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The Niacin Debate
Tuesday Sync Stack: Why Instant Release May Do More for Your Heart.
Jaylene + Aaron Patelzick
September 23, 2025
In partnership with
Hi friends,
Sometimes the comfortable choice isn't the effective choice.
We've been taking controlled-release niacin for a while—physician recommended and seemed like the practical choice (fewer side effects, better compliance). Then a friend dropped this line:
"You really should be taking regular niacin. It's better for cholesterol, easier on your liver."
Wait, what? Isn't controlled-release supposed to be safer? But she and her husband have taken instant-release for years, and their lab numbers show it. That got me digging.
What's Inside
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🔑 The Key Difference
Instant-release nicotinic acid (true niacin) → absorbed fast, causes the "flush," delivers superior benefits
Controlled-release nicotinic acid → minimizes flushing but may be harder on your liver and less effective
Important: Look for "nicotinic acid" on the label, not "niacinamide" or "no-flush niacin." Only nicotinic acid provides the cardiovascular benefits and causes the therapeutic flush.
⁉️To Flush, or Not to Flush?
That's the real question with niacin. Here's why instant release works better:
Research shows IR niacin:
🔹 Improves blood vessel function better than CR
🔹 Raises functional HDL (not just numbers on paper)
🔹 Lowers triglycerides with less liver stress
🔹 Acts as an anti-inflammatory and activates beneficial immune cells
🔹 Is safer long-term despite being less comfortable initially
About That Flush
Within 15-30 minutes, your skin warms, turns red and itches—sometimes intensely. It's niacin releasing prostaglandins that widen blood vessels—the same mechanism that improves heart health by enhancing endothelial function (how well your artery walls respond and stay flexible). Niacin also boosts nitric oxide production and reduces oxidative stress in blood vessels.
Tolerance: The flush fades in an hour and lessens over time. Start small (100-250mg), take with food, and build up gradually to 1-1.5 grams daily. The intensity of the flushing reaction typically decreases over time as the body builds a tolerance to the niacin.
Why We're Switching
Our friends' years of success with instant-release was compelling, but the research sealed it for us. With our MTHFR mutations contributing to higher CRP and cholesterol levels—and increased atherosclerosis risk—we want to maximize every cardiovascular benefit we can get.
The data shows instant-release delivers superior endothelial function, better HDL protection, and is safer for the liver long-term. Yes, the flush will be uncomfortable at first, but we're willing to trade temporary discomfort for better heart protection. We made this decision together—like all our health choices.
Important: You should not take niacin supplements to manage cholesterol or for any other medical condition without first consulting a doctor. A healthcare professional can determine if niacin supplementation is appropriate and safe for your specific health needs.
Couple's Takeaway
This whole debate reminded us of something bigger: in health (and in relationships), the "easy option" isn't always the one that builds resilience. Sometimes the uncomfortable choice—the flush, the workout you didn't want to do, the honest talk you'd rather skip—ends up protecting you the most in the long run.
So, whether it's niacin or another habit, don't dismiss the small discomforts. They might be doing more behind the scenes than you realize.
👉 This week's sync thought: What's one small discomfort you've been avoiding that might actually strengthen your health—or your relationship—if you leaned into it?
Here's to healthier hearts and stronger choices,
— Jaylene + Aaron
⚠️ As always, talk with your healthcare provider before starting new supplements.
📚 References
American Heart Association - Arteriosclerosis, Thrombosis, and Vascular Biology (2009): AHA Journals
ScienceDirect - Niacin study (2024): ScienceDirect
PMC - Niacin comprehensive review: PMCID: PMC3770072
VitaRx - Niacin flush explanation: VitaRx
Additional Peer-Reviewed Sources: 6. Kamanna VS, Kashyap ML. Mechanism of action of niacin. Am J Cardiol. 2008;101(8A):20B-26B. 7. Lukasova M, Malaval C, Gille A, et al. Nicotinic acid inhibits progression of atherosclerosis in mice through its receptor GPR109A expressed by immune cells. J Clin Invest. 2011;121(3):1163-73. 8. Carlson LA. Nicotinic acid: the broad-spectrum lipid drug. A 50th anniversary review. J Intern Med. 2005;258(2):94-114. 9. McKenney J. New perspectives on the use of niacin in the treatment of lipid disorders. Arch Intern Med. 2004;164(7):697-705. 10. Guyton JR, Bays HE. Safety considerations with niacin therapy. Am J Cardiol. 2007;99(6A):22C-31C.
Recent Research: 11. Wang W, et al. Excess niacin promotes atherosclerosis via macrophage activation. Nature Medicine. 2024. (The 4PY metabolite study) 12. Lavigne PM, Karas RH. The current state of niacin in cardiovascular disease prevention. J Am Coll Cardiol. 2013;61(4):440-6.
🛑 P.S…Two quick asks before you go.
Found something you think we should try? Reply and let us know—or DM us on IG @syncyourwellness.
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