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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does Niacin Cause Elevated Liver Enzymes?

Just for a month now, I have had stomach cramps, nausea, constipation and diarrhea; it came on very quickly - both my SGOT AND SGPT were 80. I was taking niacin to help cholesterol. I noticed the stomach problems after I upped the dose of niacin (following drs orders). Is it possible that the niacin caused the increase in my liver enzymes?
Fri, 5 Aug 2016
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General & Family Physician 's  Response
Niacin is used to lower cholesterol and triglycerides (types of fat) in blood. Common side effects are flushing, headache, abdominal pain, diarrhea, dyspepsia, nausea, vomiting, itching and rash. It has also been known to cause hepatotoxicity resulting in elevation of serum bilirubin, SGPT and SGOT. It has also been known to cause liver failure.
Advice
1.     Stop niacin immediately
2.     Investigation – plasma lipid profile, serum bilirubin, SGPT & SGOT, ultrasound abdomen to exclude other causes of raised liver enzymes
3.     You can ask your doctor to change to rosuvastatin 5 mg daily or atorvastatin 10 mg daily per oral for raised cholesterol. If triglyceride is also elevated you can add fenofibrate 145 mg daily per oral
Thanks
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Does Niacin Cause Elevated Liver Enzymes?

Niacin is used to lower cholesterol and triglycerides (types of fat) in blood. Common side effects are flushing, headache, abdominal pain, diarrhea, dyspepsia, nausea, vomiting, itching and rash. It has also been known to cause hepatotoxicity resulting in elevation of serum bilirubin, SGPT and SGOT. It has also been known to cause liver failure. Advice 1. Stop niacin immediately 2. Investigation – plasma lipid profile, serum bilirubin, SGPT & SGOT, ultrasound abdomen to exclude other causes of raised liver enzymes 3. You can ask your doctor to change to rosuvastatin 5 mg daily or atorvastatin 10 mg daily per oral for raised cholesterol. If triglyceride is also elevated you can add fenofibrate 145 mg daily per oral Thanks