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  Vitamin Niacinamide  
 
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Niacinamide is the amide (more water-soluble) form of the vitamin niacin (vitamin B3). It is also called nicotinamide and nicotinic acid amide, and does not cause the flushing that niacin does. Caution must be exercised with niacin, niacinamide and sustained release niacin because larger doses may cause liver damage. The first indications of over-use are usually nausea and elevations of liver enzymes.

Niacinamide may cause flushing and a feeling of warmth about the face and neck within the first two hours of taking a dose. Itching, tingling, or headache may occur as well. These effects should subside as your body adjusts to the medication. Stomach upset, heartburn, nausea, vomiting, and diarrhea may also occur. Less likely symptoms include vision problems, dark urine, stomach (abdominal) pain, rash, swelling, dizziness, fainting, trouble breathing, yellowing eyes or skin, irregular heartbeat, black stools, increased urination, muscle aches/pains. However, Dr. Kaufman has noted that niacinamide in approprate does (alone or combined with other vitamins) in a thousand patient-years of use has caused no adverse side effects. [ J. Amer Geriat. Society, 1955; 3: pp.927-936] In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention.

Some brands of niacinamide on the market today contains excipients that act as preservatives, probably meant to prolong shelf life. Some patients have severe adverse reactions to these preparations while most do not experience any ill effects.

Niacinamide has ready entrance to the central nervous system. It has a strong affinity for the central nervous system's benzodiazepine receptors and causes a pleasant calmative effect. In addition, it improves central nervous system function in the kinds of central nervous symptom impairments. These are noted in Dr. Kaufman's 1943 book, Common Forms of Niacinamide Deficiency Disease: Aniacin Amidosis,starting on page 3.

Niacinamide works systemically to improve joint mobility, muscle strength, decreases fatigability. It increases maximal muscle working capacity and reduces or completely eliminates arthritic joint pain. Niacinamide heals broken strands of DNA and improves many kinds of CNS functioning.

Niacinamide can be taken with food to prevent stomach upset. Frequent smaller doses, rather than larger less frequent doses are important in maintaining a steady level in the blood. It seems the half-life of niacinamide in the blood stream is about 4-6 hours. Although not really necessary, if you wanted to minimize the flushing effect (redness, itch) take a plain (not enteric-coated) 325mg aspirin tablet (or other NSAIDs such as ibuprofen) 30 minutes before each niacinamide dose. After a few weeks, this flushing effect should stop occurring, or decrease in intensity. Also, avoid alcohol or hot beverages near the time of the niacinamide dose.
 

 
 

Vitamin Niacinamide can help with the following:
 
 
Aging  Alzheimer's Disease
 An over-the-counter vitamin in high doses prevented memory loss in mice with Alzheimer's disease, and UC Irvine scientists now are conducting a clinical trial to determine its effect in humans.

Nicotinamide, a form of vitamin B3, lowered levels of a protein called phosphorylated tau that leads to the development of tangles, one of two brain lesions associated with Alzheimer's disease. This is also known as niacinamide and nicotinic acid amide. The vitamin also strengthened scaffolding along which information travels in brain cells, helping to keep neurons alive and further preventing symptoms in mice genetically wired to develop Alzheimer's.

"Nicotinamide has a very robust effect on neurons," said Kim Green, UCI scientist and lead author of the study. "Nicotinamide prevents loss of cognition in mice with Alzheimer's disease, and the beauty of it is we already are moving forward with a clinical trial."

Scientists found that the nicotinamide-treated animals had dramatically lower levels of the tau protein that leads to the Alzheimer's tangle lesion. The vitamin did not affect levels of the protein beta amyloid, which clumps in the brain to form plaques, the second type of Alzheimer's lesion.

Nicotinamide, they found, led to an increase in proteins that strengthen microtubules, the scaffolding within brain cells along which information travels. When this scaffolding breaks down, the brain cells can die. Neuronal death leads to dementia experienced by Alzheimer's patients.

"Microtubules are like highways inside cells. What we're doing with nicotinamide is making a wider, more stable highway," Green said. "In Alzheimer's disease, this highway breaks down. We are preventing that from happening."

The study appeared online Nov. 5, 2008 in the Journal of Neuroscience.

  Parkinson's Disease / Risk
 Niacinamide (nicotinamide) enhances mitochondrial energy production and may help protect mitochondria from damage by toxic substances. A product derived from nicotinamide, called nicotinamide adenine dinucleotide (NADH), is essential for cell development and energy production.

Animal studies suggest that the protective effects from an oral nicotinamide supplement are greatest when given early in the course of Parkinsonís disease, before dopamine is severely depleted. The benefits of NADH in Parkinsonís disease may result from its ability to reduce inflammation within the brain and from its effect on the immune system.

Allergy

  Allergic Rhinitis / Hay Fever

Autoimmune

  Diabetes Type I
 Niacinamide improves ATP mitochondrial production in the face of diabetogenic chemicals and thus allows Islet cells to stay alive. The Type I honeymoon period can just be extended 12-18 months and insulin requirements may be less.

Infections

  Sinusitis

Mental

  Anxiety
 The textbook description of anxiety neurosis exactly matches the symptoms of vitamin B3 (niacin) deficiency: hyperactivity, depression, fatigue, apprehension, headache, and insomnia. It has been shown in animals to work in the brain in ways similar to drugs such as benzodiazepines (Valium-type drugs) that are used to treat anxiety. One study found that niacinamide (not niacin) could help people get through withdrawal from benzodiazepines, which is a common problem. A reasonable amount of niacinamide to take for anxiety, according to some doctors, is up to 500mg four times per day.

Niacinamide locks onto the same receptor sites in the brain as do tranquilizers such as Valium, and is a natural tranquilizer. The manufacturer of valium is also the worlds largest manufacturer of niacinamide. [Nature 278: pp.563-65,1979]

  Poor Sense of Humor
 Early signs of Vitamin B3 (Niacin) depletion include the loss of a sense of humor.

Metabolic

  Methylation, Excess
  Hypoglycemia
  Headaches, Migraine/Tension

Musculo-Skeletal

  Osteoarthritis
 Results may be seen in 3-4 weeks with a plateau of improvement reached at 12 weeks. The dose may be lowered at this time but if discontinued, the symptoms will come back. Intake of 500mg 3-6 times daily has commonly been recommended. Sustained release forms require less frequent dosing.[ Inflamm Res 1996;45: pp.330-4]

Wayne Jonas from the NIH Office of Alternative Medicine conducted a 12 week, double-blind, placebo controlled study of 72 patients to assess the validity of Dr. Kaufmanís earlier work with niacinamide and osteoarthritis. Using a dose of 3 grams of niacinamide per day, they found that overall disease severity was reduced by 29%, inflammation was reduced by 22% and the use of anti-inflammatory medication was reduced by 13%. Patients taking the placebo, on the other hand, either had no improvement, or actually worsened.

Nutrients

  Vitamin B3 (Niacin) Requirement

Organ Health

  Cirrhosis of the Liver
 Niacinamide can protect the liver against alcohol-induced damage.

  Diabetes Type II
 Niacinamide improves ATP mitochondrial production in the face of diabetogenic chemicals and thus allows insulin-producing cells of the pancreas to stay alive longer. In one trial, newly diagnosed patients were given niacinamide at 25mg per kg of body weight. This restored the insulin-producing cells of the pancreas in some, slowed the cellular destruction in others and left a number no longer diabetic. Use in diabetic patients should always be monitored by a physician as insulin requirements may change.

Risks

  Increased Risk of Alzheimer's / Dementia
 An over-the-counter vitamin in high doses prevented memory loss in mice with Alzheimer's disease, and UC Irvine scientists now are conducting a clinical trial to determine its effect in humans.

Nicotinamide, a form of vitamin B3, lowered levels of a protein called phosphorylated tau that leads to the development of tangles, one of two brain lesions associated with Alzheimer's disease. The vitamin also strengthened scaffolding along which information travels in brain cells, helping to keep neurons alive and further preventing symptoms in mice genetically wired to develop Alzheimer's.

"Nicotinamide has a very robust effect on neurons," said Kim Green, UCI scientist and lead author of the study. "Nicotinamide prevents loss of cognition in mice with Alzheimer's disease, and the beauty of it is we already are moving forward with a clinical trial."

Scientists found that the nicotinamide-treated animals had dramatically lower levels of the tau protein that leads to the Alzheimer's tangle lesion. The vitamin did not affect levels of the protein beta amyloid, which clumps in the brain to form plaques, the second type of Alzheimer's lesion.

Nicotinamide, they found, led to an increase in proteins that strengthen microtubules, the scaffolding within brain cells along which information travels. When this scaffolding breaks down, the brain cells can die. Neuronal death leads to dementia experienced by Alzheimer's patients.

"Microtubules are like highways inside cells. What we're doing with nicotinamide is making a wider, more stable highway," Green said. "In Alzheimer's disease, this highway breaks down. We are preventing that from happening."

The study appeared online Nov. 5, 2008 in the Journal of Neuroscience.

Skin-Hair-Nails

  Concern Over Wrinkled Skin
 In a double-blind study of 50 women with signs of aging skin, use of niacinamide cream significantly improved skin appearance and elasticity as compared to placebo cream. [Bissett DL, Oblong JE, Berge CA et al. Niacinamide: A B vitamin that improves aging facial skin appearance. Dermatol Surg. 2005;31:860-5; discussion 865]

  Adult Acne
 Though harder to find, a topically applied 4% solution of niacinamide compared very favorably to Clindamycin in one trial. Oral niacinamide is unlikely to be of benefit.

Systemic and topical antimicrobials are effective in the treatment of inflammatory acne vulgaris; however, widespread use of these agents is becoming increasingly associated with the emergence of resistant pathogens raising concerns about microorganism resistance and highlighting the need for alternative nonantimicrobial agents for the treatment of acne. Nicotinamide gel provides potent antiinflammatory activity without the risk of inducing bacterial resistance. METHODS. In our double-blind investigation, the safety and efficacy of topically applied 4% nicotinamide gel was compared to 1% clindamycin gel for the treatment of moderate inflammatory acne vulgaris. Seventy-six patients were randomly assigned to apply either 4% nicotinamide gel (n = 38) or 1% clindamycin gel (n = 38) twice daily for 8 weeks. Efficacy was evaluated at 4 and 8 weeks using a Physician's Global Evaluation, Acne Lesion Counts, and an Acne Severity Rating. RESULTS. After 8 weeks, both treatments produced comparable (P = 0.19) beneficial results in the Physician's Global Evaluation of Inflammatory Acne; 82% of the patients treated with nicotinamide gel and 68% treated with clindamycin gel were improved. Both treatments produced statistically similar reductions in acne lesions (papules/pustules; -60%, nicotinamide vs. -43%, clindamycin, P = 0.168), and acne severity (-52% nicotinamide group vs. -38% clindamycin group, P = 0.161). CONCLUSIONS. These data demonstrate that 4% nicotinamide gel is of comparable efficacy to 1% clindamycin gel in the treatment of acne vulgaris. Because topical clindamycin, like other antimicrobials, is associated with emergence of resistant microorganisms, nicotinamide gel is a desirable alternative treatment for acne vulgaris.

  Hives
 Should be taken in combination with Tyrosine. See Hives/Tyrosine note.
 
 


KEY
May do some good
Likely to help
Highly recommended







GLOSSARY

Arthritis:  Inflammation of a joint, usually accompanied by pain, swelling, and stiffness, and resulting from infection, trauma, degenerative changes, metabolic disturbances, or other causes. It occurs in various forms, such as bacterial arthritis, osteoarthritis, or rheumatoid arthritis. Osteoarthritis, the most common form, is characterized by a gradual loss of cartilage and often an overgrowth of bone at the joints.

CNS:  Central Nervous System.

Diarrhea:  Excessive discharge of contents of bowel.

DNA:  Deoxyribonucleic acid, the large molecule that is the main carrier of genetic information in cells. DNA is found mainly in the chromosomes of cells.

Enzymes:  Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.

Milligram:  (mg): 1/1,000 of a gram by weight.

Nausea:  Symptoms resulting from an inclination to vomit.

Nervous System:  A system in the body that is comprised of the brain, spinal cord, nerves, ganglia and parts of the receptor organs that receive and interpret stimuli and transmit impulses to effector organs.

Niacin:  (Vitamin B-3): A coenzyme B-complex vitamin that assists in the breakdown of carbohydrates, fats and proteins. Essential for the health of the skin, nerves, tongue and digestive system. It is found in every cell of the body and is necessary for energy production. Niacin is also needed for DNA formation.

NSAID:  Non-steroidal anti-inflammatory drug.

Stomach:  A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomachís mucous lining must constantly regenerate itself.