The Link Between Niacin, Liver Damage & Alcohol

People who abuse alcohol may develop niacin deficiencies. Alcoholism is the leading cause of niacin deficiency in the United States, according to the University of Maryland Medical Center 1. Small amounts of niacin supplements may reverse deficiencies. But if you take niacin in large doses to treat conditions such as high cholesterol or arthritis, you face the risk of liver damage. And alcohol itself can cause liver damage. If you drink large quantities of alcohol, do not take niacin without a doctor’s consent and supervision.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

Niacin Deficiency

If alcohol use makes it difficult for your body to process niacin, you may experience side effects such as fatigue, canker sores, indigestion and depression. If niacin deficiency turns severe -- a condition called pellagra -- your skin may turn scaly or crack and your may suffer from diarrhea or dementia. Other symptoms of niacin deficiency include a swollen, red tongue and burning in your mouth. Most people get enough niacin -- about 14 mg to 16 mg a day -- in their diets, from sources such as:

  • nuts
  • beef
  • chicken
  • beets
  • yeast

Niacin Supplements

You can treat alcohol-related niacin deficiency with dietary supplements. For mild deficiency, the usual dose is 50 mg to 100 mg a day. Persons with pellagra may take 300 mg to 500 mg per day. If you take more than 50 mg of niacin a day, you may experience skin flushes -- your face turns red, itches, tingles and burns. If you drink alcohol while taking niacin supplements, you increase your chances of suffering from skin flushes, a harmless but uncomfortable side effect. No-flush and timed-release formulas of niacin can prevent or alleviate flushing, but they also increase the risk of liver damage.

Benefits and Risks

You can purchase niacin without a prescription. Over-the-counter niacin can treat niacin deficiency and type 1 diabetes and may possibly treat depression and cataracts. Regular niacin in prescription-strength formulas can lower triglycerides and low-density lipoprotein -- two types of lipids in your bloodstream -- and elevate protective high-density lipoprotein cholesterol as well as improve hardening of the arteries. Both types of niacin can cause serious side effects, including loss of vision, stomach ulcers, irregular heartbeat and liver damage.


Alcoholism can increase your need for zinc. If you take zinc supplements, your body makes extra niacin. If you take both zinc and niacin supplements, you might experience skin flushes and other side effects. Niacin has been used to treat alcohol dependence, but evidence about its effectiveness for this purpose remains insufficient. It may relieve anxiety and depression in recovering alcoholics. If you take niacin supplements, get your liver checked periodically for damage. If alcohol has damaged your liver, do not self-medicate with niacin.