The umbrella term “vitamin B3” includes both niacinamide (nicotinamide) and nicotinic acid (“niacin”) to make things even more interesting. And some companies may label niacinamide and nicotinic acid as “niacin.” It’s essential, however, not to confuse niacinamide (nicotinamide) with nicotinic acid (“niacin”), “nicotinamide mononucleotide,” “nicotinamide riboside,” nicotinamide adenine dinucleotide (NAD+)," or “nicotine.”
Although they’re both different forms of vitamin B3, niacinamide and nicotinic acid (“niacin”) have different chemical structures and 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
Oral (by mouth) niacinamide (nicotinamide) supplements have been studied for several conditions, including:
Delaying the development of type 1 diabetes Hyperphosphatemia (high blood levels of phosphate) Niacinamide deficiency Pellagra Treatment of neurological degeneration
Topical (on the skin) niacinamide has been studied for use in:
Acne treatment Aging skin Melasma Skin cancer prevention
It’s important to note that niacinamide differs from niacin (also known as nicotinic acid). For example, niacin treats high cholesterol. Niacinamide, however, does not lower cholesterol.
Let’s take a closer look at niacinamide.
Acne Treatment
Niacinamide’s anti-inflammatory effects are thought to 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 combined with other supplements treated acne. However, conclusions cannot be made about using oral niacinamide alone for acne.
Niacinamide Deficiency
Niacinamide deficiency can be due to an inability to absorb tryptophan (Hartnup disease), isoniazid treatment, carcinoid syndrome, excess alcohol consumption, or lack of dietary intake (ex., in anorexia). Symptoms include stomatitis (mouth inflammation), glossitis (red, swollen tongue), stomach upset, and pellagra which can be reversed with niacinamide supplementation. Niacinamide is generally recommended over nicotinic acid (niacin) to treat pellagra because it has fewer possible side effects. Talk with your healthcare provider if you believe you may have a niacinamide deficiency. They will be able to help diagnose and treat this condition.
Pellagra
Pellagra is a severe condition that occurs when a person is deficient in vitamin B3. Common symptoms of pellagra include:
Dementia Light-sensitive dermatitis (swollen, red skin after sun exposure) Diarrhea Fatigue (tiredness)
It’s possible to become deficient in niacinamide from not eating enough foods containing the vitamin (ex., starvation, anorexia), excess alcohol intake, disorders in which niacinamide is not adequately absorbed in the body, and certain genetic disorders.
Fortunately, pellagra can often be reversed with the help of niacinamide supplements. Niacinamide is recommended over nicotinic acid to treat pellagra because it has fewer possible side effects. If you’re experiencing pellagra symptoms, please contact your healthcare provider for further guidance.
Skin Cancer Prevention
In a randomized controlled trial, after 12 months of treatment, niacinamide 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.
Other Conditions
Niacinamide has also been studied for its use in:
Aging skin: According to a review, niacinamide increased keratin, an essential protein needed for healthy skin, in cell cultures. It may also be helpful for other aspects of skin care, including reducing the appearance of wrinkles and other signs of aging skin using topical (skin) products. 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. 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. Type 1 diabetes (T1DM): Niacinamide has been studied for delaying T1DM development in high-risk individuals. Studies used 1 gram (g) to 3 grams (g) per day for four months to four years. Neurological degeneration.
Further high-quality studies are needed before recommendations can be made.
What Are the Side Effects of Niacinamide?
Like with most supplements and medications, side effects are possible when taking niacinamide.
Your healthcare provider may recommend that you take 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 (i.e., 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 three grams (g) per day) Symptoms of thrombocytopenia (ex. , 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:
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 when used by children, as long as 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 taking 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 doses of less than 35 milligrams (mg) per day. Two hundred milligrams (mg) per day, or 50 milligrams (mg) per kilogram (kg) (eq. ~3.5 grams (g) per day) for up to 12 months, have been used in different studies. While niacinamide may be safe in higher amounts, side effects may arise (ex., increased bleeding, stomach upset).
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 used, you may need more or less niacinamide.
As a general rule, never use more niacinamide than what is listed on the supplement label unless directed to do so 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 (rare side effects, has happened at a dose of more than 3 grams (g) per day), and symptoms of thrombocytopenia (low platelet counts in people with renal disease on dialysis) have been reported. In people undergoing dialysis through the vein, the most common side effects of niacinamide (500 to 1,500 milligrams (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 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 effects of the drug in the body and increased risk of primidone side effects.
There are no known interactions between niacinamide and foods.
Niacinamide supplements can slow blood clotting and increase your bleeding risk. 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 ingredients 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
Niacinamide supplements should be stored in a cool, dry place.
You should avoid storing your supplements in places that could become too hot or too 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 & 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 and nicotinic acid (aka “niacin”) are common forms of vitamin B3 in supplements. Your body can convert tryptophan from food into niacinamide as needed, and it may make niacinamide from niacin to an extent when there’s enough of it.
In contrast, fat-soluble vitamins, like vitamins A, D, E, and K, are dissolved in fat.
Common ingredients added to niacinamide supplements include cellulose, gelatin, and stearic acid. Serums may contain vitamin B5, vitamin C, licorice extract, and glucosamine. Multivitamins may also contain niacinamide, so you’ll want to take care when taking supplements together, so you don’t get too much.
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 used in topical (skin) form as creams or serums and orally (by mouth) as capsules or powder. The supplement form you use 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 as niacinamide.
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 be used topically (on the skin) in cream or serum formulas or orally (by mouth) through capsules or powder.
Niacinamide has been studied for use in several health conditions, such as pellagra, acne, and skin cancer prevention. Niacinamide supplements may help treat certain skin conditions or if your body cannot absorb enough niacinamide.
Although niacinamide supplements are generally safe, consult a healthcare provider before taking any supplements.
