The cardiology department at Scripps Clinic recommends and prescribes pure, crystalline niacin. My understanding is that ONLY regular, "high flush" niacin causes the liver to produce less cholesterol. Furthermore, it is the flush that indicates that the niacin is working to lower blood cholesterol and LDL levels and raise HDL levels. There are myriad studies that support this.
Some thoughts on the type of B-3 taken for lipid control:
1) The flush is vasodilation similar to the effect of Viagra. A skin flush is an expected effect of vasodilation. The vasodialation promotes blood flow to areas that have deficient blood flow, including cardiac arteries. The increased blood flow to the extremities can be expected to help your vision, your complexion, and (ta-da) PN.
2) The itching is a histamine reaction. A chronic histamine release, as from allergies, is irritating and possibly harmful, but a brief histamine release promotes healing and detoxification.
3) Only nicotinic acid type niacin has been demonstrated to raise HDL, lower LDL, and lower serum cholesterol levels.
4) Sustained-release nicotinic acid niacin causes a high rate of liver damage at relatively low doses (3 gm/day) that are safe with pure crystalline nicotinic acid. This can be life threatening if a person's liver is already stressed from diabetes, drug use (including prescription medication), hepatitis, etc.
Here are two authoritative web articles on the subject:
http://www.annals.org/cgi/reprint/139/12/996.pdf
and
http://www.medicalconsumers.org/page...REDUCTION.html
Dosage depends on what your blood lipid profile is and what other drugs and supplements you are taking. I'm taking 2 gm/day but that is specifically based on my lipid profile and past history with niacin, diet changes, exercise, red-rice yeast supplementation, etc.
I take either
http://www.iherb.com/ProductDetails.aspx?c=1&pid=4344 or the type recommended by Scripps Clinic:
http://www.nextrxotc.com/detail.aspx?ID=2653
Are there recent studies concluding that no-flush niacin is safe and effective? If so, please provide links, which I'll share with the Scripps cardiologists.
Attached is a copy of the Scripps niacin protocol. It works. I have little flushing now unless I miss a dose or two. Click on the picture to expand it. If it's still too small to read, send me a private message with your email address and I'll send a larger copy out to you.