Your skin turns read and feels hot, like a sunburn. It's the number one side effect of high dose niacin. There are some prescription extended release prescription niacins to reduce that effect, but it still happens. It's very uncomfortable, which is a real problem for something you take daily.
One thing they dont mention about nicotinic acid is it will soften your bones possibly because prostaglandins uses calcium inside the cell to rebind DNA. So then it becomes a case of take some K2-mk4 to help repair your bones, and thats when people are forced to explore the chemical pathways inside their bodies to compensate for other effects which perhaps they dont want.