Niacin (Vitamin B3)
NAD+ precursor that raises HDL, lowers LDL and triglycerides, and fuels cellular energy metabolism at therapeutic doses.
Niacin (Vitamin B3) is essential for energy metabolism and is a precursor to NAD+, a critical coenzyme for cellular energy and longevity. At higher doses, niacin has well-documented effects on improving cholesterol profiles, raising HDL and lowering LDL and triglycerides. The flush form is most effective for lipids, while niacinamide avoids flushing but doesn't affect cholesterol.
Converts to NAD+ for cellular energy
Dramatically affects cholesterol levels
Causes vasodilation (the 'niacin flush')
How Niacin works — from molecular targets to health outcomes. Click an edge to see supporting research.This visualization is in beta — pathways are being refined and expanded.
500-2000mg daily for lipid effects; 50-500mg for general health
Loading: Start with 100mg and gradually increase over weeks to minimize flush
Take with food
| Form | Type |
|---|---|
| 💊Immediate-release niacin (nicotinic acid) | Recommended |
| 💊Extended-release niacin (less flush but more liver risk) | Alternative |
| 💊Niacinamide (no flush, no lipid effects) | Alternative |
| 💊Inositol hexanicotinate ('no-flush' - less effective) | Alternative |
Immediate-release is most effective for lipids. Avoid sustained-release due to liver concerns. Niacinamide doesn't affect cholesterol.
Minimum: 8 weeks
Optimal: 24 weeks
Cycling: Not required
Note: Taking with food and aspirin (30 min before) can reduce flushing. Build up dose slowly over 2-4 weeks.
Significant increase in 'good' cholesterol
Significant reduction in triglycerides
Temporary skin flushing, warmth, itching
Monitor blood sugar; may need medication adjustment
Combination may increase myopathy risk
May enhance hypotensive effects
Tip: Start low, take with food, aspirin 30 min before
Tip: Monitor liver enzymes; avoid sustained-release forms
Tip: Monitor glucose if diabetic
Top studies from 39+ peer-reviewed papers
Schandelmaier S et al. • The Cochrane database of systematic reviews (2017)
“Moderate- to high-quality evidence suggests that niacin does not reduce mortality, cardiovascular mortality, non-cardiovascular mortality, the number of fatal or non-fatal myocardial infarctions, nor the number of fatal or non-fatal strokes but is associated with side effects.”
Xie S et al. • Atherosclerosis (2025)
“Among available LLTs, PCSK9mAbs, inclisiran, CETPi, and niacin significantly decreased Lp(a) levels.”
Ferrell M et al. • Nature medicine (2024)
“The Author(s), under exclusive licence to Springer Nature America, Inc.”
Nicola CA et al. • Nutrients (2024)
“Daily dietary intake of niacin is significantly lower in patients with glaucoma compared to the general population.”
Xia J et al. • Pharmacological research (2023)
“Low to very low certainty evidence established chromium supplements as the most effective in reducing fasting blood glucose levels and homeostasis model assessment of insulin resistance (SUCRAs: 90...”
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