Can Niacin really kill you?

Written by Joe Cohen, BS | Last updated:

My inbox started blowing up recently with people sending me links to a recently published study…

It basically said that 25mg of niacin a day increases the risk of cardiovascular disease, which is the leading cause of death worldwide.

I take up to 500 mg a day, but here’s why I’m not worried.

In case you’re not familiar with niacin, aka vitamin B3, it’s become extremely popular in recent years as a longevity supplement and I find it provides me with several other benefits I’ll talk about below.

Let’s talk about this study though.

The Niacin Study

The study, published in Nature Medicine, found that there are two terminal metabolites of niacin, 2PY and 4PY, which are known for increasing cardiovascular disease. They also found evidence that niacin increased VCAM-1, a known contributor to vascular inflammation and atherogenesis.

So, essentially because higher niacin means more 2PY and 4PY, they are saying that niacin can cause cardiovascular disease.

But, there’s a lot of other variables to consider here.

First, there are numerous other studies that show that higher levels of niacin doesn’t increase all-cause mortality. And the participants in these studies were given much larger doses of niacin and one even found niacin to be correlated with lower risk of cardiovascular mortality [1, 2].

Then, the whole idea of niacin being “bad” depends on whether or not you actually have higher 2PY and 4PY and unfortunately, there’s not a lab test that you can take to measure them right now.

In general, there’s not a lot of research into what increases 4PY. So, how do I even know if taking niacin is actually resulting in this “bad” effect in my body?

I do know that while niacin may increase VCAM-1, I’m taking a number of other herbal supplements that inhibit it (e.g. curcumin, green tea extract). So, I would guess that I’m probably balancing out the effect.

I also notice a lot of positive effects from taking niacin. (As an aside, I did try megadosing this supplement and noticed negative effects when taking more than 500mg, so I average around 300mg a day now).

Some of the positive effects for me are:

  • Lp(a) and APOB decrease (I have a genetically higher risk for high APOB)
  • Food sensitivities go away
  • Immune health improves & helps me fight off infections
  • Improvements in mood and stress levels
  • And quite a few more!

For some people, it may not be as beneficial.

But I used SelfDecode and was able to see which of my genetic risks and lab markers that niacin can help with, and it was a lot:

So, for me, it’s an interesting study, but until a lab test is released to measure 4PY, I don’t think there’s really a way to determine the effects in relation to it.

I’ll probably play it safe and keep my dosage below 500mg, but other than that, I’m continuing business as usual when it comes to niacin.

If you want to see your own personalized recommendations when it comes to niacin and hundreds of other supplements, dietary and lifestyle suggestions, make sure you check out SelfDecode.

We’re continuing to release so many more reports and adding recommendations to our database so that we remain the most advanced precision health app in the world!


About the Author

Joe Cohen, BS

Joe Cohen, BS

Joe Cohen flipped the script on conventional and alternative medicine…and it worked. Growing up, he suffered from inflammation, brain fog, fatigue, digestive problems, insomnia, anxiety, and other issues that were poorly understood in traditional healthcare. Frustrated by the lack of good information and tools, Joe decided to embark on a learning journey to decode his DNA and track his biomarkers in search of better health. Through this personalized approach, he discovered his genetic weaknesses and was able to optimize his health 10X better than he ever thought was possible. Based on his own health success, he went on to found SelfDecode, the world’s first direct-to-consumer DNA analyzer & precision health tool that utilizes AI-driven polygenic risk scoring to produce accurate insights and health recommendations. Today, SelfDecode has helped over 100,000 people understand how to get healthier using their DNA and labs.
Joe is a thriving entrepreneur, with a mission of empowering people to take advantage of the precision health revolution and uncover insights from their DNA and biomarkers so that we can all feel great all of the time.


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