For hyperlipidemia, a patient is instructed to take high-dose nicotinic acid. Which statement best reflects this therapy?

• A. Take nicotinic acid supplements to lower lipids.
• B. Increase dietary niacin to treat hyperlipidemia.
• C. Nicotinamide reduces plasma lipoproteins.
• D. Dietary tryptophan is sufficient to treat hyperlipidemia.

Answer: (A)

The main idea is that high-dose niacin (nicotinic acid) is used as a lipid-lowering medication, not just as a dietary vitamin. At pharmacologic doses, nicotinic acid acts on the liver to reduce VLDL production, which lowers triglycerides and LDL, and it also increases HDL levels modestly by changing HDL metabolism. So taking nicotinic acid supplements to lower lipids reflects its therapeutic role in hyperlipidemia.

It’s important to distinguish this from nicotinamide, which does not have the same lipid-lowering effect, and from relying on dietary niacin or tryptophan. Increasing dietary niacin won’t reach the high pharmacologic levels needed to impact lipids, and tryptophan intake is not a reliable, sufficient strategy for treating hyperlipidemia.