DEAR DR. GOTT: If it has any value, perhaps sometime you might write a little about the three forms of niacin that can be bought over-the-counter: plain niacin, flush-free niacin and extended-release niacin.
I am assuming that the value of niacin in its blood vessel dilating properties which could tend to move the free cholesterol out of the blood stream. If that is true, then I question the value of either the extended-release or flush-free niacin.
My reason for asking is that the plain niacin seems to be disappearing from store shelves. CVS cannot order it for me any more and directed me to Whole Foods. I have looked elsewhere (but not the internet). If this is a stupid question, please disregard it.
DEAR READER: Your question certainly isn’t stupid. In fact, I’m sure many of my readers have had questions about the various forms of niacin at one point or another. As to why CVS no longer carries it or why it is becoming harder to find, I cannot provide an answer. Perhaps one of my readers can shed some light on this situation.
As to the three forms of niacin and their differences, that I can answer.
Niacin, also known as B3, is a water soluble vitamin that the body requires in order to create certain co-enzymes. Most individuals can get adequate amounts through a proper diet.
Nicotinic acid (the most common form of niacin) is known to reduce serum cholesterol and triglyceride levels and improve cardiovascular health. When used in doses needed to produce these effects, it is considered a drug. It has been found to work best when combined with other lipid-lowering drugs. It also enables the user to take lower doses of each to reduce the risk of side effects, the most common of which are itching, flushing and gastrointestinal disturbances.
Extended-release niacin is essentially the same as regular niacin, except that the pills that deliver the medication to the blood stream are coated with a substance that limits the release. After the pill is swallowed, the digestive juices begin to break down the pill. This coating prevents that from occurring quickly, which then allows small amounts to be released over a longer period of time. This is done to reduce side effects.
Flush-free niacin is also known as inositol niacin. The added inositol is what prevents the flushing side effects. For some, this also appears to block the cholesterol/triglyceride lowering effects of the niacin.
Anyone interested in using niacin should first speak with his or her physician, as the product can interact with some medication, may not be appropriate for some with certain medical conditions, and some people may experience allergic reactions.
Readers who are interested in learning more can order my Health Report “Vitamins and Minerals”by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print an order form from my website, www.AskDrGottMD.com.
