It is thus considered a good treatment choice when someone needs more than diet to control cholesterol, says Martin Milner, N.D., a naturopathic doctor who teaches at the National College of Naturopathic Medicine in Portland and Bastyr University in Bothell, Washington. This is one treatment, however, for which knowledgeable medical supervision is a top priority. In the large doses needed to lower cholesterol 1,500 to 3,000 milligrams a day niacin can cause liver problems. In fact, problems can start with doses as low as 500 milligrams, although some effects might not show up for years. Coffee and tea also contain appreciable amounts.
High doses can cause drops in blood pressure and can raise blood sugar in people with diabetes.
May cause flushing and allergic reactions. Anyone who is taking high doses must have regular blood tests to measure three essential liver enzymes, says Dr. Milner. There s also less chance of this form causing niacin flush, the characteristic reddening of the skin and itching that some people experience after taking niacin . Even though it s readily available from naturopathic doctors and at some health food stores, however, it s not something that you should try without regular monitoring, Dr. Milner says. With inositol hexaniacinate, the doctor might start you on a dose of 1,500 milligrams.