Amount of Niacin in 3 Ounces of Ground Beef

• Consumer
• Datos en español
• Health Professional person
• Other Resources

This is a fact canvass intended for wellness professionals. For a reader-friendly overview of Niacin, see our consumer fact sheet on Niacin.

Introduction

Niacin (also known equally vitamin B3) is one of the water-soluble B vitamins. Niacin is the generic name for nicotinic acrid (pyridine-3-carboxylic acrid), nicotinamide (niacinamide or pyridine-3-carboxamide), and related derivatives, such as nicotinamide riboside [1-3]. Niacin is naturally present in many foods, added to some food products, and available as a dietary supplement.

All tissues in the body convert absorbed niacin into its main metabolically active course, the coenzyme nicotinamide adenine dinucleotide (NAD). More than 400 enzymes require NAD to catalyze reactions in the trunk, which is more than than for whatever other vitamin-derived coenzyme [1]. NAD is besides converted into another active form, the coenzyme nicotinamide adenine dinucleotide phosphate (NADP), in all tissues except skeletal muscle [iv].

NAD and NADP are required in nigh metabolic redox processes in cells where substrates are oxidized or reduced. NAD is primarily involved in catabolic reactions that transfer the potential energy in carbohydrates, fats, and proteins to adenosine triphosphate (ATP), the cell'due south main energy currency [four]. NAD is also required for enzymes involved in critical cellular functions, such as the maintenance of genome integrity, control of gene expression, and cellular advice [3,4]. NADP, in dissimilarity, enables anabolic reactions, such as the synthesis of cholesterol and fat acids, and plays a citical role in maintaining cellular antioxidant role.

Nearly dietary niacin is in the form of nicotinic acrid and nicotinamide, but some foods contain small-scale amounts of NAD and NADP. The body also converts some tryptophan, an amino acid in protein, to NAD, so tryptophan is considered a dietary source of niacin.

When NAD and NADP are consumed in foods, they are converted to nicotinamide in the gut so captivated [four]. Ingested niacin is absorbed primarily in the small-scale intestine, but some is absorbed in the stomach [1-3].

Even when taken in very high doses of 3–four g, niacin is almost completely absorbed. Once absorbed, physiologic amounts of niacin are metabolized to NAD. Some excess niacin is taken up past red blood cells to class a circulating reserve pool. The liver methylates any remaining excess to N1-methyl-nicotinamide, N1-methyl-two-pyridone-5-carboxamide, and other pyridone oxidation products, which are so excreted in the urine. Unmetabolized nicotinic acrid and nicotinamide might be nowadays in the urine as well when niacin intakes are very loftier.

Levels of niacin in the blood are not reliable indicators of niacin status. The most sensitive and reliable measure out of niacin status is the urinary excretion of its two major methylated metabolites, N1-methyl-nicotinamide and N1-methyl-2-pyridone-five-carboxamide [2]. Excretion rates in adults of more than 17.5 micromol/twenty-four hour period of these ii metabolites reflect adequate niacin condition, while excretion rates between 5.8 and 17.5 micromol/day reflect low niacin status. An adult has deficient niacin status when urinary-excretion rates are less than 5.8 micromol/day. Indicators of inadequacy such as this and other biochemical signs (eastward.grand., a 2-pyridone oxidation product of N1-methyl-nicotinamide below detection limits in plasma or low erythrocyte NAD concentrations) occur well before overt clinical signs of deficiency [2]. Another mensurate of niacin status takes into account the fact that NAD levels decline as niacin status deteriorates, whereas NADP levels remain relatively constant [1,three,5]. A "niacin number" (the ratio of NAD to NADP concentrations in whole blood x 100) below 130 suggests niacin deficiency [6,7]. A "niacin index" (the ratio of erythrocyte NAD to NADP concentrations) beneath ane suggests that an individual is at take a chance of developing niacin deficiency [8]. No functional biochemical tests that reflect total body stores of niacin are bachelor [5].

Recommended Intakes

Intake recommendations for niacin and other nutrients are provided in the Dietary Reference Intakes (DRIs) adult by an proficient commission of the Food and Nutrition Board (FNB) at the National Academies of Sciences, Engineering, and Medicine [2]. DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of good for you people. These values, which vary by historic period and sex, include:

• Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the food requirements of nearly all (97%–98%) salubrious individuals; oft used to plan nutritionally acceptable diets for individuals.
• Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when show is insufficient to develop an RDA.
• Estimated Average Requirement (EAR): Average daily level of intake estimated to encounter the requirements of l% of healthy individuals; usually used to assess the food intakes of groups of people and to plan nutritionally adequate diets for them; tin can as well be used to assess the nutrient intakes of individuals.
• Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause agin wellness furnishings.

Table one lists the current RDAs for niacin every bit mg of niacin equivalents (NE) [2]. The FNB defines 1 NE as 1 mg niacin or threescore mg of the amino acrid tryptophan (which the body can convert to niacin). Niacin RDAs for adults are based on niacin metabolite excretion data. For children and adolescents, niacin RDAs are extrapolated from adult values on the basis of body weight. The AI for infants from birth to vi months is for niacin solitary, equally young infants use almost all the protein they consume for growth and development; information technology is equivalent to the mean intake of niacin in salubrious, breastfed infants. For infants anile 7-12 months, the AI for niacin is in mg NE and is based on amounts consumed from breast milk and solid foods.

Table 1: Recommended Dietary Allowances (RDAs) for Niacin [two]

Age	Male	Female	Pregnancy	Lactation
Birth to half dozen months*	ii mg	2 mg
seven–12 months*	4 mg NE	4 mg NE
one–3 years	half-dozen mg NE	half-dozen mg NE
four–viii years	8 mg NE	8 mg NE
9–13 years	12 mg NE	12 mg NE
14–18 years	16 mg NE	14 mg NE	xviii mg NE	17 mg NE
19+ years	xvi mg NE	14 mg NE	18 mg NE	17 mg NE

* Adequate Intake

Sources of Niacin

Nutrient
Niacin is present in a wide variety of foods. Many animal-based foods—including poultry, beef, and fish—provide about 5-10 mg niacin per serving, primarily in the highly bioavailable forms of NAD and NADP [3]. Plant-based foods, such as basics, legumes, and grains, provide about 2-5 mg niacin per serving, mainly as nicotinic acrid. In some grain products, yet, naturally present niacin is largely bound to polysaccharides and glycopeptides that brand it only about 30% bioavailable [iii,4]. Many breads, cereals, and infant formulas in the Usa and many other countries contain added niacin. Niacin that is added to enriched and fortified foods is in its free form and therefore highly bioavailable [two].

Tryptophan is some other food source of niacin because this amino acrid—when nowadays in amounts across that required for protein synthesis—tin be converted to NAD, mainly in the liver [iii,5]. The well-nigh commonly used approximate of efficiency for tryptophan conversion to NAD is 1:threescore (i.eastward., 1 mg niacin [NAD] from 60 mg tryptophan). Turkey is an example of a nutrient high in tryptophan; a three-oz portion of turkey breast meat provides about 180 mg tryptophan, which could exist equivalent to 3 mg niacin [9]. Notwithstanding, the efficiency of the conversion of tryptophan to NAD varies considerably in different people [3].

Table 2 lists several nutrient sources of niacin.

Tabular array 2: Niacin Content of Selected Foods [9]

Nutrient	Milligrams (mg) per serving	Percent DV**
Beef liver, pan fried, 3 ounces	14.ix	93
Craven breast, meat just, grilled, 3 ounces	10.3	64
Marinara (spaghetti) sauce, gear up to serve, 1 loving cup	10.3	64
Turkey breast, meat only, roasted, 3 ounces	10.0	63
Salmon, sockeye, cooked, 3 ounces	8.6	54
Tuna, light, canned in h2o, drained, 3 ounces	eight.6	54
Pork, tenderloin, roasted, iii ounces	half-dozen.three	39
Beef, ground, ninety% lean, pan-browned, 3 ounces	5.eight	36
Rice, brownish, cooked, 1 cup	5.2	33
Peanuts, dry roasted, 1 ounce	4.2	26
Breakfast cereals fortified with 25% DV niacin	four.0	25
Rice, white, enriched, cooked, i loving cup	2.3	14
Spud (russet), baked, 1 medium	2.three	14
Sunflower seeds, dry roasted, 1 ounce	ii.0	thirteen
Staff of life, whole wheat, 1 slice	ane.4	nine
Pumpkin seeds, dry roasted, 1 ounce	1.3	8
Soymilk, unfortified, 1 cup	1.3	eight
Bread, white, enriched, 1 slice	1.3	eight
Lentils, boiled and drained, ½ loving cup	1.0	6
Bulgur, cooked, 1 cup	0.9	vi
Banana, 1 medium	0.8	5
Edamame, frozen, prepared, ½ cup	0.7	iv
Raisins, ½ loving cup	0.6	4
Tomatoes, cherry, ½ cup	0.five	3
Broccoli, boiled, drained, chopped, ½ cup	0.4	three
Cashews, dry roasted, ane ounce	0.4	three
Yogurt, apparently, low fat, 1 cup	0.3	two
Apple, 1 medium	0.2	one
Chickpeas, canned, tuckered, 1 cup	0.2	1
Milk, 1% milkfat, 1 cup	0.2	one
Spinach, frozen, chopped, boiled, ½ cup	0.2	1
Tofu, raw, house, ½ cup	0.2	1
Onions, chopped, ½ cup	0.one	one
Egg, large	0	0

* These values are for the niacin content of foods just. They do not include the contribution of tryptophan, some of which is converted to NAD in the body.
** DV = Daily Value. The U.S. Food and Drug Assistants (FDA) developed DVs to help consumers compare the nutrient contents of foods and dietary supplements inside the context of a total nutrition. The DV for niacin is 16 mg for adults and children anile 4 years and older [10]. The FDA does non require food labels to list niacin content unless niacin has been added to the food. Foods providing twenty% of more than of the DV are considered to be loftier sources of a food.

The U.Southward. Section of Agronomics'southward (USDA's) FoodData Central lists the food content of many foods and provides a comprehensive list of foods containing niacin arranged by nutrient content.

Dietary supplements
Niacin is bachelor in multivitamin-mineral products, in supplements containing other B-complex vitamins, and in supplements containing niacin merely. Nicotinic acrid and nicotinamide are the two nearly mutual forms of niacin in supplements. Some niacin-only supplements contain 500 mg or more than per serving, which is much higher than the RDA for this nutrient [eleven].

Nicotinic acid in supplemental amounts beyond nutritional needs tin can cause pare flushing, so some formulations are manufactured and labeled as prolonged, sustained, extended, or timed release to minimize this unpleasant side effect. Nicotinamide does not produce skin flushing because of its slightly different chemical structure [ii,12]. Niacin supplements are also available in the form of inositol hexanicotinate, and these supplements are frequently labeled as being "flush gratuitous" because they do non cause flushing. The absorption of niacin from inositol hexanicotinate varies widely but on average is xxx% lower than from nicotinic acid or nicotinamide, which are almost completely absorbed [12-fourteen]. A niacin-like compound, nicotinamide riboside, is also available as a dietary supplement, but it is non marketed or labelled as a source of niacin [11].

Medications

Niaspan® and generic niacin ER, bachelor every bit a prescription medicine, provides 500-1,000 mg extended-release nicotinic acid. It is used to care for loftier blood cholesterol levels.

Niacin Intakes and Status

Virtually people in the United States consume more than the RDA for niacin. An analysis of data from the 2015–2016 National Health and Diet Examination Survey (NHANES) plant that the average daily niacin intake from foods and beverages was 21.iv mg for ages 2–xix [15]. In adults, the boilerplate daily niacin intake from foods and beverages was 31.iv mg in men and 21.3 mg in women. An analysis of data from the 2009-2012 NHANES found that just ane% of adults had intakes of niacin from foods and beverages below the EAR [16]. Among all racial and ethnic groups, Hispanics had the greatest prevalence, ane.3%, of niacin intakes below the EAR [17].

According to self-reported information from the 2013-2014 NHANES, 21% of all individuals aged 2 and older took a dietary supplement containing niacin [15]. The proportion of users increased with age from eight% of those aged 12-xix years to 39% of men and 40% of women anile 60 and older. Supplement utilise doubled or tripled full niacin intakes compared with intakes from nutrition alone. According to data from the 2003-2006 NHANES, 10% of all individuals aged 2 and older who took dietary supplements had total niacin intakes that reached or exceeded the UL [18].

Niacin Deficiency

Severe niacin deficiency leads to pellagra, a disease characterized by a pigmented rash or dark-brown discoloration on peel exposed to sunlight; the skin too develops a roughened, sunburned-like appearance [two,4,xix,20]. In addition, pellagra can crusade a brilliant carmine natural language and changes in the digestive tract that pb to airsickness, constipation, or diarrhea. The neurological symptoms of pellagra tin can include depression; apathy; headache; fatigue; loss of retentivity that can progress to aggressive, paranoid, and suicidal behaviors; and auditory and visual hallucinations [2-4]. As pellagra progresses, anorexia develops, and the affected private eventually dies [3].

Pellagra is uncommon in industrialized populations and is mostly limited to people living in poverty, such as refugees and displaced people who eat very limited diets low in niacin and protein [20,21]. Pellagra was not uncommon in the early 20th century among individuals living in poverty in the southern United states of america and parts of Europe whose limited diets consisted mainly of corn [ii,3]. The World Wellness Organization recommends treating pellagra with 300 mg/day nicotinamide in divided doses for 3-4 weeks along with a B-complex or yeast product to care for likely deficiencies in other B vitamins [xx].

Although frank niacin deficiencies leading to pellagra are very rare in the U.s.a., some individuals have marginal or low niacin status [2,19,21,22].

Groups at Hazard of Niacin Inadequacy

Niacin inadequacy usually arises from bereft intakes of foods containing niacin and tryptophan. It can also exist caused by factors that reduce the conversion of tryptophan to niacin, such as low intakes of other nutrients [2,21]. The following groups are among those most likely to have inadequate niacin status.

People with undernutrition
People who are undernourished because they alive in poverty or have anorexia, alcohol use disorder, AIDS, inflammatory bowel disease, or liver cirrhosis often have inadequate intakes of niacin and other nutrients [ii,19,21,22].

People with inadequate riboflavin, pyridoxine, and/or iron intakes
People who do non swallow enough riboflavin (vitamin B2), pyridoxine (vitamin B6), or iron convert less tryptophan to niacin because enzymes in the metabolic pathway for this conversion depend on these nutrients to office [ii,21].

People with Hartnup disease
Hartnup disease is a rare genetic disorder involving the renal, intestinal, and cellular send processes for several amino acids, including tryptophan. The affliction interferes with the absorption of tryptophan in the pocket-size intestine and increases its loss in the urine via the kidneys [2,22,23]. As a upshot, the body has less available tryptophan to catechumen to niacin.

People with carcinoid syndrome
Carcinoid syndrome is caused by wearisome-growing tumors in the gastrointestinal tract that release serotonin and other substances. Information technology is characterized by facial flushing, diarrhea, and other symptoms. In those with carcinoid syndrome, tryptophan is preferentially oxidized to serotonin and not metabolized to niacin [2]. Equally a result, the torso has less available tryptophan to convert to niacin.

Niacin and Health

Cardiovascular disease
Very high doses of nicotinic acid—more than than 100 times the RDA—taken for months or years are effective treatments for dyslipidemias. Nicotinamide does not have this effect because, unlike nicotinic acid, it does not bind to the receptors that mediate nicotinic acid's effects on lipid profiles [1]. Studies conducted since the late 1950s evidence that these doses can increase loftier-density lipoprotein (HDL; "expert") cholesterol levels past x-30% and reduce low-density lipoprotein (LDL; "bad") cholesterol levels by 10-25%, triglyceride levels by xx-50%, and lipoprotein(a) levels past ten-xxx% [12]. Together, these changes in lipid parameters might be expected to reduce the chance of first-time or subsequent cardiac events, such as heart attacks and strokes, in adults with atherosclerotic cardiovascular disease. Nevertheless, despite dozens of published clinical trials, experts exercise not concord on the value of nicotinic acid to treat cardiovascular disease, specially given its side effects, safety concerns, and poor patient compliance [24].

In one large clinical trial from the 1970s, viii,341 participants anile 30 to 64 years who had had one or more heart attacks were randomized to take 1 of five lipid-lowering medications, including iii,000 mg/24-hour interval nicotinic acrid, or a placebo for an average of six.2 years [25]. Those taking nicotinic acid lowered their serum cholesterol levels by an average of 9.ix% and triglyceride levels by 26.one% over five years of treatment. During five to 8.v years of handling, these participants had significantly fewer nonfatal myocardial infarctions but more than cardiac arrhythmias than those in the placebo grouping. Their overall rates of mortality and cause-specific mortality, including from coronary heart affliction, did not decline. Merely 9 years later on the report ended, participants who had taken the nicotinic acid experienced significantly fewer (11%) deaths from all causes than those who had taken the placebo [26,27].

Statin medications have become the treatment of choice for hyperlipidemia and lowering the risks of atherosclerotic cardiovascular disease. For this reason, clinical trials of nicotinic acid in the by several decades have examined whether it provides whatsoever additional cardiovascular protection to people taking statins [28].

In the largest international, multicenter, clinical trial of nicotinic acid to date, 25,673 adults anile 50-eighty years (83% men) with cardiovascular disease who were taking a statin were randomized to take 2 thou/day extended-release nicotinic acid with a medication to reduce nicotinic acid'south flushing effect and therefore improve treatment compliance or a matching placebo for a median of 4 years [29,30]. The nicotinic acid group had a hateful reduction in LDL cholesterol (of 10 mg/dl) and triglycerides (of 33 mg/dl) and an increase in HDL cholesterol (of 6 mg/dl), just this grouping had no significant reduction in rates of major vascular events compared with the placebo (statin-only) group. Furthermore, the nicotinic acid grouping had a significantly greater risk of diabetes, gastrointestinal dyspepsia, diarrhea, ulceration, haemorrhage events in the gut and brain, and peel rashes and ulcerations. An earlier randomized clinical trial of iii,414 patients with established cardiovascular disease was stopped after 3 years when the researchers establish that patients taking niacin (1,500-2,000 mg/day extended release) in add-on to their cholesterol-reduction medications did not have fewer cardiovascular events than those taking medication solitary, even though the niacin reduced triglyceride and LDL-cholesterol levels further and raised HDL cholesterol levels farther [31]. The results besides showed that patients taking niacin had an increased risk of ischemic stroke.

The authors of ii 2017 systematic reviews examining the clinical trial data concluded that nicotinic acid therapy provides piffling if whatsoever protection from atherosclerotic eye disease, even though the therapy raises HDL cholesterol levels and lowers total cholesterol, LDL cholesterol, and triglyceride levels. One of these reviews examined 23 randomized controlled trials of moderate to high quality in 39,195 participants aged 33-71 years (average 65 years; majority were male). Some had experienced a heart set on, and most were taking a statin. The doses used and handling duration in these studies varied widely; the median dose of nicotinic acrid was 2 one thousand/day (range 0.5 to 4 yard/twenty-four hour period) for a median of 11.v months (range 6 months to 6 years) [24]. Overall, use of nicotinic acid did not reduce overall mortality or cardiovascular mortality rates or the number of fatal or nonfatal myocardial infarctions or strokes. Eighteen per centum of participants taking nicotinic acid discontinued handling because of side furnishings. The second review examined 13 randomized controlled trials with 35,206 participants with, or at take a chance of, atherosclerotic cardiovascular illness [32]. Overall, the addition of nicotinic acrid supplementation (dose range non specified) to statin therapy taken for a mean of 33 months (with a broad range of 6 to 60 months) did not lead to significant reductions in rates of all-crusade or cardiovascular bloodshed, myocardial infarction, or stroke. Nicotinic acrid treatment was associated with a significantly higher take a chance of gastrointestinal and musculoskeletal adverse events. In addition, four of the studies that examined diabetes equally an outcome found that the patients taking niacin had a significantly college risk of developing the disease.

A 2018 review of 3 randomized controlled trials with 29,195 patients plant that all-cause mortality increased by 10% more in those who took 1 to 3 g/day extended release nicotinic acrid in add-on to a statin medication than patients taking the statin alone [33].

In their guidelines for lowering claret cholesterol levels, the American College of Cardiology and the American Center Association advise that nonstatin therapies, compared with or in addition to statin therapy, practice non provide atherosclerotic cardiovascular affliction risk-reduction benefits that outweigh the potential harms of their adverse effects [28]. When discussing the utilise of nicotinic acrid supplements to reduce the risk of hyperlipidemia (for example, in patients unable to tolerate statin medications), the two professional societies recommend that patients take 500 mg/day extended-release nicotinic acid supplements and increment the dose to a maximum of 2,000 mg/mean solar day over 4 to 8 weeks or accept 100 mg immediate-release nicotinic acid iii times a solar day and increase the dose to 3,000 mg/twenty-four hours divided into 2 or three doses. (Their joint statement about monitoring supplement users who take niacin to reduce hyperlipidemia chance for adverse effects is described in the Wellness Risks from Excessive Niacin section below.) In their 2018 report, these 2 professional societies stated what although niacin may exist useful in some cases of severe hypertriglyceridemia, it has only balmy LDL-lowering effects. The societies therefore practise not recommend using it every bit an add together-on drug to statin therapy [34].

Overall, the evidence indicates that nicotinic acid supplementation improves blood lipid profiles merely has no meaning effects on gamble of cardiovascular events. Although nicotinic acrid is a nutrient, if very high doses (thousands of mg) are taken to treat hyperlipidemias, the supplement is being used as a drug. Such doses should only be taken with medical approval and supervision.

Wellness Risks from Excessive Niacin

No agin effects have been reported from the consumption of naturally occurring niacin in foods [2]. Nevertheless, high intakes of both nicotinic acid and nicotinamide taken as a dietary supplement or medication can cause adverse effects, although their toxicity profiles are non the same.

Xxx to 50 mg nicotinic acrid or more typically causes flushing; the skin on the patient'due south face, arms, and chest turns a ruby-red color considering of vasodilation of small subcutaneous claret vessels. The flushing is accompanied past burning, tingling, and itching sensations [ii,12,35]. These signs and symptoms are typically transient and can occur within 30 minutes of intake or over days or weeks with repeated dosing; they are considered an unpleasant, rather than a toxic, side effect. However, the flushing tin can be accompanied by more serious signs and symptoms, such as headache, rash, dizziness, and/or a decrease in blood pressure. Supplement users can reduce the flushing effects past taking nicotinic acid supplements with food, slowly increasing the dose over fourth dimension, or just waiting for the body to develop a natural tolerance.

When taken in pharmacologic doses of i,000 to 3,000 mg/day, nicotinic acrid tin can besides cause more than serious adverse effects [two,4,12,35]. Many of these effects take occurred in patients taking high-dose nicotinic acid supplements to treat hyperlipidemias. These agin effects can include hypotension severe plenty to increase the hazard of falls; fatigue; impaired glucose tolerance and insulin resistance; gastrointestinal furnishings, such as nausea, heartburn, and abdominal pain; and ocular furnishings, such as blurred or dumb vision and macular edema (a buildup of fluid at the center of the retina). Loftier doses of nicotinic acrid taken over months or years can also be hepatotoxic; effects can include increased levels of liver enzymes; hepatic dysfunction resulting in fatigue, nausea, and anorexia; hepatitis; and acute liver failure [2,12,28,36]. Hepatotoxicity is more likely to occur with the use of extended-release forms of nicotinic acid [12,37,38].

To minimize the risk of adverse furnishings from nicotinic acid supplementation or to identify them earlier they become serious, the American College of Cardiology and the American Heart Association recommend measuring hepatic transaminase, fasting blood glucose or hemoglobin A1C, and uric acid levels in all supplement users before they start therapy, while the dose is beingness increased to a maintenance level, and every 6 months thereafter [28]. The societies also recommend that patients not apply nicotinic acid supplements or end using them if their hepatic transaminase levels are more than two or iii times the upper limits of normal; if they develop persistent hyperglycemia, acute gout, unexplained abdominal hurting, gastrointestinal symptoms, new-onset atrial fibrillation, or weight loss; or if they accept persistent and astringent pare reactions, such as flushing or rashes.

Nicotinamide does non cause skin flushing and has fewer adverse effects than nicotinic acid, and these effects typically begin with much higher doses [12]. Nausea, airsickness, and signs of liver toxicity can occur with nicotinamide intakes of three,000 mg/twenty-four hour period [2]. In several small studies of participants undergoing hemodialysis, the most common adverse effects from 500-ane,500 mg/day nicotinamide supplementation for several months were diarrhea and thrombocytopenia (depression platelet count) [35,39-41].

The FNB has established ULs for niacin that apply only to supplemental niacin for salubrious infants, children, and adults [2]. These ULs are based on the levels associated with skin flushing. The FNB acknowledges that although excess nicotinamide does not cause flushing, a UL for nicotinic acid based on flushing can foreclose the potential adverse effects of nicotinamide [2]. The UL, therefore, applies to both forms of supplemental niacin. However, the UL does non utilise to individuals who are receiving supplemental niacin under medical supervision [2].

Table 3: Tolerable Upper Intake Levels (ULs) for Niacin [2]

Age	Male person	Female person	Pregnancy	Lactation
Nativity to 6 months	None established*	None established*
7–12 months	None established*	None established*
i–3 years	10 mg	x mg
4–8 years	15 mg	15 mg
9–13 years	20 mg	xx mg
xiv–18 years	xxx mg	xxx mg	thirty mg	30 mg
xix+ years	35 mg	35 mg	35 mg	35 mg

* Breast milk, formula, and food should exist the only sources of niacin for infants.

Interactions with Medications

Niacin can interact with certain medications, and several types of medications might adversely touch niacin levels. A few examples are provided below. Individuals taking these and other medications on a regular ground should discuss their niacin status with their healthcare providers.

Isoniazid and pyrazinamide
Isoniazid and pyrazinamide (together in Rifater®), used to treat tuberculosis, are structural analogs of niacin and interrupt the production of niacin from tryptophan past competing with a vitamin B6-dependent enzyme required for this process [2,21]. In addition, isoniazid can interfere with niacin's conversion to NAD [42]. Although pellagra tin occur in patients with tuberculosis treated with isoniazid, information technology tin can be prevented with increased intakes of niacin.

Antidiabetes medications
Large doses of nicotinic acid can heighten blood glucose levels by causing or aggravating insulin resistance and increasing hepatic production of glucose [42]. Some studies have plant that nicotinic acid doses of 1.5 g/day or more are about probable to increase blood glucose levels in individuals with or without diabetes [37]. People who take any antidiabetes medications should have their blood glucose levels monitored if they take high-dose nicotinic acid supplements concomitantly because they might crave dose adjustments [42].

Niacin and Healthful Diets

The federal government'southward 2020–2025 Dietary Guidelines for Americans notes that "Because foods provide an assortment of nutrients and other components that have benefits for health, nutritional needs should exist met primarily through foods. ... In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to see needs for one or more than nutrients (east.g., during specific life stages such as pregnancy)."

For more than information about building a salubrious dietary blueprint, refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture's MyPlate.

The Dietary Guidelines for Americans describes a healthy dietary blueprint as one that:

• Includes a diversity of vegetables; fruits; grains (at least half whole grains); fat-complimentary and low-fat milk, yogurt, and cheese; and oils.

  Many vegetables, fruits, whole grains, and dairy products provide some niacin. Enriched grains are too a source of niacin.

• Includes a variety of protein foods such as lean meats; poultry; eggs; seafood; beans, peas, and lentils; nuts and seeds; and soy products.

  Fish, beef, chicken, and turkey are practiced sources of niacin. Many legumes, nuts, seeds, and soy products provide some niacin.

• Limits foods and beverages college in added sugars, saturated fatty, and sodium.


• Limits alcoholic beverages.


• Stays within your daily calorie needs.

References

1. Penberthy WT, Kirkland JB. Niacin. In: Erdman JW, Macdonald IA, Zeisel SH, eds. Present Noesis in Nutrition, 10th ed. Washington, DC: Wiley-Blackwell; 2012:293-306.
2. Found of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press, 1998.
3. Kirkland JB. Niacin. In: Ross Air-conditioning, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. Modern Nutrition in Health and Disease, 11th ed. Baltimore, Doctor: Williams & Wilkins; 2014:331-40.
4. Conservative C, Moss J. Niacin. In: Coates PM, Betz JM, Blackman MR, Cragg GM, Levine Chiliad, Moss J, White JD, eds. Encyclopedia of Dietary Supplements, 2nd ed. New York, NY: Informa Healthcare; 2010:562-nine.
5. Gibson, RS. Principles of Nutritional Assessment, 2d Edition. New York: Oxford University Press. Copyright 2005.
6. Jacobson EL, Jacobson MK Tissue NAD as a biochemical measure out of niacin status in humans. Methods in Enzymology 1997;280:221-30. [PubMed abstract]
7. Shah GM, Shah RG,Veillette H, Kirkland JB, Pasieka JL,Warner RRP. Biochemical assessment of niacin deficiency among carcinoid cancer patients. American Journal of Gastroenterology 2005;100:2307-14. [PubMed abstract]
8. Fu CS, Swendseid ME, Jacob RA, McKee RW. Biochemical markers for assessment of niacin condition in immature men: Levels of erythrocyte niacin coenzymes and plasma tryptophan. J Nutr 1989;119:1949-55. [PubMed abstract]
9. U.S. Department of Agriculture, Agricultural Research Service. FoodData Fundamental, 2019.
10. U.S. Nutrient and Drug Administration. Nutrient Labeling: Revision of the Nutrition and Supplement Facts Labels. 2016.
11. National Institutes of Health. Dietary Supplement Label Database. 2018.
12. MacKay D, Hathcock J, Guarneri. Niacin: chemical forms, bioavailability, and health effects. Nutr Rev 2012;seventy:357-66. [PubMed abstract]
13. Norris RB. "Flush-free niacin": Dietary supplement may be "do good-free." Preventive Cardiology 2006;nine:64-5. [PubMed abstract]
14. Keenan JM. Wax-matrix extended-release niacin vs inositol hexanicotinate: A comparison of wax-matrix, extended-release niacin to inositol hexanicotinate "no-flush" niacin in persons with mild to moderate dyslipidemia. Journal of Clinical Lipidology 2013;seven:14-23. [PubMed abstract]
15. What We Eat in America Data Tables.
16. Blumberg JB, Frei BB, Fulgoni III VL, Weaver CM, Zeisel SH. Touch of frequency of multi-vitamin/multi-mineral supplement intake on nutritional adequacy and nutrient deficiencies in U.S. adults. Nutrients 2017;August 9. [PubMed abstract]
17. Blumberg JB, Frei B, Fulgoni Three VL, Weaver CM, Zeisel SH. Contribution of dietary supplements to nutritional capability in race/ethnic population subgroups in the United States. Nutrients 2017;November 28. [PubMed abstract]
18. Fulgoni III VL, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where practice Americans get their nutrients? J Nutr 2011;141:1847-54. [PubMed abstract]
19. Savvidou S. Pellagra: a non-eradicated old illness. Clinics and Exercise 2014;iv:637. [PubMed abstract]
20. World Health Organization. Pellagra and its prevention and control in major emergencies. 2000.
21. Li R, Yu Yard, Wang Q, Wang L, Mao J, Qian J. Pellagra secondary to medication and alcoholism: A case study and review of the literature. Nutrition in Clinical Exercise 2016;31:785-9. [PubMed abstract]
22. Crook MA. The importance of recognizing pellagra (niacin deficiency) every bit information technology still occurs. Nutrition 2014;30:729-thirty. [PubMed abstruse]
23. National System for Rare Disorders. Hartnup affliction. 2016.
24. Schandelmaier S, Briel Thousand, Saccilotto R, Olu KK, Arpagaus A, Hemkens LG, Nordmann AJ. Niacin for primary and secondary prevention of cardiovascular events (review). Cochrane Database of Systematic Reviews 2017, Effect 6. Art. No.:CD009744. [PubMed abstract]
25. The Coronary Drug Project Research Grouping. Clofibrate and niacin in coronary heart disease. JAMA 1975;231:360-81. [PubMed abstruse]
26. Berge KG, Canner PL. Coronary drug project: Experience with niacin. Eur J Clin Pharmacol 1991;40:S49-51. [PubMed abstract]
27. Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ. Friedewald West. Xv year mortality in Coronary Drug Project patients: Long-term benefit with niacin. J Am Coll Cardiol 1986;eight:1245-55. [PubMed abstruse]
28. Stone et al. American College of Cardiology/American Middle Clan Chore Force on Practise Guidelines. 2013 ACC/AHA guideline on the treatment of claret cholesterol to reduce atherosclerotic cardiovascular risk in adults. J Am Coll Cardiol 2014;63:2889-934. [PubMed abstract]
29. HPS2-THRIVE Collaborative Grouping. Furnishings of extended-release niacin with laropiprant in high-risk patients. New Engl J Med 2014;371:203-12. [PubMed abstruse]
30. Lloyd-Jones DM. Niacin and HDL cholesterol—time to face facts. Due north Engl J Med 2014;371:271-3. [PubMed abstract]
31. The AIM-High Investigators. Niacin in patients with depression HDL cholesterol levels receiving intensive statin therapy. Due east Engl J Med 2011;365:2255-67. [PubMed abstruse]
32. Garg A, Sharma A, Krishnamoorthy P, Garg J, Virmani D, Sharma T, et al. Role of niacin in current clinical practice: A systematic review. The American Journal of Medicine 2017;130:173-87. [PubMed abstract]
33. Jenkins DJA, Spence JD, Giovannucci EL, Kim Y, Josse R, Vieth R, et al. Supplemental vitamins and minerals for CVD prevention and handling. Journal of the American College of Cardiology 2018;71:2570-84. [PubMed abstract]
34. Grundy SM, Stone NJ, Bailey AL, Axle C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAP/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol. Circulation. Published November 10, 2018. [PubMed abstract]
35. Minto C, Vecchio MG, Lamprecht M, Gregori D. Definition of a tolerable upper intake level of niacin: a systematic review and meta-assay of the dose-dependent effects of nicotinamide and nicotinic acid supplementation. Nutr Rev 2017;75:471-90. [PubMed abstruse]
36. McKenney JM, Proctor JD, Harris Due south, Chinchili VM. A comparing of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients. JAMA 1994;271:672-vii. [PubMed abstruse]
37. McKenney J. New perspectives on the use of niacin in the treatment of lipid disorders. Arch Intern Med 2004;164:697-705. [PubMed abstract]
38. Leung One thousand, Quezada M, Chen Z, Kanel G, Kaplowitz North. Niacin-induced anicteric microvesicular steatotic acute liver failure. Hepatol Commun 2018;2:1293-8. [PubMed abstruse]
39. Cheng SC, Young DO, Huang Y, Delmez JA, Coyne DW. A randomized, double-blind, placebo-controlled trial of niacinamide for reduction of phosphorus in hemodialysis patients. Xlin J Am Soc Nephrol 2008;three:1131-viii. [PubMed abstract]
40. Shahbazian H, Mohtashami AZ, Ghorbani A, Abbaspour MR, Musavi SSB, Hayati F, Lashkarara GR. Oral nicotinamide reduces serum phosphorus, increases HDL, and induces thrombocytopenia in hemodialysis patients: a double-blind randomized clinical trial. Nefrologia 2011;31:58-65. [PubMed abstract]
41. Takahashi Y, Tanaka A, Nakamura T, Fukuwatari T, Shibata K, Shinada North, et al. Nicotinamide suppresses hyperphosphatemia in hemodialysis patients. Kidney International 2004;65:1099-1104. [PubMed abstract]
42. Natural Medicines. Niacin.

Disclaimer

This fact sail by the National Institutes of Health (NIH) Office of Dietary Supplements (ODS) provides data that should not take the place of medical advice. We encourage you to talk to your healthcare providers (doctor, registered dietitian, pharmacist, etc.) about your involvement in, questions about, or use of dietary supplements and what may be best for your overall health. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that production, service, or expert advice.

rowellwasmand.blogspot.com

Source: https://ods.od.nih.gov/factsheets/Niacin-HealthProfessional/

Share this post