Vitamin B3

So let's talk about a nutrient that everybody's familiar with, lowly old vitamin B3, niacin. Everybody knows about niacin. We all know about the absence of niacin in the diet producing the disease, deficiency, disease, actually called pellagra. And you recall that there are three characteristics that are associated symptomatically with the vitamin B3 deficiency, and those are the three Ds of diarrhea, dermatitis and dementia. Meaning that the vitamin is important obviously for gastrointestinal function, for skin function and for brain function. However, we have to say that vitamin B3 has an effect. Now that's being realized in much more than just those tissues. Those must be just marker tissues of deficiency. Well, before we get to the frank deficiency symptoms, there are other signs of, of vitamin B3 insufficiency that can appear like energy and cognitive dysfunction and dysphoria, depression, things of this nature. Now this is a very interesting example of the nutritional status relative to niacin or nicotinic acid or vitamin B3. So everything I've talked about here has to do with ranges of intake of vitamin B3 that would be in the normal and customary dietary levels. Tens of milligrams per day, for instance. But what about a nutritional pharmacological dose of niacin when we get up into doses that would be considered mass action, almost pharmacological in nature. So this would be hundreds to thousands of milligrams per day. Now these are the doses that Dr. Abram Hoffer talked about some 50 years ago when he was developing the concepts of orthomolecular psychiatry. The use of high doses of specific B vitamins to modulate disorders like schizophrenia, which he reported back in medical journals in the early and middle 1950s. Certainly not every schizophrenic responds to niacin therapy because not every schizophrenic has the same condition. Really it should be schizophrenias rather than schizophrenia. It's a multiple etiological disorder. Some variant types then seem to be responsive to nicotinic acid therapy. Some seem to be responsive to pyridoxine, vitamin B6. Some seem to be responsive to a combination of, of vitamin C with vitamin B3 or niacin. Now how did Dr. Hoffer come upon this observation? He came upon this observation because in the search for anti schizophrenic therapeutics, he started to look at niacin and its relationship to cholesterol. And in fact one of the first reports of niacin's effect on cholesterol came from Hoffer's group in Saskatchewan, Canada. And they found that high dose niacin lowered cholesterol, elevated then what we later called the good cholesterol, hdl. And in the case of schizophrenics that were taking this, who also had elevated cholesterol, their schizophrenia oftentimes improve. So this shows that there is an interrelationship of multiple factors in the presentation of the individual with this interesting vitamin. Now, I want to emphasize the dose I'm talking about is nutritional therapeutic. Now what we start to see is new evidence coming out the last few years that is absolutely exploding the positive benefit of high dose niacin or nutritional therapeutics with niacin for things like metabolic syndrome, things like endothelial dysfunction and cardiovascular disease, things like relationships to elevated lipoprotein, which is an atherogenic risk factor. These particular kinds of clinical indications all appear to respond to nicotinic acid therapy, nutritional pharmacology. In this case, the dose is not tens of milligrams, it's a thousand, 1500, 2000 milligrams a day. Now, when you're using these high doses of niacin, clearly the first thing you think about is flushing, because we know niacin produces this peripheral vascular type of cutaneous flushing reaction can be very discomforting. So therefore a lot of people will use sustained released or time released niacin. In using time released niacin clinically, one wants to be cautious about the potential of liver infiltration. So you generally would want to follow your liver enzyme profiles in a blood chemistry to make sure that you're not into a therapeutically injurious effect of time release niacin. The normal release niacin generally doesn't have this problem of liver toxicity that the sustained release or time release does. But in the case of the normal release, you have to deal with a flushing reaction. Some people modify this by taking a baby aspirin about 20 minutes before taking their niacin, which then eliminates or at least lowers significantly the flushing reaction. The reason I'm bringing this up is that the only demonstrable way therapeutically to lower elevated lipoprotein levels, this atherogenic risk factor is therapeutic niacin intervention. Therapeutic niacin intervention has also been found to improve carotid artery interval thickness, meaning it regresses plaque. It also has a positive effect on metabolic syndrome there and insulin resistance. And it also helps to elevate the good cholesterol, HDL cholesterol, when given therapeutically. So here's an example of where, as we go to different doses, we get different therapeutic effects on the body. Starting with the nutritional level, which is preventing that of diarrheas, dermatitis and dementia. Now into a therapeutic level where we're using the nutrient pharmacologically to basically promote a specific health function. This is an exciting time looking at nutrients through this full range of action. And niacin is a really good example of a therapeutically definable clinical positive outcome, using it as a nutritional therapeutic agent.