Niacin is a B vitamin that can be taken in high amounts to reduce plasma cholesterol. When used for this purpose, niacin is highly effective. However, niacin also causes paresthesia as a side effect and this describes a flushing or redness in the skin that is associated with a skin itching sensation. The reason for this effect is that niacin can activate G protein coupled receptors in skin immune cells and vasodilation. In this regard, niacin may cause keratinocytes to release prostaglandin D2 which is the cause of the effect. The effect appears to be harmless and is considered a side effect of the compound’s main effects on the lipids in the blood. That niacin is so effective at reducing the lipids in the blood and normalising cholesterol levels throws up a dilemma in that anyone wishing to take advantage of this effect must also put up with the paresthesia that is associated with it. However, over time the effect does diminish, this making the long term use of niacin a viable alternative to other cholesterol lowering agents.
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