To control or counteract the flushing (which is minimized anyway after consistent use).
The negative studies published on niacin were done with Niaspan.
From Gundry's FB support group:
July 16, 2014 Q
: Just saw the results of this study today and wonder if Dr. Gundry will continue to recommend the use of Slo-Niacin as a supplement to complement the diet. Have been taking it but of course now second guessing myself. Steven Gundry
: Oh yeah, I have never recommended the prescription form of niacin, Niaspan, because of its poor profile. The head of Abbott labs has met with me twice to find out why their version of Niacin should not be used. This has been known by myself and others for over 12 years. This is not new, startling info!
In this paper http://circ.ahajournals.org/cgi/content/meeting_abstract/124/21_MeetingAbstracts/A16318
He says, "We strongly recommend that pts on Niacin should have Lp-PLA2 levels checked and if elevated, started on Fish Oil, Spirolina, Grape Seed Extract, and Pycnogenol." With one of his patients that shared Dr. G's recommendations for him, Dr. G suggests 200 mg/day of Grape Seed Extract and 60 mg/day of pycnogenol. I consume 1 g/day of DHA/EPA and I have a reaction to spirolina, so don't take it.
I was concerned as my LpPLA2 was slightly elevated before taking niacin. Even more so just before starting it. After following Gundry's niacin protocol LpPLA2 was still slightly elevated but lowest reading I'd had. For me that is 1g/day of niacin as SLO-Niacin brand, plus the 200 mg/day of GSE, 60 mg/day pycnogenol & 1 g/day of DHA/EPA.
Is SLO-Niacin (OTC) available in your country?