What You Need To Know About Niacinamide

Niacinamide (nicotinamide) is a form of vitamin B3.

Your body needs niacinamide to create energy, and your cells need it to function correctly.

Niacinamide is a water-soluble vitamin, so it's not stored in the body. You must consume it through food or supplements.

Vitamin B3 can mean niacinamide (nicotinamide) or nicotinic acid (niacin).

Some companies may label both niacinamide and nicotinic acid as "niacin."

However, they're both different forms of vitamin B3 with different chemical structures that work differently in your body. For example, niacinamide doesn't reduce cholesterol levels like niacin.

This article discusses potential uses for niacinamide, possible side effects, precautions, niacinamide dosage, known interactions, and other essential facts regarding niacinamide supplements.

Uses of Niacinamide

Niacinamide for Skin Care

Niacinamide has been studied for several different skin issues. Read on for more information about its possible benefits.

• Acne treatment: Researchers believe that niacinamide's anti-inflammatory effects can reduce the redness and inflammation caused by acne. According to a review, topical (on the skin) niacinamide reduced acne. The review also found that oral (by mouth) niacinamide and other supplements treated acne. However, conclusions about using oral niacinamide alone for acne cannot be made.
• Aging skin: According to a review, niacinamide increased keratin, an essential protein for healthy skin, in cell cultures. It may also help with other aspects of skincare, such as wrinkles and other signs of aging skin, using topical (skin) products.
• Melasma: A skin condition that causes hyperpigmentation, or dark spots, melasma often occurs on unprotected skin regularly exposed to the sun. According to a study, topical (skin) niacinamide cream reduced the appearance of dark spots in people with melasma.
• Skin cancer prevention: In a randomized controlled trial, 12 months of treatment with 500 milligrams (mg) of niacinamide by mouth twice daily reduced the risk of developing new non-melanoma skin cancers by 23% (p=0.02), new squamous-cell carcinomas (skin cancer) by 30% (p=0.05), and actinic keratosis (i.e., pre-skin cancer) by 13% (p=0.001). More high-quality studies are needed before using niacinamide for these conditions.

Always consult a healthcare provider specializing in skin health, such as a dermatologist, if you have developed a skin issue. Self-treating with supplements or delaying diagnosis and treatment has the potential to make conditions worse.

Niacin Deficiency

Niacin deficiency can result from an inability to absorb tryptophan (Hartnup disease), isoniazid treatment, carcinoid syndrome, excess alcohol consumption, or lack of dietary intake (for example, in anorexia).

Symptoms include stomatitis (mouth inflammation), glossitis (red, swollen tongue), upset stomach, and pellagra, which niacinamide supplementation can reverse.

Niacinamide is generally recommended over nicotinic acid (niacin) to treat niacin deficiency because it has fewer possible side effects (flushing, etc.).

Talk with your healthcare provider if you believe you may have a niacin deficiency. They will help diagnose and treat this condition.

Other Conditions

Researchers have also studied niacinamide for its use in the following:

• Hyperphosphatemia: Hyperphosphatemia occurs when the blood has a high phosphate level. It's one of the most common complications of chronic kidney disease. A meta-analysis found oral (by mouth) niacinamide supplements to be safe and effective in reducing blood levels of phosphate in people receiving dialysis for chronic kidney disease.
  
• Type 1 diabetes (T1DM): Niacinamide has been studied for delaying T1DM development in high-risk individuals. Studies used 1 gram (g) to 3 g daily for four months to four years.
  
• Neurological degeneration.

Further high-quality studies are necessary before recommendations can be made.

What Are the Side Effects of Niacinamide?

As with most supplements and medications, side effects are possible when taking niacinamide.

Your healthcare provider may recommend taking a niacinamide supplement for any of the reasons discussed in the previous section.

No matter the reason for taking niacinamide, it's essential to know and understand any common or severe side effects you may or may not experience.

Common Side Effects

Niacinamide is considered generally safe for oral (by mouth) and topical (skin) use. Unlike niacin (nicotinic acid), niacinamide does not cause skin flushing.

In general, niacinamide has fewer potential side effects than other forms of niacin. However, taking higher doses than normal of niacinamide can make side effects more likely.

Possible side effects from taking oral (by mouth) niacinamide supplements include:

• Diarrhea
  
• Increased liver enzymes (rare, at doses over 3 grams per day)
• Symptoms of thrombocytopenia (including increased bruising and bleeding), a rare side effect
• Upset stomach
  

Side effects of topical (skin) niacinamide creams include:

• Burning
• Itching
• Redness
  

Severe Side Effects

When niacinamide supplements are taken at a dose that's too high, severe side effects may occur.

Severe side effects of niacinamide include the following:

• Nausea
• Vomiting
• Liver damage

Be sure to talk to your healthcare provider if you experience side effects from taking niacinamide supplements. It may be necessary to stop taking niacinamide in some instances.

Precautions

Specific populations of people should take precautions when starting niacinamide supplements.

• Pregnancy and breastfeeding: Niacinamide is generally acceptable in pregnant or breastfeeding people. However, it's always best to talk with your healthcare provider before starting a new supplement if pregnant or breastfeeding.
• Children: Niacinamide is likely safe for children if the dosage does not exceed recommended amounts.
• Liver and gallbladder issues: People with liver or gallbladder disease should take special precautions when taking niacinamide. Niacinamide may worsen symptoms in these populations.
  
• Kidney issues: People receiving dialysis for kidney disease may need to avoid niacinamide. This is because niacinamide may decrease blood counts when taken by dialysis patients.
• Ulcers: People with stomach ulcers may need to avoid using niacinamide as it may worsen ulcers.
  

Dosage: How Much Niacinamide Should I Take?

Niacinamide is generally considered safe in foods and supplements in doses of less than 35 milligrams (mg) daily. Research has found it is safe when taken in doses up to 950-1500 mg daily. Though niacinamide may be safe in these higher amounts, side effects may arise (such as increased bleeding and an upset stomach).

Talk with your healthcare provider when deciding how much niacinamide to take daily.

Depending on your unique needs, health conditions, or other medications or products you use, you may need more or less niacinamide.

Generally, never use more niacinamide than the supplement's label suggests unless directed by a healthcare professional.

What Happens if I Take Too Much Niacinamide?

Of all the forms of niacin available in supplement form, niacinamide seems to be the least harmful. However, it's still possible to take too much niacinamide.

Rash, stomach upset, elevated liver enzymes, and symptoms of thrombocytopenia (low platelet counts in people with renal disease and who are on dialysis) have been reported.

In people undergoing dialysis through the vein, niacinamide's most common side effects (500–1,500 mg per day for several months) were diarrhea and low platelet counts (thrombocytopenia).

Again, it's essential not to exceed the recommended dose of niacinamide as suggested by your healthcare provider or by what's listed on the supplement label.

Interactions

The following moderate interactions are possible between niacinamide and other medications:

• Tegretol (carbamazepine): Niacinamide may slow the breakdown of this drug. This could change the effectiveness of this drug.
• Anticoagulant/antiplatelet drugs, supplements, or plant-based medicines: These blood-thinning medications slow blood clotting. Because niacinamide may also slow blood clotting, it is possible for bleeding to increase if niacinamide is mixed with these medications.
• Mysoline (primidone): Because niacinamide may decrease how quickly your body breaks down primidone, niacinamide may increase the blood levels of primidone. Higher blood levels of primidone may mean amplified medication effects on the body and an increased risk of primidone side effects.

There are no known interactions between niacinamide and foods.

Niacinamide supplements can slow blood clotting and increase your risk of bleeding. For these reasons, it may be best to avoid taking niacinamide with other supplements that may also increase bleeding, such as fish oil, garlic, ginger, ginkgo, nattokinase, and Panax ginseng.

You must carefully read the ingredient list on the nutrition label of any supplement you take to know which and how much of each ingredient is in the supplement. Please review all supplement labels with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.

How to Store Niacinamide

You should store niacinamide supplements in a cool, dry place.

You should avoid storing your supplements in places that could become too hot or cold. It's also best to keep supplements away from direct sunlight.

Some niacinamide creams or serums may require refrigeration.

Consult the label of your products for the best storage techniques.

Discard niacinamide supplements as indicated by the use-by date listed on the label.

Similar Supplements

Some supplements work similarly to niacinamide:

• Vitamin A/retinol
• Niacin
• Omega-3 fatty acids
• Zinc

Niacinamide has several potential uses. Similar supplements may replicate the effects of niacinamide.

Consult with your healthcare provider to find the safest supplement regimen.

Sources of Niacinamide and What to Look For

Typically, you may be getting enough niacinamide through your diet.

If possible, take a "food first" approach to getting enough niacinamide.

Eating a variety of whole foods can help you get most of the necessary vitamins and minerals.

Niacinamide supplements may be necessary to treat certain skin conditions.

Deficiencies can happen if your body cannot absorb enough niacinamide or if you have any other conditions.

Speak with your healthcare provider to see if they think niacinamide can help.

Food Sources of Niacinamide

Tryptophan in foods may eventually convert to niacinamide in the body through different biochemical pathways. Food sources of tryptophan include:

• Turkey
• Poultry
• Fish (tuna)
• Dairy
• Eggs
• Oats

Niacinamide Supplements

Niacinamide supplements can be applied in topical (skin) form as creams or serums and taken orally (by mouth) as capsules or powder. The supplement form you choose will depend on your health needs.

When purchasing a new supplement, look for "niacinamide" on the label. Other products may claim the benefits of niacinamide but contain different ingredients or forms of vitamin B3, like niacin (nicotinic acid). These do not work the same way niacinamide does.

Niacinamide supplements are generally safe and may help with various medical conditions. Before taking any supplements, talk to your healthcare provider. This will ensure you know the correct dosage for your health needs and goals.

Summary

Niacinamide is a form of vitamin B3 that your body needs to create energy, and your cells need to function correctly. It's often consumed through food or supplements. Niacinamide supplements can apply topically (on the skin) in cream or serum formulas or orally (by mouth) through capsules or powder.

Niacinamide has been studied for several health conditions, such as pellagra, acne, and skin cancer. Niacinamide supplements may help treat certain skin conditions or be used if your body cannot absorb enough niacinamide.

Although niacinamide supplements are generally safe, consult a healthcare provider before taking any supplements.