Dear Dr. Gott: I read your column often and notice that you mention taking niacin for many things. I started taking one tablet of 250-milligram time-released niacin to see if it would help lower my blood pressure and my cholesterol levels. After taking it for about 30 days, I was feeling great. However, one day I began having little pricks throughout my body. Thinking something was terribly wrong with me, I looked on the Internet and discovered some diseases with that symptom. I was just about to make an appointment with my doctor when I looked for information on niacin and discovered that one of the side effects is itching. I discontinued it, and my prickly sensations stopped very quickly.
Does this mean I will not ever be able to take niacin again? Are there other forms that might work better? I had renewed energy and really felt great while taking it.
Dear Reader: Niacin (vitamin B-3) has many beneficial properties. It is used to treat dizziness, headaches, circulatory problems, ringing in the ears, Raynaud’s syndrome and depression. In addition, it may increase energy, stimulate circulation, maintain normal blood pressure, raise HDL cholesterol levels and lower LDL cholesterol levels. Other uses are for acne, age-related macular degeneration, arthritis, hardening of the arteries, migraines, psoriasis, cataracts and more. It’s no wonder you felt good and had renewed energy while taking this supplement.
The prickly sensation that you experienced is a common side effect. Others include flushing of the face, neck and ears, palpitations, liver irritation and abnormal heart rhythms. Flushing and a prickling can occur when the daily dosage is 50 milligram or higher. While the feelings are often annoying, they are essentially harmless. To combat flushing, an aspirin or nonsteroidal anti-inflammatory (NSAID) can be taken for the first week or two with any form of niacin, or an antihistamine can be taken about 15 minutes prior to usage. This supplement should always be taken with food to prevent stomach upset.
The U.S. Department of Agriculture does not strictly regulate herbs and other supplements. Therefore, different forms or brands of niacin might be more appropriate for you.
A low dose of flush-free niacin can be used as a start for your hypertension and feeling of well-being. Unfortunately, perhaps because of the inclusion of the ingredient inositol hexanicotinate, the flush-free form appears to block any cholesterol benefits that might otherwise be realized. Follow the recommended dosage to maintain your nervous and digestive systems, skin health and to support cell growth.
Extended-release niacin may cause less flushing but can have a higher risk of stomach upset and liver irritation. Clotting problems, headache and decreased thyroid function have also been reported by some users. If the ultimate goal is better cholesterol readings, this is the preferred form.
Of note is the use of niacin for certain conditions associated with Type II diabetes. Its use has been controversial because of the possibility of worsening glycemic control. Therefore, patients with diabetes should check with their physician or pharmacist before taking niacin (or any other supplement).
Niacin deficiency is known as pellagra. It affects all body cells, especially those of the skin, nervous system and GI tract, where there is rapid turnover. Symptoms include indigestion, skin irregularities, weakness, fatigue and halitosis, anorexia and they can progress to include canker sores, nausea, vomiting and diarrhea.
Foods rich in niacin include lamb, poultry, tuna, eggs, peanut butter, avocados, peanuts, figs and wheat germ. The consumption of these foods will work toward lowering total cholesterol levels naturally, can relieve the pain of arthritis, and may rival prescription drugs or over-the-counter supplements. Remember, the benefits of this vitamin (and many others) can be lost through vigorous food processing, when taking sleeping pills or with alcohol consumption.
Vegetarians, vegans or people who drink alcohol in excess should consider taking a niacin supplement, as diets that lack protein are probably niacin deficient, and alcohol inhibits absorption of the vitamin.
To be on the safe side, check with your primary care physician before making the decision to resume your niacin. A simple blood test is all that is necessary to determine the possibility of vitamin B-3 deficiency. When it comes to your health, it’s always better to have a professional opinion.
To give you related information, I am sending you a copy of my Health Report “Vitamins and Minerals.” Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
Doctor Gott is a retired physician and the author of the book “Dr. Gott’s No Flour, No Sugar Diet,” available at most chain and independent bookstores, and the recently published “Dr. Gott’s No Flour, No Sugar Cookbook.”
Copyright 2008, Newspaper Enterprise Assn.
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