18 Common and Uncommon Niacin Side Effects and Solutions
However, because of the unusual range of possible niacin side effects, doctors recommend that this vital vitamin should be taken carefully with instructions from your health care provider and monitoring you on any sort of high dosage.
Starting with small doses of this vital vitamin and taking 325 mg of aspirin before each dose of this vital vitamin will help to reduce the flushing reaction.
Usually this reaction goes away as your body gets used to the medication. Alcohol can make the flushing reaction worse, avoid large amount of alcohol while taking it.
The bad experience of most users taking this vital vitamin are generally mild and raise very little concern.
Niacin Tolerable Upper Intake Level (UL)
The Food and Nutrition Board set the tolerable upper intake level (UL) for this vital vitamin (especially nicotinamide and nicotinic acid) at 35milligrams per day to avoid adverse effects of niacin flush.
The set applies to everyone, but not to those being treated with niacin under medical supervision
The most common side effect of this vital vitamin is flushing. You can experience a brief reddening of the face and neck after taking this vital vitamin that may be accompanied by itching or tingling sensations.
This may last for as little as 15 minutes, or may not subside until 4 hours after you have taken.
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The Most Common Effect
If you’re eating foods rich in niacin, the chances that you’ll experience any discomforting effect are very slim.
However it’s possible to experience discomfort or even pain when taking supplements, especially if you have high doses.
The following side effects of niacin seem to occur most often in people who are taking high dose supplements and who have pre-known medical conditions:
Nausea and Vomiting
With high amounts of this nutritional vitamin in your system, you can become nauseous. This can lead to vomiting or retching if you are susceptible to nausea in general.
Nausea and vomiting are symptoms of high consumption of this vital vitamin and not a specific disease.
Nausea is the sensation that the stomach wants to empty itself, while vomiting (emesis) or throwing up, is the act of forcible emptying of the stomach.
Skin reactions or rashes or flushed skin
Taking this vital vitamin causes the release of prostaglandins, which are chemicals in your body that are responsible for promoting the inflammatory response when you are injured.
The prostaglandins associated with this great vitamin also cause your blood vessels to dilate, which can cause a reddening, or “flushing,” of your skin — particularly the face, neck and ears — and a burning, tingling sensation in your chest or face.
Doctors prescribe large doses for specific health concerns, particularly to help control cholesterol levels. It’s these higher doses that tend to have side effects, which can include a rash or a flushing of the skin that may resemble a rash.
Headaches are stand-alone illnesses caused directly by the over activity of, or problems with, structures in your head that are pain-sensitive.
This includes the blood vessels, muscles and nerves of the head and neck. Taking too much of this vitamin with supervision may result from changes in chemical activity in your brain.
It is accompanied by other symptoms such as confusion, fever, sensory changes and stiffness. If these persist, please contact your health care provider for a solution.
Cognitive Changes (Dizziness, light-headedness)
Dizziness is the feeling of being lightheaded, woozy, or unbalanced. It affects the sensory organs, specifically the eyes and ears, so it can sometimes cause fainting. Dizziness isn’t a disease, but rather a symptom of various disorders.
High doses of this vital vitamin can also cause cognitive changes. But these changes don’t involve your emotions; they actually affect your perception.
It isn’t uncommon for high doses of this nutritional vitamin to cause dizziness, light-headedness or even faintness. It may also cause an unexplained feeling of fatigue or exhaustion.
An allergy to this vital vitamin is considered uncommon, but could be life-threatening. Niacin supplements can cause allergies because some contain histamines, chemicals substances that can trigger allergic symptoms to be released.
An allergic reaction occurs when you are hypersensitivity to an allergen. An allergen is any substance that your immune system fails to recognize as safe. The immune system begins to defend itself from the mistaken substance by creating antibodies.
The antibodies trigger mast cells to begin producing histamine throughout the body. Increased histamine levels lead to common allergy symptoms related to this vital vitamin.
High doses of this vital vitamin may increase the risk of irregular heartbeats
However, if you ingested an excessive amount of this great vitamin, this can leads to a rapid heartbeat or pulse rate.
This is one of the warning symptoms that you have too much of this nutritional vitamin in your system.
This nutritional vitamin has also been linked to a few cardiovascular side effects. Users of this vital vitamin experienced an increase in plasma homocysteine levels.
An increase in these levels can lead to coronary artery disease. More cardiovascular side effects include palpitations, atrial fibrillation, hypertension, and dizziness.
Increased blood sugar level
The effect of this great vitamin on type 2 diabetes is more complicated. People with type 2 diabetes often have high levels of fats and cholesterol in the blood. Niacin and niacinamide might increase blood sugar.
People with diabetes who take this vital vitamin or niacinamide should check their blood sugar carefully.
It increases the blood sugar levels, which is particularly dangerous for someone with diabetes. For that reason, if you have diabetes, you should take this vital vitamin only under the direction of your doctor.
Liver toxicity and inflammation (liver cells damage)
Another severe side effect related to this vital vitamin is hepatotoxicity—liver damage.
Liver damage becomes more likely the longer you take this vital vitamin, if you take niacin in any form, you should get your liver checked periodically. If you take high doses of this great vitamin, you may incur liver damage after brief use.
An article in the November 2007 issue of “Annals of Emergency Medicine” reported that a patient required a liver transplant after taking 5,000mg of this nutritional vitamin for a few days in an attempt to pass a drug screening test.
However, there are a few risk factors that could increase the risk—pre-existing liver damage, alcohol use and the use of some oral diabetes medications. In rare cases, fatal liver damage has occurred. Signs of liver damage include nausea and anorexia.
Aggravated gout symptoms
An accumulation of uric acid in your body causes gout. Gout is a disease characterized by an abnormal metabolism of uric acid, resulting in an excess of uric acid in your tissues and blood.
This nutritional vitamin helps to treat two conditions that can cause gout – excess cholesterol in your bloodstream and narrowed arteries.
But when you take this vital vitamin in large quantities (more than 100mg a day), it can be toxic. Your kidneys, while working to rid your body of this nutritional vitamin, may fail to excrete uric acid, leading to gout.
Low blood pressure
This vital vitamin can have a blood-pressure lowering effect on the body, which can be beneficial to your high blood pressure symptoms when taken in the correct dosage.
However, high-dosages of this great vitamin area associated with causing your blood pressure to dip too low.
This can be dangerous because your tissues stop getting enough blood and oxygen to them. Dosages in excess of 50mg are considered high with the potential to cause side effects and should only be taken under medical supervision.
Gastrointestinal Problems (Stomach or intestinal ulcers)
You may experience the distressing symptoms of this vital vitamin overdose in your stomach and intestines. The Mayo clinic reports that ingesting large amounts of this great vitamin can cause stomach disorders.
This nutritional vitamin can cause general indigestion if you take it in excess. This is another warning sign that you have taken too much of this substance.
Gastrointestinal disturbances include exacerbation of peptic ulcer disease, eructation, nausea, vomiting, diarrhea, flatulence, and dyspepsia. Persistent fatigue, nausea or anorexia may be a sign of hepatotoxicity.
Sweating or chills
You can take high doses of this nutritional vitamin to control lipid disorders but you need to watch out for flushing. It can cause a hot flushed feeling over the chest and face that is generally harmless, though quite annoying.
Musculoskeletal symptoms or signs (muscle or tendon discomfort, pain, or impaired function) that develop while you take high doses of this vital vitamin, decreases the health-related quality of your life and resolve after niacin discontinuation.
Most complaints are not associated with abnormalities of creatine kinase (CK), which is an imperfect marker of muscle damage
Musculoskeletal side effects associated with this vital vitamin included myalgia, myasthenia, myopathy, and leg cramps. Creatine kinase increase was reported post-marketing in the sustained release product.
Limited evidence exists to support claims that this vital vitamin helps with sleep. The “journal of clinical sleep medicine” explored this and other alternative treatments for sleep in a 2005 evaluation of controlled studies.
The authors found that nicotinamide, a supplemental form of niacin, given in escalating doses for 21 days to non-sleep disturbed study subjects increased REM sleep and insomnia diagnosed subjects given the same dosing protocol also experienced increased sleep efficiency.
Chronic insomnia may warrant seeking medical attention to rule out any underlying causes related to health complications and if you choose to take over-the-counter niacin, consult your physician first to ensure safety.
There’s tendency for you to have dry mouth if you take this vital vitamin, especially for people who are female, 60+ old , have been taking the drug for < 1 month, also take medication Aspirin, and have High blood cholesterol .
Study shows that 6,831 people who have side effects while taking Niacin from FDA and social media. Among them, 77(1.13%) have Dry mouth.
Gender of people who have Dry Mouth when taking Niacin: Female: 50.65 %, male: 49.35 %.
Age of people who have Dry Mouth when taking Niacin: 0-1: 0.0 %, 2-9: 0.0 %, 10-19: 0.0 %, 20-29: 0.0 %, 30-39: 1.35 %, 40-49: 6.76 %, 50-59: 20.27 %, 60+: 71.62 %.
Coughing is an important way to keep your throat and airways clear. However, excessive coughing may mean you have an underlying disease or disorder.
A study was conducted comparing this vital vitamin with other drugs that cause cough, to help you evaluate whether or not this great vitamin causes cough.
A report compiled by Food and Drug Administration says between January 2004 and October 2012, 148 individuals taking this vital vitamin reported cough to the FDA.
A total of 4434niacin drug adverse event reaction reports were made with the FDA during this time period.
Often the FDA only receives reports of the most critical and severe cases; these numbers may therefore under-represent the complication rate of the medication.
A urinary tract infection may involve the urinary tract at any level, including renal parenchyma, renal pelvis, ureters, bladder, and urethra.
If you take this nutritional vitamin and you exceed the daily recommendation or supervision. It can affect your sexual performance especially in men.
Genitourinary complaints of decreased sexual function have been reported in up to 3% and 22% of male patients who have taken unmodified and timed release of this vital vitamin, respectively.
You can take high doses of this vital vitamin to lower your cholesterol level but you need a guide on this from your doctor.
High doses used for lowering cholesterol levels in the blood have been seen to cause birth defects in laboratory animals, with similar effects for infant development in humans.
These vitamin b3 side effects are generally mild and will typically improve after the first two weeks of continuous treatment.
If the symptoms become worse or do not subside over time, be sure to let your doctor know. The dosage level prescribed to you may need to be adjusted.
The Uncommon effects
These are isolated cases where other niacin side effects occur. It is based on how your body is sensitive to supplements, it varies in occurrence.
For instance, body A can take this vital vitamin and has one of these effects while body B might not have any of these side effects. The rare side effects include;
Skin changes (dryness and pigmentation changes)
Dermatologic flushing (facial and whole body) and pruritus as a result of stimulation and release of prostaglandins by niacin have been major drawbacks of this vital vitamin.
These symptoms have occurred in up to 78% of patients and usually resolved after 2 weeks of continued therapy.
You can minimized with use of an extended release form of the nutritional vitamin, gradual dosage titration (over 2 to 3 months), and by administering the dosage during or within 30 minutes after meals.
A spasm of the larynx
Spasm of the larynx suddenly contracts and blocks the flow of air into your lungs. People with this condition may suddenly wake up in the middle of the night with a burning sensation in their throats or may be unable to either speak or breathe momentarily.
This effect is not that common unless you take high doses of this great vitamin without drinking enough water or without doctor’s supervision.
Flushing commonly occurs with the use of niacin supplements, a condition often referred to as “niacin flush” that is characterized by skin redness and tingling. You may feel hot and have an itching sensation on your skin as well
Hives could occur with flushing, but most people have skin irritation without raised bumps.
Contact your doctor immediately if you experience hives or swelling around your mouth, face or other locations since these symptoms could indicate a severe reaction
Decreased blood platelets
When you take this vital vitamin to lower your cholesterol levels, it works well and makes your other blood level to be normal but it decreases your blood platelets.
Platelet count decreased is found among people who take this this great vitamin, especially for people who are male, 60+ old, have been taking the drug for 10+ years, also take medication Aspirin, and have Preventive health care .
A study from FDA shows that out of 6,828 people who take this vital vitamin, 165 have Platelet count decreased.
Ocular problems (Dry eye)
The major benefit of this vital vitamin is to lower the cholesterol level, but you need to be very careful when taking high doses for treating diseases
This vital vitamin appears to cause a reversible toxic cystoid maculopathy in approximately 0.7% of patients taking at least 1.5 grams daily. The maculopathy typically has been reversible upon discontinuation of therapy.
Ocular side effects include amblyopia, sicca syndromes, blurred vision, eyelid edema, and macular edema.
You can take high doses of this vital vitamin to lower your cholesterol level and triglycerides. But you are going to experience brief periods of heart palpitations accompanied by feeling faint.
Therefore, you need to monitor your doses when taking this vital vitamin to avoid this side effect.
High blood sugar
Niacin and niacinamide might increase blood sugar. People with diabetes who take this vital vitamin or niacinamide should check their blood sugar carefully.
If you start taking high doses of this nutritional vitamin, you might need to check your blood glucose more often, and the dose of any diabetes medications might need to be adjusted.
Low amount of phosphate in the blood (Hypophosphatemia)
Hypophosphatemia is an electrolyte disturbance in which there is an abnormally low level of phosphate in your blood.
A study conducted on March 2013 by Kidney research and clinical practice described that niacin was taken by chronic kidney disease (CKD) patients from January 2009 to June 2011.
It shows that phosphorus level(P<0.05) was significantly decreased and glomerular filtration rate(GFR) was significantly increased (p>0.05).
This shows that there’s tendency for you to have a low amount of phosphate in your blood if you take this nutritional vitamin. However, more research is needed before a firm conclusion can be made.
- Metabolic problems (High amount of uric acid in the blood)
Another less common side effect is a metabolic condition called Hyperuricemia. You will experience this if you take high doses of this vital vitamin.
Hyperuricemia refers to a high level of uric acid in your blood. It is commonly caused by excessive alcohol intake, which also causes deficiency of this nutritional vitamin (alcohol pellagra).
These increased levels have been linked to new cases of gout and worsening of pre-existing cases. Another metabolic side effect is hyperglycemia or a high blood glucose level. Cases of hyperglycemia that are left untreated can lead to coma or even death.
This nutritional vitamin can also cause the skin to itch. For some individuals, this is one of the more unsavory side effects of this nutritional element. Itching can be annoying and distract you from your daily tasks.
Worsening of peptic ulcer
If you take high doses of this vital vitamin, it can either cause or worsen peptic ulcers, the America cancer society warns. Peptic ulcers are erosions in the lining of the stomach that can cause bleeding and severe stomach pain.
Though peptic ulcers are a rare side effect of this great vitamin but they can be dangerous, you need to tell your doctor before you start taking high doses of this nutritional vitamin.
In some individuals, abdominal pain similar to that of gas or cramping can occur. This is another vague symptom that you can’t always pinpoint when you experience it.
The mayo clinic reports that ingesting large amount of this vital vitamin can cause abdominal pain, nausea, vomiting, and diarrhea but is uncommon.
These side effects are signs of allergic reaction. If you experience any of these, it means that you are hypersensitive, and you need to get immediate medical help.
In any of mentioned above keeps repeating and prolongs, do not hesitate to visit your doctor and solve the problem by changing your treatment.
Flushing: the Most Common Negative Effect
The most common niacin effects are flushing. This is when the dermal blood vessels are left heated and red due to vasodilation.
It also causes a burning and tingling sensation. This flushing will usually go away within 30 minutes, 70% of people who take this vital vitamin suffered from this. Flushing is also sometimes followed by itching and skin rashes.
One of the most important aspects of flushing is prostaglandin D2 (PGD2).
These prostaglandins are created by the cells found in your bone marrow- particularly platelets and Langerhans (dendritic) cells, leading to the creation of lipids that depend on the cyclooxygenase-2 enzyme (COX-2) by dermal or epidermal cells.
It is possible for you to reduce the effect of this flushing by taking aspirin before you take this vital vitamin.
Even though taking a small dose of aspirin, such as 81mg day can suppress the release of PGD2 by niacin. The symptoms of flushing are still present when you take higher amounts of this great vitamin
Solutions/tips on how to reduce or stop the side effects of niacin
The solutions/tips listed below will serve as a guide for you in taking this vital vitamin, you can avoid total bad reactions of this nutritional element if you monitor yourself on the prescribed dose and you consult your doctor if there is need for high dose;
- Realize that the flush is temporary.
First, it is important to remember that the flushing will go away and it isn’t serious. The symptoms themselves will last less than an hour, and flushing will only occur during the beginning of your treatment regime.
Once you have built up to your recommended dose, flushing will subside and, in most cases, disappear completely.
Give it time; toughing through the first few weeks is well worth it, because this nutritional vitamin is such a powerful tool for your health.
- Start with a low dose and increase your dosage slowly.
The initial recommended dose is around 250 to 300 mg. Try 100 mg three times per day at first, and work your way up to as much as 1,000 or 2,000 mg.
When you increase more slowly, your flushing or negative effects symptoms will be less severe.
Once you reach your regular dose (only go high enough to maintain healthy cholesterol levels), keep it consistent. If you stop taking niacin and then restart, you may experience a flush again.
- Take it with meals.
If you haven’t eaten for a while, this nutritional vitamin will be absorbed more quickly, which can make the side effects worse.
Take your dose at meal times to be sure you aren’t taking it on an empty stomach. Also be sure to drink plenty of water.
- Wait until bedtime
If you take this vital vitamin before bed, your flushing symptoms may occur while you are sleeping, which may help you to avoid the flush feelings.
- Avoid alcohol, spicy foods, hot beverages, hot baths, or hot showers close to or near your dosage time
These factors may all make the side effects to worse, so be sure to avoid them near the time you take the nutritional vitamin.
- Take quercetin with your niacin
Some studies show that taking quercetin, a flavanoid antioxidant, can help to reduce the side effects or flushing symptoms. Try taking 150 mg of quercetin before your niacin dose.
- Use a low dose of aspirin with it
If you can’t tolerate the flush, a low dose of aspirin can effectively reduce the intensity and duration of flushing. Try a low dose, around 80 to 160 mg. If that doesn’t work, try 325 mg.
Researchers suggest that aspirin only be used as a temporary “bridge” to help you during the first weeks of treatment when your dosage is being increased.
Once you have reached your maximum, regular dosage, stop using the aspirin.
- Try an extended release formulation, only if you have to.
Most people take immediate-release niacin, which is the safest and most reliable formulation.
But if you are having a particularly hard time with the niacin flush (and have already tried regular niacin for a few weeks), try an extended release formulation.
These can help to reduce the side effects of this nutritional vitamin, but they are also associated with a higher risk for liver toxicity.
If you wish to try an extended release option, talk to your doctor, who can help you be sure to keep your liver safe.
- Do not choose a “no-flush” niacin product.
While these specialized formulations of niacin may not produce a flushing reaction, they are also not effective and don’t have the same cardiovascular benefits as regular niacin.
Be sure to not let some uncomfortable side effects of this nutritional vitamin get in when you are using itfor cholesterol control.
Use these strategies to reduce or stop the niacin flush and negative effects, and try to stick it out even through the initial discomfort. It will be well worth it to keep your heart healthy with this all-natural remedy
This nutritional vitamin is available as a tablet or an extended-release tablet to be taken orally. You should take it at bedtime, after a low-fat snack. Doses should be individualized according to patient response.
Therapy with this vital vitamin must be initiated at 500 mg at night to reduce the incidence and severity of side effects that may occur during early treatment.
It may interact with other cholesterol-lowering drugs, blood thinners, multivitamins or mineral supplements that contain niacin, blood pressure medications, bile acid sequestrants, aspirin, or heart medications such as statins.
Tell your doctor all the medications and supplements you use. If you are pregnant, stop taking this vital vitamin and consult your doctor. Women who are breastfeeding should not use this nutritional vitamin.