Niacinamide - B Complex

Niacinamide is one of the water-soluble B-complex vitamins. Niacin, or nicotinic acid, is also known as Vitamin B-3. When an amide molecule attaches itself to niacin, it becomes niacinamide. One major difference is that in doses exceeding 50 mg, niacin typically produces flushing of the skin. Niacin and niacinamide also have different applications. It its niacinamide form, it is useful in arthritis and early-onset type I diabetes; niacin is an effective reducer of high cholesterol levels.

Niacinamide was first linked to preventing the development of diabetes in experimental animals in the 1950s, a finding confirmed in the 1980s which led to further clinical studies. Niacinamide enhances insulin secretion and increases insulin sensitivity. Evidence points to niacinamide supplements being very effective in preventing type I diabetes from progressing in some patients if given soon enough at the onset of diabetes. It does so primarily by helping restore beta cells.

Several studies done on high-risk groups led to a larger population-based study conducted in New Zealand to see if supplements can prevent diabetes from developing in high risk groups. The results of screening 32,000 five- to seven-year-old children for islet cell antibodies and treating those at risk proved quite impressive. Treating diabetes is very costly, but early intervention by screening (as done in the New Zealand study) and treating with niacinamide supplements could dramatically cut health-care costs.1

Evidence on the impact of niacinamide on arthritis is only preliminary. Drs. William Kaufman and Abram Hoffer have reported positive clinical results in the treatment of hundreds of patients with osteoarthritis and rheumatoid arthritis using high doses of niacinamide. These results have yet to be fully evaluated in detailed clinical studies.2

1 Elliot RB and Pilcher CC, Prevention of diabetes in normal school children. Diabetes Res Clin Pract14, S85, 1991; and Mandrup Paulsen T, et al., Nicotinamide in the prevention of insulin dependent diabetes mellitus. Diabetes Metabol Rev 9, 295-309, 1993.

2 Kaufman, W, The Common Form of Joint Dysfunction: Its Incidence and Treatment. E. L. Hildreth Company, Brattleboro, VT, 1949; and Hoffer, A, Treatment of arthritis by nicotinic acid and nicotinamide. Canadian Medical Association Journal 81; 235-239, 1959.

NIACINAMIDE: SOURCES

• Beef liver
• Brewer's yeast
• Chicken
• Halibut
• Peanuts
• Pork
• Salmon
• Sunflower seeds
• Swordfish
• Tuna
• Turkey
• Veal

Available as:

• Tablets or capsules: Take with meals or 1 to 1-1/2 hours after meals unless otherwise directed by your doctor.
• Extended-release capsules or tablets: Swallow whole with full glass of liquid. Don't chew or crush. Take with or immediately after food to decrease stomach irritation.
• Oral solution: Dilute in at least 1/2 glass water or other liquid. Take with meals or 1 to 1-1/2 hours after meals unless otherwise directed by your doctor.
• Injectable forms are administered by doctor or nurse.1

1 From Griffith HW, Vitamins, Minerals, and Supplements.

NIACINAMIDE: PROVEN BENEFITS

• Maintains normal function of skin, nerves, digestive system.
• Corrects niacin deficiency.
• Dilates blood vessels.
• Treats dizziness and ringing in ears.
• Prevents premenstrual headache.
• Treats pellagra.

What this vitamin does:

• Aids in release of energy from foods.
• Helps synthesis of DNA.
• Becomes a component of two co-enzymes (NAD and NADP), which are necessary for utilization of fats, tissue respiration, production of sugars.1

1 From Griffith HW, Vitamins, Minerals, and Supplements.

NIACINAMIDE: UNPROVED SPECULATED BENEFITS

• Prevents heart attacks.
• Treats or prevents motion sickness.
• Alleviates mental illness, notably schizophrenia.
• Cures depression.
• Prevents migraine or headaches.
• Improves digestion.
• Protects against pollutants and toxins.
• Treats leprosy.
• Stimulates sex drive.1

1 From Griffith HW, Vitamins, Minerals, and Supplements.

NIACINAMIDE: SPECIAL CONSIDERATIONS

• Anyone with inadequate caloric or dietary intake or increased nutritional requirements.
• Those who abuse alcohol or other drugs.
• People with a chronic wasting illness, including malignancies, pancreatic insufficiency, cirrhosis of the liver, sprue.
• Anyone who experiences excess stress for long periods, or who has recently undergone surgery.
• Athletes and workers who participate in vigorous physical activities.
• Those with a portion of the gastrointestinal tract surgically removed.
• People with recent severe burns or injuries.
• Those with diabetes.
• Anyone with hyperthyroidism.

Miscellaneous information:

The body manufactures niacinamide from tryptophan, an amino acid.1

1 From Griffith HW, Vitamins, Minerals, and Supplements.

NIACINAMIDE: DEFICIENCY SYMPTOMS

Early symptoms:

• Muscular weakness
• General fatigue
• Irritability
• Dizziness
• Loss of appetite
• Headaches
• Swollen, red tongue
• Skin lesions, including rashes, dry scaly skin in areas exposed to sunlight, wrinkles, coarse skin texture
• Nausea and vomiting

Late symptoms of severe deficiency called pellagra:

• Dementia
• Death1

1 From Griffith HW, Vitamins, Minerals, and Supplements.

NIACINAMIDE: UNPROVED SPECULATED SYMPTOMS

• Acne
• Poor circulation
• Mental problems1

1 From Griffith HW, Vitamins, Minerals, and Supplements.

NIACINAMIDE: LAB TESTS TO DETECT DEFICIENCY

• Urinary N-1 methylnicotinamide
• Urinary 2Ñpyrindone/N-1 methylnicotinamide; test results not always conclusive
• Liver-function studies1

1 From Griffith HW, Vitamins, Minerals, and Supplements.

NIACINAMIDE: OPTIMAL LEVELS

Up to 150 mg.

NIACINAMIDE: MINIMUM DOSAGE

Recommended Dietary Allowance (RDA):

Estimate of adequate daily intake by the Food and Nutrition Board of the National Research Council, 1989.

Age RDA

0-6 months 6mg

6-12 months 8mg

1-3 years 9mg

4-6 years 11mg

7-10 years 16mg

MALES

11-18 years 18mg

19-22 years 19mg

23-50 years 18mg

50+ years 16mg

FEMALES

11-14 years 15mg

15-22 years 14mg

23+ years 13mg

Pregnant +2mg

Lactating +4mg

NIACINAMIDE: WARNINGS AND PRECAUTIONS

Don't take if you:

• Are allergic to niacin or any niacin-containing vitamin mixtures.
• Have impaired liver function.
• Have an active peptic ulcer.
• Consult your doctor if you have:
• Diabetes.
• Gout.
• Gallbladder or liver disease.

Over age 55:

• Consult your doctor if you have any questions.

Pregnancy:

• Don't take megadoses unless approved by your doctor.

Breast-feeding:

• Studies inconclusive. Consult doctor about supplements.
• Don't take megadoses unless approved by your doctor.

Effect on lab tests:

• Urinary catecholamine concentration may show falsely elevate results.
• Urine glucose (using Benedict's reagent) may produce false-positive reactions.
• Falsely elevates blood sugar.
• Falsely increases growth-hormone level in blood.
• Falsely elevates blood-uric acid with large daily doses.

Storage:

• Store in cool, dry place away from direct light, but don't freeze.
• Store safely out of reach of children.
• Don't store in bathroom medicine cabinet. Heat and moisture may change action of vitamin.

Others:

• High doses over long periods may cause liver damage or aggravate a stomach ulcer.1

1 From Griffith HW, Vitamins, Minerals, and Supplements.

NIACINAMIDE: OVERDOSE/TOXICITY

Signs and symptoms:

Body flush, nausea, vomiting, abdominal cramps, diarrhea, weakness, lightheadedness, fainting, sweating, headache, high blood sugar, high uric acid, heart-rhythm disturbances.

What to do:

For symptoms of overdosage: Discontinue vitamin, and consult doctor. Also see ADVERSE REACTIONS OR SIDE EFFECTS.

For accidental overdosage (such as child taking entire bottle): Dial emergency services, your telephone operator or your nearest Poison Control Center.1

1 From Griffith HW, Vitamins, Minerals, and Supplements.

NIACINAMIDE: ADVERSE REACTIONS OR SIDE EFFECTS

Reaction or effect What to do

Abdominal pain Discontinue. Call doctor immediately.

Diarrhea Discontinue. Call doctor immediately.

Faintness Discontinue. Call doctor immediately.

Headache Discontinue. Call doctor when convenient.

"Hot" feeling, with skin Nothing.

flushed in blush zone (always)

Jaundice (yellow skin and eyes) Seek emergency treatment.

Nausea Discontinue. Call doctor immediately.

Skin dryness Discontinue. Call doctor immediately.

Vomiting Discontinue. Call doctor immediately.1

1 From Griffith HW, Vitamins, Minerals, and Supplements.

NIACINAMIDE: INTERACTION WITH OTHER SUBSTANCES

Interacts with Combined effect

Anti-diabetics Decreases anti-diabetic effect.

Beta-adrenergic blockers Lowers blood pressure to extremely low level.

Chenodiol Decreases chenodiol effect.

Guanethidine Increases guanethidine effect.

Isoniazid Decreases niacin effect.

Mecamylamine Lowers blood pressure to extremely low level.

Pargyline Lowers blood pressure to extremely low level.

Tobacco decreases absorption. Smokers may require supplemental niacin.

Alcohol may cause excessively low blood pressure. Use caution.1

1 From Griffith HW, Vitamins, Minerals, and Supplements.

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