What are the potential side effects of niacin. How does vitamin B3 affect cholesterol levels and heart health. Can niacin supplements cause liver damage. What role does niacin play in diabetes management. How does vitamin B3 impact skin health and circulation.

The Multifaceted Functions of Vitamin B3 in the Human Body

Vitamin B3, also known as niacin, is a crucial nutrient that plays a significant role in various bodily functions. As one of the eight B vitamins, it is essential for converting food into energy, supporting the nervous system, and maintaining healthy skin, hair, and eyes. Niacin comes in different forms, including nicotinic acid, niacinamide (nicotinamide), and inositol hexanicotinate, each with unique effects on the body.

Are you aware of niacin’s role in hormone production? Niacin aids in the synthesis of sex and stress-related hormones in the adrenal glands and other parts of the body. Additionally, it promotes improved circulation and has demonstrated anti-inflammatory properties.

Water-Solubility and Dietary Sources

Like all B vitamins, niacin is water-soluble, meaning the body doesn’t store it. This characteristic underscores the importance of regular dietary intake to meet the body’s requirements. Fortunately, a balanced diet typically provides sufficient niacin, making deficiencies rare in developed countries.

Recognizing Niacin Deficiency: Symptoms and Consequences

While uncommon in developed nations, niacin deficiency can occur, particularly in individuals with alcohol use disorder. Do you know the signs of mild niacin deficiency? They include:

• Indigestion
• Fatigue
• Canker sores
• Vomiting
• Poor circulation
• Depression

Severe deficiency can lead to a condition called pellagra, characterized by cracked, scaly skin, dementia, and diarrhea. Other symptoms include a burning sensation in the mouth and a swollen, bright red tongue. Treatment typically involves a nutritionally balanced diet supplemented with niacin.

High-Dose Niacin: Potential Benefits and Risks

Prescription-strength niacin has been studied for its potential to prevent or improve various health conditions. However, high doses can be toxic and should only be taken under medical supervision. Researchers are investigating whether inositol hexanicotinate offers similar benefits with fewer side effects, but results remain inconclusive.

Niacin and Cholesterol Management

Since the 1950s, niacin (but not niacinamide) has been used to lower elevated LDL (bad) cholesterol and triglyceride levels in the blood. However, this approach comes with potential side effects, some of which can be severe. High-dose niacin can cause:

• Flushing of the skin
• Stomach upset (usually subsiding within weeks)
• Headache
• Dizziness
• Blurred vision
• Increased risk of liver damage

Time-release formulations of niacin may reduce flushing, but long-term use has been associated with liver damage. Moreover, niacin can interact with other cholesterol-lowering medications, emphasizing the need for medical supervision when using high-dose niacin supplements.

Niacin’s Impact on Heart Health and Atherosclerosis

Research has shown promising results regarding niacin’s potential benefits for heart health. In one study, men with existing heart disease who took niacin along with colestipol experienced a slower progression of atherosclerosis, fewer heart attacks, and lower mortality rates.

Another study found that individuals with heart disease and high cholesterol who combined niacin with simvastatin (Zocor) had a reduced risk of first heart attack or stroke, as well as a lower risk of death. Additionally, men taking niacin alone appeared to have a decreased risk of experiencing a second heart attack, although it did not affect overall mortality rates.

The Complex Relationship Between Niacin and Diabetes

Niacin’s role in diabetes management is multifaceted and depends on the type of diabetes in question. For type 1 diabetes, niacinamide may offer temporary protection for insulin-producing pancreatic cells. However, research results have been mixed, and more studies are needed to confirm its efficacy.

In type 2 diabetes, niacin’s effects are more complicated. While it can help lower high levels of fats and cholesterol often present in type 2 diabetics, niacin may also raise blood sugar levels. This potential increase in blood glucose is particularly concerning for individuals with diabetes and underscores the importance of medical supervision when using niacin supplements.

Niacin and Blood Sugar Control

How does niacin affect blood sugar levels in diabetics? Niacin can potentially raise blood glucose, which is particularly dangerous for individuals with diabetes. For this reason, people with diabetes should only take niacin under the guidance of a healthcare professional and with careful monitoring of their blood sugar levels.

Exploring Niacin’s Potential in Osteoarthritis Management

Preliminary research has suggested that niacinamide may offer benefits for individuals with osteoarthritis. One study indicated potential improvements in arthritis symptoms, including increased joint mobility and a reduction in the need for non-steroidal anti-inflammatory drugs (NSAIDs). However, more research is required to confirm these findings and establish niacin’s role in osteoarthritis management.

Niacin’s Promising Effects on Cognitive Health and Eye Disorders

Population studies have revealed intriguing connections between niacin intake and cognitive health. People with higher levels of dietary niacin appear to have a lower risk of developing Alzheimer’s disease. However, it’s important to note that no studies have specifically evaluated the effects of niacin supplements on cognitive decline or Alzheimer’s prevention.

Niacin and Cataract Prevention

Can niacin help protect against cataracts? One large population study found that individuals with high dietary niacin intake had a lower risk of developing cataracts. While this association is promising, more research is needed to establish a causal relationship and determine whether niacin supplements could offer similar protective benefits.

Safety Considerations and Potential Side Effects of Niacin Supplementation

While niacin is an essential nutrient with numerous health benefits, high-dose supplementation can lead to various side effects and safety concerns. It’s crucial to be aware of these potential issues and to use niacin supplements only under medical supervision when necessary.

Common Side Effects of High-Dose Niacin

What are the most frequent side effects associated with high-dose niacin intake? The most common side effects include:

• Skin flushing (often accompanied by itching or tingling)
• Gastrointestinal distress (nausea, vomiting, and abdominal pain)
• Headaches
• Dizziness
• Rapid or irregular heartbeat

These side effects are typically dose-dependent and may subside as the body adjusts to the supplement. However, some individuals may find these effects intolerable, leading to discontinuation of niacin therapy.

Liver Concerns with Long-Term Niacin Use

One of the most serious potential side effects of high-dose niacin supplementation is liver damage. Extended use of niacin, particularly in its time-release form, has been associated with an increased risk of liver toxicity. Regular liver function tests are typically recommended for individuals taking high-dose niacin supplements to monitor for any signs of liver damage.

Interactions with Other Medications

Niacin can interact with various medications, potentially altering their effectiveness or increasing the risk of side effects. Some important drug interactions to be aware of include:

• Statins: Combining niacin with cholesterol-lowering statins may increase the risk of muscle damage (rhabdomyolysis)
• Diabetes medications: Niacin can interfere with blood sugar control, necessitating adjustments to diabetes medication dosages
• Blood thinners: Niacin may enhance the effects of blood-thinning medications, increasing the risk of bleeding
• Blood pressure medications: Niacin can potentially lower blood pressure, which may require adjustments to antihypertensive medications

Due to these potential interactions, it’s crucial to inform your healthcare provider about all medications and supplements you’re taking before starting niacin therapy.

Optimizing Niacin Intake: Dietary Sources and Supplement Considerations

For most individuals, obtaining adequate niacin through a balanced diet is preferable to supplementation. Niacin is found in a variety of foods, making it relatively easy to meet daily requirements through dietary sources.

Rich Dietary Sources of Niacin

Which foods are high in niacin? Some excellent dietary sources of niacin include:

• Poultry (chicken, turkey)
• Fish (tuna, salmon)
• Lean red meat
• Peanuts and other legumes
• Whole grains
• Fortified cereals
• Avocados
• Mushrooms

By incorporating these foods into your diet, you can help ensure adequate niacin intake without the need for supplements.

Recommended Daily Allowance (RDA) for Niacin

The Recommended Daily Allowance (RDA) for niacin varies based on age, sex, and life stage. For most adults, the RDA is as follows:

• Adult men: 16 mg per day
• Adult women: 14 mg per day
• Pregnant women: 18 mg per day
• Breastfeeding women: 17 mg per day

It’s important to note that these recommendations are for niacin intake from all sources, including food and supplements.

When to Consider Niacin Supplementation

While dietary sources are generally sufficient, there are certain situations where niacin supplementation may be recommended by a healthcare provider. These may include:

• Diagnosed niacin deficiency
• Certain medical conditions (e.g., pellagra)
• High cholesterol management (under medical supervision)
• Specific health concerns where high-dose niacin therapy may be beneficial

If you’re considering niacin supplementation, it’s crucial to consult with a healthcare professional to determine the appropriate dosage and form of niacin for your specific needs.

Future Directions in Niacin Research and Therapeutic Applications

As our understanding of niacin’s effects on the body continues to grow, researchers are exploring new potential applications and refining existing therapies. Several areas of ongoing research hold promise for expanding niacin’s role in health and medicine.

Novel Formulations and Delivery Methods

Scientists are working on developing new formulations of niacin that may offer the benefits of high-dose therapy with reduced side effects. These efforts include:

• Extended-release formulations with improved safety profiles
• Combination therapies that pair niacin with other nutrients or medications
• Topical applications for skin health and local anti-inflammatory effects

These innovations may help broaden the therapeutic applications of niacin while minimizing adverse effects.

Exploring Niacin’s Role in Metabolic Health

Researchers are investigating niacin’s potential impact on various aspects of metabolic health beyond its known effects on lipid profiles. Areas of interest include:

• Insulin sensitivity and glucose metabolism
• Fat tissue function and obesity management
• Mitochondrial function and energy metabolism

These studies may uncover new ways in which niacin could contribute to overall metabolic wellness and disease prevention.

Niacin and Neurological Health

The potential neuroprotective effects of niacin are an exciting area of ongoing research. Scientists are exploring niacin’s role in:

• Cognitive function and memory
• Neurodegenerative diseases (e.g., Parkinson’s disease)
• Stroke recovery and prevention

These investigations may lead to new therapeutic applications for niacin in maintaining and improving neurological health.

Personalized Niacin Therapy

As the field of personalized medicine advances, researchers are working to identify genetic and metabolic factors that influence individual responses to niacin. This research aims to:

• Predict which patients are most likely to benefit from niacin therapy
• Identify individuals at higher risk for side effects
• Optimize dosing strategies based on individual characteristics

By tailoring niacin therapy to individual patients, healthcare providers may be able to maximize benefits while minimizing risks.

As research in these areas progresses, our understanding of niacin’s potential benefits and optimal use will continue to evolve. It’s important for individuals interested in niacin supplementation to stay informed about the latest developments and to work closely with healthcare providers to make informed decisions about its use.

Vitamin B3 (Niacin) Information | Mount Sinai

Inositol hexaniacinate; Niacin; Niacinamide; Nicotinamide; Nicotinic acid

Vitamin B3 is one of 8 B vitamins. It is also known as niacin (nicotinic acid) and has 2 other forms, niacinamide (nicotinamide) and inositol hexanicotinate, which have different effects from niacin.

All B vitamins help the body convert food (carbohydrates) into fuel (glucose), which the body uses to produce energy. These B vitamins, often referred to as B-complex vitamins, also help the body use fats and protein. B-complex vitamins are needed for a healthy liver, healthy skin, hair, and eyes, and to help the nervous system function properly.

Niacin also helps the body make various sex and stress-related hormones in the adrenal glands and other parts of the body. Niacin helps improve circulation, and it has been shown to suppress inflammation.

All the B vitamins are water-soluble, meaning that the body does not store them.

You can meet all of your body’s needs for B3 through diet. It is rare for anyone in the developed world to have a B3 deficiency. In the U.S., alcoholism is the main cause of vitamin B3 deficiency.

Symptoms of mild B3 deficiency include:

• Indigestion
• Fatigue
• Canker sores
• Vomiting
• Poor circulation
• Depression

Severe deficiency can cause a condition known as pellagra. Pellagra is characterized by cracked, scaly skin, dementia, and diarrhea. It is generally treated with a nutritionally balanced diet and niacin supplements. Niacin deficiency also causes burning in the mouth and a swollen, bright red tongue.

Very high doses of B3, available by prescription, have been studied to prevent or improve symptoms of the following conditions. However, at high doses niacin can be toxic. You should not take doses higher than the Recommended Daily Allowance (RDA) except under your doctor’s supervision. Researchers are trying to determine if inositol hexanicotinate has similar benefits without serious side effects. But results are inconclusive.

High cholesterol

Niacin, but not niacinamide, has been used since the 1950s to lower elevated LDL (bad) cholesterol and triglyceride (fat) levels in the blood. However, side effects can be unpleasant and even dangerous. High doses of niacin cause:

• Flushing of the skin
• Stomach upset (which usually subsides within a few weeks)
• Headache
• Dizziness
• Blurred vision
• An increased risk of liver damage

A time-release form of niacin reduces flushing. But long-term use is associated with liver damage. In addition, niacin can interact with other cholesterol-lowering medicines. You should not take niacin at high doses without your doctor’s supervision.

Atherosclerosis and heart disease

In one study, men with existing heart disease slowed down the progression of atherosclerosis by taking niacin along with colestipol. They experienced fewer heart attacks and deaths, as well.

In another study, people with heart disease and high cholesterol who took niacin along with simvastatin (Zocor) had a lower risk of having a first heart attack or stroke. Their risk of death was also lower. In another study, men who took niacin alone seemed to reduce the risk of having a second heart attack, although it did not reduce the risk of death.

Diabetes

In type 1 diabetes, the body’s immune system mistakenly attacks the cells in the pancreas that make insulin, eventually destroying them. Niacinamide may help protect those cells for a time. More research is needed.

Researchers have also looked at whether high-dose niacinamide might reduce the risk of type 1 diabetes in children at risk for the disease. One study found that it did. But another, larger study found it did not protect against developing type 1 diabetes. More research is needed.

The effect of niacin on type 2 diabetes is more complicated. People with type 2 diabetes often have high levels of fats and cholesterol in the blood. Niacin, often along with other medications, can lower those levels. However, niacin may also raise blood sugar levels, which is particularly dangerous for someone with diabetes. For that reason, if you have diabetes, you should take niacin only under the direction of your doctor, and you should be carefully monitored for high blood sugar.

Osteoarthritis

One preliminary study suggested that niacinamide may improve arthritis symptoms, including increasing joint mobility and reducing the amount of non-steroidal anti-inflammatory drugs (NSAIDs) needed. More research is needed.

Other

Alzheimer disease: Population studies show that people who get higher levels of niacin in their diet have a lower risk of Alzheimer disease. No studies have evaluated niacin supplements, however.

Cataracts: One large population study found that people who got a lot of niacin in their diets had a lower risk of developing cataracts.

Skin conditions: Researchers are studying topical forms of niacin as treatments for rosacea, aging, and prevention of skin cancer, although it is too early to know whether it is effective.

Although there is no evidence that it helps treat any of these conditions, researchers are also studying the use of vitamin B3 in treating:

• ADHD
• Migraines
• Dizziness
• Depression
• Motion sickness
• Alcohol dependence

Dietary Sources

The best food sources of vitamin B3 are:

• Beets
• Brewer’s yeast
• Beef liver
• Beef kidney
• Fish
• Salmon
• Swordfish
• Tuna
• Sunflower seeds
• Peanuts

Bread and cereals are usually fortified with niacin. In addition, foods that contain tryptophan, an amino acid the body coverts into niacin, include poultry, red meat, eggs, and dairy products.

Available Forms

Vitamin B3 is available in several different supplement forms:

• Niacinamide
• Niacin
• Inositol hexaniacinate.

Niacin is available as a tablet or capsule in both regular and timed-release forms. The timed-release tablets and capsules may have fewer side effects than regular niacin. However, the timed-release versions are more likely to cause liver damage. Regardless of which form of niacin you are using, doctors recommend periodic liver function tests when using high doses (above 100 mg per day) of niacin.

How to Take It

Generally, high doses of niacin are used to control specific diseases. Such high doses must be prescribed by a doctor who will increase the amount of niacin slowly, over the course of 4 to 6 weeks. Take niacin with meals to avoid stomach irritation.

Daily recommendations for niacin in the diet of healthy individuals are:

Pediatric

• Infants, birth to 6 months: 2 mg (adequate intake)
• Infants, 7 months to 1 year: 4 mg (adequate intake)
• Children, 1 to 3 years: 6 mg (RDA)
• Children, 4 to 8 years: 8 mg (RDA)
• Children, 9 to 13 years: 12 mg (RDA)
• Boys, 14 to 18 years: 16 mg (RDA)
• Girls, 14 to 18 years: 14 mg (RDA)

Adult

• Men, 19 years and older: 16 mg (RDA)
• Women, 19 years and older: 14 mg (RDA)
• Pregnant women: 18 mg (RDA)
• Breastfeeding women: 17 mg (RDA)

Precautions

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable health care provider. Side effects may include diarrhea, headache, stomach discomfort, and bloating.

High doses (50 mg or more) of niacin can cause side effects. The most common side effect is called “niacin flush,” which is a burning, tingling sensation in the face and chest, and red or flushed skin. Taking an aspirin 30 minutes prior to the niacin may help reduce this symptom.

At very high doses, used to lower cholesterol and treat other conditions, liver damage and stomach ulcers can occur. Your doctor will regularly check your liver function through a blood test.

People with a history of liver disease, kidney disease, or stomach ulcers should not take niacin supplements. Those with diabetes or gallbladder disease should do so only under the close supervision of their doctors.

Stop taking niacin or niacinamide at least 2 weeks before a scheduled surgery.

Niacin and niacinamide may make allergies worse by increasing histamine.

People with low blood pressure should not take niacin or niacinamide because they may cause a dangerous drop in blood pressure. DO NOT take niacin if you have a history of gout.

People with coronary artery disease or unstable angina should not take niacin without their doctor’s supervision, as large doses can raise the risk of heart rhythm problems.

Taking any one of the B vitamins for a long period of time can result in an imbalance of other important B vitamins. For this reason, you may want to take a B-complex vitamin, which includes all the B vitamins.

Possible Interactions

Because of its impact on the liver, vitamin B3 can interact with several medications. If you are currently taking medications, or regularly drink alcohol, you should not use niacin without talking to your health care provider first. Below is a partial list of medications that may interact with vitamin B3.

Antibiotics, tetracycline: Niacin should not be taken at the same time as the antibiotic tetracycline because it interferes with the absorption and effectiveness of this medication. All vitamin B complex supplements act in this way and should be taken at different times from tetracycline.

Aspirin: Taking aspirin before taking niacin may reduce flushing from niacin. But take it only under your doctor’s supervision.

Anti-seizure medications: Phenytoin (Dilantin) and valproic acid (Depakote) may cause niacin deficiency in some people. Taking niacin with carbamazepine (Tegretol) or mysoline (Primidone) may increase levels of these medications in the body.

Anticoagulants (blood thinners): Niacin may make the effects of these medications stronger, increasing the risk of bleeding.

Blood pressure medications, alpha-blockers: Niacin can make the effects of medications taken to lower blood pressure stronger, leading to the risk of low blood pressure.

Cholesterol-lowering medications: Niacin binds the cholesterol-lowering medications known as bile-acid sequestrants and may make them less effective. For this reason, niacin and these medications should be taken at different times of the day. Bile-acid sequestrants include colestipol (Colestid), colesevelam (Welchol), and cholestyramine (Questran).

Statins: Some scientific evidence suggests that taking niacin with simvastatin (Zocor) appears to slow the progression of heart disease. However, the combination may also increase the likelihood for serious side effects, such as muscle inflammation or liver damage.

Diabetes medications: Niacin may increase blood sugar levels. People taking insulin, metformin (Glucophage), glyburide (Dibeta, Micronase), glipizide (Glucotrol), or other medications used to treat high blood glucose levels should monitor their blood sugar levels closely when taking niacin supplements.

Isoniazid (INH): INH, a medication used to treat tuberculosis, may cause a niacin deficiency.

Nicotine patches: Using nicotine patches with niacin may worsen or increase the risk of flushing associated with niacin.

These medications may lower levels of niacin in the body:

• Azathioprine (Imuran)
• Chloramphenicol (Chloromycetin)
• Cycloserine (Seromycin)
• Fluorouracil
• Levodopa and carbidopa
• Mercaptopurine (Purinethol)

Supporting Research

AIM-HIGH Investigators. The role of niacin in raising high-density lipoprotein cholesterol to reduce cardiovascular events in patients with atherosclerotic cardiovascular disease and optimally treated low-density lipoprotein cholesterol Rationale and study design. The Atherothrombosis Intervention in Metabolic syndrome with low HDL/high triglycerides: Impact on Global Health outcomes (AIM-HIGH). Am Heart J. 2011 Mar;161(3):471-477.e2.

Bissett DL, Oblong JE, Berge CA, et al. Niacinamide: A B vitamin that improves aging facial skin appearance. Dermatol Surg. 2005;31:860-865; discussion 865.

Boden WE, Sidhu MS. Toth PP. The therapeutic role of niacin in dyslipidemia management. J Cardiovasc Pharmacol Ther. 2014;19(2):141-58.

Brown BG, Zhao XQ, Chalt A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med. 2001;345(22):1583-1592.

Cumming RG, Mitchell P, Smith W. Diet and cataract: the Blue Mountains Eye Study. Ophthalmology. 2000;107(3):450-456.

Draelos ZD, Ertel K, Berge C, et al. Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea. Cutis. 2005;76:135-141.

Elam M, Hunninghake DB, Davis KB, et al. Effects of niacin on lipid and lipoprotein levels and glycemic control in patients with diabetes and peripheral arterial disease: the ADMIT study: a randomized trial. Arterial Disease Multiple Intervention Trial. JAMA. 2000;284:1263-1270.

Garcia-Closas R. et al. Food, nutrient and heterocyclic amine intake and the risk of bladder cancer. Eur J Cancer. 2007;43(11):1731-1740.

Ginsberg HN, reyes-Soffer G. Niacin: a long history, but a questionable future. Curr Opin Lipidol. 2013;24(6):475-9.

Goldberg A, Alagona P, Capuzzi DM, et al. Multiple-dose efficacy and safety of an extended-release form of niacin in management of hyperlipidemia. Am J Cardiol. 2000;85:1100-1105.

Guyton JR. Niacin in cardiovascular prevention: mechanisms, efficacy, and safety. Curr Opin Lipidol. 2007 Aug;18(4):415-420.

Jacques PF, Chylack LT Jr, Hankinson SE, et al. Long-term nutrient intake and early age related nuclear lens opacities. Arch Ophthalmol. 2001;119(7):1009-1019.

Jones KW. Do patients on statins also need niacin? JAAPA. 2013;26(7):9-10.

Kuzniarz M, Mitchell P, Cumming RG, Flood VM. Use of vitamin supplements and cataract: the Blue Mountains Eye Study. Am J Ophthalmol. 2001;132(1):19-26.

Mittal MK, Florin T, Perrone J, Delgado JH, Osterhoudt KC. Toxicity from the use of niacin to beat urine drug screening. Ann Emerg Med. 2007;50(5):587-590.

Nutrients and Nutritional Agents. In: Kastrup EK, Hines Burnham T, Short RM, et al, eds. Drug Facts and Comparisons. St. Louis, MO: 2000;4-5.

Raja R, Thomas JM, Greenhill-Hopper M, Ley SV, Almeida Paz FA. Facile, one-step production of niacin (vitamin B3) and other nitrogen-containing pharmaceutical chemicals with a single-site heterogeneous catalyst. Chemistry. 2008;14(8):2340-2348.

Sahebkar A. effect of niacin on endothelial function: a systematic review and meta-analysis of randomized controlled trials. Vasc Med. 2014;19(1):54-66.

Sanyal S, Karas RH, Kuvin JT. Present-day uses of niacin: effects on lipid and non-lipid parameters. Expert Opin Pharmacother. 2007 Aug;8(11):1711-17.

Song WL, FitzGerald GA. Niacin, an old drug with a new twist. J Lipid Res. 2013;54(10):2486-94.

Surjana D. Damian DL. Nicotinamide in dermatology and photoprotection. Skinmed. 2011;9(6):360-365.

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Niacin (Vitamin B3) : Benefits, Dosage, Sources, Risks

Written by R. Morgan Griffin

In this Article

• Why do people take niacin?
• How much niacin should you take?
• Can you get niacin naturally from foods?
• What are the risks of taking niacin?

Having enough niacin, or vitamin B3, in the body is important for general good health. As a treatment, higher amounts of niacin can improve cholesterol levels.

As a cholesterol treatment, there are good studies showing that niacin can boost levels of good HDL cholesterol and lower triglycerides. Niacin also modestly lowers bad LDL cholesterol. It’s sometimes prescribed in combination with statins for cholesterol control, such as rosuvastatin (Crestor, Ezallor), simvastatin (Flolipid, Zocor), fluvastatin (Lescol), atorvastatin (Lipitor) and pravastatin (Pravachol).

However, niacin is only effective as a cholesterol treatment at fairly high doses. These doses could pose risks, such as liver damage, gastrointestinal problems, or glucose intolerance. So don’t treat yourself with over-the-counter niacin supplements. Instead, get advice from your health care provider, who can prescribe FDA-approved doses of niacin instead if recommended.

In addition, niacin is an FDA-approved treatment for pellagra, a rare condition that develops from niacin deficiency.

Since niacin can be used in different ways, talk to your health care provider about the best dosage for you.

Everyone needs a certain amount of niacin — from food or supplements — for the body to function normally. This amount is called the dietary reference intake (DRI), a term that is replacing the older and more familiar RDA (recommended daily allowance). For niacin, the DRIs vary with age and other factors and are given in milligrams of niacin equivalents: 

• Children: between 2-16 milligrams daily, depending on age
• Men: 16 milligrams daily
• Women: 14 milligrams daily
• Women (pregnant): 18 milligrams daily
• Women (breastfeeding): 17 milligrams daily
• Maximum daily intake for adults of all ages: 35 milligrams daily

Most people can get the amount of niacin they need by eating a healthy diet.

If your doctor prescribes niacin, you might want to take it with food. This can prevent upset stomach. To reduce flushing — a harmless but uncomfortable side effect of niacin that describes redness and warmth in the face and neck — your health care provider might recommend taking niacin along with aspirin and avoiding alcohol and spicy foods.

Niacin occurs naturally in many foods, including greens, meat, poultry, fish, and eggs, although in a fraction of the dose shown to achieve changes in cholesterol. Many products are also fortified with niacin during manufacturing.

• Side effects. Niacin can cause flushing, especially when you first begin taking it. Your health care provider will probably suggest increasing the dose slowly to reduce this problem. They might also offer a time-release prescription formulation to control flushing. Niacin can cause upset stomach and diarrhea. However, all of these side effects tend to fade over time.
• Risks. Niacin does have risks. It can cause liver problems, stomach ulcers, changes to glucose levels, muscle damage, low blood pressure, heart rhythm changes, and other issues. People with any health condition including liver or kidney disease, diabetes, high blood pressure, or cardiovascular problems need to talk to a doctor before using niacin supplements. Do not treat high cholesterol on your own with over-the-counter niacin supplements.
• Interactions. If you take any medicines or supplements regularly, talk to your doctor before you start using niacin supplements. They could interact with medicines like diabetes drugs, blood thinners, anticonvulsants, blood pressure medicines, thyroid hormones, and antibiotics as well as supplements like ginkgo biloba and some antioxidants. Alcohol might increase the risk of liver problems. Though niacin is often used along with statins for high cholesterol, this combination may increase the risk for side effects. Get advice from your healthcare provider.

At the low DRI doses, niacin is safe for everyone. However, at the higher amounts used to treat medical conditions, it can have risks. For that reason, children and women who are pregnant or breastfeeding should not take niacin supplements in excess of the DRI unless it’s recommended by a doctor. 

People with uncontrolled gout should also not take niacin supplements.

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Vitamin B3: indications for use, benefits, dosage

March 25
2021

Vitamin B3 (niacin, vitamin PP) is produced in the body from tryptophan and in small quantities, so in order to maintain normal levels of this element, it is necessary to follow a diet. Vitamin B3 takes part in the breakdown and further synthesis of amino acids, carbohydrates, fatty acids, it also regulates cholesterol levels, so a deficiency of the element is dangerous for the human body. It is useful to find out what nicotinic acid is used for and what is the dosage of nicotinic acid.

What is Vitamin B3 (Nicotinic Acid, Vitamin PP)

Niacin is considered to be a vitamin with increased stability, as it is not particularly sensitive to oxygen, heat and UV rays.

The role of vitamin B3 for the body is great. The substance is water-soluble and contributes to the correct functioning of the nervous system. Niacin is also required for the synthesis of steroid hormones (including estrogen, progesterone, testosterone, hydrocortisone), pancreatic hormones (in particular, insulin) and the thyroid gland (thyroxine).

Vitamin PP has an effect on metabolic changes that release energy. When poisoned, it slows down the toxic effect of certain chemical compounds and drugs.

Niacin is an important component that regulates blood cholesterol levels. It also dilates blood vessels, has a positive effect on mental well-being. Niacin improves carbohydrate metabolism, increases wound healing, improves general condition, and normalizes body weight.

Sources of vitamin B3

What foods contain vitamin B3? Niacin acid is mainly found in meat, fish, grains and legumes, in milk, green leafy vegetables (among them with the highest content of lettuce, dill, parsley, sorrel, spinach), in a small percentage – in tea and coffee.

Vitamin B3 is found in lean meats: veal, turkey and chicken. You can find it in almonds, pork, dairy products, organ meats, soybeans, peas and beans. Supplements in the form of vitamin preparations can compensate for the lack of vitamin PP, such an element can be chromium, which increases the absorption of the vitamin.

Vitamin B3 is also found in foods such as yeast, wheat bran and peanuts, as well as fish, especially smoked mackerel and salmon, as a source enriched with niacin. Niacin can be present in lean protein foods, both animal and vegetable.

Why vitamin B3 is prescribed

Niacin is prescribed:

• for diabetes and hypertension;
• for the treatment of disorders of the nervous system;
• for migraine;
• to improve digestion;
• to increase blood sugar;
• to improve metabolism;
• to increase the protective properties of the pancreas.

The main thing when niacin is prescribed is the lack of this substance in the body. More information on the site.

How to take vitamin B3

Breastfeeding women, as well as those using contraceptives, cancer patients and people who lack protein, especially need nicotinic acid.

Recommended daily value of vitamin B3:

1. 6-10 – children 1-3 years old;
2. 8-16 – children 4-8 years old;
3. 14 – women;
4. 16 – men;
5. 17-18 – pregnant.

The normal dosage of niacin for each individual may vary according to age and sex.

Medical use

In the medical field, vitamin B3 is used to treat lipid and lipoprotein problems. They more often than others lead to the development of such a disease as atherosclerosis. A dosage of more than 1 gram per day is able to increase HDL cholesterol levels in the blood plasma, and at the same time to reduce cholesterol and triglyceride levels of LDL.

At higher doses (>100 mg/day), vitamin B3 intake may cause side effects:

• flushing of the skin, mainly on the face;
• fever;
• pruritus and tingling;
• gastrointestinal disturbances (nausea, gagging, gas, diarrhea and possibly worsening peptic ulcer).

Niacin increases the production of adiponectin in fat cells. It is a hormone with anti-atherosclerotic action. Based on clinical studies, niacin is known to relieve migraine symptoms.

More information here.

Contraindications for use

Main contraindications for nicotinic acid:

• hypersensitivity to the substance;
• atherosclerosis;
• hyperuricemia;
• liver failure;
• pancreatitis;
• glaucoma;
• the presence of duodenal ulcer and stomach ulcer, especially during the period of exacerbation;
• arterial hypertension;
• gout;
• arterial hypotension.

It is also important to control the level of niacin in the body. Deviations from the norm are unacceptable, namely, surpluses and deficits.

Excess niacin

Excess vitamin B3 occurs when more than 35 mg per day is consumed. This is often seen with niacin tablets.

Symptoms of vitamin B3 excess:

• skin itching, dryness and redness;
• hyperglycemia;
• liver failure;
• rash;
• abdominal pain, nausea and vomiting;
• arrhythmia.

Therefore, it is not recommended to self-administer – consult your doctor.

Vitamin B3 deficiency

Diet, isoniazid drugs, sugar and alcohol abuse cause niacin deficiency. This can lead to consequences that include a decrease in resistance to cold due to a slowdown in metabolism. Also, the result of a lack of vitamin B3 can be a serious disease – pellagra.

Possible consequences of pellagra:

• dermatitis disease;
• dementia;
• death.

Distinguish between physical and psychological symptoms of vitamin B3 deficiency.

Psychological symptoms:

• increased anxiety;
• irritability;
• delusions and hallucinations;
• amnesia;
• apathy and depression.

Physical symptoms:

• hyperpigmentation;
• skin thickening;
• inflammation in the mouth;
• indigestion.

Self-diagnosis is unacceptable. It is necessary to consult a doctor with the delivery of tests.

Vitamin B3 deficiency and other diseases

Initially, a small deficiency of vitamin B3 provokes a slow metabolism. This may have different consequences. One option is to lower the thermal threshold. If niacin is not enough, it causes a disease called pellagra (Lombard erythema).

Abnormal metabolism of niacin is observed in many diseases. This is mainly found in schizophrenia, hypercholesterolemia, Hodkins’ disease, and depression. A carcinoid tumor that increases the production of serotonin is also triggered by a lack of B3.

Manifestations of pellagra:

• rashes;
• diseases of the gastrointestinal tract, including diarrhea, constipation, vomiting;
• scarlet tongue;
• diseases of the nervous system – apathy, depression, inability to concentrate, headaches, memory problems.

Pellagra is a fatal disease if left untreated. Before taking niacin, a consultation with a specialist is required. Only he can prescribe the drug, indicate the recommended dosages and duration of treatment.

Remember that self-medication can make the situation worse.

Drug Comparison Chart

References

1. https://pubmed.ncbi.nlm.nih.gov/30097857/902 43
2. https://pubmed.ncbi.nlm.nih.gov/27457213/
3. https://pubmed.ncbi.nlm.nih.gov/28983799/
4. https://pubmed.ncbi.nlm.nih.gov/24993939/

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The main scientifically proven beneficial properties of niacin. What is niacin. The principle of action of niacin

Niacin, also known to many as vitamin B3, is considered one of the most important nutrients for the human body. This vitamin is necessary for almost every organ for normal functioning.

Supplementation with niacin can lower blood cholesterol levels, relieve symptoms of arthritis and pain associated with this disease, improve brain function, as well as the functioning of several vital systems.

It should be remembered that excessive consumption of this substance can cause a number of side effects.

In this article, we’ll look at what niacin is, how it affects the human body, recommended amounts of the vitamin, and possible side effects.

What is niacin

Niacin is a B vitamin. It is also known as B3. This trace element can be found both in natural products and in nutritional supplements, where it is presented in several forms, each of which has a different effect on the body.

The first form is nicotinic acid, which lowers cholesterol levels and reduces the risk of developing diseases of the cardiovascular system.

The second form is called nicotinamide or niacinamide. This form is not able to affect the level of cholesterol in the blood, but it can prevent the development of non-melanoma skin cancer and psoriasis.

Both of the above forms of vitamin B3 can dissolve in water, making it unable to accumulate in the human body. In other words, excessive amounts of niacin are almost instantly excreted by the body.

In most cases, the main source of vitamin B3 is food, but in some cases the body is able to independently generate this element from tryptophan, an amino acid stored in the human body.

How Niacin Works

Like other B vitamins, niacin is used by the body to convert food into energy. Moreover, vitamin B3 is part of the NADP and NAD enzymes involved in cellular metabolism. Also, this vitamin is used to transmit signals from cells to the brain and create DNA. It is important to note that, in addition to all of the above, niacin has antioxidant properties.

An acute deficiency of vitamin B3 in the body may be accompanied by the following symptoms:

memory impairment;

confusion;

increased level of fatigue;

headaches;

deterioration of skin quality;

disruption of the gastrointestinal tract;

depression.

But it is worth noting that the deficiency of this vitamin can be observed in the least developed countries, since the diet of the inhabitants of these states is not very diverse.

Recommended Intake of Vitamin B3

Daily allowance for niacin varies by age and gender. Volumes exceeding the recommended daily allowance should be taken only on the recommendation of the attending physician.

1. Daily intake of vitamin B3 for children from 0 to 6 months – 2 mg, from 7 to 12 months – 4 mg, from 1 year to 3 years – 6 mg, from 4 -x to 8 years – 8 mg, from 9 to 13 years – 12 mg.
2. For adults 14 years of age and older, the recommended adult dose of vitamin B3 is 16 mg per day for men and 14 mg per day for women.

For women during pregnancy, the recommended intake of niacin is 18 mg per day, but during breastfeeding it is recommended to reduce the dosage to 17 mg per day.

Benefits of Niacin

Next, we will look at the positive effects of vitamin B3 on the human body.

Lowering Bad Cholesterol

Since the 1950s, niacin has been used as a cholesterol-lowering supplement. According to research, adding vitamin B3 to your diet can reduce bad cholesterol levels by 5-20 percent.

However, please note that this supplement should not be used as a primary cholesterol lowering agent due to possible side effects.

In most cases, this supplement is recommended for people with statin intolerance.

Increasing “good” cholesterol

In addition to the previous effect, vitamin B3 also increases the level of “good” cholesterol by 15-35 percent.

Lower triglycerides

It is also worth paying attention to the fact that niacin is able to lower the level of triglycerides in the blood by 20-50 percent by blocking the enzyme involved in their synthesis.

This effect, among other things, also reduces the production of harmful cholesterol and low density lipoproteins.

Many people with high cholesterol are prescribed therapeutic doses of vitamin B3 to improve their condition.

Reducing the risk of cardiovascular diseases

Thanks to the effect of niacin on lowering cholesterol levels, the risk of developing diseases of the cardiovascular system is significantly reduced. This risk is also reduced by reducing the level of oxidative stress and inflammation. The latter effects also prevent the development of atherosclerosis and strengthen the arteries.

Combining vitamin B3 and a statin, also called niacin therapy, has been shown to significantly reduce the risk of heart disease.

However, it should be noted that the results of studying this effect of niacin are mixed.

For example, a recent study found that niacin supplementation did not reduce the risk of stroke, heart attack, and cardiovascular-related death.

Can be used to treat type 1 diabetes

Type 1 diabetes is an autoimmune disease in which the body has a damaging effect on the pancreatic cells responsible for producing insulin. According to scientists, vitamin B3 can protect these cells and significantly reduce the risk of developing this disease, especially in children.

However, the use of this vitamin in the treatment of type 2 diabetes is a matter of controversy. This is because vitamin B3 is able to lower blood cholesterol levels in individuals suffering from type 2 diabetes, but at the same time, it can increase blood sugar levels.

This is why people using niacin to treat diabetes need to constantly monitor their blood sugar levels.

Improving brain function

The human brain needs vitamin B3, as it is part of the NADP and NAD coenzymes that ensure the normal functioning of this organ by providing it with the right amount of energy.

Researchers note that most mental disorders are caused by niacin deficiency, which can lead to brain cell destruction and schizophrenia. That is why this vitamin is used by many psychiatric hospitals to treat various mental disorders.

Preliminary research suggests that niacin may also be used to promote brain health in individuals suffering from Alzheimer’s disease.

Skin improvement

Researchers claim that vitamin B3 helps to protect the skin from the negative effects of ultraviolet radiation. To accomplish this task, niacin is often used in the form of a lotion or specialized nutritional supplements. According to some scientists, this property of this vitamin can reduce the risk of developing skin cancer.

So, during one of the experiments, the researchers found that taking up to 500 mg of nicotinamide per day can significantly reduce the risk of developing non-melanoma skin cancer.

Relief of arthritis symptoms

In one study, niacin significantly reduced pain and the need for non-steroidal anti-inflammatory drugs in people with symptoms of osteoarthritis, thereby increasing their level of mobility.

In another animal study, vitamin B3 injections were found to reduce inflammatory markers associated with arthritis.

Can be used to treat pellagra

An acute deficiency of vitamin B3 in the body can cause a disease such as pellagra. One of the best remedies to treat it is niacin supplements.

It should be noted that vitamin B3 deficiency is extremely rare. The cause of its occurrence can be Hartnup’s disease, alcoholism and anorexia.

The amount of vitamin B3 the human body needs can be obtained from many foods, including beef, poultry, fish, certain nuts, and legumes. It is important to note that B vitamins can also be found in energy drinks.

Foods with the highest niacin content include:

chicken breast – 59 percent of the RDI;

tuna in oil 53 percent of the RDI;

beef 33 percent of the RDI;

cold smoked salmon 32 per cent of the RDI;

peanuts 19 percent of the RDI;

lentils – 10 percent of the RDI.

In this list, RDI refers to the recommended daily intake of vitamin B3.

Niacin Recommendations

Obtaining niacin from natural foods is absolutely safe for human health, while excessive intake of this vitamin can cause a number of side effects such as nausea, gag reflex and liver damage.

Some of the most common side effects when taking large amounts of vitamin B3 include:

blood flow to the face, chest, or neck due to vasodilation, which may also be accompanied by pain and burning;

gag reflex and nausea most commonly associated with nicotinic acid, which affects certain liver enzymes;

damage to liver cells and malfunction of this organ can be caused by a long course of treatment with nicotinic acid;

uncharacteristic changes in blood sugar levels may be associated with the use of excessively large doses of niacin – from 3 to 9 grams per day;

visual impairment associated with excess of recommended doses;

gout caused by abnormal levels of uric acid due to the abuse of vitamin B3.

What else you need to know about niacin

Many people need niacin, but some people may well get enough of the vitamin from natural foods.

However, if there is a deficiency of this microelement in the body, it is necessary to contact your doctor, who will be able to prescribe certain supplements and determine the individual amount of their intake.

In most cases, vitamin B3 supplements are recommended for people with high cholesterol and people suffering from cardiovascular diseases.

Because excessive consumption of niacin can adversely affect health, it is recommended that you consult your healthcare professional before including this vitamin in your diet.

Conclusion

Niacin is one of the B vitamins used by most organs and vital systems of the body. Fortunately, today almost everyone can get the required amount of niacin from common foods such as meat, fish and nuts.

However, in some cases, people are advised to take dietary supplements with a high content of this vitamin, namely in the treatment of heart disease and high blood cholesterol.