NIACIN (Vitamin B3)

In these next 2 emails, we’re going to cover some really important B vitamins when it comes to mental and emotional health: Vitamin B3 (or Niacin) and Vitamin B6. These are a couple of nutrients that should be tested if you’re dealing with any kind of mental health challenges, including depression and anxiety.

Unfortunately, these vitamins are typically overlooked by conventional medicine. If you are able to get lab tests done, the reference ranges given on the lab reports are generally based on a sick population rather than on optimal levels.

The good news is that integrative doctors will often test these vitamins and will work toward helping you achieve healthy, optimal levels. Doing so may go a long way toward improving your mental and emotional health.


Vitamin B3 or Niacin is another water-soluble vitamin that can have a large impact on mental health. While, niacinamide, nicotinic acid, and inositol hexanicotinate are forms of niacin, they are not equivalent and will not have the same effects. The recommended intake of B3 for most people is 14-18 mg per day. However, some people may require more than that to address a deficiency (1)

Niacin Deficiency

An extreme Niacin deficiency is diagnosed as a condition called pellagra. Symptoms of pellagra include a rash that appears on the skin when exposed to sunlight, a bright red tongue, and gut-brain issues. Because of the fortification of foods, that condition is now uncommon. (1)

However, a deficiency that isn’t quite that extreme can also cause a lot of health issues, such as: (2)

  • Skin issues
  • Headaches
  • Depression
  • Memory problems
  • Paranoia
  • Aggressive behavior
  • Suicidal tendencies
  • High LDL (“bad”) cholesterol or Low HDL (“good”) cholesterol

How can you become deficient in in niacin? One reason is that you may not be eating enough food sources of niacin. Some examples are meat, fish, dairy, eggs, and green vegetables. (3)

It’s also possible that you’re just not absorbing the Niacin you do take in. For example, if you have any gut problems (including Inflammatory Bowel Disease, for example), you may not be able to absorb nutrients well. (4)

Another possibility for deficiency is not taking in enough of other nutrients. Niacin depends on Tryptophan to be made and is obtained from eating meat. These other nutrients include: Vitamin B2, Vitamin B6, or Iron. That’s why it’s important to make sure you have enough of all the B vitamins and that you’re not anemic. (4)

Of course, it is possible to have too much of a good thing.

Niacin Excess

Niacin is very safe and it’s difficult to take too much straight Niacin. However, it can be done with extremely high supplementation, which people have done to mask drugs in urine testing.

Initially, may cause skin flushing due to increased blood flow. Severe excess may result in multiple organ failure, including liver failure. Eventually, a severe excess may require a liver transplant. (5)

As mentioned earlier, Vitamin B6 helps the body to get enough Niacin. We’ll cover this important nutrient in the next email as well as how to test/measure for both.

Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington (DC): National Academies Press (US); 1998. 6, Niacin. Available from:
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 sciences, 20(4), 974.
Natural Medicines Comprehensive Database Consumer Version [Internet]. Stockton (CA): Therapeutic Research Faculty; c1995-2018. Niacin; [updated 2021 Jan 29; reviewed 2020 Oct 16; cited 2021 Feb 28]; [about 4 p.]. Available from: 2011. Office of Dietary Supplements – Niacin. [online] Available at: <> [Accessed 2021 Feb 28].
Ellsworth, M. A., Anderson, K. R., Hall, D. J., Freese, D. K., Lloyd, R. M. (2014). Acute Liver Failure Secondary to Niacin Toxicity, Case Reports in Pediatrics, 2014:692530,

Dr. Laurie Goldman is a medical doctor, psychiatrist, and functional medicine practitioner who’s been in private practice since 1999. She founded Clear Path Wellness to help her patients reach their maximum state of mental and physical health using a personalized, comprehensive approach powered by the principles of functional medicine, which treats the whole person, not just symptoms.   

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B VitaminsVitamin B3 AKA Niacin