This describes my own experience and I could find no studies reporting the same… for your reflection.

My first niacin flush happened about 6 weeks before my 2nd onset of CFS. It has been filed under “odd, no exact meaning facts” for many years. With onset, I took <a title=”WIkipedia: Nicotinamide adenine dinucleotide” href=”; target=”_blank”>NADH</a> (because of PubMed studies on NADH and CFS) and found that it helped (as has been reported in PubMed studies). When I discovered that NADH was a precursor to Niacin, I went over to low dosage niacin (much cheaper and greater impact)….

Jump ahead to earlier this year. I started<a title=”Mutaflor landing page” href=”; target=”_blank”> Mutaflor</a> (E.Coli Nissle 1917 probiotic) after reading that E.Coli populations was greatly reduced in CFS patients (from Conference Proceedings). There were three things that I noticed when I started Mutaflor:
<li>One major herx with a very impressive headache (which the product insert warns about!)</li>
<li>Dry Eye and Dry Mouth disappeared after 4 days</li>
<li>I stopped flushing from niacin</li>
Subsequently, in my readings on E.Coli, I discovered that it produces/releases NADH. A light went on, a bell sounded. Prior to 2nd onset, my E.Coli population was dropping resulting in less NADH being produced. Less NADH leads to less niacin. Less niacin (a natural vascular dilator), means reduced blood flow through blood vessel, less oxygen, more brain fog…. It also seems to result in niacin flushes because of the low functional level of niacin.

NADH is not the sole precursor to Niacin, so issues with other precursors may also occur.  This is a connecting of dots which could be totally wrong — but I thought that it may be worth sharing…
<h2>BEWARE of your antibiotics</h2>
I went on a pulse of amoxicillian which I know inhibits E.Coli. It was interesting to note that after a few days that mild dry mouth appeared after 30 minutes of WII fit activity. Taking 500 mg of niacin at that time, I also experienced a very mild niacin flush. I am not concerned, because we will likely be moving on to other antibiotics soon — ideally ones that are friendly to E.Coli and Mutaflor.