Vitamin B3

AKA: Niacin, niacinamide, nicotinic acid, nicotinamide.

L-tryptophan can be converted by the body into B-3, though it takes 60 parts tryptophan to make one part niacin, and a person who is deficient in B-l, B-2, and B-6 may not be able to produce niacin in this manner.

Food Sources: Avocados, brewer's yeast, dates, eggs, figs, fish, lima beans, liver, lean meat, milk, roasted peanuts, poultry (white meat), prunes, wheat germ, whole wheat products.

Effects: Improves memory and other mental functions, protects against stress, reduces blood clotting, and improves the oxygen-carrying ability of red blood cells. Drs. Humphry Osmond and Abram Hoffer contend that B-3 is an effective treatment for schizophrenia, though other researchers have not been able to duplicate their success. Vitamin B-3 is a histamine releaser, which can cause a flushing, tingling, and redness of the skin in some people, effects which can heighten sexual pleasure. It is also necessary for the synthesis of cortisone, throxine, and insulin, as well as the sex hormones estrogen, progesterone, and testosterone. The vitamin can relieve gastrointestinal problems, maintain the health of the skin, ease the severity of (or even prevent) migraines, fight canker sores and bad breath, and lower cholesterol and triglyceride levels. It is used to treat vertigo, ringing in the ears, premenstrual headaches, reduced levels of cholesterol and triglycerides in the blood, and pellegra.

The active coenzymatic form, and a natural metabolite, of B-3, called variously niacinamide adenine dinucleotide, nicotinamide adenine dinucleotide, NAD, or NADH (the reduced form), has shown promise in mental enhancement, though only recently has a process been developed that can stabilize this nutrient so that it can be taken orally, and one admittedly flawed study using 17 subjects suggests that 5 mg twice daily can improve the symptoms of Alzheimer's. Much more research is needed.

A deficiency is known as pellegra, and is characterized by gastrointestinal disturbances leading to a redness of the skin and inflammation, inability to recall recent events, apprehension, depression, emotional instability, and hyperirritability. An unusual sensitivity of the skin to sunlight may be an early warning sign. The victims of pellegra suffer from dermatitis, diarrhea, dementia, and some cases lead even to death.

Precautions: It should not be taken by those sensitive to niacin or who have liver disease, stomach ulcers, very low blood pressure, gout, or hemorrhaging. It should be taken only under the guidance of a physician if any of the following conditions are present: diabetes, gall bladder or liver disease, glaucoma, gout, high blood pressure, impaired liver function, porphyria, sensitivity to tartrazine dye, or ulcers. Those with ulcers may have to take an antacid to prevent aggravating their condition, and those with gout may find their symptoms increasing because of increased uric acid levels in the blood. Individuals with allergies may have problems, as nicotinic acid reportedly raises the histamine level in the body. Some may also find that they have an abnormal glucose tolerance such as found in diabetics.

In some cases, extremely high doses — over 750 mg/day — can cause abdominal cramps, diarrhea, fainting, body flush, jaundice, lightheadedness, liver damage, nausea, sweating, vomiting, weakness, and "niacin hepatitis," though the latter is not life-threatening. In doses larger than 50 mg (the RDA is 18 mg/day for men, 13 mg/day for women), it may cause dry skin, a flushing or redness of the skin accompanied by a tingling, dizziness, itching, or headaches for about 10 to 20 minutes when first starting supplementation; the flushing usually occurs on an empty stomach, is reportedly harmless, and should go away within two months. Some say this only occurs with pure niacin, and that taking aspirin an hour before taking B-3 or drinking a glass of water with the vitamin can prevent these symptoms, while others say that this only occurs with nicotinic acid. It should be noted that there is good evidence that toxicity can result from long-term intake of as low as two and one-half times the RDA. There are time-release niacin tablets that avoid the flush, but some evidence indicates that the continuous release of niacin may be detrimental to the liver. Other uncommon side effects may include abdominal pain, bloating, low blood pressure, diarrhea, fainting, gas, rapid or irregular heartbeat, heartburn, and hunger pains. Even rarer are incidents of nervousness and panic caused by high doses of nicotinic acid, blurred vision and related eye problems, and apparently one case of hypothyroidism. "Nicotinic analogues" or "niacin analogues" are drugs used to treat specific conditions, and have no value as vitamin supplements. Similarly, niacinimide, which avoids the niacin flush, lacks many of the beneficial effects of niacin, and can also cause liver damage and, in some people, depression.

Nicotinic acid can also interact with ganglionic blocking drugs, enhancing their blood pressure-lowering effect. Isoniazid, used to treat tuberculosis, can increase the need for niacin. Nicotinic acid can also interfere with the Benedict's reagent test for sugar in the urine, the measurement of catecholamines in the blood or urine, and — in one case — it has decreased the liver's uptake of the chemical used to make that organ visible for a liver scan. Niacin can reduce the effectiveness of antidiabetic drugs, probenecid, and sulfinpyrazone. Combining with betaandrenergic blocking agents, mecamylamine, methyldopa, or alcohol could result in excessively low blood pressure. Combining with HMG-CoA reductase inhibitors could increase the risk of heart or kidney problems. With cocaine, it could cause an increased flushing of the skin.

Niacin can be destroyed by alcohol, antacids, aspirin, estrogen, food processing, sleeping pills, sulfa drugs, and water. Its effectiveness can be reduced by tobacco and obesity.

Dosage: Start at low doses and gradually increase to 100 to 200 mg/day. It should be taken in 3 to 4 divided doses, preferably with meals. A highprotein diet with meat, eggs, enriched cereals, and other foods high in B-3 can provide adequate amounts.

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