Articles

Vitamin B3

Introduction

Niacin is a water-soluble vitamin that can be produced in the body. It is instrumental in producing two of the body’s important co-enzymes, which are further involved in more than 200 chemical reactions in the body. It is also important for metabolism of carbohydrates, fatty acids and amino acids, as well as energy production on the cellular level.

There are three forms of niacin on the market today, all with potential health benefits. The first, which is known as nicotinic acid, has shown promise in controlling cholesterol levels. (1) The second, which is called nicotinamide, has seen use in the treatment of diabetes (2) , (3) , (4) and arthritis. (5) The third, inositol hexaniacinate, shares similar benefits with nicotinic acid. However, it does not produce the unpleasant tingling redness commonly associated with nicotinic acid.

Foods that contain niacin and its precursor, tryptophan, are considered sources of the vitamin. Organ meats, brewer’s yeast, milk, legumes, peanuts, and peanut butter are the best sources of niacin. Lean meats, poultry, fish, and peanuts are good sources of both niacin and tryptophan.

Dosage Info

Dosage Range

10-3,000mg daily is used commonly. (6) A few published studies report using dosages greater than 7,000mg daily. (7) Dosages above 2,000mg daily should only be administered under medical supervision.

Most Common Dosage

50mg daily.

Dosage Forms

Tablets, capsules, liquids, liposomal sprays, and effervescent tablets.

Interactions and Depletions

Depletions

Reported Uses

Nicotinic acid, but not niacinamide, effectively lowers elevated LDL—the so-called “bad" cholesterol—levels while simultaneously raising levels of the “good" HDL cholesterol. (8) , (9) , (10) The use of inositol hexaniacinate has grown in popularity because it reportedly does not produce the side affects associated with nicotinic acid.

Niacinamide has been used to treat a number of complications arising from diabetes. (11) , (12) It may also help maintain proper blood sugar levels in diabetics when use in concert with chromium. (13) Niacinamide may also be a potential treatment for rheumatoid and osteoarthritis, as well as acne when used topically. (14) , (15) , (16)

Other studies suggest that nicotinic acid may reduce the recurrence rate of heart attacks in people who are at risk. (17) Combining nicotinic acid with riboflavin may also reduce cataracts. (18) It may improve symptoms of schizophrenia. (19)

Finally, inositol hexaniacinate may have targeted applications in the treatment of two circulatory disorders, Raynaud’s disease (20) and intermittent claudication. (21) , (22)

Toxicities & Precautions

Introduction

[span class=alert]Be sure to tell your pharmacist, doctor, or other health care providers about any dietary supplements you are taking. There may be a potential for interactions or side effects.[/span]

General

This dietary supplement is considered safe when used in accordance with proper dosing guidelines.

Side Effects

Occasional side effects reported with large doses of this dietary supplement include a "niacin flush," which produces tingling sensations, flushing of the skin and head throbbing. Effects are not serious and usually subside within 10 to 30 minutes. Tell your doctor if these side effects become severe or do not go away.

Talk to your doctor before taking this dietary supplement. It may be harmful to the liver and should be used under medical supervision.

Pregnancy / Breast Feeding

To date, the medical literature has not reported any adverse effects related to fetal development during pregnancy or to infants who are breast-fed. Proper nutrition is essential during pregnancy for the healthy development of the fetus. Numerous vitamins and minerals are a vital part of proper nutrition. If you are pregnant, think you might be pregnant, trying to get pregnant, or breast-feeding an infant, talk to your healthcare professional about supplementing your diet with appropriate vitamins and minerals.

Age Limitations

To date, the medical literature has not reported any adverse effects specifically related to the use of this dietary supplement in children. Vitamins and minerals are an essential part of proper growth and development. Talk to your healthcare professional about the appropriate use of vitamins and minerals in children. Do not use any vitamin or mineral in children under 2 years of age unless first discussed with your healthcare professional.

References

  1. View Abstract: Gardner SF, et al. Combination of Low-dose Niacin and Pravastatin Improves the Lipid Profile in Diabetic Patients without Compromising Glycemic Control. Ann Pharmacother. Jun1997;31(6):677-82.
  2. View Abstract: Pozzilli P, et al. Meta-analysis of Nicotinamide Treatment in Patients with Recent-onset IDDM. The Nicotinamide Trialists. Diabetes Care. Dec1996;19(12):1357-63.
  3. View Abstract: Polo V, et al. Nicotinamide Improves Insulin Secretion and Metabolic Control in Lean Type 2 Diabetic Patients with Secondary Failure to Sulphonylureas. Acta Diabetol. Apr1998;35(1):61-64.
  4. View Abstract: Crino A, Schiaffini R, Manfrini S, et al. A randomized trial of nicotinamide and vitamin E in children with recent onset type 1 diabetes (IMDIAB IX). Eur J Endocrinol. May2004;150(5):719-24.
  5. View Abstract: Jonas WB, et al. The Effect of Niacinamide on Osteoarthritis: A Pilot Study. Inflamm Res. Jul1996;45(7):330-34.
  6. View Abstract: Wolfe ML, Vartanian SF, Ross JL, et al. Safety and effectiveness of Niaspan when added sequentially to a statin for treatment of dyslipidemia. Am J Cardiol. Feb2001;87(4):476-9.
  7. View Abstract: Nessim SA, Chin HP, Alaupovic P, Blankenhorn DH. Combined therapy of niacin, colestipol, and fat-controlled diet in men with coronary bypass, effect on blood lipids and apolipoproteins. Arteriosclerosis. Nov1983;3(6):568-73.
  8. View Abstract: Alderman JD, et al. Effect of a Modified, Well-tolerated Niacin Regimen on Serum Total Cholesterol, High Density Lipoprotein Cholesterol and the Cholesterol to High Density Lipoprotein Ratio. Am J Cardiol. Oct1989;64(12):725-29.
  9. View Abstract: Ryan MJ Jr, Gibson J, Simmons P, Stanek E. Effectiveness of aggressive management of dyslipidemia in a collaborative-care practice model. Am J Cardiol. Jun2003;91(12):1427-31.
  10. View Abstract: Goldberg AC. A meta-analysis of randomized controlled studies on the effects of extended-release niacin in women. Am J Cardiol. Jul2004;94(1):121-4.
  11. View Abstract: Pozzilli P, et al. Meta-analysis of Nicotinamide Treatment in Patients with Recent-onset IDDM. The Nicotinamide Trialists. Diabetes Care. Dec1996;19(12):1357-63.
  12. View Abstract: Polo V, et al. Nicotinamide Improves Insulin Secretion and Metabolic Control in Lean Type 2 Diabetic Patients with Secondary Failure to Sulphonylureas. Acta Diabetol. Apr1998;35(1):61-64.
  13. View Abstract: Urberg M, et al. Evidence for Synergism Between Chromium and Nicotinic Acid in the Control of Glucose Tolerance in Elderly Humans. Metabolism. Sep1987;36(9):896-99.
  14. View Abstract: Jonas WB, et al. The Effect of Niacinamide on Osteoarthritis: A Pilot Study. Inflamm Res. Jul1996;45(7):330-34.
  15. Hoffer A. Treatment of Arthritis by Nicotinic Acid and Nicotinamide. Canadian Medical Assoc Journal. 1959;81:235-39.
  16. View Abstract: Shalita AR, et al. Topical Nicotinamide Compared with Clindamycin Gel in the Treatment of Inflammatory Acne Vulgaris. Int J Dermatol. Jun1995;34(6):434-37.
  17. View Abstract: Canner PL, et al. Fifteen-year Mortality in Coronary Drug Project Patients: Long-term Benefit with niacin. J Am Coll Cardiol. Dec1986;8(6):1245-55.
  18. View Abstract: Sperduto RD, et al. The Linxian Cataract Studies. Two Nutrition Intervention Trials. Arch Ophthalmol. Sep1993;111(9):1246-53.
  19. Osmond H, Hoffer A. Massive Niacin Treatment in Schizophrenia: Review of a Nine-year Study. Lancet. 1962;1:316-20.
  20. View Abstract: Belch JJ, Ho M. Pharmacotherapy of Raynaud's phenomenon. Drugs. Nov1996;52(5):682-95.
  21. O'Hara J, et al. The Therapeutic Efficacy of Inositol Nicotinate (Hexopal) in Intermittent Claudication: A Controlled Trial. Br J Clin Pract. Sep1988;42(9):377-83.
  22. View Abstract: Sunderland GT, et al. A Double-blind Randomised Placebo Controlled Trial of Hexopal in Primary Raynaud's Disease. Clin Rheumatol. Mar1988;7(1):46-49.