Niacin is used in energy metabolism. The two supplement forms behave very differently: nicotinic acid causes flushing at low doses, nicotinamide does not.
These are doses tested in research, not personal advice. Some exceed the upper limit because they were short courses or given under medical care.
Strong evidenceStrong: meta-analyses of randomised trials or a large trial, with results that agree.Based on 1 randomised trial.How grades workNo benefit or harm found
Prevent heart attacks and strokes on top of a statin
2,000 mg a day
HPS2-THRIVE: 25,673 high-risk patients took 2 g extended-release niacin a day (with laropiprant) or placebo for about 4 years. There was no reduction in major vascular events, and more serious infections, bleeding, muscle problems and new diabetes.
Why: Nicotinamide (niacinamide) does not cause skin flushing and has fewer side effects than nicotinic acid. EFSA also sets its safe limit much higher (900 mg against 10 mg).
Alternatives: Nicotinic acid causes flushing even at low doses; high doses are a prescription matter.