Vitamin B3 - Don’t be Afraid of the Niacin Flush

Niacin is vitamin B3, one of the water soluble B-complex vitamins. 

Top Health Benefits Of Niacin:

1. Healthy Skin

Dermatitis or irritated, flaky skin is a symptom of niacin deficiency. There is also some evidence that niacin may help prevent skin cancer and maybe even improve the appearance of wrinkles. Most of the effects of niacin on the skin have been seen when it is applied topically to the affected area, but sufficient niacin in your diet can also help with preventing irritation.

2. Cardiovascular Disease

High doses of niacin have been used to help improve cholesterol levels in people who cannot tolerate statins. Niacin can raise good cholesterol (HDL) by up to 35%. Niacin has also been shown to naturally lower blood pressure and reduce the risk of a heart attack and stroke.

3. Relief of Arthritis Pain

Since niacin plays a role in increasing blood flow to certain areas, it can also help relieve arthritis pain by encouraging blood flow to painful areas. It seems to help improve joint flexibility and reduce pain. 

Niacin is vital for over 50 different processes in our body and is an essential vitamin for human health mainly due to its many enzymatic functions.

One of niacin's unique properties is its ability to help you naturally relax and get to sleep more rapidly at night. Niacin helps reduce harmful cholesterol levels in the bloodstream.

Abram Hoffer, M.D., Ph.D. explains: "Niacin is one of the best substances for elevating high density lipoprotein cholesterol (the "good cholesterol) and so decreases the ratio of the total cholesterol over  high density cholesterol." 

Another niacin feature is its ability to greatly reduce anxiety and depression. 

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Even at high doses, niacin is safe. However, if you take niacin on an empty stomach, when dehydrated or at a high dose there can be a common, but harmless, side-effect known as the “niacin flush.”  The skin becomes red, warm and is often accompanied by a burning sensation and occasionally some itching. It may feel like sunburn.

A large dose of niacin when dehydrated or on an empty stomach is likely to cause flushing. We recommend taking NeuraBoost with a meal, ideally immediately after breakfast.

When it occurs, the niacin flush usually begins on your scalp, face, and ears. You may feel a slight burning sensation, and your face may turn “reddish” in color or “splotchy”. Slowly, this sensation, along with the discoloration, may move down your body, usually stopping at your chest and arms.

Even if the flushing is extreme and temporarily uncomfortable, it will go away and is harmless.

The duration of the flushing can last from ten minutes an hour or two.

Drinking extra water helps reduce the flushing sensation. Besides reducing the flushing sensation, the added water helps the body to rid itself of toxins. 

The Flushing Effect Resolves Over Time

Your body does “get used to” a specific dose of niacin over time. So at some point, the niacin flush will no longer occur and you will no longer experience a flushing.

Some advocates of niacin say taking an aspirin thirty minutes or so before taking the niacin helps to reduce the flushing effect. Getting in the habit of eating food and drinking plenty of filtered water before taking the niacin is a much healthier practice.

Remember, when it comes to certain health conditions it is the “flush” that is a desired effect, so Extended Release Niacin is not effective.

Some medical professionals advocate niacin for overall good health and for treatment of multiple sclerosis, diabetes and as a safe alternative to statin drugs. 

Remember, the flushing occurs by the dilation of blood vessels which creates a sensation of warmth, called a "niacin flush."  This is often accompanied with a blushing of the skin. It is this "flush" or sensation of heat that indicates a temporary saturation of niacin.

Some people can experience this adverse reaction to niacin, called "flushing". When this occurs it is typically because of taking B3 for the first time in higher doses for hypercholesterolemia or other indications. This is not an "allergic" reaction to the vitamin.

A large dose of niacin on an empty stomach or when dehydrated can cause flushing. We recommend taking NeuraBoost with a meal, ideally immediately after breakfast.

When you flush, you can literally see and feel that you've taken enough niacin. The idea is to initially take just enough niacin to have a slight flush.  This means a pinkness about the cheeks, ears, neck, forearms and perhaps elsewhere. A slight niacin flush should end in about fifteen minutes or so. 

"With larger initial doses, the flush is more pronounced and lasts longer," says Dr. Hoffer. "But with each additional dose, the intensity of the flush decreases and in most patients becomes a minor nuisance rather than an irritant. Niacin should always be taken immediately after finishing ones meal." 

The best way to accurately control the flushing sensation is to start with small amounts of niacin and gradually increase until the first flush is noticed. One method is to start with 25 milligrams (25 mg) three times a day, say with each meal - this would be breaking open the capsule and taking one third with each meal that first day. The next day, try up to 50 mg at breakfast and the rest with another meal - ie still breaking open a capsule and taking most with breakfast and the balance with another meal. You can do this for the next few days if you wish. Then, take the whole capsule with breakfast. If you are taking more niacin for medical reasons, for example to control cholesterol, you can continue to increase the dosage by 25 mg per day until the flush occurs. 

 It is difficult to predict a saturation level for niacin because each person is different. As a general rule, the more you hold, the more you need.  If you flush early, you don't need much niacin. If flushing doesn't happen until a high level, then your body is obviously using the higher amount of the vitamin.

 Now that you've had your first flush, what next? Since a flush indicates saturation of niacin, it is desirable to continue to repeat the flushing, just very slightly, to continue the saturation. This could be done three or more times a day. To get to sleep sooner at night, niacin can be taken to saturation at bedtime, too. You might be asleep before you even notice the flush.

Possibly those with the highest risk of a vitamin B3 Niacin deficiency are those who consume mostly a diet of processed foods.  Sugary foods, processed grains, white bread, white flour, wheat products and corn syrup can cause inadequate Niacin levels.

In addition to your NeuraBoost, you might want to make sure to eat some of these Top Niacin Rich Foods daily.

1) Peanuts
1 cup: 21.9 mg (over 100% DV)

2) Mushrooms
1 cup: 7.6 mg (34% DV)

3) Green peas
1 cup: 3 mg (15% DV)

4) Sunflower seeds

1 cup: 3.8 mg (19% DV)

5) Avocado
1 whole fruit: 3.5 (17% DV)

 An important point here is that niacin is a vitamin, not a drug. It is not habit forming. Niacin does not require a prescription because it is that safe.  It is a nutrient that everyone needs each day. Different people in different circumstances require different amounts of niacin.

 Says Dr. Hoffer: "A person's upper limit is that amount which causes nausea, and, if not reduced, vomiting. The dose should never be allowed to remain at this upper limit. The usual dose range is 3,000 to 9,000 milligrams daily divided into three doses, but occasionally some patients may need more. The toxic dose for dogs is about 5,000 milligrams per 2.2 pounds (1 kilogram) body weight. We do not know the toxic dose for humans since niacin has never killed anyone."

Physician skepticism and questions about niacin's proven safety and effectiveness are best answered in Orthomolecular Psychiatry, edited by David Hawkins, M.D. and Linus Pauling, Ph.D. This nearly 700 page textbook is the standard reference for details on niacin therapy.  Persons with a history of heavy alcohol use, liver disorders, diabetes, or experiencing pregnancy will especially want to have their physician monitor their use of niacin in quantity. Monitoring long-term use of niacin is a good idea for anyone.  It consists of having your doctor check your liver function with a simple blood test. 

If a niacin tablet is taken on an empty stomach, a flush will occur (if it is going to occur at all) within about 20 minutes. If niacin is taken right after a meal, a flush may be delayed. In fact, the flush may occur long enough afterwards that you forgot that you took the niacin! Don't let the flush surprise you.  Remember that niacin does that, and you can monitor it easily. 

Powdered niacin - as is contained in your NeuraBoost capsule - on an empty stomach can result in a flush within minutes. Sustained release niacin is often advertised as not causing a flush at all. This claim may not be completely true; sometimes the flush is just postponed. It would probably be difficult to determine your saturation level with a sustained- or time-released product.  They are also more costly. But the biggest reason to avoid sustained-release niacin is that most reports of side effects stem from use of that form. That's why we don't use it.

Here are some commonly asked questions and answers about "flushing" from niacin:

Q: I recently started taking niacin for high cholesterol. The first time I took it I experienced a hot flushing sensation on my skin that took an hour to go away. I thought I was having an allergic reaction. Can you tell me what happened?

Niacin (nicotinic acid vitamin), or vitamin B3, is an essential vitamin. Adults require a daily dietary intake of about niacin.

At much higher doses (1000 to 2000 mg per day) niacin is used as a treatment for high cholesterol. These higher doses of niacin can cause an intense flushing or "prickly heat" sensation to the face and upper body, usually 15-30 minutes after taking a relatively large dose (e.g. 500 mg). When taken at this quantity, flushing is experienced by almost everyone and, while it might feel like an allergy, it is not a true allergic reaction.

Other than causing discomfort the flushing is harmless and usually subsides within 1 or 2 hours. Symptoms are most intense after the first dose and typically diminish over days or weeks with continued use of niacin.

Q: Are there different types of niacin that might reduce the flushing?

The flushing occurs with over-the-counter immediate-release niacin tablets. With this type of niacin the vitamin is delivered to the body in a short burst and the flushing reaction is more intense.

Sustained-release niacin tablets deliver the vitamin to the body in a slower fashion over many hours. This reduces the intensity of the flushing but this type of niacin causes liver damage in some people.

A prescription extended-release niacin product called Niaspan® releases niacin in a slower way but over a shorter period of time compared to the sustained-release tablets. This gives the liver a "break" from processing the niacin making liver damage less likely. This type of niacin has been shown to have positive effects on cholesterol with reduced flushing. However, it is more expensive than regular niacin tablets.

Q: What about "no-flush" niacin?

No-flush niacin contains something called inositol nicotinate, which the body is supposed to slowly convert to niacin. However, there is evidence that it does not actually provide the body with much niacin. This is probably the reason it does not produce any flushing. Of course, this also means that no-flush niacin does not have any of the beneficial effects.

Q: If I continue to take the regular niacin tablets, are there any tips to minimize the flushing?

The key to reducing the intensity of niacin flushing is to start with a low dose and gradually increase the dose over a period of weeks. Taking it with food also helps reduce the intensity of the reaction.

One approach is to start immediate-release niacin at 100 mg twice daily after a meal for the first week, then double the daily dose each week until you are taking what the doctor has prescribed.

Aspirin will also help to reduce the flushing. If you are already taking low-dose aspirin (81 to 325 mg daily) try taking it about 30 minutes before your first niacin dose of the day.

NeuraBoost contains all the B Vitamins along with the mineral selenium. More information here https://getyourboomback.ladesk.com/892270-What-is-this-NeuraBoost-Ive-heard-about.  

NiacinAMIDE is a form of vitamin B-3 which does not cause a flush at all. In may Doctor's opinions, it is less effective in inducing relaxation and calming effects. Niacinamide also does not lower serum cholesterol.

 It is a good idea to take all the B-complex vitamins in addition to the niacin. The B-vitamins, like professional baseball players, work best as a team. Many physicians consider the current RDA for niacin to be way too low for optimum health. While the government continues to discuss this, it is possible to decide for yourself based on the success of doctors that use niacin for their patients every day.


"Generally speaking, people in fairly good health usually choose to increase their doses gradually in order to minimize flushing. If they do increase the dose slowly, what I describe is pretty accurate. For instance, I've been taking niacin for years, in daily but varying doses depending on my stress level or dietary intake. I know by the flush when I've had enough for the moment. It is like turning off the hot water when the tub is full enough for a nice bath. Dr Hoffer is highly experienced with serious psychiatric cases. Such patients have a niacin dependency, not a mere deficiency." Andrew Saul

"Most people flush at the beginning and gradually get adapted to it unless they stop for a few days and then resume it. A few cannot ever get used to it, and they take the no-flush preparations. But the intensity of the flush is very variable. Generally people who need it the most flush the least. That includes arthritics, schizophrenics, and elderly people with cardiovascular problems. Some schizophrenics do not flush until they get well and then they do. But the presence of the flush or its intensity can not be uniquely used measure the need as there are too many variables such as food in the stomach, whether the drink with it is hot or cold, the kind of food, other medication. Antipsychotics reduce the intensity of the flush as do aspirin and antihistamines.” Abram Hoffer, MD

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References:

  1. Niacin: The Real Story by Abram Hoffer, Andrew W. Saul and Harold D. Foster. Reviewed at http://www.doctoryourself.com/niacinreviews.html

  2. Orthomolecular Medicine for Everyone by Abram Hoffer and Andrew W. Saul. Reviewed at http://www.doctoryourself.com/orthomolecular.html

  3. http://www.doctoryourself.com/niacin.html

  4. Anon. Don't overlook niacin for treating cholesterol problems. Harvard Heart Letter. April 2004.

  5. Jacobson TA. A "hot" topic in dyslipidemia management - "How to beat a flush": Optimizing niacin tolerability to promote long-term treatment adherence and coronary disease prevention. Mayo Clin Proc. 2010;85(4):365-79.
  6. Lee T. Is no-flush niacin as effective as other kinds of niacin? Harvard Heart Letter. March 2010.
  7. Meyers CD, et al. Varying cost and free nicotinic acid content in over-the-counter niacin preparations for dyslipidemia. Ann Intern Med. 2003;139(12):996-1002.
  8. http://www.dpic.org/article/professional/niacin-facts-flushing - Rob Gair, BSc (Pharm), CSPI
  9. http://www.doctoryourself.com/niacin.html
  10. http://www.onlineholistichealth.com/the-niacin-flush