{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:17:52Z","timestamp":1787019472541,"version":"build-2736575974"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Investigative Medicine High Impact Case Reports"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Niacin, an important component of a balanced diet, is central to lipid metabolism. Occasionally used to treat hyperlipidemia, niacin is widely available without a prescription, making its use often unknown to treating physicians. Severe hepatotoxicity has been reported with niacin use. In the following report, we describe a case of hospitalization for acute decompensated cirrhosis with cholestatic morphology in a patient taking self-initiated large quantities of extended-release niacin. Despite medical management and support, the patient unfortunately expired on day 16 of hospitalization. Given ease of access and unclear long-term benefit in hyperlipidemia, the current case serves to raise awareness of niacin\u2019s potential hepatotoxicity through highlighting a severe outcome. Although mode of liver injury remains unknown, the use of extended-release niacin formulations and prolonged high-dose supplementation is associated with enhanced hepatotoxicity. Careful review and counseling of commonly available supplements remains an important task of both hospital and primary care physicians.<\/jats:p>","DOI":"10.1177\/23247096231224349","type":"journal-article","created":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T07:49:37Z","timestamp":1704786577000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Cholestatic Drug-Induced Liver Injury in a Patient Taking High-Dose Niacin for Hyperlipidemia"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1749-747X","authenticated-orcid":false,"given":"Nanjiba","family":"Nawaz","sequence":"first","affiliation":[{"name":"Mayo Clinic, Jacksonville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Mistretta","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Jacksonville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Karime","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Jacksonville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Lewis","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Jacksonville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4849-4279","authenticated-orcid":false,"given":"Emily","family":"Wolf","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Jacksonville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,1,9]]},"reference":[{"key":"bibr1-23247096231224349","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2008.02.029"},{"issue":"6","key":"bibr2-23247096231224349","volume":"6","author":"Schandelmaier S","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr3-23247096231224349","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2010.07.019"},{"key":"bibr4-23247096231224349","unstructured":"Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. 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