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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]. To put that in perspective, the recommended daily intake for most men and women is 14–16 mg per day ( 9, 10). 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]. 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. What are the risks of taking 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]. 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 ( 10).Studies have shown that niacin flush benefits can include reduced LDL cholesterol, triglyceride levels and oxidative stress while increasing HDL cholesterol. 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 age 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] Age Cholesterol, high-density lipoprotein (HDL), serum. Mayo Clinic Laboratories. https://www.mayocliniclabs.com/test-catalog/overview/8429#Clinical-and-Interpretive. Accessed March 16, 2022. Niacin flush is a common side effect of taking high doses of niacin supplements. It’s uncomfortable, but it’s harmless.
High doses of nicotinic acid trigger a response that causes your capillaries to expand, which increases the flow of blood to the skin’s surface ( 1, 6, 7, 8). A niacin flush can be a temporary side effect of taking niacin; it’s also a protocol used by some physicians to lower lipid profiles and boost heart health. Niacin works to convert food into energy. Thus, niacin can provide you energy with food consumption. When should you not take niacin? As mentioned above, to avoid unwanted symptoms, including flushing, some people opt for extended-release or long-acting niacin.The study included 17 patients with hypercholesterolemia (high cholesterol) and low HDL cholesterol along with eight healthy control subjects. Overall, the study found that niacin supplementation decreased oxidative stress and triglyceride levels while significantly increasing HDL levels in the high cholesterol subjects. ( 6) 2. Can Increase Good Cholesterol 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. Hepatotoxic drugs, herbs and supplements. These drugs, herbs and supplements, like niacin, cause liver damage. In high doses, niacin also supports already-healthy cholesterol levels. It helps regulate the healthy ratio between low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Research has shown that high-dose nicotinic acid, at amounts that may cause flushing in some people, may help promote balance in already-healthy HDL and LDL cholesterol levels. Anticoagulant and anti-platelet drugs, herbs and supplements. These types of drugs, herbs and supplements reduce blood clotting. Taking niacin with them might increase your risk of bleeding.
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