Vitamin B3, also known as niacin, has long been hailed for its role in promoting healthy blood lipids, boosting brain health, aiding digestion, and more. However, most supplements come with potential risks—and niacin is no different. In fact, recent research has suggested concerning downsides of excessive niacin intake when it comes to your heart.
To learn more about how niacin could negatively impact your heart health, we spoke to integrative medicine practitioner David M. Brady, ND, DC, CCN, DACBN, IFMCP, FACN chief medical officer at Designs for Health. He highlighted research that indicates this supplement could lead to a higher risk of inflammation, heart attack, stroke, and more. Find all of his expert insight below.
Niacin associated with higher risk of heart attack and more
Niacin is undoubtedly crucial to many of our body's functions, and supplementation certainly has potential benefits. As Dr. Brady notes, "Niacin's ability to promote healthy blood lipids was discovered in the 1950s. Since then, many health care practitioners have chosen to recommend niacin for patients who need assistance in supporting healthy lipid levels, as well as change their characteristics to less risky forms, without some of the undesirable side-effects of pharmaceutical drugs." He also highlighted niacin's pivotal role in vasodilation, which supports healthy circulation. However, recent studies have uncovered a potential risk associated with high niacin intake.
"In a recent study published in Nature Medicine revealed a previously unknown risk from excessive amounts of the vitamin, a metabolite known as 4PY which is thought to potentially increase inflammation in the blood vessels," Dr. Brady revealed. "Two investigations, one in the U.S. and one in Europe, showed that this niacin breakdown product predicted participants’ future risk of heart attack, stroke and death." Yikes!
While this information is certainly alarming, it's important to note that, as Dr. Brady reminds us, "This finding shows an 'association' and not 'causality,'" and more research is needed to understand the complex relationships involved. He points out that it could simply indicate that people who are prone to inflammation and cardiovascular disease are also the people most likely to take higher-dose niacin. "More careful and controlled study is needed to fully flush out these complicated relationships and issues before broad and sweeping recommendations can be made," he states.
However, if nothing else, this is certainly a reminder to proceed with caution when it comes to niacin supplements—or any supplements, for that matter. When it comes to safely taking B3 supplements, Dr. Brady emphasizes the critical importance of professional guidance. "I think you should consider taking niacin supplements only under the management and recommendation of a qualified healthcare practitioner with adequate formal training in clinical nutrition," he says. "They can best determine the pros and cons of doing so, as well as guide you on correct dosing depending on the intended use-case and your individual circumstances."
Who should avoid niacin?
But should anyone avoid niacin supplements altogether? Dr. Brady recommends that induvial with high risk for cardiovascular issues and objective markers of systemic inflammation—like positive blood testing for highly sensitive CRPs—proceed with the utmost caution and "probably avoid higher-dose therapeutic levels of niacin until more is known."
Instead, he advocates for healthy lifestyle habits and a healthy diet. Things like adequate exercise, stress management, and heart-healthy foods can make a major difference. He also suggests the use of nutraceuticals like bergamot, resveratrol, fish oil, and quality standardized red yeast rice, or a low-dose lipid lowering medication.
The bottom line
While niacin has long been regarded as a beneficial supplement, recent research highlights potential risks associated with excessive intake. Dr. Brady's insights underscore the importance of informed decision-making under professional guidance and the exploration of alternative strategies to promote heart health.
As the landscape of nutritional science continues to evolve, it's always important to stay informed and consult with qualified healthcare practitioners for personalized recommendations tailored to your unique needs and circumstances.
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