1. Facial flushing which lasts for about 15 to 30 minutes, and is sometimes accompanied by a prickly or itching sensation.
2. Hyperuricemia, a condition whereby uric acid rises in the blood and increases the risk of developing gout.
3. Gastrointestinal complaints, such as indigestion
4. Acute liver failure.
5. Hyperglycemia: High-dose niacin may also elevate blood sugar, thereby worsening diabetes mellitus.
6. Cardiac arrhythmias: It is a condition where heartbeat maybe irregular.
7. Niacin at doses used in lowering cholesterol has been associated with birth defects in laboratory animals, with possible consequences for infant development in pregnant women
8. Orthostasis: It is the drop in blood pressure when you stand up from sitting down or lying down. Orthostasis can cause light headedness and dizziness and lead to a fall.
9. Niacin at extremely high doses can have life-threatening acute toxic reactions. Extremely high doses of niacin can also cause niacin thickening of the macula and retina, which leads to blurred vision and blindness.

Most of the above conditions were experience by people taking pharmacological doses of niacin (1.5 - 6 g per day).From the several clinical trials data it was concluded that an intake of 1000mg per day carries significant risk and no adverse reactions at intakes of 500 mg per day, an intake well above the RDA for adult males. Most clinicians agree that up to approximately 1,000 mg of niacin per day for therapeutic purposes is safe.

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