To the editor:

I read with interest a recent column by Dr. Paul Donohue which discusses the use of time-release niacin as part of cholesterol-lowering therapy.Niacin is considered a "drug of first choice" for those requiring medication according to a panel of experts convened by the National Institutes of Health. In addition, niacin is one of the most effective medicines in lowering total- and LDL-cholesterol levels and raising HDLcholesterol.

As mentioned in the article, common side effects of niacin, flushing and gastrointestinal distress, can be alleviated by taking niacin with aspirin and after meals. However, I disagree with Donohue's recommendation to take time-release niacin. Although time-release niacin may reduce initial flushing reactions, the risk of hepatotoxicity may be greater because of increased contact time in the liver.

While niacin is available without prescription, it should never be used in the amounts above the recommended dietary allowance without consulting a physician both before and during treatment. The physician can then monitor the patient's progress.

The Niacin Information Center is an information service exclusively for physicians and other health professionals. Health professionals can obtain a free copy of the government report cited above and other information about niacin by writing the Niacin Information Center at 111 Great Neck Road, Suite 414, Great Neck, NY 11021.

Gail L. Becker, R.D.

Manager, Niacin Information Center

Great Neck, N.Y.