7 Signs & Symptoms of Niacin (Vitamin B3) Deficiency & Treatment – Research Studies

What is Niacin (Vitamin B3)?

Niacin, also referred to as the combination of nicotinamide and nicotinic acid, is a pharmacological agent used in the treatment of various conditions. Niacin or vitamin B3 has a significant role in neuronal death and neuroprotection, making this vitamin integral to the function of the central nervous system (CNS) and the development of neurons. [1]

In the human body, niacin is converted into nicotinamide adenine dinucleotide (NAD), which is the active form of vitamin B3. This process occurs in the mitochondria. Niacin targets various mechanisms in the body including lipid metabolism, malignancy, aging-related pathologies, and glucose levels in the blood. [1]

Why Niacin is Important?

The importance of niacin in the human body is determined by its role in different metabolic and pathological processes. Concerning malignant glioma, niacin stops the invasion of gliomas and downregulates E-cadherin, thus, allowing normal development and migration of mesoderm and neural crest cells, respectively. Intake of niacin and concentrations of NAD in the body are also integral to the growth and division of cells. Reduced concentrations of vitamin B3 and intracellular NAD are associated with various aging-related pathologies. The stimulation of the G-protein coupled receptor mediates an increase in the glucose uptake of intestinal cells, resulting in the loss of glycemic control. Niacin is also important in the metabolism of lipids. This vitamin decreases the biosynthesis of hepatic triglyceride and increases the levels of high-density lipoprotein (HDL) cholesterol. [1] 

7 Signs & Symptoms of Niacin (Vitamin B3) Deficiency

1. Gastrointestinal Distress 

Individuals suffering from niacin deficiency experience several gastrointestinal symptoms. These include poor appetite, diarrhea, glossitis, dysphagia, nausea, increased salivation, abdominal pain, gastritis, and soreness of the mouth. Atrophy of the papillae on the tongue may also cause the tongue to appear raw and beefy. Diarrhea can occasionally be accompanied by mucus or blood. [2] 

2. Skin Abnormalities 

There are various dermatological manifestations of niacin deficiency in the body. These include the development of erythematous skin associated with a burning sensation in the neck, hands, feet, and face. The distribution of the rash is bilateral and symmetrical, which is present in the sun-exposed regions of the body. The skin findings corresponding to niacin deficiency are considered an early sign of Crohn’s disease. [2]

3. Neurological Signs and Symptoms 

On clinical examination of patients suffering from vitamin B3 deficiency, the physician may find paresthesia and muscle weakness. Such individuals may also suffer from disorientation, delirium, lethargy, irritability, depression, disorientation, and anxiety. With a further deficiency in the vitamin and the lack of adequate treatment, affected individuals may become comatose and stuporous. [2]

4. Insomnia 

Individuals suffering from niacin deficiency may also experience insomnia or an inability to sleep. The underlying mechanism is based on the role of nicotinic acid in lipid metabolism, and its interaction with various sleep regulatory mechanisms. According to medical literature, the administration of nicotinic acid stimulates an increase in non-rapid-eye movement sleep (NREMS) and a decrease in food intake, body temperature, and expenditure of energy. [3] 

5. Migraine Headache 

The clinical significance of niacin in migraine headaches is reflected by the fact that vitamin B3 is beneficial for the treatment of migraine headaches. Intravenous or oral administration of niacin stimulates cutaneous flushing. This process causes the vasodilation of intracranial vessels, inhibiting the onset of acute migraine symptoms. This also prevents the subsequent extracranial vasoconstriction. Vitamin B3 is effective in the prophylaxis and treatment of tension-type headaches and migraine. [4]

6. Alzheimer’s Disease 

Dietary intake of niacin has protective properties for neurodegenerative conditions such as Alzheimer’s disease. Dietary niacin is also associated with protection against age-related cognitive decline. The underlying mechanisms are based on the role of niacin in mediating mitochondrial functions, cell death, energy metabolism, and calcium homeostasis. Increasing the concentration of NAD in the brain not only restores the function of mitochondria but also attenuates cognitive decline in Alzheimer’s disease patients. NAD supplementation is also implicated in preventing mitochondrial defects and protecting against the degeneration of neurons. [5]

7. Dyslipidemia 

Nicotinic acid has been utilized in the treatment of dyslipidemia, owing to the role of vitamin B3 in increasing the levels of HDL. Niacin is considered the treatment of choice in metabolic syndrome, which comprises low levels of HDL and high levels of triglycerides, which is indicative of the relationship between dyslipidemia and vitamin B3 deficiency. The combination of niacin with statin drugs is useful in minimizing the occurrence of side effects by reducing the doses of each. Niacin is also among the few cholesterol medications, which does not elevate the risk of occurrence of gallstones. By treating dyslipidemia, niacin supplementation is useful in reducing claudication, atherosclerosis, heart attack, strokes, and overall mortality. [6]

Niacin Deficiency Treatment 

Take advantage of free consultation with one of our Health Coach through the chat icon on the website to determine of vitamin B3 deficiency along with the identification of appropriate dosages for patients. ASTR program recommends taking all types of vitamins together because they depend on each other for absorption. Too much of one vitamin may cause a deficiency of another, which is why it is recommended that all vitamin Bs are taken together in a single capsule.

The therapeutic administration of niacin is based on immediate- and oral extended-release tablets. Niacin supplementation is not advisable during breastfeeding and pregnancy since it may enter into the breast milk and may cause harm to the fetus, respectively. Other contraindications of niacin include patients suffering from active peptic ulcer disease, active liver disease, arterial bleeding, and hypersensitivity to niacin. [1] 


  1. Djadjo S, Bajaj T. Niacin. [Updated 2022 Mar 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541036/
  2. Redzic S, Hashmi MF, Gupta V. Niacin Deficiency. [Updated 2023 Feb 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557728/
  3. Szentirmai, É., & Kapás, L. (2019). Nicotinic acid promotes sleep through prostaglandin synthesis in mice. Scientific reports9(1), 17084. https://doi.org/10.1038/s41598-019-53648-7
  4. Prousky, J., & Seely, D. (2005). The treatment of migraines and tension-type headaches with intravenous and oral niacin (nicotinic acid): systematic review of the literature. Nutrition journal4, 3. https://doi.org/10.1186/1475-2891-4-3
  5. Gasperi, V., Sibilano, M., Savini, I., & Catani, M. V. (2019). Niacin in the Central Nervous System: An Update of Biological Aspects and Clinical Applications. International journal of molecular sciences20(4), 974. https://doi.org/10.3390/ijms20040974
  6. Prousky, J., Millman, C. G., & Kirkland, J. B. (2011). Pharmacologic use of niacin. Journal of Evidence-Based Complementary & Alternative Medicine16(2), 91-101