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100 Vegetarian Caplets

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Description
Supports a healthy blood lipid profile & blood vessel health*

* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Supplement Facts

A dietary supplement, take one caplet daily.

Serving Size 1 Caplet
Servings Per Container 100
Amount Per Serving % DV
Niacin (as Inositol Nicotinate) 500.00 mg 2500%
** Daily Value (DV) not established

Other Ingredients: Cellulose, Dicalcium Phosphate

No Sugar, No Starch, No Artificial Colors, No Artificial Flavors, No Preservatives, Sodium Free, No Wheat, No Gluten, No Corn, No Dairy, Yeast Free.

Warning: Keep out of reach of children.

Distributed by: General Nutrition Corporation Pittsburgh, PA 15222

Health Notes

Vitamin B3

Vitamin B3
This nutrient has been used in connection with the following health goals
  • Reliable and relatively consistent scientific data showing a substantial health benefit.
  • Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
  • For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary "Star-Rating" system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

This supplement has been used in connection with the following health conditions:

High Cholesterol
Dose: 1,500 to 3,000 mg daily under a doctor's supervision
High amounts (several grams per day) of niacin, a form of vitamin B3, have been shown to lower cholesterol.(more)
High Triglycerides
Dose: 500 mg three times per day
The niacin form of vitamin B3 is used by some doctors to lower triglycerides, however, the quantity needed to achieve reductions may cause side effects. Ask your doctor is niacin is right for you.(more)
Intermittent Claudication
Dose: 2 grams twice per day
Inositol hexaniacinate, a special form of vitamin B3, has been used successfully to reduce symptoms, this treatment should be monitored by a doctor.(more)
Atherosclerosis
Dose: 2,000 mg per day (only under a doctor's supervision)
In a preliminary trial, doctor-supervised supplementation with extended-release niacin in combination with a cholesterol-lowering statin drug appeared to reverse atherosclerosis of the carotid arteries (the arteries that supply blood to the brain).(more)
Peripheral Vascular Disease
Dose: 1,200 mg a day of inositol hexaniacinate
Vitamin B3 may help prevent and treat skin ulcers caused by peripheral vascular disease.(more)
Raynaud's Disease
Dose: 3 to 4 grams daily of inositol hexaniacinate
A variation on the B vitamin niacin, inositol hexaniacinate has been shown to reduce arterial spasm and improve peripheral circulation.(more)
High Cholesterol
Dose: 500 to 1,000 mg of inositol hexaniacinate three times daily under medical supervision
Inositol hexaniacinate, a special form of vitamin B3, has been reported to lower serum cholesterol, and apparently without the toxicity of high levels of niacin.(more)
High Triglycerides
Dose: 500 mg three times per day
Some doctors recommend inositol hexaniacinate (a special form of vitamin B3) as an alternative to niacin, which can have negative side effects.(more)
Osteoarthritis
Dose: Refer to label instructions
Supplemental niacinamide (a form of vitamin B3) has been reported to increase joint mobility, improve muscle strength, and decrease fatigue in people with osteoarthritis. (more)
Dysmenorrhea
Dose: 200 mg daily throughout menstrual cycle; for cramps: 100 mg every two to three hours
The niacin form of vitamin B3 has been reported to be effective in relieving menstrual cramps in 87% of a group of women supplementing with it throughout the menstrual cycle.(more)
Dysmenorrhea
Dose: 200 mg niacin daily, 300 mg vitamin C daily, and 60 mg rutin daily througout menstrual cycle; for cramps: 100 mg niacin every two to three hours
Supplementing with a combination of vitamin B3, vitamin C, and the flavonoid rutin resulted in a 90% effectiveness for relieving menstrual cramps in one study.(more)
Dysmenorrhea
Dose: 200 mg daily throughout menstrual cycle; for cramps: 100 mg every two to three hours
The niacin form of vitamin B3 has been reported to be effective in relieving menstrual cramps in 87% of a group of women supplementing with it throughout the menstrual cycle.(more)
Dysmenorrhea
Dose: 200 mg niacin daily, 300 mg vitamin C daily, and 60 mg rutin daily througout menstrual cycle; for cramps: 100 mg niacin every two to three hours
Supplementing with a combination of vitamin B3, vitamin C, and the flavonoid rutin resulted in a 90% effectiveness for relieving menstrual cramps in one study.(more)
Acne Vulgaris
Dose: Apply 4% gel twice per day
In a double-blind trial, applying a topical 4% niacinamide gel twice daily for two months significantly improved acne.(more)
Photosensitivity
Dose: Refer to label instructions
Niacinamide, a form of vitamin B3, can reduce the formation of a kynurenic acid-a substance that has been linked to photosensitivity.(more)
Dermatitis Herpetiformis
Dose: Refer to label instructions
Preliminary evidence indicates that, when drug therapy with dapsone is not tolerated, people may respond to a combination of tetracycline and nicotinamide (a form of vitamin B3).(more)
Type 1 Diabetes
Dose: Consult a qualified healthcare practitioner
Taking vitamin B3 (as niacin or niacinamide) might prevent or limit the severity of type 1 diabetes in your family.(more)
Type 2 Diabetes
Dose: Refer to label instructions
Small amounts of niacin (a form of vitamin B3) may help some people with type 2 diabetes.(more)
Hypoglycemia
Dose: Refer to label instructions
Research has shown that supplementing with niacinamide (vitamin B3) can prevent blood sugar levels from falling excessively in people with hypoglycemia.(more)
Schizophrenia
Dose: Consult a qualified healthcare practitioner
High amounts of vitamin B3 may create a more optimal biochemical environment and increase recovery rate and reduce hospitalization and suicide rates.(more)
Anxiety
Dose: Refer to label instructions
Niacinamide (a form of vitamin B3) has been shown in animals to work in the brain in ways similar to anxiety medications. One study found that niacinamide helped people get through withdrawal from benzodiazepines-a common problem.(more)
Anxiety
Dose: Refer to label instructions
Niacinamide (a form of vitamin B3) has been shown in animals to work in the brain in ways similar to anxiety medications. One study found that niacinamide helped people get through withdrawal from benzodiazepines-a common problem.(more)
Hypothyroidism
Dose: Refer to label instructions
Vitamin B3 (niacin) supplementation may decrease thyroid hormone levels.(more)
Cataracts
Dose: 40 mg daily with 3 mg daily vitamin B2
Vitamin B3 is needed to protect glutathione, an important antioxidant in the eye.(more)
HIV and AIDS Support
Dose: Refer to label instructions
Vitamin B3 may play a role in HIV prevention and treatment. A form of vitamin B3 (niacinamide) has been shown to inhibit HIV in test tube studies.(more)
High Cholesterol
Dose: 1,500 to 3,000 mg daily under a doctor's supervision

High amounts (several grams per day) of niacin, a form of vitamin B3, lower cholesterol, an effect recognized in the approval of niacin as a prescription medication for high cholesterol.1 The other common form of vitamin B3-niacinamide-does not affect cholesterol levels. Some niacin preparations have raised HDL cholesterol better than certain prescription drugs.2 Some cardiologists prescribe 3 grams of niacin per day or even higher amounts for people with high cholesterol levels. At such intakes, acute symptoms (flushing, headache, stomachache) and chronic symptoms (liver damage, diabetes, gastritis, eye damage, possibly gout) of toxicity may be severe. Many people are not able to continue taking these levels of niacin due to discomfort or danger to their health. Therefore, high intakes of niacin must only be taken under the supervision of a doctor.

Symptoms caused by niacin supplements, such as flushing, have been reduced with sustained-release (also called "time-release") niacin products. However, sustained-release forms of niacin have caused significant liver toxicity and, though rarely, liver failure.3, 4, 5, 6, 7 One partial time-release (intermediate-release) niacin product has lowered LDL cholesterol and raised HDL cholesterol without flushing, and it also has acted without the liver function abnormalities typically associated with sustained-release niacin formulations.8 However, this form of niacin is available by prescription only.

References

1. Brown WV. Niacin for lipid disorders. Postgrad Med 1995;98:185-93 [review].

2. Guyton JR, Blazing MA, Hagar J, et al. Extended-release niacin vs gemfibrozil for the treatment of low levels of high-density lipoprotein cholesterol. Niaspan-Gemfibrozil Study Group. Arch Intern Med 2000;160:1177-84.

3. McKenney JM, Proctor JD, Harris S, Chinchili VM. A comparison of the efficacy and toxic effects of sustained-vs immediate-release niacin in hypercholesterolemic patients. JAMA 1994;271:672-7.

4. Knopp RH, Ginsberg J, Albers JJ, et al. Contrasting effects of unmodified and time-release forms of niacin on lipoproteins in hyperlipidemic subjects: clues to mechanism of action of niacin. Metabolism 1985;34:642-50.

5. Gray DR, Morgan T, Chretien SD, Kashyap ML. Efficacy and safety of controlled-release niacin in dyslipoproteinemic veterans. Ann Intern Med 1994;121:252-8.

6. Rader JI, Calvert RJ, Hathcock JN. Hepatic toxicity of unmodified and time-release preparations of niacin. Am J Med 1992;92:77-81 [Review].

7. Knopp RH. Niacin and hepatic failure. Ann Intern Med 1989;111:769 [letter].

8. Goldberg A, Alagona P Jr, Capuzzi DM, et al. Multiple-dose efficacy and safety of an extended-release form of niacin in the management of hyperlipidemia. Am J Cardiol 2000;85:1100-5.

High Triglycerides
Dose: 500 mg three times per day

The niacin form of vitamin B3 is used by doctors to lower cholesterol levels, but niacin also lowers TG levels.1 The amount of niacin needed to achieve worthwhile reductions in cholesterol and TG levels is several grams per day. Such quantities can cause side effects, including potential damage to the liver, and should not be taken without the supervision of a doctor. Some doctors recommend inositol hexaniacinate (a special form of vitamin B3) as an alternative to niacin. A typical amount recommended is 500 mg three times per day.2, 3 This form of vitamin B3 does not typically cause a skin flush and is said to be safer for the liver than niacin. However, the alleged safety advantage of inositol hexaniacinate needs to be confirmed by additional clinical trials. Moreover, it is not clear whether inositol hexaniacinate is as effective as niacin at lowering cholesterol and TG levels.

References

1. Brown WV. Niacin for lipid disorders. Postgrad Med 1995;98:183-93 [review].

2. Head KA. Inositol hexaniacinate: a safer alternative to niacin. Alt Med Rev 1996;1:176-84 [review].

3. Murray M. Lipid-lowering drugs vs. Inositol hexaniacinate. Am J Natural Med 1995;2:9-12 [review].

Intermittent Claudication
Dose: 2 grams twice per day

Inositol hexaniacinate (IHN), a special form of vitamin B3, has been used successfully to treat intermittent claudication. The alleged advantage of IHN over niacin (another form of vitamin B3) is a lower risk of toxicity. A double-blind trial explored the effect of 2 grams of IHN taken twice per day for three months.1 In nonsmokers and in people with unchanged smoking habits, the increase in walking distance was significantly greater in the IHN group than in the placebo group. Other double-blind research has confirmed IHN's ability to improve symptoms of intermittent claudication compared with placebo.2 This treatment should be monitored by a doctor.

References

1. Kiff RS, Wuick CRG. Does inositol nicotinate (Hexopal) influence intermittent claudication?-a controlled trial. Br J Clin Pract 1988;42:141-5.

2. O'Hara J, Jolly PN, Nicol CG. The therapeutic efficacy of inositol nicotinate (Hexopal) in intermittent claudication: a controlled trial. Br J Clin Pract 1988;42:377-83.

Atherosclerosis
Dose: 2,000 mg per day (only under a doctor's supervision)Niacin is known to reduce serum cholesterol levels and to increase levels of HDL ("good") cholesterol. In a preliminary trial, supplementation with extended-release niacin, when used in combination with a cholesterol-lowering statin drug, appeared to reverse atherosclerosis of the carotid arteries (the arteries that supply blood to the brain). The combination of a statin drug and niacin was significantly more effective than a statin drug combined with a second cholesterol-lowering drug (ezetimibe). In addition, the statin-niacin combination was associated with a significant reduction in the number of major cardiovascular event (such as myocardial infarction or death from coronary heart disease). Niacin was used in this study in amounts up to 2,000 mg per day.1 These large amounts of niacin have the potential to cause side effects, including liver damage, and should be taken only with the supervision of a doctor.
References

1. Taylor AJ, Villines TC, Stanek EJ, et al. Extended-release niacin or ezetimibe and carotid intima-media thickness. N Engl J Med 2009 [E-pub ahead of print].

Peripheral Vascular Disease
Dose: 1,200 mg a day of inositol hexaniacinate

One controlled study compared a type of niacin (vitamin B3) known as inositol hexaniacinate to the drug pyridinolcarbamate for the treatment of skin ulcers caused by PVD.1 A placebo was not included in this trial, and both 1.2 grams daily of inositol hexaniacinate and 1.5 grams daily of the drug produced beneficial results in about half of the patients.

References

1. Mishima Y, Kamiya K, Sakaguchi S, et al. A multiclinic double-blind trial of pyridinolcarbamate and inositol niacinate in ischemic ulcer due to chronic arterial occlusion. Angiology 1977;28:84-94.

Raynaud's Disease
Dose: 3 to 4 grams daily of inositol hexaniacinate has been used with some success for relieving symptoms of Raynaud's disease.1 In one study, 30 people with Raynaud's disease taking 4 grams of inositol hexaniacinate each day for three months showed less spasm of their arteries.2 Another study, involving six people taking 3 grams per day of inositol hexaniacinate, again showed that this supplement improved peripheral circulation.3 People taking this supplement in these amounts should be under the care of a doctor.
References

1. Aylward M. Hexopal in Raynaud's disease. J Int Med Res 1979;7:484-91.

2. Holti G. An experimentally controlled evaluation of the effect of inositol nicotinate upon the digital blood flow in patients with Raynaud's phenomenon. J Int Med Res 1979;7:473-83.

3. Ring EF, Bacon PA. Quantitative thermographic assessment of inositol nicotinate therapy in Raynaud's phenomenon. J Int Med Res 1977;5:217-22.

High Cholesterol
Dose: 500 to 1,000 mg of inositol hexaniacinate three times daily under medical supervisionIn an attempt to avoid the side effects of niacin, alternative health practitioners increasingly use inositol hexaniacinate, recommending 500 to 1,000 mg, taken three times per day, instead of niacin.1, 2 This special form of niacin has been reported to lower serum cholesterol but so far has not been found to cause significant toxicity.3 Unfortunately, compared with niacin, far fewer investigations have studied the possible positive or negative effects of inositol hexaniacinate. As a result, people using inositol hexaniacinate should not take it without the supervision of a doctor, who will evaluate whether it is helpful (by measuring cholesterol levels) and will make sure that toxicity is not occurring (by measuring liver enzymes, uric acid and glucose levels, and by taking medical history and doing physical examinations).
References

1. Head KA. Inositol hexaniacinate: a safer alternative to niacin. Alt Med Rev 1996;1:176-84 [review].

2. Murray M. Lipid-lowering drugs vs. Inositol hexaniacinate. Am J Natural Med 1995;2:9-12 [review].

3. Dorner Von G, Fisher FW. Zur Beinflussung der Serumlipide und-lipoproteine durch den Hexanicotinsaureester des m-Inositol. Arzneimittel Forschung 1961;11:110-3.

High Triglycerides
Dose: 500 mg three times per dayThe niacin form of vitamin B3 is used by doctors to lower cholesterol levels, but niacin also lowers TG levels. The amount of niacin needed to achieve worthwhile reductions in cholesterol and TG levels1 is several grams per day. Such quantities can cause side effects, including potential damage to the liver, and should not be taken without supervision of a doctor. Some doctors recommend inositol hexaniacinate (a special for of vitamin B3) as an alternative to niacin. A typical amount recommended is 500 mg three times per day.2, 3 This form of vitamin B3 does not typically cause a skin flush and is said to be safer for the liver than niacin. However, the alleged safety advantage of inositol hexaniacinate needs to be confirmed by addition clinical trials. Moreover, it is not clear whether inositol hexaniacinate is as effective as niacin at lowering cholesterol and TG levels.
References

1. Brown WV. Niacin for lipid disorders. Postgrad Med 1995;98:183-93 [review].

2. Head KA. Inositol hexaniacinate: a safer alternative to niacin. Alt Med Rev 1996;1:176-84 [review].

3. Murray M. Lipid-lowering drugs vs. Inositol hexaniacinate. Am J Natural Med 1995;2:9-12 [review].

Osteoarthritis
Dose: Refer to label instructions

In the 1940s and 1950s, one doctor reported that supplemental niacinamide (a form of vitamin B3) increased joint mobility, improved muscle strength, and decreased fatigue in people with osteoarthritis.1, 2, 3 In the 1990s, a double-blind trial confirmed a reduction in symptoms from niacinamide within 12 weeks of beginning supplementation.4 Although amounts used have varied from trial to trial, many doctors recommend 250 to 500 mg of niacinamide four or more times per day (with the higher amounts reserved for people with more advanced arthritis). The mechanism by which niacinamide reduces symptoms is not known.

References

1. Kaufman W. The use of vitamin therapy for joint mobility. Therapeutic reversal of a common clinical manifestation of the 'normal' aging process. Conn State Med J 1953;17(7):584-9.

2. Kaufman W. The use of vitamin therapy to reverse certain concomitants of aging. J Am Geriatr Soc 1955;3:927-36.

3. Hoffer A. Treatment of arthritis by nicotinic acid and nicotinamide. Can Med Assoc J 1959;81:235-8.

4. Jonas WB, Rapoza CP, Blair WF. The effect of niacinamide on osteoarthritis: a pilot study. Inflamm Res 1996;45:330-4.

Dysmenorrhea
Dose: 200 mg daily throughout menstrual cycle; for cramps: 100 mg every two to three hours

The niacin form of vitamin B3 has been reported to be effective in relieving menstrual cramps in 87% of a group of women taking 200 mg of niacin per day throughout the menstrual cycle. They then took 100 mg every two or three hours while experiencing menstrual cramps.1 In a follow-up study, this protocol was combined with 300 mg of vitamin C and 60 mg of the flavonoid rutin per day, which resulted in a 90% effectiveness for relieving menstrual cramps.2 Since these two preliminary studies were published many years ago, no further research has explored the relationship between niacin and dysmenorrhea. Niacin may not be effective unless taken for seven to ten days before the onset of menstrual flow.

References

1. Hudgins AP. Am Practice Digest Treat 1952;3:892-3.

2. Hudgins AP. Vitamins P, C and niacin for dysmenorrhea therapy. West J Surg 1954;Dec:610-1.

Dysmenorrhea
Dose: 200 mg niacin daily, 300 mg vitamin C daily, and 60 mg rutin daily througout menstrual cycle; for cramps: 100 mg niacin every two to three hoursThe niacin form of vitamin B3 has been reported to be effective in relieving menstrual cramps in 87% of a group of women taking 200 mg of niacin per day throughout the menstrual cycle.1 They then took 100 mg every two or three hours while experiencing menstrual cramps.2 In a follow-up study, this protocol was combined with 300 mg of vitamin C and 60 mg of the flavonoid rutin per day, which resulted in a 90% effectiveness for relieving menstrual cramps. Since these two preliminary studies were published many years ago, no further research has explored the relationship between niacin and dysmenorrhea. Niacin may not be effective unless taken for seven to ten days before the onset of menstrual flow.
References

1. Hudgins AP. Am Practice Digest Treat 1952;3:892-3.

2. Hudgins AP. Vitamins P, C and niacin for dysmenorrhea therapy. West J Surg 1954;Dec:610-1.

Dysmenorrhea
Dose: 200 mg daily throughout menstrual cycle; for cramps: 100 mg every two to three hours

The niacin form of vitamin B3 has been reported to be effective in relieving menstrual cramps in 87% of a group of women taking 200 mg of niacin per day throughout the menstrual cycle. They then took 100 mg every two or three hours while experiencing menstrual cramps.1 In a follow-up study, this protocol was combined with 300 mg of vitamin C and 60 mg of the flavonoid rutin per day, which resulted in a 90% effectiveness for relieving menstrual cramps.2 Since these two preliminary studies were published many years ago, no further research has explored the relationship between niacin and dysmenorrhea. Niacin may not be effective unless taken for seven to ten days before the onset of menstrual flow.

References

1. Hudgins AP. Am Practice Digest Treat 1952;3:892-3.

2. Hudgins AP. Vitamins P, C and niacin for dysmenorrhea therapy. West J Surg 1954;Dec:610-1.

Dysmenorrhea
Dose: 200 mg niacin daily, 300 mg vitamin C daily, and 60 mg rutin daily througout menstrual cycle; for cramps: 100 mg niacin every two to three hoursThe niacin form of vitamin B3 has been reported to be effective in relieving menstrual cramps in 87% of a group of women taking 200 mg of niacin per day throughout the menstrual cycle.1 They then took 100 mg every two or three hours while experiencing menstrual cramps.2 In a follow-up study, this protocol was combined with 300 mg of vitamin C and 60 mg of the flavonoid rutin per day, which resulted in a 90% effectiveness for relieving menstrual cramps. Since these two preliminary studies were published many years ago, no further research has explored the relationship between niacin and dysmenorrhea. Niacin may not be effective unless taken for seven to ten days before the onset of menstrual flow.
References

1. Hudgins AP. Am Practice Digest Treat 1952;3:892-3.

2. Hudgins AP. Vitamins P, C and niacin for dysmenorrhea therapy. West J Surg 1954;Dec:610-1.

Acne Vulgaris
Dose: Apply 4% gel twice per dayIn a double-blind trial, topical application of a 4% niacinamide gel twice daily for two months resulted in significant in improvement in people with acne.1 However, there is little reason to believe this vitamin would have similar actions if taken orally.
References

1. Shality AR, Smith JR, Parish LC, et al. Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris. Internat J Dermatol 1995;34:434-7.

Photosensitivity
Dose: Refer to label instructions

Niacinamide, a form of vitamin B3, can reduce the formation of a kynurenic acid-a substance that has been linked to photosensitivity. One trial studied the effects of niacinamide in people who had polymorphous light eruption.1 While taking one gram three times per day, most people remained free of problems, despite exposure to the sun. Because of the potential for adverse effects, people taking this much niacinamide should do so only under medical supervision.

References

1. Neumann R, Rappold E, Pohl-Markl H. Treatment of polymorphous light eruption with nicotinamide: a pilot study. Br J Dermatol 1986;115:77-80.

Dermatitis Herpetiformis
Dose: Refer to label instructions
Type 1 Diabetes
Dose: Consult a qualified healthcare practitioner

Taking large amounts of niacin (a form of vitamin B3), such as 2 to 3 grams per day, may impair glucose tolerance and should be used by people with diabetes only with medical supervision.1, 2

Some clinical trials have shown that niacinamide (another form of vitamin B3) supplementation might be useful in the very early stages of type 1 diabetes,3 though not all trials support this claim.4, 5, 6 Although an analysis of research shows that niacinamide does help preserve some function of insulin-secreting cells in people recently diagnosed with type 1 diabetes, the amount of insulin required for those given niacinamide has remained essentially as high as for those given placebo.7 A controlled trial found no beneficial effect of niacinamide supplementation (700 mg three times per day in addition to intensive insulin therapy) on pancreatic function and glucose tolerance in people newly diagnosed with type 1 diabetes.8

Some,9 but not all,10 reports suggest that healthy children at high risk for type 1 diabetes (such as the healthy siblings of children with type 1 diabetes) may be protected from the disease by supplementing with niacinamide. Parents of children with type 1 diabetes should consult their doctor regarding niacinamide supplementation as a way to prevent diabetes in their other children. Although the optimal amount of niacinamide is not known, recent evidence suggests that 25 mg per 2.2 pounds of body weight per day may be as effective as higher amounts.11

References

1. Molnar GD, Berge KG, Rosevear JW, et al. The effect of nicotinic acid in diabetes mellitus. Metabolism 1964;13:181-9.

2. Gaut ZN, Pocelinko R, Solomon HM, Thomas GB. Oral glucose tolerance, plasma insulin, and uric acid excretion in man during chronic administration in nicotinic acid. Metabolism 1971;20:1031-5.

3. Clearly JP. Vitamin B3 in the treatment of diabetes mellitus: case reports and review of the literature. J Nutr Med 1990;1:217-25.

4. Lewis CM, Canafax DM, Sprafka JM, Bazrbosa JJ. Double-blind randomized trail of nicotinamide on early-onset diabetes. Diabetes Care 1992;15:121-3.

5. Chase HP, Butler-Simon N, Garg S, et al. A trial of nicotinamide in newly diagnosed patients with type 1 (insulin-dependent) diabetes mellitus. Diabetologia1990;33:444-6.

6. Mendola G, Casamitjana R, Gomis R. Effect of nicotinamide therapy upon B-cell function in newly diagnosed type 1 (insulin-dependent) diabetic patients. Diabetologia1989;32:160-2.

7. Pozzilli P, Browne PD, Kolb H. Meta-analysis of nicotinamide treatment in patients with recent-onset type 1. The nicotinamide trialists. Diabetes Care 1996;19:1357-63.

8. Vidal J, Fernandez-Balsells M, Sesmilo G, Aguilera E. Effects of nicotinamide and intravenous insulin therapy in newly diagnosed type 1 diabetes. Diabetes Care 2000;23:360-4.

9. Elliott RB, Picher CC, Fergusson DM, Stewart AW. A population based strategy to prevent insulin-dependent diabetes using nicotinamide. J Pediatr Endocrinol Metab 1996;9:501-9.

10. Lampeter EF, Klinghammer A, Scherbaum WA, et al. The Deutsche Nicotinamide Intervention Study. An attempt to prevent type 1 diabetes. Diabetes1998;47:980-4.

11. Visalli N, Cavallo MG, Signore A, et al. A multi-centre randomized trial of two different doses of nicotinamide in patients with recent-onset type 1 diabetes (The IMDIAB VI). Diabetes Metab Res Rev 1999;15:181-5.

Type 2 Diabetes
Dose: Refer to label instructionsThe intake of large amounts of niacin (a form of vitamin B3), such as 2 to 3 grams per day, may impair glucose tolerance and should be used by people with diabetes only with medical supervision.1, 2 Smaller amounts (500 to 750 mg per day for one month followed by 250 mg per day) may help some people with type 2 diabetes,3 though this research remains preliminary.
References

1. Molnar GD, Berge KG, Rosevear JW, et al. The effect of nicotinic acid in diabetes mellitus. Metabolism 1964;13:181-9.

2. Gaut ZN, Pocelinko R, Solomon HM, Thomas GB. Oral glucose tolerance, plasma insulin, and uric acid excretion in man during chronic administration in nicotinic acid. Metabolism 1971;20:1031-5.

3. Clearly JP. The importance of oxidant injury as a cause of impaired mitochondrial oxidation in diabetes. J Orthomolec Med 1988;3:164-74.

Hypoglycemia
Dose: Refer to label instructions

Research has shown that supplementing with chromium (200 mcg per day)1 or magnesium (340 mg per day)2 can prevent blood sugar levels from falling excessively in people with hypoglycemia. Niacinamide (vitamin B3) has also been found to be helpful for hypoglycemic people.3 Other nutrients, including vitamin C, vitamin E, zinc, copper, manganese, and vitamin B6, may help control blood sugar levels in diabetics.4 Since there are similarities in the way the body regulates high and low blood sugar levels, these nutrients might be helpful for hypoglycemia as well, although the amounts needed for that purpose are not known.

References

1. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471.

2. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131-4.

3. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68-69,104-5.

4. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57-71.

Schizophrenia
Dose: Consult a qualified healthcare practitioner

The term "orthomolecular psychiatry" was coined by Linus Pauling in 1968 to refer to the treatment of psychiatric illnesses with substances (such as vitamins) that are normally present in the body. In orthomolecular psychiatry, high amounts of vitamins are sometimes used, not to correct a deficiency per se, but to create a more optimal biochemical environment. The mainstay of the orthomolecular approach to schizophrenia is niacin or niacinamide (vitamin B3) in high amounts. In early double-blind trials, 3 grams of niacin daily resulted in a doubling of the recovery rate, a 50% reduction in hospitalization rates, and a dramatic reduction in suicide rates.1 In a preliminary trial, some schizophrenic patients continued a course of vitamins (4 to 10 grams of niacin or niacinamide, 4 grams of vitamin C, and 50 mg or more of vitamin B6) after being discharged from the hospital, while another group of patients discontinued the vitamins upon discharge. Both groups continued to take their psychiatric medications. Those who continued to take the vitamins had a 50% lower re-admission rate compared with those who did not.2 Several later double-blind trials, including trials undertaken by the Canadian Mental Health Association, have been unable to reproduce these positive results.3, 4 Early supporters of niacin therapy contend that many of these trials were poorly designed.5 One clinical trial reported no greater improvement in a group of schizophrenic patients given 6 grams of niacin than in others given 3 mg of niacin; all patients were also being treated with psychiatric medications.6

There are potential side-effects of niacin therapy, including an uncomfortable flushing sensation, dermatitis (skin inflammation), heartburn, aggravation of peptic ulcers, increased blood sugar, increased panic and anxiety, and elevation of liver enzymes, which may indicate damage to liver cells. A positive side effect of niacin therapy is reduction of cholesterol levels. Some of these effects, such as flushing, gastric upset, and reduction of serum cholesterol, do not occur with the use of niacinamide.7 Because of the seriousness of some of these side effects, high amounts of niacin should not be used without the supervision of a healthcare practitioner.

Vitamin B6 has been used in combination with niacin in the orthomolecular approach to schizophrenia. Pioneers of orthomolecular medicine reported benefits from this combination. However, although two placebo-controlled trials found significant improvement when schizophrenic patients were given either 3 grams of niacin or 75 mg of pyridoxine along with their psychiatric medications, this improvement was lost when the two vitamins were combined.8, 9 In a double-blind trial, schizophrenic patients were given either a vitamin program based on their individual laboratory tests or a placebo (25 mg of vitamin C) in addition to their psychiatric medications. The vitamin program included large amounts of various B vitamins, as well as vitamin C and vitamin E. After five months, the number of patients who improved was not different in the vitamin group compared with the placebo group.10

Clinical trials of the effects of vitamin B6 have yielded differing results. The results of supplementation with 100 mg daily in one schizophrenic patient included dramatic reduction in side effects from medication, as well as reduction in schizophrenic symptoms.11 In a preliminary trial, 60 mg per day of vitamin B6 resulted in symptomatic improvement in only 5% of schizophrenic patients after four weeks.12 Another preliminary trial, however, found that a higher amount of vitamin B6-50 mg three times daily given for eight to twelve weeks-in addition to psychiatric medications, did bring about significant improvements in schizophrenic patients. These patients experienced a better sense of well-being, increased motivation, and greater interest in their "personal habits and their environment."13

References

1. Hawkins DR, Bortin AW, Runyon RP. Orthomolecular psychiatry: niacin and megavitamin therapy. Psychosomatics 1970;11:517-21 [review].

2. Hawkins DR, Bortin AW, Runyon RP. Orthomolecular psychiatry: niacin and megavitamin therapy. Psychosomatics 1970;11:517-21 [review].

3. Autry JH. Workshop on orthomolecular treatment of schizophrenia: a report. Schizophr Bull 1975:94-103.

4. Petrie WM, Ban TA. Vitamins in psychiatry. Do they have a role? Drugs 1985;30:58-65 [review].

5. Hoffer A. Megavitamin B-3 therapy for schizophrenia. Can Psychiatr Assoc J 1971;16:499-504.

6. Wittenborn JR, Weber ES, Brown M. Niacin in the long-term treatment of schizophrenia. Arch Gen Psychiatry 1973;28:308-15.

7. Newbold HL, Mosher LR. Niacin and the schizophrenic patient. Am J Psychiatry 1970;127:535-6.

8. Petrie WM, Ban TA, Ananth JV. The use of nicotinic acid and pyridoxine in the treatment of schizophrenia. IntPharmacopsychiatry 1981;16:245-50.

9. Ananth JV, Ban TA, Lehmann HE. Potentiation of therapeutic effects of nicotinic acid by pyridoxine in chronic schizophrenics. Can Psychiatr Assoc J 1973;18:377-83.

10. Vaughan K, McConaghy N. Megavitamin and dietary treatment in schizophrenia: a randomised, controlled trial. Aust N Z J Psychiatry 1999;33:84-8.

11. Sandyk R, Pardeshi R. Pyridoxine improves drug-induced parkinsonism and psychosis in a schizophrenic patient. Int J Neurosci 1990;52:225-32.

12. Yamauchi M. Effects of L-dopa and vitamin B6 on electroencephalograms of schizophrenic patients: a preliminary report. Folia Psychiatr Neurol Jpn 1976;30:121-51.

13. Bucci L. Pyridoxine and schizophrenia. Br J Psychiatry 1973;122:240 [letter].

Anxiety
Dose: Refer to label instructions

Niacinamide (a form of vitamin B3) has been shown in animals to work in the brain in ways similar to drugs such as benzodiazepines (Valium-type drugs), which are used to treat anxiety.1 One study found that niacinamide (not niacin) helped people get through withdrawal from benzodiazepines-a common problem.2 A reasonable amount of niacinamide to take for anxiety, according to some doctors, is up to 500 mg four times per day.

References

1. Mohler H, Polc P, Cumin R, et al. Niacinamide is a brain constituent with benzodiazepine-like actions. Nature 1979;278:563-5.

2. Vescovi PP, et al. Nicotinic acid effectiveness in the treatment of benzodiazepine withdrawal. Curr Ther Res 1987;41:1017.

Anxiety
Dose: Refer to label instructions

Niacinamide (a form of vitamin B3) has been shown in animals to work in the brain in ways similar to drugs such as benzodiazepines (Valium-type drugs), which are used to treat anxiety.1 One study found that niacinamide (not niacin) helped people get through withdrawal from benzodiazepines-a common problem.2 A reasonable amount of niacinamide to take for anxiety, according to some doctors, is up to 500 mg four times per day.

References

1. Mohler H, Polc P, Cumin R, et al. Niacinamide is a brain constituent with benzodiazepine-like actions. Nature 1979;278:563-5.

2. Vescovi PP, et al. Nicotinic acid effectiveness in the treatment of benzodiazepine withdrawal. Curr Ther Res 1987;41:1017.

Hypothyroidism
Dose: Refer to label instructions

Preliminary data indicate that vitamin B3 (niacin) supplementation may decrease thyroid hormone levels. In one small study, 2.6 grams of niacin per day helped lower blood fat levels.1 After a year or more, thyroid hormone levels had fallen significantly in each person, although none experienced symptoms of hypothyroidism. In another case report, thyroid hormone levels decreased in two people who were taking niacin for high cholesterol and triglycerides; one of these two was diagnosed with hypothyroidism.2 When the niacin was discontinued for one month, thyroid hormone levels returned to normal.

References

1. Shakir KMM, Kroll S, Aprill BS, et al. Nicotinic acid decreases serum thyroid hormone levels while maintaining a euthyroid state. Mayo Clin Proc 1995;70:556-8.

2. O'Brien T, Silverberg JD, Nguyen TT. Nicotinic acid-induced toxicity associated with cytopenia and decreased levels of thyroxine-binding globulin. Mayo Clin Proc 1992;67:465-8.

Cataracts
Dose: 40 mg daily with 3 mg daily vitamin B2

People with low blood levels of antioxidants and those who eat few antioxidant-rich fruits and vegetables have been reported to be at high risk for cataracts.1, 2

Vitamin B2 and vitamin B3 are needed to protect glutathione, an important antioxidant in the eye. Vitamin B2 deficiency has been linked to cataracts.3, 4 Older people taking 3 mg of vitamin B2 and 40 mg of vitamin B3 per day were partly protected against cataracts in one trial.5 However, the intake of vitamin B2 in China is relatively low, and it is not clear whether supplementation would help prevent cataracts in populations where vitamin B2 intake is higher.

References

1. Jacques PF, Chylack LT Jr. Epidemiologic evidence of a role for the antioxidant vitamins and carotenoids in cataract prevention. Am J Clin Nutr 1991;53:352S-5S.

2. Knekt P, Heliovaara M, Rissanen A, et al. Serum antioxidant vitamins and risk of cataract. BMJ 1992;305:1392-4.

3. Bhat KS. Nutritional status of thiamine, riboflavin and pyridoxine in cataract patients. Nutr Rep Internat 1987;36:685-92.

4. Prchal JT, Conrad ME, Skalka HW. Association of presenile cataracts with heterozygosity for galactosaemic states and with riboflavin deficiency. Lancet 1978; 1:12-3.

5. Sperduto RD, Hu TS, Milton RC, et al. The Linxian cataract studies. Arch Ophthalmol 1993;111:1246-53.

HIV and AIDS Support
Dose: Refer to label instructions

Preliminary observations suggest a possible role for vitamin B3 in HIV prevention and treatment.1 A form of vitamin B3 (niacinamide) has been shown to inhibit HIV in test tube studies.2 However, no published data have shown vitamin B3 to inhibit HIV in animals or in people. One study did show that HIV-positive people who consume more than 64 mg of vitamin B3 per day have a decreased risk of progression to AIDS or AIDS-related death.3, 4 Clinical trials in humans are required to validate these preliminary observations.

References

1. Murray MF. Niacin as a potential AIDS preventive factor. Med Hypotheses 1999;53:375-9.

2. Murray MF, Srinivasan A. Nicotinamide inhibits HIV-1 in both acute and chronic in vitro infection. Biochem Biophys Res Commun 1995;210:954-9.

3. Tang AM, Graham NMH, Saah AJ. Effects of micronutrient intake on survival in human immunodeficiency type 1 infection. Am J Epidemiol 1996;143:1244-56.

4. Tang AM, Graham NMH, Saah AJ. Effects of micronutrient intake on survival in human immunodeficiency type 1 infection. Am J Epidemiol 1996;143:1244-56.

The body uses the water-soluble vitamin B3 in the process of releasing energy from carbohydrates. It is needed to form fat from carbohydrates and to process alcohol. The niacin form of vitamin B3 also regulates cholesterol, though niacinamide does not.

Copyright 2014 Aisle7. All rights reserved. Aisle7.com

The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2015.

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