by Nils Osmar. March 26, 2022
Many people in the anti-aging community are following David Sinclair’s lead and trying to raises their NAD+ levels. Taking precursors (which the body assembles into NAD+) is one approach. But their effects are not identical in the body:
- NMN (nicotinamide mononucleotide)
- NR (nicotinamide riboside)
- NAM (niacinamide, also known as nicotinamide) ( Note: David Sinclair considers this form dangerous because some studies have shown that it switches off the sirtuin genes) (It’s actually used medically when doctors want to lower sirtuin activation.) (For this reason, I’m no longer taking it myself.)
- NA (niacin, also known as nicotinic acid)
- Tryptophan (a precursor of both serotonin and niacin)
In this article, I’ll be looking at the fourth item on the list, a form of vitamin B3 called niacin, and addressing some questions that are sometimes raised about it.
Is Niacin Really Safe?
Niacin is a highly beneficial (in fact, essential) nutrient found in many foods. It raises NAD levels, lowers lowers LDL and triglycerides, raises HDL, and increases human growth hormone. I take it myself for all of the above reasons. I often take it myself (two or three days a week) for these benefits.
But I sometimes get a little worried when I see people taking it without an awareness of its possible side effects. People think of it as a cheap alternative to NMN and NR, which it is — it’s an affordable, readily available NAD precursor. But there are reasons that NMN and NR may sometimes be better choices.
Possible Side Effects
- One side effect is that niacin can cause a sudden and severe flush due to the dilation of blood vessels. I don’t consider this harmful, and I don’t actually mind it most of the time. But some people dislike it intensely and avoid niacin for this reason. A severe flush will turn your skin beet-red for as long an hour. You may feel waves of heat radiating from your body due to your blood vessels dilating – and feel chilled afterwards as the flush passes. I actually knew someone once who called 911, who sent an ambulance, when she started flushing — she had not realized it’s a harmless side effect and assumed that she was having a stroke.
- According to an article called “The effect of aspirin on niacin-induced cutaneous reactions“, taking a baby aspirin along with niacin will reportedly prevent the flushing – but may also prevent most of niacin’s benefits.
- Other drugs (in addition to aspirin) can also blunt the flushing effect – but may also be negating niacin’s benefits according to this article. (“Taken together, these interwoven findings suggest that blocking the effects of PGD2 on DP1 is likely to be undesirable in patients with heart disease, and perhaps in particular, those taking niacin. That possibility is not addressed by the design of the large ongoing trial of the niacin/DP1 antagonist combination, say the researchers.
- Niacin’s effect on blood glucose is a bigger and more serious concern (to my mind) than the flush. According to a study called “Niacin therapy and the risk of new-onset diabetes: a meta-analysis of randomised controlled trials” which was published in the British Medical Journal, niacin raises blood glucose enough to move people into pre-diabetes or even diabetes, if large amounts are taken over a long period of time.
- According to a study called “Clinical and Research Information on Drug-Induced Liver Injury“, the sustained-release form of niacin can cause liver damage. (This is far less likely with the immediate-release (IR) version)
- Niacin can also raise uric acid.
What I’m (Currently) Doing
- I take NMN and NR every day (1.5 grams of NMN and 0.5 grams of NR), usually along with a fasting mimicking smoothie. I’m not saying that others need to take them both; I actually took NMN without any NR for a couple of years and liked it fine by itself. But since adding in a little NR, I feel more of a boost from it. I buy both from DoNotAge.
- I’m a fan of niacin (in spite of the flush) and do take it sometimes. But I’m cautious about it and keep the dose low.
- To prevent blood glucose problems, I take some Ceylon cinnamon or benfotiamine or berberine or metformin or chromium along with it.
- To prevent uric acid problems, I eat some parsley along with it, which lowers uric acid levels. See the study, “Effects of Parsley (Petroselinum crispum) and its Flavonol Constituents, Kaempferol and Quercetin, on Serum Uric Acid Levels“
- To be proactive against liver damage, I avoid all of the sustained-release forms of niacin, and take milk thistle, which has been found to be liver-protective.
- I also do the other things known to raise NAD levels which I’ve listed below:
Other Ways of Raising NAD+
NMN and NR both raise NAD levels without causing a flush or increasing blood sugar. So as I mentioned above, I take both. Other ways of maintaining high NAD+ levels include:
- doing lots of fasting
- taking hot/cold contrast showers (to trigger heat shock and cold shock)
- taking ice baths (just for cold shock)
- doing HIIT exercise
- taking saunas
- eating parsley or chamomile, or taking apigenin supplements.