Niacin, which is also known as vitamin B3 or niacinamide / nicotinic acid, is a water-soluble vitamin that plays an important role in heart health. It has been used since the 1950s to improve lipid profiles in the blood.

A “flush” is either a temporary side effect of taking the vitamin, or the result of an intentional decision to take higher doses of it for a particular health concern.

First we’ll look at what niacin is, before we discuss flushing in particular.

Niacin Uses

Niacin molecule

Vitamin B3 is one among eight B vitamins. Apart from the standard form of the vitamin, there are other forms, niacinamide and inositol hexanicotinate, but it should be noted that these have different effects from the standard vitamin.

What does niacin do? Like the other B vitamins, B3 helps our bodies convert the food we eat into usable fuel. More specifically, it also helps the body to produce key sex hormones as well as stress-related hormones in the adrenal glands and other parts of the body. Benefits also include the vitamin’s ability to decrease inflammation and boost blood circulation.

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The vitamin can naturally be obtained in the diet. Foods that are high in B3 include grass-fed beef, free-range chicken, lamb, salmon, sardines and sunflower seeds.

It can also, obviously, be obtained by supplementing with tablets.

The vitamin is water-soluble, just like the other B-vitamins, which means the body does not store it.

Niacin flushing

See the source image
That’s a hell of a flush you’ve got going on there, buddy.

Side effects can include a flush, which is when someone temporarily experiences red, warm and tingling burning and/or itchy skin after taking a supplement. Why? Because the capillaries expand, which increases the flow of blood to the skin’s surface.

A nicin flush is a common visible reaction to high doses of the vitamin or an overdose. It can look and feel somewhat like a sunburn. Unlike sunburn, it usually lasts only an hour or so. It’s worth emphasizing that the flush is considered harmless, but it can be uncomfortable. For this reason, some companies now make flush-free niacin supplements.

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For specific purposes, some people intentionally take higher doses. Research has shown that it can be helpful for certain people. Here are a few specific uses.

Alter lipid profiles

According to a study published in the American Journal of Medical Science, research has shown that “in pharmacological doses, niacin (vitamin B3) was proven to reduce total cholesterol, triglyceride, very-low-density lipoprotein, and low-density lipoprotein levels, and to increase high-density lipoprotein (HDL) levels.”

Treat atherosclerosis (hardening of the arteries)

Studies have pointed toward the vitamin’s ability to reduce atherosclerosis. As shown in one scientific review, it has been shown to selectively increase the plasma levels of Lp-AI, a component of HDL that has a cardio-protective effect in patients with low HDL levels. In addition, supplementation has been shown to decrease oxidative stress, which is known to contribute to atherosclerosis.


Many believe that B3 can be used as a way to ‘flush’ drug metabolites out of the body, mainly by increasing the rate of fat breakdown. Body fat is where drug metabolites typically end up being deposited. There doesn’t appear to be any scientific research into this use, but it’s definitely one you’re likely to come across when looking into flushing.

Help with weight loss

This is another common use. Although there aren’t many scientific studies, at least one study of mice showed that treatment helped reduce obesity by reducing inflammation.

The researchers write:
“Niacin treatment attenuates obesity-induced adipose tissue inflammation through increased adiponectin and anti-inflammatory cytokine expression and reduced pro-inflammatory cytokine expression in a niacin receptor-dependent manner.”

Niacin flush protocol

Below is a recommended dosage for a flush.

  • Weeks 1–4: Daily dose of 500 milligrams of niacin extended-release taken at bedtime
  • Weeks 5–8: Daily dose of 1,000 milligrams of niacin extended-release taken at bedtime (can be one 1,000-milligram tablet or two 500-milligram tablets)

After eight weeks, a doctor would typically evaluate the patient’s response to the niacin.

In general, female patients are known to require lower doses than male patients to see a desirable response. If the response to 1,000 milligrams is not adequate, the dosage may be increased to 1,500 and then 2,000 milligrams if needed.

Doses over 2,000 milligrams daily are usually not recommended. It’s also recommended not to raise dosage more than 500 milligrams over the course of four weeks.


Apart from the general discomfort that comes from flushing, users can also suffer an upset stomach or diarrhea. These symptoms usually pass quickly.

According to Dr Axe:

“High doses of niacin have been associated with liver damage, gastrointestinal problems, glucose intolerance, low blood pressure, heart rhythm changes and other health issues. This is why it’s important to speak with your health care provider about the appropriate niacin supplement and dose for your particular needs.”

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