Niacin, or vitamin B3, occurs naturally in a variety of foods, including tuna and peanuts. You can also take niacin supplements, by prescription or over the counter, to treat conditions such as high cholesterol, arthritis and atherosclerosis (hardening of the arteries). Niacin in your diet will unlikely cause side effects. But if you take niacin supplements in large quantities, side effects, including gout, may occur.

Gout

Gout often develops without warning. You might awaken in the middle of the night with intense pain in your big toe or in other joints in your feet, hands, ankles, knees and wrists. Severe joint pain can last up to a day and lesser discomfort for days or weeks. If you suffer gout once, you are susceptible to future, more severe attacks. Untreated, gout can lead to joint damage, so see a doctor as soon as possible.

Causes

An accumulation of uric acid in your blood causes gout. Urate crystals form around a joint or joints, causing inflammation and intense pain. Persons who drink too much alcohol – more than one drink a day for women, two for men – put themselves at risk for gout. Untreated high blood pressure and chronic conditions such as diabetes also make you more susceptible. Niacin helps treat two conditions that can cause gout – excess cholesterol in your bloodstream and narrowed arteries. But when you take niacin in large quantities – more than 100 mg a day – it can turn toxic. Your kidneys, while working to rid your body of niacin, may fail to excrete uric acid, leading to gout.

Niacin and Gout

Niacin commonly causes skin flushes, a condition that makes your face and chest redden, itch, tingle and burn. Skin flushes, uncomfortable but not serious, give you an early warning sign of toxicity. If you lower your dose of niacin and gradually increase it, you may alleviate skin flushes. If your body, including your kidneys, can slowly adjust to higher amounts of niacin in your system, you may prevent gout. Other serious side effects of taking niacin include stomach ulcers and liver damage. The National Institutes of Health halted a niacin study in May 2011, 18 months earlier than planned, after participants who took 2,000 mg of niacin daily suffered twice as many strokes as study participants who did not take niacin.

Considerations

Other medications, including low-dose aspirin and drugs given to prevent the rejection of organ transplants, can cause gout. If you take thiazide diuretics to lower your blood pressure, you increase your chances of sustaining a gout attack. Some foods in your diet, including asparagus and herring, can lead to uric acid buildup and gout. A doctor can treat gout with pain relief and anti-inflammatory medication and prescribe medications to help prevent recurrences. If niacin causes gout or other side effects, ask your doctor about switching to a different medication.