Harvard Men's Health Watch

On call: Niacin for cholesterol

On call

Niacin for cholesterol

Q. I hope you can clear up some family confusion. My doctor gave me a prescription for Niaspan, but my wife found the same medication, niacin, at the supermarket at a much lower price. Is it a drug or a vitamin?

A. Niacin is a natural substance "" in fact, it's vitamin B3. Like other vitamins, it's required to keep the metabolism working properly. But the recommended dietary allowance (RDA) for B3 is only 18 mg a day, far less than the amount needed to improve cholesterol levels. Still, any dose of niacin can be sold as a "dietary supplement" without a doctor's prescription and without FDA oversight.

In the doses needed to improve cholesterol, niacin is a drug "" and a potent drug at that. On average, it can lower LDL ("bad") cholesterol levels by 10%""25%. The statins and other lipid-lowering drugs can do even better, but niacin outshines them all for lowering triglyceride levels (down 20%""50%) and raising HDL ("good") cholesterol levels (up 15%""35%).

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