What are the side effects of niacin flush. How can you manage niacin flush symptoms. Is niacin flush harmful to your health. What causes niacin flush and how can it be prevented. How does niacin affect cholesterol levels. What are the recommended dosages for niacin supplementation. Are there alternatives to niacin for managing cholesterol.

What Is Niacin Flush and Why Does It Occur?

Niacin flush is a common side effect experienced by individuals taking high doses of niacin supplements, particularly in the form of nicotinic acid. This reaction occurs when blood vessels near the skin’s surface dilate, causing increased blood flow. While the symptoms can be uncomfortable, niacin flush is generally considered harmless.

The primary symptoms of niacin flush include:

• Reddening of the skin, particularly on the face and upper body
• Tingling, burning, or itching sensations
• Warm or hot skin to the touch

These symptoms typically begin 15-30 minutes after taking the supplement and subside within an hour. It’s important to note that niacin flush is distinct from more serious allergic reactions, which may require immediate medical attention.

The Role of Niacin in Cholesterol Management

Niacin, also known as vitamin B3, plays a crucial role in the body’s energy production processes. However, its use as a supplement is primarily focused on managing cholesterol levels. High-dose niacin therapy has been shown to have several beneficial effects on blood lipid profiles:

1. Increases HDL (good) cholesterol by 20-40%
2. Reduces LDL (bad) cholesterol by 5-20%
3. Lowers triglycerides by 20-50%

These improvements in cholesterol levels are typically observed at therapeutic doses ranging from 1,000 to 2,000 mg per day, which is significantly higher than the recommended daily intake of 14-16 mg for most adults.

How does niacin improve cholesterol levels?

Niacin works through several mechanisms to improve cholesterol profiles:

• It prevents the breakdown of apolipoprotein A1, a key component in HDL cholesterol production
• It accelerates the breakdown of apolipoprotein B in LDL cholesterol, reducing its release from the liver
• It interferes with an enzyme essential for triglyceride production

While niacin can be effective in managing cholesterol, it’s important to note that it’s not typically the first-line treatment. Statins are generally preferred due to their more favorable side effect profile. However, niacin may be prescribed for individuals who don’t respond well to statins or as a complementary therapy.

Managing Niacin Flush: Strategies for Minimizing Discomfort

While niacin flush is harmless, the discomfort it causes can lead some individuals to discontinue their niacin therapy. Fortunately, there are several strategies that can help manage or reduce the intensity of niacin flush:

• Start with a low dose and gradually increase it over time
• Take niacin with meals to slow its absorption
• Use extended-release formulations, which are less likely to cause flushing
• Take a small dose of aspirin 30 minutes before niacin intake (consult with a healthcare provider first)
• Avoid alcohol and spicy foods, which can exacerbate flushing

It’s worth noting that many people develop a tolerance to niacin over time, and the flushing symptoms often diminish or disappear with continued use.

Are there alternatives to immediate-release niacin?

Yes, extended-release niacin formulations are available and may cause less flushing. However, these formulations may carry a higher risk of liver toxicity and should be used under close medical supervision. Another form of niacin, niacinamide, does not cause flushing but also doesn’t have the same cholesterol-lowering effects as nicotinic acid.

Potential Risks and Side Effects of High-Dose Niacin Therapy

While niacin flush itself is harmless, high-dose niacin therapy can potentially cause other, more serious side effects. These are relatively rare but warrant careful consideration and medical supervision:

• Liver damage: High doses of niacin can affect liver function and may cause liver damage in some individuals
• Gastrointestinal issues: Stomach cramping and other digestive discomforts may occur
• Blood sugar fluctuations: Niacin can affect blood sugar levels and may interfere with diabetes management
• Muscle damage: In rare cases, high-dose niacin may cause muscle breakdown (rhabdomyolysis)

Given these potential risks, it’s crucial that niacin supplementation at therapeutic doses is only undertaken under the guidance of a healthcare professional.

How does niacin compare to other cholesterol-lowering medications?

While niacin can be effective in improving cholesterol profiles, it’s generally not considered as effective or well-tolerated as statins. Statins typically have a more favorable side effect profile and are more potent in lowering LDL cholesterol. However, niacin may be particularly useful in raising HDL cholesterol, which statins do not do as effectively.

The Importance of Medical Supervision in Niacin Therapy

Given the potential for side effects and the need for high doses to achieve cholesterol-lowering benefits, niacin therapy should always be conducted under medical supervision. Healthcare providers can:

• Determine the appropriate dosage based on individual needs and health status
• Monitor for potential side effects and adjust treatment as necessary
• Conduct regular blood tests to assess liver function and lipid profiles
• Provide guidance on managing side effects like niacin flush
• Evaluate the overall effectiveness of the treatment

Self-administering high-dose niacin without medical oversight can be dangerous and is not recommended.

How often should individuals on niacin therapy be monitored?

The frequency of monitoring may vary depending on the individual and their specific health situation. However, it’s common for healthcare providers to conduct blood tests every 6-8 weeks during the initial phase of treatment, and then every 3-6 months once the treatment is stabilized.

Niacin in the Context of Overall Cardiovascular Health

While niacin can be effective in improving cholesterol profiles, it’s important to consider its role within the broader context of cardiovascular health. Other factors that contribute to heart health include:

• Regular physical activity
• A balanced, heart-healthy diet
• Maintaining a healthy weight
• Managing stress
• Avoiding tobacco use
• Controlling other risk factors such as high blood pressure and diabetes

Niacin therapy should be viewed as one potential tool in a comprehensive approach to cardiovascular health, rather than a standalone solution.

Can lifestyle changes replace the need for niacin therapy?

In some cases, lifestyle modifications can significantly improve cholesterol levels and may reduce or eliminate the need for pharmaceutical interventions like niacin therapy. However, for individuals with genetic predispositions to high cholesterol or those who have not achieved sufficient improvements through lifestyle changes alone, medications may still be necessary.

Future Directions in Niacin Research and Cholesterol Management

While niacin has been used for decades to manage cholesterol levels, ongoing research continues to explore its efficacy and potential applications. Some areas of current interest include:

• Developing new formulations with reduced side effects
• Investigating the potential synergistic effects of niacin with other cholesterol-lowering medications
• Exploring the impact of niacin on other aspects of cardiovascular health beyond lipid profiles
• Studying the long-term outcomes of niacin therapy in various populations

As our understanding of cardiovascular health evolves, the role of niacin in cholesterol management may continue to be refined and reevaluated.

Are there promising alternatives to niacin on the horizon?

Research is ongoing into new cholesterol-lowering medications and approaches. Some areas of interest include PCSK9 inhibitors, which have shown promise in lowering LDL cholesterol, and various nutraceutical approaches. However, it’s important to note that these are still being studied and may not be suitable for all individuals.

Niacin and Its Impact on Overall Health

While niacin is primarily discussed in the context of cholesterol management, it’s worth noting that this vitamin plays numerous roles in overall health. Some of the other potential benefits of niacin include:

• Supporting brain function and potentially reducing the risk of cognitive decline
• Improving skin health and potentially helping with certain skin conditions
• Supporting DNA repair and cellular health
• Potentially reducing inflammation in the body

However, it’s important to distinguish between the effects of niacin at normal dietary intake levels and the high doses used for cholesterol management. Most people obtain sufficient niacin through their diet for general health purposes.

Can dietary sources provide enough niacin for health benefits?

For most individuals, a balanced diet can provide sufficient niacin for general health. Good dietary sources of niacin include:

• Poultry and red meat
• Fish, especially tuna and salmon
• Nuts and seeds
• Legumes
• Fortified grains and cereals

However, the high doses used for cholesterol management are typically not achievable through diet alone and require supplementation under medical supervision.

Is Niacin Flush Harmful?

Niacin flush is a common side effect of taking high doses of supplemental niacin, which treats cholesterol problems. While harmless, its symptoms — skin that’s red, warm, and itchy — can be uncomfortable.

The symptoms of niacin flush can make people stop taking niacin (1). The good news is that you can reduce your likelihood of getting niacin flush.

This article describes what you need to know about niacin flush, including:

• what it is
• what causes it
• what you can do about it

Niacin flush is a common side effect of taking high doses of niacin supplements. It’s uncomfortable, but it’s harmless.

It appears as a flush of red on the skin, which may be accompanied by an itching or burning sensation (1).

Niacin is also known as vitamin B3. It’s part of the B complex of vitamins that play an essential role in turning food into energy for the body (2).

As a supplement, niacin is primarily used to treat high cholesterol levels. Nicotinic acid is the supplement form people usually use for this purpose.

The other supplemental form, niacinamide, doesn’t produce flushing. However, this form isn’t effective at altering blood fats, such as cholesterol (3).

There are two main forms of nicotinic acid supplements:

• immediate release, where the whole dose is absorbed at once
• extended release, which has a special coating that makes it dissolve more slowly

Niacin flush is a very common side effect of taking the immediate-release form of nicotinic acid. It’s so common that at least half of people who take high doses of immediate-release niacin supplements experience it (4, 5).

High doses of nicotinic acid trigger a response that causes your capillaries to expand, which increases the flow of blood to the skin’s surface (1, 6, 7, 8).

By some reports, virtually every person who takes high doses of nicotinic acid experiences flush (6).

Other medications, including some antidepressants and hormone replacement therapies (HRTs), can also trigger flush (1).

SUMMARY

Niacin flush is a common reaction to high doses of niacin. It happens when capillaries expand, increasing blood flow to the skin’s surface.

When niacin flush occurs, symptoms typically set in about 15–30 minutes after taking the supplement and taper off after about an hour.

The symptoms mainly affect the face and upper body, and include (9, 10):

• Reddening of the skin. It can appear as a mild flush or be red like a sunburn.
• Tingling, burning, or itching. This can feel uncomfortable or even painful (9).
• Skin that’s warm to the touch. As is the case with sunburn, skin may feel warm or hot to the touch (11).

People generally develop a tolerance to high-dose niacin. So even if you experience niacin flush when you first start taking it, that will probably stop in time (1, 8).

SUMMARY

Niacin flush can appear and feel much like a sunburn. However, symptoms typically go away after an hour. People usually develop a tolerance to the supplements over time.

Doctors have long prescribed high doses of niacin to help people improve their cholesterol levels and prevent heart disease (5).

Taking high doses of niacin has been shown to produce the following improvements in blood cholesterol and lipids:

• Increase HDL (good) cholesterol. It prevents the breakdown of apolipoprotein A1, which is used to make HDL (good) cholesterol. It can increase HDL (good) cholesterol by up to 20–40% (1, 12).
• Reduce LDL (bad) cholesterol. Niacin speeds the breakdown of apolipoprotein B in LDL (bad) cholesterol, causing less to be released by the liver. It can reduce LDL (bad) cholesterol by 5–20% (11, 13, 14).
• Lower triglycerides. Niacin interferes with an enzyme that’s essential for making triglycerides. It can lower triglycerides in the blood by 20–50% (3, 11).

People only experience these positive effects on blood fats when they take therapeutic doses of niacin in the range of 1,000–2,000 mg per day (5).

To put that in perspective, the recommended daily intake for most men and women is 14–16 mg per day (9, 10).

Niacin treatment isn’t typically the first line of defense against cholesterol problems, since it can cause side effects other than flush.

However, it’s often prescribed for people whose cholesterol levels don’t respond to statins, which are the preferred treatment (15).

It’s also sometimes prescribed to accompany statin therapy (16, 17, 18, 19).

Niacin supplements should be treated like a drug and only taken under medical supervision, since they can have side effects.

SUMMARY

High doses of niacin are typically used to improve cholesterol and triglyceride counts. They should only be taken under medical supervision, since they carry a risk of side effects.

Niacin flush is harmless.

However, high doses of niacin can cause other, more dangerous side effects, although these are rare (20).

The most harmful of these is liver damage. High doses of niacin may also cause stomach cramping, so don’t take them if you have a stomach ulcer or active bleeding (9, 21, 22, 23, 24).

You also shouldn’t take high doses if you’re pregnant since it’s considered a category C drug, meaning at high doses, it could cause birth defects (22).

Interestingly, although the flush isn’t harmful, people often cite it as the reason they want to discontinue their treatment (1).

And that in itself can be a problem, since if you don’t take niacin as it’s prescribed, it’s not at all effective at preventing heart disease.

According to reports, 5–20% of people who have been prescribed niacin stop using it because of flush (5).

If you’re experiencing niacin flush, or are concerned about it as a possible side effect of these supplements, tell your healthcare provider. They can help you figure out how to reduce the chances of flush or discuss alternative treatments.

Also, because there are other, more harmful side effects associated with taking these supplements, do not try self-medicating with niacin.

SUMMARY

Niacin flush is harmless. However, the supplements can have other harmful side effects, and certain people should not take them.

Here are the main strategies people use to prevent niacin flush:

• Try a different formula. Roughly 50% of people taking immediate-release niacin experience flushing, but extended-release niacin is less likely to cause it. And even when it does, symptoms are less severe and don’t last as long (1, 4, 11). However, extended-release forms may carry a greater risk of liver damage.
• Take aspirin. Taking 325 mg of aspirin 30 minutes before the niacin can help reduce the risk of flush. Antihistamines and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can also minimize the risk (5, 10, 25, 26).
• Ease into it. Some experts recommend starting with a smaller dose like 500 mg and then increasing to 1,000 mg gradually over the course of 2 months, before finally increasing to 2,000 mg. This strategy could bypass flush entirely (5).
• Have a snack. Try taking niacin with meals or with a low-fat evening snack (5).
• Eat an apple. Some early research suggests that eating an apple or applesauce prior to taking niacin may have a similar effect to aspirin. Pectin in apple seems to be responsible for the protective effect (10).

SUMMARY

Taking aspirin, eating a snack, slowly increasing the dosage, or switching formulas may help you prevent niacin flush.

As mentioned above, to avoid unwanted symptoms, including flushing, some people opt for extended-release or long-acting niacin.

However, extended-release and long-acting niacin differ from immediate-release niacin and may cause different health effects.

Long-acting niacin is associated with significantly reduced flushing, as it’s absorbed over a long time period that typically exceeds 12 hours. Because of this, taking long-acting niacin significantly reduced the chances of flushing (11).

However, because of the way the body breaks it down, taking long-acting niacin may have toxic effects on the liver, dependent on the dose taken (11).

Although uncommon, switching from an immediate-release niacin to a long-acting niacin or significantly increasing your dose can result in serious liver damage (27).

What’s more, niacin absorbability depends on the niacin supplement that you take.

For example, the body absorbs nearly 100% of nicotinic acid, which raises niacin blood levels to an optimal range in about 30 minutes.

In contrast, inositol hexanicotinate (IHN), a “no-flush” niacin, isn’t absorbed as well as nicotinic aid (28).

Its absorption rate varies widely, with an average of 70% being absorbed into the bloodstream.

Plus, IHN is significantly less effective than nicotinic acid at increasing serum niacin. IHN usually takes between 6-12 hours to raise blood levels of niacin to near the optimal range (28).

Some studies suggest that peak niacin blood levels can be over 100 times greater when supplementing with nicotinic acid compared to supplementing with IHN.

Research also shows that IHN has minimal effect on blood lipid levels (28).

Because absorbability can significantly vary depending on the form of niacin used, it’s a good idea to ask your healthcare provider what form would be best for your specific health needs.

summary

Absorbability differs between forms of niacin. Some types of niacin are more effective at raising blood levels than others.

Niacin flush can be an alarming and uncomfortable experience.

However, it’s actually a harmless side effect of high-dose niacin therapy. What’s more, it may be preventable.

That said, large doses of niacin can have other, more harmful side effects.

If you want to take high doses of niacin for health reasons, make sure to do so under medical supervision.

Why does it occur? Is it dangerous?

Niacin flush is a flushing of the skin that can occur after taking higher doses of niacin (vitamin B3) as supplements or prescription medications. A harmless and temporary side effect, it usually goes away without treatment in 1–2 hours.

People may also call niacin vitamin B3. Niacin may come in the form of nicotinic acid or nicotinamide.

In this article, we examine niacin flush and its associated symptoms. We also discuss why people may use niacin, whether it is harmful, and how to prevent niacin flush.

High doses of niacin can cause the skin to flush, and people may experience an itching or hot, prickly sensation on the skin. Although it may seem like an allergic reaction, it is not. Flushing may affect the face and upper body.

Flushing occurs from dilating blood vessels, which increases blood flow and causes the skin to redden or darken. The dilation of blood vessels may occur due to how niacin reacts with certain proteins within the skin, causing an increase in prostaglandins and the blood vessels to dilate.

Many people taking niacin may experience a niacin flush. People may experience flushing around 30 minutes after taking a high dose of niacin, such as 500 milligrams (mg) or above.

Symptoms of niacin flush may include:

• the skin on the face and upper body flushing
• itching, tingling, or prickly sensations on the skin
• a hot or burning sensation on the skin

Symptoms of niacin flush may clear within 1–2 hours of taking niacin.

People may find that symptoms of niacin flush are most intense when they first start taking high doses of niacin but may reduce with continued use.

The National Institutes of Health (NIH) recommends a daily niacin intake of 14 (milligrams) mg for adult females and 16 mg for adult males.

People may take high doses of niacin, such as 1,000 mg daily, to treat high cholesterol.

High doses of niacin may help lower the risk of heart attack and stroke in people with plaque buildup in the arteries.

High levels of niacin, as nicotinic acid, can help reduce low-density lipoprotein (LDL), or “bad” cholesterol, raise high-density lipoprotein (HDL), or “good” cholesterol, and reduce triglyceride levels.

However, high doses of niacin are unsuitable for people taking statins.

Niacin flush is harmless. It may cause discomfort, but it doesn’t damage the body. This flushing will usually go away without treatment within 1–2 hours.

As people continue to take niacin, they may find that the intensity of niacin flush reduces.

According to the NIH, niacin supplements of 30 mg or more may cause headaches, rashes, or dizziness.

Taking high doses of niacin of 1,000 mg or more without the approval of a doctor may have harmful side effects, such as:

• low blood pressure, which may increase the risk of falling
• fatigue
• high blood sugar levels
• nausea
• heartburn
• abdominal pain
• blurred vision and buildup of fluid in the eyes

Inositol nicotinate, or inositol hexanicotinate, is a combination of a form of niacin and inositol, a type of sugar that occurs in the body.

Retailers may sell inositol nicotinate as “no-flush” niacin. It may reduce flushing symptoms compared with other forms of niacin, as the body takes longer to break it down. Inositol nicotinate also lowers LDL cholesterol and triglycerides and increases HDL cholesterol.

Other sources suggest that although inositol nicotinate reduces or prevents flushing, it may not provide the body with high enough levels of niacin to lower cholesterol.

Niaspan is a prescription, slow-release form of nicotinic acid. It may reduce flushing and still provide benefits for lowering cholesterol. However, it may be more expensive than other forms of niacin.

Niaspan releases niacin more slowly but over a shorter period than other extended-release forms. This means there is less pressure on the liver to process niacin, reducing the risk of liver damage.

If people take immediate-release niacin with food, it may help decrease the intensity of niacin flush symptoms.

People may also find they can minimize flushing by starting with a lower dose of niacin and gradually working up to higher doses over the following weeks.

For example, individuals may take 100 mg of niacin twice daily with meals for the first week, then double the daily amount each week until they reach the prescribed amount. People can discuss with a healthcare professional whether this is safe for them.

According to a 2017 study, taking aspirin alongside niacin may help reduce the effects of flushing.

People can speak with a healthcare professional about the safety of taking aspirin or other medications alongside prescription niacin.

Niacin occurs naturally in many foods, including:

• poultry
• fish
• legumes
• fortified foods, such as cereals and bread

According to the NIH, niacin supplements come in two main forms: nicotinic acid and nicotinamide.

Nicotinic acid is the form of niacin that doctors prescribe to treat high cholesterol.

Extended-release nicotinic acid releases niacin more slowly into the body over an extended period. Long-term use of high niacin doses and extended-release forms of nicotinic acid may cause liver damage, including hepatitis and liver failure.

Nicotinamide may not cause as many side effects as nicotinic acid. However, doses of 500 mg or more each day may cause diarrhea, easy bruising, and increased wound bleeding.

Doses of 3,000 mg or more daily may cause nausea, vomiting, and liver damage.

Niacin flush is the skin flushing after taking high doses of niacin. Most people will experience this side effect.

People may take higher doses of prescription niacin to treat high cholesterol. Without supervision from a doctor, high doses of niacin may cause harmful side effects.

Niacin flush may also cause a tingling, pricking, or burning sensation and may affect the skin on the face and upper body. It is harmless and usually resolves without intervention within a few hours.

The intensity of niacin flush may vary with different forms of niacin. People may find that increasing dosage slowly to the prescribed amount or taking niacin with food may help reduce symptoms.

Vitamin B3: indications for use, benefits, dosage

March 25
2021

Vitamin B3 (niacin, vitamin PP) is produced in the body from tryptophan and in small quantities, so in order to maintain normal levels of this element, it is necessary to follow a diet. Vitamin B3 takes part in the breakdown and further synthesis of amino acids, carbohydrates, fatty acids, it also regulates cholesterol levels, so a deficiency of the element is dangerous for the human body. It is useful to find out what nicotinic acid is used for and what is the dosage of nicotinic acid.

What is Vitamin B3 (Nicotinic Acid, Vitamin PP)

Niacin is considered to be a vitamin with increased stability, as it is not particularly sensitive to oxygen, heat and UV rays.

The role of vitamin B3 for the body is great. The substance is water-soluble and contributes to the correct functioning of the nervous system. Niacin is also required for the synthesis of steroid hormones (including estrogen, progesterone, testosterone, hydrocortisone), pancreatic hormones (in particular, insulin) and the thyroid gland (thyroxine).

Vitamin PP has an effect on metabolic changes that release energy. When poisoned, it slows down the toxic effect of certain chemical compounds and drugs.

Niacin is an important component that regulates blood cholesterol levels. It also dilates blood vessels, has a positive effect on mental well-being. Niacin improves carbohydrate metabolism, increases wound healing, improves general condition, and normalizes body weight.

Sources of vitamin B3

What foods contain vitamin B3? Niacin acid is mainly found in meat, fish, grains and legumes, in milk, green leafy vegetables (among them with the highest content of lettuce, dill, parsley, sorrel, spinach), in a small percentage – in tea and coffee.

Vitamin B3 is found in lean meats: veal, turkey and chicken. You can find it in almonds, pork, dairy products, organ meats, soybeans, peas and beans. Supplements in the form of vitamin preparations can compensate for the lack of vitamin PP, such an element can be chromium, which increases the absorption of the vitamin.

Vitamin B3 is also found in foods such as yeast, wheat bran and peanuts, as well as fish, especially smoked mackerel and salmon, as a source enriched with niacin. Niacin can be present in lean protein foods, both animal and vegetable.

Why vitamin B3 is prescribed

Niacin is prescribed:

• for diabetes and hypertension;
• for the treatment of disorders of the nervous system;
• for migraine;
• to improve digestion;
• to increase blood sugar;
• to improve metabolism;
• to increase the protective properties of the pancreas.

The main thing when niacin is prescribed is the lack of this substance in the body. More information on the site.

How to take vitamin B3

Breastfeeding women, as well as those using contraceptives, cancer patients and people who lack protein, especially need nicotinic acid.

Recommended daily value of vitamin B3:

1. 6-10 – children 1-3 years old;
2. 8-16 – children 4-8 years old;
3. 14 – women;
4. 16 – men;
5. 17-18 – pregnant.

The normal dosage of niacin for each individual may vary according to age and sex.

Medical use

In the medical field, vitamin B3 is used to treat lipid and lipoprotein problems. They more often than others lead to the development of such a disease as atherosclerosis. A dosage of more than 1 gram per day is able to increase HDL cholesterol levels in the blood plasma, and at the same time to reduce cholesterol and triglyceride levels of LDL.

At higher doses (>100 mg/day), vitamin B3 intake may cause side effects:

• flushing of the skin, mainly on the face;
• fever;
• pruritus and tingling;
• gastrointestinal disturbances (nausea, gagging, gas, diarrhea and possibly worsening peptic ulcer).

Niacin increases the production of adiponectin in fat cells. It is a hormone with anti-atherosclerotic action. Based on clinical studies, niacin is known to relieve migraine symptoms.

More information here.

Contraindications for use

Main contraindications for nicotinic acid:

• hypersensitivity to the substance;
• atherosclerosis;
• hyperuricemia;
• liver failure;
• pancreatitis;
• glaucoma;
• the presence of duodenal ulcer and stomach ulcer, especially during the period of exacerbation;
• arterial hypertension;
• gout;
• arterial hypotension.

It is also important to control the level of niacin in the body. Deviations from the norm are unacceptable, namely, surpluses and deficits.

Excess niacin

Excess vitamin B3 occurs when more than 35 mg per day is consumed. This is often seen with niacin tablets.

Symptoms of vitamin B3 excess:

• skin itching, dryness and redness;
• hyperglycemia;
• liver failure;
• rash;
• abdominal pain, nausea and vomiting;
• arrhythmia.

Therefore, it is not recommended to self-administer – consult your doctor.

Vitamin B3 deficiency

Diet, isoniazid drugs, sugar and alcohol abuse cause niacin deficiency. This can lead to consequences that include a decrease in resistance to cold due to a slowdown in metabolism. Also, the result of a lack of vitamin B3 can be a serious disease – pellagra.

Possible consequences of pellagra:

• dermatitis disease;
• dementia;
• death.

Distinguish between physical and psychological symptoms of vitamin B3 deficiency.

Psychological symptoms:

• increased anxiety;
• irritability;
• delusions and hallucinations;
• amnesia;
• apathy and depression.

Physical symptoms:

• hyperpigmentation;
• skin thickening;
• inflammation in the mouth;
• indigestion.

Self-diagnosis is unacceptable. It is necessary to consult a doctor with the delivery of tests.

Vitamin B3 deficiency and other diseases

Initially, a small deficiency of vitamin B3 provokes a slow metabolism. This may have different consequences. One option is to lower the thermal threshold. If niacin is not enough, it causes a disease called pellagra (Lombard erythema).

Abnormal metabolism of niacin is observed in many diseases. This is mainly found in schizophrenia, hypercholesterolemia, Hodkins’ disease, and depression. A carcinoid tumor that increases the production of serotonin is also triggered by a lack of B3.

Manifestations of pellagra:

• rashes;
• diseases of the gastrointestinal tract, including diarrhea, constipation, vomiting;
• scarlet tongue;
• diseases of the nervous system – apathy, depression, inability to concentrate, headaches, memory problems.

Pellagra is a fatal disease if left untreated. Before taking niacin, a consultation with a specialist is required. Only he can prescribe the drug, indicate the recommended dosages and duration of treatment.

Remember that self-medication can make the situation worse.

Drug Comparison Chart

References

1. https://pubmed.ncbi.nlm.nih.gov/30097857/902 43
2. https://pubmed.ncbi.nlm.nih.gov/27457213/
3. https://pubmed.ncbi.nlm.nih.gov/28983799/
4. https://pubmed.ncbi.nlm.nih.gov/24993939/

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Nicotinic acid overdose: symptoms and prevention

2 An overdose of nicotinic acid is a dangerous condition that occurs during treatment with the drug in large doses. It can be fatal, so it is important to know how to help the victim. You also need to find out how niacin works on humans.

Article content

1. Information about the drug
2. Description
3. Field of application
4. Contraindications of the drug
5. Way of taking nicotinic acid
6. Adverse reactions
7. Causes of overdose of nicotinic acid
8. Symptoms overdose with vitamin PP
9. First aid and treatment of overdose
10. Possible consequences
11. Prevention measures

Nicotinic acid, the benefits and harms of which have long been known to scientists, is produced in tablets and ampoules for injection by a number of pharmaceutical companies, so the composition of the auxiliary components of the drug may differ.

Description

Nicotinic acid, niacin, vitamin PP or B3 is involved in the metabolism of lipids, proteins, amino acids and purines. Its deficiency causes pellagra, a disease that, if left untreated, can lead to death. Niacin is essential for tissue respiration, the breakdown of glycogen to glucose. It lowers the content of “bad” cholesterol in the body and increases the level of “good”.

Niacin causes dilation of small vessels, improves blood circulation, has anticoagulant properties.

The benefits of nicotinic acid are as follows:

• normalizes metabolism, reduces cravings for sweets and promotes rapid weight loss;
• restores nerve fibers;
• improves circulation;
• increases the body’s resistance to infectious diseases;
• improves tissue oxygen supply;
• removes harmful substances from the body.

Vitamin PP prevents hair loss and dandruff. To do this, when washing your hair, it is recommended to add 1-2 drops of the solution to the shampoo or conditioner. You can make a mask 2-3 times a week for a month: mix 1 ml of medication with 0.5 tbsp. l. aloe juice; Apply the resulting solution to the scalp, cover with plastic wrap and a towel on top. Wash your hair with shampoo after 40 minutes.

Vitamin PP has a positive effect on the skin of the face, with its deficiency it becomes dry, rashes appear on it. To get rid of these problems, it is recommended to add 2 drops of the drug to cosmetics.

Before using vitamin PP in a hair mask or adding it to cosmetics, you need to make sure that there is no allergy. To do this, apply a small amount of the drug to the bend of the elbow and see if redness, rash, swelling of the skin appears.

Do not exceed the dose of the vitamin indicated in the prescriptions, otherwise, even with the external use of the product, an overdose may occur.

After oral administration, the drug is rapidly absorbed in the digestive tract, the highest concentration in the bloodstream is reached after 45 minutes.

Vitamin PP in the human body is deposited mainly in the liver, kidneys and adipocytes (fat cells). Passing through the liver, it undergoes metabolism. Regardless of the dosage form, nicotinic acid is completely excreted in the urine within 1. 5 hours.

Field of application

Oral and parenteral niacin is used in the presence of the following pathologies:

• pellagra;
• cerebral blood flow disorder caused by ischemic stroke;
• obliterating diseases of the vessels of the arms and legs, including Raynaud’s syndrome, thromboangiitis;
• hypoacid gastritis;
• long non-healing wounds and trophic ulcers;
• Bell’s palsy;
• acute and chronic inflammation of the liver;
• spasm of the vessels of the arms and legs, urinary and biliary tract;
• diabetes mellitus complicated by diabetic polyneuropathy and macroangiopathy;
• Hartnup’s disease is a genetic pathology in which there is a violation of the absorption of a number of amino acids;
• poisoning of various origins, including ethyl alcohol, drugs.

The preparation for the prevention of hypo- and avitaminosis is used in case of a poor diet, in violation of its absorption, for example, due to pancreatic dysfunction.

Contraindications of the drug

The drug can harm the body even without an overdose when used for certain diseases.

Treatment with nicotinic acid is contraindicated if:

• allergic to the composition of the drug;
• atherosclerosis;
• recurrent gastrointestinal ulcer;
• cirrhosis of the liver;
• decompensated diabetes mellitus;
• gout;
• a large amount of uric acid in the blood.

Vitamin PP is incompatible with breastfeeding, so the infant must be switched to formula during treatment, otherwise the child may overdose. Tablets are prohibited for children under 3 years of age and for women in position. Niacin injections are administered only to adults.

Niacin should be used with caution in patients suffering from the following pathologies:

• increased intraocular pressure;
• hemorrhages;
• gastritis with high acidity;
• history of peptic ulcer;
• hypotension.

Whether it is possible to give injections of vitamin B3 to pregnant women, you need to specify in the annotation, since depending on the manufacturer, the recommendations on this matter will be different. For example, a medicine manufactured by Atoll LLC can be administered during the period of gestation, while the medicine of Organika OJSC is contraindicated.

How to take nicotinic acid

Tablets should be taken after meals. Injections can be done intravenously, intramuscularly and subcutaneously. Depending on what needs to be treated, the vitamin is prescribed in different dosages, which must be strictly observed:

1. For prevention, the drug is prescribed orally in a daily dose of 15-25 mg for adults, 5-20 mg for minors.
2. For the treatment of pellagra in children, the drug in tablets is prescribed 50 mg twice to thrice a day, adults 100 mg three to four times a day for 15 to 20 days. In injections, the drug is administered in 1 ml (10 mg) twice or thrice a day for 10-15 days.
3. In ischemic stroke, inject 1 ml slowly into a vein.
4. If Hartnup’s disease is observed, “nicotine” is prescribed 40-200 mg per day.
5. In case of other diseases in injections, the drug is administered 1 ml 1 or 2 times a day for 10 or 15 days. In tablets, people over 18 years of age are prescribed 50 or 100 mg 2 to 4 times a day for a month.

To avoid overdose, it must be taken into account that the highest single dose for adults should not exceed 100 mg, the daily dose should not exceed 300 mg in injections, and 500 mg in tablets.

In children, an overdose is possible if nicotinic acid is taken in a single dose of more than 50 mg, or more than 150 mg per day.

To reduce the negative effect of the vitamin on the body, the following recommendations should be followed:

1. To reduce the risk of liver dysfunction during therapy, it is worth adhering to a diet with a high content of methionine. There is a lot of this substance in cottage cheese. You can also use lipotropic drugs, for example, methionine or lipoic acid.
2. During the period of treatment, especially with large doses, it is necessary to periodically do an ultrasound of the abdominal cavity and donate blood for analysis. This will allow timely detection of liver problems, which can be no less dangerous than an overdose of the drug.
3. When taking the medicine by mouth, to reduce the irritating effect of niacin on the human body, you need to drink it with milk. This will protect the gastrointestinal mucosa from the harmful effects of the vitamin.

Adverse reactions

Side effects of nicotinic acid may occur even in the absence of an overdose:

• hot flashes, reddening of the skin, drop in blood pressure, collapse, cephalalgia, impaired sensitivity, dizziness;
• hepatic steatosis;
• allergy manifested by rashes, pruritus, wheezing;
• decreased tissue sensitivity to glucose;
• increased activity of liver enzymes and the level of uric acid in the body;
• general weakness, fatigue.

Tablets may cause dyspepsia. The introduction of the drug under the skin or into the muscle is accompanied by pain.

If the vitamin is injected into a vein quickly, the medicine can greatly lower blood pressure and cause dizziness.

During treatment, it is advisable to refrain from driving and activities that require a quick response.

Causes of niacin overdose

An overdose of a medicine is possible for the following reasons:

• a child found and drank the medicine;
• the dose of the drug was calculated incorrectly by the doctor or by the patient himself;
• taking medication again due to memory problems;
• erroneous use of medication due to poor vision;
• non-compliance with the doctor’s recommendations and annotations, for example, the use of large doses in order to get a faster result.

Often an overdose of vitamin PP is diagnosed in women who are trying to lose weight and drink large amounts of the drug.

Poisoning by nicotinic acid is possible if the medicinal product has passed its expiration date or has been stored in inappropriate conditions.

In addition, an overdose of vitamin PP is possible if it is used in combination with other medicines. During treatment, the following should be considered:

1. When using the vitamin in combination with drugs containing sulfonylurea, the risk of developing hyperglycemia increases.
2. When treated simultaneously with Lovastatin, the likelihood of myopathy is high.
3. Niacin should be used with caution in patients receiving antihypertensive and anticoagulant agents.
4. Vitamin PP reduces the harmful effect of Neomycin and reduces the amount of “bad” cholesterol, which may increase due to antibiotic treatment.

Vitamin PP overdose symptoms

Nicotinic acid overdose symptoms can be as follows:

• drop in blood pressure, which can lead to dizziness, loss of consciousness, deep coma, death;
• fever, hot flashes, sensation of heat;
• nausea, vomiting, stool retention;
• dysphagia, dry mouth;
• speech disorder;
• increased sweating, mood swings, depression;
• weakening of reflexes;
• lethargy, drowsiness, indifference to what is happening.

Signs of chronic overdose due to long-term treatment with high doses of vitamin PP may be as follows:

• hepatic steatosis;
• urination (uremia) – poisoning of the body by the components of urine;
• decreased glucose tolerance;
• increased activity of liver enzymes;
• headaches;
• vertigo;
• redness of the skin;
• sensation of heat.

These symptoms do not always indicate an overdose, but in any case require specialist advice.

First aid and overdose treatment

If symptoms of an overdose appear, the drug should be discontinued. The victim must be laid on a horizontal surface so that due to a drop in blood pressure, he does not fall and is not injured.

With an overdose of vitamin PP, gastric lavage is in most cases useless, since the drug is quickly absorbed into the blood. It makes sense to induce artificial vomiting if the drug was taken in tablets no more than 30 minutes ago. To do this, the victim is given to drink 1 liter of water and pressed on the root of the tongue. For gastric lavage in case of overdose, you can not use a solution of manganese, as it can cause a burn of the gastrointestinal tract.

In case of an overdose of nicotinic acid at home, gastric lavage is not recommended for pregnant women and young children.

Immediate medical attention required.

Antidote for overdose of vitamin PP is unknown, the patient is prescribed drugs that eliminate the symptoms of intoxication.

Potential effects

In most cases, overdose of niacin is rapidly eliminated from the body, but sometimes it can cause health problems such as:

• hyperglycemic coma, which can be fatal; an overdose of vitamin PP in diabetics is especially dangerous;
• liver dysfunction;
• fall injury due to low blood pressure.

Preventive measures

To reduce the risk of an overdose of nicotinic acid, the following rules must be observed:

• keep ampoules and tablets in a place where they cannot be reached by minors and people with mental disabilities;
• before taking, carefully read the annotation and do not exceed the doses indicated in it;
• do not self-medicate, be sure to tell the doctor about all the drugs you are taking, as some of them may interact with the vitamin and cause an overdose;
• do not take the medicine if it has expired or has been stored incorrectly;
• remember that vitamin overdose is possible even with external use, so it is important to strictly follow the recipes.