Dear Dr. Gott: Recently, there have been a lot of recommendations to use niacin as a treatment for high cholesterol instead of statin drugs, but no one has said anything about the side effects.

This past summer, I was out mowing my grass. The sun was hot, but I didn't think it was that hot.

Shortly after coming into the house, I felt prickly feelings all over my face, and then my face got hot and red.

I tried to cool it with a cold washcloth, but it didn't work, so I went down to the emergency room.

The diagnosis was heat exhaustion. Just a few weeks ago, I had this same prickly feeling all over my face. I was indoors and the weather was cool. Again, I couldn't stop it, so I went to the ER again.

This time they asked me what I had taken prior to this prickly feeling. When I told them I took some vitamins and niacin, they said the niacin was the culprit and that a lot of people get this same reaction from it.

Side effects last for about two hours. I had been taking niacin off and on, so it probably was the cause of my first trip to the ER and not the heat. Niacin has its side effects, and I want to let others know.

Reply: As I have written before, there are several options for dealing with and preventing flushing associated with niacin.

For some people, flush-free niacin can be as beneficial as traditional niacin, while in others it may be ineffective.

Another option is to take one aspirin before taking the niacin. This option, however, must be considered carefully because aspirin can adversely affect health, especially in people with sensitive stomachs, ulcers, clotting disorders and more.

A more appropriate option is to start with a low dose and slowly work up to 1,000 to 1,500 milligrams of niacin daily.

This approach allows the body to adjust at a more comfortable pace that often prevents flushing. I suggest you speak with your primary care physician about appropriate options.

Perhaps you would benefit from flaxseed oil and omega-3 fish oil instead of niacin. To give you related information, I am sending you a copy of my Health Report "Understanding Cholesterol". Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, Ohio 44092. Be sure to mention the title.

Dear Dr. Gott: I have an in-law, age 39, who, upon sitting down, crosses his leg and shakes his foot in a rapid manner. If he uncrosses the leg, he shakes his entire leg up and down, pounding his heel on the floor.

Sitting on the same couch with him is nearly impossible; sitting across the room from him is also distracting and unnerving.

When asked why he does this nonstop, he says his mother did it when she was pregnant with him. Is there any explanation or reasoning theory for this behaviour?

Reply: I don't believe there is an explanation or reason for this behaviour. Perhaps it is simply a bad habit or the result of boredom or agitation. It may even be a subconscious behaviour. I had several patients who would do the same thing and, when asked if everything was OK, they would respond with an apology for not realising the action.

Dr. Gott is a retired physician and the author of "Dr. Gott's No Flour, No Sugar Diet" and "Dr. Gott's No Flour, No Sugar Cookbook''. Contact him c/o United Media, 200 Madison Avenue, fourth floor, New York, New York 10016.