Should I take nicotinamide?

Our read is that nicotinamide shows promise for skin health, potentially reducing inflammation, assisting with conditions like rosacea and acne, and preventing certain types of skin cancer, as suggested by Andrew Huberman and Rhonda Patrick. It may also offer benefits for muscle NAD+ levels and in specific therapeutic contexts like ALS and glaucoma, according to Peter Attia and Andrew Huberman.

However, Peter Attia and Paul Saladino caution against high doses due to its inhibitory effect on sirtuins and its potential to drive methylation pathways, leading to elevated homocysteine levels and anxiety. David Sinclair's lab and R. de Cabo's lab also found that nicotinamide does not extend lifespan in studies.

Andrew Huberman suggests oral niacinamide supplementation can be taken at 1000mg per day, divided into 2x 500mg doses. For skincare, Bryan Johnson includes niacinamide in a daily protocol with face washing, mineral sunscreen, moisturizing, vitamin C, hyaluronic acid, and tretinoin.

• 01Peter Attia claims increased nicotinamide drives methylation pathways, leading to elevated homocysteine levels.
• 02Peter Attia and Paul Saladino claim nicotinamide acts as a feedback inhibitor of sirtuins, slowing NAD+ production.
• 03Peter Attia claims nicotinamide may be a better substrate than NR for increasing muscle NAD+ because it is the circulating form that enters muscle.
• 04David Sinclair claims a supplement combining Nicotinamide (250 mg), Micronized Palmitoylethanolamide (600 mg), Oleoylethanolamide (400 mg), and Spermidine (8 mg) mimics benefits of fasting, including reduced hunger, lower LDL cholesterol, and improved fasting glucose.
• 05Bryan Johnson claims SCF is a novel skin anti-inflammatory and anti-aging compound that demonstrates superior effects to niacinamide in reducing wrinkles, improving texture, hydration, radiance, luminosity, brightness, and overall skin appearance.
• 06Andrew Huberman claims niacinamide supplementation may reduce skin inflammation, potentially assisting with conditions like rosacea and acne.
• 07Andrew Huberman and Rhonda Patrick claim nicotinamide may prevent certain types of skin cancer, as suggested by a study from Australia.
• 08Paul Saladino claims Acipimox, a derivative of niacinamide, is an approved drug that inhibits lipolysis and can lower triglycerides, free fatty acids, and blood glucose in type 2 diabetic patients, even in the presence of obesity.
• 09David Sinclair claims boosting NAD levels in the skin has beneficial effects, such as thickening, likely by activating sirtuin defenses, and molecules like nicotinamide or nicotinic acid are found in cosmetics for this purpose.
• 10Andrew Huberman claims high-dose vitamin B3 (nicotinic acid or nicotinamide) is being investigated for its protective effects in glaucoma and other optic neuropathies.
• 11Bryan Johnson claims a daily skincare protocol includes face washing morning and night, applying mineral sunscreen, moisturizing, and using creams such as niacinamide, vitamin C, hyaluronic acid, and tretinoin.
• 12Peter Attia claims a combination of nicotinamide and terban showed a short delay in disease progression in a small study of ALS patients.
• 13Andrew Huberman claims for rosacea, nicotinamide and licorice root may offer additional benefits alongside cleansing, sun protection, and moisture locking.
• 14Rhonda Patrick claims David Sinclair takes approximately 1 gram of nicotinamide daily.
• 15David Sinclair claims human trials for Nicotinamide (Vitamin B3) have been completed.
• 16Rhonda Patrick and Paul Saladino claim nicotinamide is not sufficiently effective on its own for boosting NAD levels.
• 17Paul Saladino claims NAD+ is synthesized from vitamin B3, specifically nicotinic acid or nicotinamide, which are converted to ADP-ribose and then NMN, before finally becoming NAD+.
• 18Paul Saladino claims over-the-counter niacin is typically sold as nicotinic acid, which is converted to nicotinamide during the detoxification process.
• 19Peter Attia claims oral nicotinamide resulted in a much smaller NAD+ response in muscle compared to NR in a 2016 Rabinowitz group study.
• 20Paul Saladino and David Sinclair claim niacinamide differs from NMN by lacking the sugar and phosphate components necessary for NAD synthesis.
• 21Paul Saladino claims nicotinic acid and nicotinamide can both be converted to NAD+ through different pathways.

Peter Attia and Paul Saladino strongly advise avoiding high doses of nicotinamide unless the patient has cancer, as it inhibits sirtuins. Paul Saladino further notes that nicotinamide may inhibit sirtuin activity and that high doses can deplete methyl groups, potentially leading to anxiety. David Sinclair's lab and R. de Cabo's lab found that nicotinamide does not extend lifespan in studies.

The verdict would change if new evidence emerged demonstrating that nicotinamide does not inhibit sirtuins at commonly used doses, or if studies showed a clear lifespan extension benefit. Conversely, stronger evidence of significant adverse effects on methylation pathways or other critical biological processes would further diminish support.