Question

Is there anything I can do to reduce the flushing I get from taking 500 mg B3 daily?

Answer

Flushing is a common side effect when taking niacin and the reaction can be controlled by a number of methods. It occurs in approximately 60-90% of patients. Fewer episodes of flushing are reported by patients who take an extended-release preparation. Occurrence or non-occurrence of flushing has nothing to do with the absorption of the niacin from the gut.

Flushing episodes can be accompanied by symptoms of dizziness, palpitations, shortness of breath, sweating, chills, and, rarely, fainting. Within 2-6 weeks after starting oral high-dose niacin therapy, flushing and skin sensations usually disappear, in most patients.

Symptoms may be reduced by initiating therapy with low dosages, gradual increasing dosage, and avoiding administration on an empty stomach.

Because niacin-induced vasodilatation in the skin appears to be caused by prostaglandins, pretreatment with an inhibitor of prostaglandin synthesis (e.g., 325 mg of aspirin 30 minutes prior to administration of niacin) may reduce flushing. Of course, aspirin should not be taken before niacin if there are any symptoms of gastric upset, peptic ulcer, or intestinal irritation.

In general, taking the vitamin after meals will be less likely to provoke flushing.