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hc8meifmdc|20005939267D|healthm_live|health_library|health_library_details|0xfdffd14e090000002f05000001000100
| Overview |
Vitamin B3 is one of 8 B vitamins. It is also known as niacin (nicotinic acid) and has 2 other forms, niacinamide (nicotinamide) and inositol hexanicotinate, which have different effects from niacin.
All B vitamins help the body to convert food (carbohydrates) into fuel (glucose), which is "burned" to produce energy. These B vitamins, often referred to as B complex vitamins, also help the body metabolize fats and protein. B complex vitamins are necessary for healthy skin, hair, eyes, and liver. They also help the nervous system function properly.
Niacin also helps the body make various sex and stress-related hormones in the adrenal glands and other parts of the body. Niacin is effective in improving circulation and reducing cholesterol levels in the blood.
All the B vitamins are water-soluble, meaning that the body does not store them.You can meet all of your body's needs for B3 through diet; it is rare for anyone in the developed world to have a B3 deficiency. In the United States, alcoholism is the prime cause of vitamin B3 deficiency.
Symptoms of mild deficiency include indigestion, fatigue, canker sores, vomiting, and depression. Severe deficiency can cause a condition known as pellagra. Pellagra is characterized by cracked, scaly skin, dementia, and diarrhea. It is generally treated with a nutritionally balanced diet and niacin supplements. Niacin deficiency also results in burning in the mouth and a swollen, bright red tongue.
Very high doses of B3 (available by prescription) have been shown to prevent or improve symptoms of the following conditions. However, taken at high doses niacin can be toxic, so you should take doses higher than the Recommended Daily Allowance only under your doctor's supervision. Researchers are trying to determine if inositol hexanicotinate has similar benefits without serious side effects, but so far results are preliminary.
What is Niacin ?
Niacin is a type of B vitamin. It is water-soluble, which means it is not stored in the body. Water-soluble vitamins dissolve in water. Leftover amounts of the vitamin leave the body through the urine. That means you need a continuous supply of such vitamins in your diet. Niacin acts in the breakdown and use of all major foods.
Niacin is necessary for healthy skin, normal working of the stomach and intestinal tract, caring for the nervous system, and production of the sex hormones. It may also improve circulation and reduce high blood cholesterol levels. Niacin deficiency causes the following:
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Niacin deficiency affects every cell, especially where there is rapid cell turnover, such as the skin, gastrointestinal (GI) tract, and nervous system. |
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Niacin deficiency is a disease called pellagra. Pellagra is the disease of the three Ds, diarrhea, dermatitis, and dementia. NA/RNA synthesis. Some characteristics of pellagra include decreased energy and problems maintaining the integrity of the skin and intestinal tract. Symptoms include weakness and fatigue, anorexia, indigestion, and skin irregularities. These can progress to canker sores, nausea, vomiting, and diarrhea. Reduced stomach acid production will contribute to malabsorption of a number of nutrients including fat and fat-soluble vitamins. The initial neurological symptoms are irritability and insomnia with headaches and can progress to extreme anxiety, depression and psychosis. |
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Niacin, in the form of nicotinic acid, can produce a niacin flush. This is a redness, warmth, and itching to the skin. |
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This typically happens when the dosage is 50 mg or higher. The flush is the result of vasodilation. | |
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Where it is found
The best dietary sources of vitamin B3 are found in beets, brewer's yeast, beef liver, beef kidney, fish, salmon, swordfish, tuna, sunflower seeds, and peanuts. Bread and cereals are usually fortified with niacin. In addition, foods that contain tryptophan, an amino acid the body coverts into niacin, include poultry, red meat, eggs, and dairy products.
Best Form for Human Consumption
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Benefits / uses
Digestion: As a family of B-complex vitamins, niacin aids in normal functioning of the human digestive system, promoting healthy appetite, good nerves and a glowing skin.
Energy: Vitamin B3 performs the important function of converting proteins, carbohydrates and fats into energy.
High Cholesterol
Niacin (but not niacinamide) has been used since the 1950s to lower elevated LDL ("bad") cholesterol and triglyceride (fat) levels in the blood and is more effective in increasing HDL ("good") cholesterol levels than other cholesterol-lowering medications.
Atherosclerosis
Because niacin lowers LDL and triglycerides in the blood, it may help prevent atherosclerosis (hardening of the arteries) and is sometimes prescribed along with other medications.
Diabetes
Some evidence suggests that niacinamide (but not niacin) might help delay the onset of insulin dependence (in other words, delay the time that you would need to take insulin) in type 1 diabetes. In type 1 diabetes, the body's immune system mistakenly attacks the cells in the pancreas that make insulin, eventually destroying them. Niacinamide may help protect those cells for a time. The effect of niacin on type 2 diabetes is more complicated. People with type 2 diabetes often have high levels of fats and cholesterol in the blood, and niacin, often in conjunction with other drugs, can lower those levels.
Osteoarthritis
One preliminary study suggested that niacinamide may improve arthritis symptoms, including increasing joint mobility and reducing the amount of nonsteroidal anti-inflammatory drugs (NSAIDs) needed.
Alzheimer's disease -- Population studies show that people who get higher levels of niacin in their diet have a lower risk of Alzheimer's disease.
Doses
Recommended daily allowances (RDAs) are defined as the levels of intake of essential nutrients that the Food and Nutrition Board at the Institute of Medicine has found to be adequate to meet the known nutrient needs of most healthy persons. The Food and Nutrition Board at the Institute of Medicine recommends the following dietary intake for niacin:
Infants
0 - 6 months: 2 milligrams per day (mg/day)
7 - 12 months: 4 mg/day
Children
1 - 3 years: 6 mg/day
4 - 8 years: 8 mg/day
9 - 13 years: 12 mg/day
Adolescents and Adults
Males age 14 and older: 16 mg/day
Females age 14 and older: 14 mg/daySpecific recommendations depend on age, gender, and other factors (such as pregnancy). Women who are pregnant or producing breast milk (lactating) need higher amounts. Ask your health care provider which amount is best for you.
Possible Side effects / Precautions / Possible Interactions:
Large doses of niacin can cause liver damage, peptic ulcers, and skin rashes. Even normal doses can be associated with skin flushing. It can be prescribed as a treatment for elevated total cholesterol and other types of lipid disorders, but it should only be used with medical supervision due to its potential for severe side effects.
Possible Interactions:
If you are currently taking any of the following medications, you should not use niacin without first talking to your health care provider.
Antibiotics, Tetracycline -- Niacin should not be taken at the same time as the antibiotic tetracycline because it interferes with the absorption and effectiveness of this medication. (All vitamin B complex supplements act in this way and should therefore be taken at different times from tetracycline.)
Aspirin -- Taking aspirin before taking niacin may reduce flushing associated with this vitamin, but should only be done under your doctor's supervision.
Anticoagulants (blood thinners) -- Niacin may make the effects of these medications stronger, increasing the risk of bleeding.
Blood Pressure Medications, Alpha-blockers -- Niacin can make the effects of medications taken to lower blood pressure stronger, leading to the risk of low blood pressure.
Cholesterol-lowering Medications -- Niacin binds bile-acid sequestrants (cholesterol-lowering medications such as colestipol, colesevelam, and cholestyramine) and may decrease their effectiveness. For this reason, niacin and these medications should be taken at different times of the day.
Recent scientific evidence suggests that taking niacin with simvastatin (a drug that belongs to a class of cholesterol-lowering medications known as HMG-CoA reductase inhibitors, or statins), appears to slow down the progression of heart disease. However, the combination may also increase the likelihood for serious side effects, such as muscle inflammation or liver damage.
Diabetes Medications -- Niacin may increase blood glucose (sugar) levels. People taking insulin, metformin, glyburide, glipizide, or other medications used to treat high blood sugar levels should monitor their blood sugar levels closely when taking niacin supplements.
Isoniazid (INH) -- INH, a medication used to treat tuberculosis, may lower levels of niacin in the body and cause a deficiency.
Nicotine Patches -- Using nicotine patches with niacin may worsen or increase the risk of flushing associated with niacin.}
Research studies / References
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Jaconello P (October 1992). "Niacin versus niacinamide". CMAJ 147 (7): 990. PMC 1336277. PMID 1393911. |
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http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1336277. |
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Knip M, Douek IF, Moore WP, et al. (2000). "Safety of high-dose nicotinamide: a review". Diabetologia 43 (11): 1337-45. doi:10.1007/s001250051536. PMID 11126400. |
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Cox, Michael; Lehninger, Albert L; Nelson, David R. (2000). Lehninger principles of biochemistry. New York: Worth Publishers. ISBN 1-57259-153-6 |
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Cardiac Biomarkers May Predict Heart Attacks |
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Weidel, H (1873). "Zur Kenntniss des Nicotins". Justus Liebig's Annalen der Chemie und Pharmacie 165: 330-349. doi:10.1002/jlac.18731650212. |
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Samuel M. McElvain (1941), "Nicotinic Acid", Org. Synth., http://www.orgsyn.org/orgsyn/orgsyn/prepContent.asp?prep=CV1P0385.pdf; Coll. Vol. 1: 385 |
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Elvehjem, C.A.; Madden, R.J.; Strongandd, F.M.. "W. WOOLLEY 1938 The isolation and identification of the anti-blacktongue factor J". J. Biol. Chem 123: 137. |
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LAGUNA J, CARPENTER KJ (September 1951). "Raw versus processed corn in niacin-deficient diets". J. Nutr. 45 (1): 21-8. PMID 14880960.http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=14880960. |
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"Vitamin B3". University of Maryland Medical Center. 2002-01-04. http://www.umm.edu/altmed/articles/vitamin-b3-000335.htm. Retrieved 2008-03-31 |
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United States Department of Agriculture, National Agriculture Library, Food and Nutrition Information Center, Dietary Reference Intakes: Recommended Intakes for Individuals, Vitamins [1] |
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Institute of Medicine. (2006). Dietary Reference Intakes Research Synthesis: Workshop Summary, p. 37. National Academies Press. |
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Jacob RA, Swendseid ME, McKee RW, Fu CS, Clemens RA (April 1989). "Biochemical markers for assessment of niacin status in young men: urinary and blood levels of niacin metabolites". J. Nutr. 119 (4): 591-8. PMID 2522982. |
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http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=2522982. |
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Pitsavas, Stergios; Christina Andreou, Franzesca Bascialla, Vasilis P. Bozikas, Athanasios Karavatos (2004). "Pellagra Encephalopathy Following B-Complex Vitamin Treatment without Niacin". International Journal of Psychiatry in Medicine 31 (1): 91-96. http://baywood.metapress.com/link.asp?id=29xv1gg1u17krgjh. Retrieved 2009-11-27. |
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a b c d Prakash, Ravi; Sachin Gandotra, Lokesh Kumar Singh, Basudeb Das, Anuja Lakra. "Rapid resolution of delusional parasitosis in pellagra with niacin augmentation therapy". General Hospital Psychiatry 30 (6): 581-584. doi:10.1016/j.genhosppsych.2008.04.011. PMID 19061687. |
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http://www.sciencedirect.com/science/article/B6T70-4T24FKB-D/2/f619871a3d1f1d626b775c84523d6d94. Retrieved 2009-11-27. |
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"Guidelines for Niacin Therapy For the Treatment of Elevated Lipoprotein a (Lpa)". Rush Hemophilia & Thrombophilia Center. August 15, 2002, Revised July 27, 2005. Retrieved 20 November 2009. "facial flushing is a common side effect of niacin therapy that usually subsides after several weeks of consistent niacin use" |
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Marks, Jay W. (2005). "Niacin Monograph". MedicineNet, Inc.. |
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a b Katzung, Bertram G. (2006). Basic and clinical pharmacology. New York: McGraw-Hill Medical Publishing Division. ISBN 0071451536. http://www.medicinenet.com/niacin/article.htm. |
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McGovern ME (2005). "Taking aim at HDL-C. Raising levels to reduce cardiovascular risk". Postgrad Med 117 (4): 29-30, 33-5, 39 passim. PMID 15842130. |
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Canner PL, Berge KG, Wenger NK, et al. (1986). "Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin". J. Am. Coll. Cardiol. 8 (6): 1245-55. doi:10.1016/S0735-1097(86)80293-5. PMID 3782631. |
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N Engl J Med 361:2113 |
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Singer, Natasha (November 15, 2009). "Study Raises Questions About Cholesterol Drug’s Benefit". The New York Times. http://www.nytimes.com/2009/11/16/health/research/16heart.html. Retrieved November 16, 2009. |
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PMID 20079494. |
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Paolini JF, Bays HE, Ballantyne CM, et al. Extended-release niacin/laropiprant: reducing niacin-induced flushing to better realize the benefit of niacin in improving cardiovascular risk factors. Cardiol Clin. 2008 Nov;26(4):547-60. |
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a b c d Keith Parker; Laurence Brunton; Goodman, Louis Sanford; Lazo, John S.; Gilman, Alfred (2006). Goodman & Gilman's the pharmacological basis of therapeutics. New York: McGraw-Hill. ISBN 0071422803. |
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"Guidelines for Niacin Therapy For the Treatment of Elevated Lipoprotein a (Lpa)". Rush Hemophilia & Thrombophilia Center. August 15, 2002, Revised July 27, 2005. http://www.rush.edu/Rush_Document/Niacin%20therapy%20for%20elevated%20Lpa,0.pdf. Retrieved 20 November 2009. "facial flushing is a common side effect of niacin therapy that usually subsides after several weeks of consistent niacin use" |
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Barter, P (2006). "Options for therapeutic intervention: How effective are the different agents?". European Heart Journal Supplements 8 (F): F47-F53. doi:10.1093/eurheartj/sul041. |
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Chapman MJ, Assmann G, Fruchart JC, Shepherd J, Sirtori C (2004). "Raising high-density lipoprotein cholesterol with reduction of cardiovascular risk: the role of nicotinic acid--a position paper developed by the European Consensus Panel on HDL-C". Curr Med Res Opin 20 (8): 1253-68. doi:10.1185/030079904125004402. PMID 15324528. |
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a b "Niacin-induced "Flush" Involves Release of Prostaglandin D2 from Mast Cells and Serotonin from Platelets: Evidence from Human Cells in Vitro and an Animal Model". Journal of Pharmacology and Experimental Therapeutics. 2008. |
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Capuzzi DM, Morgan JM, Brusco OA, Intenzo CM (2000). "Niacin dosing: relationship to benefits and adverse effects". Curr Atheroscler Rep 2 (1): 64-71. doi:10.1007/s11883-000-0096-y. PMID 11122726. |
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Mittal MK, Florin T, Perrone J, Delgado JH, Osterhoudt KC (2007). "Toxicity from the use of niacin to beat urine drug screening". Ann Emerg Med 50 (5): 587-90. doi:10.1016/j.annemergmed.2007.01.014. PMID 17418450. |
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Gass JD (2003). "Nicotinic acid maculopathy. 1973". Retina (Philadelphia, Pa.) 23 (6 Suppl): 500-10. PMID 15035390. |
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Taheri, R (2003-01-15). "No-Flush Niacin for the Treatment of Hyperlipidemia". Medscape. http://www.medscape.com/viewarticle/447528. Retrieved 2008-03-31. |
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Kruse W, Kruse W, Raetzer H, Heuck CC, Oster P, Schellenberg B, Schlierf G (1979). "Nocturnal inhibition of lipolysis in man by nicotinic acid and derivatives". European Journal of Clinical Pharmacology 16 (1): 11-15. doi:10.1007/BF00644960. PMID 499296. |
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Meyers CD, Carr MC, Park S, Brunzell JD (2003). "Varying cost and free nicotinic acid content in over-the-counter niacin preparations for dyslipidemia". Annals of Internal Medicine 139 (12): 996-1002. PMID 14678919. http://www.annals.org/content/139/12/996.full.pdf+html. |
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Benjó AM, Maranhão RC, Coimbra SR, Andrade AC, Favarato D, Molina MS, Brandizzi LI, da Luz PL (2006). "Accumulation of chylomicron remnants and impaired vascular reactivity occur in subjects with isolated low HDL cholesterol: effects of niacin treatment". Atherosclerosis 187 (1): 116-122. doi:10.1016/j.atherosclerosis.2005.08.025. PMID 16458316. |
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Jacobson, EL (2007). "Niacin". Linus Pauling Institute. http://lpi.oregonstate.edu/infocenter/vitamins/niacin/. Retrieved 2008-03-31. |
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Zhang Y, Schmidt RJ, Foxworthy P, et al. (2005). "Niacin mediates lipolysis in adipose tissue through its G-protein coupled receptor HM74A". Biochem. Biophys. Res. Commun. 334 (2): 729-32. doi:10.1016/j.bbrc.2005.06.141. PMID 16018973. |
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Zellner C, Pullinger CR, Aouizerat BE, et al. (2005). "Variations in human HM74 (GPR109B) and HM74A (GPR109A) niacin receptors". Hum. Mutat. 25 (1): 18-21. doi:10.1002/humu.20121. PMID 15580557. | |
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