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Niacin (Vitamin B3) for High Cholesterol (Hyperlipidemia)

B

Most effective HDL-raising agent (+15-35%). Coronary Drug Project: 27% MI reduction. However, AIM-HIGH and HPS2-THRIVE showed no incremental benefit when added to statins. Best evidence as monotherapy.

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            B

        

        

            
The Bottom Line

            
            
Most effective HDL-raising agent (+15-35%). Coronary Drug Project: 27% MI reduction. However, AIM-HIGH and HPS2-THRIVE showed no incremental benefit when added to statins. Best evidence as monotherapy.

            
            
        

    











    
    

        
        

            

  
Key Statistics





            


    

        
10

        
Studies

    

    

        
12000

        
Participants

    

    

        
            
            ↑
            
        
        
Positive

    

    

        B

        
Grade

    




        


        
        

        
        
        

            

  
Dosage & Usage





            
mg = milligrams · mcg = micrograms (1,000× smaller) · IU = International Units


            
            

                
Commonly Used Dosages

                

                    
                    

                        
generalnutrition:

                        
14-16 mg/day

                    

                    
                    

                        
lipidmodification:

                        
1,000-2,000 mg/day (start at 500 mg/day and titrate)

                    

                    
                

                
                

                    Upper limit: 35 mg/day for non-prescription use; prescription doses up to 3,000 mg/day under medical supervi
                

                
            

            

            

            
            

                Best taken: With dinner or at bedtime with a low-fat snack; aspirin 30 min before may reduce flushing
            

            
        

        

        
        
        

            

  
Safety & Side Effects





            

                
                

                    
Reported Side Effects

                    
    
                        
                        
  • 
                            ⚠
                            Flushing (redness, warmth, itching — most common, especially immediate-release)
                        
    • 
                        
                        
  • 
                            ⚠
                            Gastrointestinal discomfort (nausea, diarrhea)
                        
    • 
                        
                        
  • 
                            ⚠
                            Hepatotoxicity (especially extended-release at high doses)
                        
    • 
                        
                        
  • 
                            ⚠
                            Hyperglycemia (may worsen blood sugar control)
                        
    • 
                        
                        
  • 
                            ⚠
                            Hyperuricemia (may precipitate gout)
                        
    • 
                        
                    

                

                

                
                

                    
Known Interactions

                    
    
                        
                        
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                            ●
                            Statins (increased risk of myopathy/rhabdomyolysis)
                        
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                            Blood pressure medications (additive hypotensive effect)
                        
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                            ●
                            Diabetes medications (may counteract blood sugar control)
                        
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                            Anticoagulants (may increase bleeding risk)
                        
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  • 
                            ●
                            Alcohol (may worsen flushing and hepatotoxicity)
                        
    • 
                        
                    

                

                

                
                

                    

                        Tolerable upper intake: 35 mg/day for non-prescription use; prescription doses up to 3,000 mg/day under medical supervi
                    

                

                
            

            

                Always consult your healthcare provider before starting any supplement.
            

        

        

        
        
        

            

  
Frequently Asked Questions





            




    
    

        
            Does Niacin (Vitamin B3) help with High Cholesterol (Hyperlipidemia)?
            
        
        

            Based on 10 studies with 12,000 participants, there is moderate evidence from clinical studies that Niacin (Vitamin B3) may support High Cholesterol (Hyperlipidemia) management. Our evidence grade is B (Good Evidence).
        

    

    
    

        
            How much Niacin (Vitamin B3) should I take for High Cholesterol (Hyperlipidemia)?
            
        
        

            Studies have used various dosages. A commonly studied range is 14-16 mg/day. Always consult your healthcare provider before starting any supplement regimen.
        

    

    
    

        
            Are there side effects of Niacin (Vitamin B3)?
            
        
        

            Reported side effects may include Flushing (redness, warmth, itching — most common, especially immediate-release), Gastrointestinal discomfort (nausea, diarrhea), Hepatotoxicity (especially extended-release at high doses), Hyperglycemia (may worsen blood sugar control). Most side effects are mild and dose-dependent. Consult your doctor if you experience any adverse reactions.
        

    

    
    

        
            How strong is the evidence for Niacin (Vitamin B3) and High Cholesterol (Hyperlipidemia)?
            
        
        

            We rate the evidence as Grade B (Good Evidence). This rating is based on 10 peer-reviewed studies with 12,000 total participants. The overall direction of effect is positive.
        

    

    




        

        

        
        
        

            

  
Related Evidence





            

                
                
                

                
                

                    
Niacin (Vitamin B3) for other conditions

                    

                        
                        
                            High Triglycerides (Hypertriglyceridemia)
                            B

                        
                        
                    

                

                
            

        

        

    


    
    












    

        FDA Disclaimer:
        These statements have not been evaluated by the Food and Drug Administration. The products and information on this website are not intended to diagnose, treat, cure, or prevent any disease. The evidence grades presented are based on our analysis of published peer-reviewed research and do not constitute medical advice. Always consult your healthcare provider before starting any supplement regimen.