Upper level niacin

Abnormal accumulation in tissues and overloading of normal metabolic pathways, leading to signs of toxicity and possibly irreversible lesions. Niacin (Section 8.7.1), and vitamins A (Section 2.5.1), D (Section 3.6.1), and Bg (Section 9.6.4) are all known to be toxic in excess (see Section 1.2.4.3 for a discussion of tolerable upper levels of intake). 

Sources Shrimpton, 1997 Institute of Medicine, 1997, 1998, 2000, 2001 Scientific Committee for Food, 1993 where two figures are shown for vitamin A, the lower is for women and the higher is for men (Table 2.5). for niacin and nicotinic acid, the lower values are for sustained reiease preparations the EU upper level of 25 mg of vitamin Be was proposed by the Scientific Committee for Food Opinion, 2000 and the EU upper level of 200 xg of vitamin B12 was set because of the possible presence of inactive corrinoids in pharmaceutical preparations, not because of toxicity of the vitamin itself. 

Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, other B vitamins, and Choline and Subcommittee on Upper Reference Levels of Nutrients. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Washington DC National Academy Press, 1998. 

F Before initiating statin therapy, it is recommended to have baseline measurements of the lipoprotein profile and LFTs. If the LFTs are more than three times the upper limit of normal (ULN), statins should be avoided. If the LFTs are less than three times the ULN, statin therapy can be initiated, but the patient should be monitored closely. If LFTs become elevated, reversal of the transaminase elevation is common upon discontinuation of the statin. Some experts also recommend obtaining a baseline creatine kinase (CK) level. If the CK level is more than 10 times the ULN while on a statin, the statin should be discontinued. The combination of a statin with niacin or a fibrate should be used cautiously because of an increased risk of myopathy. Although most statins are taken at dinner or bedtime, atorvastatin can be taken at any time of the day due to its longer T /i ( 14 hours). Lovastatin should be taken with food because this increases its bioavailabilty. 

Hypervitaminosis Niacin. Niacin is considered nontoxic, and there are no Tolerable Upper Intake Levels based on its use as a vitamin. These refer only to niacin and niaci-... 

However, as a side-effect of the therapy, his patients suffered from a massive flush syndrome (harmless but mostly unpleasant reddening ofthe skin on the face, neck, chest and upper arm). For a better assessment, Hoffer himself took gram quantities of niacin over several months, and discovered to his surprise that this treatment had healed his serious inflammatory gum disease. Inspired by Rudolf Virchow s hypothesis, that atherosclerosis was an inflammatory process, which was associated with serum cholesterol, Rudolf Altschul (1901-1963), Hoffer s former histology teacher, demonstrated in his hypercholesterolemic rabbit model, that within a few days niacin brought cholesterol levels back to normal. This prompted corresponding studies by Hoffer in the psychiatric patients. 

Sources Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Huoride (1997) Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin 85, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998) EHetary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids (2000) Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001) Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (2005) and EHetary Reference Intakes for Calcium and Vitamin D (2011). These reports may be accessed via www.nap.edu A Tolerable Upper Intake Level (UL) is the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population. Unless otherwise specified, the UL represents total intake from food, water, and supplements. Due to a lack of suitable data, ULs could not be established for vitamin K, thiamin, riboflavin, vitamin B12, pantothenic acid, biotin, and carotenoids. In the absence of a UL, extra caution may be warranted in consuming levels above recommended intakes. Members of the general population should be advised not to routinely exceed the UL. The UL is not meant to ply to individuals who are treated with the nutrient under medical supervision or to individuals with predisposing conditions that modify their sensitivity to the nutrient... 

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