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Head-to-head evidence comparison — which supplement is right for you?
Probiotics wins 2 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Probably helps
2 of 3 studies with measurable effects showed benefit.
Top outcomes
Verdict
Likely helps
30 of 39 studies with measurable effects showed benefit.
Top outcomes
500mg twice daily
Morning and evening with meals
Niacinamide tablets (500mg)
10-20 billion CFU
With or without food (strain-dependent), Same time daily for consistency
Capsules with multiple strains
3-12 months
8 weeks
Days
First days
2-4 weeks
4-8 weeks
4-8 weeks
First 1-2 weeks
A Phase 3 Randomized Trial of Nicotinamide for Skin-Cancer Chemoprevention.
The New England journal of medicine (2015) · Rct · n=386
ONTRAC: phase-3, double-blind RCT randomizing 386 patients with ≥2 prior non-melanoma skin cancers to 500 mg nicotinamide twice daily or placebo for 12 months
Skin Cancer Prevention and Antiaging: Role of Nicotinamide.
International journal of molecular sciences (2026) · Review
Review of the biological rationale and clinical evidence for nicotinamide and NAD+ precursors in photoaging and cutaneous carcinogenesis
Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris.
International journal of dermatology (1995) · Rct · n=76
Double-blind RCT of 76 patients randomized to 4% nicotinamide gel or 1% clindamycin gel twice daily for 8 weeks for moderate inflammatory acne
Preventive Effect of Probiotics on Oral Mucositis Induced by Cancer Treatment: A Systematic Review and Meta-Analysis
International journal of molecular sciences (2022) · Meta analysis · n=708
Three trials using Lactobacilli-based probiotics reported that the incidence of oral mucositis in the probiotic group was significantly low (risk ratio [RR] = 0.84, 95% confidence interval [CI] = 0.77−0.93, p = 0.0004).
Probiotics for treating acute infectious diarrhoea
The Cochrane database of systematic reviews (2020) · Meta analysis · n=12127
Effect size was similar in the sensitivity analysis and marked heterogeneity persisted.
Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children
The Cochrane database of systematic reviews (2017) · Meta analysis · n=9955
A complete case analysis (i.e. participants who completed the study) among trials investigating CDAD (31 trials, 8672 participants) suggests that probiotics reduce the risk of CDAD by 60%.
The ONTRAC RCT used 500 mg twice daily (1000 mg/day total) and reduced new non-melanoma skin cancers by 23%. Effect requires continuous use; it disappeared after discontinuation. Curve is indicative — only the 1000 mg/day regimen is directly RCT-supported.
Based on meta-analyses showing benefits for IBS and digestive symptoms. Effect sizes varied considerably between studies with low to very low certainty of evidence. Initial GI symptoms common when starting but typically resolve within 1-2 weeks.
AI-estimated from published studies. Interpret as directional guidance.
Probiotics has a higher evidence score (9/10 vs 5.5/10) and wins in 2 of 3 categories.
For reduce inflammation, Probiotics has a higher relevance score (95 vs 45).
No known interactions between Nicotinamide and Probiotics have been documented in our database. However, always consult a healthcare provider before combining supplements.