Taking Niacin? Seven Reasons You May Want to Take Berberine Instead

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  • by Nils Osmar. July 21, 2023
  • This post is not intended as, and should not be taken as, medical advice. 
  • See full Medical Disclaimer

Niacin has several known health benefits. Small amounts of it occur naturally in the diet and are not thought to be harmful. But the large amounts people often take as supplements can have serious dangers.

Berberine accomplishes many of the same things niacin does without causing the health problems that niacin can trigger.

  1. Niacin raises NAD+ levels… and so does berberine. “Berberine increases NAD+/NADH ratio through induction of NAMPT expression in C2C12 cells.” (I take both berberine and NMN, which further increrases NAD+) See study
  2. Niacin lowers total cholesterol, increases HDL, lowers LDL and triglycerides… and so does berberine. “We found that on average berberine can modestly reduce low-density lipoprotein (LDL) cholesterol by 0.5 mmol/L (18 mg/dL) and triglycerides by 0.3 mmol/L (30 mg/dL). Berberine also increases high-density lipoprotein (HDL) cholesterol by 0.06 mmol/L (2 mg/dL).” See study
  3. Niacin raises blood glucose and can cause new-onset diabetes. “One potentially important side effect known to occur on niacin is a rise in glucose levels in those with diabetes. 5 Findings from a post-hoc analysis of the Coronary Drug Project suggested that this effect also occurred in those without diabetes, leading to an increase in the risk of developing diabetes.” See study
  4. Unlike niacin, berberine lowers blood sugar. “Several studies among people with type 2 diabetes have shown that taking 600–2,700 mg of berberine daily may lower fasting and long-term blood sugar levels by up to 20% and 12%, respectively” See article
  5. Niacin can damage the retina. “Several recent studies have shown an association between too much niacin and damage to the retina (the nerve layer lining the back of the eye, which is crucial for sight).” See article
  6. Unlike niacin, berberine is protective against diabetic retinopathy. “A number of studies have reported that diabetic retinopathy (DR) is the major cause of blindness. Berberine (BBR) is a bioactive constituent that displays effects on blood glucose…” See study – and – Berberine Protects Human Retinal Pigment Epithelial Cells from Hydrogen Peroxide-Induced Oxidative Damage through Activation of AMPK
  7. Niacin activates AMPK (the longevity pathway – but so does berberine. See study.

Cautions and caveats

“Side effects are few and largely mild and transient gastrointestinal symptoms of nausea, abdominal bloating, diarrhea or constipation. In most controlled studies, adverse events were no more frequent with berberine than with placebo and serious adverse events have been rare.” – See study

Caution: Berberine should never be taken by women who are pregnant, or think they may be. “Typical side effects for a healthy individual with no medical conditions may include diarrhea, constipation, gas and upset stomach. Berberine can cross the placenta and may cause harm to the fetus. Kernicterus, a type of brain damage, has developed in newborn infants exposed to it.” – See article

Note: With any supplement, there can be dangers of idiosyncratic individual reactions. So it’s always good to check with a health care professional before taking any new supplement if you have any concerns.

What I’m doing

I take niacin once or twice a month because (unlike some folks) I like the niacin flush. But I’ve noticed that my blood sugar spikes and my vision gets blurry for several hours after taking it. My blood sugar was creeping up and I realized niacin was part of the reason. So I’ve stopped taking it regularly, and switched to taking berberine once or even twice a day.

There are many good brands of berberine. The one I take is from DoNotAge. The capsules are a rich orange/yellow color. My blood sugar goes down after taking them.

I don’t rely on berberine alone to raises NAD+ levels; I also take some NMN at the same time. (Like niacin, NMN is a precursor to NAD+. Unlike niacin, it does not raise blood glucose.)

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 supplement(s), just reporting on what I’m doing. Supplements, like medications and other interventions, can have side effects; I would encourage people to research both possible benefits and side effects before starting on any supplementation regimen, and consult with a medical professional about any issues which might have a medical component.  See full Medical Disclaimer

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One Comment

  1. Paul Cohen says:

    Excellent summery, Nils. I’ve had some of the same concerns about niacin but wasn’t really ready to comment on them. Thanks for the thorough analysis. Well done!

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