Try to survive on a
corn-based diet, and you run the risk of getting pellagra, a disease caused by niacin deficiency.
Corn lacks niacin. Years ago, people in the South who depended
on corn grits as a diet staple suffered from this body-wide disease that leads to
dermatitis, diarrhea, and depression. It can even lead to death, if deprivation continues
long enough.
Today, nearly everyone gets
sufficient niacin. Meat, poultry, and fish are rich in this B
vitamin, and it’s also added to flour and other cereal products to help ensure that
our needs are met. Pellagra, for the most part, is a thing of the past.
Like most of the other B vitamins, niacin
assists enzymes, the catalysts that help spark chemical reactions. An all-around booster
shot for enzymes, it helps many of them do their jobs properly.
Confusingly, niacin has several different chemical structures,
which also have different names. One of the forms prescribed by doctors is nicotinic acid.
A second form is called niacinamide—also known as nicotinamide. And there’s yet
a third form—different from the other two—called inositol hexaniacinate.
Some forms are recommended for
certain conditions but not for others. Niacinamide, for instance, is used to treat
osteoarthritis and rheumatoid arthritis. Other forms may be selectively prescribed in
large doses to treat high cholesterol and Raynaud’s disease, a circulatory problem
that causes cold hands and feet.
Large doses of nicotinic acid and inositol
hexaniacinate do a good job of lowering cholesterol, possibly by affecting liver function.
Niacin also raises "good" HDL cholesterol. In fact, it does this better than any
drug on the market. Several studies also show that regular doses of niacin can reduce the
risk of death from heart disease. It is thus considered a good treatment choice when
someone needs more than diet to control cholesterol, says Martin Milner, N.D., a
naturopathic doctor who teaches at the National College of Naturopathic Medicine in
Portland and Bastyr University in Bothell, Washington.
This is one treatment, however, for which
knowledgeable medical supervision is a top priority. In the large doses needed to lower
cholesterol—1,500 to 3,000 milligrams a day—niacin can cause liver problems. In
fact, problems can start with doses as low as 500 milligrams, although some effects might
not show up for years.
- Niacin
- Supplement forms: Nicotinic acid, niacinamide (nicotinamide), and inositol hexaniacinate;
also known as vitamin B3.
-
- May help: Niacin and inositol hexaniacinate may help high cholesterol and
Raynaud’s disease; Niacinamide may help osteoarthritis, rheumatoid arthritis, and diabetes.
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- Daily Value: 20 milligrams.
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- Special instructions: Take with food to minimize side effects whenever you’re taking high
doses.
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- Who’s at risk for
deficiency: Alcoholics and people taking isoniazid
(Laniazid) for long periods of time.
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- Good food sources: Meat, milk, eggs, fish, poultry, peanuts, and enriched breads and
cereals. Coffee and tea also contain appreciable amounts.
-
- Cautions and possible
side effects: Do not take more than 35 milligrams a
day of any form without medical supervision; do not take more than 35 milligrams daily if
you have a history of gout, liver damage, peptic ulcers, gallbladder disease, or heart
rhythm disturbances. Taking niacin in addition to certain cholesterol-lowering drugs
(“statin” drugs) increases risk of liver damage. High doses can cause drops in
blood pressure and can raise blood sugar in people with diabetes. May cause flushing and
allergic reactions.
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Product Recommendations |
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For Healthy Skin & Heart. Each tablet of Flush Free Niacin contains: 500
mg Niacin (from Inositol Hexaniacinate Niacin in a flush-free from)   |
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(B-3) Each Capsules
contains: 100 mg of Niacin
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- Anyone who is taking high doses must have regular
blood tests to measure three essential liver enzymes, says Dr. Milner. You may find timed-
release forms of niacin on your drugstore shelf, but immediate-release niacin is less likely to cause liver damage.
Dr. Milner uses inositol hexaniacinate (Niacinol)
because studies show that it is also less likely than the timed-release form to cause
liver damage. There’s also less chance of this form causing niacin flush, the
characteristic reddening of the skin and itching that some people experience after taking niacin. Even though it’s readily available from
naturopathic doctors and at some health food stores, however, it’s not something that
you should try without regular monitoring, Dr. Milner says.
With inositol hexaniacinate, the doctor might start
you on a dose of 1,500 milligrams. If you take regular niacin, your doctor will begin with a much lower dose and
increase it gradually over a period of weeks to help minimize flushing, says Dr. Milner.
Because niacin helps blood vessels expand, it seems to be just
what the doctor ordered for Raynaud’s. Some doctors, usually naturopaths, do
prescribe it for this condition. "Niacin’s ability to dilate the superficial
blood vessels of the skin, mostly around the chest and face but also in the hands, helps
to stop bouts of Raynaud’s," Dr. Milner says.
The rationale for using niacinamide for arthritis is
based mostly on the work of William Kaufman, M.D., Ph.D., a doctor who pioneered
nutritional therapy for people with the joint inflammation caused by this disease. Some
naturopathic doctors recommend up to 500 milligrams twice a day. "This form acts
differently in the body than niacin does," Dr. Milner says.
"It’s thought to improve certain functions in the cells. It does seem to be safe
at these amounts, though."
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