Why Does Niacin Cause Skin Flushing and Redness?
What is Niacin and What Benefits Does it Have?
Niacin (vitamin B3) is an essential nutrient that has been used to treat pallagra and dyslipidemia, and has more recently shown promise for treating MS (multiple sclerosis) and other neurological disorders. Studies have found that niacin can facilitate remyelination in animal models of MS, Parkinson’s, and Alzheimer’s disease (2)(3).
Through a series of metabolic pathways, Niacin generates nicotinamide adenine dinucleotide (NAD+) and NADP and NADPH, which is a reduction agent for creating fatty acids and nucleatides. NADPH is also a cofactor for the production of glutathione and reduces oxidative stress (4). NAD+ can be stimulated by the precursor tyrptophan, but through a much longer and more energy inefficient process comapred to Niacin supplements. NAD+ is also involved with DNA damage response and Ca2+ signalling.
"Niacin restores proper metabolic functions”
- from Wuerch,Urgoti & Yong, 2023) (4).
Human studies have found that niacin alone has positive effects on plasma lipids by lowering triglycerides, while increasing beneficial HDL cholesterol. One study found that even the extended release form of niacin, had these beneficial effects (5). Larger studies, such as one of over 12,000 adults, found that niacin intake was associated with decreased hypertension (6).
What Causes the Flushing by Niacin and is it Harmful?
The flushing effect caused by niacin (vitamin B3) is almost never harmful. It is a common but temporary side effect, particularly when taking higher doses of niacin supplements. While it can be uncomfortable, causing redness, warmth, and itching of the skin, especially on the face and neck, it usually doesn't pose any serious health risks for most people. However, it's important to follow the recommended dosages and consult with a healthcare provider before starting high-dose niacin supplements.
The flushing effect from niacin is caused by the dilation of small blood vessels in the skin. This dilation is triggered by the release of prostaglandins, which are chemicals that improve blood flow. Here's a more detailed breakdown of the process:
- Prostaglandin Release: Niacin stimulates the production of prostaglandins, particularly prostaglandin D2 and E2 (1).
- Vasodilation: These prostaglandins cause the blood vessels in the skin to expand (vasodilation), increasing blood flow to the surface of the skin.
- Symptoms: The increased blood flow results in redness, a sensation of warmth, and itching, commonly referred to as "flushing." This effect can start within 30 minutes of taking niacin and may last for up to an hour or more.
Managing Niacin Flushing
There are several ways to minimize or manage niacin flushing:
- Gradual Increase: Start with a lower dose of niacin (25mg) and gradually increase it over time to allow your body to adjust.
- Extended-Release Formula: Although this is not an optimal form, extended-release forms of niacin release the vitamin more slowly and reduce the intensity of the flushing. However, this form needs to be taken at a very low dose because it poses a greater risk of damaging the liver, due to prolonged niacin processing, defeating the purpose of taking naicin for improved liver function (7).
- Taking with Food: Consuming niacin with food can help lessen the flushing effect.
- Aspirin: Taking an aspirin about 30 minutes before the niacin supplement may reduce flushing, as aspirin can inhibit the production of prostaglandins.
- Stay Hydrated: Drinking plenty of water can help reduce the severity of the flushing.
In summary, while niacin flushing is a harmless but potentially healing effect, it can be uncomfortable. Understanding its cause and taking steps to manage it can help mitigate this common side effect and enjoy the range of benefits from this supplement. Both of Dr. Clark's Niacin (B3) are made with the nicotinic acid form, and not the extended release variety.
References
-
Kamanna, V. S., Ganji, S. H., & Kashyap, M. L. (2009). The mechanism and mitigation of niacin‐induced flushing. International journal of clinical practice, 63(9), 1369-1377.
-
M Moutinho, SS Puntambekar, AP Tsai, I Coronel, PB Lin, BT Casali, et al.The niacin receptor HCAR2 modulates microglial response and limits disease progression in a mouse model of Alzheimer's disease Sci Transl Med, 14 (637) (2022), Article eabl7634
-
TK Motawi, NAH Sadik, MA-O Hamed, SA Ali, WKB Khalil, YR AhmedPotential therapeutic effects of antagonizing adenosine A(2A) receptor, curcumin and niacin in rotenone-induced Parkinson’s disease mice modelMol Cell Biochem, 465 (2020), pp. 89-102(1573–4919
-
Wuerch, E., Urgoiti, G. R., & Yong, V. W. (2023). The promise of niacin in neurology. Neurotherapeutics, 20(4), 1037-1054.
-
Gordon, S. M., Amar, M. J., Jeiran, K., Stagliano, M., Staller, E., Playford, M. P., ... & Remaley, A. T. (2020). Effect of niacin monotherapy on high density lipoprotein composition and function. Lipids in Health and Disease, 19, 1-10.
-
Zhang, Z., Liu, M., Zhou, C., He, P., Zhang, Y., Li, H., ... & Qin, X. (2021). Evaluation of dietary niacin and new-onset hypertension among Chinese adults. JAMA Network Open, 4(1), e2031669-e2031669.
-
Guyton, J. R., & Bays, H. E. (2007). Safety considerations with niacin therapy. The American journal of cardiology, 99(6), S22-S31.
Susan: That is so amazing to hear! And thank you for the information about depression. Google Scholar shows quite a few recent studies on this effect, due to its role in neurotransmitter signalling.
George: Many indeed like the feeling and recognize its benefitial effects. The flush can be a great indicator of your niacin levels, and areas of the skin that are most red, or the extent that the flush travels around the body, can also indicate different aspects of deficiency and affected organs and systems.
I’ve been taking niacin for about 3 years for depression. It obliterated my depression immediately. It normalized my husband’s cholesterol. We are off all prescription meds! I can’t say enough great things about niacin. Sadly, I have recommended it to several people, and even given them some of my own niacin, but the flushing scares them off. It is a minor annoyance compared to the huge benefits of niacin.
Use B 3 (Niacin) regularly in high doses and get the sensation of being in a sauna. Great 👍 feeling
Leave a comment