Deficiency/Heart/Longevity

Niacin (Vitamin B3)

Water-soluble vitamin B3 that prevents deficiency and, at higher doses, improves blood lipids in selected adults.

Niacin (Vitamin B3)

Water-soluble vitamin B3 that prevents deficiency and, at higher doses, improves blood lipids in selected adults.

score

evidence

Caution

risk

Proven Benefits

01Corrects niacin deficiency

02Improves lipid profile

03Lowers lipoprotein(a)

04Reduces recurrent skin cancers

05May improve endothelial function

Chemical Forms

Recommended

Niacinamide (nicotinamide)
Nicotinic acid
Extended-release nicotinic acid (clinician-guided use)

Avoid

Inositol hexanicotinate / "no-flush niacin" (poor evidence for lipid effects)
High-dose sustained-release niacin from unclear sources (higher liver-toxicity concern)

Expert Note

Niacinamide is usually best for routine vitamin B3 replacement because it corrects deficiency without the classic flush. Nicotinic acid is the form with the best evidence for improving lipid markers, but effective doses are much higher and need monitoring. "No-flush" forms often do not provide the same nicotinic acid exposure, so lipid effects are less reliable.

Protocol

Amount

16-35 mg

Frequency

Once daily

When

With food if using nicotinic acid to reduce stomach upset and flushing; niacinamide can be taken any time.

Condition-Based Dosing

Adult men with low dietary intake

16 mg daily— Matches the usual daily requirement for men.

Adult women with low dietary intake

14 mg daily— Matches the usual daily requirement for women.

Confirmed niacin deficiency or pellagra risk

100-300 mg daily in divided doses— Use under medical supervision; dose depends on severity and cause.

Clinician-managed dyslipidemia

Start 250-500 mg daily nicotinic acid, then titrate to 1-2 g daily— Requires monitoring of liver enzymes, glucose, and uric acid.

Recurrent non-melanoma skin cancer

Nicotinamide 500 mg twice daily— Studied mainly in high-risk adults; discuss with a dermatologist.

Safety & Limits

Upper Safe Limit

35 mg/day from supplements or fortified foods (IOM UL for adults; flushing-based, not physician-supervised therapy)

Cycling

Safe for continuous use

Contraindications

Active liver disease — higher risk of hepatotoxicity, especially at gram doses

Gout or hyperuricemia — niacin can raise uric acid

Poorly controlled diabetes — higher doses can worsen glucose control

Active peptic ulcer disease — may aggravate symptoms

High-dose statin therapy — combination may increase risk of liver injury or myopathy

Pregnancy or breastfeeding — avoid high-dose use unless prescribed

Updated Invalid Date