Having enough niacin, or vitamin B3, in the body is important for general good health. As a treatment, higher amounts of niacin can improve cholesterol levels and lower cardiovascular risks.
As a cholesterol treatment, niacin has strong evidence. Several studies have shown that it can boost levels of good HDL cholesterol and lower triglycerides as well or better than some prescription drugs. Niacin also modestly lowers bad LDL cholesterol. It’s often prescribed in combination with statins for cholesterol control, such as Crestor, Lescol, or Lipitor.
However, niacin is only effective as a cholesterol treatment at fairly high doses. These doses could pose risks, such as liver damage, gastrointestinal problems, or glucose intolerance. So don’t treat yourself with over-the-counter niacin supplements. Instead, get advice from your health care provider, who can prescribe FDA-approved doses of niacin instead.
Niacin has other benefits. There’s good evidence that it helps reduce atherosclerosis, or hardening of the arteries. For people who have already had a heart attack, niacin seems to lower the risk of a second one. In addition, niacin is an FDA-approved treatment for pellagra, a rare condition that develops from niacin deficiency.
Niacin has also been studied as a treatment for many other health problems. There’s some evidence that it might help lower the risk of Alzheimer’s disease, cataracts, osteoarthritis, and type 1 diabetes. However, more research needs to be done.
Since niacin can be used in different ways, talk to your health care provider about the best dosage for you.
Everyone needs a certain amount of niacin — from food or supplements — for the body to function normally. This amount is called the dietary reference intake (DRI), a term that is replacing the older and more familiar RDA (recommended daily allowance). For niacin, the DRIs vary with age and other factors.
However, the ideal dosage of niacin depends on how you’re using it. For instance, much higher doses — 2 to 3 grams or more — are used to treat high cholesterol.
Since niacin can upset your stomach, you might want to take it with food. To reduce flushing, your health care provider might recommend taking niacin along with aspirin, an NSAID painkiller, or an antihistamine for a few weeks until tolerance to the niacin develops.
Niacin occurs naturally in many foods, including greens, meat, poultry, fish, and eggs, though in a fraction of the dose shown to achieve changes in cholesterol. Many products are also fortified with niacin during manufacture.