What Type of Niacin and How Much do You Prescribe?

Dr George Yiachos
Cardiologist Dr. George Yiachos

What Type of Niacin and How Much do You Prescribe?

What's important to know about Niacin is that you need to take in more than once a day.  And a minimum of 50 milligrams. I'm talking about niacinamide right now. When you get to the really high doses of Niacin you can get a lot of the side effects but if you're taking it multiple times a day, niacinamide, and you're looking to do this for the purposes of feeding your mitochondria what it needs that would be the way I would approach it.  

There are a lot of other ways to increase your NAD.  If this is for the purposes of increasing your NAD levels there's a lot of ways to do that that don't necessarily come from taking exogenous Niacinamide.  If you're talking about Niacin for the purposes of lowering cholesterol I will usually start very slow and this is not a practice that many people follow these days because of some data related to carotid interval thickening but  I always started low when it comes to Niacin.  500 milligrams.  You take it at bedtime. You take it with a full dose aspirin.  

All four ways to try to improve compliance so that people don't get that itching, that hot flash you can get with Niacin dosing.  Obviously long-acting niacin in those situations.  You gradually build it up.  I've had people as high as 2.5 grams and they were getting fantastic cholesterol lowering numbers.  I'm not really doing that that much these days, but that's how I would use it.