Niacin (Vitamin B3)

    Written by:
    Kamal Patel
    Last Updated: October 13, 2024

    Niacin is an essential B-vitamin. Supplementation results in improved cholesterol and triglyceride levels. However, since a side-effect of supplementation is increased insulin resistance, niacin supplementation only provides benefits for cardiovascular health if precautions are taken.

    8 references on this page
    11,999 participants in 16 trials and 1 meta-analysis

    Summary

    Vitamin B3 refers to the molecule commonly called nicotinic acid, or niacin, though it may also refer to the other vitamin B3 vitamer, called nicotinamide. Vitamin B3 is necessary to support the function of many enzymes.

    Niacin supplementation is very effective at normalizing blood lipid levels. Supplementation increases HDL-C levels and decreases LDL-C and triglyceride levels. This makes niacin look like a great cardioprotective supplement on paper. Unfortunately, niacin supplementation does not reliably result in a reduced risk of cardiovascular disease, possibly because it also increases insulin resistance, which could negate the benefits niacin provides for blood lipid levels.

    Niacin supplementation is theorized to benefit cognition and longevity. This is because niacin supplementation increases cellular nicotinamide adenine dinucleotide (NAD+) levels. Preliminary evidence suggests increased NAD+ levels may result in the above benefits, but much more research is needed to determine if this effect actually occurs.

    Topical application of nicotinamide is sometimes used for skin health, though it is not as effective as vitamin A. Nicotinamide is used for topical application because it does not result in the flushed skin that niacin supplementation can cause.

    Current evidence suggests prolonged niacin supplementation increases insulin resistance because it hinders the ability of insulin to suppress glucose synthesis in the liver. This causes an increase in blood glucose levels, which leads to lowered insulin sensitivity over time, since the relevant receptor is eventually desensitized to the elevated glucose levels in the blood.

    The flush caused by niacin supplementation is a temporary effect. Though it may be uncomfortable, it is not harmful. There are many case studies describing people overdosing on niacin in an effort to pass a urine test. Niacin overdose results in multiple organ failure and is not effective at masking a urine test.

    What are other names for Niacin (Vitamin B3)?

    Note that Niacin (Vitamin B3) is also known as:

    • Niacin
    • Vitamin B3
    • Nicotinamide Riboside

    Niacin (Vitamin B3) should not be confused with:

    Dosage information

    Most of the benefits from niacin supplementation occur after doses of at least one gram. This is approximately 5,000% the recommended daily intake.

    Research Breakdown

    Examine Database References

    1. Low-density lipoprotein (LDL) - Westphal S, Borucki K, Taneva E, Makarova R, Luley CExtended-release niacin raises adiponectin and leptinAtherosclerosis.(2007 Aug)
    2. Low-density lipoprotein (LDL) - Kelly JJ, Lawson JA, Campbell LV, Storlien LH, Jenkins AB, Whitworth JA, O'Sullivan AJEffects of nicotinic acid on insulin sensitivity and blood pressure in healthy subjectsJ Hum Hypertens.(2000 Sep)
    3. Ketone Bodies - Chen X, Iqbal N, Boden GThe effects of free fatty acids on gluconeogenesis and glycogenolysis in normal subjectsJ Clin Invest.(1999 Feb)
    4. Insulin - Chang AM, Smith MJ, Galecki AT, Bloem CJ, Halter JBImpaired beta-cell function in human aging: response to nicotinic acid-induced insulin resistanceJ Clin Endocrinol Metab.(2006 Sep)
    5. Insulin - Fraterrigo G, Fabbrini E, Mittendorfer B, O'Rahilly S, Scherer PE, Patterson BW, Klein SRelationship between Changes in Plasma Adiponectin Concentration and Insulin Sensitivity after Niacin TherapyCardiorenal Med.(2012 Aug)
    6. Wound Healing - Gebicki J, Sysa-Jedrzejowska A, Adamus J, Woźniacka A, Rybak M, Zielonka J1-Methylnicotinamide: a potent anti-inflammatory agent of vitamin originPol J Pharmacol.(2003 Jan-Feb)
    7. Blood glucose - Valeria Nasser Figueiredo, Felipe Vendrame, Bruno A Colontoni, Thiago Quinaglia, Jose Roberto Matos-Souza, Filipe Azevedo Moura, Otavio R Coelho, Eliana C de Faria, Andrei C SpositoShort-term effects of extended-release niacin with and without the addition of laropiprant on endothelial function in individuals with low HDL-C: a randomized, controlled crossover trialClin Ther.(2014 Jun 1)
    8. Apolipoprotein B - T Sakai, V S Kamanna, M L KashyapNiacin, but not gemfibrozil, selectively increases LP-AI, a cardioprotective subfraction of HDL, in patients with low HDL cholesterolArterioscler Thromb Vasc Biol.(2001 Nov)
    9. Total cholesterol - No authors listedClofibrate and niacin in coronary heart diseaseJAMA.(1975 Jan 27)
    10. Stroke Risk - Jasleen K. Duggal, Mukesh Singh, Navneet Attri, Param P. Singh, Neyaz Ahmed, Suneet Pahwa, Janos Molnar, Sarabjeet Singh, Sandeep Khosla, Rohit AroraEffect of Niacin Therapy on Cardiovascular Outcomes in Patients With Coronary Artery DiseaseJournal of Cardiovascular Pharmacology and Therapeutics.()
    11. High-density lipoprotein (HDL) - Blond E, Rieusset J, Alligier M, Lambert-Porcheron S, Bendridi N, Gabert L, Chetiveaux M, Debard C, Chauvin MA, Normand S, Roth H, de Gouville AC, Krempf M, Vidal H, Goudable J, Laville M, “Niacin” Study GroupNicotinic acid effects on insulin sensitivity and hepatic lipid metabolism: an in vivo to in vitro studyHorm Metab Res.(2014 Jun)
    12. Apolipoprotein A - AIM-HIGH Investigators, Boden WE, Probstfield JL, Anderson T, Chaitman BR, Desvignes-Nickens P, Koprowicz K, McBride R, Teo K, Weintraub WNiacin in patients with low HDL cholesterol levels receiving intensive statin therapyN Engl J Med.(2011 Dec 15)
    13. Apolipoprotein B - Fabbrini E, Mohammed BS, Korenblat KM, Magkos F, McCrea J, Patterson BW, Klein SEffect of fenofibrate and niacin on intrahepatic triglyceride content, very low-density lipoprotein kinetics, and insulin action in obese subjects with nonalcoholic fatty liver diseaseJ Clin Endocrinol Metab.(2010 Jun)
    14. Erythema - Bissett DL, Oblong JE, Berge CANiacinamide: A B vitamin that improves aging facial skin appearanceDermatol Surg.(2005 Jul)
    15. Skin Quality - Hakozaki T, Minwalla L, Zhuang J, Chhoa M, Matsubara A, Miyamoto K, Greatens A, Hillebrand GG, Bissett DL, Boissy REThe effect of niacinamide on reducing cutaneous pigmentation and suppression of melanosome transferBr J Dermatol.(2002 Jul)
    16. Acne Symptoms - Khodaeiani E, Fouladi RF, Amirnia M, Saeidi M, Karimi ERTopical 4% nicotinamide vs. 1% clindamycin in moderate inflammatory acne vulgarisInt J Dermatol.(2013 Aug)
    17. Acne Symptoms - Shalita AR, Smith JG, Parish LC, Sofman MS, Chalker DKTopical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgarisInt J Dermatol.(1995 Jun)