Vitamin C and D get all the love these days. It’s entirely justified due to their criticality in many bodily processes especially keeping your complex immune system functioning well. But Vitamin B3 has to come in a close third with its essentialness but rarely given the attention it deserves.
Vitamin B3 is known as niacin. Actually its scientific name is nicotinic acid but niacin is preferred to avoid confusion with nicotine. It is converted to nicotinamide adenine dinucleotide (NAD) in the body which is involved in over 400 gene functions. The importance of NAD explains why niacin is so vital and why a deficiency can impact a wide range of health conditions. Scientific literature going back decades validates niacin therapy to cure conditions such as mental health disorders, alcoholism, arthritis, heart disease, autoimmune conditions, migraines, Parkinson’s, kidney disease, skin conditions and even cancer.
It is converted to nicotinamide adenine dinucleotide (NAD) in the body which is involved in over 400 gene functions.
A stand-out member of the family of B-vitamins
There are eight B vitamins which are all distinct molecules but share the common trait of being water soluble and also tend to be found in common foods. They are all essential which means the body can’t make them by itself. Water soluble means they can’t be stored in fat so you need to keep ingesting an adequate supply. The B vitamins are all important to health and discerning professionals will recommend a B-complex supplement containing B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B7 (biotin), B9 (folate), and B12 (cobalamin). However the amount of niacin in these preparations is too low for most people so a separate supplement is highly recommended.
There was actually talk in scientific circles that niacin was mis-classified as a B-vitamin when it was found to be made by the body from tryptophan (though fairly inefficiently) and that it is used in quantities more like an amino acid.
A Bit of History
A hundred years ago there were a number of common and often fatal diseases discovered to be due to a simple deficiency of an essential vitamin. Scurvy (vitamin C), beriberi (vitamin B1, thiamine), and rickets (Vitamin D and/or calcium). Another of the classic deficiency diseases was pellagra which was found to be a deficiency of vitamin B3 (niacin). One of the common symptoms of pellagra was psychosis. In fact schizophrenia was so similar to pellagra psychosis the only diagnostic criteria to distinguish the two back in the 1950s was whether or not the condition responded to standard niacin therapy.
Since the 1950s it became clearer that just as people have different food or sleep or protein requirements, people need different amounts of critical vitamins to stay healthy. It was also found that a prolonged deficiency of certain vitamins, over many years, can lead to a more critical dependency. While regular doses of niacin will avoid pellagra for example, some people, many schizophrenics, appear to have a more severe dependency and need much higher doses to recover and maintain their health.
For more on the history of niacin and the scientific studies confirming its efficacy for various conditions you can read the helpful book Niacin: The Real Story (2nd edition) by Dr Andrew Saul and the late Dr Abram Hoffer. A search through PubMed will also reveal Dr Hoffer’s many published articles.
Forms of Niacin
Niacin is a very cheap nutrient and can be easily obtained in different strengths. However there are various derivatives and formulations which can get a bit confusing as they have different properties. Basic niacin is most beneficial as it normalizes blood lipid levels and is the only substance known to reduce Lipoprotein (a), Lp(a), considered a risk factor for heart disease. (It also reduces LDL much to Big Pharma’s chagrin making billions on statins but see my earlier post on the myth of statins). Niacin also lowers C-reactive protein, a marker of inflammation. The only potential downside of niacin is that it can cause a brief vasodilation known as a flush. While not harmful (and most likely beneficial) it can be uncomfortable to some people, discussed more below.
Niacinamide is another precursor to NAD and has many of the same therapeutic properties except that it does not have the beneficial effect on lipid levels or C-reactive protein. It may be preferred to niacin as it rarely produces a flush. But it can produce nausea at far lower levels than basic niacin.
Inositol Hexaniacinate is a derivative that is probably the best of both worlds. It has all the properties of niacin without the flush. However, it tends to cost three times as much as niacin. Big pharma is also trying to sell extended-release, time-release or “no-flush” niacin formulations. These tend to be inositol hexaniacinate with various tablet coatings and a higher price tag. My advice is to avoid these as generally harder on the stomach with the necessary additives.
How to Take Niacin
As with all supplements the amount you need can be very individual and may take trial and error. You need to consider quantity and frequency. Just like vitamin C it is important to keep a consistent blood saturation so it should be taken throughout the day. A minimum of three times a day with food.
I would always recommend starting with basic niacin as whether or not you flush and at what levels, can give you insight to how much you need. The flush usually involves a tingling sensation starting in your forehead and travelling down. For some people it is brief and doesn’t go beyond the neck but for others it might last 30 minutes and involve a bright red face, chest and even arms. You can minimize the flush by always taking niacin right after a meal and with plenty of water. The flush usually dissipates with each subsequent dose and after a week of taking daily you may not flush at all.
Just like bowel flushing with vitamin C can indicate appropriate blood saturation, if you don’t flush when initially taking niacin it’s an indication you haven’t yet reached your needed level. There is no upper limit so you can’t do yourself harm by over-dosing. You may feel a little nauseous and even vomit if you keep going up but just ratchet back at that point. Case studies of severe schizophrenics have told of doses as high as 50,000mg a day before they became entirely normal. A more common formula for psychosis-type conditions (believed to be a form of pellagra) is 1,000mg three to four times a day taken with a similar amount of vitamin C. For arthritis it depends on the severity of the condition with 250mg four times a day often seeing results for the milder cases with the more severe taking 1,000mg three to four times a day to see major improvement. It’s been found to be particularly important with arthritis to split the daily doses up into smaller spaced-out increments to keep a constant blood saturation.
To get started with niacin you might begin with as little as 50mg three times a day and build up from there ratcheting up week by week. It’s more common to underdose than overdose. If the flushing becomes bothersome then you could switch to niacinamide (particularly if your lipids are already optimized) or you could mix and match. I actually take niacin after breakfast, niacinamide after lunch and niacin again after dinner. It has a relaxing effect in the evening and you’re usually asleep and unaware of any later flushing. I also take a B-complex which has a little inositol hexaniacinate in it.
The only known side-effect of niacin they say is living a longer life!
Here’s suggestions for further reading:
Niacin: The Real Story (2nd edition) by Dr Andrew Saul and the late Dr Abram Hoffer
