top of page

What to Do if You have a Niacin Reaction

More recently I had a client share she had crazy amounts of #flushing and a rash after taking a new supplement and immediately after seeing the combination that had been recommended to her I recognized what she had experienced was a #niacin flush. This isn't too uncommon to those who are recommended niacin to address their lipids, but offering high levels of niacin in pregnancy isn't the norm. We don't have any clear data to what impact this may have on the developing baby, but outside of pregnancy, there isn't real dangers to experiencing a niacin flush unless it is associated with a rash, difficulty breathing, or swelling of the face or tongue, which indicates a more severe reaction. It does suggest that you are unlikely to have a deficiency of niacin though.

Also known as vitamin B3, niacin is found in the meats we consume, dairy, and our fortified grains. If you don't have some level of difficulty absorbing niacin, then your levels shouldn't be too deficient; however, functional and integrative practitioners may recommend higher doses of niacin to address elevated lipids, especially triglycerides, as an alternative to statins. This isn't a strategy I commonly use in my own practice, specifically because of its potential to cause flushing, and because I have pretty good outcomes with berberine and red yeast rice, but even with flushing, niacin has fewer side effects than statin treatment.

Niacin reactions create a fairly intense flushing, similar to a moderate sunburn, and some describe a prickly-feeling in their skin and significant warmth which also isn't unlike experiencing a sunburn. This may even move down the neck, arms, and chest, but seldom progressing further.

Upwards of 2,000mg might be recommended daily for lowering lipid levels, but as little as 50mg can cause a flush. Niacin causes the capillaries near the surface of the skin to dilate, bringing more blood to the area. Reactions are most common in those who consume niacin in the form of nicotinic acid delivered in an immediate-release formula, but the incidence is about 50 percent of those who take it will experience some level of flushing and this typically occurs within about 20 to 30 minutes. This reaction typically lasts only a few minutes and the longer niacin is taken the less significant these reactions are, so some tolerance at first might really be worth the lipid lowering response.

Niacin Improves Circulation

The reason flushing occurs is because blood flow is enhanced in the face, and this improved circulation overall is a contributor to lowering your #lipids. Experiencing the flush is somewhat reassuring that the blood is flowing more freely through the body. Functional and integrative practitioners recommend niacin because it helps reduce the "bad cholesterol," while increasing the "good cholesterol." Niacin containing drugs reduce the risk of heart attack in those with high cholesterol and coronary artery disease.

The higher the dose, the more significant the reaction may be so we typically start with lower doses and gradually build up to higher levels as appropriate. There aren't great reasons for recommending high levels of vitamin B3 in pregnancy though, so while higher levels of folate are recommended, which is vitamin B9, this is not one-in-the-same as vitamin B3. If you experience a more significant reaction, such as one with rash or swelling, an anti-histamine is recommended, more specifically Claritin or Allegra.

8 views0 comments

Recent Posts

See All


bottom of page