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Stephanie Eckelkamp |

Vitamin B3, also called niacin, is a water-soluble vitamin found in many common foods such as chicken, tuna, beets, and lentils. It plays a role in countless bodily functions and helps convert the food we eat into energy.

Specifically, vitamin B3 plays an important role in digestion, mental health, heart health, the nervous system, maintaining healthy skin, making a variety of hormones, and acting as a precursor to the coenzyme nicotinamide adenine dinucleotide (NAD+).

But vitamin B3 is also a little more complex than your average vitamin. It’s naturally found in several different forms, each of which has a slightly different effect on the body.

Here, learn all about vitamin B3, its different forms and health benefits, signs of deficiency, common food sources, and when to consider a supplement.

 

Different forms of vitamin B3 (niacin)

Niacin is actually a blanket term for three different compounds that have similar activity in the body: nicotinic acid, nicotinamide (aka niacinamide), and nicotinamide riboside (NR). You’ll find that “vitamin B3” and “niacin” are often used interchangeably to refer to these compounds.

Of these, nicotinic acid and nicotinamide are the main forms of vitamin B3 or niacin—they’re both widely available from the same food sources and sold as dietary supplements. NR, on the other hand, is quite scarce in food and only recently started being sold as a supplement.

All three forms of vitamin B3 are converted to an important coenzyme called NAD+ in the body. NAD+ is found in all living cells, and it plays a vital role in energy metabolism and maintaining proper cell functioning—particularly the functioning of our mitochondria, the power plants in our cells that turn our food and oxygen into energy. It also plays an important role in protecting cells all over the body from age-related damage and decline in function.

While all three forms of vitamin B3 share common traits, each has a slightly different effect on the body and serves a different role when taken as a supplement:

Nicotinic acid: This form of vitamin B3 is readily available from food. As a supplement, it’s frequently used to treat high cholesterol and heart disease, and it often just goes by the name niacin. It also promotes circulation, and supplemental doses can cause what’s called “niacin flush,” skin that becomes red and itchy. Our bodies can convert nicotinic acid into nicotinamide.

Nicotinamide (aka niacinamide): This form of vitamin B3 is also readily available from food. It’s the form that typically appears in multivitamins and fortified foods, like cereal, since it does not cause flushing. As a supplement, it doesn’t treat cardiovascular conditions, but it does hold promise for treating skin conditions, arthritis, and type 1 diabetes. Increasingly, it’s also being added to skin care products (where it’s often listed as niacinamide) for its anti-inflammatory and photoprotective perks.

Nicotinamide riboside (NR): Found predominantly in NR supplements (and in trace amounts in milk), NR is the most recently discovered form of vitamin B3. It’s not commonly used, but it holds great promise in boosting cognitive function and slowing the aging process. Compared to the other two forms of vitamin B3, it is the most efficient at increasing levels of NAD+ in the body and brain, which is really appealing:

“Appropriate levels of NAD+ are critical to support the body’s response to stress,” Ilene Ruhoy, M.D., Ph.D., integrative neurologist, told mbg. “That’s because NAD+ is used by enzymes to modulate cellular activity in response to extrinsic and intrinsic assaults, including those triggered by environmental toxins, pro-inflammatory foods, microbes such as viruses and bacterium, trauma, disease, and even chronic use of medication.”

[Pro tip: Many articles that reference “niacin” without specifying which form usually mean nicotinic acid—even though niacin is technically a blanket term. It’s confusing, so we’ll call everything by its true name in this article.]

 

Vitamin B3 health benefits

The various forms of vitamin B3 or niacin in the form of food, supplements, and even topical creams have been associated with everything from improved heart and mental health to clearer skin. Here are some of their most well-researched perks, along with some promising preliminary findings that warrant further study:

 

1. Boosts heart health and lowers cholesterol

High doses of vitamin B3 in the form of nicotinic acid are an established treatment for lowering “bad” LDL cholesterol, raising “good” HDL cholesterol, and lowering triglycerides, a type of fat found in your blood that can lead to atherosclerosis—a condition characterized by narrowing of the arteries due to fatty plaque buildup. Specifically, studies show that nicotinic acid may raise HDL cholesterol 15 to 35 percent, lower LDL cholesterol by 5 to 25 percent, and lower triglycerides by 20 to 50 percent—which is all pretty impressive.

Additionally, nicotinic acid favorably alters the composition of LDL cholesterol particles from small and dense to large and more buoyant. Larger LDL particles are far less damaging, suggesting that nicotinic acid could play a role in reducing risk of atherosclerosis.

But even though some research is promising, cardiologists like Joel Kahn, M.D., warn that this vitamin is not always a foolproof fix. “Generally we only need about 20 to 35 mg a day of niacin, but doses of up to 3,000 mg a day or more are used to control cholesterol,” Dr. Kahn told mbg—and these high doses can be associated with issues like ulcers, muscle damage, and gout.

So, before taking high doses of vitamin B3 to help control cholesterol, always talk with your doctor to make sure it’s the right approach. Tweaking your diet and exercising could be all you need!

 

2. Reduces risk of skin cancer

Failing to get adequate levels of vitamin B3 in your diet can lead to severe skin sensitivity and damage when exposed to sunlight. This makes sense when you understand that NAD+ plays a role in DNA repair and that low levels of vitamin B3 deplete NAD+.

In one study, use of a topical cream containing nicotinamide decreased the risk of UV-induced skin cancers in mice. And in humans, a recent analysis of two prospective cohort studies following men and women for up to 26 years found that higher dietary intake of vitamin B3 (from food and oral supplements) may offer protection against certain types of skin cancer, including squamous-cell carcinoma but not basal-cell carcinoma or melanoma. This is good news since it suggests that you can consume enough vitamin B3 from food to reap this benefit. Sunscreens containing nicotinamide(where it’s usually listed as niacinamide) are already on the market and may offer further protection.

A recent clinical trial also found that after taking an oral nicotinamide supplement for 12 months reduced non-melanoma skin cancers by 23 percent and actinic keratoses (scaly patches on skin due to years of sun exposure) by 13 percent among high-risk patients. But more research is needed before nicotinamide can be recommended for preventing skin cancer.

 

3. Helps treat persistent acne

Expanding on its skin-healing properties, both topical and oral nicotinamide may help treat acne as well—likely due to its anti-inflammatory properties. In a recent review, researchers found that six out of eight studies using topical nicotinamide led to a significant reduction in acne or at least performed as well as more mainstream acne creams. And, two of the studies using an oral form of this vitamin led to a significant reduction in acne. Some researchers believe this form of vitamin B3 may be an effective way to treat severe acne without antibiotics. (Just remember, getting your diet and stress in check is also super important for clear skin.)

More studies are needed to confirm appropriate dosing of nicotinamide for acne. If you’re interested in taking it orally as a treatment, talk to a dermatologist first to make sure it’s the best possible option—not everyone’s fully on board yet. Some over-the-counter facial cleansers and creams containing nicotinamide containing lower doses than what has been used in studies may be a safe option to experiment with, just watch out for potential side effects such as skin irritation.

 

4. Soothes achy joints

Vitamin B3 has been shown to have anti-inflammatory effects in the body, which may translate to reduced joint pain and arthritis symptoms. In one small study, patients with osteoarthritis who took a nicotinamide supplement were able to reduce the number of anti-inflammatory pain meds they used by 13 percent compared to the placebo group. They also experienced greater joint flexibility.

While getting adequate vitamin B3 in your diet may help keep inflammation somewhat in check, a high-dose nicotinamide supplement would likely be required for osteoarthritis relief. This should only be done under the supervision of your doctor, though, as nicotinamide makes it more difficult to clear uric acid from your body, which could increase your risk for gout, another painful joint condition.

 

5. Boosts brain function

Vitamin B3 supports proper brain functioning, and a severe deficiency has been associated with dementia, leading some researchers to believe that getting enough in your diet is crucial to the prevention of Alzheimer’s disease. Deficiency has also been associated with symptoms of psychosis, and supplemental nicotinic acid and nicotinamide have been used to treat schizophrenia.

The form of vitamin B3 known as NR is of particular interest when it comes to brain health and Alzheimer’s prevention. In a recent study, researchers created a strain of mice with features mimicking human Alzheimer’s disease. They then added an NR supplement to the drinking water of half the mice for three months. Over this period, researchers found that the NR-treated mice had less DNA damage, higher neuroplasticity, increased production of new neurons, and lower levels of neuronal damage. In the hippocampus area of the brain (where damage and loss of volume is found in people with dementia), NR seemed to clear existing DNA damage or prevent it from spreading further. The mice also performed better on memory tests.

But studies on NR’s long-term effects on human health are still few and far between. Much more research is needed to determine if it would have a similar effect. 

 

6. Could promote good digestion and gut health

Vitamin B3 is critical for many digestive functions—the breakdown of carbs, fats, and alcohol—and keeping your GI tract happy. Low levels of vitamin B3 in the diet can cause an upset digestive system, and a deficiency can result in a disease called pellagra, which causes diarrhea, vomiting, and other serious symptoms.

Research that may link vitamin B3 to digestive ailments such as irritable bowel disease is very preliminary and needs to be validated in human studies. In the meantime, know that human studies looking at treatment with high supplemental doses of nicotinic acid has been associated with ulcers in the digestive tract. So for now, focus on eating quality food sources of vitamin B3, and don’t self-treat with supplements unless you consult with a doctor.

 

We can typically get all the vitamin B3 we need through diet alone. Many of the same foods contain both nicotinic acid and nicotinamide. Our bodies can also convert the amino acid tryptophan to vitamin B3—60 mg tryptophan is equal to 1 mg niacin. Here are the recommended daily amounts (RDA) for adults: 

Men (19 years and older): 16 mg

Women (19 years and older): 14 mg

Pregnant women: 18 mg

Breastfeeding women: 17 mg
 

13 major food sources of vitamin B3

It’s possible to get more than enough vitamin B3 from either plants or animals. But keep in mind, all B vitamins are water-soluble, which means you need to consume them every day since our bodies don’t store them. Here are some of the best vitamin B3 foods.

Nutritional yeast* (¼ cup): 46 mg

Turkey (3 oz): 10 mg

Chicken (3 oz): 9 mg

Tuna (3 oz, canned): 8½ mg

Salmon (3 oz): 8½ mg

Bran flakes (¾ cup): 5 mg

Beef (3 oz): 4½ mg

Peanuts (1 oz): 4 mg

Mushrooms (1 sliced cup): 2½ mg

Lentils (1 cooked cup): 2 mg

Coffee (1 brewed cup): 2 mg

Whole-wheat bread (1 slice): 1½ mg

Beets (1 sliced cup): 1 mg

*Add a drizzle of olive oil and a sprinkle of nutritional yeast to your next batch of popcorn for a cheesy flavor that’s totally vegan!

 

How to tell if you have vitamin B3 deficiency.

Vitamin B3 deficiency is extremely rare in developed countries. There are two forms of deficiency: primary and secondary.

  • Primary deficiency is caused by poor nutritional intake, when someone doesn’t consume enough vitamin B3 or tryptophan in their diet.
  • Secondary deficiency occurs with another health condition—like alcoholism, chronic diarrhea, Crohn’s disease—that interferes with your ability to absorb vitamins.

Alcoholism is the main cause of vitamin B3 deficiency in the United States. Blood and urine tests can diagnose a deficiency.

Common symptoms of mild vitamin B3 deficiency, which can usually be addressed with diet changes and/or a multivitamin, often include indigestion, fatigue, canker sores and/or a bright red tongue, poor circulation, and depression.

Severe vitamin B3 deficiency is known as pellagra. This disease affects the skin, digestive system, and nervous system and can be deadly if it’s not treated. Symptoms, which can be treated with a prescription nicotinic acid or nicotinamide supplement from your doctor, often include delusions or mental confusion, scaly and cracked skin, a swollen mouth, diarrhea, vomiting, headaches, fatigue, and depression.

 

Should you take a vitamin B3 supplement?

Most generally healthy people don’t need to take a vitamin B3 supplement since deficiency is rare and food sources are plentiful. Occasionally, though, doctors will prescribe a high dose of nicotinic acid or nicotinamide to treat a specific health condition, e.g., nicotinic acid for high cholesterol, especially if you can’t tolerate statins. In these cases, following your doctor’s dosing instructions carefully is crucial. 

If you’re interested in using a vitamin B3 supplement to manage a minor health condition on your own, it’s still wise to consult a health care provider about the appropriate dose and form. Many nicotinic acid and nicotinamide supplements contain doses that are far higher than the RDA (typically around 500 mg per dose), which could be dangerous or cause side effects if taken unnecessarily or incorrectly.

If you want to supplement, consider getting your vitamin B3 as part of a multivitamin or B-complex vitamin, since taking any single B vitamin for a long period of time could cause an imbalance in other B vitamins. If you’re going to take one, integrative doctor Andrew Weil, M.D., recommends 50 mg of vitamin B3 in the form of nicotinamide (sometimes listed as niacinamide) as part of a B-complex vitamin. 

Side effects of nicotinic acid and nicotinamide supplements

As supplements, these two forms of vitamin B3 are usually well-tolerated at doses up to what would appear in a multivitamin or B-complex vitamin (usually around 50 mg), but at higher doses, they may carry more serious side effects, particularly nicotinic acid.

For both forms, minor side effects include diarrhea, headache, stomach discomfort, and bloating. They may also make seasonal allergies worse, as they trigger the release of histamine. With doses above 50 mg, nicotinic acid may also cause “niacin flush,” or red flushed skin along with a burning or tingling sensation in the face or chest. Slow-release alternatives to nicotinic acid (under the name inositol hexaniacinate) may reduce flushing, but they’re actually more likely to cause liver damage.

With very high doses of vitamin B3, like those used to treat specific health conditions, these supplements may cause liver damage, stomach ulcers, and nausea and vomiting, among other side effects. That’s why doctors recommend periodic blood tests to check liver function with doses above 100 mg per day. High doses may also increase blood sugar, so people with diabetes should be cautious.

Vitamin B3 supplements could also interfere with a variety of medications, including common antibiotics and blood thinners, so always be sure to talk with your doctor about interactions before taking either of these forms of vitamin B3.

 

What about nicotinamide riboside (NR) supplements?

Unlike the more common forms of vitamin B3, nicotinic acid and nicotinamide, you can only get NR in meaningful quantities from supplements—which might make you tempted to purchase one. While preliminary research shows that these supplements significantly boost levels of the anti-aging coenzyme NAD+, we still don’t know what health benefits occur as a result. Longer-term studies on NR supplements are needed before we can say just how helpful they are at boosting brain function or slowing the overall aging process.

 

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