Healthy_back (healthy_back) wrote,
Healthy_back
healthy_back

Ниацин (витамин В3) и Пантотеновая кислота (Витамин B5)

Про ниацин было в посте про витамины: https://healthy-back.dreamwidth.org/372283.html (https://healthy-back.livejournal.com/380239.html)

Витамин B3 используют для понижения холестерина. В больших дозах его продают в качестве лекарства за дурные деньги и строго по рецепту.

http://www.diabetesincontrol.com/special-otc-feature-niacin-er-a-viable-alternative-to-niaspan/
НиаспаН - это витамин В3. Не путать с НиаспаМ

The average cost of 100 extended release niacin 500mg tablets is approximately $10. For 1000mg tablets, the cost for 100 tablets increases by only a couple dollars. The cost of immediate release niacin products is not significantly different than the extended release products. In contrast, the approximate cost of 100 Niaspan 500mg tablets is $230, and the cost of 100 Niaspan 1000mg tablets is $430.

Niaspan offers efficacy and convenience, but at a large cost. For patients who cannot afford the high price of prescription Niaspan, over the counter extended release niacin should be recommended, as it offers efficacy at a significantly lower price.


Slowreleaseform - это просто метод упаковки, чтобы не было жжения, это было описано в посте про витамины.

Ниацин существует в 3 формах: niacinamide, niacin (nicotinic acid), inositol hexanicotinate. Некоторые источники утверждают, что они работают по-разному и не взаимозаменяемы.

https://www.swansonvitamins.com/blog/vitamins-supplements-faqs/what-is-the-difference-between-niacin-and-niacinamide
Each form has specific health applications when used in higher doses. Niacin is often taken to support cholesterol levels already within the healthy range (both LDL and HDL), while niacinamide is used to help promote a healthy insulin response, as well as to help maintain joint health. A third form of vitamin B-3 known as inositol hexaniacinate is similar to niacin, but it does not produce the red, prickly flush that often accompanies the latter form, and for this reason it is commonly referred to as flush free niacin.

Niacin is used for support for healthy cholesterol levels already within the normal range. Niacinamide is used for support for joint comfort, support for sugar balance and support for brain function, but does not support cholesterol balance.

https://www.ncbi.nlm.nih.gov/pubmed/23351578

http://www.medbroadcast.com/channel/nutrition/supplements-and-nutraceuticals/dont-be-fooled-by-no-flush-niacin
Products that are simply labelled as "niacin" contain nicotinic acid. This is the substance that, at doses higher than those needed for its vitamin effect, has been shown to have benefit in people with high cholesterol. Nicotinic acid is known to lower two types of "bad" cholesterol (LDL and VLDL) as well as increase levels of "good" cholesterol (HDL). In fact, it is able to increase HDL more than any other medication.

The nicotinic acid is the substance that causes the flushing side effect of niacin. The flush normally begins as a deep red in the face and then spreads to the rest of the body. Intense warmth and itching usually accompany the flush and this lasts for about 30 minutes. Other side effects of niacin include increased blood sugar levels, increased uric acid levels (which can affect people with gout), dry skin, stomach irritation, or heartburn.

Products labelled as "no-flush" niacin generally contain no nicotinic acid. The main component in these products is inositol hexanicotinate (a different form of vitamin B3 mentioned earlier). While inositol hexanicotinate works as other B vitamins work to promote energy metabolism and nervous system health, it has not been shown to have any effect on cholesterol levels. This product does not cause flushing because it does not work the same way as niacin.

http://www.berkeleywellness.com/supplements/vitamins/article/niacin-and-cholesterol
The form that improves cholesterol levels is called nicotinic acid. The standard dose for treating cholesterol is one to three grams daily, 50 to 150 times more than what’s in a basic multivitamin. But you’ll also find other forms for sale, such as niacinamide and inositol hexanicotinate, which have little or no effect on cholesterol.

In addition, there are three categories based on the rate of release of the niacin:

Immediate-release niacin is effective and least expensive, but causes more flushing. It has to be taken two or three times a day.

Sustained-release/extended-release niacin causes less flushing. However, some over-the-counter formulations may be less effective and increase the risk of liver toxicity. The extended-release form sold by prescription (Niaspan is the best-known brand) is effective, least likely to cause intense flushing and safer for the liver—but it costs even more than brand-name statins. An over-the-counter sustained-release preparation called Slo-Niacin is similar to Niaspan but much less expensive.

No-flush niacin (inositol hexanicotinate) has no “free” nicotinic acid, so it has little or no effect on cholesterol. Still, some labels say “supports normal cholesterol.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3942300/
A total of 32 subjects were randomized to pantethine (600 mg/day from weeks 1 to 8 and 900 mg/day from weeks 9 to16) or placebo. Compared with placebo, the participants on pantethine showed a significant decrease in total cholesterol at 16 weeks (P=0.040) and LDL-C at 8 and 16 weeks (P=0.020 and P=0.006, respectively), and decreasing trends in non-high-density lipoprotein cholesterol at week 8 and week 12 (P=0.102 and P=0.145, respectively) that reached significance by week 16 (P=0.042). An 11% decrease in LDL-C from baseline was seen in participants on pantethine, at weeks 4, 8, 12, and 16, while participants on placebo showed a 3% increase at week 16. This decrease was significant between groups at weeks 8 (P=0.027) and 16 (P=0.010).

This study confirms that pantethine lowers cardiovascular risk markers in low to moderate CVD risk participants eligible for statins according to NCEP guidelines.
Tags: Фармакология
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