Medicine (MD/DO)
Water-soluble Vitamins
Niacin Therapy (Vitamin B3)

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Niacin Therapy (Vitamin B3)

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Niacin Therapy (Vitamin B3)

Niacin, also known as vitamin B3, has been used for many years to decrease cholesterol in patients at risk for cardiovascular events. Niacin therapy has been shown to decrease LDL and triglycerides and increase HDL levels. Niacin’s therapeutic effect is thought to be related to inhibition of lipolysis in adipose tissue, as well as via reduction of hepatic VLDL secretion. A red, flushed face is a well-known side effect of niacin use. Because the flushing is mediated by prostaglandin activation, aspirin can reduce flushing by altering or blocking the prostaglandin mediated pathway. Niacin therapy is also associated with hyperglycemia and hyperuricemia.
Inhibits Lipolysis in Adipose Tissue
Tied-up with Lip-lights

Niacin's therapeutic effect is thought to be related to inhibition of lipolysis in adipose tissue. This limits free fatty acids available for the liver to produce triglycerides and VLDL, and consequently LDL.

Reduces Hepatic VLDL Secretion
Tied-up Veiled-lady-bug-devil with Liver

Niacin therapy leads to a reduction in hepatic VLDL secretion via decreased free fatty acid availability for the liver to produce TG and VLDL. Decrease in free fatty acids also suppresses hepatic expression of apolipoprotein C3 and leads to reduced VLDL production.

Decrease Triglycerides
Down-arrow TAG-triceratops

Triglycerides are esters derived from glycerol and three fatty acids. High levels of triglycerides in the bloodstream have been linked to atherosclerosis, and niacin therapy can decrease triglyceride levels in the body.

Decrease LDL
Down-arrow Ladybug-devil

Low-density lipoprotein (LDL) is associated with health problems, including heart disease, which is why it is commonly called the "bad" cholesterol. Niacin decreases blood LDL levels.

Increase HDL
Up-arrow Hot-dog-angel

High density lipoprotein particles remove fats like cholesterol from cells and transport it back to the liver for excretion or re-utilization. Therefore, HDL is often referred to as "good" cholesterol. Niacin is associated with increased HDL levels in users.

Flashlight on flushed face

Flushing is a well known side effect of niacin use. Flushing usually lasts for about 15-30 minutes and is mediated by prostaglandin activation.

Decreased by Aspirin
Down-arrow Aspirin

Because the flushing related with niacin use is mediated by prostaglandin activation, aspirin can reduce flushing by altering or blocking the prostaglandin mediated pathway.


High doses of niacin have been associated with elevations in blood sugar, thereby worsening diabetes mellitus.


Hyperuricemia is another side effect of taking high doses of niacin and may exacerbate gout in certain patients.


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