The Truths about Niacin Flush

Niacin (Vitamin B3)is vital for over 50 different processes in your body and is an essential vitamin for human health mainly due to its many enzymatic functions.

Even at high doses, it is safe. However, at a higher dose there is a common, but harmless, side-effect known as the “Niacin Flush.”

Your skin becomes red, warm and is often accompanied by a burning sensation and occasionally some itching. You will feel as if you have sunburn.

It is best you begin by taking this vital vitamin in lower dosages at first, and slowly build up over time.

Most people find that starting with 50 mg once per day for a week, then twice a day for another week before progressing to 100 mg, is a comfortable way to go.

What Is the Niacin Flush?

Niacin very predictably causes flushing. Flushing is a warm, tingling, itching feeling of the skin accompanied by redness of the skin. It occurs most commonly in the face and the trunk, although it can occur from head to toe.

Flush can be extremely uncomfortable and may be accompanied by a rapid heartbeat, chills, shortness of breath, sweating, dizziness, and even fainting.

This vital vitamin causes flushing by dilating (expanding) the blood vessels on the surface of the skin. Although this side effect of niacin is harmless, it is often severe enough for people to stop taking niacin.

How it starts in your body

The Flush usually begins on your scalp, face, and Ears.

You will 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. However, if you take too large of a dose too soon, it may flush your entire body.

Again, even if the flushing is extreme, though uncomfortable, it will go away and is harmless.

The duration of the flushing depends on the severity of it, but usually lasts from ten minutes to thirty minutes. In some cases it could last for an hour or two. Drinking extra water helps reduce the flushing sensation.

Make sure that the water you are drinking is filtered and not tap water. Besides reducing the flushing sensation, the added water helps your body to rid itself of toxins. Drinking tap water rather than filtered may add more toxins to your body.

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The flushing effect resolves over time

Your body will “get used to” a specific dose of niacin over time. So at some point, it will no longer occur as it once did.

For example, in about a week, your body will “get use to” 50 mg once per day and you will no longer experience a flushing.

Keep in mind, that each time you increase the dose, you should expect the Niacin flush to start again.

Some advocates of this vital vitamin say taking an aspirin thirty minutes or so before taking the niacin helps to reduce the flushing effect.

Although this does seem to be effective, but getting in the habit of eating food and drinking plenty of filtered water before taking the vital vitamin 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.

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 this vital vitamin causes liver damage in some people.

A prescription extended-release niacin product called Niaspan releases this vital vitamin 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 vital vitamin making liver damage less likely. This type of vital vitamin has been shown to have positive effects on cholesterol with reduced flushing.

However, it is more expensive than regular niacin tablets. (Read more about its deficiencies here)

What about “no-flush” niacin

This contains a substance called inositol nicotinate, which your body slowly converts to this vital vitamin. 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 on cholesterol

It is a great way to increase this vital vitamin intake without the uncomfortable flushing side effects.

Don’t be fooled by no-flush

It helps to lower your levels of bad cholesterol while increasing good cholesterol. When used with lifestyle changes such as losing weight, eating healthy, and increasing physical activity, it helps to lower high cholesterol.

Many doctors recommend their patients to take this vital vitamin in addition to their other cholesterol-lowering therapy.

But beware – not all products that have the word “niacin” on their label will actually benefit your cholesterol health.

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The difference between regular niacin and “no-flush” niacin

Products that are simply labeled as “niacin” contain nicotinic acid. This is the substance that, at doses higher than those needed for its vitamin effect, has been shown to have benefit in people with high cholesterol.

Nicotinic acid is known to lower two types of “bad” cholesterol (LDL low density lipoprotein and very low density lipoprotein VLDL) as well as increase levels of “good” cholesterol (HDL).

In fact, it is able to increase high-density lipoprotein HDL more than any other medication. It is the substance that causes the flushing side effect of niacin.

Products labelled as “no-flush” niacin generally contain no nicotinic acid. The main component in these products is inositol hexanicotinate (a different form of vitamin B3 mentioned earlier).

While inositol hexanicotinate works as other B vitamins work to promote energy metabolism and nervous system health, it has not been shown to have any effect on cholesterol levels.

This product does not cause flushing because it does not work the same way as niacin.

Preventing or Reducing It

Fortunately, there are several steps that you can take to greatly reduce and possibly eliminate this flush.

  • Starting with lower dose

Most importantly, never start with a high dose of this vital vitamin. Instead, start with a very low dose and gradually work your way up to a higher dose.

Even with careful dosing, you might experience a little flushing, although this tends to go away over time.

If you stop taking this vital vitamin for a while, you must start back at the lower dose, or you will flush severely.

  • Taking Aspirin

Taking aspirin (non-coated) 30 minutes before a dose of this vital vitamin also helps prevent the flush. Nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen seem to work as well.

However, it is a good idea to check with your healthcare provider before taking aspirin or anNSAID , as they can cause stomach bleeding or other problems in certain people.

  • Avoid Alcohol and hot beverages

Don’t drink alcohol or hot beverages near the time you take this vital vitamin (or when you expect the flush), as this can set off an attack of flushing. Taking this vital vitamin with or after a meal or snack might also reduce flushing (and helps reduce stomach upset from niacin).

  • Taking extended-release niacin product and immediate-release niacin

Consider the extended-release niacin product (Niaspan), which can be taken just once a day at bedtime.

It is possible that you may sleep through any flushing that occurs.Another option is to use time-release forms of niacin, which is absorbed and metabolised slower than regular niacin.

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.


There’s also a supplement called inositol nicotinate, which your body converts to niacin. The conversion is slow enough that it doesn’t cause a flush in most people.

The problem is that you may not get much actual niacin from products that contain inositol nicotinate

Are There Some Benefits…?

If you’re looking to enjoy its benefits, you should start out with a low dose of 50 to 100 mg a day, gradually building up the dosage.

If you start with a high dosage, you’ll build up a tolerance and you won’t enjoy the benefits of niacin flush. Niacin flush benefits can be enjoyed for not just arthritis, but also a number of other medical conditions.

Here’s just a few of them:

  • For Arthritis

The flush benefits and its results are great for patients who suffer from arthritis.

But for true relief, taking niacinamide is recommended for the best results, since it opens blood vessels deep within the skin closer to the joints.

If you suffer from moderate arthritis, taking 1000 to 1,500 mg of niacinamide is recommended.

While it may not provide the same flush, the benefits you’ll enjoy will become noticeable when your pain begins to ease.

For those suffering from more severe cases of arthritis, you may need to take 3,000 to 4,000mg of niacinamide a day.

Regardless of the size of the dose you’re taking, you should divide it up into five or six doses throughout the day, letting your doctor know beforehand.

  • For Cholesterol and Triglycerides

If you’re looking to lower your blood lipids (cholesterol and triglycerides) in a cost-effective manner, niacin flush benefits even extend to this, as taking 1,000 to 3,000 mg a day canlower your cholesterol by up to 25%.

Patients reported seeing these results after they started out on 1,000 mg a day, followed by 2,000mg a day before working their way up to 3,000mg a day.

They also reported a 50% reduction in triglycerides as well. (how to improve cholesterol levels here.)

  • For Heart Disease

It should come as no surprise to you that it is highly effective in treating heart disease. Patients suffering from heart disease who were given this vital vitamin reported lower rates of illness and death than those who did not receive it.

Another study surprisingly found that taking this vital vitamin regularly actually reversed the signs of heart disease in patients with genetically related cholesterol issues.

It benefits the heart disease patients by opening blood vessels to improve circulation to parts of the body that are otherwise starved for oxygen and nutrition.

It also helps to lower blood fats called very low-density lipoproteins (VLDL). In addition to heart disease, these blood fats have also been linked to cancer.

  • For Senility and Memory Loss

In a study Dr. Abram Hoffer , one of niacin’s biggest advocates, patients suffering from dementia and memory loss who were given 1,000 mg of this vital vitamin a day reported improvements in their memory.

In fact, in one of Dr. Hoffer’s studies, five out of 10 patients totally recovered and two showed a marked improvement.

Incorporating more of this vital vitamin into your diet via traditional foods has been found to greatly assist the body in improving natural detoxification pathways.

In some extreme cases where you have been exposed to highly toxic situations, gradual increases in this vital vitamin dosage can be beneficial, according to Dr. Joseph Mercola .

The benefits of this flush to boost detoxification efforts were described and published in 2005 in the Journal of Internal Medicine.

He found that doses of this essential vitamin cause what is termed “rebound lipolysis”.

This involves initial inhibiting of the breakdown of fats for a short period of time, followed by a detoxification rebound causing a large and simultaneous release of triglycerides and toxic chemicals from the tissues.

These toxins are then free to be expelled from the body either via the gastrointestinal tract or the skin.

  • For Insomnia

While you may think that opening blood vessels, one of its benefits, would be the last thing you would need if you were having trouble sleeping.

There is evidence that niacinamide taken before going to bed can help you get to sleep, since it activates benzodiazepine receptors i n the brain; a dose of 50 right up to 1,000 mg is recommended. This vital vitamin can be taken as well, since the body converts it to niacinamide.

Miscellaneous uses

If you suffer from niacin deficiency, you may be especially sensitive to the sun. Taking 200 mg a day, along with the proper precautions to protect against the sun, means you can enjoy outdoor activities.

Taking 200 to 300 mg of niacin before flying or driving can also help to reduce the symptoms of motion sickness. It is also effective in treating acne.

Since it opens blood vessels, it benefits include improving circulating in diabetics and stimulating the production of hydrochloric acid in the stomach.

For anyone suffering from ear-related ailments such as deafness, vertigo, or tinnitus, niacin flush benefits include opening the blood flow to the ear.

It’s even been reported that if women take this vital vitamin 15 to 20 minutes before sex, it can also encourage the production of vaginal mucous in women, eliminating the need for use of lubricants that many women have to use as they get older.

Possible Side Effects of NF

While its benefits are many, there are possible side effects of taking niacin that you should be aware of.

It may cause irritation to the lining of the stomach; that’s why it is recommended that you take it after you’ve had something to eat.

If you suffer from gout, it contains uric acid, so it may aggravate the condition. Also, avoid time-released niacin at all costs, since it has been found to cause liver damage.

It has been around for a while, but given the niacin flush benefits for people suffering from any number of medical conditions, such as heart disease and arthritis, more people should consider using this old-school remedy.

Symptoms of the flush

People vary widely in the sensations experienced from the inclusion of additional niacin to the diet.

As little as 50 mg can cause a niacin flush in some people who are mildly deficient, while it may take significantly larger doses in others who maintain good overall Vitamin B3 status to experience the same effect.The symptoms include;

  • A pleasant warming of the cheeks
  • Prickliness in the extremities
  • Mild light headedness similar to what is experienced by drinking a glass of wine before dinner.
  • Stomach pain or nausea
  • Rapid heartbeat
  • Skin itching or rash

Hence, some people incorrectly assume that they are buzzed from the minute amount of alcohol in fermented beverages like kombucha, and this is what is responsible for the niacin flush.

In actuality, it is the presence of highly bioavailable B3 that has caused the reaction – not alcohol.

No-Flush Niacin: Too Good to Be True

In many causes, no-flush niacin products are indeed too good to be true. They might not cause flushing, but they might not work either.

If you take this vital vitamin for cholesterol, make sure the niacin product you take contains nicotinic acid, not niacinamide (also known as nicotinamide).

Niacinamide (another form of niacin) does not cause flushing and it does not have any effect on cholesterol.

The non-prescription, sustained-release niacin products (also known as slow-release, controlled-release, or timed-release) are often claimed to produce less flushing.

While this may be true for some people, these products appear to carry a higher risk for liver damage, compared to immediate-release niacin or the extended-release prescription niacin (Niaspan).

Lastly, there are several different “no-flush” niacin products that contain inositol nicotinate, a compound which consists of six molecules of nicotinic acid attached to a molecule of inositol.

The idea behind this compound is that your body slowly breaks it down into niacin (and inositol) slowly, helping to reduce flushing. Inositol nicotinate products are usually sold as “flush-free” or “no-flush” niacin.

While it is true that these products theoretically create little or no flushing, it is not clear if they have the same properties as nicotinic acid for improving cholesterol.

Critics claim that these products do not increase the level of niacin in the blood enough to have an effect on cholesterol.

Final Thoughts

Flushing is a predictable and bothersome side effect of niacin. However, you can take measures to reduce or prevent it.

This vital vitamin can be a very powerful tool for increasing good cholesterol, but many people will stop taking it if not properly warned about flushing (and what to do to prevent it).

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