Although people take niacin for a variety of purposes, medical reasons for using the vitamin remain few. Doctors may prescribe niacin to treat high cholesterol or another type of vitamin B-3, niacinimide, to treat type 1 diabetes. If you're taking vitamin B-3, available at drugstores and health-food stores, on your own, understand the limited benefit and potentially dangerous risks of taking niacin. Both niacin and niacinamide may interact with other vitamins and herbs.
Chromium and Antioxidants
If you take niacin by itself, it could dramatically elevate your blood sugar. If you take niacin with chromium, the combination may lower your blood sugar. If you have diabetes, monitor your blood sugar levels closely if you take niacin alone or with chromium. If you take medications to control diabetes, you may need to alter your dose. Niacin, prescribed for more than 50 years to treat cholesterol, works to elevate high-density lipoprotein as well as reduce low-density lipoprotein and triglycerides in your bloodstream. If you take niacin with antioxidants such as vitamin C, selenium, vitamin E and beta-carotine, this might reduce niacin's effect on HDL cholesterol.
Herbs and Liver Damage
Both niacin and niacinamide, if taken in large doses, can harm your liver. This risk increases over time so, if you take either form of vitamin B-3, get your liver checked periodically for signs of damage. You should also exercise caution about combining niacin with alcohol or herbs that might damage your liver. Some herbs that may cause liver damage on their own -- and increase your risk for liver damage if combined with niacin -- include red yeast, chapparal, kava and borage leaf. Other products to avoid if you take niacin include pennyroyal oil, comfrey and dehydroepiandrosterone, or DHEA.
Zinc and Skin Flushes
Niacin commonly causes skin flushes, a condition that makes your face and chest turn red and your skin burn, itch and tingle. If you take niacin and zinc together, you increase your risk of skin flushes. Over-the-counter formulas of niacin usually contain niacinamide, less likely than regular niacin to cause skin flushes. If you take regular niacin to treat high cholesterol and experience skin flushes, your doctor may switch your medication to a timed-release formula. Timed-release niacin will less likely cause skin flushes but will increase your risk of sustaining liver damage. Taking aspirin 30 minutes before you take niacin may help safely prevent or alleviate skin flushes.
Considerations
Niacin, whether taken alone or in combination with other vitamins, can cause serious side effects. In addition to liver damage, niacin may cause stomach ulcers, gout and vision loss. Taking niacin may also worsen kidney disease. Niacin and niacinamide provide different benefits but pose similar risks if you take them in amounts of more than 100 mg a day. Some over-the-counter niacinamide contains 500 mg of niacin and doctors may prescribe niacin in amounts of up to 3,000 mg a day. Persons who took 2,000 mg of niacin daily suffered more than twice as many strokes as persons who did not take niacin, according to preliminary results of a National Institutes of Health study. The government study ended early amid safety concerns.
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