Vitamin B3 exists as a dietary supplement in two forms: niacinamide and nicotinic acid. In literature, the term niacin only covers nicotinic acid.
Niacinamide is the most widely used form and can be found in practically all dietary supplements. The reason for this is that vitamin B3 intake in the form of nicotinic acid causes some reactions which may be inconvenient if one is not warned beforehand. However, these reactions may sometimes further the treatment.
Nicotinic acid can therefore be used in the treatment of a number of illnesses on which niacinamide has little or no effect on. Because of this difference, the two forms of the vitamin are dealt with separately in this text. However, it should be made clear in this introduction that nicotinic acid has the same vitamin effect as niacinamide. The deficiency symptoms are therefore, by all accounts, similar for the two forms.
The amino acid tryptophan is under normal circumstances converted in the body into niacin to some extent. The conversion factor is 60 mg. of tryptophan to 1 mg. of niacin, which is referred to as 1 niacin equivalent (NE).
Defeciency symptoms may be anxiety, fear, suspiciousness, melancholy, depression, headache, insomnia, fatigue, delusions, distorted sensory impressions, amoral behaviour, burning sensations throughout
the body, raised papillae (strawberry tongue) especially on the tip, white coating of the tongue with cracks along the central line and tooth marks on the edge of the tongue, very bad breath, mouth pain, swollen and aching gums, indigestion with intestinal gas and uneven, badly shaped foul-smelling stools, abdominal pain, eczema, and dermatitis.
Deficiency is commonly connected with alcoholism, drug addiction, and other kinds of addiction.
The deadly form of vitamin B3 deficiency is pellagra, historically known from the big epidemics in Southern Europe and the southern states of the USA in the beginning of last century. Tryptophan deficiency is one of the causes of this disease. Pellagra was particularly widespread in poor areas where corn was one of the major staples. This is because the body cannot easily transform the kind of tryptophan found in corn to vitamin B3.
Since then the world has witnessed another kind of pellagra: a kind of pellagra which is not caused by malnutrition but by medicinal poisoning and afflicts e.g. patients who are treated with chemotherapy in the form of 3-mercaptopurine.
Pellagra was characterized by the 3 D's: diarrhoea, dermatitis and dementia. From early on several scientists noticed that the mental implications of vitamin B3 deficiency were quite similar to schizophrenia. This observation would later prove important for the development of orthomolecular psychiatry, where the question was raised whether or not schizophrenics were individuals with an extreme biochemistry and an abnormal need for vitamin B3. This has been a starting point for the successful treatment of schizophrenics.
Richest natural sources
Dried liver powder, brewer's yeast, wheat germ, lean meat, poultry, and fish
About niacinamide
RDA: 18 mg. However this is considered by many to be inadequate.
E Cheraskin and others have set an "optimal RDA" which is at least 6 times higher on average at approximately 115 mg.
Therapeutic dosage:
As a general supplement is set by many physicians to 50 mg. In many case of severe deficiency a daily supplement varying from 0.1 to 10 g. could prove usefull.
About niacin = nicotinic acid:
Nicotinic acid offers the possibility of drawing up treatment programmes with a considerable, sometimes unique healing effect even for therapeutically difficult cases. However, the reactions to this form of vitamin B3 are of such a nature that the patient should receive thorough guidance on the proper use.
If possible, the practitioner should set aside time with the patient to test the first dosage undisturbed. This course of action has a reassuring effect on the patient, particularly if the practitioner himself takes a dose equivalent to the one administered to the patient and they both observe and assess the individual reactions. If the reactions are violent - and this has not been seen yet with the doses mentioned here - one can moderate them quickly by taking a calcium supplement, either in the form of a large soluble calcium tablet dissolved in water or simply a large glass of milk.
A dose of nicotinic acid of 10 mg. or less will often prove sufficient to give most people hot flushes in the upper third of their bodies. This reaction is due to a strong dilation of the capillaries and is can be accompanied by reddening and a prickly, light irritation of the skin, as well as itching.
Even though this effect is quite brief and harmless, it is so extraordinary for the patient that it can lead to panic reactions and an irredeemable aversion to this form of treatment, especially if the practitioner is not present and or does not give sufficient psychological support.
There are many instances of patient treatment where there is a need for exactly the reactions which nicotinic acid can give. The practitioner should know these instances. At the same time, the practitioner should make himself acquainted with all the effects of nicotinic acid, so that it can effectively and safely be a part of the total patient treatment programme.
It goes without saying that all conditions which call for better, more effective capillary circulation in the upper part of the body can benefit from the effects of nicotinic acid.
Impaired hearing and even total deafness have in some cases been improved with nicotinic acid. Another illness often miraculously cured by nicotinic acid is Ménière's disease, a degeneration caused by sclerosis of the inner ear which causes dizziness and a sense of vertigo with 'spinning' vision and nausea which can be disabling and force the patient to give up his job or normal life style.
Some kinds of headache and migraine react positively to nicotinic acid. Since reduced blood flow to the central nervous system is a concomitant factor in senility, it is rather unsurprising that nicotinic acid has been used successfully for a number of the symptoms generally known as senility.
Because of the dilatory effect, nicotinic acid prevents disease and protects the heart.
Many people don’t produce enough gastric acid. Nicotinic acid, as opposed to niacinamide, induces the production of gastric acid. Whereas niacinamide does not reduce the fat content -cholesterol and triglycerides - in the blood, as nicotinic acid does. The same goes for high blood pressure which is not only lowered in the short term by the temporary dilution of the capillary system, but also improved considerably in the long term.
Niacinamid does not appear to offer alcoholics any particular relief, whereas nicotinic acid has been know to fortify the alcoholic's nervous system and mental balance, but also reduce the cravings for alcohol and counteract withdrawal symptoms.
Having all these excellent effects, why is nicotinic acid not used far more extensively and intensely in the treatment of patients?
For several reasons, of which the most important are:
- Most clinical tests have been made in orthodox medicine whose test setup cannot assess concurrent effects.
- The "side effects" - hot flushes etc. frighten practitioners who don't know how to handle the situation.
- Lack of understanding of the drug's biochemistry and effect leads to confusion and insecurity in the practitioners, who prefer to ignore the option of using it.
Let us try to remedy this mistake.
Nicotinic acid has these main biochemical effects:
(A) - Nicotinic acid chelates minerals - i.e. combines (a metal ion) with a chemical compound to form a ring. This compound is excreted from the body. This is desirable, when the chelate consists of a surplus of minerals and undesirable salts, particularly heavy metal compounds. It can be less desirable or even dangerous in the long term, if it leads to the loss of vital body salts.
(B) Nicotinic acid provokes a histamine response. This may cause an allergic attack in histamine-type allergy sufferers - i.e. people suffering from allergies similar to hay fever, which leads to sniffling, red eyes, and irritated mucous membranes. Contrary to this, people with too low histamine production may experience sexual problems, because they cannot have an orgasm, and they may benefit from an increased production of histamine.
(C) Nicotinic acid increases the amount of uric acid in the body. This may be a nuisance for people who suffer from gout and can provoke an attack.
(D) Nicotinic acid increases blood sugar. In patients with diabetes - particularly those who suffer from insulin-dependent diabetes - this can lead to violent fluctuations of the insulin need.
(E) The effect of nicotinic acid on the circulation and blood pressure can be stressful for patients with organic heart disease or weakened heart. For this reason people who have been suffering from e.g. rheumatic fever should avoid nicotinic acid or take the first doses with caution in a clinical environment where the patient's reactions can be monitored and needed assistance provided.
The first condition (A) makes it necessary to make sure that the patient is supplemented with a sufficient amount of all essential mineral salts before and during the nicotinic acid treatment.
In case of massive nicotinic acid treatment, minerals will be excreted because of the chelating effect. As mentioned before this has the advantage of removing harmful minerals - lead, cadmium, mercury, aluminium, and a surplus of minerals - perhaps copper or calcium are gradually removed. The drawback of this effect is that vital minerals are also removed, unless they are continually replaced in the therapeutic programme.
Unforeseen "side effects" of nicotinic acid treatment such as extreme fatigue because of mineral deficiency have been observed in non-concurrent therapy programmes.
Nonetheless, most practitioners seem to ignore this risk completely. Some patients are also known to have taken large quantities of nicotinic acid for several years without incurring any mineral deficiency. Unfortunately, this problem has not been well explored, and it is not possible to state the numbers or quantitative ratios involved.
With regards to condition (B), some allergy sufferers are marked by a high concentration of histamine in the tissues. An increase of this histamine can provoke an allergic reaction. Therefore one should employ nicotinic acid treatment of histamine-type allergy with caution and test with small doses to assess the reaction. Other kinds of allergy sufferers will often improve considerably with nicotinic acid treatment. Practitioners have reported good individual results for the treatment of asthma and bronchitis.
The treatment of people suffering from gout should be based on careful testing, since an increased amount of uric acid in the body can provoke an attack. An introductory treatment programme with harpago tablets, which reduces uric acid, e.g. administered throughout one week will often make the patient able to benefit from nicotinic acid treatment without risking any annoying uric acid reactions.
Diabetics' need of insulin may fluctuate much under the influence of nicotinic acid and may periodically increase the need of insulin. However during long term therapy nicotinic acid has the opposite effect since it reduces the need of insulin and improves the patient's general condition. This is, among other things, due to the fact that nicotinic acid activates chrome and forms the chromium-containing compound glucose tolerance factor (GTF), which regulates the blood sugar.
Nicotinic acid can also ward off low blood sugar attacks in patients with hypoglycaemia. Both in the case of diabetes and hypoglycaemia, it is recommended to stabilize the blood sugar with a GTF supplement before nicotinic acid treatment is initiated.
Since nicotinic acid also has a direct acidic effect, large doses should be avoided in cases of peptic ulcer or liver disease.
Since nicotinic acid dilates the capillary vessels and thus lowers the blood pressure, this form of treatment should be used only with the utmost care in patients who suffer from low blood pressure or regularly take medicine for high blood pressure.
Tolerance is quite important for this form of treatment. Increasingly large doses of nicotinic acid reduce the capillary-dilating effect in the short term. If hot flushes and a dilation of the capillary vessels are desired for every dose (vasodilation), the daily doses must be steadily increased to achieve the same effect. But increased doses will mean increased loss of minerals.
Everything considered, it is necessary to devise a clear and practicable treatment programme which yields the maximum effect with the minimum of risks and inconveniences.
Such a programme could look like this:
After having completed a 3-week basic plan of minerals and other nutrients, the nicotinic acid treatment begins. Set aside time - preferably 30-45 minutes in the morning or in the evening - to provoke hot flushes. Use either 30 mg. or 50 mg. tablets. Quite often half a tablet will induce the desired effect, especially if taken on an empty stomach. If the effect does not show up within 10-15 minutes, try with a larger dose.
The following day the effective dose is e.g. doubled to make sure that an equivalent effect is achieved. Continue to increase the dose steadily for an additional week or 10 days. After this, the levels of nicotinic acid that are reached are so high that the mineral loss in some patients - even those who take mineral supplements - surpasses the beneficial effect of the therapy. For this reason, take a week's break from nicotinic acid.
After this break it is possible to provoke a reaction once more with a relatively small dose. Repeat the whole sequence from the first period of treatment and take a break again after that.
One can continue with such alternating programmes through months or years without any kind of side effects. Using this pattern of treatment, one can reap large benefits from nicotinic acid treatment without running any risk of being surprised by any unexpected reactions.
It must be emphasized that the procedure outlined here takes aim at the advantages to be gained from hot flushes, dilation of the capillaries, and increased capillary blood circulation and with that improved energy supply and cleansing of the upper body's organs. But there are other therapeutic aims than these for which the procedure described here does not necessarily apply.
New slow releasing nicotinic acid drugs makes the administration of very large doses possible without the usual reactions. This has opened up new opportunities for the treatment of patients suffering from mental disorder, alcoholics and drug addicts, diabetics, and patients suffering from hypoglycaemia and hypertension. However, it is not possible as of yet to estimate exactly the effectiveness of new slow release drugs.
The release factor varies much from one drug to the next which may play a role for the total effect. It appears that many of the drugs, including those in which nicotinic acid is bound to calcium, are not quite as effective as pure nicotinic acid.
Other slow release drugs are amino acid compounds containing e.g. glycine. Their effect is quite different, and they appear to be more effective. These drugs make it possible to take up to severals grams of nicotinic acid daily on a regular basis without periodic interruptions.
For the treatment of high blood cholesterol, blood triglycerides and free fatty acids in the blood, doses of pure nicotinic acid up to 3 g. daily are necessary. Such doses reduce both LDL cholesterol and VLDL cholesterol and induce the formation of HDL cholesterol.
Some practitioners have administered doses up to 12 g. under strict clinical observation. This is unnecessary and cannot be recommended.
It is very important that one receives expert medical advice before starting such treatment.
Inositol hexanicotinate
Is sometimes also called inositol niacinate. It is quite a new nicotinic acid preparation consisting of niacin bound to inositol. It is slowly metabolized and for this reason does not cause the reddening of the skin which niacin can do. Inositol hexanicotinat is used to promote healthy cholesterol levels and good circulation.
Therpeutic dosage:
Generally: approximately 500 mg. - 1 g. a day
In case of cholesterol problems: approximately 2 g. a day.
In case of Raynaud's phenomenon and intermittent claudication: approximately 4 g. a day.
The dose should be spread out over the day.
Warning
Do not use therapeutic doses of vitamin B3 for longer periods of time if you suffer from liver disease.
Make sure that the vitamin is part of a program with other B vitamins.
