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Niacin Titration Protocols

Niacin is vitamin B3. Vitamin B3 has long been to be vital for good health. Titration is just a fancy word for increasing your dosage over time. Therefore, niacin titration is simply starting to take vitamin B3 at a low initial dose, and increasing that dose over some time period. Niacin gives some people what is known as the "niacin flush."

  1. B3 and Diseases of Aging

    • Niacin is considered to be one of the "heart healthy" vitamins. It's also one of the eight B vitamins, all of which are considered to be important to the maintenance of optimum health. Very high doses of B3, which is niacin, are considered to have a positive impact on several serious health conditions: Alzheimer's disease, osteoarthritis and cardiac disease and atherosclerosis. Titration protocols under a doctor's supervision are employed in reaching the medically high doses of niacin needed for these conditions.

    Titration and Diabetes

    • Titration is also employed in using niacin to treat diabetes, because of serious side effects that can accompany high niacin dosages. Niacin intake high enough to impact the disease states can also raise blood sugar in diabetics and homocysteine levels in cardiac patients, respectively. However, monitoring the B3 levels, according to the Journal of the American Medical Association, can yield significant benefits: "The reduction in total cholesterol, LDL-C, and triglycerides with niacin treatment were all significant in participants both with and without diabetes. Levels of HDL-C were significantly increased by 29% in participants with and without diabetes, respectively."

    The Reason for Titration

    • Most specifically, niacin may be used in treatment of cardiac conditions because of niacin's tendency to reduce LDL (low density lipoproteins, aka bad cholesterol) and triglyceride levels in the blood. Such doses can produce the "niacin flush", but also can lead to itching, gout, and occasionally liver damage. According to Merck's materials on B vitamins, these "side effects can be lessened by starting with a relatively low dose and gradually increasing the dose." This is the titration protocol.

    Niacin Forms

    • Vitamin B3 is available in different supplement forms as niacinamide, niacin and inositol hexaniacinate. Niacin is available in both tablet or capsule form, and both forms are available in regular and timed-release forms. The University of Maryland Medical Center states that "the timed-release tablets and capsules may have fewer side effects than regular niacin; however, the timed-release versions are more likely to cause liver damage." This is why titration protocols are used, and periodic liver function tests are given with high doses of niacin (above 100 mg daily).

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