Dangers and Benefits of Niacin and Niacinamide

by Nils Osmar. Dec. 8, 2022. Medical Disclaimer

Niacin (NA) (in the nicotinic acid form) has many health benefits, including raising HDL levels, lowering LDL and lowering triglycerides. According to a Mayo Clinic article:

Niacin can lower triglycerides by 25% and raise HDL cholesterol by more than 30%.

Triglyceride levels over 150 milligrams per deciliter (mg/dL) or 1.7 millimoles per liter (mmol/L) have been associated with a higher risk of heart disease.

The risk of heart disease is also increased in men who have HDL levels below 40 mg/dL (1.0 mmol/L) and in women who have HDL levels below 50 mg/dL (1.3 mmol/L).

There’s currently some debate about the exact role HDL plays in the body and in the development of heart disease. But HDL has generally been thought to pick up excess bad cholesterol in the blood and take it to the liver for disposal, which is why HDL is dubbed the good cholesterol.

Niacinamide (NAM), by contrast, does not have any beneficial effects on cholesterol levels.

Both niacin and niacinamide raise NAD+

Both NA and NAM also raise NAD+ levels, if taken in large enough doses. According to this study, 100 mg of NAM had no effect on NAD+; but 500 mg did raise it significantly.

So some people take them as a low cost substitute for NMN or NR. For those doing so, it’s important to be aware that both NA and NAM (niacinamide, AKA nicotinamide) raise blood glucose and promote insulin resistance. Niacin (NA) in large doses can trigger new onset diabetes.

See study: Niacin therapy and the risk of new-onset diabetes: a meta-analysis of randomised controlled trials

Niacin (in large doses) can also cause problems with vision, including blurred vision. See study: Ocular Effects of Niacin: A Review of the Literature

Time-released niacin (in large doses) can cause liver damage. See study: Clinical and Research Information on Drug-Induced Liver Injury

What I’m doing

  • I used to take both niacin and niacinamide.
  • I have stopped taking NAM. As far as I’m aware, it has no benefits which can’t be obtained by taking NR, NMN or NA.
  • To raise NAD+, I’m currently taking 0.5 to 1 grams of NMN plus 0.5 gram of NR in the mornings. (I take them along with fucoidan, i.e., SIRT6 Activator.)
  • To keep my cholesterol at a healthy level, I take 0.5 grams of NA (niacin) in the afternoon. When I do so, I take it along with 1 gram of berberine. Berberine, like niacin, lowers cholesterol. It also lowers blood glucose, so I’m hoping it will counterbalance niacin’s tendency to raise blood glucose. See study: Efficacy of Berberine in Patients with Type 2 Diabetes

Not medical advice

This article is not intended as, and should not be taken as, medical advice. I’m not advising that people eat any particular diet or take any particular supplements, just reporting on what I’m doing. All supplements can have side effects; I would encourage people to research both possible benefits and side effects before starting on any supplementation regimen.  See full Medical Disclaimer

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