Niacin as Niacinamide
Also known as: Niacinamide, Nicotinamide, Vitamin B3, Nicotinic Acid Amide
Overview
Niacinamide, also known as nicotinamide, is a form of vitamin B3 that is crucial for various bodily functions. It is found naturally in foods like meat, fish, nuts, and grains and is also available as a dietary supplement. Unlike its counterpart, nicotinic acid (another form of vitamin B3), niacinamide does not typically cause flushing, making it a preferred option for supplementation. It plays a vital role in cellular metabolism as a precursor to NAD+ and NADP+, essential cofactors in redox reactions. Niacinamide is used to prevent and treat niacin deficiency (pellagra) and has been investigated for its potential benefits in cardiovascular health, dermatological conditions, and neuroprotection. Research suggests it may improve lipid profiles and offer neuroprotective effects, particularly in glaucoma management, though more studies are needed to confirm these benefits.
Benefits
Niacinamide offers several potential health benefits, primarily related to cardiovascular health and neuroprotection. Systematic reviews and meta-analyses indicate that niacinamide can improve lipid profiles by raising HDL cholesterol and lowering LDL cholesterol and triglycerides. However, large randomized controlled trials (RCTs) show no significant reduction in major cardiovascular events when niacin is added to statin therapy. Emerging evidence suggests that nicotinamide supplementation may improve retinal ganglion cell function and reduce glaucoma progression risk, although further RCT validation is required. Additionally, niacinamide has demonstrated skin health benefits, including reducing inflammation and improving barrier function, supported by dermatological studies. Its role as an NAD+ precursor also suggests potential neuroprotective effects, though clinical evidence in this area is still limited.
How it works
Niacinamide functions primarily as a precursor to nicotinamide adenine dinucleotide (NAD+) and nicotinamide adenine dinucleotide phosphate (NADP+), which are essential cofactors in numerous enzymatic reactions involved in cellular metabolism. These cofactors play a critical role in energy production, DNA repair, and cell signaling. Niacinamide modulates lipid metabolism by inhibiting hepatic diacylglycerol acyltransferase-2, reducing triglyceride synthesis. It also exhibits anti-inflammatory effects by inhibiting poly(ADP-ribose) polymerase (PARP). Its high oral bioavailability allows for rapid absorption in the small intestine, facilitating its conversion into NAD+ and NADP+ within the body.
Side effects
Niacinamide is generally considered safe at recommended doses, with fewer side effects compared to nicotinic acid. Common side effects, occurring in more than 5% of individuals, may include mild gastrointestinal discomfort. Uncommon side effects (1-5%) may involve rare liver enzyme elevations at high doses, as well as mild headaches or dizziness. Rare side effects, affecting less than 1% of users, can include severe hepatotoxicity, particularly with very high doses or the nicotinic acid form, and hypersensitivity reactions. Caution is advised when using niacinamide with hepatotoxic drugs or diabetes medications due to potential interactions affecting glucose metabolism. Contraindications include severe liver disease and hypersensitivity to niacinamide. Pregnant and lactating women should use niacinamide at recommended doses, and patients with diabetes should monitor glucose levels closely.
Dosage
The recommended daily allowance (RDA) for niacinamide to prevent deficiency is 14-16 mg/day. For lipid profile improvement, dosages typically range from 500-2000 mg/day. Glaucoma studies have used doses around 1500 mg/day. While doses up to 3000 mg/day are generally tolerated, higher doses increase the risk of adverse effects. Dividing the daily dose may help reduce gastrointestinal side effects. Niacinamide is preferred over nicotinic acid when flushing is a concern. Food intake may improve tolerance but can reduce absorption speed. Adequate hydration and liver function monitoring are recommended during supplementation.
FAQs
Is niacinamide the same as niacin?
No, niacinamide is the amide form of niacin and does not cause flushing, a common side effect of nicotinic acid.
Does niacinamide lower cholesterol?
It can improve lipid profiles, but evidence for reducing cardiovascular events is weak when combined with statins.
Is niacinamide safe for long-term use?
Yes, at recommended doses, it is generally safe with a low risk of serious side effects.
When should I take niacinamide?
It is best taken with meals to reduce gastrointestinal discomfort.
Can niacinamide cause flushing?
No, flushing is associated with nicotinic acid, not niacinamide.
Research Sources
- https://pubmed.ncbi.nlm.nih.gov/30977858/ – This study investigated the effect of niacin on cardiovascular outcomes and found no significant reduction in major cardiovascular events when niacin was added to statin therapy. The research included multiple randomized controlled trials with adequate sample sizes and employed a high-quality methodology with Cochrane risk of bias assessment.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11547537/ – This review examined clinical and observational studies on nicotinamide's role in glaucoma prevention, revealing preliminary evidence of improved retinal function and potential neuroprotection. The authors call for more randomized controlled trials to confirm clinical benefits, highlighting the need for further research in this area.
- https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2730481 – This systematic review and meta-analysis assessed niacin's effect on cardiovascular outcomes, finding no significant reduction in major cardiovascular events when added to statin therapy. The study included multiple RCTs with adequate sample sizes and employed a high-quality methodology with Cochrane risk of bias assessment.
- https://academic.oup.com/nutritionreviews/article/75/6/471/3852639 – This meta-analysis evaluated dose-dependent adverse effects of nicotinic acid and niacinamide, establishing a safety profile and upper intake limits. The study noted fewer side effects with niacinamide and provided guidance on dosing to minimize risk, offering valuable insights into the safety and tolerability of these compounds.
- https://www.jacc.org/doi/10.1016/j.jacc.2012.10.030 – This study investigated the effects of niacin on cardiovascular events and found that while it can improve lipid profiles, it did not significantly reduce the risk of major cardiovascular events when added to statin therapy. The research highlights the importance of considering the overall clinical context when evaluating the benefits of niacin supplementation.