What is the recommended dosage for Niacin (Vitamin B3)?

General Nutrition: 14-16 mg/day; Lipid Modification: 1,000-2,000 mg/day (start at 500 mg/day and titrate)

What are the side effects of Niacin (Vitamin B3)?

Potential side effects include: Flushing (redness, warmth, itching — most common, especially immediate-release), Gastrointestinal discomfort (nausea, diarrhea), Hepatotoxicity (especially extended-release at high doses), Hyperglycemia (may worsen blood sugar control), Hyperuricemia (may precipitate gout).

What is niacin and how may it support cardiovascular health?

Niacin (vitamin B3) is one of the most effective agents for raising HDL cholesterol, with increases of 15–35% at pharmacologic doses. It also lowers LDL cholesterol and triglycerides. However, large trials (AIM-HIGH, HPS2-THRIVE) failed to show additional cardiovascular benefit when niacin was added to statin therapy.

What dosage of niacin has been studied for cardiovascular outcomes?

Cardiovascular studies used pharmacologic doses of 1,000–2,000 mg of immediate-release or extended-release niacin per day. These are prescription-level doses, far exceeding the RDA of 14–16 mg. Extended-release forms reduce flushing but may increase hepatotoxicity risk. Dosing should be supervised by a healthcare provider.

What are the potential side effects of niacin at cardiovascular doses?

Flushing (warmth, redness, itching) is the most common side effect, affecting 70–80% of users. Other side effects include liver enzyme elevations (especially with sustained-release forms), hyperglycemia, hyperuricemia, and gastrointestinal upset. The HPS2-THRIVE trial found increased risks of serious adverse events. Medical supervision is essential.

Niacin (Vitamin B3)

vitamin

Also known as: Nicotinic Acid, Vitamin B3, Niacinamide (does not affect lipids)

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About

Niacin is the most effective agent for raising HDL cholesterol (15-35%) and uniquely lowers Lp(a) (up to 30%). The Coronary Drug Project (8,341 men) showed niacin at 3g/day reduced recurrent MI by 27%. However, the AIM-HIGH and HPS2-THRIVE trials showed no incremental cardiovascular benefit when added to statin therapy.

How It Works

Activates GPR109A (HCA2) receptor in adipocytes reducing lipolysis and free fatty acid flux to the liver, decreasing hepatic VLDL/triglyceride production; significantly raises HDL cholesterol (15-35%) by reducing hepatic HDL-apoA-I catabolism; lowers LDL (5-25%) and Lp(a) (up to 30%); may reduce vascular inflammation through macrophage GPR109A activation.

Evidence For Conditions

Condition	Grade	Studies	Participants
High Cholesterol (Hyperlipidemia)	B	10	12000	View →
High Triglycerides (Hypertriglyceridemia)	B	8	4000	View →

Side Effects

Flushing (redness, warmth, itching — most common, especially immediate-release)
Gastrointestinal discomfort (nausea, diarrhea)
Hepatotoxicity (especially extended-release at high doses)
Hyperglycemia (may worsen blood sugar control)
Hyperuricemia (may precipitate gout)

Drug & Supplement Interactions

Statins (increased risk of myopathy/rhabdomyolysis)
Blood pressure medications (additive hypotensive effect)
Diabetes medications (may counteract blood sugar control)
Anticoagulants (may increase bleeding risk)
Alcohol (may worsen flushing and hepatotoxicity)

Always inform your healthcare provider about all supplements you take.

Related Ingredients

Folate (Vitamin B9) Vitamin D Vitamin E Vitamin K2

Quick Facts

Dosage: General_Nutrition: 14-16 mg/day; Lipid_Modification: 1,000-2,000 mg/day (start at 500 mg/day and titrate)
Forms: tablet (immediate-release) tablet (extended-release) capsule
Natural Sources: Chicken breast, Tuna, Turkey, Salmon, Peanuts, Mushrooms
Upper Limit: 35 mg/day for non-prescription use; prescription doses up to 3,000 mg/day under medical supervi
Best Time: With dinner or at bedtime with a low-fat snack; aspirin 30 min before may reduce flushing

Evidence Summary

High Cholesterol (Hyperlipidemia) B

High Triglycerides (Hypertriglyceridemia) B

FDA Disclaimer: These statements have not been evaluated by the Food and Drug Administration. The products and information on this website are not intended to diagnose, treat, cure, or prevent any disease. The evidence grades presented are based on our analysis of published peer-reviewed research and do not constitute medical advice. Always consult your healthcare provider before starting any supplement regimen.