If you stop taking Flush Free Niacin for any length of time, talk with your doctor before starting the medication again. You may need to restart the medication at a lower dose. As a scientific article published in the International Journal of Clinical Practice points out, “Therapeutically used for more than 50 years, niacin is the most effective clinically available agent for increasing high-density lipoprotein cholesterol (HDL-C) levels.” Multiple studies have shown that for people with abnormally high overall cholesterol, niacin may increase HDL cholesterol by 20 percent to 40 percent. ( 7) 3. Aids in Reducing Hardening of the Arteries Fortunately, a more recent review of studies found that niacin did not have significant negative effects on blood sugar management in people with type 2 diabetes ( 12). 4. Boosts brain function Risks. Niacin does have risks. It can cause liver problems, stomach ulcers, changes to glucose levels, muscle damage, low blood pressure, heart rhythm changes, and other issues. People with any health condition including liver or kidney disease, diabetes, high blood pressure, or cardiovascular problems need to talk to a doctor before using niacin supplements. Do not treat high cholesterol on your own with over-the-counter niacin supplements.

Flush Free Niacin can cause flushing (warmth, itching, redness, or tingly feeling under your skin). These effects should disappear over time as you keep taking the medicine. Flushing may be worse if you drink alcohol or hot beverages shortly after taking Flush Free Niacin. Since niacin can be used in different ways, talk to your health care provider about the best dosage for you. Statins. Research indicates that taking niacin with these cholesterol medications offers little additional benefit when compared with statins alone, and might increase the risk of side effects.Premedical care and a view from your doctor are critical for those at risk. Taking niacin can worsen certain conditions. Thus, ensuring it is safe for you to take niacin before consuming the supplements is essential. There are major risks to a niacin flush that should be seriously considered before choosing it as a line of treatment. You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

Nicotinic acid in supplemental amounts beyond nutritional needs can cause skin flushing, so some formulations are manufactured and labeled as prolonged, sustained, extended, or timed release to minimize this unpleasant side effect. Nicotinamide does not produce skin flushing because of its slightly different chemical structure [ 2, 12]. Niacin supplements are also available in the form of inositol hexanicotinate, and these supplements are frequently labeled as being flush free because they do not cause flushing. The absorption of niacin from inositol hexanicotinate varies widely but on average is 30% lower than from nicotinic acid or nicotinamide, which are almost completely absorbed [ 12-14]. Two niacin-like compounds, nicotinamide riboside and nicotinamide mononucleotide (NMN; also referred to as β-NMN), are also available as dietary supplements, but are not marketed or labeled as sources of niacin [ 11]. However, FDA ruled in November 2022 that NMN may not be legally marketed as a dietary supplement because it has been authorized for investigation by FDA as a new drug [ 15]. Medications Hepatotoxic drugs, herbs and supplements. These drugs, herbs and supplements, like niacin, cause liver damage. Niacin flush is common and typically causes the skin to flush red. It is harmless unless it occurs after an overdose. To prevent harm, ensure to take the daily dosage recommendations. Niacin, also known as vitamin B3 and niacinamide, is a water-soluble vitamin that plays an important role in heart health. A niacin flush can be a temporary side effect of taking niacin (vitamin B3), or it can be the intentional act of taking higher doses of niacin for a particular health concern. What are some niacin uses? For starters, niacin has been used since the 1950s to lower elevated LDL (bad) cholesterol and triglyceride levels in the blood. ( 1) In high doses, niacin also supports already-healthy cholesterol levels. It helps regulate the healthy ratio between low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Research has shown that high-dose nicotinic acid, at amounts that may cause flushing in some people, may help promote balance in already-healthy HDL and LDL cholesterol levels.However, because of the way the body breaks it down, taking long-acting niacin may have toxic effects on the liver, dependent on the dose taken ( 11). 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. For example, individuals may take 100 mg of niacin twice daily with meals for the first week, then double the daily amount each week until they reach the prescribed amount. People can discuss with a healthcare professional whether this is safe for them. Overall, the evidence indicates that nicotinic acid supplementation improves blood lipid profiles but has no significant effects on risk of cardiovascular events. Although nicotinic acid is a nutrient, if very high doses (thousands of mg) are taken to treat hyperlipidemias, the supplement is being used as a drug. Such doses should only be taken with medical approval and supervision. Health Risks from Excessive Niacin

Niacin supplements should be treated like a drug and only taken under medical supervision, since they can have side effects. SUMMARY

Usual Pediatric Dose for Vitamin/Mineral Supplementation during Pregnancy/Lactation

That said, deficiency is very rare in most Western countries. People who are malnourished — which may stem from HIV/AIDS, anorexia nervosa, liver failure, alcohol abuse, or other medical problems, or poverty — are most at risk. Niacin (also known as vitamin B3) is one of the water-soluble B vitamins. Niacin is the generic name for nicotinic acid (pyridine-3-carboxylic acid), nicotinamide (niacinamide or pyridine-3-carboxamide), and related derivatives, such as nicotinamide riboside [ 1-3]. Niacin is naturally present in many foods, added to some food products, and available as a dietary supplement.