Niacin plus 20 mg of Laropiprant. The Laropiprant is a prostaglandin inhibitor and prevents flushes.
    The brand name is "Tredaptive".

    My LDL Cholesterol went from 160 to 120 within 1 month. Trigs from 75 to 55.

    I combine the tablet with 500 mg of milk-thistle (for liver protection) and have not had any increase in liver enzymes.

    That is really a workable compromise and easy to take as one tablet a day.

    Not sure if this is available in the US though, I am living in Germany.

  • Anonymous

    4/20/2011 1:06:25 PM |

    I'd be interested in knowing more about the twice-a-day recommendation. I've been taking my immediate-release 2gm/day dose once a day for a couple of years now. (Yes, I get the flush--and my liver numbers are good.)  Dr Davis seems to be saying to take (in my case) 1gm every 12 hours?  Is this easier on the liver?

  • Anonymous

    4/20/2011 1:22:59 PM |

    Too many adverse effects from taking Niacin.  It's not worth the risk.

  • Anonymous

    4/20/2011 2:52:24 PM |

    I would like to hear the author's opinions on the best forms of excersise for heart health.

  • Dr. William Davis

    4/20/2011 3:17:43 PM |

    Hi, Renfrew-

    I believe you have earlier access to this preparation than we do.

    This may an interesting, though prescription, possibility for those who have intolerable flushes.

  • Dr. William Davis

    4/20/2011 3:19:36 PM |

    Re: comments about the potential dangers of niacin.

    We always have to weight the risks vs. benefits. If I have, for instance, a 45-year survivor of sudden cardiac death with 3 stents who I meet with BMI 23.0 and a lipoprotein(a) of 450 nmol/L, then niacin is a small price to pay.

    Every situation is unique.

  • Anonymous

    4/20/2011 4:45:00 PM |

    In regards to the risks - can you direct me to research on that. A personal friend of mine had been on a research program in the past for a major pharma in northern Illinois. What they were trying to do was find exactly how niacin works so the process could be synthesized and patented. The project was not successful. In laying the groundwork for the project he had to look at past use of it in the treatment for heart disease. Older docs he interviewed had used up to 3 grams a day with no adverse effects to their patients. Used as a drug, my friend feels it is the safest non diet way to control Tri's and raise HDL. Personally I have take 2 grams a day for well over a year. No harmful effects, blood work normal.
    Without statins, tri - 151, HDL - 32
    With Crestor 10mg tri 80 to 100, HDL 45.
    With 2 gram niacin - Tri 52, HDL 80.
    I take regular niacin. After a while, you will experience almost no flushing. Your body will acclimate.
    I tout the use of it because it seems a lot of docs have forgotten it's usefulness. Keep up the info when you can.

  • Anonymous

    4/20/2011 4:59:05 PM |

    I've taken immediate-release niacin since 2003 and the only time I developed elevated liver enzymes was when I split a 4 gram daily dose into three divided doses.  I can take 1 gram three times a day with no problems, or up to 2.5 grams twice a day with no problems.  However, HDL elevation seems to plateau at 3 grams a day.

    Once in the last 3 years my doctor took me off niacin for 3 weeks to perform an NMR lipoprotein test.  With carbohydrate consumption under 70 grams a day and fat intake of 67%, my LDL particle count was over 2,000 and over 75% of them were small and dense.

    Niacin is the only way for me to reduce my small, dense LDL to a safer level.  Diet and exercise is not enough.  I suppose this explains why every male (except for me) has a major heart attack or stroke by the age of 50.

  • Anonymous

    4/20/2011 5:04:31 PM |

    One reason aspirin blocks only part of the flush is that the flush is produced by two separate mechanisms.  The most well known is the release of PGD2 from mast cells.  The other, which is rarely mentioned, is the release of serotonin from platelets.  Serotonin antagonists completely block the flushing due that mechanism (see "Niacin-induced “flush” Involves Release of PGD2 from Mast Cells and Serotonin from Platelets: Evidence from Human Cells In Vitro and an Animal Model", Dean Papaliodis,2008, American Society for Pharmacology and Experimental Therapeutics"

  • Sara

    4/20/2011 7:42:08 PM |

    I think niacin and metformin are 2 of the most powerful and safest drugs for metabolic syndrome.

  • pjnoir

    4/20/2011 9:39:57 PM |

    High doses of Niacin will increase blood sugars - I'll take my chances with Chloresterol (mind is low enough) then mess with my sugars.

  • pjnoir

    4/20/2011 10:07:25 PM |

    *mine    not mind  
    Sara- since blood sugars go up- how can it be a good choice to improve metabolism?

  • Might-o'chondri-AL

    4/20/2011 11:00:14 PM |

    ? Anyone with input on the supposed benefit of taking Niacin every other day, instead of daily ?
    Someone brought it up once in an old niacin post of this blog, but nobody else seemed to know about that dosing.

  • Christi

    4/21/2011 12:16:02 AM |

    You could also add Protandim to your daily regimen. Pubmed.gov studies have shown Protandim to be extremely helpful in heart disease. It reduces Oxidative Stress and inflammation in the cells. www.dailylifesource.com

  • christi

    4/21/2011 12:18:13 AM |

    You should also add Protandim to your daily regimen. I first was exposed to this product on the ABC Primetime news investigative report. Pubmed.gov has published peer reviewed studies that show Protandim is very effective with heart disease. Check out the ABC news program here: www.dailylifesource.com

  • Anonymous

    4/21/2011 3:18:08 AM |

    Christi:

    I looked up on Wikipedia the supplement Protandim you mentioned. I am familiar with 4 of the 5 ingredients it contains and while the 4 have a good reputation, I am not impressed with the overall product. Most of the studies were conducted in an animal model. If I was looking to raise my endogenous antioxidant levels (SOD, catalase & glutathione) like Protandim claims, I would take GliSODin instead...probably in the form of Life Extension brand Endothelial Defense. I am sure Endothelial Defense is more cost effective and a has meaningful doses of better researched ingredients.

    Pjnoir:

    While it is true that Niacin can raise fasting glucose a few points, this can be more than made up for with a better diet and exercise. In fact, niacin might actually increase insulin sensitivity. Niacin is also extremely cardio protective. The HATS trial showed that Simvastatin+niacin reduced CHD events 89% less than the placebo group.

    John M.

  • Anonymous

    4/21/2011 6:42:52 AM |

    Kenneth....
    After a long period of utterly fruitless treatment with flush-free niacin as high as 4 grams a day, I started good old fashioned immediate release niacin.

    The flushing is manageable. The key is in slowly titrating up to your target dose. I think I went up maybe 50 mg a day every two weeks. I've been at 500 mg twice a day for months. I only get bad flushing when I let myself get dehydrated or indulge in sugar or other pro-inflammatory foods ie fast food or chips, things you shouldn't be eating anyway.

    There is some evidence that flavanoids can mitigate the flush, and I've had good luck with 600 mg or so of quercetin taken with my fish oil half an hour or so before the niacin. Baby aspirin helps, as does celebrex when I happen to take it for aches. I haven't been able to escalate the dose as I started getting muscle pains and fatigue even though my liver panels didn't indicate any problem. Everyone has different reactions, but don't write off niacin until you've given it a fair shot.  

    I will also tell you that Niaspan is NOT in fact flush-free either. I tried it for a short while and found that it simply delayed the flushing. The product literature says as much. The strategy is simply to put off the flushing until you're already asleep, and you pay hundreds of dollars more for that dubious benefit.

  • Hans Keer

    4/21/2011 10:07:15 AM |

    Why pills? Meat, vegetables and fruit deliver all the B3 you need.

  • Anonymous

    4/21/2011 12:36:50 PM |

    Even though I'm pre-diabetic, I've never experienced blood sugar elevation with niacin.

    The tolerance to the flushing develops with continuous use.  Although I've never tried it, every other day dosing may result in a more pronounced flushing effect.

    I've also used quercetin concurrently with niacin and have noticed a decrease in flushing.  I'm very fair-skinned and still experience flushing after all these years.

  • Anonymous

    4/21/2011 12:50:54 PM |

    What would be interesting if people who are using Niacin here tell us, what effect it had on their respective Cholesterol levels (HDL, LDL, Trigs).
    And if they had any issues with increasing liver enzymes or higher bloodsuger.

  • Kent

    4/21/2011 3:16:42 PM |

    Just an observation on the (Niaspan or intermediate release verses the imediate release.  I found Niaspan along with other LP(a) supplements (fish oil, Coq10, Pauling Protocol, low wheat) to work much better than the Intermediate release niacin. My LP(a) started at 198 and dropped to 45 with Naiaspan included in the regimen. I switched to imediate release and it went up to 150. I switched back to Niaspan and the LP(a) dropped back down. Has anyone else experienced this phenomena?

  • Leshme

    4/22/2011 2:30:31 AM |

    Since I began taking 1,000mg of regular niacin/day, my blood platelet count has hovered around 120,000. I have read online that niacin may cause a reduction in blood platelets. Can anyone comment?

  • Anonymous

    4/22/2011 6:52:39 AM |

    I use immediate release Niacin 2 grams a day.  Have used as much as 4 grams a day.

    I find that if I take any other supplements with plenty of fluid/food - usually a glass of tomato juice and a glass of water - and then wait for about 15 minutes before taking the niacin, I don't get a flush except maybe once a month and only slightly.  I use capsules and pull them slightly apart so that I can seperate them before swallowing, otherwise I might get a flush at some random time in the future when the capsules finally break open.  When I used to use tablets, I would chew them up so I wouldn't get a random flush at some future point.

  • Anonymous

    4/22/2011 3:26:02 PM |

    I took Niaspan for almost six months.  My physician started me off at 700mg and I ended up at 1000mg by the time I was taken off of it.  My blood work was somewhat better but nothing spectacular and it sure wasn't good enough for me to endure the extreme flushing I experienced three or four times a week. My whole body turned a dark apple red and I experienced extreme itching over every square inch of my body at once for thrity to forty-five minutes, as if I had millions of ants crawling on me.  I've read comments about how people enjoy this experience and I cannot begin to comprehend that as it was like being tortured to me.  I would scratch myself so much that I tore my skin.  Flushing took place even after taking aspirin and eating yogurt thirty minutes to an hour prior to taking it. You can have your niacin.  I'll stick to my Crestor.

  • Anonymous

    4/22/2011 5:08:25 PM |

    Dr. William Davis said...

        A discussion of the downsides of niacin, even when done properly, sounds like it might be of help to many people.

        I'l put it on the "to-do" list.
    .................

    I scheduled a general checkup in a few weeks, which I'm going to request a purines test, since I've read Niacin might affect gout sufferers.

    I've not been diagnosed with gout, but as it runs in my family, and I've also read that even though females get it less - that changes after (menopause, which I've started).

    Paternal grandfather suffered from diagnosed gout for years - he had many stomach bleeds from gout meds, so was taken off them. His last gout attack landed him in the hospital: Normal diet, IVF @ 125cc/hr, Foley output at end of day: ZERO.

    Younger brother's first gout attack  in late 30's (has one kidney, which probably hastened things). Mother also thinks she had one gout attack after over-indulging on a roast too many days in a row - she recognized her toe as looking like granddaddy's (not her father).

    So I'll play it safe and wait to see that my hormone situation didn't trigger high purine levels before starting slowly on SloNiacin.

    Please consider including Gout/Niacin info in your article Dr. Davis, and correct any mis-info I might have misinterpreted. I'll ask my GP if he orders liver functions with checkups at my age.

    Shreela

  • Jim (formerly anonymous)

    4/22/2011 11:53:16 PM |

    A Different Anonymous said...

        What would be interesting if people who are using Niacin here tell us, what effect it had on their respective Cholesterol levels (HDL, LDL, Trigs).
        And if they had any issues with increasing liver enzymes or higher bloodsuger.

        April 21, 2011

    I gave my results much earlier.

    I think that people here fail to understand that the very first successful Cholesterol lowering "drug" was niacin, plain old drugstore type.

    Evidently, the first American drug trial of Niacin was run by William Parsons Jr. MD in 1955 who was then a Resident at Mayo clinic. The actual use of Niacin was pioneered by the Canadians, and Parsons heard about it from a visiting Canadian Physician.

    There is therefore well over a half a century of use of Niacin for cholesterol control.

    Many MD's did't like it, because it is an unregulated non-prescription substance. Now there is a prescription form which is very expensive and well promoted with big bucks and drug representatives to push it.

    Dr. Parsons became less of a researcher and more of a clinician in later years. He has published a book "Cholesterol Control Without Diet : The Niacin Solution" which I suggest that you look at (library) or buy, if you are interested in the use of Niacin for cholesterol control.ISBN 0966256875 $14.95. 276 pages.

    With the expensive prescription Niaspan, now made and sold and marketed by Abbott Laboratories,the classical resistance of MD's to use this treatment is falling. No vitamin supplement firm could do this level of marketing for a cheap generic pill.

    From page 196:
    "Since the 1996 edition, there have been no more significant reports of liver problems with niacin. ...... and yet there are still no more than the 18 cases we listed here, 5 of them questionable."

    He also discusses the studies designed to make Niacin look bad, and Statins look good.

    It can be said that there is considerable confusion as to how Statins actually work. The first theory was cholesterol lowering. As evidence for inflammation to be a more dominant mechanism for CHD, there are now more reports that Statins have anti-inflammatory properties. But after all of the millions and millions of dollars spent on Statin R&D, the exact behavior of Statins is still not understood in detail.

    In fact, there were no real good theories for the painkilling behavior of Aspirin until sometime in about the 1960's or later.

    There are tons of information about Niacin out there, you have to go look for them, or buy the books. Well, you can just ask somebody to feed the information to you. That still works as a labor saving device.

  • Anonymous

    4/23/2011 2:23:35 PM |

    Thank you for the reminder to check into my "Now" brand Niacin.  

    Now claims sustained release formula on the bottle but there is nothing in the ingredients to suggest any coating or binding.  Regardless, I have been taking 2grms for a long time last thing at night along with my 2.7grms omega3 and 20mg crestor. Trigs and LDL were well controlled with this combo but my HDL was still only 45.  Then I switched back to eating meat(saturated fat), lowered my grain intake and last blood test HDL was 67.  the down side was my LDL went up 10%

    Regarding the Flush. If I awake after a few hrs into my sleep, often I will feel the flush/itchy skin.  Small price to pay for 90% reduction in a heart attack.

    Trev

  • Anonymous

    4/23/2011 2:45:06 PM |

    http://www.scribd.com/doc/50437/Niacin#fullscreen:off

    excellent summary of Niacin types and explanation  for liver toxicity.
    Trev

  • jbuch

    4/26/2011 2:51:35 PM |

    Excellent article on the Pharmacists knowledge of the different forms of niacin.

    Inspired me to do some more digging and I found this excellent webpage which is a baseline discussion of the ARBITER 6 Trial, with excellent comments on Niacin myths and factoids.

    http://www.theheart.org/article/1022265.do

    In particular, look at the readers comments, evidently almost exclusively MD, numbers 34 to about 57. It is here that some of the common myths and factoids are noted, mostly with literature citations rather than unsubstantiated claims.

    Below is one example.
    ---------------------------

    Niacin Dissolution Rates
    I recently came across an interesting paper on the dissolution rates of various niacin formulations. Niaspan was best in terms of slow dissolution, followed by Enduracin and Slo-niacin. For those interested:

    Poon, Ivy O., Chow, Diana S.-L., Liang, Dong
    Dissolution profiles of nonprescription extended-release niacin and inositol niacinate products
    Am J Health Syst Pharm 2006 63: 2128-2134
    ------------------------

  • Susan

    5/8/2011 7:20:26 AM |

    You might want to take a closer look at Protandim, it's not a simple product and takes a bit of time to take in what it really does in the body. There is proof that it  raises SOD in a human peer-reviewed study. Protandim is proven to increase catalase, glutathione, and a number of other endogenous antioxidants in addition to increasing SOD. The science is there, but how I really know it works is through what it has done for me and quite a number of people I know who have had notable improvements in their health. There is nothing wrong with glisodin, but it isn't in the same class as Protandim.  Protandim is proven to work through the activation of the Nrf2 transcription factor, up-regulating the antioxidant response gene sequence that causes the body to produce it's own native antioxidant products in every cell of the body. This site explains more about it and has links to supportive science:  www.radicalresults.net

  • yves

    5/11/2011 12:37:31 AM |

    Any insight as to whether Nicotinamide may be effective for those with fungal infections?
    http://www.wellnessresources.com/studies/niacinamide_helps_combat_candida_albicans/

  • georgepds

    5/20/2011 4:40:12 PM |

    "Why pills? Meat, vegetables and fruit deliver all the B3 you need."

    Because you would have to eat too much to get a clinical benefit

    You need 1000 to 2000 mg, 4 oz of chicken gets only 14 mg.. so, for the clinical benefit, you'd have to eat ~400 oz of chicken, or about 25 pounds of chicken a day.. just a  tad too much chiken for me


    http://www.whfoods.com/genpage.php?tname=nutrient&dbid=83

  • Ken Levin

    6/5/2011 11:00:23 PM |

    Hi Dr Davis, I'm a new Track Your Plaque member and noticed two new studies claiming niacin was not helpful in reducing the incidence of heart attack. One study compared Zocor with and without  niaspan (summarized in New York Times about a week ago)  and one studied niacin (not sure which form, heard about the study through a physician)  alone.   Do these studies change your recommendations about niacin for Track Your Plaque members?  Thanks in advance and thank you for your Track your Plaque program.

  • Jonathan

    6/6/2011 5:03:29 PM |

    All I could find around here locally was slow release niacin (capsule shaped tablet).  I pop two 500mg and chew them.  I get a real nice flush.

  • Jesse

    6/24/2011 4:42:46 PM |

    Dr Davis, can you comment on the studies mentioned by Ken Levin above? I would be interested to know the specifics about them, and if they hold nay water.

    Thanks

  • M2

    7/2/2011 6:17:01 PM |

    Dr. Davis, very interested in a response to the niacin studies referenced by Ken and Jesse above.

    Thanks!

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