Inositol hexanicotinate (INH), commonly known as “no-flush” niacin, is a dietary supplement that is used to lower the amount of blood cholesterol in the body. A chemical-cousin of Niacin (otherwise known as Vitamin B3), Inositol hexanicotinate is produced by infusing 6 molecules of niacin onto one molecule of another chemical compound, Inositol.
To understand how inositol hexanicotinate works on cholesterol levels in the blood, let’s take a quick look at the background of ‘good’ and ‘bad’ cholesterol. Since it is insoluble in human blood, cholesterol is transported between cells by carriers known as lipoproteins. Lipoprotein is of two types. LDL (Low-density lipoprotein) is the bad cholesterol, while HDL (High-density lipoprotein) is the good one. LDL and HDL combined with triglyceride and Lp(a) cholesterol constitute the total blood cholesterol count of a person. Evidently, the key to preventing heart attacks, peripheral vascular disease, strokes and other heart diseases is to maintain a lower level of LDL and triglycerides, and higher level of HDL in the blood. This is where the Niacin contained in inositol hexanicotinate plays a vital role.
When a capsule of inositol hexanicotinate enters the body, it breaks down and starts releasing its component parts – Inositol and Niacin – into the blood stream. Niacin or vitamin B3 then starts its act of reducing LDL and increasing HDL cholesterol levels in the blood. The lipid-lowering property of Niacin enables it to inhibit the release of triglycerides – a form of fat made in the body. Niacin in inositol hexanicotinate also prevents the liver from producing more blood sugar. While the exact mechanism by which this is accomplished still remains largely unknown, it has been observed that Niacin can successfully lower LDL by 15 to 25%, triglycerides by 20 to 25% and increase HDL levels by 15 to 30% in human blood.
A valid question at this point would be that if Niacin is the component actually causing the cholesterol reduction, why not take Vitamin B3 capsules instead of Inositol hexanicotinate. The reason for this would be the side effects caused by pure niacin intake. These include headaches and flushing – where the skin gets itchy, red and warm – within a few minutes of consumption. Other side effects could be elevated liver enzymes, reduced glucose tolerance, palpitations and gastrointestinal upset. While flushing is not entirely harmful, many people find these occurrences highly uncomfortable and are put off from taking their daily dosage to avoid experiencing a flush. An alternative for such people is inositol hexanicotinate with which the side effects of Niacin are reduced to a great extent.
As mentioned before, inositol hexanicotinate has 6 molecules of niacin attached to one molecule of Inositol that are broken down and released into the blood stream. This break down or hydrolysis of inositol hexanicotinate into separate Niacin and Inositol molecules happens at a very slow rate. Inositol causes the metabolism of Niacin molecules to slow down, thereby causing the peak effect of Inositol hexanicotinate on the blood cholesterol to actually occur 10-12 hours after drug intake. It is important to note that while this theoretical assumption has been proposed mainly on the basis of pharmacokinetics, it cannot be sufficiently justified by real clinical experience.
Inositol hexanicotinate is available over the counter either by its own name or in the form of a multi-vitamin. It is sold as a 250, 500 or 1000 mg tablet or capsule. No-flush Niacin or Inositol hexanicotinate should not be confused with “timed-released” niacin. This is a formulation of niacin packaged in such a way that it is released slowly into the blood stream.
While Niacin is otherwise available to humans in the natural diet, a larger dosage in the form of inositol hexanicotinate may be prescribed to people with elevated cholesterol levels or a higher risk of heart disease. As is the case with any medication, it is advisable to consume Inositol hexanicotinate with the approval of a physician and at the prescribed level of dosage only.
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