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Most drugs used to prevent heart attacks lower either cholesterol or triglycerides, but niacin lowers both (3). Many doctors do not prescribe this very safe vitamin because it can cause terrible itching, burning and redness around 45 minutes after it is swallowed. You can prevent this skin reaction by taking a time-release capsule at the end of a meal and one adult aspirin each day (3). It doesn't matter when you take the aspirin and taking two aspirins are not more effective than one (1).

Niacin can cause abnormal liver function tests, high blood sugar levels and muscle pains. If you take niacin, you should have blood drawn for liver function tests every six to eight weeks. You can usually prevent high blood sugar levels by restricting foods made from sugar or flour such as bread, rolls, macaroni, spaghetti, bagels, crackers, cookies and white rice, and you should do that anyway if your blood levels of triglycerides or cholesterol are high. The muscle pain associated with taking niacin is usually associated with exercise.

1) PW Jungnickel, PA Maloley, EL Vandertuin, TE Peddicord, JR Campbell. Effect of two aspirin pretreatment regimens on niacin-induced cutaneous reactions. Journal of General Internal Medicine 12: 10 (OCT 1997):591-596.

2) JP Rindone, OG Arriola. Experience with crystalline niacin as the preferred drug for dyslipidemia in a specialty clinic. Pharmacotherapy 17: 6 (NOV-DEC 1997):1296-1299. Thus crystalline niacin was largely ineffective in treating patients with dyslipidemia.

3) JR Guyton, AC Goldberg, RA Kreisberg, DL Sprecher, HR Superko, CM Oconnor. Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia. American Journal of Cardiology 82: 6 (SEP 15 1998):737-743.

Checked 8/31/05

May 29th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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