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B36.0
Niacin Research
Probably helps
273 peer-reviewed studies
What the evidence says
Probably helps
Niacin helped in about half (4/6) of the studies that measured an effect — promising, but not unanimous.
Most evidence is from high-quality meta-analyses and randomised trials published 1983–2026 with a typical study size of 1,521 participants.
Based on 273 studies · 31 meta-analyses · 214 RCTs · 517,703 total participants
Confidence
High confidence
What the studies found
4helped2unclear· 267 more without graded effect data
By outcome
Cholesterol & lipidsRaises HDL and modifies lipid profiles at pharmacological doses · 4-8 weeks
Likely helps246 studies
Niacin flush & tolerability
Too few graded studies93 studies
Glucose & metabolic
Too few graded studies25 studies
Heart & blood pressureRaises HDL and modifies lipid profiles at pharmacological doses · 4-8 weeks
Too few graded studies15 studies
Skin health
Too few graded studies15 studies
Therapeutic & clinical
Too few graded studies12 studies
Safety profile
Too few graded studies12 studies
Longevity & agingLarge trials show niacin does not reduce mortality, heart attacks or strokes despite raising HDL, and it adds side effects. An NAD+ longevity benefit is unproven · Ongoing
Too few graded studies7 studies
Pellagra & niacin deficiency
Too few graded studies2 studies
Neuroprotection & brain aging
Too few graded studies2 studies
By the numbers
Pulled from 27 studies with measurable effects
Likely real effects
75%
across studies
People studied
518k
typical study: 1521 people
Strongest designs
245
31 pooled, 214 randomised
Showed benefit
67%
4/6 studies
How long studies ran
Under a week
1
1–3 months
2
3+ months
1
Populations Studied
Healthy adults3
Patients on lipid-lowering therapies1
Type 2 diabetes patients in primary care1
Patients requiring lipid management1
Steady research
42 studies in the last 5 years · Latest meta-analysis: 2026
198320042026
1Lipoprotein(a) levels reductionMeta-AnalysisCited 23×n=145,314 · very large study2025
In plain English: Among available LLTs, PCSK9mAbs, inclisiran, CETPi, and niacin significantly decreased Lp(a) levels.
Xie S et al. · Atherosclerosis (2025)
145,314 subjects from 147 RCTs were included.
Niacin lowered Lp(a) by -7.06 mg/dL (-9.27 to -4.85), a 37% reduction from baseline. Statins, bempedoic acid, ezetimibe, omega-3 fatty acids, and fibrates did not affect Lp(a) concentration.
Among available LLTs, PCSK9mAbs, inclisiran, CETPi, and niacin significantly decreased Lp(a) levels.
2Triglyceride reductions and HDL cholesterol levelsMeta-AnalysisCited 34×n=14,223 · very large study2023
In plain English: 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...
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: 90.4% and 78.3%, respectively).
Vitamin K supplements ranked best in reducing glycated hemoglobin A1c and fasting insulin levels (SUCRAs: 97.0% and 82.3%, respectively), with moderate to very low certainty evidence.
Vanadium supplements ranked best in lowering total cholesterol levels with very low evidence certainty (SUCRAs:100%).
3Carotid intima-media thickness reductionMeta-AnalysisCited 8×n=8,762 · very large study2021
In plain English: Statins combined with niacin performed a greater CIMT reduction compared to high-intensity statins alone and combination therapies with ezetimibe.
Li H et al. · European journal of clinical pharmacology (2021)
Network meta-analysis of 33 RCTs (8,762 participants) on carotid intima-media thickness (CIMT) with statins alone or combined with niacin or ezetimibe.
High-intensity statins or statin combinations with niacin or ezetimibe reduced CIMT more than moderate or low-intensity statins (SMD -0.287, 95% CI -0.460 to -0.114), and statin plus niacin ranked first (mean rank 1.7).
The advantage of niacin-combined statins therapies to improve cardiovascular endpoint needs further validation through randomized controlled trials.
4Lipoprotein(a) levelsMeta-AnalysisCited 111×n=9,013 · very large study2016
In plain English: In this meta-analysis of randomized placebo-controlled clinical trials, treatment with nicotinic acid was associated with a significant reduction in Lp(a) levels.
Sahebkar A et al. · Metabolism: clinical and experimental (2016)
Large benefit
← WorseNo effectBetter →
Likely real
Meta-analysis suggested a significant reduction of Lp(a) levels following ER niacin treatment (weighted mean difference - WMD: -22.90%, 95% CI: -27.32, -18.48, p<0.001).
Results also remained similar when the meta-analysis was repeated with standardized mean difference as summary statistic (WMD: -0.66, 95% CI: -0.82, -0.50, p<0.001).
When the studies were categorized according to the administered dose, there was a comparable effect between the subsets of studies with administered doses of <2000mg/day (WMD: -21.85%, 95% CI: -30.61, -13.10, p<0.001) and ≥2000mg/day (WMD: -23.21%, 95% CI: -28.41, -18.01, p<0.001).