Niacin scams

As most of you know, niacin (vitamin B3) is an important tool for many in the Track Your Plaque program.


--raises HDL cholesterol
--reduces small LDL
--reduces lipoprotein(a)

And it's the most potent agent we have for all three patterns, despite just being a vitamin. Niacin also reduces LDL cholesterol, VLDL, IDL, triglycerides; reduces heart attack risk dramatically either alone or in combination with other agents.

Unfortunately, some people who are either afraid of the "hot flush" side effect, or experience excessive degrees of it, have resorted to two preparations sold in stores that have none of these effects.

Most notorious is "No-flush" niacin, also known as inositol hexaniacinate. This compound is an inositol sugar molecule complexed with 6 ("hexa-") niacin molecules. Unfortunately, it exerts none of niacin's effects in the human body. No-flush niacin has no effect on HDL, small LDL, or Lp(a), nor on LDL or heart attack.

In short, no-flush niacin is a scam. It's also not cheap. I've met people who have spent hundreds of dollars on this agent before they realize that nothing is happening, including a flush.

Likewise, nicotinamide does not work. It sounds awfully close to the other name for niacin, nicotinic acid. But they are two different things. Like no-flush niacin, nicotinamide has no effect on HDL, small LDL, Lp(a), etc.

Though I've discussed this issue in past, somehow these two "supplements" seem to sneak back into people's consciousness. You walk down the health food store aisle and spy that bottle of X-brand No-flush niacin, promising all the benefits of niacin with none of the bother. Then you remember that rough night you spent a few months back when the hot flush lasted longer than usual. That's when some people end up buying this agent making extravagant--and false--promises.

For now, for all its imperfections, niacin is still a pretty darn good agent for these patterns. Remember that the best strategy to minimize the hot flush effect is to drink plenty of water. We generally recommend taking the dose at dinner along with water. If the hot flush occurs, drink two large glasses of water (total volume 16-24 oz). Nine times out of ten, the flush is gone. It also dissipates the longer you take niacin.

Comments (11) -

  • auntulna

    1/12/2009 11:06:00 PM |

    I've been taking Slo-niacin for more than six months, and about three times it must have broken down too fast. That is an intense hot pins and needles rush! Anyone else had that happen?

  • Grandma S.

    1/13/2009 2:37:00 PM |

    Dr. Davis,
    I do appreciate your blog and the information you provide. I am switching to SloNiacin!

  • stern

    1/13/2009 7:54:00 PM |

    it appears to me that the only    final decisive enemy for the heart is the LA sort LDL,all other are the indicators that your body inclines forward to get that enemy .all other encompassess high tryglicerides ,high ldl,low small hdl,c reactive proyien ,am i wright ?

  • Anonymous

    1/13/2009 9:46:00 PM |

    Niamax is also a slow release niacin.

    Is Niamax acceptable or does it also fall into the scam group?

  • Anonymous

    1/14/2009 12:27:00 AM |

    Please comment on a niacin product I have been using for years by Endurance Products,a sustained form of nicotinic acid that causes no flush (1000 mg daily) plus their regular version of immediate release (250 mg daily). Thanks...

  • martha

    2/4/2009 4:06:00 PM |

    My name is Martha and I am  a  writer working on a story about niacin for Better Homes & Gardens' Heart-Healthy Living magazine. I hope to interview Dr. Davis but also wanted to talk to people who are taking niacin for my story. If you are interested, please email me at My deadline is Feb. 16. Thanks
    -martha miller

  • IggyDalrymple

    2/28/2009 2:37:00 AM |

    My VA doc has been prodding me for years to take statins for my bad LDL/HDL ratio.  I finally took Dr Davis' advice and starting taking niacin and it worked.  My doc is now happy.

  • SES

    3/3/2009 10:29:00 PM |

    There are so many people commenting on the side effects of statins I wonder if there are side effects to something like Niaspan. Hot flashes are not what I am talking about.

  • Mary P

    4/28/2009 6:23:00 AM |

    I was talking to a dietitian friend about your strong feelings about no-flush niacin. I'm confused because she pointed me towards a recent European Food Standards Agency report that states that inositol hexanicotinate is bioavailable to humans and a source of niacin (they say, on average, 70% of an oral dose is absorbed into the blood stream).

  • buy jeans

    11/2/2010 7:40:15 PM |

    Nicotinamide--Also called niacinamide. While the nicotinamide/niacinamide forms of vitamin B3 can be used to treat B3 deficiency ("pellagra"), they do not reproduce the lipid and lipoprotein effects of niacin. For our purposes, they are useless.

  • Troy Honaker

    1/4/2011 5:00:05 AM |

    Niacin does have a tendency to have a prickly flushing effect on the skin.  This is normal to my knowledge.  It's not really a "side effect," it's just niacin doing its job.  I have never known it to be dangerous.  It is temporary.