What Is Niacinamide?
Medically reviewed by Jamie Johnson, RDN
Niacinamide (also known as nicotinamide) is a specific form of vitamin B3 (niacin). Using it topically can support skin health while taking it orally may help prevent skin cancer and reduce phosphorus levels in people on hemodialysis. It’s also key for treating pellagra—a niacin deficiency—since it doesn’t cause flushing like nicotinic acid does.
Niacinamide is generally safe to take, but not everyone needs the supplement. Besides supplements, you can find niacinamide in a variety of foods including eggs, meat, fish, milk, and vegetables.
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Benefits of Niacinamide
Niacinamide is especially helpful for treating a niacin deficiency and supporting skin health. It has a few other health benefits that might support certain conditions.
Helps Reverse Niacin Deficiency
A severe niacin deficiency can result in pellagra, which leads to several uncomfortable and potentially dangerous symptoms. Moderate symptoms include discolored, rough skin; a bright red tongue; and gastrointestinal symptoms like vomiting, diarrhea, or constipation. More severe symptoms include mood disturbances leading to depression, apathy, and eventually hallucinations and suicidal behavior. A niacin deficiency can also cause headache, fatigue, and memory loss.
Niacinamide is the recommended form of supplemental niacin for reversing a deficiency because it doesn’t lead to flushing, itching, or a tingling sensation in high doses like nicotinic acid does. Experts recommend taking 250–500 milligrams (mg) of niacinamide per day for a few weeks to reverse the deficiency, but it’s best to consult with a healthcare provider if you’re concerned you may be deficient.
A niacin deficiency is very uncommon in the United States and other industrialized countries, but some people are at higher risk than others. These groups include people who are undernourished due to conditions like anorexia, AIDS, and inflammatory bowel disease (IBD); people with Hartnup disease; people with carcinoid syndrome; and people who don’t consume enough riboflavin, pyridoxine, or iron.
May Prevent Against Skin Cancer
Niacinamide supplements may reduce the risk of skin cancer in people who are at high risk of developing it. One study found that participants with a history of nonmelanoma skin cancer who were assigned to take 500 mg of niacinamide twice daily had less new nonmelanoma skin cancers than participants who took a placebo for 12 months.
Another review of studies found that niacinamide was associated with a significantly reduced risk of basal cell carcinoma and cutaneous squamous cell carcinoma in people with a history of skin cancer.
Researchers believe this is because of niacinamide’s ability to repair damage to DNA and reduce suppression of the immune system caused by exposure to UV rays.
May Help Treat Acne
Both oral and topical forms of niacinamide may help treat acne thanks in part to its anti-inflammatory effects.
A review of studies found that niacinamide significantly improved the appearance of skin in participants with acne. Topical niacinamide—typically in the form of a cream or serum—appears to improve acne by reducing sebum excretion, decreasing inflammation, and protecting the skin against infection.
The review included two studies using oral niacinamide, but it was taken in combination with other vitamins and minerals so we can’t be sure it was the niacinamide itself that was beneficial for acne.
Most research on niacinamide to date has been done using topical forms of niacinamide, so we need more research on the effectiveness of oral niacinamide for acne before it becomes a routine treatment approach.
Related: How Can You Get Your Acne Scars to Go Away?
May Help Treat Hyperphosphatemia
Hyperphosphatemia happens when you have elevated blood levels of phosphorus. It’s a potentially dangerous condition that’s most common in people with kidney failure on dialysis since their kidneys cannot remove excess phosphorus from the blood.
Interestingly, niacinamide may help. It can moderately lower phosphorus absorption in the intestines by reducing the expression of a phosphate transporter called NaPi2b.
Studies have found that patients on hemodialysis who took niacinamide had significantly lower serum phosphorus levels than the control group. However, the niacinamide group had higher risk of thrombocytopenia—a low blood platelet count. That being said, any adverse events were tolerable so it’s generally considered to be a safe intervention for hyperphosphatemia in patients on hemodialysis.
Related: The 5 Stages of Kidney Disease
Good Sources of Niacinamide
Niacinamide is found in a variety of foods including meat, fish, vegetables, legumes, and whole or enriched grains. Note that the measurement is for total niacin equivalents, which includes niacinamide, nicotinic acid, and other niacin derivatives. Some common food sources of niacin are:
Chicken breast: 10.3 mg per 3 ounces grilled, or 64% of the daily value (DV)
Marinara sauce: 10.3 mg per 1 cup, or 64% of the DV
Turkey breast: 10 mg per 3 ounces roasted, or 64% of the DV
Sockeye salmon: 8.6 mg per 3 ounces cooked, or 54% of the DV
Tuna, canned in water: 8.6 mg per 3 ounces, or 54% of the DV
Pork tenderloin: 6.3 mg per 3 ounces roasted, or 39% of the DV
Brown rice: 5.2 mg per 1 cup cooked, or 33% of the DV
Peanuts: 5.2 mg per ounce, or 26% of the DV
Baked potato: 2.3 mg per medium potato, or 14% of the DV
How to Take Niacinamide
Niacinamide can be found in creams or serums for topical use, or in capsules or powders for oral use. For oral forms, it’s generally best to take it with food to reduce the risk of unpleasant side effects.
Your healthcare provider can also give you niacinamide in prescription capsules, in which case it’s always best to follow your provider's recommendations for use.
Dosage
The recommended dietary allowances (RDAs) for total daily niacin intake–nicotinic acid, niacinamide, and other derivatives—vary based on age, sex, and whether you’re pregnant or lactating. The RDAs for total niacin intake from food and supplements combined are:
Birth to 6 months: 2 mg
7–12 months: 4 mg
1–3 years: 6 mg
4–8 years: 8 mg
9–13 years: 12 mg
14+ years: 16 mg for males, 14 mg for females, 18 mg if pregnant, 17 mg if lactating
Taking up to 35 mg of niacinamide from food or supplements daily is considered safe. It may even be safe to take up to 900–1500 mg daily, but the chances of side effects are higher at higher doses.
Niacinamide supplements can be taken safely in higher doses than nicotinic acid supplements, which can have adverse effects at doses as low as 30–50 mg.
Is Niacinamide Safe?
Niacinamide is generally safe for healthy people to take, including people who are pregnant or breastfeeding, as long as you stay within the recommended dosage range. However, most people with diabetes, gallbladder disease, stomach ulcers, or who are on dialysis should not take niacinamide as it can worsen these conditions.
Potential Drug Interactions
Niacinamide may interact with certain drugs, so if you’re taking one of these drugs it’s important to speak with your healthcare provider before starting a niacinamide supplement.
Anticoagulant/antiplatelet drugs or supplements. Niacinamide may slow blood clotting, which could increase the risk of bruising and bleeding if taken with these types of drugs or supplements.
Carbamazepine (Carbatrol). Niacinamide may slow the rate your body breaks down this drug.
Primidone (Mysoline). Niacinamide may slow the rate your body breaks down primidone.
What to Look For
There are two forms of vitamin B3: niacinamide (nicotinamide) and nicotinic acid. Each has a slightly different chemical structure which alters its effects on the body. Most notably, niacinamide doesn’t help reduce cholesterol like nicotinic acid does.
Supplements are not inspected by the U.S. Food and Drug Administration (FDA) for purity and potency, so we recommend purchasing a niacinamide supplement that is third-party tested for purity and potency. Reputable third-party testers include USP, NSF, and ConsumerLab.com.
When in doubt, shop from reputable brands and always speak with a healthcare provider before starting a new supplement, especially if you have a medical condition, are pregnant or breastfeeding, or are taking any prescription medications.
Can You Have Too Much Niacinamide?
Having excess niacinamide from food sources doesn’t appear to be harmful, but having excessive doses of niacinamide supplements may have adverse effects. The tolerable upper intake levels (ULs) for supplemental forms of niacin, like a nicotinamide supplement, vary based on age and are meant for healthy individuals. They are as follows:
Birth to 12 months: none established
1–3 years: 10 mg
4–8 years: 15 mg
9–13 years: 20 mg
14–18 years: 30 mg
19+ years: 35 mg
If you are taking niacinamide under supervision from a medical provider, then the UL does not apply; your healthcare provider will establish an appropriate, safe dose based on your needs.
As far as doses above the UL go, consuming 500–1,500 mg per day has been associated with diarrhea and a low platelet count, while consuming over 3,000 mg per day can cause nausea, vomiting, and signs of liver toxicity.
Side Effects of Niacinamide
Common side effects of niacinamide supplements include stomach upset, gas, dizziness, headache, and rash. The risk of side effects is higher if you have a high dose of niacinamide, increase your dose too fast, or take the supplement without food.
A Quick Review
Niacinamide is most helpful for preventing or treating a vitamin B3 deficiency, but it may also be helpful for skin health and hyperphosphatemia in dialysis. It’s often preferred over nicotinic acid because it doesn’t have as many adverse effects and can be taken in higher doses safely. If you’re thinking of taking a dose of niacinamide that’s higher than the UL, speak with your healthcare provider or a registered dietitian beforehand to be sure it’s safe for you.
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