I started by seeing how I tolerated 500mg immediate release niacin. I turned red and felt like I had a sun burn. That lasted .25 to .5 hour.
I then went on 500mg Niaspan* and over a year titrated to 2g in 500mg steps.
I tried a number of measures to control the flushing. Taking before bed, nonfat snack, aspirin, benadryl. Those helped a lot and I stuck with the program. Flushing became less severe and increasingly less frequent over time. Even at 2g, and after several years of treatment, I rarely flush and the change in the lipid levels and ratios is extraordinary.
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* Note that the 1g dose seemed to cause less flushing than the 500mg dose form.
PS - I was motivated to improve my lipid levels due to a bad family history that suggested I should do something.
There are times when rules and precedents cannot be broken; others when they cannot be adhered to with safety. (Thomas Joplin)
