Dietary supplements Do not crush, break, or chew it. This content does not have an Arabic version. However, supplemental forms are sometimes recommended to treat certain medical conditions, including high cholesterol. Hartnup disease is a rare genetic disorder involving the renal, intestinal, and cellular transport processes for several amino acids, including tryptophan. However, if needed to prevent or treat niacin deficiency, niacin is likely safe to take during pregnancy and in breast-feeding women when used in recommended amounts . Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Niacin side effects can include a niacin flush, which is when someone temporarily experiences red, warm and tingling burning and/or itchy skin after taking a niacin supplement. 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. [, Li R, Yu K, Wang Q, Wang L, Mao J, Qian J. Pellagra secondary to medication and alcoholism: A case report and review of the literature. This article looks at the use of niacin and its different forms. 2017;377:544. Niacin can cause an excess of uric acid in the blood (hyperuricemia), putting you at risk of gout. Niacin Overdose: Is It Possible? Experts Explain | Care/of This can occur when taking 3050 mg or more of supplemental niacin in a single dose. 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]. Review/update the 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]. Many breads, cereals, and infant formulas in the United States and many other countries contain added niacin. doi:10.1001/jamanetworkopen.2020.31669, Ding Y, Li Y, Wen A. However, results are mixed (15, 16). Methods in Enzymology 1997;280:221-30. http://www.wolterskluwercdi.com/facts-comparisons-online/. However, healthcare providers sometimes prescribe niacin for those who can not tolerate statins. No functional biochemical tests that reflect total body stores of niacin are available [5]. [, Fulgoni III VL, Keast DR, Bailey RL, Dwyer J. Present Knowledge in Nutrition, 10th ed. 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]. [, Keenan JM. Coronary drug project: Experience with niacin. NDI 1259 B-Nicotinamide Mononucleotide (NMN) from Inner Mongolia Kingdomway Pharmaceutical Limited. 2021;4(1):e2031669. Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or doctor. The two most common forms of niacin in food and supplements are nicotinic acid and nicotinamide. 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]. If this medicine upsets your stomach, it may be taken with meals or milk. Vitamin B3 Vitamin B3 Uses The body uses the water-soluble vitamin B3 in the process of releasing energy from carbohydrates. Swallow the tablet whole. As with all B vitamins, niacin helps convert food into energy by aiding enzymes. Niacin is found in a variety of foods, especially meat, poultry, fish, nuts, and legumes. In addition, isoniazid can interfere with niacin's conversion to NAD [43]. Your brain needs niacin as a part of the coenzymes NAD and NADP to get energy and function properly. Supplement use doubled or tripled total niacin intakes compared with intakes from diet alone. Accessed Aug. 9, 2017. When taken orally in appropriate amounts, niacin appears to be safe. For oral dosage form (extended-release tablets): Adults and children older than 16 years of ageAt first, 500 milligrams (mg) per day, taken at bedtime. Fast Lean Pro Reviews (Customer Scam Alert 2023) Safe Ingredients Or Niacin: Myths and Facts - Cholesterol - HealthCentral Updated on January 26, 2023 4 min read Think you can't overdose on B vitamins because the body just gets rid of what it doesn't use? Use Caution/Monitor. High doses can cause serious side effects. Even when taken in very high doses of 34 g, niacin is almost completely absorbed. These side effects may be common or severe. 2020;16(S9). When taken at prescription-level doses, niacin has been shown to improve "good" HDL cholesterol . Penberthy WT, Kirkland JB. The most common niacin supplement side effect is skin flushing. Nutr Rev 2012;70:357-66. There are more than 400 enzymes in the body that require NAD for performing functions like: In addition, some people take niacin for the benefits related to specific health conditions, including heart disease, Alzheimer's disease, high blood pressure, and diabetes. 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]. In those with carcinoid syndrome, tryptophan is preferentially oxidized to serotonin and not metabolized to niacin [2]. It causes a reddening of the skin along with burning or itching sensations. It is needed to form fat from carbohydrates and to process alcohol. However, consuming a supplement like niacin may have potential side effects. Vitamin B3 (Niacin) Information | Mount Sinai - New York Although pellagra can occur in patients with tuberculosis treated with isoniazid, it can be prevented with increased intakes of niacin. When NAD and NADP are consumed in foods, they are converted to nicotinamide in the gut and then absorbed [4]. Niacin is one of the eight B vitamins, and its also called vitamin B3 (1). Niacin: Side Effects, Dosage, Uses, and More - Healthline information highlighted below and resubmit the form. However, niacin is only effective as a cholesterol treatment at fairly high doses. The FDA does not require food labels to list niacin content unless niacin has been added to the food. Niacin. information and will only use or disclose that information as set forth in our notice of Avoid drinking alcohol or hot drinks or eating spicy foods around the time you take Niaspan. If you have side effects, you may want to try a different formula or start with a smaller dose. In fact, brain fog and even psychiatric symptoms are associated with niacin deficiency (1, 13). Do not keep outdated medicine or medicine no longer needed. If you consume more than this amount or more than what is recommended by your healthcare provider, you may experience the severe side effects listed above. Food Labeling: Revision of the Nutrition and Supplement Facts Labels. They do not include the contribution of tryptophan, some of which is converted to NAD in the body. 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. Cochrane Database of Systematic Reviews. After 4 weeks, your doctor will increase your dose to 1000 mg per day, taken at bedtime. However, if needed to prevent or treat niacin deficiency, niacin is likely safe to take during pregnancy and in breast-feeding women when used in recommended amounts. Taking niacin also might worsen allergies, gallbladder disease and symptoms of certain thyroid disorders. Niacin. This is a fact sheet intended for health professionals. Niacin is one of eight water-soluble B vitamins. The key role of niacin in your body is to synthesize the coenzymes nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP), which are involved in over 400 biochemical reactions in your body mainly related to obtaining energy from the food you eat (1). Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine. The Gale Encyclopedia of Alternative Medicine, third edition, 2009. Cochrane Database of Systematic Reviews. 2012;70(6):357-66. doi:10.1111/j.1753-4887.2012.00479.x. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. If you're pregnant, don't take prescription niacin for high cholesterol. Niacin can interact with certain medications, and several types of medications might adversely affect niacin levels. Fatigue. [, Shahbazian H, Mohtashami AZ, Ghorbani A, Abbaspour MR, Musavi SSB, Hayati F, Lashkarara GR. ER nicotinic acid is released into the body more slowly than the IR type. Again, scientists did this research on animals, and therefore, it is uncertain whether these results apply to humans. Niacin is water-soluble, which means it is quickly absorbed in water and available for immediate use by your body. Preliminary research shows that it could also help keep the brain healthy in cases of Alzheimers disease. Since those with diabetes tend to have high fat levels in their blood, researchers have looked at whether niacin could affect type 2 diabetes. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. 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]. Niacin: Uses, Side Effects, Dosage & Reviews - GoodRx Carcinoid syndrome is caused by slow-growing tumors in the gastrointestinal tract that release serotonin and other substances. Copyright 2005. J Am Coll Cardiol 1986;8:1245-55. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Each form can affect your body differently. For this reason, SR nicotinic acid comes with the risk of vitamin toxicity, which can lead to liver damage. One role of niacin is to release prostaglandins, or chemicals that help your blood vessels widen improving blood flow and reducing blood pressure. Niacin, or vitamin B3, is an essential nutrient, which aids your metabolism and nervous system and which you must obtain through your 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 -- yourhealth careprovider might recommend taking niacin along withaspirinand avoiding alcohol and spicy foods. The Recommended Daily Allowance (RDA) for niacin depends on your age and gender. These values, which vary by age and sex, include: Table 1 lists the current RDAs for niacin as mg of niacin equivalents (NE) [2]. However, your body does not store niacin, so you should consume it regularly. Medically reviewed by Drugs.com. To avoid toxicity, be aware of the appropriate dosage and keep the tolerable upper limit in mind. Niacin is one of 8 types of B vitamins important for every part of your body. 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. Pellagra is uncommon in industrialized nations. There are two chemical forms of niacin: nicotinic acid and niacinamide (nicotinamide). The memory-related symptoms can be severe and lead to aggression, paranoia, hallucinations, and even suicide. The niacin form of vitamin B3 also regulates cholesterol, though niacinamide does not. Immediate-release (IR) nicotinic acid is also known as "fast-release." This form releases nicotinic acidover a period of time rather than all at once. Niacin supplements are available in several different forms. Jennifer Moll, MS, PharmD, is a pharmacist actively involved in educating patients about the importance of heart disease prevention. 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 acids flushing effect and therefore improve treatment compliance or a matching placebo for a median of 4 years [30,31]. Researchers measured participants' recalled dietary niacin intake over three consecutive 24-hour periods. If not, you may want to speak with a healthcare professional about supplementation. In adults, the average daily niacin intake from foods and beverages was 31.4 mg in men and 21.3 mg in women. Medicine. Most people get enough niacin from food. Nicotinamide supplements are used to treat skin conditions and niacin deficiencies. https://naturalmedicines.therapeuticresearch.com. Keep from freezing. The results also showed that patients taking niacin had an increased risk of ischemic stroke. All rights reserved. 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. Deficiency is characterized by skin problems, memory loss, and digestive problems. Since niacin can be used in different ways, talk to your health care provider about the best dosage for you. Nicotinic acid and nicotinamide are the two most common forms of niacin in supplements. Niacin is water-soluble so that excess amounts the body does not need are excreted in the urine. If you stop taking this medicine for any period of time, contact your doctor prior to restarting taking niacin. However, supplemental doses can have various side effects, including nausea, vomiting, and liver toxicity (1). Niacin is LIKELY SAFE for most people when taken by mouth. 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]. Melmed S, et al. Using the best form of vitamin B3: niacin vs nicotinamide [, HPS2-THRIVE Collaborative Group. Vitamin B3 (Niacin) Vitamin B3 is one of 8 B vitamins. Speak with a healthcare professional before you start taking a niacin supplement. All rights reserved. Think again! Prescription niacin is used to reduce the levels of cholesterol and triglycerides (fatty substances) in your blood, and decrease your risk of a heart attack. Institute of Medicine. Niacin is available in animal-based foods, plant-based foods, and grains. Dietary supplements are not regulated in the United States, meaning the Food and Drug Administration does not approve them for safety and effectiveness before products are marketed. Nutrients 2017;August 9. Niacin is known to reduce LDL cholesterol and triglycerides. Includes a variety of protein foods such as lean meats; poultry; eggs; seafood; beans, peas, and lentils; nuts and seeds; and soy products. Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs. J Nutr 1989;119:1949-55. Niacin is a vitamin that acts as an antioxidant and plays a role in cell signaling and DNA repair. The meta-analysis of randomized controlled trials with 2,110 participants found a reduction in LDL cholesterol levels. On one hand, it can help lower the high cholesterol levels that are often seen in people with type 2 diabetes. There is a problem with 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. Participants' mean intake level was 14.8 mg per day (mg/d). 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). Nicotinamide is a water-soluble form of vitamin B3 or niacin. Wax-matrix extended-release niacin vs inositol hexanicotinate: A comparison of wax-matrix, extended-release niacin to inositol hexanicotinate no-flush niacin in persons with mild to moderate dyslipidemia. [, Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. However, research is limited, and insufficient evidence supports it for these uses. 2017;2017(6). Everyone needs niacin, but most people can get enough from their diet alone. Researchers looked at how niacin affected diseased mouse brains in the study. this form can be taken twice a day in smaller doses. National Library of Medicine. Sci Transl Med. Schandelmaier S, Briel M, Saccilotto R, Olu KK, Arpagaus A, Hemkens LG, Nordmann AJ. Many products are also fortified with niacin during manufacturing. Nutr Rev 2017;75:471-90. Large doses of nicotinic acid can raise blood glucose levels by causing or aggravating insulin resistance and increasing hepatic production of glucose [43]. 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]. While there is such a thing as bad cholesterol, good cholesterol is actually important for heart health. History of changes to this fact sheet, U.S. Department of Health & Human Services, Division of Program Coordination, Planning, and Strategic Initiatives, Strengthening Knowledge and Understanding of Dietary Supplements, My Dietary Supplement and Medicine Record, Analytical Methods and Reference Materials (AMRM), NIH Consortium for Advancing Research on Botanical and Other Natural Products (CARBON) Program, Computer Access to Research on Dietary Supplements (CARDS) Database, Dietary Supplement Ingredient Database (DSID), ODS Participation in NIH Funding Initiatives, Administrative Supplements for Research on Dietary Supplements, Administrative Supplements for Validation Studies of Analytical Methods, Frequently Asked Questions About ODS Grants & Co-funding, Resources for Investigators Submitting Natural Products Research Grant Applications, Staff Bios, Publications, and Presentations, Federal Working Group on Dietary Supplements, NIH Dietary Supplement Research Coordinating Committee. As a treatment, higher amounts of niacin can improve cholesterol levels. Review/update the Mayo Clinic does not endorse companies or products. The recommended daily amount of niacin for adult males is 16 milligrams (mg) a day and for adult women who aren't pregnant, 14 mg a day. 2016;102(3):198-203. doi:10.1136/heartjnl-2015-308055. People use prescription niacin (Niacor, Niaspan) to help control their cholesterol. Even when taken in very high doses of 3-4 g, niacin is almost completely absorbed. Niacin deficiency can cause diarrhea, confusion ( dementia ), tongue redness/swelling, and peeling red skin. MacKay D, Hathcock J, Guarneri. The second review examined 13 randomized controlled trials with 35,206 participants with, or at risk of, atherosclerotic cardiovascular disease [33]. Niacinamide ( nicotinamide ) is a form of vitamin B3. Bourgeois C, Moss J. Niacin. 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.