A lot of the attention regarding cholesterol has been focused 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.
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.
Niacin is found in many foods, including:
- Dairy products
- Lean meats
- Poultry
- Fish
- Nuts
- Eggs
- Enriched breads and cereals
Niacin is also available in a variety of different forms as either prescription medication or over-the-counter supplements. 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.
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.
Niacin comes in a variety of forms, ranging from fast-acting forms to those that are longer acting. Some forms of niacin, especially in high doses — 1,000 milligrams or more — do cause temporary flushing of the skin. The flushing can make your skin redden and possibly feel warm to the touch. While annoying, this flushing isn’t harmful. If you have flushing, talk to your doctor about taking an aspirin shortly before you take your niacin. Aspirin can counteract this flushing effect. Also, avoiding hot drinks and alcohol can decrease the flushing. Versions of niacin with reduced flushing effects also are available by prescription.
Other possible side effects include:
- Upset stomach
- Headache
- Dizziness
- Liver damage
- Increased blood sugar
However, your doctor may be able to find the right dose and form of niacin that minimizes side effects. Also, taking niacin with food may help prevent side effects. Remember, don’t take niacin — even in the over-the-counter form — without discussing it with your doctor first. Niacin can cause side effects when taken in high doses.
However, don’t start taking niacin to raise your HDL without talking to your doctor. Niacin must usually be given at high doses to raise your HDL cholesterol, and the use of high-dose niacin needs to be monitored by your doctor to make sure it doesn’t cause any harmful side effects.
Lifestyle changes are also helpful in boosting HDL. These include:
- Stop smoking if you are a smoker.
- Eat a healthy diet.
- Start an exercise program, with your doctor’s OK.
If you try steps like this and your HDL is still too low, your doctor may suggest you take niacin.
Niacin is usually given along with statins or other medications to people who have high LDL levels and low HDL. Check with your doctor before taking niacin with another medication to avoid any dangerous drug interactions.
However, in general, niacin seems to work even better when used in combination with statins, drugs used to lower your LDL cholesterol. In fact, when used with some statins, niacin can increase your HDL level by 50 percent or more, as well as reduce LDL levels more than when just statins are used.