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Mar 27, 2013

In High Doses, Niacin Causes More Harm than Good

Commonly used to treat high cholesterol, the B vitamin can cause serious side effects and complications.

Experts were disappointed to hear that niacin does more harm than good in patients with high cholesterol according to findings presented for the first time at the American College of Cardiology’s 62nd Annual Scientific Session. Niacin, an important B vitamin, is commonly used in high doses to help reduce risk for heart attack and stroke by lowering “bad” cholesterol and raising “good” cholesterol. But according to a four-year study known as the HPS2-THRIVE Study (Heart Protection Study 2 – Treatment of HDL to Reduce the Incidence of Vascular Events), high doses of niacin can cause serious side effects and complications.

With nearly 25,700 patients at risk for heart disease, the HPS2-THRIVE Study was the largest of its kind to study the effects of niacin in reducing cardiovascular risk. Over the course of four years, some study participants were prescribed a drug containing a high-dose of niacin and laropiprant, a compound that reduces facial flushing—a common side effect associated with taking niacin. Others were prescribed a placebo containing no active medication, so that researchers could compare outcomes between the two groups. After tracking patients for years, researchers found that the niacin/laropiprant treatment was not effective in reducing risk for heart attack and stroke. In addition, this treatment caused a number of serious complications, such as bleeding, infections, diabetes, skin issues, and gastrointestinal problems.

The implications of these findings are enormous. Merck, a pharmaceutical company that spent years developing the niacin/laropiprant combo, will no longer seek FDA approval for the drug. And although the drug was already approved in 70 countries, it has been taken off the market as a result of this study.

Despite their disappointment, researchers are grateful for the knowledge gained from this study. For years, experts have believed that niacin can help prevent heart attack or stroke, but it turns out that the side effects far outweigh the expected benefits. And experts believe discovering that a therapy is ineffective or even harmful as just as important as finding benefits.

Based on the findings of the HPS2-THRIVE Study, patients currently taking niacin to prevent heart disease should consider talking with their health care providers to determine whether they should continue taking this therapy. Also, it’s important to note that niacin doses used in this study were about 100 times higher than the amount recommended as part of our daily intake. In normal amounts, niacin is still an important vitamin needed by the body for digestive, skin and nerve functions.

Questions for You to Consider

  • Does niacin help reduce cardiovascular risk?
  • Although niacin is commonly used to lower cholesterol and reduce cardiovascular risk, studies have found that in high doses, niacin can actually cause serious complications. If you’re taking niacin or considering taking niacin to reduce cardiovascular risk, it’s important to discuss this decision with your healthcare provider.


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