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At higher doses, niacin has been used to treat high cholesterol and triglyceride levels, since it can help lower LDL (“bad”) cholesterol and raise levels of HDL (“good”) cholesterol.
Although niacin and nicotinamide are identical in their vitamin activity, nicotinamide does not have the same pharmacological, lipid-modifying effects or side effects as niacin, i.e., when niacin takes on the -amide group, it does not reduce cholesterol nor cause flushing.
For example, lowering your LDL cholesterol by 1 millimole per liter (mmol/L) ... Niacin. PCSK9 inhibitors. More research is needed to find out if supplements like green tea, ...
Nicotinic acid, like fibrates, is also well suited for lowering triglycerides by 20–50%. It may also lower LDL by 5–25% and increase HDL by 15–35%. Niacin may cause hyperglycemia and may also cause liver damage. The niacin derivative acipimox is also associated with a modest decrease in LDL.
Pharmacologic (1- to 3-gram/day) niacin doses increase HDL levels by 10–30%, [61] making it the most powerful agent to increase HDL-cholesterol. [62] [63] A randomized clinical trial demonstrated that treatment with niacin can significantly reduce atherosclerosis progression and cardiovascular events. [64]
For example, Hensrud advised against using niacin, which lowers cholesterol but has side effects, among them flushing. It also can raise liver enzymes when taken in large doses, Hensrud said ...
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