Cholesterol lowering with niacin: Niacin or nicotinic acid, one of the water-soluble B vitamins, improves all lipoproteins when given in doses well above the vitamin requirement. Nicotinic acid lowers the total cholesterol, "bad" LDL-cholesterol, and triglyceride levels, while raising the "good" HDL-cholesterol level.
There are two types of nicotinic acid: immediate release and timed release. Most experts recommend starting with the immediate-release form; discuss with your doctor which type is best for you.
Nicotinic acid is inexpensive and widely accessible to patients without a prescription but must not be used for cholesterol lowering without the monitoring of a physician because of the potential side effects. (Nicotinamide, another form of the vitamin niacin, does not lower cholesterol levels and should not be used in the place of nicotinic acid.)
All patients taking nicotinic acid to lower serum cholesterol should be closely monitored by their doctor to avoid complications from this medication. Self-medication with nicotinic acid should definitely be avoided because of the possibility of missing a serious side effect if not under a doctor's care.
Patients on nicotinic acid are usually started on low daily doses and gradually increased to an average daily dose of 1.5 to 3 grams per day.
Nicotinic acid reduces LDL-cholesterol levels by 10 to 20 percent, reduces triglycerides by 20 to 50 percent, and raises HDL-cholesterol by 15 to 35 percent.