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HOW TO DETERM!E " #"T$R"TO! %E&E% O' !"(!
!iacin is )itamin B-3, one of the water soluble B-complex vitamins. One of
niacin's unique properties is its ability to help you naturally relax and
get to sleep more rapidly at night. "nd it is well esta*lished that niacin helps
reduce harmful cholesterol le)els in the *loodstream. "*ram Hoffer+ M.D.+ ,h.D.
explains: -!iacin is one of the *est su*stances for ele)atin. hi.h density lipoprotein
cholesterol /the -.ood cholesterol0 and so decreases the ratio of the total cholesterol o)er
hi.h density cholesterol.-
"nother niacin feature is its ability to greatly reduce anxiety and depression.
1et another feature of niacin is that it dilates blood vessels and creates a sensation of
warmth, called a niacin flush. This is often accompanied with a *lushin.
2im*u3orare4 of the s5in. t is this -flush- or sensation of heat that indicates a
temporary saturation of niacin, and that is our topic here.
When you flush+ you can literally see and feel that you6)e ta5en enou.h niacin. !he
idea is to initially ta"e #ust enough niacin to have a slight flush. !his
means a pin"ness about the chee"s, ears, nec", forearms and perhaps
elsewhere. $ slight niacin flush should end in about fifteen minutes or
so. %f you ta"e too much niacin, the flush may be more pronounced and
longer lasting. %f you flush beet red for half an hour and feel weird,
well, you too" too much. $nd a large dose of niacin on an empty
stomach is certain to cause profound flushing.
-With lar.er initial doses+ the flush is more pronounced and lasts lon.er+- says Dr. Hoffer.
-7ut with each additional dose+ the intensity of the flush decreases and in most patients
*ecomes a minor nuisance rather than an irritant. !iacin should always *e ta5en
immediately after finishin. ones meal.-
ha)e found that the *est way for me to accurately control the flushin. sensation is to
start with )ery small amounts of niacin and .radually increase until the first flush is
noticed. One method is to start with a mere 89 milli.rams /89 m.0 three times a day+ say
with each meal. The next day+ try 9: m. at *rea5fast+ 89 m. at lunch and 89 m. at supper.
The followin. day+ one mi.ht try 9: m. at *rea5fast+ 9: m. at lunch+ and 89 m. at
supper. "nd+ the next day+ 9: m. at each of the three meals. The next day+ ;9 m.+ 9: m.
and 9: m.. Then+ ;9. ;9 and 9:+ and so on. n this way you ha)e increased at the easy
rate of only 89 m. per day. One would continue to increase the dosa.e *y 89 m. per day
until the flush occurs.
%t is difficult to predict a saturation level for niacin because each person is different.
"s a .eneral rule+ the more you hold+ the more you need. f you flush early+ you don6t
need much niacin. f flushin. doesn6t happen until a hi.h le)el+ then your *ody is
o*)iously usin. the hi.her amount of the )itamin.
!ow that you6)e had your first flush+ what next< #ince a flush indicates saturation of
niacin+ it is desira*le to continue to repeat the flushin.+ 3ust )ery sli.htly+ to continue the
saturation. This could *e done three or more times a day. To .et to sleep sooner at ni.ht+
niacin can *e ta5en to saturation at *edtime+ too. 1ou mi.ht *e asleep *efore you e)en
notice the flush.
"n important point here is that niacin is a )itamin+ not a dru.. t is not ha*it formin..
!iacin does not re=uire a prescription *ecause it is that safe. t is a nutrient that e)eryone
needs each day. Different people in different circumstances re=uire different amounts of
niacin.
#ays Dr. Hoffer: -" person6s -upper limit is that amount which causes nausea+ and+ if not
reduced+ )omitin.. The dose should ne)er *e allowed to remain at this upper limit. The
usual dose ran.e is >+::: to ?+::: milli.rams daily di)ided into three doses+ *ut
occasionally some patients may need more. The toxic dose for do.s is a*out 9+:::
milli.rams per 8.8 pounds /@ 5ilo.ram0 *ody wei.ht. We do not 5now the toxic dose for
humans since niacin has ne)er 5illed anyone.-
ne)ita*le physician s5epticism and =uestions a*out niacin6s pro)en safety and
effecti)eness are *est answered in Orthomolecular &sychiatry+ edited *y Da)id
Haw5ins+ M.D. and %inus ,aulin.+ ,h.D.
This nearly ;:: pa.e text*oo5 is the standard reference for details on niacin therapy.
,ersons with a history of hea)y alcohol use+ li)er disorders+ dia*etes+ or experiencin.
pre.nancy will especially want to ha)e their physician monitor their use of niacin in
=uantity. Monitorin. lon.Aterm use of niacin is a .ood idea for anyone. t consists of
ha)in. your doctor chec5 your li)er function with a simple *lood test.
,lain and simple niacin may *e purchased in ta*lets at any pharmacy or health food
store. Ta*lets typically are a)aila*le in 9: m.+ @:: m.+ or 89: m. dosa.es. The ta*lets
are usually scored down the middle so you can *rea5 them in half easily. 1ou can *rea5
the hal)es in half+ too+ to .et the exact amount you want.
f a niacin ta*let is ta5en on an empty stomach+ a flush will occur /if it is .oin. to occur
at all0 within a*out 8: minutes. f niacin is ta5en ri.ht after a meal+ a flush may *e
delayed. n fact+ the flush may occur lon. enou.h afterwards that you for.ot that you too5
the niacinB Don6t let the flush surprise you. Remem*er that niacin does that+ and you can
monitor it easily.
f you want a flush ri.ht away+ you can powder the niacin ta*let. This is easily done *y
crushin. it *etween two spoons. ,owdered niacin on an empty stomach can result in a
flush within minutes. #ustained release niacin is often ad)ertised as not causin. a flush at
all. This claim may not *e completely trueC sometimes the flush is 3ust postponed. t
would pro*a*ly *e difficult to determine your saturation le)el with a sustainedA or timeA
released product. They are also more costly. 7ut the *i..est reason to a)oid sustainedA
release niacin is that most reports of side effects stem from use of that form.
There is nothin. wron. with niacin"MDE+ *y the way. That form of )itamin 7A> is
fre=uently found in multiple )itamins and 7Acomplex preparations. !iacinamide does not
cause a flush at all. n my opinion+ it is less effecti)e in inducin. relaxation and calmin.
effects. !iacinamide also does not lower serum cholesterol. This is an important
distinction to ma5e when purchasin..
t is a .ood idea to ta5e all the other 7Acomplex )itamins in a separate supplement in
addition to the niacin. The 7A)itamins+ li5e professional *ase*all players+ wor5 *est as a
team. #till+ the *ody seems to need proportionally more niacin than the other 7 )itamins.
E)en the $.#. Recommended Daily "llowance /RD"0 for niacin is much more than for
any other 7A)itamin. Many physicians consider the current RD" for niacin of only 8:
m. to *e way too low for optimum health. While the .o)ernment continues to discuss
this+ it is possi*le to decide for yourself *ased on the success of doctors that use niacin for
their patients e)ery day.

TO '%$#H OR !OT TO '%$#H< That is this readerDs =uestion:

EWe ha)e learned a .reat deal from your site and your *oo5s and also en3oy them. We
ha)e also incorporated some of your su..estions in our lifestyle. My =uestion for you is
an attempt to clarify what seems to *e a difference of opinion a*out the niacin flush
*etween you and Dr. Hoffer. He had written /
http://www.doctoryourself.com//hofferFniacin.html 0 that the niacin flush is normal with
many people and will diminish or .o away as the patient continues to use niacin at his
recommended le)el of >+::: milli.rams per day. 1ou+ howe)er+ state that the flush is an
indication of no niacin deficiency. Who is correct or am misinterpretin. one of you<E

"ndrew #aulDs Response:

This is how loo5 at it: Generally spea5in.+ people in fairly .ood health usually choose
to increase their doses .radually in order to minimiHe flushin.. f they do increase the
dose slowly+ what descri*e is pretty accurate. 'or instance+ 6)e *een ta5in. niacin for
years+ in daily *ut )aryin. doses dependin. on my stress le)el or dietary inta5e. 5now
*y the flush when 6)e had enou.h for the moment. t is li5e turnin. off the hot water
when the tu* is full enou.h for a nice *ath. Dr Hoffer is hi.hly experienced with serious
psychiatric cases. #uch patients ha)e a niacin dependency+ not a mere deficiency. %etDs let
him spea5 for himself:

"*ram Hoffer+ MD+ writes:

IWe are *oth correct. Most people flush at the *e.innin. and .radually .et adapted to it
unless they stop for a few days and then resume it. " few cannot e)er .et used to it+ and
they ta5e the noAflush preparations. 7ut the intensity of the flush is )ery )aria*le.
Generally people who need it the most flush the least. That includes arthritics+
schiHophrenics+ and elderly people with cardio)ascular pro*lems. #ome schiHophrenics
do not flush until they .et well and then they do. 7ut the presence of the flush or its
intensity can not *e uni=uely used measure the need as there are too many )aria*les such
as food in the stomach+ whether the drin5 with it is hot or cold+ the 5ind of food+ other
medication. "ntipsychotics reduce the intensity of the flush as do aspirin and
antihistamines.E

RE(OMME!DED RE"D!G:
!iacin: The Real #tory *y "*ram Hoffer+ "ndrew W. #aul and Harold D. 'oster.
Re)iewed at http://www.doctoryourself.com/niacinre)iews.html
Orthomolecular Medicine for E)eryone *y "*ram Hoffer and "ndrew W. #aul. Re)iewed
at http://www.doctoryourself.com/orthomolecular.html
The a*o)e Dr. Hoffer =uotes are from a pri)ate communication+ "pril ;+ 8::8
(opyri.ht ( 8:@>+ 8::J+ and pre)ious years *y "ndrew W. #aul.
"ndrew #aul is the author of the *oo5s 'RE 1O$R DO(TORB How to *e
ndependently Healthy /re)iews at http://www.doctoryourself.com/re)iew.html 0 and
DO(TOR 1O$R#E%': !atural Healin. that Wor5s. /re)iewed at
http://www.doctoryourself.com/saul*oo5s.html 0
These *oo5s are all a)aila*le from any internet *oo5 seller+ *ut are not for sale at this
we*site.