Niacin is the most effective intervention for raising HDL or good cholesterol. Not only will niacin (nicotinic acid) raise HDL cholesterol by 8-35% and lower LDL cholesterol by 10-25%, it has been shown to lower the risk of stroke and heart disease. Nicotinic acid should not be confused with another water soluble B vitamin, nicotinamide, which does not lower cholesterol levels.

Although many patients on niacin initially complain of skin flushing (niacin flush), they may later develop tolerance. Other adverse side effects of niacin include elevated blood sugar, liver toxicity, worsening of stomach ulcers and gout. Gastrointestinal complaints include nausea, diarrhea, vomiting, and indigestion. You should only take niacin under the care of your physician who can monitor for side effects and liver toxicity.

Be aware that vitamin C, E and beta-carotene supplements appear to impair HDL elevation, when taken with statin and niacin combination therapy.

Consider lifestyle modifications such as weight loss, diet, smoking cessation, and exercise to help raise HDL cholesterol.