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Rarely, there can be systemic side effects

Major Modifications On 30 September 2021, WADA also published the 2022 Summary of Major Modifications and Explanatory Notes (along with the 2022 Monitoring Program)

When taken in the form of nicotinic acid, niacin can lead to high blood pressure, abdominal pain, impaired vision, and liver damage when consumed in high doses of 13 grams per day (16)

Scientific References (External Links) Nature Chemical Biology: Small molecule inhibitors of nicotinamide N-methyltransferase View Study Biochemical Pharmacology: Nicotinamide N-methyltransferase: A promising target for treating metabolic disorders View Study FASEB Journal: Nicotinamide N-methyltransferase knockdown protects against diet-induced obesity in mice View Study Journal of Biological Chemistry: Inhibition of nicotinamide N-methyltransferase in vivo regulates cellular energy metabolism View Study

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The issue is usually temporary and not severe enough to become problematic