Even small deviations from a vegetarian diet can cause cholesterol levels to climb in many people

Niacin should be used as an addition to a low-fat, vegetarian diet, never as a replacement for it. These effects are much more common at doses higher than three grams per day, and particularly when sustained release varieties are used. Less commonly, niacin can cause liver problems, gastritis, and gout and can aggravate diabetes. These effects gradually diminish over time and can be further reduced by taking niacin with meals, using aspirin, and avoiding alcohol and hot liquids at the time you take it. Its major side effect is an uncomfortable flushing or itching that occurs in almost everyone who takes it. Most people need one to three grams per day, split between two to three doses. Niacin treatment usually begins at doses of 100-250 mg one to three times a day with meals and is gradually increased.

It reduces total cholesterol levels by 15-20 percent, cuts triglycerides by 20-50 percent, and increases HDL (the good cholesterol) by 15-20 percent. Its benefits are now well established. If you are considering medications, at the top of the list is vitamin Bs, or niacin. It also reduces your risk of many other health problems. Evidence shows that consuming less cholesterol reduces your risk of heart problems, even if your blood cholesterol level does not decrease.' If your problem is genetic, avoiding cholesterol and fat in your diet is still a good idea.

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