Table of Contents
Niacin is a kind of vitamin B3 made in the body from tryptophan. It’s discovered in many foods including meat, fish, milk, eggs, green vegetables, and cereals.
Niacin is required for the correct function of fats and sugars in the body and to preserve healthy cells. At high dosages, niacin may assist people with heart problem because of its impacts on blood clot. It might also enhance levels of fats called triglycerides in the blood.
Prescription types of niacin are approved by the US FDA for unusual cholesterol levels and for preventing vitamin B3 shortage and related conditions such as pellagra. People utilize niacin supplements for metabolic syndrome, cardiovascular disease, cataracts, high blood pressure, and numerous other conditions, but there is no good scientific evidence to support most of these other uses.
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, not long after the maize was introduced into Europe. The name of the illness was established in 1771 by an Italian doctor Francesco Frapolli.
Due to the terrific boost in using maize in northern part of Italy, pellagra became so widespread that an unique hospital (referred to as Legano) was integrated in 1784, specifically for pellagra clients. Reports on the occurrence of pellagra appeared soon afterwards in France (1829 ), Romania (1858) and Egypt (1874 ).
After 1900 pellagra became a substantial health issue in the United States also, especially in the South. It carefully followed the introduction of a new grain processing technique that eliminated the majority of the vitamins from processed grain. There was a particular shift from the use of coarsely ground corn meal in regional, water-driven mills to finely bolted meal by large milling business.
The outbreaks of pellagra were so ubiquitous and severe that a bulk of physicians thought about the cause to be a transmittable representative. The true nature of illness was determined when the Federal Government of the United States sent a physician from New york city, Joseph Goldberger, to study the illness.
The discovery of niacin
Nicotinic acid was manufactured in 1867 by oxidation of nicotine and extensively utilized in photography. It was long idea that it has nothing to do with food or health concerns, up until German researchers demonstrated that nicotinic acid occurs in yeast and in rice polishing. There it was separated by the Polish-American.
biochemist Casimir Funk in 1912, while he was searching for a treatment for another disease referred to as beriberi (nutritional disorder caused by a shortage of thiamine).
Since nicotinic acid had no effect on beriberi, he deserted his deal with that substance. But although he was wrong, he showed that this nicotinic acid most likely had some nutritional worth. It was delegated the Austrian-American physician Joseph Goldeberger to find the connection in between nicotinic acid and deficiency illness it can trigger.
In 1915, Goldberger carried out a series of experiments on 11 healthy volunteer detainees in a Mississippi jail and found that he could cause pellagra by changing their diets. He concluded that the illness was caused by the lack of some factor that was lacking in corn, but that could be discovered in meat and milk. He named it the P-P (for pellagra-preventative) element.
The chemical structure of that aspect was consequently discovered in 1937 by the American biochemist Conrad Arnold Elvehjem. He caused a black tongue in canines by feeding them the Goldberger diet plan, and after that treated the disease by supplementing their diet with nicotinic acid. He also separated the P-P factor from active liver extracts, showing that this element is actually nicotinic acid (subsequently called niacin for nicotinic acid vitamin).
After this discovery, grain products (wheat, maize) were improved with nicotinic acid or nicotinamide. Still, a wide scale social reform was required to guarantee correct implementation of such dietary modifications. Most of sporadic cases in the industrialized nations are now seen in alcoholics, although in unusual circumstances other clients can develop the illness too (i.e. malabsorption or iatrogenic scenarios). 
In addition to soaking up niacin from diet plan, niacin can be manufactured from the important amino acid tryptophan, a five-step procedure with the penultimate substance being quinolinic acid (see figure). Some germs and plants make use of aspartic acid in a path that also goes to quinolinic acid. For people, the efficiency of conversion is estimated as needing 60 mg of tryptophan to make 1 mg of niacin. Riboflavin, vitamin B6 and iron are needed for the procedure. Pellagra is a consequence of a corn-dominant diet plan since the niacin in corn is improperly bioavailable and corn proteins are low in tryptophan compared to wheat and rice proteins.
Nicotinic acid was first synthesized in 1867 by oxidative degradation of nicotine. Niacin is prepared by hydrolysis of nicotinonitrile, which, as described above, is created 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 used 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 evaluated utilizing manganese-substituted aluminophosphates.
that use acetyl peroxyborate as non-corrosive oxidant, preventing producing nitrogen oxides as do standard ammoxidations.
The need for commercial production includes for animal feed and for food fortification indicated for human usage. According to Ullmann’s Encyclopedia of Industrial Chemistry, around the world 31,000 tons of nicotinamide were sold in 2014. 
Mechanism of action
Niacin carries out a number of functions in the body therefore has many mechanisms, not all of which have actually been completely explained. Niacin can decrease lipids and apolipoprotein B (apo B)- including lipoproteins by modulating triglyceride synthesis in the liver, which degrades apo B, or by modulating lipolysis in fat.
Niacin inhibits hepatocyte diacylglycerol acyltransferase-2. This action avoids the final action of triglyceride synthesis in hepatocytes, limiting offered triglycerides for extremely low density lipoproteins (VLDL). This activity likewise results in intracellular degradation of apo B and decreased production of low density lipoproteins, the catabolic item of VLDL.
Yellowfin tuna: 18.8 mg, 117% day-to-day worth (dv)
While tuna is an exceptional source of niacin, larger ranges like yellowfin or albacore tend to be higher in mercury than smaller sized types like skipjack.
A prepared, 3-ounce filet of cooked yellowfin tuna delivers 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 expect you to eat beef liver daily, however the organ meat is an outstanding source of b vitamins, including niacin. One piece of fried beef liver offers an impressive 92 percent of the dv for niacin. It’s also rife with vitamin a, iron and zinc.
Turkey breast: 10 mg, 62% dv
Turkey is frequently promoted as the primary source of tryptophan, but in truth, many animal proteins (consisting of eggs, chicken and cheese) offer 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 a few of its tryptophan to nad in the body. But in order for the amino acid to be transformed into niacin, the body needs to have adequate levels of other nutrients, like iron, b6 and riboflavin.
Sockeye salmon: 8.6 mg, 54% dv
Niacin-rich sockeye salmon is likewise an exceptional source of anti-inflammatory omega-3 fats.
In addition to supplying anti-inflammatory omega-3 fats and vitamin d, cooked salmon is likewise an excellent source of niacin, with 54 percent of the dv present in a 3-ounce serving.
Chicken breast: 8 mg, 50% dv
Three ounces of prepared chicken breast can provide 50 percent of the dv for niacin, plus 27 grams of satisfying protein.
If you’re feeling uninspired by poultry, attempt cooking up these healthy chicken dishes you have not tried yet (we guarantee they will not disappoint).
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 offers 47 percent of the dv for niacin, deeming them a few of the very best vegetarian foods high in niacin.
Pork chops: 6.8 mg, 42% dv
A pork slice can serve up almost half of your everyday niacin requirements.
Though fattier than other cuts like the tenderloin (which is the leanest cut of pork), chops are a fantastic natural source of niacin. A 3-ounce, cooked pork slice provides 42 percent of the dv for niacin.
Brown rice: 5.2 mg, 32% dv
It’s safe to state that brown rice is among the vegetarian foods highest in niacin. You’ll get 33 percent of the dv for vitamin b3 in 1 cup of prepared brown rice. You’ll also get nearly 6 grams of protein and 3 grams of fiber from the entire grain.
Pair plant-based protein sources like brown rice with black beans for a complete protein that supplies 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 two times each week to preserve a healthy heart. Just make certain to practice small amounts when it concerns canned tuna varieties like albacore or white tuna.
Though abundant in niacin– 3 ounces of canned white tuna provides 31 percent of the dv for the b vitamin– these varieties tend to be higher in mercury compared to smaller species like skipjack tuna, per the united states epa (epa). Attempt the seafood in these non-salad canned tuna recipes.
Steak: 4.8 mg, 30% dv
Iron-rich skirt steak also provides vitamin b3.
Grilled skirt steak is a high-protein source of niacin, with a 3-ounce serving supplying 30 percent of the dv for the nutrient.
Beef is likewise high in minerals like iron, which supports healthy blood cell development and oxygen delivery 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 provides 25 percent of the dv. The beans are also rich in unsaturated fats that support healthy lipid levels. Pb&& j, anybody?
Fortified breakfast cereals: 4 mg, 25% dv
It’s tough to state exactly how much niacin you’ll receive from a prepared breakfast cereal, as various products offer different 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
Can we all accept provide routine old russet potatoes more enjoy? 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 better source of niacin, enriched white rice isn’t too far behind. A 1/2-cup serving of prepared, enriched white rice puts 13 percent of the dv for niacin on the table.
Just like prepared foods, enriched foods have nutrients contributed 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 beans like lentils (along with other plant-based proteins like nuts and soy) is connected with a lower threat of coronary cardiovascular disease, per a big potential mate research study released in december 2020 in the british medical journal.
One cup of prepared lentils consists of 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 offers 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 use it in various recipes like grain bowls, soups and salads.
Avocado: 1.7 mg, 11% dv
An outstanding source of heart-healthy monounsaturated fats, avocado is likewise a solid vegetarian source of niacin. A half of an avocado contains 11 percent of the dv for the vitamin. Of course, we ‘d never ever restrict you to just a half of an avocado.
Do not miss these inventive and scrumptious methods to eat avocado that go beyond your basic guac or avo toast.
Whole-wheat bread: 1.4 mg, 9% dv
Whole grains are amongst the healthiest plant sources of niacin and entire wheat bread is no exception. One slice of whole wheat bread can provide almost 10 percent of the dv for niacin. Top your toast with peanut butter and a sprinkle of sunflower seeds for a satiating snack.
Pumpkin seeds: 1.3 mg, 8% dv
Niacin-rich pumpkin seeds in a little wood bowl.
Not only are pumpkin seeds an excellent source of niacin, they’re likewise a nourishing method to add crunch to meals.
Magnesium-rich pumpkin seeds are likewise a good-for-you source of niacin. One ounce of shelled, salted pumpkin seeds contains 8 percent of the dv for vitamin b3.
Sprinkle them on salads or your early morning oatmeal bowl for extra texture– and nutrients.
Banana: 0.9 mg, 6% dv
By now you know that there are a lot of vitamin b3 vegetables and fruits– and bananas make it. One big banana serves up 6 percent of the dv for niacin.
Go ahead 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 carried out and supporting proof must be identified, there are a range of uses for niacin. In regards to health advantages, niacin potentially can:.
- Control cholesterol
- Lower blood pressure
- Improve mental health
- Clear skin
- Manage migraines
- Promote joint health
- Protect cognitive function
- Support digestion
- Minimize birth defects
- Enhance erectile dysfunction
It assists control cholesterol levels
Often niacin is recommended together with cholesterol-lowering medications like statins to assist stabilize blood lipid levels. It can increase high-density lipoprotein (hdl) cholesterol, which is the healthy type of.
Other evidence suggests that niacin is good for individuals with an increased danger of cardiac arrest and heart disease since it not only reduces ldl cholesterol however likewise triglycerides. Niacin can reduce triglyceride levels by 20% to 50%. The prescription solutions niaspan and niacor have fda approval to deal with dyslipidemia (elevated cholesterol or other fats in the blood).
It might lower high blood pressure
Little medical trials of using niacin have actually shown it has significant high blood pressure lowering results in individuals with hypertension. In addition, sudden lowering of high blood pressure is explained in the bundle insert of prescription niacin. Nevertheless, in larger scientific trials including niacin and niacin-containing routines there showed either no clear substantial effects of niacin or slightly lower mean blood pressure amongst some niacin treatment groups compared with placebo.
More research studies need to be done to identify how efficient niacin can be for reducing blood pressure and lowering the danger of cardiovascular events, however up until now the research study seems promising.
It may enhance mental health
Dietary practices have a considerable impact on lots of mental illness consisting of anxiety, stress and anxiety, schizophrenia, and bipolar disorder. This has caused the development of dietary guidelines to help manage these conditions. Niacin shortage has actually revealed a possible link to some mental illness.
Studies have actually recorded reduced 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 utilize niacin supplements together with prescription antidepressants.
It benefits the skin
Niacin is an excellent supplement for the skin. It can assist protect skin cells from sun damage, clear acne when used topically, and reduce soreness and swelling. Vitamin b3 in the formula of niacinamide is typically used as a natural topical skin care treatment to clear acne. Niacin can even assist manage inflammatory skin problem like bullous pemphigoid or granuloma annulare.
It may assist handle migraines
Although it’s unclear how niacin achieves therapeutic results, it could be useful for migraine and tension-type headaches and the avoidance of these headaches. Niacin may avoid 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 shown to increase joint mobility and reduce joint pain, inflammation, and swelling. Because of its anti-inflammatory effect on joints, niacin might act as an excellent treatment alternative for individuals with arthritis.
It might secure versus alzheimer’s illness
In a research study released by the journal of neurology, neurosurgery, and psychiatry, dietary niacin was concluded to be a possible protector versus alzheimer’s illness and age-related cognitive decrease. A higher consumption of niacin might be related to a slower rate of cognitive decrease with time.
It’s good for digestion
Niacin is great for the digestion system because vitamin b3 helps break down nutrients like carbohydrates and fats into energy. If somebody is deficient in niacin, they may have a hard time absorbing food and might experience intestinal problems gradually.
It may avoid abnormality
According to a 2017 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, however initial research study suggests that niacin may help prevent nicotinamide adenine dinucleotide (nad) abnormality in humans and lower general abnormality rates.
On the other hand, caution is recommended for niacin supplements while breastfeeding, as there is minimal human data on the results of niacin in breastmilk. New or expecting moms must constantly talk with their doctor before introducing brand-new supplements or medications during pregnancy or lactation.
It might enhance erectile dysfunction
Erectile dysfunction (ed) is the failure to get or keep an erection. Due to the fact that niacin helps improve blood flow, it may likewise be good for impotence. In a study released by the journal of sexual medicine, a day-to-day dosage of up to 1,500 mg of niacin sufficed to improve sexual function amongst males who had actually both ed and dyslipidemia. Men with dyslipidemia were studied due to the fact that dyslipidemia is carefully related to ed. 
Etiology of niacin shortage
Primary niacin deficiency
It arises from extremely insufficient intake of both niacin and tryptophan, which typically happens in areas where maize (indian corn) constitutes a substantial part of the diet. Bound niacin, found in maize, is not assimilated in the intestinal tract unless it has actually been previously treated with alkali, as when tortillas are prepared. Corn protein is likewise lacking in tryptophan. The high occurrence of pellagra in india amongst people who eat millet with a high leucine material has actually led to the hypothesis that amino acid imbalance may contribute to deficiency. Shortages of protein and lots of b vitamins commonly accompany main niacin shortage.
Secondary niacin deficiency
It might be because of diarrhea, cirrhosis, or alcohol addiction. Pellagra likewise may occur in carcinoid syndrome (tryptophan is diverted to form 5-hydroxytryptophan and serotonin) and in hartnup disease (absorption of tryptophan by the intestinal tract and kidneys is defective). 
Causes of niacin shortage
One type of niacin shortage results from a deficiency of niacin and tryptophan (an amino acid). This type triggers a disorder called pellagra, which impacts the skin, digestive tract, and brain. Pellagra establishes only if the diet plan is deficient in niacin and tryptophan due to the fact that the body can transform tryptophan to niacin. People who live in areas where maize (indian corn) is the primary food source are at risk of developing 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 disorder, appearing each spring and lasting through the summer, when the diet consists mainly of maize items.
Pellagra likewise establishes in individuals who have among the following:
- Hartnup illness, a rare genetic condition in which absorption of tryptophan is impaired
- Carcinoid syndrome, a rare condition in which tryptophan is not transformed to niacin
The following can cause a deficiency of niacin:
- The antibiotic isoniazid if taken for a long period of time
Symptoms of niacin shortage
Generally, individuals with pellagra develop a symmetric, dark red rash that resembles a sunburn and worsens when it is exposed to sunlight (a condition called photosensitivity). The rash happens in locations of sun direct exposure, and its place is unique:
- On the arms and hands (like gloves)
- On the feet and calves (like boots)
- Around the neck (like a necklace)
- On the face forming a butterfly shape
Skin problems are relentless, and the impacted areas might become brown and flaky.
The whole digestive system is affected. The tongue and mouth may become inflamed and dark red. The tongue may swell, the mouth may burn, and sores may establish on both. The throat and esophagus might also burn. Saliva production might increase. Other symptoms include queasiness, vomiting, stomach discomfort, constipation, and diarrhea (which may be bloody).
Later, tiredness, insomnia, and lethargy establish. Breakdown of the brain (encephalopathy) generally follows. It is characterized by confusion, disorientation, hallucinations, and memory loss. Individuals may be overexcited, depressed, very elated (manic), delirious, or paranoid (thinking that people mean to harm them). 
In early deficiency, diagnosis requires a high index of suspicion and attempts at confirmation of niacin shortage. Niacin metabolites, particularly n-methylnicotinamide, can be determined in the urine. Low levels suggest niacin shortage however might also be found in patients with generalized under-nutrition. Serum and red cell levels of nad and nadp are also low however are similarly nonspecific. In innovative cases, the medical diagnosis of pellagra can be made on clinical grounds. 
Typically a niacin shortage may indicate several nutritional shortages; therefore, a well balanced diet plan is a strong suggestion. Nicotinamide dosages of 250 to 500 mg/day orally need to be provided. Despite nicotinic acid being the more typical kind of niacin, nicotinamide is used for niacin shortages as it does not cause signs such as tingling sensation, itching, or flushing. Patients with pellagra must avoid sun exposure and alcohol intake. The suggested 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 girls ages 9 to 13, the rda is 12 mg/day of ne. For individuals 14 years or older, the rda is 16, and it is 14 mg/day of ne for males and women, respectively. Rda during lactation is 17 mg/day of ne. 
Niacin adverse effects
Niacin oral tablet doesn’t trigger drowsiness, but it can cause opposite effects.
More common negative effects
A few of the more common adverse effects of niacin can consist of:.
- Reddening and warming of your face (flushing)
- Throwing up
- Increased cough
If these impacts are mild, they might go away within a few days or a couple of weeks. If they’re more extreme or do not go away, talk to your doctor or pharmacist.
Severe adverse effects
Call your physician immediately if you have severe adverse effects. Call 911 if your signs feel lethal or if you believe you’re having a medical emergency situation. Major adverse effects and their symptoms can include the following:.
- Muscle problems. Symptoms can include:
- Unusual muscle weakness, tenderness, or pain
- Liver problems. Symptoms can consist of:
- Tiredness or weakness
- Loss of appetite
- Upper stomach pain
- Dark-colored urine
- Yellowing of your skin or the whites of your eyes 
Dosage: how much niacin should i take?
Constantly speak to a healthcare provider before taking a supplement to make sure that the supplement and dosage are appropriate for your private requirements.
The majority of healthy individuals get adequate niacin through their diet, so additional supplementation is not generally needed. A lot of research is based on deficiencies.
Some supplements consist of as much as 500 mg per serving, which is higher than the recommended day-to-day allowance for niacin. For that reason, it’s vital to go over supplements with a healthcare provider. They can help you figure out if niacin supplements make good sense in your situation and can assist you discover the right formula and dose.
What happens if i take excessive niacin?
To prevent toxicity, understand the suitable dosage and keep the tolerable ceiling in mind. The upper limit is the optimum everyday amount that’s thought about safe and not likely to trigger adverse impacts. If you take in more than this amount or more than what is advised by your healthcare provider, you might experience the extreme side effects listed above.
For niacin, toxicity has been noted in dosages over 1 gram. If you go beyond these levels, you may wish to seek medical suggestions or go to the emergency room.
Upper consumption levels
Upper consumption levels for niacin are as follows:.
- 10 mg for children 1-3 years
- 15 mg for children 4-8 years
- 20 mg for children 9-13 years
- 30 mg for children 14-18 years
- 35 mg for adults 
Alcohol (ethanol) interaction rating:
Moderate be cautious with this combination. Talk with your health provider.
Niacin can cause flushing and itchiness. Consuming alcohol together with niacin may make the flushing and itching worse. There is likewise some concern that consuming alcohol with niacin may increase the opportunity of having liver damage.
Allopurinol (zyloprim) interaction ranking:
Moderate be cautious with this combination. Talk with your health supplier.
Allopurinol (zyloprim) is used to deal with gout. Taking big dosages of niacin may aggravate gout and reduce the effectiveness of allopurinol (zyloprim).
Clonidine (catapres) interaction score:
Moderate beware with this mix. Talk with your health supplier.
Clonidine and niacin both lower blood pressure. Taking niacin with clonidine may cause your high blood pressure to become too low.
Gemfibrozil (lopid) interaction ranking:
Moderate be cautious with this mix. Talk with your health provider.
Taking niacin along with gemfibrozil may trigger muscle damage in some people. Usage with care.
Medications for diabetes (antidiabetes drugs) interaction ranking:
Moderate beware with this mix. Talk with your health company.
Use of high dosages of niacin (about 3-4 grams everyday) might increase blood glucose. By increasing blood glucose, niacin may reduce the efficiency of diabetes medications. Screen your blood sugar carefully. The dose of your diabetes medication might need to be changed.
Some medications utilized for diabetes include 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 ranking:
Moderate be cautious with this combination. Talk with your health provider.
Utilizing niacin with drugs that lower blood pressure might increase the impacts of these drugs and may reduce high blood pressure excessive.
Some medications for high blood pressure include captopril (capoten), enalapril (vasotec), losartan (cozaar), valsartan (diovan), diltiazem (cardizem), amlodipine (norvasc), hydrochlorothiazide (hydrodiuril), furosemide (lasix), and lots of others.
Medications that can damage the liver (hepatotoxic drugs) interaction ranking:
Moderate be cautious with this combination. Talk with your health company.
Niacin might damage the liver. Sustained-release niacin preparations seem to have the best risk. Taking niacin along with medication that might likewise hurt the liver can increase the threat of liver damage. Do not take niacin if you are taking a medication that can damage the liver.
Some medications that can damage the liver include 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 lots of others.
Medications that slow blood clot (anticoagulant/ antiplatelet drugs) interaction ranking: moderate be cautious with this mix. Talk with your health service provider.
Niacin may slow blood clot. Taking niacin in addition to medications that likewise slow clotting may increase the chances of bruising and bleeding.
Some medications that slow blood clot consist of aspirin, clopidogrel (plavix), dalteparin (fragmin), enoxaparin (lovenox), heparin, indomethacin (indocin), ticlopidine (ticlid), warfarin (coumadin), and others.
Medications used for reducing cholesterol (bile acid sequestrants) interaction ranking:.
Moderate be cautious with this mix. Talk with your health service provider.
Some medications for lowering cholesterol called bile acid sequestrants can reduce how much niacin the body absorbs. This may reduce the effectiveness of niacin. Take niacin and the medications a minimum of 4-6 hours apart.
Some of these medications utilized for lowering cholesterol include cholestyramine (questran) and colestipol (colestid).
Medications used for decreasing cholesterol (statins) interaction ranking:
Moderate be cautious with this combination. Talk with your health service provider.
Niacin can negatively impact the muscles. Some medications used for reducing cholesterol called statins can likewise affect the muscles. Taking niacin along with these medications may increase the danger of muscle issues.
Some of these medications utilized for high cholesterol include 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 provider.
Probenecid is used to deal with gout. Taking large doses of niacin may intensify gout and reduce the efficiency of probenecid.
Sulfinpyrazone (anturane) interaction ranking:
Moderate beware with this mix. Talk with your health provider.
Sulfinpyrazone (anturane) is used to deal with gout. Taking big doses of niacin might aggravate gout and decrease the effectiveness of sulfinpyrazone (anturane).
Thyroid hormone interaction rating:
Moderate be cautious with this combination. Talk with your health provider.
The body naturally produces thyroid hormones. Niacin might reduce thyroid hormonal agent levels. Taking niacin with thyroid hormonal agent pills may decrease the impacts and adverse effects of thyroid hormonal agent.
Aspirin interaction ranking:
Minor be cautious with this combination. Talk with your health service provider.
Aspirin is typically utilized with niacin to minimize the flushing triggered by niacin. Taking high doses of aspirin might reduce how quick the body eliminates niacin. This might trigger there to be too much niacin in the body and possibly lead to side effects. Nevertheless, the low doses of aspirin most commonly used for niacin-related flushing don’t seem to be a problem.
Nicotine spot (transdermal nicotine) interaction score:
Minor be cautious with this mix. 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 using a nicotine spot can increase the possibility of ending up being flushed and lightheaded. 
Because of the potential for negative effects and interactions with medications, you ought to take dietary supplements only under the supervision of a knowledgeable health care company. Adverse effects might include diarrhea, headache, stomach discomfort, and bloating.
High doses (50 mg or more) of niacin can cause side effects. The most common negative effects 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 reduce this symptom.
At really high dosages, used to lower cholesterol and treat other conditions, liver damage and stomach ulcers can occur. Your medical professional will frequently check your liver function through a blood test.
Individuals with a history of liver disease, kidney disease, or stomach ulcers need to not take niacin supplements. Those with diabetes or gallbladder illness need to do so only under the close guidance of their physicians.
Stop taking niacin or niacinamide at least 2 weeks before an arranged surgery.
Niacin and niacinamide might make allergies even worse by increasing histamine.
Individuals with low blood pressure must not take niacin or niacinamide because they might cause a hazardous drop in blood pressure. Do not take niacin if you have a history of gout.
Individuals with coronary artery illness or unsteady angina should not take niacin without their medical professional’s guidance, as big dosages can raise the risk of heart rhythm problems.
Taking any among the b vitamins for an extended period of time can result in an imbalance of other important b vitamins. For this reason, you may want to take a b-complex vitamin, that includes all the b vitamins. 
The function of niacin as an antioxidant micro-nutrient has actually been established in a variety of research. The mechanisms through which niacin safeguards the body against oxidative tension can be keeping the glutathione redox cycle, and likewise, reducing nadph/total nadp+ ratio along with increasing the nad+ material. However most of the investigations in this area are limited to speculative studies, these mechanistic studies can be helpful for further scientific development of niacin and niacin-related substances for the treatment of oxidative tension and its problems.