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Niacin (vitamin B3)

Niacin (vitamin B3)

Best for

Raise cellular NAD+ levels

Large effect, needs confirmation · 1000–1500 mg/day for 4–48 weeks · 7 studies , n=184

46 papers · 4 claims · 94 outcomes scored · 4 positive

Evidence summary

Evidence summary

Proven benefit

Niacin (vitamin B3) delivers a proven benefit for blood lipid markers in adults with dyslipidemia, lowering LDL and total cholesterol and raising HDL at high doses.

  • Across 12 studies (n=163,231), niacin lowered LDL and total cholesterol on lipid panels, a noticeable lipid shift.1
  • Evidence centers on high-dose nicotinic acid in statin-treated or high-risk adults, not routine multivitamin dosing.
  • Flushing is common, and liver risk rises with the doses needed for lipid changes.

Outcomes

What niacin (vitamin b3) actually does, by outcome

Each row is one outcome with effect size, evidence base, the dose that worked in trials, and time to first effect. Magnitude tiers come from native-unit MCID where available, Cohen's d otherwise.

Raise cellular NAD+ levels Large effect, needs confirmation

Replenish the coenzyme that powers hundreds of metabolic reactions.

7 RCTs n=184 1000–1500 mg 4–48 wk #2/2
29599478·32320006·35235774·35620522 +3 more
Raise good cholesterol levels Likely benefit

Boosts the cholesterol that pulls fat out of artery walls.

17 meta-analyses n=199k 500–3000 mg 6–166 wk #2/72
17583186·20216298·21565796·22892157 +13 more
Lower bad and total cholesterol Proven benefit

Cuts the cholesterol that builds into artery plaque over time.

12 meta-analyses n=163k 500–3000 mg 8–166 wk #3/104
23444397·23872591·24035168·25750540 +8 more
Lower triglycerides Likely modest benefit

Reduces the blood fats that rise after meals and drive heart risk.

11 meta-analyses n=158k 500–2000 mg 8–166 wk #2/90
22840917·22892157·23444397·23872591 +7 more

Forms & standardisation

The lipid data come from nicotinic acid, especially extended-release niacin, not from flush-free niacinamide.123 If you are reading a label, look for the active ingredient name, nicotinic acid or extended-release niacin, because that is the form the trials actually used.12 Niacinamide still counts as vitamin B3, but it does not carry the same cholesterol-lowering track record.1

Risk profile

Adverse events and known drug interactions

Safety events

hepatitis / hepatic toxicity severe
Revascularization (CABG, PCI, carotid endarterectomy) severe
Stroke severe
vasovagal syncope severe
hepatic encephalopathy severe
severe coagulopathy severe
hemodynamic instability / hypotension severe
Flushing moderate

Drug interactions

Isoniazid major decreases concentration
Cisplatin major decreases effect
Oxaliplatin major decreases effect
Antineoplastic Agents major decreases effect
Warfarin major increases toxicity
Indomethacin moderate decreases effect
MK-0524 moderate decreases effect
Laropiprant (DP1 Antagonist) moderate decreases effect
other moderate decreases effect
Laropiprant (PGD2 Receptor Antagonist) moderate decreases effect

Co-studied with

Supplements that share evidence with niacin (vitamin b3)

Drug:Simvastatin 21 shared outcomes · d=0.47
Drug:Ezetimibe 3 shared outcomes · d=0.10

Frequently asked

Common questions

Does niacin really raise HDL?

Yes. High-dose niacin consistently raises HDL in human trials, and the clearest signals show up in the 1,500 mg/day range.23

Why does niacin make you flush?

It flips on a skin vessel signal that opens the capillaries, so your face can turn red and hot soon after a dose, especially if you take it on an empty stomach.14

Is niacinamide the same as niacin?

No. Niacinamide fixes vitamin B3 deficiency, but the cholesterol-changing data come from nicotinic acid, the form that also causes flushing.12

Should you take niacin every day?

Yes, if you use it for lipids. The studies used daily dosing for weeks to months, not occasional use.23

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Sources

  1. 1. Niacin Fact Sheet for Health Professionals
  2. 2. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy (2011) ↑
  3. 3. Effects of extended-release niacin with laropiprant in high-risk patients (2014) ↑
  4. 4. Niacin

Generated May 15, 2026

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