Niacin (Vitamin B3) has historically been prescribed as a therapy to improve adverse lipid profiles by lowering LDL cholesterol and triglycerides while raising HDL. While its incremental benefit for cardiovascular events is now considered modest, interest has shifted to its role in healthspan optimization. This emerging use focuses on niacin's function as a direct precursor to NAD+, a vital coenzyme that supports cellular energy production and repair mechanisms that decline with age.
Verdict
A cost-effective NAD+ precursor with proven benefits for lipid management.
HEALTHSPAN IMPACT
Moderate
RISK LEVEL
Moderate
EVIDENCE GRADE
B
MONTHLY COST
$5 - $20
Protocol
- Daily doses of 500mg to 2000mg of nicotinic acid are common for lipid management.
- Niacinamide (a no-flush form) is often used at similar doses for NAD+ precursor support.
Flags
- The 'niacin flush' (intense redness, warmth, itching) is a common side effect of the nicotinic acid form.
- High doses (>2g/day) can increase the risk of liver damage and require medical supervision.
- May increase blood sugar levels, requiring caution for individuals with diabetes.
- Can worsen gout by increasing uric acid levels.
- May increase risk of myopathy when combined with statins.