Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Vitamin B3, also known as niacin or nicotinic acid, has scientific validation for its use in treating high triglycerides. Niacin has been studied extensively since the mid-20th century for its lipid-modifying effects. Clinical trials have demonstrated that pharmacological doses of niacin can significantly lower triglyceride levels—by 20% to 50%—in patients with hypertriglyceridemia. Niacin works by inhibiting hepatic diacylglycerol acyltransferase-2, reducing very-low-density lipoprotein (VLDL) synthesis and secretion, which leads to lower triglyceride concentrations in the blood.

Historically, niacin was one of the first agents used to manage dyslipidemia before the advent of statins and other modern lipid-lowering drugs. Large randomized controlled trials, such as the Coronary Drug Project (1975) and the AIM-HIGH trial (2011), confirmed niacin's efficacy in lowering triglycerides, raising HDL cholesterol, and, to a lesser degree, lowering LDL cholesterol. However, recent studies have questioned its overall benefit on cardiovascular outcomes, especially when added to statin therapy, due to side effects such as flushing, hepatotoxicity, and glucose intolerance. Despite this, its triglyceride-lowering effect is well documented and mechanistically understood.

In summary, there is robust scientific evidence supporting the use of niacin (vitamin B3) to lower high triglyceride levels, although its use is now more limited due to the availability of newer agents with better side effect profiles.

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