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What's in a name?

Niacin, also known as vitamin B3, is an essential nutrient that aids in the growth and development of the human body.

Niacin is the generic name for nicotinic acid (pyridine-3-carboxylic acid), nicotinamide (niacinamide or pyridine-3-carboxamide), and related derivatives, such as nicotinamide riboside. For those who are interested, please see NIH Niacin Health Sheet


Vitamin B3, strictly speaking, is not a vitamin because the body can make it from the amino acid tryptophan. However, if people are eating low protein diets then niacin does become an essential B vitamin. It is present in three forms, namely nicotinic acid, niacin and niacinamide - the first two cause dreadful flushing and so please make sure that you use niacinamide, if you are buying it as a supplement.

The active form of niacinamide in the body is NAD (Nicotinamide adenine dinucleotide) and this is a vital intermediary in energy production. Essentially, it links the two major biochemical pathways of Kreb's citric acid cycle with oxidative phosphorylation in order that the body can make our essential energy molecule, namely adenosine triphosphate (ATP). Without sufficient NAD, energy production is slowed and every single cell in the body will go slow. Therefore, it is not surprising that a deficiency of NAD has widespread effects and, by implication, NAD has many therapeutic uses. For this reason, I recommend Niacinamide to my CFS/ME patients. Please see CFS - The Central Cause: Mitochondrial Failure for further details. My mitochondrial support package is:

  • Coenzyme Q10 as ubiquinol – 200 milligrams
  • Vitamin B3 as niacinamide – 500-1500 milligrams – slow release
  • Acetyl-L-carnitine – 1-2 grams
  • D-ribose – up to 15 grams (but this must be part of the carb count of the PK diet)
  • Vitamin B12 – 5 milligrams sublingually or ideally B12 by injection
  • Magnesium – ½ ml 50% magnesium sulphate by injection, ideally, together with 300mg orally and vitamin D 10,000iu daily to enhance absoprtion

and can be purchased here - My Sales Website - MITOCHONDRIAL PACKAGE (Starter Kit). Niacinamide can be purchased separately here - My Sales Website - Niacinamide B3 1500 mg 100 tablets

And also please see my three published studies about the link between CFS/ME and mitochondrial failure:

Therapeutical uses of niacinamide

The therapeutic uses that are now well established are as follows:

  • Treatment of fatigue

For the reasons given above, low B3 will result in fatigue. Any condition associated with poor mitochondrial function, such as chronic fatigue syndrome, any organ failure, and any neurological disease such as Parkinson's disease, may well benefit from high doses of NAD.

  • Arthritis

Work done by Dr William Kaufman in the 1940s and written up in his book "The Common Form of Joint Dysfunction" demonstrated that many forms of arthritis can benefit from high dose B3. Kaufman was insistent that the full daily dose of as much as 3000 - 5000 mg be given in many small divided doses throughout the day. He got excellent results. This is an intervention well worth trying. See Arthritis - Nutritional treatments You can access Dr Kaufman's book online free of charge at this web address - Dr Kaufman's "The Common Form of Joint Dysfunction".

  • Schizophrenia and Psychosis

Dr Abram Hoffer routinely uses high dose niacinamide, up to 3 grams daily, with excellent results for patients suffering from psychosis. It may take some months, or even years, to get the full benefit, but normal mental health can be restored. This is taken in conjunction with other nutritional supplements. You can read more about Dr Hoffer's work at this web address Successful Treatment of Schizophrenia Requires Optimal Daily Doses of Vitamin B3

  • Anxiety and mood swings

A study comparing the benefits of high dose niacinamide compared to diazepam came up with the interesting result that niacinamide was more effective. The reference for the study can be found at Nicotinamide is a brain constituent with benzodiazepine-like actions, although, sadly, this paper is not open source. You will, however, find three case studies of the use of Niacinamide for anxiety at this web address Supplemental Niacinamide Mitigates Anxiety Symptoms: Three Case Reports.

  • Control of blood sugar levels

I find myself talking more about the control of blood sugar levels so much. I only talk about diet more! It is not just a case of maintaining a low glycaemic index diet. Taking Nutritional Supplements, reducing allergies, correcting hormonal imbalances and managing stress efficiently are all essential in maintaining normal blood sugar levels. See Hypoglycaemia and also see my PK diet pages as here -

  1. The Paleo Ketogenic Diet - this is a diet which we all should follow
  2. The Paleo Ketogenic Diet - meals which require no cooking or preparation
  3. The Paleo Ketogenic Diet - PK Bread
  4. The Paleo Ketogenic Diet - PK Dairy
  5. Diet - what you need to eat to slow the normal ageing process
  6. Ketogenic diet - the practical details
  7. My book - Paleo-Ketogenic: The Why and The How
  • Parkinson's disease

A trial of high dose niacinamide is well worth it in patients with Parkinson's disease because some will see marked improvements. This may be because niacinamide also has an effect on neurotransmitter levels. See Parkinson's UK - "Vitamin B3 supplement shows early promise for Parkinson's", March 2022 and The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson’s disease

  • Neurotransmitter levels

Niacinamide may be converted by the body back to tryptophan and this is the raw material for the pathway that includes 5-HTP, serotonin and melatonin. This pathway will have profound effects on mood and sleep. So, for example, tryptophan and 5-HTP are very effective in the treatment of depression. Melatonin - the sleep hormone is obviously essential for quality sleep.

The dose of niacinamide

To get these therapeutic effects, one has to use niacinamide in much higher doses than the recommended daily allowances. Because it is so short acting, the best effects are achieved through small doses taken regularly throughout the day. See My Sales Website - Niacinamide B3 1500 mg 100 tablets. In doses above this, there will be a few people who will develop abnormal liver enzymes and this is almost invariably accompanied by a feeling of nausea. In this event, therefore, check liver function tests. Having said that, I have recommended niacinamide to hundreds of patients and have yet to see any abnormal liver function tests. I think this is because side effects and problems with drugs and nutritional supplements almost invariably arise as a result of nutritional deficiencies. Since I like to start all my patients on a basic package of nutritional supplements see Nutritional Supplements, this situation is very unlikely to arise.

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