HOW TO TAKE NIACIN THE RIGHT WAY

Oh, yes, there is a right way to take high-dose immediate release niacin. Take it at the right time and you can get a host of health benefits, especially reduced triglycerides, LDL, and VLDL and increased HDL—at the wrong time, you lose some of these benefits. Here’s why.

Niacin causes cellular metabolism to switch from primarily using glucose as a fuel to primarily using fats, except in the heart, where lipids are the primary fuel and niacin causes a switch to glucose (Carlson, 2005). This switch takes place postprandially, that is, right after you eat, which is when you experience the highest level of blood fats, high enough to increase the risk of a heart attack. That is why some people have a heart attack after eating a heavy meal.

The process of being able to switch between using metabolic substrates is termed metabolic flexibility ... (Virtue, 2012).

After eating, fats are taken up and stored by adipose tissue, which releases fatty acids (a process called lipolysis) to the liver and to muscles. “During the fed state, net lipid flux into adipose tissue increases, whereas in the fasted state net lipid efflux predominates” (Virtue, 2012). Niacin prevents lipolysis, the release of these fatty acids from adipose tissue into the bloodstream. (The liver uses the fatty acids to produce triglycerides. The reduction in the availability of free fatty acids for the liver to make triglycerides is why niacin causes a reduction in triglycerides (Virtue, 2012; Kroon, 2017).

There is a strong negative correlation between plasma triglyceride levels and the concentration of HDL—as the level of triglycerides go up, HDL levels go down. The major components of VLDL (very low density lipoproteins) are triglycerides derived from the liver; the VLDL then carry triglycerides in the bloodstream. Reduction of the synthesis of triglycerides in the liver by niacin importantly increases HDL and reduces VLDL.

During the periods when you haven’t eaten (or at night when you sleep), your cells primarily use fats as primary fuel. Taking niacin can’t “switch” the choice of metabolic fuel to fats when you are already using fats as a fuel, but it can reduce the ability of cells to use glucose, which is why some people have a small increase in blood glucose when they use niacin. “We suggest that postprandial FFA lowering is the primary mechanism driving the metabolic improvements resulting from NiAc timed to feeding. Reduced FFA supply to the tissues lowers substrate competition with glucose and improves insulin sensitivity just when it is needed the most (i.e., during the influx of dietary carbohydrate in the postprandial phase), resulting in reduced postprandial hyperglycemia and hyperinsulinemia (Kroon, 2017).”