Table of Contents
Niacin is a form of vitamin B3 made in the body from tryptophan. It’s discovered in many foods consisting of meat, fish, milk, eggs, green veggies, and cereals.
Niacin is needed for the correct function of fats and sugars in the body and to keep healthy cells. At high doses, niacin might help individuals with cardiovascular disease because of its effects on blood clotting. It may likewise enhance levels of fats called triglycerides in the blood.
Prescription forms of niacin are authorized by the US FDA for irregular cholesterol levels and for preventing vitamin B3 deficiency and related conditions such as pellagra. People utilize niacin supplements for metabolic syndrome, heart disease, cataracts, high blood pressure, and lots of other conditions, but there is no good clinical proof to support the majority of these other usages.
Do not confuse niacin with NADH, niacinamide, inositol nicotinate, IP-6, or tryptophan. These are not the exact same. 
History of pellagra
Pellagra was unidentified to the doctors of the ancient world and the Middle Ages. It was initially described by the physician Gaspar Casal in Spain in 1735, right after the maize was introduced into Europe. The name of the illness was established in 1771 by an Italian physician Francesco Frapolli.
Due to the excellent boost in using maize in northern part of Italy, pellagra ended up being so widespread that an unique healthcare facility (referred to as Legano) was built in 1784, exclusively for pellagra clients. Reports on the occurrence of pellagra appeared quickly afterwards in France (1829 ), Romania (1858) and Egypt (1874 ).
After 1900 pellagra ended up being a significant health problem in the United States too, particularly in the South. It carefully followed the intro of a brand-new grain processing method that got rid of the majority of the vitamins from processed grain. There was a specific shift from the use of coarsely ground corn meal in regional, water-driven mills to finely bolted meal by large milling companies.
The break outs of pellagra were so common and extreme that a majority of doctors thought about the cause to be a transmittable agent. The true nature of disease was figured out when the Federal Government of the United States sent a doctor from New York, Joseph Goldberger, to study the disease.
The discovery of niacin
Nicotinic acid was synthesized in 1867 by oxidation of nicotine and commonly utilized in photography. It was long idea that it has nothing to do with food or health problems, until German scientists demonstrated that nicotinic acid happens in yeast and in rice polishing. There it was isolated by the Polish-American.
biochemist Casimir Funk in 1912, while he was looking for a remedy for another disease known as beriberi (dietary condition triggered by a shortage of thiamine).
Since nicotinic acid had no impact on beriberi, he deserted his deal with that compound. However although he was wrong, he showed that this nicotinic acid probably had some dietary worth. It was delegated the Austrian-American physician Joseph Goldeberger to find the connection in between nicotinic acid and deficiency illness it can cause.
In 1915, Goldberger carried out a series of experiments on 11 healthy volunteer prisoners in a Mississippi jail and discovered that he might induce pellagra by changing their diets. He concluded that the disease was triggered by the lack of some factor that was doing not have in corn, however that could be found in meat and milk. He named it the P-P (for pellagra-preventative) aspect.
The chemical structure of that element was consequently found in 1937 by the American biochemist Conrad Arnold Elvehjem. He induced a black tongue in pets by feeding them the Goldberger diet, and then treated the disease by supplementing their diet plan with nicotinic acid. He likewise isolated the P-P aspect from active liver extracts, showing that this element is in fact nicotinic acid (subsequently called niacin for nicotinic acid vitamin).
After this discovery, grain items (wheat, maize) were improved with nicotinic acid or nicotinamide. Still, a large scale social reform was needed to make sure proper application of such dietary adjustments. The majority of sporadic cases in the developed countries are now seen in alcoholics, although in unusual circumstances other clients can establish the illness too (i.e. malabsorption or iatrogenic circumstances). 
In addition to soaking up niacin from diet, niacin can be manufactured from the important amino acid tryptophan, a five-step process with the penultimate compound being quinolinic acid (see figure). Some bacteria and plants make use of aspartic acid in a path that also goes to quinolinic acid. For humans, the effectiveness of conversion is approximated as requiring 60 mg of tryptophan to make 1 mg of niacin. Riboflavin, vitamin B6 and iron are required for the procedure. Pellagra is a consequence of a corn-dominant diet plan since the niacin in corn is inadequately bioavailable and corn proteins are low in tryptophan compared to wheat and rice proteins.
Nicotinic acid was first synthesized in 1867 by oxidative deterioration of nicotine. Niacin is prepared by hydrolysis of nicotinonitrile, which, as described above, is produced by oxidation of 3-picoline. Oxidation can be effected by air, however ammoxidation is more effective. In the latter process, nicotinonitrile is produced by ammoxidation of 3-methylpyridine. Nitrile hydratase is then utilized to catalyze nicotinonitrile to nicotinamide, which can be converted to niacin. Alternatively, ammonia, acetic acid and paraldehyde are used to make 5-ethyl-2-methyl-pyridine, which is then oxidized to niacin.  New “greener” catalysts are being checked utilizing manganese-substituted aluminophosphates.
that usage acetyl peroxyborate as non-corrosive oxidant, avoiding producing nitrogen oxides as do conventional ammoxidations.
The demand for industrial production includes for animal feed and for food fortification meant for human consumption. According to Ullmann’s Encyclopedia of Industrial Chemistry, around the world 31,000 lots of nicotinamide were offered in 2014. 
System of action
Niacin performs a variety of functions in the body therefore has lots of mechanisms, not all of which have been totally explained. Niacin can decrease lipids and apolipoprotein B (apo B)- including lipoproteins by regulating triglyceride synthesis in the liver, which breaks down apo B, or by modulating lipolysis in fat.
Niacin inhibits hepatocyte diacylglycerol acyltransferase-2. This action prevents the last step of triglyceride synthesis in hepatocytes, restricting available triglycerides for very low density lipoproteins (VLDL). This activity also causes intracellular deterioration of apo B and decreased production of low density lipoproteins, the catabolic item of VLDL.
Niacin also prevents a high density lipoprotein (HDL) catabolism receptor, which increases the levels and half life of HDL. 
Yellowfin tuna: 18.8 mg, 117% daily value (dv)
While tuna is an exceptional source of niacin, bigger ranges like yellowfin or albacore tend to be higher in mercury than smaller species like skipjack.
A cooked, 3-ounce filet of prepared yellowfin tuna provides 117 percent of the dv for niacin, plus 83 percent of the dv for vitamin b12, which is needed for energy.
Beef liver: 14.7 mg, 92% dv
Ok, so we don’t anticipate you to eat beef liver on a daily basis, but the organ meat is an excellent source of b vitamins, consisting of niacin. One piece of fried beef liver provides an outstanding 92 percent of the dv for niacin. It’s also swarming with vitamin a, iron and zinc.
Turkey breast: 10 mg, 62% dv
Turkey is often promoted as the main source of tryptophan, but in truth, lots of animal proteins (consisting of eggs, chicken and cheese) provide the necessary amino acid, according to the u.s. National library of medicine.
So, you’ll probably get even more than 62 percent of the dv for niacin from this 3-ounce serving of roasted turkey breast thanks to the conversion of some of its tryptophan to nad in the body. However in order for the amino acid to be transformed into niacin, the body must have sufficient levels of other nutrients, like iron, b6 and riboflavin.
Sockeye salmon: 8.6 mg, 54% dv
Niacin-rich sockeye salmon is also an exceptional source of anti-inflammatory omega-3 fats.
In addition to offering anti-inflammatory omega-3 fatty acids and vitamin d, prepared salmon is also an exceptional source of niacin, with 54 percent of the dv present in a 3-ounce serving.
Chicken breast: 8 mg, 50% dv
Three ounces of cooked chicken breast can dish out half of the dv for niacin, plus 27 grams of satisfying protein.
If you’re feeling unimaginative by poultry, attempt cooking up these healthy chicken dishes you have not tried yet (we assure they will not dissatisfy).
Portobello mushrooms: 7.6, 47% dv
For a niacin-rich meal, toss portobello mushrooms on the grill together with your protein of option. One cup of grilled portobello mushrooms provides 47 percent of the dv for niacin, considering them a few of the best vegetarian foods high in niacin.
Pork chops: 6.8 mg, 42% dv
A pork slice can serve up nearly half of your everyday niacin needs.
Though fattier than other cuts like the tenderloin (which is the leanest cut of pork), chops are a great natural source of niacin. A 3-ounce, prepared pork slice delivers 42 percent of the dv for niacin.
Wild rice: 5.2 mg, 32% dv
It’s safe to say that wild rice is among the vegetarian foods greatest in niacin. You’ll get 33 percent of the dv for vitamin b3 in 1 cup of prepared wild rice. You’ll likewise get almost 6 grams of protein and 3 grams of fiber from the entire grain.
Set plant-based protein sources like wild rice with black beans for a complete protein that provides all nine of the vital amino acids.
Canned white tuna: 4.9 mg, 31% dv
The american heart association recommends eating fish a minimum of 2 times per week to keep a healthy heart. Simply be sure to practice moderation when it concerns canned tuna ranges like albacore or white tuna.
Though abundant in niacin– 3 ounces of canned white tuna offers 31 percent of the dv for the b vitamin– these ranges tend to be higher in mercury compared to smaller species like skipjack tuna, per the united states environmental protection agency (epa). Attempt the seafood in these non-salad canned tuna dishes.
Steak: 4.8 mg, 30% dv
Iron-rich skirt steak likewise dishes out vitamin b3.
Grilled skirt steak is a high-protein source of niacin, with a 3-ounce serving offering 30 percent of the dv for the nutrient.
Beef is also high in minerals like iron, which supports healthy blood cell development and oxygen shipment throughout the body, according to the university of california san francisco health.
Peanuts: 4.1 mg, 25% dv
If you’re searching for vegan foods high in niacin, 1 ounce of dry-roasted peanuts supplies 25 percent of the dv. The vegetables are also abundant in unsaturated fats that support healthy lipid levels. Pb&& j, anyone?
Fortified breakfast cereals: 4 mg, 25% dv
It’s hard to state precisely how much niacin you’ll get from a prepared breakfast cereal, as different products provide various amounts of the b vitamin, but approximates variety anywhere from 20 to 27 percent of the dv per 1 cup, according to oregon state university.
Baked potato: 2.6 mg, 17% dv
Potatoes are a top quality carb that not just provide niacin however likewise deliver potassium and vitamin c.
Can all of us accept offer routine old russet potatoes more like? Sure, sweet potatoes are high in the antioxidant beta-carotene, but one medium baked russet potato delivers 17 percent of the dv for niacin, plus potassium and vitamin c.
White rice (enriched): 2 mg, 13% dv
Though wild rice is a much better source of niacin, enriched white rice isn’t too far behind. A 1/2-cup serving of cooked, enriched white rice puts 13 percent of the dv for niacin on the table.
Just like prepared foods, enriched foods have nutrients added to them. The distinction here is that the added nutrients were initially in the food, but stripped away throughout processing.
Lentils: 2.1 mg, 13% dv
Replacing animal proteins like meat with legumes like lentils (along with other plant-based proteins like nuts and soy) is connected with a lower risk of coronary heart disease, per a large potential mate study published in december 2020 in the british medical journal.
One cup of prepared lentils contains 13 percent of the dv for niacin. The pulses are also a terrific source of non-heme iron, folate and resistant starch, per the harvard t.h. Chan school of public health.
Sunflower seeds: 2 mg, 12% dv
An ounce of dry-roasted sunflower seeds can bring you 12 percent of the dv for niacin. Spray them on top of salads or blend them into entire grains like farro for a satisfying crunch.
Bulgur: 1.8 mg, 11% dv
A cup of prepared bulgur supplies 11 percent of the dv for niacin, plus minerals like iron, magnesium and manganese. Whip up a batch of the entire grain for the week, then utilize it in different dishes like grain bowls, soups and salads.
Avocado: 1.7 mg, 11% dv
An excellent source of heart-healthy monounsaturated fats, avocado is also a solid vegetarian source of niacin. A half of an avocado includes 11 percent of the dv for the vitamin. Of course, we ‘d never ever restrict you to just a half of an avocado.
Don’t miss out on these inventive and tasty ways to eat avocado that exceed your basic guac or avo toast.
Whole-wheat bread: 1.4 mg, 9% dv
Entire grains are among the healthiest plant sources of niacin and whole wheat bread is no exception. One slice of entire wheat bread can provide nearly 10 percent of the dv for niacin. Top your toast with peanut butter and a spray of sunflower seeds for a satisfying snack.
Pumpkin seeds: 1.3 mg, 8% dv
Niacin-rich pumpkin seeds in a little wooden bowl.
Not just are pumpkin seeds a great source of niacin, they’re also a nourishing way to add crunch to meals.
Magnesium-rich pumpkin seeds are also a good-for-you source of niacin. One ounce of shelled, salted pumpkin seeds consists of 8 percent of the dv for vitamin b3.
Spray them on salads or your early morning oatmeal bowl for additional texture– and nutrients.
Banana: 0.9 mg, 6% dv
By now you understand that there are plenty of vitamin b3 fruits and vegetables– and bananas make the cut. One big banana dishes out 6 percent of the dv for niacin.
Go on and include the fruit to your cereal bowl with a spoonful of peanut butter and a (spoiler alert) cup of coffee on the side for a healthy, high-niacin start to the day.
Coffee: 0.5 mg, 3% dv
While coffee isn’t sky-high in vitamin b3, 1 cup of joe can deliver about 3 percent of the DV for niacin. 
Advantages of niacin
While more research studies require to be conducted and supporting evidence needs to be identified, there are a range of uses for niacin. In terms of health advantages, niacin potentially can:.
- Control cholesterol
- Lower blood pressure
- Improve mental health
- Clear skin
- Manage migraines
- Promote joint health
- Safeguard cognitive function
- Support digestion
- Lessen birth defects
- Improve impotence
It assists control cholesterol levels
Often niacin is recommended together with cholesterol-lowering medications like statins to assist normalize blood lipid levels. It can increase high-density lipoprotein (hdl) cholesterol, which is the healthy type of.
Cholesterol, by 15% to 35%. And it can decrease low-density lipoprotein (ldl), the bad cholesterol, by 5% to 25%.
Other proof indicates that niacin is good for individuals with an increased threat of cardiovascular disease and heart problem since it not only lowers ldl cholesterol but likewise triglycerides. Niacin can reduce triglyceride levels by 20% to 50%. The prescription solutions niaspan and niacor have fda approval to treat dyslipidemia (raised cholesterol or other fats in the blood).
It may decrease high blood pressure
Little scientific trials of using niacin have actually revealed it has considerable blood pressure reducing effects in individuals with hypertension. In addition, sudden lowering of high blood pressure is described in the plan insert of prescription niacin. However, in bigger clinical trials involving niacin and niacin-containing programs there revealed either no clear considerable impacts of niacin or a little lower mean high blood pressure amongst some niacin treatment groups compared with placebo.
More studies need to be done to identify how effective niacin can be for reducing high blood pressure and reducing the risk of cardiovascular occasions, however up until now the research study appears appealing.
It may improve mental health
Dietary routines have a substantial impact on lots of mental illness including depression, anxiety, schizophrenia, and bipolar affective disorder. This has actually caused the development of nutritional guidelines to help manage these conditions. Niacin shortage has shown a possible link to some mental illness.
Studies have recorded minimized cerebral blood flow in depressed clients and improved cerebral blood flow following antidepressant treatment. Niacin is believed to increase cerebral blood circulation, so there is possible to use niacin supplementation in addition to prescription antidepressants.
It benefits the skin
Niacin is an excellent supplement for the skin. It can help safeguard skin cells from sun damage, clear acne when used topically, and reduce soreness and inflammation. Vitamin b3 in the formulation of niacinamide is often used as a natural topical skincare treatment to clear acne. Niacin can even help manage inflammatory skin conditions like bullous pemphigoid or granuloma annulare.
It may assist handle migraines
Although it’s uncertain how niacin achieves therapeutic results, it could be helpful for migraine and tension-type headaches and the avoidance of these headaches. Niacin may prevent migraine signs by expanding the intracranial vessels and following contractions of the extracranial vessels.
It promotes joint health
Vitamin b3 in the form of niacinamide has actually been revealed to increase joint movement and reduce joint pain, swelling, and swelling. Because of its anti-inflammatory effect on joints, niacin may serve as an excellent treatment option for individuals with arthritis.
It might secure against alzheimer’s disease
In a research study released by the journal of neurology, neurosurgery, and psychiatry, dietary niacin was concluded to be a possible protector against alzheimer’s illness and age-related cognitive decrease. A greater intake of niacin might be connected with a slower rate of cognitive decrease in time.
It’s good for food digestion
Niacin is excellent for the digestion system because vitamin b3 helps break down nutrients like carbs and fats into energy. If someone lacks niacin, they may have a tough time digesting food and might experience intestinal issues with time.
It might prevent abnormality
According to a 2017 research study published by the brand-new england journal of medication, niacin supplements during pregnancy avoided malformations in mice. More human studies need to be done, but preliminary research study indicates that niacin may help avoid nicotinamide adenine dinucleotide (nad) abnormality in humans and lower total birth defect rates.
On the other hand, caution is recommended for niacin supplementation while breastfeeding, as there is restricted human data on the impacts of niacin in breastmilk. New or expecting mothers need to always speak with their healthcare provider before presenting brand-new supplements or medications during pregnancy or lactation.
It may improve erectile dysfunction
Erectile dysfunction (ed) is the failure to get or keep an erection. Due to the fact that niacin assists enhance blood circulation, it might also be good for impotence. In a research study published by the journal of sexual medication, a day-to-day dose of up to 1,500 mg of niacin sufficed to improve sexual function amongst males who had both ed and dyslipidemia. Men with dyslipidemia were studied due to the fact that dyslipidemia is closely related to ed. 
Etiology of niacin deficiency
Main niacin deficiency
It results from extremely inadequate intake of both niacin and tryptophan, which normally occurs in locations where maize (indian corn) constitutes a substantial part of the diet. Bound niacin, discovered in maize, is not assimilated in the gastrointestinal system unless it has actually been previously treated with alkali, as when tortillas are prepared. Corn protein is also lacking in tryptophan. The high incidence of pellagra in india amongst people who eat millet with a high leucine material has actually caused the hypothesis that amino acid imbalance may add to deficiency. Shortages of protein and lots of b vitamins typically accompany main niacin deficiency.
Secondary niacin deficiency
It may be because of diarrhea, cirrhosis, or alcoholism. Pellagra also may take place in carcinoid syndrome (tryptophan is diverted to form 5-hydroxytryptophan and serotonin) and in hartnup illness (absorption of tryptophan by the intestine and kidneys is defective). 
Reasons for niacin shortage
One type of niacin deficiency results from a shortage of niacin and tryptophan (an amino acid). This kind triggers a disorder called pellagra, which affects the skin, digestion system, and brain. Pellagra establishes only if the diet plan lacks niacin and tryptophan since the body can transform tryptophan to niacin. People who reside in areas where maize (indian corn) is the primary food source are at risk of establishing pellagra because maize is low in niacin and tryptophan. In addition, the niacin in maize can not be soaked up in the intestinal tract unless the maize is treated with alkali (as it is when tortillas are
Prepared). Pellagra may be a seasonal condition, appearing each spring and lasting through the summer season, when the diet consists mainly of maize items.
Pellagra likewise develops in individuals who have among the following:
- Hartnup disease, an unusual hereditary condition in which absorption of tryptophan is impaired
- Carcinoid syndrome, a rare disorder in which tryptophan is not transformed to niacin
The following can lead to a shortage of niacin:
- Alcohol addiction
- The antibiotic isoniazid if considered a long period of time
Signs of niacin shortage
Typically, individuals with pellagra develop a symmetric, dark red rash that resembles a sunburn and becomes worse when it is exposed to sunlight (a condition called photosensitivity). The rash takes place in areas of sun exposure, and its location is distinct:
- On the arms and hands (like gloves)
- On the feet and calves (like boots)
- Around the neck (like a pendant)
- On the face forming a butterfly shape
Skin irregularities are relentless, and the impacted locations might become brown and flaky.
The whole digestion system is affected. The tongue and mouth might become irritated and dark red. The tongue might swell, the mouth might burn, and sores may develop on both. The throat and esophagus might likewise burn. Saliva production may increase. Other signs consist of nausea, vomiting, stomach discomfort, irregularity, and diarrhea (which may be bloody).
Later, tiredness, insomnia, and lethargy establish. Malfunction of the brain (encephalopathy) usually follows. It is identified by confusion, disorientation, hallucinations, and amnesia. People might be overexcited, depressed, exceptionally elated (manic), delirious, or paranoid (believing that people mean to damage them). 
In early shortage, medical diagnosis requires a high index of suspicion and efforts at confirmation of niacin deficiency. Niacin metabolites, especially n-methylnicotinamide, can be determined in the urine. Low levels recommend niacin shortage however may likewise be found in clients with generalized under-nutrition. Serum and red cell levels of nad and nadp are also low however are similarly nonspecific. In advanced cases, the medical diagnosis of pellagra can be made on medical grounds. 
Typically a niacin deficiency may indicate several nutritional deficiencies; for that reason, a balanced diet plan is a strong suggestion. Nicotinamide doses of 250 to 500 mg/day orally need to be given. Regardless of nicotinic acid being the more typical form of niacin, nicotinamide is used for niacin deficiencies as it does not trigger signs such as tingling experience, itching, or flushing. Patients with pellagra should prevent sun exposure and alcohol consumption. The recommended dietary allowance (rda) for niacin is expressed as niacin equivalents (ne). The rda for children ages 1 to 3 and 4 to 8 years of age is 6 and 8 mg/day of ne. For both young boys and women ages 9 to 13, the rda is 12 mg/day of ne. For people 14 years or older, the rda is 16, and it is 14 mg/day of ne for males and women, respectively. Rda throughout lactation is 17 mg/day of ne. 
Niacin side effects
Niacin oral tablet doesn’t trigger sleepiness, but it can cause opposite results.
More common adverse effects
A few of the more common negative effects of niacin can consist of:.
- Reddening and warming of your face (flushing)
- Increased cough
If these effects are moderate, they might go away within a couple of days or a couple of weeks. If they’re more severe or don’t disappear, speak to your doctor or pharmacist.
Major side effects
Call your medical professional immediately if you have major negative effects. Call 911 if your signs feel deadly or if you think you’re having a medical emergency. Severe negative effects and their symptoms can include the following:.
- Muscle issues. Signs can include:
- Unusual muscle weakness, inflammation, or pain
- Liver problems. Symptoms can consist of:
- Tiredness or weakness
- Anorexia nervosa
- Upper stomach pain
- Dark-colored urine
- Yellowing of your skin or the whites of your eyes 
Dosage: how much niacin should i take?
Always consult with a doctor prior to taking a supplement to guarantee that the supplement and dosage are appropriate for your private needs.
Most healthy people get adequate niacin through their diet plan, so extra supplements is not typically required. Most research is based on shortages.
Some supplements contain as much as 500 mg per serving, which is higher than the advised daily allowance for niacin. For that reason, it’s essential to talk about supplements with a healthcare provider. They can assist you identify if niacin supplements make sense in your scenario and can assist you find the best formula and dosage.
What happens if i take excessive niacin?
To avoid toxicity, be aware of the appropriate dose and keep the tolerable upper limit in mind. The ceiling is the optimum day-to-day quantity that’s considered safe and unlikely to trigger negative impacts. If you consume more than this quantity or more than what is advised by your doctor, you may experience the serious side effects listed above.
For niacin, toxicity has actually been noted in dosages over 1 gram. If you exceed these levels, you may want to seek medical advice or go to the emergency room.
Upper intake levels
Upper consumption levels for niacin are as follows:.
- 10 mg for kids 1-3 years
- 15 mg for kids 4-8 years
- 20 mg for kids 9-13 years
- 30 mg for kids 14-18 years
- 35 mg for grownups 
Alcohol (ethanol) interaction score:
Moderate beware with this mix. Talk with your health company.
Niacin can trigger flushing and itchiness. Consuming alcohol in addition to niacin might make the flushing and itching even worse. There is likewise some concern that consuming alcohol with niacin might increase the chance of having liver damage.
Allopurinol (zyloprim) interaction rating:
Moderate be cautious with this combination. Talk with your health provider.
Allopurinol (zyloprim) is used to treat gout. Taking large dosages of niacin might aggravate gout and decrease the efficiency of allopurinol (zyloprim).
Clonidine (catapres) interaction score:
Moderate be cautious with this mix. Talk with your health service provider.
Clonidine and niacin both lower blood pressure. Taking niacin with clonidine may cause your blood pressure to become too low.
Gemfibrozil (lopid) interaction score:
Moderate be cautious with this combination. Talk with your health supplier.
Taking niacin along with gemfibrozil might trigger muscle damage in some individuals. Use with care.
Medications for diabetes (antidiabetes drugs) interaction score:
Moderate be cautious with this mix. Talk with your health supplier.
Use of high doses of niacin (about 3-4 grams everyday) may increase blood glucose. By increasing blood sugar, niacin might decrease the effectiveness of diabetes medications. Display your blood sugar closely. The dose of your diabetes medication might need to be altered.
Some medications utilized for diabetes consist of glimepiride (amaryl), glyburide (diabeta, glynase prestab, micronase), insulin, pioglitazone (actos), rosiglitazone (avandia), metformin (glucophage), nateglinide (starlix), repaglinide (prandin), chlorpropamide (diabinese), glipizide (glucotrol), tolbutamide (orinase), and others.
Medications for high blood pressure (antihypertensive drugs) interaction score:
Moderate beware with this mix. Talk with your health supplier.
Utilizing niacin with drugs that lower blood pressure may increase the results of these drugs and might reduce blood pressure too much.
Some medications for high blood pressure include captopril (capoten), enalapril (vasotec), losartan (cozaar), valsartan (diovan), diltiazem (cardizem), amlodipine (norvasc), hydrochlorothiazide (hydrodiuril), furosemide (lasix), and many others.
Medications that can damage the liver (hepatotoxic drugs) interaction ranking:
Moderate be cautious with this mix. Talk with your health provider.
Niacin might damage the liver. Sustained-release niacin preparations seem to have the best threat. Taking niacin together with medication that may likewise harm the liver can increase the danger of liver damage. Do not take niacin if you are taking a medication that can hurt the liver.
Some medications that can hurt the liver consist of acetaminophen (tylenol and others), amiodarone (cordarone), carbamazepine (tegretol), isoniazid (inh), methotrexate (rheumatrex), methyldopa (aldomet), fluconazole (diflucan), itraconazole (sporanox), erythromycin (erythrocin, ilosone, others), phenytoin (dilantin), lovastatin (mevacor), pravastatin (pravachol), simvastatin (zocor), and many others.
Medications that slow blood clot (anticoagulant/ antiplatelet drugs) interaction ranking: moderate beware with this mix. Talk with your health service provider.
Niacin might slow blood clot. Taking niacin in addition to medications that likewise sluggish clotting may increase the chances of bruising and bleeding.
Some medications that slow blood clotting consist of aspirin, clopidogrel (plavix), dalteparin (fragmin), enoxaparin (lovenox), heparin, indomethacin (indocin), ticlopidine (ticlid), warfarin (coumadin), and others.
Medications utilized for decreasing cholesterol (bile acid sequestrants) interaction rating:.
Moderate beware with this combination. Talk with your health service provider.
Some medications for lowering cholesterol called bile acid sequestrants can reduce just how much niacin the body soaks up. This might reduce the efficiency of niacin. Take niacin and the medications at least 4-6 hours apart.
Some of these medications used for lowering cholesterol consist of cholestyramine (questran) and colestipol (colestid).
Medications used for reducing cholesterol (statins) interaction score:
Moderate beware with this combination. Talk with your health company.
Niacin can adversely affect the muscles. Some medications utilized for decreasing cholesterol called statins can also impact the muscles. Taking niacin in addition to these medications might increase the threat of muscle problems.
Some of these medications used for high cholesterol consist of rosuvastatin (crestor), atorvastatin (lipitor), lovastatin (mevacor), pravastatin (pravachol), fluvastatin (lescol), and simvastatin (zocor).
Probenecid interaction ranking:
Moderate be cautious with this mix. Talk with your health supplier.
Probenecid is used to deal with gout. Taking large dosages of niacin might get worse gout and decrease the efficiency of probenecid.
Sulfinpyrazone (anturane) interaction score:
Moderate be cautious with this mix. Talk with your health provider.
Sulfinpyrazone (anturane) is utilized to deal with gout. Taking large doses of niacin might intensify gout and decrease the efficiency of sulfinpyrazone (anturane).
Thyroid hormonal agent interaction rating:
Moderate beware with this mix. Talk with your health provider.
The body naturally produces thyroid hormones. Niacin might reduce thyroid hormone levels. Taking niacin with thyroid hormone pills might decrease the effects and adverse effects of thyroid hormonal agent.
Aspirin interaction rating:
Minor beware with this mix. Talk with your health service provider.
Aspirin is typically used with niacin to lower the flushing triggered by niacin. Taking high dosages of aspirin may reduce how quick the body eliminates niacin. This might cause there to be too much niacin in the body and possibly cause adverse effects. However, the low dosages of aspirin most typically used for niacin-related flushing don’t seem to be an issue.
Nicotine patch (transdermal nicotine) interaction rating:
Minor beware with this combination. Talk with your health service provider.
Niacin can in some cases cause flushing and dizziness. The nicotine spot can likewise cause flushing and lightheadedness. Taking niacin or niacinamide and utilizing a nicotine patch can increase the possibility of ending up being flushed and woozy. 
Because of the potential for negative effects and interactions with medications, you need to take dietary supplements only under the guidance of a well-informed healthcare company. Side effects may include diarrhea, headache, stomach pain, and bloating.
High dosages (50 mg or more) of niacin can trigger adverse effects. The most typical side effect is called “niacin flush,” which is a burning, tingling experience in the face and chest, and red or flushed skin. Taking an aspirin 30 minutes prior to the niacin may help in reducing this symptom.
At extremely high doses, utilized to lower cholesterol and deal with other conditions, liver damage and stomach ulcers can occur. Your medical professional will frequently inspect your liver function through a blood test.
People with a history of liver disease, kidney disease, or stomach ulcers must not take niacin supplements. Those with diabetes or gallbladder illness need to do so only under the close guidance of their doctors.
Stop taking niacin or niacinamide at least 2 weeks prior to a scheduled surgery.
Niacin and niacinamide might make allergic reactions even worse by increasing histamine.
Individuals with low high blood pressure should not take niacin or niacinamide due to the fact that they might cause a harmful drop in high blood pressure. Do not take niacin if you have a history of gout.
People with coronary artery illness or unsteady angina need to not take niacin without their doctor’s guidance, as large doses can raise the threat of heart rhythm problems.
Taking any one of the b vitamins for an extended period of time can result in an imbalance of other important b vitamins. For this reason, you might wish to take a b-complex vitamin, which includes all the b vitamins. 
The function of niacin as an antioxidant micro-nutrient has actually been developed in a variety of research. The systems through which niacin secures the body against oxidative tension can be keeping the glutathione redox cycle, and also, decreasing nadph/total nadp+ ratio along with increasing the nad+ material. However the majority of the examinations in this area are restricted to experimental research studies, these mechanistic studies can be helpful for more clinical advancement of niacin and niacin-related compounds for the treatment of oxidative tension and its problems.