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Niacin and Psoriasis: Risks, Benefits, and Dosage Issues

Medically reviewed by Kelsey Stalvey, PharmD
Written by Sarah Winfrey
Posted on May 22, 2023

Niacin is an essential nutrient with several health benefits, including turning food into energy and maintaining the health of your nervous system, digestive system — and your skin. Thus, some people living with psoriasis naturally wonder whether adding niacin supplements to their prescribed psoriasis treatment might help bring psoriasis symptom relief.

Like other supplements, niacin may indeed help bring some relief to people living with psoriasis. But as with other supplements, you should always ask your doctor before adding more niacin to your diet.

Read on to learn more about niacin, its potential to help with psoriasis symptoms, and what to watch out for when taking it as a supplement.

What Is Niacin?

Also called vitamin B3, niacin is a water-soluble B vitamin, meaning it dissolves in water. Scientific names for this vitamin include nicotinic acid and nicotinamide, and it has other forms, like nicotinamide riboside.

Niacin is naturally found in many foods, particularly animal-based foods. Some food manufacturers fortify products, such as cereal and bread, with niacin. You can also find it as a supplement in the form of a pill or capsule.

How Does Niacin Affect the Body?

The body converts niacin into a form it can use called coenzyme nicotinamide adenine dinucleotide (NAD). More than 400 enzymes in the body need NAD in order to complete chemical reactions that keep the body functioning well.

Sometimes, niacin is also converted to coenzyme nicotinamide adenine dinucleotide phosphate (NADP), which is also biologically active in the human body. Some amount of niacin is required for the body’s chemical processes to continue to function normally.

The body is quite good at absorbing niacin. No matter how much you take, most of it gets absorbed. In fact, the body keeps a reserve of niacin when it can, just in case it runs out at some point. If you take a lot of niacin, your liver will convert any excess into a form that you can eliminate through urination.

What Are the Health Benefits of Niacin?

Scientists have long recognized niacin for its cardiovascular effects. In some forms, it can raise levels of HDL, or “good” cholesterol, and lower levels of LDL, or “bad” cholesterol. In fact, some health experts believe niacin may be as effective or more effective at this than statin medications are, which are the standard prescription treatment for cholesterol-related problems. However, more research is necessary to determine whether this is true. Also, high amounts of niacin are required to achieve these effects, which may cause additional medical issues in some people.

More recently, research has shown that niacin may be good for the skin, too. It seems to help fight acne, atopic dermatitis (the most common type of eczema), and some autoimmune skin conditions. It may also help prevent aging of the skin, lighten areas of skin with too much pigment, and fight skin cancers.

How Is Niacin Related to Psoriasis?

Niacin may also help fight psoriasis and lower or limit the number of symptoms you experience. Niacin helps lower inflammation, particularly along pathways that seem connected to psoriasis. Specifically, it helps produce cellular signals that can reduce the body’s activation of the inflammatory pathway. Researchers have found that methotrexate or topical calcipotriene combined with niacin may work better than either of those medications when used alone.

This doesn’t necessarily mean that you should start adding more niacin to your treatment regimen. It’s important that you talk to your doctor before you start any new supplements. That way, they can work with you to make sure niacin is right for you, that you are taking a safe dose, and that you aren’t experiencing any significant symptoms because of your niacin intake. They can also help monitor your psoriasis to determine whether niacin is helping you to feel better.

Are There Downsides or Risks To Taking Niacin?

There are a few risks if you take too much niacin. At relatively high doses — usually between 30 and 50 milligrams of nicotinic acid — your skin will flush and you might experience itching, tingling, or even burning sensations. This usually happens within 30 minutes of taking the niacin, and you may have to take it for weeks or months before you experience that sensation. This isn’t toxic. It happens because niacin causes your blood vessels to dilate (widen), so more blood flows through them than normal. Researchers aren’t exactly sure how this occurs.

At higher levels — usually 1,000 to 3,000 milligrams of nicotinic acid per day — you may start to experience signs of niacin toxicity. Most people have to take high levels of niacin for weeks or months before they show symptoms.

The symptoms of niacin toxicity include:

  • Extreme skin flushing that does not go away and may be accompanied by dizziness or lightheadedness
  • Abdominal pain, with or without diarrhea
  • Nausea, with or without vomiting
  • Blurred or otherwise impaired vision
  • Severe or significant itching
  • Increased heartbeat
  • Gout
  • Low blood pressure, to the point that you feel like you might fall

If you continue to take large doses of niacin over months or years while experiencing these side effects, you may develop liver problems — including hepatitis, or even complete liver failure.

Notably, medical experts don’t believe it’s possible to overdose on niacin when you are taking it in through your diet. This only occurs when adding niacin via supplementation.

Niacin and Psoriasis Medication

Some psoriasis medications should not be taken with niacin, including leflunomide (Arava) and medications processed primarily by your liver. Talk to your doctor about other medications to make sure there are not similar issues.

How To Supplement With Niacin

If you and your dermatology team choose to increase your levels of niacin to help treat psoriasis, there are a few ways you can access it.

Supplements

Most stores that sell vitamins sell niacin, or vitamin B3, supplements. You can buy these over the counter and take them according to your doctor’s specifications. These are usually capsules or pills, though you may be able to find niacin in liquid or powder form, depending on where you live and what is available in your area.

Foods With Niacin

You can also focus on eating niacin-rich foods if you want to increase your niacin intake. Good sources include:

  • Beef
  • Poultry such as chicken and turkey
  • Pork
  • Fish, including salmon, tuna, and swordfish
  • Brown rice
  • Nuts and seeds
  • Legumes
  • Beets

Safe Niacin Dosages

Recommended daily allowances of niacin, according to the National Institutes of Health Office of Dietary Supplements, are as follow:

  • Males 14 and up should get at least 16 milligrams of niacin each day and should not take more than 35 milligrams.
  • Females 14 and up should keep their intake between 14 and 35 milligrams, except when pregnant or lactating.
  • Pregnant people need at least 18 milligrams and lactating people need at least 17 milligrams, with the upper limit remaining the same.

Some people may take more than this at the discretion of their doctor.

Talk to Your Health Care Provider

If you’re interested in adding niacin to your psoriasis regimen, talk to your health care provider about it. They can help you choose which kind of niacin to take and the best formulation, and they can monitor your body for reactions or responses to it. Never quit your psoriasis medication without talking to your provider first, and avoid substituting any vitamin or supplement for prescribed medication unless you have the go-ahead from your health care professional.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis, and their loved ones. On MyPsoriasisTeam, more than 117,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.

Have you tried niacin supplements for your psoriasis? Share your experience in the comments below, or start a conversation by posting on your Activities page.

    Posted on May 22, 2023
    All updates must be accompanied by text or a picture.

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    Kelsey Stalvey, PharmD received her Doctor of Pharmacy from Pacific University School of Pharmacy in Portland, Oregon, and went on to complete a one-year postgraduate residency at Sarasota Memorial Hospital in Sarasota, Florida. Learn more about her here
    Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here

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