Vitamin B 3 (Niacin)

Question: After I ate vitamin B3, I have a fever, red face and red neck like urticaria, my ears were red and hot, and both hands and arms were itchy. After about 20 minutes the symptoms were gone. What caused it and when did these symptoms disappear?

Answer: Vitamin B3 or niacin has been reported to cause flushing about 88%. The symptoms mostly occur in the face or in the upper part of body. In some cases which have severe symptoms, can cause palpitations, hyperventilation, edema, burning sensation around the skin and fainting.

The mechanism is believed to be caused by niacin that can induce the body producing prostaglandin which causes vasodilation.

Such side effects are reduced:-

1. When administered in low dose, which gradually increase the dose of niacin later.

2. Avoid taking medicine on an empty stomach.

3. Taking aspirin before niacin can reduce side effect because aspirin can inhibit the formation of prostaglandin.

4. Avoid drinking alcohol because it may increase the severity of side effects.

It is reported that people those taking niacin can tolerate the side effect after 2-3 weeks of medication.

But niacin is not recommended in the case of the severe adverse reactions.

References:

1. Kamanna VS, Ganji SH, Kashyap ML. The mechanism and mitigation of niacin-induced flushing. Int J Clin Pract 2009; 63 (9). 1369-77.

2. MICROMEDEX 2.0® [Database on the internet]: Truven health analytics; 2014. mobileMicromedex®, Niacin; Available from: http://www.micromedexsolutions.com