What is Niacin?

Niacin is also known as nicotinic acid, Vitamin B3, and Vitamin PP. It's an organic compound that occurs naturally in plants and animals. A lack of niacin is associated with a nutritional deficiency disease called pellagra. As a supplement, Niacin has been used years to increase High Density Lipoproteins (HDL) levels. Research into Niacin supplementation has indicated it can decrease the risk of cardiovascular events

Another form of Niacin is Nicotinamide (Niacinamide). Although Niacin and Nicotinamide are identical as far as their vitamin activity, Nicotinamide doesn't have the same HDL raising effects as Niacin. Nicotinamide does not positively effect cholesterol/HDL ratios and doesn't cause the common side effect known as the "Niacin flush". In addition, Nicotinamide may be toxic to the liver at doses exceeding 3,000mg per day in adults.

Niacin is involved in both DNA repair, and the production of steroid hormones in the adrenal gland. Supplemental Niacin is used to treat and/or prevent a lack of natural niacin in the body, and to lower cholesterol and triglycerides. It is also used to lower the risk of heart attack in people with high cholesterol who have already had a heart attack. It is also sometimes used to treat coronary artery disease (also called atherosclerosis).

Unlike statins, not only does Niacin lower cholesterol, it also drops triglycerides while at the same time increasing beneficial HDL cholesterol. Niacin may also be one of the few ways to lower lipoprotein (a), a significant heart disease risk factor. This suggests that it may be ideal for reducing cardiovascular risk (along with fish oil and plant phytosterols). 

Recommended Daily Allowance for Niacin

One thing important to remember is that the Recommended Daily Allowance (RDA) is the MINIMUM amount required to prevent a deficiency. The Niacin RDA is 2-12mg per day for children, 14mg per day for women, 16mg per day for men, and 18mg per day for pregnant or breast-feeding women.

Niacin deficiency is rarely seen in developed countries and more often occurs in third world countries where there is a higher level of poverty, malnutrition. Chronic alcoholism can also cause a Niacin deficiency.

An individual suffering from a severe Niacin deficiency will most likely be suffering from the disease called pellagra, the symptoms of which are diarrhea, dermatitis and thickening of the skin, dementia, hyperpigmentation, inflammation of the mouth and tongue, digestive disturbances, amnesia, delirium, and eventually death.

Niacin, Cholesterol and HDL

Niacin has been shown to cause the inhibition of fat breakdown in fatty tissue. Nicotinamide does not, and as such does not affect blood lipid levels. Because Niacin blocks the breakdown of fats, it causes a decrease in free fatty acids in the blood and, as a consequence, decreases the secretion of Very Low Density Lipoproteins (VLDL) and cholesterol by the liver.

By lowering VLDL levels, Niacin also increases the level of high-density lipoprotein (HDL) (the "good" cholesterol). It is sometimes prescribed for people with low HDL who are also at high risk of a heart attack due to hereditary or environmental factors.

One thing to consider is that Niacin doesn't seem to offer health benefits through raising HDL in patients who are already lowering LDL by taking a statin. If you're already taking a statin for cholesterol control, make sure you consult with your physician before attempting Niacin supplementation.