Niacin vs Nicotinamide vs Nicotinamide Riboside: What's the Difference?

Niacin, the original vitamin B3

Vitamin B3 is most often associated with niacin (NA), labeled almost synonymously in multivitamins.

Niacin's roots are old, stretching back through history where it was used to treat a disease called pellagra, Italian for "rough skin." Spreading throughout the American South, pellagra patients suffered severe symptoms known as the "4 D's": dermatitis, diarrhea, dementia, and death.

Pellagra continued to become an unmanageable problem until Dr. Joseph Goldberger traced pellagra to a dietary deficiency in vitamin B3 in 1926. Afterward, Goldberger's discovery led to the widespread supplementation of niacin as an effective treatment.

Government mandates called for food groups like flour to be niacin-enriched in efforts to address the larger populace.

Nicotinamide and Niacinamide are the same thing

Is niacinamide the same as nicotinamide? Niacinamide, also called nicotinamide (WebMD), is a form of vitamin B3. 

Nicotinamide (NAM) and niacinamide are the exact same thing. The older name of niacinamide is nicotinamide but it was switched because too many people confused it with nicotine.

For the purposes of this post, we’ll just be saying niacinamide.

Niacinamide is also a form of vitamin B3, but has a different molecular structure. This subtle difference allows nicotinamide to bypass the step that causes niacin's annoying flushing, providing the benefits of vitamin B3 without making you self-conscious.

Niacinamide is the vitamin B3 that you get from meat and poultry. In other words, it comes from animal based foods. Many grain products are also fortified with it.

As a blanket recommendation for optimal health, we recommend taking 50 mg of niacinamide three times per day. Niacinamide will only cost you about 25 cents a month if you get it as a powder. Typically, one sixty-fourth of a teaspoon of niacinamide powder is about 50 mg. 

The reason we recommend getting it in powder form is because in most supplement brands, the lowest available dose is 500 mg, and that will decrease NAD+ due to negative feedback on NAMPT, which is the opposite of what you’re looking for. Also note that although niacinamide and niacin are both classified as vitamin B3, niacin will not activate NAMPT like niacinamide, so it is best to use niacinamide. Additionally, niacinamide, unlike niacin, will not cause flushing which is due to a large release of histamine.

Related: Can Niacinamide transform natural killer cells into a cancer therapy?

Niacinamide also helps keep your skin healthy and is a popular additive in skincare products. It’s often used to treat acne or rosacea. 

More Niacinamide Is NOT Better

Keep in mind that the dosages used in the research studies discussed below do vary widely, but as a rule, we only recommend taking small doses of 50 milligrams of niacinamide three times a day.

This dosage has been shown to optimize energy metabolism and boost NAD+ levels, which are foundational for everything else to work. It can be taken four times a day if you space them out. Take a dose as soon as you get up, before going to bed, and twice evenly spaced between those times.

The problem with taking too much vitamin B3, whether in the form of niacin or niacinamide, is that it might backfire and contribute to cardiovascular disease as documented by the Cleveland Clinic.

“The new study out of the Cleveland Clinic, published in Nature Medicine, determined there is a delicate balance between too much niacin and just enough — a sort of Goldilocks effect ... [As] observed by the Cleveland Clinic team, too much niacin creates a byproduct known as 4PY.

This product circulates within the bloodstream and is associated with a higher risk of heart attack, stroke, and other cardiac events. Additionally, 4PY was shown in preclinical studies to trigger vascular inflammation, damaging blood vessels and eventually leading to atherosclerosis.

The researchers discovered this by examining data from 1,162 patients who had experienced major cardiovascular events. Just under half of the patients (442) were female. Initially, the team sought common markers that could lead to cardiovascular events. The most common factor within the pool of patients was excess levels of niacin.

The findings led to additional studies to validate the initial research. Both cohort studies, conducted in the United States and Europe, confirmed that niacin breakdown predicted an individual’s future risk of heart attack, stroke, and death from cardiovascular disease.”

Related: Even More Health Benefits of Niacinamide

Niacinamide's side effects

A review published in Diabetologia reports some people having GI symptoms when taking nicotinamide. The same publication reported that it might increase the risk of type II diabetes in high doses.

Nicotinamide also may inhibit a unique class of protective enzymes called sirtuins. As reported in the Journal of Cell Science, sirtuins are essential to DNA repair and cell survival.

Sirtuins, like many regulatory enzymes, help ensure that cells monitor and mend their DNA before they replicate. This process prevents cells from passing on mutated genes, akin to faulty instruction, possibly causing many cellular processes to go awry.

Sirtuins regulate the rate at which our cells break down energy, maintain their machinery, and replicate, making them a popular target for longevity research. A review published in Biomolecules suggests that sirtuins may even extend lifespan in some animals.

Unfortunately, nicotinamide seems to turn off sirtuins, which runs the risk of having a negative impact on cell health and survival.

The next generation of vitamin B3: nicotinamide riboside

Nicotinamide riboside (NR) was first identified in the 1940s, but in the 2000s, scientists discovered it could raise a coenzyme called NAD+ far more efficiently than either niacin or nicotinamide.

NAD+ is an essential molecule your body uses to regulate cellular metabolism, aging, and DNA repair.

NAD+ and aging?

Promising research from a team of researchers at the University of New South Wales uncovered age-associated changes in NAD+ metabolism in humans. Their research showed that NAD+ levels decline by up to 50% between the ages of 40-60.

The team found a strong negative correlation between NAD+ levels and age by observing NAD's role in fueling the mechanisms needed to combat oxidative stress, a significant contributor to age-associated changes in the body.

Nicotinamide riboside and oxidative stress

Besides inflammation and infection, many processes in our daily lives, such as the breakdown of food, can damage our DNA and cellular machinery. Our metabolism causes this damage in a process called “oxidative stress.” Repair enzymes utilize and deplete NAD+ to fix the damage and prevent permanent complications.

While aging decreases NAD+ levels naturally, other stressors such as sleep deprivation, a sedentary lifestyle, poor diet, and alcohol consumption can also deplete NAD+ levels.

NR is the most efficient supplement to restore NAD+ levels that may become depleted from these everyday stressors.

Nicotinamide riboside's side effects

NR is uniquely safe— it's been evaluated in 13 published human trials without any severe attributable side effects reported in clinical trials.

However, there are several forms of NR. Amongst them, Niagen® is the only patented form that has gone through the regulatory procedures to assess safety in key markets around the world.

Nicotinamide riboside: A promising way to raise NAD+

NR is the latest member of the B3 family. However, it does not have the same résumé as niacin in terms of its use in treating high cholesterol or supporting kidney function. Also, it has not yet been investigated for helping with acne, as does nicotinamide.

Still, scientists find that NR’s role as the most efficient NAD+ booster may be the most promising benefit that unlocks our understanding of cellular health as more research continues.

Related: NMN vs NR

Sources and References:


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