Most people familiar with The BaleDoneen method are well acquainted with niacin — also known as vitamin B3 — as a workhorse for cardiovascular health. But beyond its role in cardiovascular health, niacin has a long and fascinating history (and future) in medicine.
Initially prescribed to lower cholesterol (including Lipoprotein(a)), it’s now being studied again for its effects on inflammation, blood clotting, skin health and even aging. Of interest, BaleDoneen has been using niacin to effectively manage Lipoprotein(a) for the past 25 years with great success.
Let’s take a closer look at what we know — and what we’re still learning — about this multi-talented vitamin!
Lipid Effects
For decades niacin has been used to improve cholesterol levels and patterns. It raises HDL cholesterol and lowers LDL and ApoB cholesterol, triglycerides and especially the dangerous lipid particle called lipoprotein(a).
Niacin works by reducing the liver’s production of cholesterol-carrying particles, improving the overall lipid profile.
Supporting Healthy Blood Flow and Clotting
Research shows niacin may also help make blood “less sticky.” Several studies have shown that niacin can help reduce fibrinogen, a protein that promotes blood clot formation, and increases the body’s ability to break down clots (called fibrinolysis).
By reducing inflammatory biomarkers and improving blood vessel function, niacin helps to support vascular health.
Preventing Certain Skin Cancers
One of the most exciting modern uses of niacin is in skin cancer prevention; — specifically using a non-flushing form of niacin called nicotinamide.
In a major paper1 published in JAMA Dermatology in 2025, researchers presented real-world data to reinforce prior clinical trial evidence that niacin can be a helpful tool in the prevention of skin cancers. Nicotinamide (500 mg twice daily) is associated with a modest but meaningful reduction (~14%) in the risk of new non-melanoma skin cancers in persons with prior skin cancer.
More strikingly, when initiated soon after a first skin cancer diagnosis, the magnitude of risk reduction seems to escalate to nearly 50%, suggesting that timing of initiation is crucial. Benefit was noted for both basal and squamous cell carcinoma, with a more robust risk reduction in the squamous cell group.
Brain, Energy and Aging Research
Early studies2 suggest niacin might improve muscle strength in mitochondrial diseases, support retinal health in glaucoma and even help protect neurons in early Alzheimer’s disease. These findings are promising but still early.
Niacin has a beneficial impact on a plethora of neurological conditions3 such as Parkinson’s Disease, Alzheimer’s Disease, Multiple Sclerosis and improved cognition.
Safety and Cautions
Niacin is now an over-the-counter supplement. However, its use should be directed by your healthcare provider to ensure safety. Even at lower doses, niacin may cause flushing, warmth or itchiness. At higher doses, niacin can result in mild liver enzyme elevation, elevated blood sugar or increased uric acid. Extended release forms of Niacin tend to help with the flushing side effect, while blood sugar elevation tends to return to baseline after a few months of use.
Nicotinamide does not generally cause flushing and is the specific form that has been studied in terms of skin health.
Because of possible side effects and medication interactions, niacin should only be taken after discussing with your own healthcare provider.
Niacin is much more than a simple vitamin; it’s a molecule that touches nearly every aspect of human metabolism. While its role in heart disease prevention is well established and has long been utilized within The BaleDoneen Method, exciting new research is uncovering additional benefits for skin protection, vascular health and cellular energy.
References:
1 Breglio KF, Knox KM, Hwang J, et al. Nicotinamide for Skin Cancer Chemoprevention. JAMA Dermatol. Published online September 17, 2025. doi:10.1001/jamadermatol.2025.3238
2 Pirinen E, Auranen M, Khan NA, et al. Niacin Cures Systemic NAD+ Deficiency and Improves Muscle Performance in Adult-Onset Mitochondrial Myopathy. Cell Metab. 2020;32(1):144. doi:10.1016/j.cmet.2020.05.020
3 Wuerch E, Urgoiti GF, Young VW. The Promise of Niacin in Neurology. Neurottherapeutics, 2023 Jul;20(4): 1037-1054