Niacinamide for Health & Longevity - Quick Reference Sheet
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Niacinamide for Health & Longevity

Created on 07/09/2026 – Quick Reference based on Evidence Review created using AI4L / Opus 4.8 – Audit

A cheap, well-tolerated form of vitamin B3 the body turns into a coenzyme for energy production and DNA repair. Its clearest uses are correcting B3 deficiency and, in high-risk people with prior skin cancers, lowering the rate of new skin cancers — though not in organ-transplant recipients. Skin, eye, kidney, and longevity uses are modest, unproven, or still being tested. (Full Review)

Protocol

Skin-Cancer Chemoprevention
500 mg twice daily
Oral; high-risk immunocompetent adults with prior non-melanoma skin cancer or actinic keratoses
Deficiency / General Supplement
25–100 mg/day
No established need for high doses in replete, low-risk individuals
Topical Dermatologic Use
2–5%, once or twice daily
For barrier, pigmentation, and acne goals; often combined with other actives
Time to effect
Skin-Cancer Prevention
12 months
Risk reduction measured over continuous use
Deficiency Correction
Days to weeks
Pellagra and B3 insufficiency symptoms resolve
Topical Skin Benefits
4–12 weeks
Barrier, pigmentation, and fine-line improvements build gradually

Benefits

Contraindications
  • Active liver disease or unexplained transaminase elevations
  • Bleeding disorder or thrombocytopenia (platelets <100 × 10⁹/L)
  • Pregnancy or breastfeeding (above nutritional doses)
  • Dialysis without monitoring
    •
Key Interactions
  • Anticonvulsants (carbamazepine, primidone)
  • Other hepatotoxic drugs or sustained-release niacin
  • Over-the-counter agents (acetaminophen, alcohol)
  • Other NAD+ precursors (NMN, NR) and nicotinic acid
  • Methyl-donor supplements (folate, B12, methionine, betaine, choline)
  • Phosphate binders (in kidney disease)
    •

Risk & Side Effects

  • High: Gastrointestinal upset at high doses
    •
  • Medium: Hepatotoxicity at high doses; methyl-group depletion; thrombocytopenia in kidney-disease dosing
    •
  • Low: Glucose and insulin effects at very high doses; headache, dizziness, and minor neurologic complaints
    •
  • Speculative: Theoretical cancer-promotion concern from NAD+ boosting; sirtuin inhibition offsetting longevity goals
    •

Monitoring

Marker Target Why
ALT / AST ~10–26 U/L Detect dose-related liver stress
Homocysteine <7–8 µmol/L Track methyl-group depletion
Fasting glucose 75–86 mg/dL Detect worsening insulin resistance
HbA1c <5.4% Longer-term glucose control
Platelet count 200–350 × 10⁹/L Detect thrombocytopenia in therapeutic dosing
Serum phosphate 3.0–4.0 mg/dL Assess phosphate lowering / avoid over-suppression
Uric acid 3.5–6.0 mg/dL (higher end for men) High-dose vitamin B3 can raise uric acid

Cadence: Baseline, then ~4–8 weeks after starting or dose escalation, thereafter every 6–12 months (every 4–8 weeks for platelets in kidney-disease dosing)

Qualitative Assessment

  • Skin appearance: fewer new actinic lesions, improved barrier, reduced hyperpigmentation
  • Gastrointestinal comfort: absence of nausea or diarrhea signaling excess dose
  • Energy and cognitive clarity: subjective, non-specific, and not a reliable NAD+ readout
  • Sleep quality: any subjective calming effect if used in the evening
Not medical advice. Educational distillation of a single evidence review. Confirm any decision with a qualified clinician, especially in the presence of prescription drugs or chronic conditions.