Niacin is a B vitamin that performs a variety of functions, including keeping the digestive system, skin and nerves working properly. It also aids in the process that converts food to energy. Niacin is water-soluble, which means that excess amounts are passed out of the body through urine. Niacin also has a pharmacological function, and high doses are sometimes prescribed for treatment of low HDL cholesterol, high LDL cholesterol and high triglycerides. While niacin can be an effective cholesterol treatment, it sometimes causes a condition called "flush," which includes uncomfortable itching.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
If your doctor decides to treat your abnormal cholesterol or triglyceride levels with niacin, there is a possibility you could experience niacin flush. Typically, niacin is available over the counter in doses of 250 milligrams or less, and in doses of 500 milligrams or more by prescription. The dose your doctor prescribes will depend on your specific circumstance, but over-the-counter doses of niacin are not effective at treating abnormal cholesterol or triglyceride levels. Doses of 50 milligrams or more can cause flushing symptoms. Niacin flushing may feel like the blushing feeling you get when you are embarrassed. This is sometimes accompanied by a prickly sensation around the face, neck and chest.
- If your doctor decides to treat your abnormal cholesterol or triglyceride levels with niacin, there is a possibility you could experience niacin flush.
Can I Stop Niacin Flush?
Does Niacin Help With Weight Loss?
While niacin flush can be uncomfortable, the symptoms should only last around 20 minutes. You can do reduce the severity of niacin flush symptoms in a few ways. When experiencing flush, drink plenty of water. You should consult your doctor about drinking water with medicine if restricting fluids for a heart condition. Taking aspirin with your niacin dose will also help to reduce your flush symptoms. In addition, some find that avoiding spicy foods and alcohol when taking niacin helps reduce their symptoms.
- While niacin flush can be uncomfortable, the symptoms should only last around 20 minutes.
- In addition, some find that avoiding spicy foods and alcohol when taking niacin helps reduce their symptoms.
There are widely available prescription niacin options on the market that claim to offer the same benefits of niacin with none of the flushing symptoms. However, the effectiveness of these medications has been called into question. While they do not cause flushing symptoms, there is much debate as to their ability to actually lower cholesterol. A study published in "Preventive Cardiology" in 2007 that followed a 48-year-old male with abnormal cholesterol and elevated triglycerides saw no improvement after eight weeks of using no-flush niacin 5. The study concluded that while no-flush niacin was effective in eliminating flushing symptoms, it did not improve cholesterol panel numbers.
- There are widely available prescription niacin options on the market that claim to offer the same benefits of niacin with none of the flushing symptoms.
- The study concluded that while no-flush niacin was effective in eliminating flushing symptoms, it did not improve cholesterol panel numbers.
Niacin & Anxiety
The dietary reference intake for niacin varies depending on age. Sixteen milligrams per day is sufficient to meet the needs of people age 14 and older. A balanced diet from a variety of foods should meet your daily niacin needs. To be effective in treating cholesterol, niacin must be taken in much larger doses. Your doctor may prescribe as much as 4 grams per day.
- The dietary reference intake for niacin varies depending on age.
- A balanced diet from a variety of foods should meet your daily niacin needs.
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- MedlinePlus: Niacin
- National Institutes of Health: Niacin and Niacinamide (Vitamin B3)
- International Journal of Clinical Practice: The Mechanism and Mitigation of Niacin-Induced Flushing
- Life Extension Magazine: Using Niacin to Improve Cardiovascular Health
- Preventive Cardiology: Flush Free Niacin: Dietary Supplements May Be Benefit Free
- University of Maryland Medical Center: Vitamin B3 (Niacin)
- National Institutes of Health. Office of Dietary Supplements. Niacin Fact Sheet for Health Professionals. Updated June 3, 2020.
- Banka SS, Thachil R, Levine A, Lin H, Kaafarani H, Lee J. Randomized controlled trial of different aspirin regimens for reduction of niacin-induced flushing. Am J Health Syst Pharm. 2017;74(12):898-903. doi:10.2146/ajhp160219
- MacKay D, Hathcock J, Guarneri E. Niacin: Chemical forms, bioavailability, and health effects. Nutr Rev. 2012;70(6):357‐366. doi:10.1111/j.1753-4887.2012.00479.x
- National Institutes of Health. Office of Dietary Supplement. Niacin Consumer Guide. Updated July 11, 2019.
Derek Helderman is a Bariatric Registered Dietitian currently working in a nutrition counseling role. Helderman graduated summa cum laude from Southeast Missouri State and completed his dietetic internship at Vanderbilt University Medical Center in Nashville, Tenn.