VITAMIN B 3 (NIACIN, NIACINAMIDE)

What is it? The body uses the water-soluble vitamin B 3 in the process of releasing energy from carbohydrates. It is needed to form fat from carbohydrates and to process alcohol. The niacin form of vitamin B 3 also regulates cholesterol (page 223), though niacinamide does not. Vitamin B 3 comes in two basic forms— niacin (also called nicotinic acid) and niacinamide (also called nicotinamide). A variation on niacin, called inositol hexaniacinate, is also available in supplements. Since it has not been linked with any of the usual niacin toxicity in scientific research, some doctors recommend inositol hexaniacinate for people who need large amounts of niacin. The min B Where is it found? best food sources of vitamin B 3 are peanuts, brewer’s yeast (page 480), fish, and meat. Some vitais also found in whole grains.

Who is likely to be deficient? Pellagra, the disease caused by a vitamin B 3 deficiency, is rare in Western societies. Symptoms include loss of appetite, skin rash, diarrhea (page 163), mental changes, beefy tongue, and digestive and emotional disturbance. How much is usually taken? In part because it is added to white flour, most people generally get enough vitamin B 3 from their diets to prevent a deficiency. However, 10– 25 mg of the vitamin can be taken as part of a B-complex (page 603) or multivitamin (page 559) supplement. Larger amounts are used for the treatment of various health conditions.

Are there any side effects or interactions? Niacinamide is almost always safe to take, though rare liver problems have occurred at amounts in excess of 1,000 mg per day. Niacin, in amounts as low as 50– 100 mg, may cause flushing, headache, and stomachache (page 260) in some people. Doctors sometimes prescribe very high amounts of niacin (as much as 3,000 mg per day or more) for certain health problems. These large amounts can cause liver damage, diabetes (page 152), gastritis (page 195), damage to eyes, and elevated blood levels of uric acid (which can cause gout [page 208]). Symptoms caused by niacin supplements, such as flushing, have been reduced with sustained-release (also called “time-release”) niacin products. However, sustainedrelease forms of niacin have caused significant liver toxicity and, rarely, liver failure. One partial time-release (intermediate-release) niacin product has demonstrated clinical efficacy without flushing, and also without the liver function abnormalities typically associated with sustained-release niacin formulations. 6 However, this form of niacin is available by prescription only. In a controlled clinical trial, 1,000 mg or more per day of niacin raised blood levels of homocysteine (page 234), a substance associated with increased risk of heart disease (page 98). 7 Since other actions of niacin lower heart disease risk, 8, 9 the importance of this finding is unclear. Nonetheless, for all of the reasons discussed above, large amounts of niacin should never be taken without consulting a doctor. The inositol hexaniacinate form of niacin has not been linked with the side effects associated with niacin supplementation. In a group of people being treated alternatively with niacin and inositol hexaniacinate for skin problems, niacin supplementation (50– 100 mg per day) was associated with numerous side effects, including skin flushing, nausea, vomiting and agitation. 10 In contrast, people taking inositol hexaniacinate experienced no complaints whatsoever, even at amounts two to five times higher than the previously used amounts of niacin. However, the amount of research studying the safety of inositol hexaniacinate remains quite limited. Therefore, people taking this supplement in large amounts (2,000 mg or more per day) should be under the care of a doctor. Vitamin B 3 works with vitamin B 1 (page 597) and vitamin B 2 (page 598) to release energy from carbohydrates. Therefore, these vitamins are often taken together in a B-complex (page 603) or multivitamin (page 559) supplement (although most B 3 research uses niacin or niacinamide alone).

Gaby, Alan R.; Lininger, Schuyler W.. Natural Pharmacy : Complete A-Z Reference to Alternative Treatments for Common Health Conditions (Revised and Updated 3rd Edition).

Westminster, MD, USA: Crown Publishing Group, 2006. p 599.

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