An acid C6H5NO2 of the vitamin B complex discovered extensively in animals and plants and used especially versus pellagra. 
Niacin is a type of vitamin B3 made in the body from tryptophan. It’s discovered in lots of foods consisting of meat, fish, milk, eggs, green veggies, and cereals.
Niacin is required for the appropriate function of fats and sugars in the body and to preserve healthy cells. At high dosages, niacin may assist individuals with cardiovascular disease because of its impacts on blood clotting. It might likewise enhance levels of fats called triglycerides in the blood.
Prescription kinds of niacin are authorized by the United States FDA for irregular cholesterol levels and for preventing vitamin B3 deficiency and associated conditions such as pellagra. People utilize niacin supplements for metabolic syndrome, cardiovascular disease, cataracts, hypertension, and many other conditions, but there is no good clinical proof to support the majority of these other uses.
History of pellagra
Pellagra was unknown to the physicians of the ancient world and the Middle Ages. It was initially explained by the doctor Gaspar Casal in Spain in 1735, not long after the maize was introduced into Europe. The name of the disease was established in 1771 by an Italian physician Francesco Frapolli.
Due to the excellent boost in making use of maize in northern part of Italy, pellagra became so widespread that a special healthcare facility (referred to as Legano) was integrated in 1784, solely for pellagra clients. Reports on the incident of pellagra appeared soon afterwards in France (1829 ), Romania (1858) and Egypt (1874 ).
After 1900 pellagra became a considerable health issue in the United States as well, especially in the South. It carefully followed the introduction of a new grain processing approach that got rid of the majority of the vitamins from processed grain. There was a specific shift from the use of coarsely ground corn meal in local, water-driven mills to carefully bolted meal by big milling companies.
The outbreaks of pellagra were so ubiquitous and severe that a majority of physicians considered the cause to be an infectious agent. The true nature of illness was determined when the Federal Government of the United States sent a medical professional from New york city, Joseph Goldberger, to study the disease.
The discovery of niacin
Nicotinic acid was manufactured in 1867 by oxidation of nicotine and commonly utilized in photography. It was long idea that it has nothing to do with food or health issues, till German researchers showed that nicotinic acid happens in yeast and in rice polishing. There it was isolated by the Polish-American.
biochemist Casimir Funk in 1912, while he was trying to find a cure for another illness known as beriberi (nutritional condition brought on by a shortage of thiamine).
Since nicotinic acid had no effect on beriberi, he abandoned his deal with that compound. But although he was wrong, he revealed that this nicotinic acid probably had some nutritional worth. It was left to the Austrian-American doctor Joseph Goldeberger to discover the connection in between nicotinic acid and shortage diseases it can trigger.
In 1915, Goldberger carried out a series of experiments on 11 healthy volunteer prisoners in a Mississippi jail and found that he could induce pellagra by modifying their diets. He concluded that the illness was caused by the absence of some aspect that was lacking in corn, but that could be found in meat and milk. He called it the P-P (for pellagra-preventative) element.
The chemical structure of that element was subsequently found in 1937 by the American biochemist Conrad Arnold Elvehjem. He caused a black tongue in canines by feeding them the Goldberger diet plan, and after that treated the illness by supplementing their diet with nicotinic acid. He also separated the P-P element from active liver extracts, showing that this element is actually nicotinic acid (consequently called niacin for nicotinic acid vitamin).
After this discovery, grain products (wheat, maize) were improved with nicotinic acid or nicotinamide. Still, a wide scale social reform was required to make sure correct implementation of such dietary adjustments. The majority of erratic cases in the developed nations are now seen in alcoholics, although in rare circumstances other patients can establish the illness as well (i.e. malabsorption or iatrogenic scenarios). 
In addition to taking in niacin from diet plan, niacin can be manufactured from the important amino acid tryptophan, a five-step procedure with the penultimate compound being quinolinic acid (see figure). Some germs and plants utilize aspartic acid in a path that likewise goes to quinolinic acid. For human beings, the effectiveness of conversion is approximated as needing 60 mg of tryptophan to make 1 mg of niacin. Riboflavin, vitamin B6 and iron are needed for the process. Pellagra is a consequence of a corn-dominant diet plan because the niacin in corn is poorly bioavailable and corn proteins are low in tryptophan compared to wheat and rice proteins.
Nicotinic acid was first synthesized in 1867 by oxidative degradation of nicotine. Niacin is prepared by hydrolysis of nicotinonitrile, which, as explained above, is created by oxidation of 3-picoline. Oxidation can be effected by air, however ammoxidation is more efficient. In the latter process, nicotinonitrile is produced by ammoxidation of 3-methylpyridine. Nitrile hydratase is then utilized to catalyze nicotinonitrile to nicotinamide, which can be converted to niacin. Additionally, ammonia, acetic acid and paraldehyde are used to make 5-ethyl-2-methyl-pyridine, which is then oxidized to niacin.  New “greener” drivers are being tested using manganese-substituted aluminophosphates.
that use acetyl peroxyborate as non-corrosive oxidant, preventing producing nitrogen oxides as do standard ammoxidations.
The need for industrial production consists of for animal feed and for food fortification meant for human consumption. According to Ullmann’s Encyclopedia of Industrial Chemistry, around the world 31,000 lots of nicotinamide were sold in 2014. 
System of action
Niacin performs a number of functions in the body therefore has many mechanisms, not all of which have been completely explained. Niacin can decrease lipids and apolipoprotein B (apo B)- including lipoproteins by modulating triglyceride synthesis in the liver, which degrades apo B, or by modulating lipolysis in adipose tissue.
Niacin hinders hepatocyte diacylglycerol acyltransferase-2. This action prevents the final step of triglyceride synthesis in hepatocytes, restricting available triglycerides for extremely low density lipoproteins (VLDL). This activity also leads to intracellular destruction of apo B and decreased production of low density lipoproteins, the catabolic item of VLDL.
Niacin also inhibits a high density lipoprotein (HDL) catabolism receptor, which increases the levels and half life of HDL. 
Yellowfin tuna: 18.8 mg, 117% daily value (dv)
While tuna is an excellent source of niacin, bigger varieties like yellowfin or albacore tend to be higher in mercury than smaller sized species like skipjack.
A cooked, 3-ounce filet of cooked yellowfin tuna provides 117 percent of the dv for niacin, plus 83 percent of the dv for vitamin b12, which is required for energy.
Beef liver: 14.7 mg, 92% dv
Ok, so we don’t anticipate you to consume beef liver every day, but the organ meat is an excellent source of b vitamins, consisting of niacin. One piece of fried beef liver supplies an outstanding 92 percent of the dv for niacin. It’s likewise swarming with vitamin a, iron and zinc.
Turkey breast: 10 mg, 62% dv
Turkey is often promoted as the main source of tryptophan, however in truth, numerous animal proteins (consisting of eggs, chicken and cheese) provide the important amino acid, according to the u.s. National library of medicine.
So, you’ll most likely get even more than 62 percent of the dv for niacin from this 3-ounce serving of roasted turkey breast thanks to the conversion of some of its tryptophan to nad in the body. But in order for the amino acid to be transformed into niacin, the body needs to have adequate levels of other nutrients, like iron, b6 and riboflavin.
Sockeye salmon: 8.6 mg, 54% dv
Niacin-rich sockeye salmon is also an outstanding source of anti-inflammatory omega-3 fats.
In addition to offering anti-inflammatory omega-3 fats and vitamin d, cooked salmon is also an outstanding source of niacin, with 54 percent of the dv present in a 3-ounce serving.
Chicken breast: 8 mg, 50% dv
3 ounces of prepared chicken breast can dish out 50 percent of the dv for niacin, plus 27 grams of satisfying protein.
If you’re feeling uninspired by poultry, attempt cooking up these healthy chicken dishes you haven’t tried yet (we promise they will not disappoint).
Portobello mushrooms: 7.6, 47% dv
For a niacin-rich meal, throw portobello mushrooms on the grill together with your protein of choice. One cup of grilled portobello mushrooms provides 47 percent of the dv for niacin, deeming them a few of the very best vegetarian foods high in niacin.
Pork chops: 6.8 mg, 42% dv
A pork chop can dish out almost half of your day-to-day niacin requirements.
Though fattier than other cuts like the tenderloin (which is the leanest cut of pork), chops are a great natural source of niacin. A 3-ounce, prepared pork slice delivers 42 percent of the dv for niacin.
Wild rice: 5.2 mg, 32% dv
It’s safe to say that brown rice is among the vegetarian foods highest in niacin. You’ll get 33 percent of the dv for vitamin b3 in 1 cup of cooked wild rice. You’ll also get almost 6 grams of protein and 3 grams of fiber from the entire grain.
Pair plant-based protein sources like wild rice with black beans for a total protein that provides all 9 of the necessary amino acids.
Canned white tuna: 4.9 mg, 31% dv
The american heart association recommends consuming fish a minimum of two times weekly to preserve a healthy heart. Simply make certain to practice moderation when it pertains to canned tuna ranges like albacore or white tuna.
Though rich in niacin– 3 ounces of canned white tuna provides 31 percent of the dv for the b vitamin– these ranges tend to be greater in mercury compared to smaller sized species like skipjack tuna, per the united states epa (epa). Attempt the seafood in these non-salad canned tuna recipes.
Steak: 4.8 mg, 30% dv
iron-rich skirt steak likewise dishes out vitamin b3.
Grilled skirt steak is a high-protein source of niacin, with a 3-ounce serving supplying 30 percent of the dv for the nutrient.
Beef is also high in minerals like iron, which supports healthy blood cell formation and oxygen delivery throughout the body, according to the university of california san francisco health.
Peanuts: 4.1 mg, 25% dv
If you’re looking for vegan foods high in niacin, 1 ounce of dry-roasted peanuts provides 25 percent of the dv. The legumes are likewise rich in unsaturated fats that support healthy lipid levels. Pb&& j, anybody?
Fortified breakfast cereals: 4 mg, 25% dv
It’s tough to state exactly just how much niacin you’ll receive from a prepared breakfast cereal, as various products provide different amounts of the b vitamin, however approximates variety anywhere from 20 to 27 percent of the dv per 1 cup, according to oregon state university.
Baked potato: 2.6 mg, 17% dv
Can we all consent to give routine old russet potatoes more enjoy? Sure, sweet potatoes are high in the antioxidant beta-carotene, however one medium baked russet potato delivers 17 percent of the dv for niacin, plus potassium and vitamin c.
White rice (enriched): 2 mg, 13% dv
Though wild rice is a much better source of niacin, enriched white rice isn’t too far behind. A 1/2-cup serving of prepared, enriched white rice puts 13 percent of the dv for niacin on the table.
Similar to fortified foods, enriched foods have nutrients contributed to them. The distinction here is that the included nutrients were originally in the food, however stripped away during processing.
Lentils: 2.1 mg, 13% dv
Changing animal proteins like meat with vegetables like lentils (in addition to other plant-based proteins like nuts and soy) is related to a lower risk of coronary heart problem, per a large prospective mate research study released in december 2020 in the british medical journal.
One cup of prepared lentils consists of 13 percent of the dv for niacin. The pulses are likewise a fantastic source of non-heme iron, folate and resistant starch, per the harvard t.h. Chan school of public health.
Sunflower seeds: 2 mg, 12% dv
An ounce of dry-roasted sunflower seeds can bring you 12 percent of the dv for niacin. Sprinkle them on top of salads or blend them into whole grains like farro for a satisfying crunch.
Bulgur: 1.8 mg, 11% dv
A cup of prepared bulgur provides 11 percent of the dv for niacin, plus minerals like iron, magnesium and manganese. Work up a batch of the whole grain for the week, then utilize it in different dishes like grain bowls, soups and salads.
Avocado: 1.7 mg, 11% dv
An outstanding source of heart-healthy monounsaturated fatty acids, avocado is likewise a strong vegetarian source of niacin. A half of an avocado contains 11 percent of the dv for the vitamin. Naturally, we ‘d never limit you to simply a half of an avocado.
Don’t miss these inventive and scrumptious ways to eat avocado that go beyond your basic guac or avo toast.
Whole-wheat bread: 1.4 mg, 9% dv
Whole grains are amongst the healthiest plant sources of niacin and whole wheat bread is no exception. One piece of whole wheat bread can provide almost 10 percent of the dv for niacin. Leading your toast with peanut butter and a spray of sunflower seeds for a satiating treat.
Pumpkin seeds: 1.3 mg, 8% dv
Niacin-rich pumpkin seeds in a little wood bowl.
Not only are pumpkin seeds a good source of niacin, they’re likewise a nourishing method to include crunch to meals.
Spray them on salads or your morning oatmeal bowl for additional texture– and nutrients.
Banana: 0.9 mg, 6% dv
By now you understand that there are a lot of vitamin b3 vegetables and fruits– and bananas make the cut. One big banana provides 6 percent of the dv for niacin.
Go on and include the fruit to your cereal bowl with a spoonful of peanut butter and a (spoiler alert) cup of coffee on the side for a healthy, high-niacin start to the day.
Coffee: 0.5 mg, 3% dv
While coffee isn’t sky-high in vitamin b3, 1 cup of joe can deliver about 3 percent of the DV for niacin. 
Benefits of niacin
While more research studies require to be performed and supporting evidence must be identified, there are a range of uses for niacin. In terms of health advantages, niacin potentially can:.
- Control cholesterol
- Lower blood pressure
- Enhance psychological health
- Clear skin
- Manage migraines
- Promote joint health
- Secure cognitive function
- Assistance food digestion
- Lessen abnormality
- Improve erectile dysfunction
It helps manage cholesterol levels
In some cases niacin is prescribed along with cholesterol-lowering medications like statins to help stabilize blood lipid levels. It can increase high-density lipoprotein (hdl) cholesterol, which is the healthy type of.
Cholesterol, by 15% to 35%. And it can decrease low-density lipoprotein (ldl), the bad cholesterol, by 5% to 25%.
Other proof indicates that niacin is good for individuals with an increased threat of cardiovascular disease and cardiovascular disease due to the fact that it not only lowers ldl cholesterol but also triglycerides. Niacin can reduce triglyceride levels by 20% to 50%. The prescription solutions niaspan and niacor have fda approval to treat dyslipidemia (elevated cholesterol or other fats in the blood).
It may lower blood pressure
Little clinical trials of using niacin have shown it has substantial blood pressure decreasing impacts in people with hypertension. In addition, unexpected lowering of high blood pressure is explained in the plan insert of prescription niacin. However, in bigger clinical trials involving niacin and niacin-containing routines there showed either no clear significant impacts of niacin or a little lower mean high blood pressure among some niacin treatment groups compared to placebo.
More research studies need to be done to identify how reliable niacin can be for lowering blood pressure and reducing the danger of cardiovascular occasions, but up until now the research appears appealing.
It may enhance mental health
Dietary routines have a considerable influence on numerous mental illness including depression, anxiety, schizophrenia, and bipolar illness. This has actually caused the advancement of dietary guidelines to help handle these conditions. Niacin shortage has shown a possible link to some mental disorders.
Research studies have documented decreased cerebral blood circulation in depressed clients and enhanced cerebral blood flow following antidepressant treatment. Niacin is believed to increase cerebral blood flow, so there is potential to use niacin supplements together with prescription antidepressants.
It benefits the skin
Niacin is an excellent supplement for the skin. It can assist safeguard skin cells from sun damage, clear acne when used topically, and decrease redness and inflammation. Vitamin b3 in the solution of niacinamide is typically used as a natural topical skincare treatment to clear acne. Niacin can even help manage inflammatory skin conditions like bullous pemphigoid or granuloma annulare.
It might assist handle migraines
Although it’s uncertain how niacin accomplishes therapeutic effects, it could be helpful for migraine and tension-type headaches and the prevention of these headaches. Niacin might prevent migraine symptoms by expanding the intracranial vessels and following contractions of the extracranial vessels.
It promotes joint health
Vitamin b3 in the form of niacinamide has actually been revealed to increase joint movement and decrease joint pain, swelling, and swelling. Because of its anti-inflammatory effect on joints, niacin may act as a good treatment alternative for people with arthritis.
It may protect against alzheimer’s illness
In a study released by the journal of neurology, neurosurgery, and psychiatry, dietary niacin was concluded to be a possible protector versus alzheimer’s disease and age-related cognitive decrease. A higher intake of niacin may be connected with a slower rate of cognitive decrease gradually.
It’s good for digestion
Niacin is fantastic for the digestion system since vitamin b3 assists break down nutrients like carbs and fats into energy. If someone lacks niacin, they might have a hard time absorbing food and might experience intestinal issues with time.
It may prevent birth defects
According to a 2017 study published by the brand-new england journal of medication, niacin supplements during pregnancy avoided malformations in mice. More human research studies need to be done, but preliminary research suggests that niacin might assist prevent nicotinamide adenine dinucleotide (nad) birth defects in humans and lower general abnormality rates.
On the other hand, caution is recommended for niacin supplementation while breastfeeding, as there is restricted human information on the results of niacin in breastmilk. New or anticipating moms must constantly talk with their healthcare provider prior to presenting new supplements or medications during pregnancy or lactation.
It might improve impotence
Impotence (ed) is the inability to get or keep an erection. Since niacin helps enhance blood flow, it might also benefit impotence. In a study published by the journal of sexual medicine, a daily dose of up to 1,500 mg of niacin sufficed to enhance sexual function among guys who had actually both ed and dyslipidemia. Men with dyslipidemia were studied because dyslipidemia is closely related to ed. 
Etiology of niacin shortage
Main niacin deficiency
It arises from incredibly inadequate intake of both niacin and tryptophan, which normally happens in locations where maize (indian corn) constitutes a substantial part of the diet. Bound niacin, discovered in maize, is not assimilated in the intestinal tract unless it has actually been formerly treated with alkali, as when tortillas are prepared. Corn protein is likewise deficient in tryptophan. The high occurrence of pellagra in india among people who eat millet with a high leucine material has resulted in the hypothesis that amino acid imbalance might contribute to shortage. Shortages of protein and lots of b vitamins typically accompany primary niacin shortage.
Secondary niacin deficiency
It might be because of diarrhea, cirrhosis, or alcohol addiction. Pellagra also may occur in carcinoid syndrome (tryptophan is diverted to form 5-hydroxytryptophan and serotonin) and in hartnup illness (absorption of tryptophan by the intestine and kidneys is defective). 
Reasons for niacin deficiency
One kind of niacin shortage results from a shortage of niacin and tryptophan (an amino acid). This kind triggers a condition called pellagra, which affects the skin, digestive system, and brain. Pellagra establishes just if the diet is deficient in niacin and tryptophan because the body can convert tryptophan to niacin. People who reside in locations where maize (indian corn) is the primary food source are at danger of developing pellagra since maize is low in niacin and tryptophan. Additionally, the niacin in maize can not be soaked up in the intestine unless the maize is treated with alkali (as it is when tortillas are
Prepared). Pellagra might be a seasonal condition, appearing each spring and lasting through the summer, when the diet consists mainly of maize items.
Pellagra likewise develops in people who have one of the following:
- Hartnup illness, an unusual hereditary disorder in which absorption of tryptophan is impaired
- Carcinoid syndrome, a rare disorder in which tryptophan is not transformed to niacin
The following can lead to a deficiency of niacin:
- Alcohol addiction
- The antibiotic isoniazid if considered a long period of time
Signs of niacin shortage
Generally, people with pellagra establish a symmetric, dark red rash that looks like a sunburn and worsens when it is exposed to sunlight (a condition called photosensitivity). The rash happens in areas of sun exposure, and its area is unique:
- On the arms and hands (like gloves)
- On the feet and calves (like boots)
- Around the neck (like a necklace)
- On the face forming a butterfly shape
Skin problems are relentless, and the affected areas may end up being brown and flaky.
The entire digestion system is impacted. The tongue and mouth might become irritated and dark red. The tongue may swell, the mouth may burn, and sores might develop on both. The throat and esophagus may also burn. Saliva production might increase. Other symptoms consist of queasiness, vomiting, abdominal discomfort, constipation, and diarrhea (which may be bloody).
Later on, fatigue, sleeping disorders, and apathy establish. Malfunction of the brain (encephalopathy) usually follows. It is identified by confusion, disorientation, hallucinations, and amnesia. Individuals might be overexcited, depressed, exceptionally elated (manic), delirious, or paranoid (thinking that people intend to harm them). 
In early shortage, medical diagnosis requires a high index of suspicion and attempts at confirmation of niacin shortage. Niacin metabolites, particularly n-methylnicotinamide, can be determined in the urine. Low levels suggest niacin deficiency however may likewise be discovered in patients with generalized under-nutrition. Serum and red cell levels of nad and nadp are likewise low but are similarly nonspecific. In sophisticated cases, the diagnosis of pellagra can be made on medical grounds. 
Usually a niacin shortage may suggest numerous dietary deficiencies; for that reason, a balanced diet plan is a strong suggestion. Nicotinamide doses of 250 to 500 mg/day orally must be provided. In spite of nicotinic acid being the more common form of niacin, nicotinamide is utilized for niacin shortages as it does not trigger signs such as tingling feeling, itching, or flushing. Patients with pellagra ought to prevent sun exposure and alcohol consumption. The recommended dietary allowance (rda) for niacin is expressed as niacin equivalents (ne). The rda for children ages 1 to 3 and 4 to 8 years of age is 6 and 8 mg/day of ne. For both young boys and girls ages 9 to 13, the rda is 12 mg/day of ne. For people 14 years or older, the rda is 16, and it is 14 mg/day of ne for males and females, respectively. Rda during lactation is 17 mg/day of ne. 
Niacin adverse effects
Niacin oral tablet does not trigger drowsiness, but it can trigger opposite effects.
More typical side effects
Some of the more typical side effects of niacin can include:.
- Reddening and warming of your face (flushing)
- Throwing up
- Increased cough
If these effects are mild, they might go away within a couple of days or a couple of weeks. If they’re more serious or don’t disappear, talk with your doctor or pharmacist.
Serious side effects
Call your medical professional right now if you have severe negative effects. Call 911 if your signs feel life-threatening or if you believe you’re having a medical emergency situation. Serious negative effects and their symptoms can consist of the following:.
- Muscle problems. Symptoms can consist of:
- Unexplained muscle weakness, tenderness, or discomfort
- Liver problems. Signs can consist of:
- Tiredness or weakness
- Loss of appetite
- Upper stomach discomfort
- Dark-colored urine
- Yellowing of your skin or the whites of your eyes 
Dosage: just how much niacin should i take?
Always speak to a healthcare provider prior to taking a supplement to make sure that the supplement and dosage are appropriate for your individual needs.
Most healthy people obtain enough niacin through their diet plan, so extra supplementation is not typically needed. The majority of research is based on deficiencies.
Some supplements contain as much as 500 mg per serving, which is higher than the advised everyday allowance for niacin. For that reason, it’s necessary to go over supplementation with a doctor. They can assist you determine if niacin supplements make good sense in your scenario and can help you find the ideal formula and dose.
What occurs if i take too much niacin?
To avoid toxicity, understand the proper dose and keep the tolerable ceiling in mind. The upper limit is the optimum day-to-day amount that’s thought about safe and not likely to trigger adverse results. If you consume more than this quantity or more than what is recommended by your healthcare provider, you may experience the severe side effects listed above.
For niacin, toxicity has been noted in dosages over 1 gram. If you go beyond these levels, you might wish to seek medical recommendations or go to the emergency room.
Upper consumption levels
Upper consumption levels for niacin are as follows:.
- 10 mg for children 1-3 years
- 15 mg for kids 4-8 years
- 20 mg for children 9-13 years
- 30 mg for children 14-18 years
- 35 mg for adults 
Alcohol (ethanol) interaction rating:
Moderate beware with this combination. Talk with your health provider.
Niacin can cause flushing and itchiness. Consuming alcohol in addition to niacin might make the flushing and itching worse. There is also some issue that consuming alcohol with niacin may increase the chance of having liver damage.
Allopurinol (zyloprim) interaction score:
Moderate beware with this mix. Talk with your health provider.
Allopurinol (zyloprim) is utilized to treat gout. Taking big doses of niacin might intensify gout and decrease the efficiency of allopurinol (zyloprim).
Clonidine (catapres) interaction score:
Moderate beware with this combination. Talk with your health supplier.
Clonidine and niacin both lower blood pressure. Taking niacin with clonidine may trigger your high blood pressure to end up being too low.
Gemfibrozil (lopid) interaction rating:
Moderate beware with this combination. Talk with your health supplier.
Taking niacin along with gemfibrozil may cause muscle damage in some individuals. Use with caution.
Medications for diabetes (antidiabetes drugs) interaction rating:
Moderate be cautious with this mix. Talk with your health supplier.
Use of high doses of niacin (about 3-4 grams daily) may increase blood sugar. By increasing blood sugar, niacin may decrease the efficiency of diabetes medications. Monitor your blood sugar carefully. The dosage of your diabetes medication might need to be altered.
Some medications utilized for diabetes include glimepiride (amaryl), glyburide (diabeta, glynase prestab, micronase), insulin, pioglitazone (actos), rosiglitazone (avandia), metformin (glucophage), nateglinide (starlix), repaglinide (prandin), chlorpropamide (diabinese), glipizide (glucotrol), tolbutamide (orinase), and others.
Medications for high blood pressure (antihypertensive drugs) interaction rating:
Moderate be cautious with this mix. Talk with your health service provider.
Using niacin with drugs that lower blood pressure might increase the results of these drugs and may decrease high blood pressure too much.
Some medications for high blood pressure include captopril (capoten), enalapril (vasotec), losartan (cozaar), valsartan (diovan), diltiazem (cardizem), amlodipine (norvasc), hydrochlorothiazide (hydrodiuril), furosemide (lasix), and lots of others.
Medications that can hurt the liver (hepatotoxic drugs) interaction rating:
Moderate beware with this mix. Talk with your health service provider.
Niacin might hurt the liver. Sustained-release niacin preparations seem to have the best risk. Taking niacin along with medication that may also damage the liver can increase the risk of liver damage. Do not take niacin if you are taking a medication that can hurt the liver.
Some medications that can damage the liver consist of acetaminophen (tylenol and others), amiodarone (cordarone), carbamazepine (tegretol), isoniazid (inh), methotrexate (rheumatrex), methyldopa (aldomet), fluconazole (diflucan), itraconazole (sporanox), erythromycin (erythrocin, ilosone, others), phenytoin (dilantin), lovastatin (mevacor), pravastatin (pravachol), simvastatin (zocor), and lots of others.
Medications that slow blood clotting (anticoagulant/ antiplatelet drugs) interaction rating: moderate beware with this mix. Talk with your health service provider.
Niacin might slow blood clot. Taking niacin along with medications that also sluggish clotting might increase the opportunities of bruising and bleeding.
Some medications that slow blood clot include aspirin, clopidogrel (plavix), dalteparin (fragmin), enoxaparin (lovenox), heparin, indomethacin (indocin), ticlopidine (ticlid), warfarin (coumadin), and others.
Medications utilized for decreasing cholesterol (bile acid sequestrants) interaction score:.
Moderate beware with this combination. Talk with your health provider.
Some medications for decreasing cholesterol called bile acid sequestrants can decrease just how much niacin the body soaks up. This may lower the efficiency of niacin. Take niacin and the medications a minimum of 4-6 hours apart.
A few of these medications used for reducing cholesterol include cholestyramine (questran) and colestipol (colestid).
Medications used for decreasing cholesterol (statins) interaction score:
Moderate be cautious with this combination. Talk with your health service provider.
Niacin can adversely impact the muscles. Some medications used for decreasing cholesterol called statins can also impact the muscles. Taking niacin together with these medications might increase the risk of muscle issues.
A few of these medications used for high cholesterol consist of rosuvastatin (crestor), atorvastatin (lipitor), lovastatin (mevacor), pravastatin (pravachol), fluvastatin (lescol), and simvastatin (zocor).
Probenecid interaction rating:
Moderate beware with this combination. Talk with your health supplier.
Probenecid is used to treat gout. Taking big dosages of niacin may get worse gout and decrease the efficiency of probenecid.
Sulfinpyrazone (anturane) interaction ranking:
Moderate beware with this combination. Talk with your health service provider.
Sulfinpyrazone (anturane) is used to deal with gout. Taking large doses of niacin may intensify gout and decrease the effectiveness of sulfinpyrazone (anturane).
Thyroid hormone interaction rating:
Moderate beware with this combination. Talk with your health company.
The body naturally produces thyroid hormonal agents. Niacin might decrease thyroid hormone levels. Taking niacin with thyroid hormonal agent pills may decrease the results and adverse effects of thyroid hormonal agent.
Aspirin interaction score:
Minor beware with this mix. Talk with your health provider.
Aspirin is typically utilized with niacin to lower the flushing brought on by niacin. Taking high dosages of aspirin might reduce how fast the body gets rid of niacin. This might cause there to be excessive niacin in the body and possibly lead to side effects. However, the low doses of aspirin most frequently used for niacin-related flushing don’t seem to be a problem.
Nicotine spot (transdermal nicotine) interaction rating:
Minor beware with this mix. Talk with your health service provider.
Niacin can often cause flushing and dizziness. The nicotine patch can also trigger flushing and dizziness. Taking niacin or niacinamide and using a nicotine patch can increase the possibility of ending up being flushed and lightheaded. 
Because of the capacity for side effects and interactions with medications, you must take dietary supplements only under the guidance of an educated health care service provider. Side effects might consist of diarrhea, headache, stomach discomfort, and bloating.
High doses (50 mg or more) of niacin can cause adverse effects. The most common adverse effects is called “niacin flush,” which is a burning, tingling feeling in the face and chest, and red or flushed skin. Taking an aspirin thirty minutes prior to the niacin may help reduce this symptom.
At extremely high dosages, utilized to lower cholesterol and treat other conditions, liver damage and stomach ulcers can take place. Your physician will frequently check your liver function through a blood test.
Individuals with a history of liver disease, kidney disease, or stomach ulcers ought to not take niacin supplements. Those with diabetes or gallbladder disease ought to do so just under the close guidance of their doctors.
Stop taking niacin or niacinamide at least 2 weeks before a set up surgical treatment.
Niacin and niacinamide may make allergies even worse by increasing histamine.
People with low blood pressure must not take niacin or niacinamide because they may cause a hazardous drop in blood pressure. Do not take niacin if you have a history of gout.
People with coronary artery illness or unsteady angina should not take niacin without their physician’s supervision, as large dosages can raise the risk of heart rhythm problems.
Taking any one of the b vitamins for an extended period of time can lead to an imbalance of other crucial b vitamins. For this reason, you may wish to take a b-complex vitamin, that includes all the b vitamins. 
The role of niacin as an antioxidant micro-nutrient has been established in a variety of research study. The systems through which niacin secures the body against oxidative stress can be maintaining the glutathione redox cycle, and likewise, decreasing nadph/total nadp+ ratio in addition to increasing the nad+ content. Nevertheless most of the examinations in this area are restricted to speculative research studies, these mechanistic research studies can be helpful for more clinical development of niacin and niacin-related compounds for the treatment of oxidative tension and its issues.