The use of niacin for treating abnormal lipids and preventing cardiovascular disease has been historically widespread amongst conventional and holistic doctors. However, in recent years, the published literature has not supported niacin's use to prevent cardiovascular disease. In light of this, I will review a study examining the effectiveness of niacin for cardiovascular disease.

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Niacin Study

‍Researchers conducted a systematic review and meta-analysis of randomized clinical trials that reported niacin’s effect on at least one long-term cardiovascular disease outcome. 119 clinical trials were identified for systematic review; ultimately, 17 studies met the criteria for inclusion in the meta-analysis. The number of patients involved was 35,760, with 47.8% randomly assigned to niacin arms and 52.5% receiving placebo, usually therapy (statin drugs) or other lipid-lowering agents. The authors concluded that, overall, niacin was not effective in preventing cardiovascular disease. The exception to this finding was two earlier trials in the 1970s and 1980s that found that niacin as a monotherapy was associated with reducing some cardiovascular events. Moreover, a separate analysis found no association between increased HDL-C and improved cardiovascular outcomes.

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‍My Thoughts

‍I discontinued niacin as a primary treatment for cardiovascular diseases years ago. There were several reasons for this, including:

1. Research demonstrated the benefit for cardiovascular disease prevention was not significant
2. Many users experienced unpleasant side effects such as flushing, headache, digestive upset, and sometimes elevated liver enzymes
3. The studies used a pharmaceutical time-released niacin, which was very expensive if not covered by insurance
4. We have much better nutritional and supplemental approaches to use for lipid balancing so that niacin is not required. You can review our Cholesterol Wellness and Bergamot Wellness at www.drstengler.com

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Dr. Mark Stengler NMD, MS, is a bestselling author in private practice in Encinitas, California, at the Stengler Center for Integrative Medicine. His newsletter, Dr. Stengler’s Health Breakthroughs, is available at  www.markstengler.com and his product line at www.drstengler.com

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‍Reference

‍D'Andrea, E., Hey, S. P., Ramirez, C. L., & Kesselheim, A. S. (2019). Assessment of the Role of Niacin in Managing Cardiovascular Disease Outcomes: A Systematic Review and Meta-analysis. JAMA network open, 2(4), e192224. https://doi.org/10.1001/jamanetworkopen.2019.2224