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Cholesterol is essential for life and optimal functioning of the body.  It is an essential ingredient in bile acids that digest foods.  In addition hormones, that control the workings of your body and the cell membrane of all 3 trillion cells in your body contain cholesterol.1 Without it, human life is impossible.  Nonetheless, cholesterol has become almost a profanity in the medical field.  It kills you, right?  Only if you have too much and that’s where nicotinic acid comes in.

As with everything we consume, cholesterol ultimately ends up in your blood.  Once there, it has the potential to stick to and clog arteries.  Current research has suggested that this may be due, at least in part, to inflamed arteries.2  In other words, cholesterol does not stick well to un-inflamed arteries so inflammation may be more of the problem that high cholesterol.  Nevertheless, some people are genetically predisposed to have high cholesterol levels and thus are at higher risk for heart attacks and stroke.3 

What Is, and Isn’t Cholesterol?

There are two lipoproteins, incorrectly referred to as LDL and HDL cholesterol.  These are NOT cholesterol, although they do contain some.  Both carry fats and cholesterol into and out of the blood, respectively.  And of course, the more you have in your blood, the higher the risk of problems.  So, high LDL is “bad” and high LDL is “good.” 4  A diet high in saturated and/or trans-fats tends to encourage higher LDL’s while a diet high in unsaturated fats, particularly omega-3’s, tends to promote HDL’s.  But, as I just said, some people have a genetic predisposition to have high LDL and/or low HDL and thus high blood cholesterol and therefore higher risk of heart disease and stroke.  This is probably because the liver makes cholesterol too and is simply making too much. 

How About Niacin as one of the Ways to lower Cholesterol?

So, although diet and exercise are perhaps the most important ways to control cholesterol, they are not always enough.  Thus, supplemental help may be necessary.  Fish oil, plant sterols, fiber, red yeast rice and others have all shown some promise, but they don’t always do the job for everyone.  Niacin, or vitamin B3, of which there are several types, is also frequently sold to this end.  However, what is often left out of the conversation is the type of niacin they use.

Flush Free vs. Effective at Lowering Cholesterol

Ironically, many products advertise to be ‘flush free’ niacin, a tell-tale sign that the form of niacin is NOT nicotinic acid.  Other forms can lower cholesterol, but only in huge doses.5  In fact, nicotinic acid is the only form of niacin that will flush your skin. Of course, this is likely part of the reason it works.  Your skin will become red and may feel a little itchy.  You will also feel warmer, or maybe colder, than normal for about 30 minutes, maybe 60.  The reason is that nicotinic acid causes vasodilation, meaning your blood vessels sort of stretch out and allow more blood flow.  This allows it to get around better and inhibit the formation of LDL’s.  With fewer LDL’s, there is less cholesterol flowing INTO your blood and more flowing INTO cells to be used up.6 

My Story with Nicotinic Acid

I seem to have a genetic predisposition for high cholesterol myself, probably from my grandmother.  She has alwasys been high as well and even despite a diet of almost no fat or cholesterol, wasn’t able to change it.  In fact, her cupboards were always full of crackers and cereals that tasted like a tree.  It seems that her liver was making so much cholesterol that even removing it from her diet wasn’t enough.  Ironically however, my grandfather has consumed large amounts of butter and salt his whole life and is still alive at 93! 

Nicotinic Acid was the Only Supplement that Made a Real Difference for Me

Anyway, I had the same problem.  My total cholesterol was stubbornly above 200 with high LDL and low HDL from the time my doctor started

testing me for it.  I fought drugs for years and chose instead to try a natural approach.  Fish oil, red yeast rice, fiber, plant sterols, garlic, I tried them all.  I won’t say they didn’t work because they helped, but they didn’t get me out of the danger zone.  Then I tried nicotinic acid, a surprisingly cheap, but not well advertised product.  I took one pill a day for a year and dropped from 220 total cholesterol to 187!  It was amazingly effective.  Although I do have to admit I don’t love the flushing effect that nicotinic acid gives me, but it is a small price to pay.  I have noticed that the effects are mediated by taking it with food, however. 

It Works, but Make Sure Nicotinic Acid is Right for You

I must warn you however, that nicotinic acid can be a problem if you have previous health conditions.  Also, it may interact with some medications.  It is always a good idea to make sure it won’t be a problem for you.  In fact, I should tell you to talk to your doctor, but the fact is, most don’t know much about nutrition.7 Nevertheless, they could tell you if it will react with medications you are taking or if it could pose a problem for you. 
as a general rule, your doctor should know about everything you are taking anyway.