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A case report found that taking very high doses of over 5 grams of extended-release niacin can lead to metabolic acidosis, a buildup of acid in body fluids, as well as acute liver failure — both of which can be fatal ( Keep in mind that these potentially deadly side effects are associated with taking exceptionally high doses of vitamins

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However, given studies show that weight tends to rebound upon discontinuation the high cost of these medications for long term weight loss can be prohibitive, indicating a need for lower cost options