Niacin in Adrenal Fatigue and Chronic Fatigue Syndrome Treatment

By: Dorine Lam, RDN, MS, MPH

What is Niacin?

Niacin, also known as Vitamin B3, can be helpful in Chronic Fatigue Syndrome treatmentNiacin, better known as vitamin B3, is one of eight B vitamins and is commonly used for lowering cholesterol and triglycerides. However, there are other uses for niacin that are valuable for the Adrenal Fatigue sufferer or useful in chronic fatigue syndrome treatment, which we will discuss in further detail. When used correctly, niacin can be a very useful tool in supporting your journey to adrenal recovery. But let us first understand this beneficial vitamin and the role it can play.

Niacin does not require a prescription, and it is a nutrient that everyone needs on a daily basis. Niacin is water soluble, so any niacin our body does not need is excreted in the urine, not stored in the body, meaning it needs to be consumed daily. On the flip side of this, there is no danger in consuming higher than usual doses, as compared to over dosing on pharmaceuticals where the effects can be detrimental to your health.

Bear in mind that although vitamins such as niacin are more gentle on the body, it does not necessarily mean that they are less effective than pharmaceuticals. In fact, used in combination with other vitamins, minerals, glandulars and/or herbs in a holistic chronic fatigue syndrome treatment, they can be just as effective, or even more so.

Depending on the unique circumstances of the person, varying amounts of niacin are required, and these dosages need to be monitored closely as they do have the potential to cause paradoxical reactions for the sensitive adrenal fatigue sufferer. In terms of deficiency, an insufficient supply of niacin in the diet can cause a multitude of problems such as nausea, skin and mouth lesions, anemia, headaches and tiredness.

When the body is chronically deficient in niacin, it can lead to a disease called pellagra, and is most often found in underdeveloped or developing countries with areas of widespread poverty and malnutrition. Common psychiatric symptoms of niacin deficiency include irritability, poor concentration, anxiety, fatigue, restlessness, apathy, and depression.

For those who desire to increase this valuable vitamin through dietary means, there are many different types of foods that have naturally occurring niacin which you could incorporate into your diet to help increase levels of niacin. Foods that have higher levels of niacin include leafy greens, crimini mushrooms, tomatoes, asparagus, red meat (especially in organ meats such as liver and kidneys), poultry, fish (tuna, salmon, anchovies), and also eggs.

The amount of niacin present in these foods, however, is only a fraction of the dose that is required to see significant change in your health if you are suffering from some form of niacin deficiency. To experience a noticeable difference in your health, much higher doses are required than what is available from diet alone and supplements are required.

Although niacin is considered a comparably safe and gentle vitamin, extreme care must be taken as niacin should only be taken as part of a structured protocol from an experienced healthcare practitioner, because it is also a detoxifying agent, which we will discuss further.

How Does Niacin Help With Chronic Fatigue Syndrome Treatment?

Let us now consider the other use of niacin that is helpful for those with chronic fatigue syndrome or adrenal fatigue syndrome. It is an undeniable fact of life that in the Western world we are living in a largely toxic environment. In North America alone, over 75,000 chemicals are produced, 3,000 of which go into our food supply.

Dietary improvements and Chronic Fatigue Syndrome TreatmentChanging our lifestyles with diet and exercise and choosing to use natural products in our homes and on our bodies are a great start towards detoxification. But this alone cannot completely eliminate the toxins that are stored in our bodies because fat cells within the body end up storing toxins that cannot be metabolized or eliminated by either diet or exercise. These fat cells have the ability to shrink, but they also have the ability to grow again. It is believed that between 400 and 800 toxins can be stored in our fat cells.

From a biological perspective, the liver is one of the most vital organs in the body. Physiological processes such as chemical balances cannot occur when its function is impaired. Significantly, the liver plays a pivotal role in the elimination of toxic substances from the body by converting them into water soluble byproducts for excretion.

In theory, the liver filters the blood of noxious substances such as pesticides, fertilizers, and other chemicals which are acquired from the environment and through diet. In many cases, when the liver is overloaded with toxins, this causes liver congestion, which diminishes the ability of the liver to detoxify.

Best Practices for Chronic Fatigue Syndrome Treatment

Failure of the liver to filter wastes and toxic substances from the blood for elimination leads to excessive accumulation of toxins in the body, which causes physiological imbalances and cellular toxicity. Liver congestion can be addressed through liver flushes and cleanses to remove toxins from the blood.

In practice, cleansing of the blood improves the functioning of body cells owing to the improved supply of nutrients and clearance of wastes. Another method of addressing liver congestion is through niacin as a detoxifying agent.

Read Part 2 Now!

© Copyright 2014 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Question

There is no study to show this, but we do notice that for people who have a ‘Heaty” type body, as defined by traditional Chinese medicine ( TCM), tend to have them occur more frequently.

Niacin, also known as Vitamin B3, can be helpful in Chronic Fatigue Syndrome treatment
5 - "Thank you for all of your advice"
Thank you for all of your advice and help. I love how knowledgeable you are and all the help you give people through your sessions and website.


  • Laurence says:

    Hello, Is there any reason that someone should avoid B53?

    • Dr. Lam says:

      B vitamins may be stimulatory for your body. If your body is in reactive sympathetic overload and anxious, B vitamins may not be recommended.

  • Sophie says:

    I tried Niacin and felt very flushed, red and kind of itchy. Would this indicate a clearance problem?

  • Milo says:

    Are there any nutrients that are synergistic with Niacin?

  • Gretchin says:

    My body has a difficult time processing niacin for some reason. Are there other vitamins that can help me recover from Adrenal Fatigue syndrome?

  • Becky says:

    Can vitamin B12 also be beneficial for adrenal fatigue recovery?

  • Darla says:

    I didn’t even know what Niacin was! Now I know it is the same thing as Vitamin B3. I also did not know that it was a detoxifier or that I should be careful about just taking it on my own. This was a very informative article. Thank you!

  • Rich says:

    I see this in many energy type soft drinks. I’ve always been curious about using it.

    • Dr.Lam says:

      They put it in there to calm the system while stimuting the body with caffeine, all at the same time. Its like driving with your foot on the gas pedal and brake at the same time. you can imagine the consequence long term

      Dr Lam

  • Loniel says:

    What form of niacin is the most beneficial? I have been told liquid was, in the past.

  • Christine says:

    Hello DR LAM, I have just a couple of questions. I am hopeful after reading your article because I have been diagnosed with Chronic fatigue syndrome. I know it’s not the same situation but hoping for some relief! Is it better to take liquid or pill Niacin? Also can I take Niacimide instead to avoid flush? I am 5ft 100 lbs. How much should I start with? How soon would I increase dosage? Ahhhh sorry for all the questions!! I’m excited! Thanks so much

    • Dr.Lam says:

      Liquid or pill are both acceptable. niacimide is rush free so most people like it. Dosage varies from person to person. I would not suggest you start on niacin unless you have a complete plan on what to do with your CFS. Recovery usually takes a comprehensive approach and niacin can be one of the tools, but not the only tool.

      Dr Lam

  • Jamie says:

    Im concerned about Niacin because it been added to things like Monster and other energy drinks. Could that mean it’s to stimulating for someone in Adrenal Fatigue?

    • Dr.Lam says:

      The best is not to take energy drinks. The biggest damage is the stimulants inside these drinks

      Dr Lam

  • Peggy says:

    What is the recommended daily intake of niacin?

    • Dorine Lam RDN says:

      The recommended daily requirement is 16 mg. For therapeutic purposes, it can go up to 4000mg.

      Dorine Lam, RDN, MS, MPH
      Registered Dietitian and Senior Holistic Nutritionist

  • Nate says:

    Is a niacin flush related to food sensitivities?

  • Ram.. says:

    Hi dr lam..
    I am taking Terminalia chebula( one of three fruits used in Triphala powder).. does it causes any stimulating effect in advanced adrenal fatigue ?…I found it good for stomach and liver…

  • rahul says:

    Hi..Dr. Lam…
    how much amount of B12 should a person take to avoid stimulating effect if he/she is deficient in B12. does vitamin B6 also causes stimulation of adrenals?
    Is it helpful to take multivitamins in small doses?

    • Dr.Lam says:

      Everyone is different. For most people 100 mcg can be enough to prevent deficiency and not stimulating, but some cannot even take lower amount.

      Dr Lam

  • Angel says:

    B vitamins can typically be stimulating would this be stimulating for me?

  • Marci Chipps says:

    My vitamin B complex has niacin as niacinamide 130mg. Is this sufficient or do I need to take niacin in it’s pure form for adrenal fatigue?

  • Namee says:

    Can I take Niacin at the same time I take a magnesium citrate supplement?

    • Dr.Lam says:

      You can, generally speaking. Some people dont tolerate both together,especially those who are in advanced AFS.

      DR Lam

  • Codie says:

    What is the recommended daily dose of Niacin?

    • Dr.Lam says:

      there is no recommended daily dose as everyone is different . Most people do well from 50-300 mg provided that there is no flush.

      Dr Lam

  • Elma calasara says:

    I’m taking Advanced sleep formula which contains 500mg of niacin as niacianamide since i cannot sleep. Is this too much niaicinamide?

    • Dr.Lam says:

      It is not outside the general range. Whether it is too much for your specific body depends on a host of factors that you should talk to your doctor.

      Dr Lam

  • Mike says:

    If you take niacin for a long period of time and decide to stop, would you suggest weaning off? If so, any foods you would recommend in this process?

    • Dr.Lam says:

      you should consult your doctor and the longer you are on, the longer you should take some time to wean off.

      Dr Lam

  • Cam says:

    Hello Dr Lam,

    I was wondering if N-acetyl cysteine could be used as a charcoal substitute, in combination with niacin, and as part of a detox? Thank-you for the great site.

    Auckland, New Zealand.

  • Holly says:

    Dr. Lam, I have read a LOT of what you have written on this site and the links. I am really thinking that I may have the Adrenal Fatigue in a near chronic state. I have major muscle spasms in my back, abdominal area, shoulders and neck. I have had back pain due to degenerative discs for 23 years with one being the L5/S1 level which I had to have a spinal fusion in December 2015 at 47 years old. My back and shoulders especially tend to spasm to the point of great pain and discomfort much of the time without me doing anything to cause it. I am still in Physical Therapy for my back recovery and still having to keep my exercises at a very low level because anything more sends my body into such spasms that I feel it sets me back on my recovery. My physical therapist has been a PT for over 30 years and is excellent. She works trigger points and muscle tissue hands on before I do exercises and stretches each time to go but she says she could work on me solid for a and still not get all the spasms. I need to get better but I don’t know what to do to get better. She says I’m hypersensitive to almost everything because I was in such intense pain for so long. She said we have to desensitize me, but I am wondering if there is more going on than that. What are your thoughts and if you think it could be adrenal fatigue what do you suggest I do to help myself. I don’t even know where to start. I have many of the other symptoms you have spoken of is why I am wondering if this is truly an issue for me. Please help. I have been in pain for years and really would like to feel like living again and be able to live without it causing me to be miserable if I do try to get active. I have a 12 year old and I want him to know me as a fun mom, not a sick and pained mom all the time. Thank you in advance.

    • Holly says:

      Some of the spasms I have are actual knots in my back that when trying to get a massage, it is extremely painful because the pressure rolls over those knots. Under my shoulder blades they are super painful and no one can seem to get them to release. I am taking several vitamins, including calcium, vit-D3, Powdered magnesium dissolved in water, multi-vitamin, turmeric, vitamin c.

    • Dr.Lam says:

      When you get into a state of hypersensitivity, that usually means the internal body systems are quite fragile, and in this case, no surprise. Chronic pain can lead to musculoskeletal and inflammatory issues tied to the adrenals. unfortunately, most docs are not alert on that connection. Do focus your effort to find someone one are AFS literal and who can understand you. I know what you are going thru. We have a telephone coaching service and many of our clients have similar history.

      Dr Lam

  • Phil says:

    Great article! but where can i purchase Niacin? and how do i know what dosage is right for my body?

  • Candice says:

    what would be the best amount of Niacin to take on a day to day basis? How will I know if it is too much?

    • Dr.Lam says:

      there is no best amount because each body is different. Most people start with 50 mg and scale up slolwy. Remember that many develop a harmless rash that goes away when stopped.

      Dr Lam

  • patricia marchant says:

    Michael Lam, I have adrenal fatigue low cortisol in morning and higher at night, but recently I have had severe high blood pressure connected to my salyilate sensitivities If I eat any salyilates my pulse races and blood pressure goes high I am sure it is connected with my cortisol levels.

  • Michael says:

    Is it possible my pain is related to stress? Also, does the excess Niacin get excreted?

    • Dr.Lam says:

      There are many kinds of pain, and certain types, such as pain of unknown origin, can be adrenal related. Because pain is a warning signal, you should check with your doctor and have a full workup. Excess niacin does get excreted by the kidneys.

      Dr Lam

  • Wilbur says:

    Just curious, for excess fat soluble nutrients, does it get excreted in the urine like niacin, in the bowels, or in some other form?

    • Dr.Lam says:

      Some of it get metabolized into the kidneys and out the body. some get accumulated in the body.

      Dr Lam

  • Michael says:

    This is in no way shape or form a negative comment about Niacin. It is due to my own absent mind-ness that I am in this situation. Was just hoping for some insight.

    I know health and lifestyle are big factors in all health related matters so here is a basic overview of my body.

    Very Healthy – Young Adult – Work Out almost everyday;Heavy Cardio – Do not smoke or drink more than twice a week. No history of any medical illness; except for asthma as a kid (outgrew it)

    On a Sunday, when I got word I would be taking a drug test the following week and had been partying hard the same weekend, I went and grabbed a bottle of Niacin from whole foods. 1 pill was 500mg.

    I took 500mg of niacin Sunday night. The next morning I took 2 of those pills in the morning at the same time equaling 1000mg – and later that evening 2 more at the same time. All while drinking cranberry juice and other detoxification liquids. Ya bone headed I know, but wait.. it gets better. I did the same thing for the next 3 days. So I was taking about 2000mg of Niacin for 4 days. Of course I got the flushing and I was expecting it so it didn’t bother me all that much, but it still took over my whole body for about 2 hours every time.

    After my 4 day niacin phase I completely stopped. I passed the test and everything seemed fine. Then I had some heartburn in the following weeks with some acid reflex but I thought “Well this is expected you completely drowned your system with a foreign substance.” The heartburn eased up after a while but still had some acid reflex.

    As time progressed I developed a gnawing, constant, everyday uncomfort feeling/pain favoring my left side under my pectoral. At first I thought I had done something real bad and almost life threatening; so I went to the emergency room. They did an EKG and some other tests and found nothing.

    The uncomfort/pain is in the same area all the time.

    Then I did some research and figured I rubbed my GI tract raw and caused an Ulcer. I got an Endoscopy with a GI specialist that cost about $1000 dolllars and they found absolutely nothing.

    Then i factored in I could have some chest pain due to high emotional stress (lots of other things going on in life at this point)

    Then I went and saw a Cardiologist and did an EKG and Stress Test. They took pictures of my heart and everything and I was sure they could give me some insight. Well, they found absolutely nothing and said they were even impressed by my stress test.

    So here I am, Its 7 months later and I still have a gnawing, constant, everyday uncomfort feeling/pain favoring my left side right around what feels like my left heart area. Its not hindering my life badly (Except for always thinking about it) I just wish I could get an answer, and hope I didnt do anything to harmful in the long run. Any insight what so ever?

    • Dr.Lam says:

      Your symptoms are very unusual. I am not able to put a finger on it based on what you mentioned after reading it. sorry.

      Dr Lam.

    • Nick says:

      Man, I’ve had the same discomfort in my chest/left side for over a year now. Have had the same tests you’ve had but I cannot find any answers. I was worried it was heart related as it started feeling as though it was moving down my left arm. It does feel like there’s some weird pressure being applied to my heart/chest in that area and I’ve wondered about vaso-constriction. I think it’s possible though that there’s a connection with a nerve being pinched somewhere in my back or my neck that’s caused this as referred pain, which could explain why it was also going down my arm.

      I didn’t get the pain from taking niacin. I wonder if all the stress you brought on yourself caused some muscles to really knot up and trigger some nerve pain. It’s the only thing I can imagine is left on the list of causes for my chest/heart pain. Let me know if you’ve found a solution or if you’ve found the pain has changed or dissipated over time.

  • Brenton says:

    What is a good measure of how successful my blood detox plan is?

  • Mervin says:

    Aw, this was a really good post. Finding the time and actual effort to produce a good article… but what caan I say… I procrastinate a lot and don’t seem to get nearly anything done.

  • Stepanie says:

    Thank you for every other excellent post. The place else could anyone get that type of information in such an ideal means of writing?
    I have a presentation susequent week, and I’m at the search
    for such information.

    • Newsletter says:

      Thanks for your positive comment. Niacin is an important nutrient. Most people do not appreciate it enough. In addition to its cholesterol lowering properties, it is also a good sleep aid. Unfortunately, not everyone can tolerate it, and can develop a flush. The key is knowing the proper dosage that is right for your body. there are niacin alternatives such as nicacinamide one can consider in that case.

  • Jackie says:

    Your way of explaining everything in this paragraph is actually
    pleasant, all be able to easily be aware of it, Thanks a lot.

    • Sophies says:

      According to my friend who has done the major cleanse with Scientology that niacin
      is hard on your stomach you always take it with food. I would suggest that you need to heal your stomach take mega probiotics . Or it could be entire another issue. I generally look at any changes during that time. Could it be acid reflux