First, a word about no-flush Niacin. You've probably heard of this, but what you probably haven't heard is the no-flush Niacin is not actually Niacin (nicotinic acid), but is instead an isomer of Niacin called inositol hexanicotinate. Inositol hexanicotinate does not impart the same benefits for your cholesterol, so taking it would be useless for that purpose.
Some things you can do to help prevent or reduce the Niacin flush
- Start with lower doses and work your way up. Start with very small amounts of niacin and gradually increase. One method might be to start with a 25mg three times a day, such as with each meal. The next day, try 50mg at breakfast, 25mg at lunch and 25mg at supper. The day after that, take 50mg with breakfast, 50mg with lunch, and 25mg at supper. The next day, 50mg at each meal. Then 75mg, 50mg and 50mg, then 75mg, 65mg, 50mg, and so on.The most effective benefits from Niacin for cholesterol usually start around 1,500mg a day, which would be 500mg with each meal. Work with your doctor to figure out what daily dose works best for you. I, personally, take 2,000mg a day - 1,000mg in the morning and 1,000mg in the evening. I still get the flush, but I'm used to it now and it no longer bothers me.
- Niacin supplements are available in regular and a timed-release form. Timed-release versions of Niacin are supposed to help people avoid the flush effect. The problem with most time-release Niacin supplements is that they have been associated with liver problems.The time-release forms of nicotinic acid formulated in a way that the niacin is slowly released as the tablet travels through the intestines. Unfortunately, this means the liver is constantly processing niacin, and, for some individuals, this can cause liver issues. Be aware that if you take time-release Niacin, your doses should be approximately half what you would take with a quick release version. Also know that a time-release version of Niacin may only delay the flush, not prevent it!
- Try taking a 325mg dose of aspirin (1 tablet) 15 to 30 minutes before you take your Niacin. Studies have indicated taking an aspirin before taking the Niacin can decrease the flushing and itching. Know that this doesn't work for everyone and while it might reduce the effects of the flush, it probably won't completely prevent it.
- Take Niacin on a full stomach or with a meal. This can lessen or even prevent the flush completely, mainly because it slows the absorption of Niacin. Be aware though that sometimes taking Niacin with a meal might only delay the flush effect, causing it to occur much later. So don't panic if you start experiencing the flush and hour or even longer after taking the Niacin on a full stomach.
- Drink a lot of water. Some people claim that drinking 12 - 16 ounces of water when taking your Niacin dose can help prevent or limit the flush. personally, this method has been hit or miss for me, so I can't attest to it's effectiveness.
- A new study appearing in the online edition January 29, 2009 of the British Journal of Pharmacology reveals that the supplement quercetin is a very efficient flush-blocker when teamed with niacin. Quercetin is a common bioflavonoid found in apples, buckwheat, tea and onions. It is associated with protection from cancer, and blocks the release of histamine, making it an ideal allergy blocker. In the experiment, the quercetin was injected, so it remains to be seen if oral dosing will have the same benefits, but it's worth a try if you're taking niacin and are bothered by flushing. Two 500 mg capsules of quercetin an hour or so before niacin dosing might work.