14 Proven Benefits Of Niacin, Dosage, And Side Effects.+5 Science-Based Benefits of Niacin (Vitamin B3).+the 12 Proven Health Benefits of Niacin. +Niacin Fact Sheet for Health Professionals
Niacin is a type of B vitamin. It is a water-soluble vitamin. It is not stored in the body. Water-soluble vitamins dissolve in water. Leftover amounts of the vitamin leave the body through the urine.
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14 Proven Benefits Of Niacin, Dosage, And Side Effects
We are sure you don’t want to miss out on the amazing effects it can have on your health.
Reviewed by Thais Tisatto, BHSc
By Ravi Teja Tadimalla, Professional Certificate In Food, Nutrition & Health • Feb 14, 2023
Evidence Based
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Niacin benefits our body in numerous ways. It is essential for cellular and DNA health. Also known as vitamin B3, many of us know it just as a prescription drug. But as you dig deeper, you will be shocked to know its potential. This article explores what niacin is, its benefits, recommended daily dosage, the foods rich in this nutrient, and more. Keep scrolling!
Did You Know?
Niacin was first described by Austrian chemist Hugo Weidel while studying nicotine in 1873.
In This Article
What Is Niacin?
Also called vitamin B3, this nutrient is water-soluble and found in several common foods like meat, tuna fish, seeds, mushrooms, etc. It is a part of the B-complex vitamins, which also include thiamine (vitamin B1), riboflavin (vitamin B2), and others.
Niacin is the medical name of vitamin B3 and comes in 3 forms – nicotinic acid, niacinamide (also called nicotinamide), and inositol hexaniacinate. It is an important vitamin and benefits one in several ways – right from protecting the heart and improving metabolism to enhancing brain function and aiding diabetes treatment (1).
Nicotinic acid works as a supplement and is used to treat high blood cholesterol and heart disease. Niacinamide can help treat type 1 diabetes, certain skin conditions, and schizophreniai (it doesn’t lower cholesterol, though). Hence, certain forms of niacin offer you certain benefits. We strongly recommend you consult your doctor to understand which is which.
Well, the benefits are so many. But before we speak about them, we must first know how niacin works.
How Does Niacin Work?
In simple terms, niacin helps the enzymes do their job. Specifically speaking, niacin is a major component of NAP and NADP, which are two coenzymes involved in cellular metabolism. Niacin also prepares and repairs DNA and even works as an antioxidant.
But hey, how will you know if you are getting enough niacin? The next section can help you understand.
What Are The Symptoms Of Niacin Deficiency?
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This deficiency occurs not only when you don’t get enough niacin but also when your body can’t absorb tryptophan, its amino acid precursor.
Following are the symptoms of niacin deficiency:
Fatigue
Indigestion
Vomiting
Canker soresi
Depression
Severe deficiency of niacin (also called pellagra, which we will discuss later in this post) can lead to the following symptoms:
Scaly rashes on the skin exposed to sunlight
Vomiting and diarrhea
Apathy
Disorientation
Depression
Swollen mouth
Consuming adequate niacin not only prevents these symptoms, but, more importantly, offers certain significant benefits.
What Are The Benefits Of Niacin (Vitamin B3)?
Though certain supported benefits of niacin have conflicting evidence, this vitamin does improve skin and brain health, along with improving digestion and arthritis symptoms.
1. Improves Heart Health
Niacin is often used to improve the levels of good cholesterol, which, in turn, reduces the bad cholesterol – ultimately strengthening the heart (2). Niacin works by blocking the way your liver makes cholesterol.
But hold on – niacin seems to work only in those people who are already on cholesterol medications. And sources also state that it can often cause uncomfortable and dangerous side effects. Hence, make sure you talk to your doctor before taking niacin for your heart as there is conflicting evidence in this regard.
Related: 10 Best Exercises For Heart Health To Reduce The Risk Of Stroke
2. Might Help Treat Type 1 Diabetes
This could be true with type 1 diabetes, where the immune system mistakenly attacks the cells in the pancreas that produce insulin. Niacinamide might protect these cells for a while. But we need more research to understand if niacin can help in the long run (3).
High dose of niacin also had cut the risk of type 1 diabetes in children who were at risk, but that was the result of just one preliminary research.
3. Can Improve Skin And Hair Health
Niacin is known to boost the water content in the skin – and this can be achieved by topically applying nicotinamide cream. The cream was also found to help treat acne.
Niacin also has beneficial effects for rosacea, which is a skin condition that causes red facial skin, flushing, pustules, and red bumps.
Niacin is also known to have a beneficial effect on skin cancer. Studies have shown that it can prevent premalignant cells from becoming malignant. And talking about anti-aging, niacin does play its part. One study showed that topical niacinamide helped reduce fine lines and wrinkles and other issues with skin elasticity concerned with aging.
Some reports say that niacin helps improve the health of the hair follicles.
4. Boosts Brain Function
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Niacin is so important to the brain that brain fog and certain other psychiatric symptoms have been associated with its deficiency (4). Also, research has shown that some forms of schizophreniai can be treated with niacin – as the vitamin helps undo the damage done to the brain (5).
Niacin can also prevent memory loss in the elderly and aid in depression treatment. It can keep the brain healthy in the case of Alzheimer'si . However, the results have been mixed.
5. Helps Treat Arthritis
According to the Arthritis Foundation, niacinamide might improve osteoarthritisi by suppressing inflammation (6). However, the information here is limited, and we advise you to talk to your doctor.
Related: How To Use Castor Oil To Treat Arthritis?
6. Helps Treat Pellagra
Remember we spoke of this? Pellagra is a condition that occurs due to insufficient niacin (or tryptophan) in the diet. This disease is most common in those parts of the world where people consume a lot of corn (7). It affects the skin, the digestive system, and the brain.
Since pellagra is caused by niacin deficiency, it is but obvious that supplementing niacin can help treat the condition.
7. Can Treat Erectile Dysfunction
Studies have concluded that niacin can improve men’s ability to maintain an erection if they are suffering from erectile dysfunction. Since it is just a vitamin, experts feel using niacin is a simple and safe way to treat erectile dysfunction and impotence (8).
Also, erectile dysfunction might be caused by inflammation of the blood vessels. The anti-inflammatory properties of niacin come into the picture here.
But in case you already are on medication for treating erectile dysfunction, talk to your doctor before you take niacin. This is because the former might often lower blood pressure levels, and so does niacin. Both, in combination, might lower your blood pressure way too much.
8. Helps Treat Insomnia
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Though we have limited evidence, certain studies suggest that niacin might increase REM sleep (Rapid Eye Movement, which is the deep state of sleep).
Related: 8 Home Remedies For Insomnia That Will Help You Sleep Quickly
9. Treats Sun Sensitivity
Photodermatitis, a condition related to sun sensitivity, is known to be caused due to a deficiency of niacin. Pellagra, the disease caused by insufficient niacin, is also linked to sun sensitivity (9).
Not only that, niacin has been identified to have preventive effects against skin cancer, a disease whose likelihood increases with sun sensitivity (10).
10. Can Prevent Motion Sickness
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We have very little research on this. One report says niacin might help prevent motion sickness (11). But please consult your doctor in this regard.
11. Helps With Detoxification
How niacin helps with detoxification is quite fascinating. It ruptures the fat cells storing toxins, and this releases the stored toxins and ultimately eliminates them. This phenomenon is called lipolysis.
12. Boosts Energy
Niacin is quite important to the body when it comes to generating energy. Without the vitamin, your body simply cannot convert the protein, carbs, and fat into usable energy.
Niacin is one of the B vitamins that help you acquire energy from the food you eat. It also helps in the formation of red blood cells.
13. Can Promote Longevity
Roundworms fed with niacin food supplements lived longer, as per one study. The study says that niacin tricks the body into believing that it is exercising, even though it isn’t. In fact, such compounds are called exercise mimetics – of which niacin is one (12).
The metabolic pathway initiated by niacin in roundworms is similar to that of higher organisms, and this can include humans as well.
14. Promotes Digestion
Niacin plays a role in the breakdown of carbohydrates, fats, and alcohol – which is an important function of the digestive tract. Also, some of the symptoms of niacin deficiency include abdominal discomfort and constipation.
We saw the benefits. But this doesn’t mean you start loading yourself up with niacin. There is a limit to whatever you take.
What Is The Recommended Daily Allowance Of Niacin (Vitamin B3)?
The following table will give you the information.
AGE/STATE OF LIFERDA OF NIACINBirth to 6 months2 mg7 to 12 months4 mg1 to 3 years6 mg4 to 8 years8 mg9 to 13 years12 mg14 years and above (male)16 mg14 years and above (female)14 mgPregnant women18 mgBreastfeeding women17 mg
The upper limit of niacin for adults of all ages is 35 milligrams daily.
That’s about the dosage. But how do you ensure you get enough niacin daily?
What Are The Foods Rich In Niacin (Vitamin B3)?
Most foods that we regularly consume contain niacin. The richest sources of niacin include:
Turkey Breast: 1 turkey breast contains 101 mg of niacin (over 100% of daily value).
Peanuts: 1 cup of peanuts contains 21.9 mg (over 100% DV).
Beef Liver: 1 slice of beef liver contains 11.9 mg (60% DV).
Tuna: 3 oz of tuna contains 11.3 mg (56% DV).
Chicken Breast: 3 oz of chicken breast contains 8.9 mg (44% DV).
Grass-Fed Beef: 3 oz of grass-fed beef contains 7.6 mg (36% DV).
Mushrooms: 1 cup of mushrooms contains 7.6 mg (34% DV).
Sunflower Seeds: 1 cup of sunflower seeds contains 3.8 mg (19% DV).
Green Peas: 1 cup of green peas contains 3 mg (15% DV).
Avocado: 1 whole avocado contains 3.5 mg (17% DV).
StyleCraze Says
Boiling and poaching food may result in the loss of niacin. You can cook niacin-rich vegetables in a small amount of water or stir fry them to retain the nutrients.
And in case you are wondering…
How To Add More Niacin To Your Diet
Practically speaking, you don’t need to – if you already are getting enough of it through your regular diet. But in case you are not, you can supplement.
Niacin supplements are usually recommended for people who have high cholesterol and are at a heart disease risk and can’t take statins. Supplemental forms usually have much higher doses – and large amounts can have side effects. Hence, talk to your doctor before you use supplements.
And wait, side effects.
Any Side Effects Of Niacin?
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Some of the side effects of excess niacin intake include:
Niacin Flush
This is the most common (and often immediate) side effect of niacin consumption. It happens when one takes more than 100 mg of niacin at a time. It is harmless, though. The flush starts on your face and might travel to your chest and arms, and eventually disappears in 30 minutes to two hours.
Allergies
Niacin can aggravate allergies because it releases histamine, which is a chemical responsible for allergies.
Irregular Heartbeat
Large amounts of niacin can cause irregular heartbeat.
Issues With Diabetes
Niacin might increase blood sugar.
Might Lower Blood Pressure Way Too Much
Don’t take niacin if you have low blood pressure. If you are on blood pressure medication, talk to your doctor before taking niacin.
Other Issues
Niacin can make things worse for individuals with kidney or liver disease and those with stomach ulcers. So, it is recommended to avoid its intake if you are suffering from any of these.
Issues With Pregnancy And Breastfeeding
Niacin is safe for both pregnant and breastfeeding women when taken in the recommended amounts. Don’t exceed the limits.
Infographic: Warnings And Precautions Before Taking Niacin
Now that you are aware of what niacin is and its benefits for your health, let’s look at the safety measures you should take before taking this supplement. You must also avoid taking niacin completely under certain circumstances. Remember to discuss the points listed in the infographic below with your doctor and pharmacist.
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Niacin is a B-complex vitamin that plays a crucial in the health of your DNA and cells and aids in the operation of enzymes. Some of the health benefits of niacin include reducing cholesterol levels, the risk of heart disease and type 1 diabetes, and arthritis symptoms. It may also aid in treating erectile dysfunction, improving brain health, and promoting sleep. However, if you are deficient in this micronutrient, you may experience symptoms like fatigue, depression, canker soresi , vomiting, memory loss, scaly rashes, and a swollen mouth. Foods like turkey breast, peanuts, beef liver, chicken breast, and mushrooms are rich in niacin, so consume them as much as possible.
Frequently Asked Questions
When should I take niacin?
Medical experts recommend taking an immediate-release form shortly after having your evening meals, or an extended-release form after taking a light snack at bedtime. It is not advised to take it on an empty stomach to avoid flushing and stomach discomfort.
Does niacin clean your arteries?
No. Niacin can raise HDL (good cholesterol) levels in the body, which was once thought to reduce LDL levels and clear arteries (13). However, recent studies found that increased HDL levels may not lower LDL levels that cause plaques in the arteries (14).
Does niacin cause weight gain?
Yes. Niacin is an appetite stimulant that may also induce insulin resistance, leading to weight gain when taken in excessive doses (15).
Is B12 the same as niacin?
No. Niacin is Vitamin B3 which controls cholesterol and triglyceride levels in the human body. B12 aids in DNA synthesis for fatty acid and amino acid metabolism.
Sources
“Niacin”. US National Library of Medicine.
“Niacin can boost “good” cholesterol”. Mayo Clinic.
“Vitamin B3 (Niacin)”. University of Maryland Medical Center.
“Case report of mental disorder induced by niacin deficiency”. Anning Hospital, China.
“Niacin-respondent subset of…”. Liaocheng People’s Hospital, China.
“Vitamin B-3”. Arthritis Foundation.
“Pellagra”. MedlinePlus.
“A daily dose of niacin may improve…”. The Independent.
“Photodermatitis”. University of Maryland Medical Center.
“NAD in skin: therapeutic…”. The University of Arizona, USA.
“Possible Adverse Effects of High-Dose Nicotinamide: Mechanisms and Safety Assessment”. Biomolecules.
“Role of sirtuins in lifespan regulation is linked to methylation of nicotinamide.
Effects of niacin on atherosclerosis and vascular function
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145140/The role of HDL on plaque stabilization and regression: basic mechanisms and clinical implications
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042826/Excess vitamin intake: An unrecognized risk factor for obesity
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3932423/
5 Science-Based Benefits of Niacin (Vitamin B3)
Niacin is one of 8 types of B vitamins important for every part of your body. You can get them from meat, fish, and nuts. Supplements are sometimes an option, but you should consult your doctor first.
How does it work?
As with all B vitamins, niacin helps convert food into energy by aiding enzymes.
Specifically, niacin is a major component of NAD and NADP, two coenzymes involved in cellular metabolism.
Furthermore, it plays a role in cell signaling and making and repairing DNA, in addition to acting as an antioxidant (2Trusted Source).
Deficiency
These are some of the symptoms of niacin deficiency (1Trusted Source):
skin rash or discoloration
bright red tongue
vomiting
constipation or diarrhea
depression
fatigue
memory loss
loss of appetite
That said, deficiency is very rare in most Western countries. People who are malnourished — which may stem from HIV/AIDS, anorexia nervosa, liver failure, alcohol abuse, or other medical problems, or poverty — are most at risk.
Severe niacin deficiency, or pellagra, mostly occurs in developing countries, where diets are not as varied. It can be treated with niacinamide supplementation (1Trusted Source).
SUMMARY
Niacin is a vitamin that acts as an antioxidant and plays a role in cell signaling and DNA repair. Deficiency is characterized by skin problems, memory loss, and digestive problems.
How much do you need?
The Recommended Daily Allowance (RDA) for niacin depends on your age and gender. For ages 7 months and older, it is expressed as mg niacin equivalents (NE). One NE is equal to 1 mg of niacin or 60 mg of tryptophan (1Trusted Source).
Infants
0–6 months: 2 mg/day*
7–12 months: 4 mg NE/day*
*These figures represent the Adequate Intake (AI), similar to RDA, but it relies more on observation and approximations of healthy populations and less on scientific evidence (3Trusted Source).
Children
1–3 years: 6 mg NE/day
4–8 years: 8 mg NE/day
9–13 years: 12 mg NE/day
Adolescents and adults
Men ages 14 years and older: 16 mg NE/day
Women ages 14 years and older: 14 mg NE/day
Pregnant women: 18 mg NE/day
Breastfeeding women: 17 mg NE/day
SUMMARY
The recommended amount of niacin depends on your age and gender. Men need 16 mg NE per day, while women who are not pregnant or breastfeeding need 14 mg NE per day.
5 health benefits of niacin
1. Improves blood fat levels
Niacin may help to improve your blood fat levels by:
increasing your HDL (good) cholesterol
reducing your LDL (bad) LDL cholesterol
reducing your triglyceride levels
This may translate to a decrease in heart disease risk, although several studies have found no link between niacin supplementation and a decrease in heart disease risk or deaths (4Trusted Source, 5Trusted Source).
It also takes high doses of niacin, typically 1,500 mg or greater, to achieve blood fat level improvements, which increases the risk of experiencing unpleasant or potentially harmful side effects (6Trusted Source).
For these reasons, niacin is not a primary treatment for high cholesterol. It’s primarily used to help improve blood fat levels in people who cannot tolerate statin drugs (5Trusted Source, 7Trusted Source).
2. May reduce blood pressure
One role of niacin is to release prostaglandins, or chemicals that help your blood vessels widen — improving blood flow and reducing blood pressure. For this reason, niacin may play a role in the prevention or treatment of high blood pressure (8Trusted Source).
In one observational study of over 12,000 adults, researchers found that each 1 mg increase in daily niacin intake was associated with a 2% decrease in high blood pressure risk — with the lowest overall high blood pressure risk seen at a daily niacin intake of 14.3 to 16.7 mg per day (8Trusted Source).
A high quality study also noted that single doses of 100 mg and 500 mg of niacin slightly reduced right ventricular systolic pressure (9Trusted Source).
However, more research is needed to confirm these effects.
3. May help treat type 1 diabetes
Type 1 diabetes is an autoimmune disease in which your body attacks and destroys insulin-creating cells in your pancreas.
There’s research to suggest that niacin could help protect those cells and possibly even lower the risk of type 1 diabetes in children who have a higher chance of developing this condition (10Trusted Source).
However, for people with type 2 diabetes, the role of niacin is more complicated.
On one hand, it can help lower the high cholesterol levels that are often seen in people with type 2 diabetes. On the other, it has the potential to increase blood sugar levels. As a result, people with diabetes who take niacin to treat high cholesterol also need to monitor their blood sugar carefully (11Trusted Source).
Fortunately, a more recent review of studies found that niacin did not have significant negative effects on blood sugar management in people with type 2 diabetes (12Trusted Source).
4. Boosts brain function
Your brain needs niacin — as a part of the coenzymes NAD and NADP — to get energy and function properly.
In fact, brain fog and even psychiatric symptoms are associated with niacin deficiency (1Trusted Source, 13Trusted Source).
Some types of schizophrenia can be treated with niacin, as it helps undo damage to brain cells that’s caused by a niacin deficiency (14Trusted Source).
Preliminary research shows that it could also help keep the brain healthy in cases of Alzheimer’s disease. However, results are mixed (15Trusted Source, 16Trusted Source).
5. Improves skin health
Niacin helps protect skin cells from sun damage, whether it’s used orally or applied as a lotion (17Trusted Source).
It may help prevent certain types of skin cancer as well. One high quality study in over 300 people at high risk of skin cancer found that taking 500 mg of nicotinamide twice daily reduced rates of nonmelanoma skin cancer compared to a control (18Trusted Source).
SUMMARY
Niacin can help treat many conditions. It appears to exert positive effects on blood fat and blood pressure levels, and may play a role in type 1 diabetes, brain health, and skin cancer prevention. However, more research is needed.
Top food sources
Niacin is found in a variety of foods, especially meat, poultry, fish, nuts, and legumes. Some foods may also be fortified with niacin and other vitamins, like breakfast cereals (1Trusted Source).
Some energy drinks also list doses — sometimes high — of B vitamins (19Trusted Source).
Here are some common food sources of niacin, along with how much of the Daily Value (DV) they provide (1Trusted Source):
grilled chicken breast, 3 ounces: 64% of the DV
roasted turkey breast, 3 ounces: 63% of the DV
cooked brown rice, 1 cup: 33% of the DV
dry roasted peanuts, 1 ounce: 26% of the DV
medium baked potato: 14% of the DV
SUMMARY
Many foods contain niacin, especially meat, nuts, and legumes. Some foods are also fortified with extra B vitamins.
the 12 Proven Health Benefits of Niacin
Nutrition, Superfoods / Last Modified on September 27, 2021 / By Takalani Netshiomvani
Attaining health benefits from essential vitamins is simple and a crucial part of healthy bodily functions. This superfood is an essential vitamin that provides the body with nourishment and care. They often help reduce health conditions and improve overall health.
The Five Biggest Sports Clubs In The World
Niacin is an essential B vitamin that promotes improved heart, skin, eye, and brain health. To find out more on its proven health benefits, the dosages to respect, and potential risks, see below:
Contents [show]
What is Niacin?
There are eight essential B vitamins, and Niacin is one of them. Niacin is a B3 vitamin, which is a water-soluble vitamin.
The body can obtain a small dosage of niacin through food. Familiar food sources that contain niacin include meat, poultry, fish, and eggs. To increase daily intake, a person can take niacin in the supplement form.
Within niacin, there are two chemical formations, nicotinic acid, and niacinamide. Both are in food or supplements that contain niacin, but both have diverse effects and health benefits.
Lowering cholesterol is possible with nicotinic acid. Whereas niacinamide cannot lower cholesterol but help treat skin conditions like psoriasis. Find out more on the health benefits of niacin below:
→ For more on fat burner supplements, please read our PhenQ review or LeanBean
The 12 Proven Health Benefits of Niacin
The consumption of niacin has many proven health benefits. From reducing medical conditions to helping with symptoms, the vitamin can improve your health in 12 efficient ways:
1 – Improves cholesterol
Niacin has been a useful ingredient to lower LDL and triglycerides for decades. Although it is not a source to entirely rely on, it has shown impressive results. A clinical study for effect niacin has on cholesterol levels show a decrease in bad cholesterol (LDL) by up to 20%.
Simultaneously, as decreasing LDL, niacin increases good cholesterol (HDL) by up to 35%.
2 – Reduces the risk of heart disease
Due to the positive effect niacin has on cholesterol levels, the B vitamin may also reduce heart disease risk. Strokes, heart attacks, and infections are all issues that may be preventable with regular use of niacin. Evidence suggests that increasing your intake through the supplement form or foods that contain niacin can show efficacy for heart health.
Niacin also decreases oxidative stress and inflammation, a common cause of artery conditions such as atherosclerosis.
=> Did you know that Konjac Roots are good for your health ?
3 – Decreases the risk of type 1 diabetes
Type 1 diabetes is common for all ages. This autoimmune disorder attacks cells and causes insulin levels to drop very low. Niacin works to protect these cells and stabilize insulin levels.
Nicotinamide can sometimes cause a spike in blood sugar levels, justifying why it may not be a useful treatment for type 2 diabetes.
4 – Increases cognitive function
Science suggests that niacin deficiency can cause psychiatric conditions. The brain requires the coenzymes of niacin to function well. Hence, niacin is effective at regulating the brain’s function and the release of neurotransmitters.
Due to its efficacy on the brain and the energy it requires, niacin may also improve symptoms of cognitive disorders, such as schizophrenia and Alzheimer’s disease.
5 – Improves skin health
Niacin can be taken orally or used as a cream. The risk of non-melanoma skin cancers has proven in a study to reduce with regular daily consumption of niacin. Niacin therapy works to protect the cells in the skin and blocks harmful rays, which can cause cancer.
6 – May improve arthritic symptoms
Niacin contains natural anti-inflammation properties, which can help release arthritis symptoms. Or may reduce the risk of developing the joint disorder.
Using niacin can lessen the need for nonsteroidal anti-inflammatory drugs (NSAIDs). Using niacin offers a more natural way of reducing arthritic symptoms.
7 – Helps to treat pellagra
Pellagra is a common disease known due to the lack of niacin in the diet. The condition causes sores, inflammation, dementia, and diarrhea. Studies show that pellagra often affects developing countries due to the lack of resources and access to niacin foods and supplements.
Niacin supplements and nad therapy are the most effective option for treating pellagra.
8 – Improves circulation
Vitamin B3 is useful for reducing inflammation in blood vessels and increases their function. Hence, niacin is useful for blood vessel health. The health of blood vessels excels circulation.
Consuming niacin as a daily treatment is the most effective way to attain its circulation benefits.
9 – Reduces signs of ADHD
Although vitamins cannot effectively prevent or cure attention deficit hyperactivity disorder (ADHD), evidence shows it can help reduce the high signs and symptoms. Vitamin therapy, using vitamin B3, is a common way to help patients induce calamity and peace.
The attention disorder commonly causes hyperactivity, which specific vitamins, like niacin, can reduce.
10 – Prevents premenstrual syndrome
Period symptoms and premenstrual syndrome in women are often associated with vitamin deficiencies. Vitamin B3 is known for regulating sex and stress hormones, which evidence links with menstruation.
PMS syndrome causes headaches, swelling of the breasts, pain, anxiety, and dizziness. Niacin therapy can help reduce most symptoms due to its hormones balancing properties.
→ Have a look at Chromium Picolinate Benefits here
11 – Improves digestion
Digestive tract functioning can improve with sufficient vitamin consumption. Niacin, in particular, can help break down carbohydrates, fats, lipid forms, and sugars, which lead to a healthy digestive cycle. Their efficiency of converting food into energy may also increase metabolism.
12 – Improves immunity
A study shows that niacin can effectively reduce inflammation and fight harmful bacterias. Niacin treatment helps to lessen the risk of developing immune conditions such as asthma and infections.
To attain the health benefits niacin can provide, it is best to maximize your intake through daily supplements. If a person is vegetarian or vegan, they may find it challenging to obtain niacin through natural food sources. Most food sources include meat and dairy produce. Thus, supplements can help increase daily intake.
For further information on the pros and cons of niacin, see below:
Pros and Cons of Niacin
If you are unsure of the potential health risks niacin may cause for your health, see below more on the side effects and hazards:
Side Effects, Risks, and Hazards of Niacin
Although niacin is a natural vitamin, it can pose certain health risks and cause side effects when taken as a supplement. Typically, side effects occur if a person consumes too much niacin.
Consuming niacin through food sources does not pose any harmful side effects or risks. The concentration of niacin in food is too small to affect the body.
Supplement overdosing can cause possible side effects:
Vomiting
Liver damage
Niacin flushing
Stomach irritation
Blood sugar impairment
Blurred vision
Gout
Niacin supplements can interact with medical conditions and drugs. This could lead to poor health and worsen conditions. Anyone with the following issues should take extra precaution before taking niacin:
Allergies
Heart disease
Chron’s disease
Gallbladder disease
Type 2 diabetes
Kidney disease
Liver disease
Stomach ulcers
Thyroid disorders
Taking the following contraindicative medications: zinc, aspirin, blood pressure drugs, alcohol, chromium, statins, and diabetes drugs
Premedical care and a view from your doctor are critical for those at risk. Taking niacin can worsen certain conditions. Thus, ensuring it is safe for you to take niacin before consuming the supplements is essential.
If it is safe for you to take niacin, ensure you follow the safe dosage requirements to combat potential side effects.
More on how to take niacin and dosages to respect:
How To Take Niacin
Low doses of niacin are safe for most people to take. Everyone needs niacin for their bodies to function properly.
Dosages to respect
To obtain more niacin, the following doses are the general daily amounts to respect:
Children: 250mg daily, for those over 16 years of age
Adults: 250mg daily, which can be increased
The maximum daily intake of niacin for any person is 250 mg per day. The daily dosage may increase over time to up to 1000mg per day. It is possible to overdose.
Overdose advice
It can be difficult to overdose on niacin containing foods. Yet, it is possible to exceed the daily dosage requirements when taking the supplement form. The maximum dosage limit is 1000mg unless your doctor instructs you to increase your intake.
If you believe you have taken too much niacin, it is crucial to seek medical help immediately. An overdose cannot cause any immediate risk. Yet, it could cause strokes, and kidney and liver issues.
For further information on niacin, see below our FAQs:
FAQ
Is it safe to take 500mg of niacin a day?
The average daily dosage requirement is 250mg per day for anyone over the age of 16. Yet, this dosage can increase with advice from a doctor. It is safe to double the dosage of niacin to 500mg, with confirmation from your doctor.
Does niacin help you sleep?
Niacin can reduce stress in the adrenal glands. Stress reduction can lead to an improvement in sleep. Niacin deficiency may cause lack of, or poor, sleep. But, do not rely on niacin to help you fall to sleep.
Does niacin give you energy?
Niacin works to convert food into energy. Thus, niacin can provide you energy with food consumption.
When should you not take niacin?
Anyone with the following medical concerns should avoid taking niacin: liver conditions, kidney or heart issues, those taking certain medications (see the list above), type 2 diabetes, stomach ulcers, thyroid patients, people with allergies, and drug and alcohol addiction.
Does niacin remove plaque from the arteries?
Niacin effectively increases HDL, which improves cholesterol. An increase in HDL is effective in removing bad cholesterol and plaque from the arteries. In time, this can reduce heart conditions.
Is niacin flush safe?
Niacin flush is common and typically causes the skin to flush red. It is harmless unless it occurs after an overdose. To prevent harm, ensure to take the daily dosage recommendations.
For our roundup thoughts on niacin:
Niacin is a B3 vitamin, which is an essential vitamin for healthy bodily functioning. Without vitamin B3, the body can be at risk of heart conditions, poor cholesterol levels, bad skin health, and cognitive function. A niacin deficiency can lead to medical conditions, such as pellagra.
Niacin intake is essential for your health. Not only does it promote many health benefits, but it can also lower the risk of developing many medical conditions.
Increase your intake with daily supplements to maximize the benefits.
More questions or feedback on niacin and its benefits are welcome.
Niacin
Fact Sheet for Health Professionals
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Health Professional
Table of Contents
This is a fact sheet intended for health professionals. For a reader-friendly overview of Niacin, see our consumer fact sheet on Niacin.
Introduction
Niacin (also known as vitamin B3) is one of the water-soluble B vitamins. Niacin is the generic name for nicotinic acid (pyridine-3-carboxylic acid), nicotinamide (niacinamide or pyridine-3-carboxamide), and related derivatives, such as nicotinamide riboside [1-3]. Niacin is naturally present in many foods, added to some food products, and available as a dietary supplement.
All tissues in the body convert absorbed niacin into its main metabolically active form, the coenzyme nicotinamide adenine dinucleotide (NAD). More than 400 enzymes require NAD to catalyze reactions in the body, which is more than for any other vitamin-derived coenzyme [1]. NAD is also converted into another active form, the coenzyme nicotinamide adenine dinucleotide phosphate (NADP), in all tissues except skeletal muscle [4].
NAD and NADP are required in most metabolic redox processes in cells where substrates are oxidized or reduced. NAD is primarily involved in catabolic reactions that transfer the potential energy in carbohydrates, fats, and proteins to adenosine triphosphate (ATP), the cell’s primary energy currency [4]. NAD is also required for enzymes involved in critical cellular functions, such as the maintenance of genome integrity, control of gene expression, and cellular communication [3,4]. NADP, in contrast, enables anabolic reactions, such as the synthesis of cholesterol and fatty acids, and plays a citical role in maintaining cellular antioxidant function.
Most dietary niacin is in the form of nicotinic acid and nicotinamide, but some foods contain small amounts of NAD and NADP. The body also converts some tryptophan, an amino acid in protein, to NAD, so tryptophan is considered a dietary source of niacin.
When NAD and NADP are consumed in foods, they are converted to nicotinamide in the gut and then absorbed [4]. Ingested niacin is absorbed primarily in the small intestine, but some is absorbed in the stomach [1-3].
Even when taken in very high doses of 3–4 g, niacin is almost completely absorbed. Once absorbed, physiologic amounts of niacin are metabolized to NAD. Some excess niacin is taken up by red blood cells to form a circulating reserve pool. The liver methylates any remaining excess to N1-methyl-nicotinamide, N1-methyl-2-pyridone-5-carboxamide, and other pyridone oxidation products, which are then excreted in the urine. Unmetabolized nicotinic acid and nicotinamide might be present in the urine as well when niacin intakes are very high.
Levels of niacin in the blood are not reliable indicators of niacin status. The most sensitive and reliable measure of niacin status is the urinary excretion of its two major methylated metabolites, N1-methyl-nicotinamide and N1-methyl-2-pyridone-5-carboxamide [2]. Excretion rates in adults of more than 17.5 micromol/day of these two metabolites reflect adequate niacin status, while excretion rates between 5.8 and 17.5 micromol/day reflect low niacin status. An adult has deficient niacin status when urinary-excretion rates are less than 5.8 micromol/day. Indicators of inadequacy such as this and other biochemical signs (e.g., a 2-pyridone oxidation product of N1-methyl-nicotinamide below detection limits in plasma or low erythrocyte NAD concentrations) occur well before overt clinical signs of deficiency [2]. Another measure of niacin status takes into account the fact that NAD levels decline as niacin status deteriorates, whereas NADP levels remain relatively constant [1,3,5]. A “niacin number” (the ratio of NAD to NADP concentrations in whole blood x 100) below 130 suggests niacin deficiency [6,7]. A “niacin index” (the ratio of erythrocyte NAD to NADP concentrations) below 1 suggests that an individual is at risk of developing niacin deficiency [8]. No functional biochemical tests that reflect total body stores of niacin are available [5].
Recommended Intakes
Intake recommendations for niacin and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by an expert committee of the Food and Nutrition Board (FNB) at the National Academies of Sciences, Engineering, and Medicine [2]. DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. These values, which vary by age and sex, include:
Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to plan nutritionally adequate diets for individuals.
Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA.
Estimated Average Requirement (EAR): Average daily level of intake estimated to meet the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes of groups of people and to plan nutritionally adequate diets for them; can also be used to assess the nutrient intakes of individuals.
Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects.
Table 1 lists the current RDAs for niacin as mg of niacin equivalents (NE) [2]. The FNB defines 1 NE as 1 mg niacin or 60 mg of the amino acid tryptophan (which the body can convert to niacin). Niacin RDAs for adults are based on niacin metabolite excretion data. For children and adolescents, niacin RDAs are extrapolated from adult values on the basis of body weight. The AI for infants from birth to 6 months is for niacin alone, as young infants use almost all the protein they consume for growth and development; it is equivalent to the mean intake of niacin in healthy, breastfed infants. For infants aged 7-12 months, the AI for niacin is in mg NE and is based on amounts consumed from breast milk and solid foods.
Table 1: Recommended Dietary Allowances (RDAs) for Niacin [2]AgeMaleFemalePregnancyLactationBirth to 6 months*2 mg2 mg7–12 months*4 mg NE4 mg NE1–3 years6 mg NE6 mg NE4–8 years8 mg NE8 mg NE9–13 years12 mg NE12 mg NE14–18 years16 mg NE14 mg NE18 mg NE17 mg NE19+ years16 mg NE14 mg NE18 mg NE17 mg NE
* Adequate Intake
Sources of Niacin
Food
Niacin is present in a wide variety of foods. Many animal-based foods—including poultry, beef, and fish—provide about 5-10 mg niacin per serving, primarily in the highly bioavailable forms of NAD and NADP [3]. Plant-based foods, such as nuts, legumes, and grains, provide about 2-5 mg niacin per serving, mainly as nicotinic acid. In some grain products, however, naturally present niacin is largely bound to polysaccharides and glycopeptides that make it only about 30% bioavailable [3,4]. Many breads, cereals, and infant formulas in the United States and many other countries contain added niacin. Niacin that is added to enriched and fortified foods is in its free form and therefore highly bioavailable [2].
Tryptophan is another food source of niacin because this amino acid—when present in amounts beyond that required for protein synthesis—can be converted to NAD, mainly in the liver [3,5]. The most commonly used estimate of efficiency for tryptophan conversion to NAD is 1:60 (i.e., 1 mg niacin [NAD] from 60 mg tryptophan). Turkey is an example of a food high in tryptophan; a 3-oz portion of turkey breast meat provides about 180 mg tryptophan, which could be equivalent to 3 mg niacin [9]. However, the efficiency of the conversion of tryptophan to NAD varies considerably in different people [3].
Table 2 lists several food sources of niacin.
Table 2: Niacin Content of Selected Foods [9]FoodMilligrams
(mg) per
servingPercent
DV**Beef liver, pan fried, 3 ounces14.993Chicken breast, meat only, grilled, 3 ounces10.364Marinara (spaghetti) sauce, ready to serve, 1 cup10.364Turkey breast, meat only, roasted, 3 ounces10.063Salmon, sockeye, cooked, 3 ounces8.654Tuna, light, canned in water, drained, 3 ounces8.654Pork, tenderloin, roasted, 3 ounces6.339Beef, ground, 90% lean, pan-browned, 3 ounces5.836Rice, brown, cooked, 1 cup5.233Peanuts, dry roasted, 1 ounce4.226Breakfast cereals fortified with 25% DV niacin4.025Rice, white, enriched, cooked, 1 cup2.314Potato (russet), baked, 1 medium2.314Sunflower seeds, dry roasted, 1 ounce2.013Bread, whole wheat, 1 slice1.49Pumpkin seeds, dry roasted, 1 ounce1.38Soymilk, unfortified, 1 cup1.38Bread, white, enriched, 1 slice1.38Lentils, boiled and drained, ½ cup1.06Bulgur, cooked, 1 cup0.96Banana, 1 medium0.85Edamame, frozen, prepared, ½ cup0.74Raisins, ½ cup0.64Tomatoes, cherry, ½ cup0.53Broccoli, boiled, drained, chopped, ½ cup0.43Cashews, dry roasted, 1 ounce0.43Yogurt, plain, low fat, 1 cup0.32Apple, 1 medium0.21Chickpeas, canned, drained, 1 cup0.21Milk, 1% milkfat, 1 cup0.21Spinach, frozen, chopped, boiled, ½ cup0.21Tofu, raw, firm, ½ cup0.21Onions, chopped, ½ cup0.11Egg, large00
* These values are for the niacin content of foods only. They do not include the contribution of tryptophan, some of which is converted to NAD in the body.
** DV = Daily Value. The U.S. Food and Drug Administration (FDA) developed DVs to help consumers compare the nutrient contents of foods and dietary supplements within the context of a total diet. The DV for niacin is 16 mg for adults and children aged 4 years and older [10]. The FDA does not require food labels to list niacin content unless niacin has been added to the food. Foods providing 20% of more of the DV are considered to be high sources of a nutrient.
The U.S. Department of Agriculture’s (USDA’s) FoodData Central lists the nutrient content of many foods and provides a comprehensive list of foods containing niacin arranged by nutrient content.
Dietary supplements
Niacin is available in multivitamin-mineral products, in supplements containing other B-complex vitamins, and in supplements containing niacin only. Nicotinic acid and nicotinamide are the two most common forms of niacin in supplements. Some niacin-only supplements contain 500 mg or more per serving, which is much higher than the RDA for this nutrient [11].
Nicotinic acid in supplemental amounts beyond nutritional needs can cause skin flushing, so some formulations are manufactured and labeled as prolonged, sustained, extended, or timed release to minimize this unpleasant side effect. Nicotinamide does not produce skin flushing because of its slightly different chemical structure [2,12]. Niacin supplements are also available in the form of inositol hexanicotinate, and these supplements are frequently labeled as being “flush free” because they do not cause flushing. The absorption of niacin from inositol hexanicotinate varies widely but on average is 30% lower than from nicotinic acid or nicotinamide, which are almost completely absorbed [12-14]. Two niacin-like compounds, nicotinamide riboside and nicotinamide mononucleotide (NMN; also referred to as β-NMN), are also available as dietary supplements, but are not marketed or labelled as sources of niacin [11]. However, FDA ruled in November 2022 that NMN may not be legally marketed as a dietary supplement because it has been authorized for investigation by FDA as a new drug [15].
Medications
Niaspan® and generic niacin ER, available as a prescription medicine, provides 500-1,000 mg extended-release nicotinic acid. It is used to treat high blood cholesterol levels.
Niacin Intakes and Status
Most people in the United States consume more than the RDA for niacin. An analysis of data from the 2015–2016 National Health and Nutrition Examination Survey (NHANES) found that the average daily niacin intake from foods and beverages was 21.4 mg for ages 2–19 [16]. In adults, the average daily niacin intake from foods and beverages was 31.4 mg in men and 21.3 mg in women. An analysis of data from the 2009-2012 NHANES found that only 1% of adults had intakes of niacin from foods and beverages below the EAR [17]. Among all racial and ethnic groups, Hispanics had the greatest prevalence, 1.3%, of niacin intakes below the EAR [18].
According to self-reported data from the 2013-2014 NHANES, 21% of all individuals aged 2 and older took a dietary supplement containing niacin [16]. The proportion of users increased with age from 8% of those aged 12-19 years to 39% of men and 40% of women aged 60 and older. Supplement use doubled or tripled total niacin intakes compared with intakes from diet alone. According to data from the 2003-2006 NHANES, 10% of all individuals aged 2 and older who took dietary supplements had total niacin intakes that reached or exceeded the UL [19].
Niacin Deficiency
Severe niacin deficiency leads to pellagra, a disease characterized by a pigmented rash or brown discoloration on skin exposed to sunlight; the skin also develops a roughened, sunburned-like appearance [2,4,20,21]. In addition, pellagra can cause a bright red tongue and changes in the digestive tract that lead to vomiting, constipation, or diarrhea. The neurological symptoms of pellagra can include depression; apathy; headache; fatigue; loss of memory that can progress to aggressive, paranoid, and suicidal behaviors; and auditory and visual hallucinations [2-4]. As pellagra progresses, anorexia develops, and the affected individual eventually dies [3].
Pellagra is uncommon in industrialized populations and is mostly limited to people living in poverty, such as refugees and displaced people who eat very limited diets low in niacin and protein [21,22]. Pellagra was not uncommon in the early 20th century among individuals living in poverty in the southern United States and parts of Europe whose limited diets consisted mainly of corn [2,3]. The World Health Organization recommends treating pellagra with 300 mg/day nicotinamide in divided doses for 3-4 weeks along with a B-complex or yeast product to treat likely deficiencies in other B vitamins [21].
Although frank niacin deficiencies leading to pellagra are very rare in the United States, some individuals have marginal or low niacin status [2,20,22,23].
Groups at Risk of Niacin Inadequacy
Niacin inadequacy usually arises from insufficient intakes of foods containing niacin and tryptophan. It can also be caused by factors that reduce the conversion of tryptophan to niacin, such as low intakes of other nutrients [2,22]. The following groups are among those most likely to have inadequate niacin status.
People with undernutrition
People who are undernourished because they live in poverty or have anorexia, alcohol use disorder, AIDS, inflammatory bowel disease, or liver cirrhosis often have inadequate intakes of niacin and other nutrients [2,20,22,23].
People with inadequate riboflavin, pyridoxine, and/or iron intakes
People who do not consume enough riboflavin (vitamin B2), pyridoxine (vitamin B6), or iron convert less tryptophan to niacin because enzymes in the metabolic pathway for this conversion depend on these nutrients to function [2,22].
People with Hartnup disease
Hartnup disease is a rare genetic disorder involving the renal, intestinal, and cellular transport processes for several amino acids, including tryptophan. The disease interferes with the absorption of tryptophan in the small intestine and increases its loss in the urine via the kidneys [2,23,24]. As a result, the body has less available tryptophan to convert to niacin.
People with carcinoid syndrome
Carcinoid syndrome is caused by slow-growing tumors in the gastrointestinal tract that release serotonin and other substances. It is characterized by facial flushing, diarrhea, and other symptoms. In those with carcinoid syndrome, tryptophan is preferentially oxidized to serotonin and not metabolized to niacin [2]. As a result, the body has less available tryptophan to convert to niacin.
Niacin and Health
Cardiovascular disease
Very high doses of nicotinic acid—more than 100 times the RDA—taken for months or years are effective treatments for dyslipidemias. Nicotinamide does not have this effect because, unlike nicotinic acid, it does not bind to the receptors that mediate nicotinic acid’s effects on lipid profiles [1]. Studies conducted since the late 1950s show that these doses can increase high-density lipoprotein (HDL; “good”) cholesterol levels by 10-30% and reduce low-density lipoprotein (LDL; “bad”) cholesterol levels by 10-25%, triglyceride levels by 20-50%, and lipoprotein(a) levels by 10-30% [12]. Together, these changes in lipid parameters might be expected to reduce the risk of first-time or subsequent cardiac events, such as heart attacks and strokes, in adults with atherosclerotic cardiovascular disease. However, despite dozens of published clinical trials, experts do not agree on the value of nicotinic acid to treat cardiovascular disease, especially given its side effects, safety concerns, and poor patient compliance [25].
In one large clinical trial from the 1970s, 8,341 participants aged 30 to 64 years who had had one or more heart attacks were randomized to take one of five lipid-lowering medications, including 3,000 mg/day nicotinic acid, or a placebo for an average of 6.2 years [26]. Those taking nicotinic acid lowered their serum cholesterol levels by an average of 9.9% and triglyceride levels by 26.1% over 5 years of treatment. During 5 to 8.5 years of treatment, these participants had significantly fewer nonfatal myocardial infarctions but more cardiac arrhythmias than those in the placebo group. Their overall rates of mortality and cause-specific mortality, including from coronary heart disease, did not decline. But 9 years after the study ended, participants who had taken the nicotinic acid experienced significantly fewer (11%) deaths from all causes than those who had taken the placebo [27,28].
Statin medications have become the treatment of choice for hyperlipidemia and lowering the risks of atherosclerotic cardiovascular disease. For this reason, clinical trials of nicotinic acid in the past several decades have examined whether it provides any additional cardiovascular protection to people taking statins [29].
In the largest international, multicenter, clinical trial of nicotinic acid to date, 25,673 adults aged 50-80 years (83% men) with cardiovascular disease who were taking a statin were randomized to take 2 g/day extended-release nicotinic acid with a medication to reduce nicotinic acid’s flushing effect and therefore improve treatment compliance or a matching placebo for a median of 4 years [30,31]. The nicotinic acid group had a mean reduction in LDL cholesterol (of 10 mg/dl) and triglycerides (of 33 mg/dl) and an increase in HDL cholesterol (of 6 mg/dl), but this group had no significant reduction in rates of major vascular events compared with the placebo (statin-only) group. Furthermore, the nicotinic acid group had a significantly greater risk of diabetes, gastrointestinal dyspepsia, diarrhea, ulceration, bleeding events in the gut and brain, and skin rashes and ulcerations. An earlier randomized clinical trial of 3,414 patients with established cardiovascular disease was stopped after 3 years when the researchers found that patients taking niacin (1,500-2,000 mg/day extended release) in addition to their cholesterol-reduction medications did not have fewer cardiovascular events than those taking medication alone, even though the niacin reduced triglyceride and LDL-cholesterol levels further and raised HDL cholesterol levels further [32]. The results also showed that patients taking niacin had an increased risk of ischemic stroke.
The authors of two 2017 systematic reviews examining the clinical trial data concluded that nicotinic acid therapy provides little if any protection from atherosclerotic heart disease, even though the therapy raises HDL cholesterol levels and lowers total cholesterol, LDL cholesterol, and triglyceride levels. One of these reviews examined 23 randomized controlled trials of moderate to high quality in 39,195 participants aged 33-71 years (average 65 years; majority were male). Some had experienced a heart attack, and most were taking a statin. The doses used and treatment duration in these studies varied widely; the median dose of nicotinic acid was 2 g/day (range 0.5 to 4 g/day) for a median of 11.5 months (range 6 months to 6 years) [25]. Overall, use of nicotinic acid did not reduce overall mortality or cardiovascular mortality rates or the number of fatal or nonfatal myocardial infarctions or strokes. Eighteen percent of participants taking nicotinic acid discontinued treatment because of side effects. The second review examined 13 randomized controlled trials with 35,206 participants with, or at risk of, atherosclerotic cardiovascular disease [33]. Overall, the addition of nicotinic acid supplementation (dose range not specified) to statin therapy taken for a mean of 33 months (with a broad range of 6 to 60 months) did not lead to significant reductions in rates of all-cause or cardiovascular mortality, myocardial infarction, or stroke. Nicotinic acid treatment was associated with a significantly higher risk of gastrointestinal and musculoskeletal adverse events. In addition, four of the studies that examined diabetes as an outcome found that the patients taking niacin had a significantly higher risk of developing the disease.
A 2018 review of three randomized controlled trials with 29,195 patients found that all-cause mortality increased by 10% more in those who took 1 to 3 g/day extended release nicotinic acid in addition to a statin medication than patients taking the statin alone [34].
In their guidelines for lowering blood cholesterol levels, the American College of Cardiology and the American Heart Association advise that nonstatin therapies, compared with or in addition to statin therapy, do not provide atherosclerotic cardiovascular disease risk-reduction benefits that outweigh the potential harms of their adverse effects [29]. When discussing the use of nicotinic acid supplements to reduce the risk of hyperlipidemia (for example, in patients unable to tolerate statin medications), the two professional societies recommend that patients take 500 mg/day extended-release nicotinic acid supplements and increase the dose to a maximum of 2,000 mg/day over 4 to 8 weeks or take 100 mg immediate-release nicotinic acid three times a day and increase the dose to 3,000 mg/day divided into two or three doses. (Their joint statement about monitoring supplement users who take niacin to reduce hyperlipidemia risk for adverse effects is described in the Health Risks from Excessive Niacin section below.) In their 2018 report, these two professional societies stated what although niacin may be useful in some cases of severe hypertriglyceridemia, it has only mild LDL-lowering effects. The societies therefore do not recommend using it as an add-on drug to statin therapy [35].
Overall, the evidence indicates that nicotinic acid supplementation improves blood lipid profiles but has no significant effects on risk of cardiovascular events. Although nicotinic acid is a nutrient, if very high doses (thousands of mg) are taken to treat hyperlipidemias, the supplement is being used as a drug. Such doses should only be taken with medical approval and supervision.
Health Risks from Excessive Niacin
No adverse effects have been reported from the consumption of naturally occurring niacin in foods [2]. However, high intakes of both nicotinic acid and nicotinamide taken as a dietary supplement or medication can cause adverse effects, although their toxicity profiles are not the same.
Thirty to 50 mg nicotinic acid or more typically causes flushing; the skin on the patient’s face, arms, and chest turns a reddish color because of vasodilation of small subcutaneous blood vessels. The flushing is accompanied by burning, tingling, and itching sensations [2,12,36]. These signs and symptoms are typically transient and can occur within 30 minutes of intake or over days or weeks with repeated dosing; they are considered an unpleasant, rather than a toxic, side effect. However, the flushing can be accompanied by more serious signs and symptoms, such as headache, rash, dizziness, and/or a decrease in blood pressure. Supplement users can reduce the flushing effects by taking nicotinic acid supplements with food, slowly increasing the dose over time, or simply waiting for the body to develop a natural tolerance.
When taken in pharmacologic doses of 1,000 to 3,000 mg/day, nicotinic acid can also cause more serious adverse effects [2,4,12,36]. Many of these effects have occurred in patients taking high-dose nicotinic acid supplements to treat hyperlipidemias. These adverse effects can include hypotension severe enough to increase the risk of falls; fatigue; impaired glucose tolerance and insulin resistance; gastrointestinal effects, such as nausea, heartburn, and abdominal pain; and ocular effects, such as blurred or impaired vision and macular edema (a buildup of fluid at the center of the retina). High doses of nicotinic acid taken over months or years can also be hepatotoxic; effects can include increased levels of liver enzymes; hepatic dysfunction resulting in fatigue, nausea, and anorexia; hepatitis; and acute liver failure [2,12,29,37]. Hepatotoxicity is more likely to occur with the use of extended-release forms of nicotinic acid [12,38,39].
To minimize the risk of adverse effects from nicotinic acid supplementation or to identify them before they become serious, the American College of Cardiology and the American Heart Association recommend measuring hepatic transaminase, fasting blood glucose or hemoglobin A1C, and uric acid levels in all supplement users before they start therapy, while the dose is being increased to a maintenance level, and every 6 months thereafter [29]. The societies also recommend that patients not use nicotinic acid supplements or stop using them if their hepatic transaminase levels are more than two or three times the upper limits of normal; if they develop persistent hyperglycemia, acute gout, unexplained abdominal pain, gastrointestinal symptoms, new-onset atrial fibrillation, or weight loss; or if they have persistent and severe skin reactions, such as flushing or rashes.
Nicotinamide does not cause skin flushing and has fewer adverse effects than nicotinic acid, and these effects typically begin with much higher doses [12]. Nausea, vomiting, and signs of liver toxicity can occur with nicotinamide intakes of 3,000 mg/day [2]. In several small studies of participants undergoing hemodialysis, the most common adverse effects from 500-1,500 mg/day nicotinamide supplementation for several months were diarrhea and thrombocytopenia (low platelet count) [36,40-42].
The FNB has established ULs for niacin that apply only to supplemental niacin for healthy infants, children, and adults [2]. These ULs are based on the levels associated with skin flushing. The FNB acknowledges that although excess nicotinamide does not cause flushing, a UL for nicotinic acid based on flushing can prevent the potential adverse effects of nicotinamide [2]. The UL, therefore, applies to both forms of supplemental niacin. However, the UL does not apply to individuals who are receiving supplemental niacin under medical supervision [2].
Table 3: Tolerable Upper Intake Levels (ULs) for Niacin [2]AgeMaleFemalePregnancyLactationBirth to 6 monthsNone established*None established*7–12 monthsNone established*None established*1–3 years10 mg10 mg4–8 years15 mg15 mg9–13 years20 mg20 mg14–18 years30 mg30 mg30 mg30 mg19+ years35 mg35 mg35 mg35 mg
* Breast milk, formula, and food should be the only sources of niacin for infants.
Interactions with Medications
Niacin can interact with certain medications, and several types of medications might adversely affect niacin levels. A few examples are provided below. Individuals taking these and other medications on a regular basis should discuss their niacin status with their health care providers.
Isoniazid and pyrazinamide
Isoniazid and pyrazinamide (together in Rifater®), used to treat tuberculosis, are structural analogs of niacin and interrupt the production of niacin from tryptophan by competing with a vitamin B6-dependent enzyme required for this process [2,22]. In addition, isoniazid can interfere with niacin’s conversion to NAD [43]. Although pellagra can occur in patients with tuberculosis treated with isoniazid, it can be prevented with increased intakes of niacin.
Antidiabetes medications
Large doses of nicotinic acid can raise blood glucose levels by causing or aggravating insulin resistance and increasing hepatic production of glucose [43]. Some studies have found that nicotinic acid doses of 1.5 g/day or more are most likely to increase blood glucose levels in individuals with or without diabetes [38]. People who take any antidiabetes medications should have their blood glucose levels monitored if they take high-dose nicotinic acid supplements concomitantly because they might require dose adjustments [43].
Niacin and Healthful Diets
The federal government’s 2020–2025 Dietary Guidelines for Americans notes that “Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. … In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients (e.g., during specific life stages such as pregnancy).”
For more information about building a healthy dietary pattern, refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture’s MyPlate.
The Dietary Guidelines for Americans describes a healthy dietary pattern as one that:
Includes a variety of vegetables; fruits; grains (at least half whole grains); fat-free and low-fat milk, yogurt, and cheese; and oils.Many vegetables, fruits, whole grains, and dairy products provide some niacin. Enriched grains are also a source of niacin.
Includes a variety of protein foods such as lean meats; poultry; eggs; seafood; beans, peas, and lentils; nuts and seeds; and soy products.Fish, beef, chicken, and turkey are good sources of niacin. Many legumes, nuts, seeds, and soy products provide some niacin.
Limits foods and beverages higher in added sugars, saturated fat, and sodium.
Limits alcoholic beverages.
Stays within your daily calorie needs.
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Natural Medicines. Niacin.
Disclaimer
This fact sheet by the National Institutes of Health (NIH) Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. We encourage you to talk to your health care providers (doctor, registered dietitian, pharmacist, etc.) about your interest in, questions about, or use of dietary supplements and what may be best for your overall health. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.
Updated: November 18, 2022 History of changes to this fact sheet
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Funny that every off the shelf B3 is 100x the recommend dose.