Niacin Flush: Causes, Symptoms, and Management

Niacin is a water-soluble type of vitamin B3 present in dietary dietary supplements. Healthcare suppliers additionally prescribe greater dosages of niacin to handle levels of cholesterol. Although niacin has appreciable well being advantages, taking excessive quantities could cause unintended effects, together with niacin flush.

Niacin flush happens when the pores and skin on the face, arms, or chest turns crimson and turns into itchy or uncomfortable. It arises as niacin within the bloodstream triggers an immune response. This causes blood vessels within the outer layers of the pores and skin to dilate, rising blood move.

Assaults usually resolve inside a half hour, making this situation extra disagreeable than harmful. Nonetheless, very excessive ranges of niacin can injury the liver and have an effect on imaginative and prescient, amongst different signs. It’s essential to know what niacin does, the way it can have an effect on you, and what you are able to do to handle niacin flush.    

Niacin, or vitamin B3, performs a essential function in metabolism, or the chemical technique of absorbing and utilizing power from meals. Tissues within the physique convert niacin into energetic types that assist to switch power from carbohydrates, fatty acids, and ldl cholesterol to the cells. These even have an antioxidant perform, neutralizing free radicals and reactive oxygen species (ROS), that are damaging compounds that may construct up within the physique.    

Primarily, healthcare suppliers suggest or prescribe niacin to assist handle unhealthy levels of cholesterol, often called dyslipidemia. Excessive doses of niacin decrease triglycerides and low-density lipoprotein (LDL) ldl cholesterol—”unhealthy” ldl cholesterol—and lift high-density lipoprotein (HDL), or “good” ldl cholesterol. This helps stop cardiovascular circumstances like:

• Coronary heart illness
• Coronary heart failure
• Atherosclerosis (buildup of fat, ldl cholesterol, and different substances in and on the artery partitions).

Boosting niacin additionally has an anti-inflammatory impact. This implies it reduces irritation—the physique’s immune response—triggered by infections or illnesses. In a research of people that had been hospitalized with acute non-ST-elevation acute coronary syndrome (NSTE-ACS), a coronary heart situation that causes chest pains, researchers discovered dietary supplements of niacin safely lowered irritation ranges.  

Niacin dietary supplements or prescriptions also can deal with niacin deficiency, which is once you don’t have sufficient vitamin B3. This results in a situation known as pellagra, characterised by a sunburn-like discolored crimson or brown rash on pores and skin uncovered to daylight. Pellagra can also trigger a brilliant crimson tongue, nausea or vomiting, and fatigue, amongst different signs. Nonetheless, niacin deficiency is commonly brought on by malnutrition and is uncommon.

The flushed, crimson pores and skin and the opposite signs of niacin flush come up as blood fills in small, dilated subcutaneous vessels within the pores and skin slightly below the floor. Extra niacin within the bloodstream prompts Langerhans cells within the pores and skin, which regulate immune perform. These cells set off the discharge of prostaglandins, chemical substances that trigger blood vessels to open up.

It takes 30-50 milligrams (mg) of niacin to set off this response, so it’s primarily a priority with high-dose dietary supplements and prescribed types. The danger can also be greater should you take dietary supplements or medicines on an empty abdomen.

Your tolerance to niacin can also make you extra delicate to niacin flush. Think about beginning niacin dietary supplements with smaller doses and regularly rising. 

Niacin flush units on a couple of half hour after taking niacin, with the signs lasting about 60 minutes earlier than resolving on their very own. Particular person instances of niacin flush can fluctuate, with typical indicators of niacin flush together with:

• Pores and skin redness that’s much like blushing, usually within the face, arms, or higher chest
• Hotter pores and skin in affected areas
• Itchy pores and skin
• Tingling or burning sensation anyplace in your higher physique

Largely, healthcare suppliers contemplate this situation an disagreeable side-effect reasonably than a harmful well being situation. Nonetheless, niacin flush could also be accompanied by different signs, like headache, rash, dizziness, and low blood stress. Very excessive doses of niacin could cause diarrhea, nausea, and jaundice, a yellowing of the pores and skin and eyes attributable to liver injury.

Although it causes among the identical pores and skin signs—like redness and itchiness—a niacin flush shouldn’t be an allergic response. Allergic reactions are immune responses triggered by publicity to sure meals, pet dander, pollen, vegetation, insect bites, and medicines. Allergy signs have an effect on the pores and skin and different physique components. Frequent indicators of allergy symptoms embrace:

• Hives, welts, and swelling within the pores and skin
• Itchiness
• Nasal congestion and problem respiratory
• Cough, wheezing
• Rash, patches of discolored pores and skin
• Crimson or watery eyes
• Diarrhea
• Flushing within the face, redness
• Nausea and vomiting
• Coronary heart palpitations
• Swelling within the face, eyes, or tongue

Very extreme allergic reactions trigger anaphylactic shock, a medical emergency that may turn into deadly. Get emergency assist should you expertise extreme signs like facial swelling, problem swallowing, wheezing, and lack of consciousness.

Whereas a niacin flush will be very uncomfortable, it doesn’t injury your physique. The sensation ought to move by itself inside a few hours, and it doesn’t require medical therapy. Individuals who use niacin frequently also can develop a tolerance to it over time. As they do, they turn into much less liable to its unintended effects, together with niacin flush.

Whereas niacin flush is a comparatively innocent facet impact, very excessive doses of niacin can profoundly have an effect on the physique. Because the liver processes nutritional vitamins, doses of 1,000-3,000 mg of niacin each day—used to deal with excessive ldl cholesterol—could cause liver injury and failure. This excessive dose can also result in dangerously low blood stress, imaginative and prescient issues, and different dangerous results.

Managing niacin flush could contain treating the signs and altering niacin consumption to cease the response. Strategies that will assist embrace:

• Altering niacin sort: There are various kinds of niacin, with nicotinic acid and nicotinamide (or niacinamide) being the most typical sorts present in dietary supplements. Nicotinic acid helps with hyperlipidemia (excessive blood lipid ranges), however nicotinamide doesn’t. Nicotinamide is much less prone to trigger pores and skin flushing and unfavourable well being results.
• Utilizing extended-release niacin: Dietary supplements and medicines with niacin will be fast-acting or have an extended launch. As a result of they work extra regularly, extended-release sorts are much less prone to trigger niacin flushing, and once they do, it’s much less extreme.
• Scaling up: For those who’re taking therapeutic niacin for ldl cholesterol, contemplate beginning with a smaller dose for a while earlier than shifting as much as bigger quantities. This manner, you’ll be able to develop a greater tolerance for this remedy.
• Taking aspirin: Aspirin blocks the prostaglandin exercise, which manages niacin flush. Usually, suppliers suggest doses of 325 mg aspirin about half-hour earlier than taking niacin.
• Taking it with meals: Taking your dietary supplements with meals and on a full abdomen slows down how shortly your physique absorbs the niacin. This helps stop flushing signs.
• Consuming apples: Apple pectin, a form of plant fiber, can assist handle niacin flushing. Researchers discovered this impact akin to that of aspirin for this situation.

Niacin flush is a wave of redness and heat within the face, chest, or arms after taking excessive ranges of the B vitamin, niacin. Present in dietary dietary supplements and accessible in very excessive, prescription-strength doses, niacin helps to handle excessive ldl cholesterol.

An excessive amount of niacin within the blood, reminiscent of from taking excessive doses, triggers an immune response. Along with facial flushing, this situation could cause itching, burning, and tingling within the pores and skin.

Although disagreeable, a niacin flush isn’t a harmful situation and infrequently requires therapy. The signs are momentary, usually resolving on their very own inside a few hours. Some strategies to handle this situation embrace adjusting your niacin consumption and taking aspirin.