Niacin: The Most Powerful Nutrient Medicine for Mental Disorders
What is niacin (vitamin B3)?
Niacin (vitamin B3) is a water-soluble nutrient currently categorized as a B vitamin. Although vitamin B3 is present in certain foods, one of the main ways that humans receive this vitamin is through the conversion of tryptophan to niacin via the kynurenine pathway. As such, although niacin is usually referred to as a vitamin, technically it doesn’t fit the profile of a vitamin, since it can be produced naturally in the body from other nutrients. In any case, throughout this article I use the terms niacin and vitamin B3 interchangeably since both of these are well-known and commonly accepted.Vitamin B3 deficiency is known as pellagra, and the symptoms of this deficiency disease include the “4 D’s”: dementia, diarrhea, dermatitis, and death. Formal pellagra is relatively uncommon, but even a minor B3 deficiency, or the presence of a vitamin B3 dependency (which I talk more about below in the section about niacin and schizophrenia), can lead to the development of dementia, diarrhea, and/or dermatitis. A deficiency of tryptophan can also cause pellagra symptoms since tryptophan is the main source of vitamin B3 production in the body.
Other common symptoms of vitamin B3 deficiency may include these:
- Nausea
- Skin and mouth lesions
- Anemia
- Headaches
- Mental confusion
- Fatigue and tiredness
Niacin Therapy for ADHD and Learning Disorders
Vitamin B3 may be used therapeutically as a treatment for severe ADHD symptoms and for learning and/or behavioral disorders. Since the 1960s, more than 1500 cases of children with learning/behavioral disorders have been found to dramatically improve with the use of high-dose niacin therapy. In one case report of a 7-year-old boy who received niacinamide at a dose of 1000mg given 3 times per day, niacin therapy completely resolved the boy’s inability to read and concentrate, as well as serious behavioral problems, within only 4 months of starting the niacin protocol. The boy later went on to graduate high school, get married, and be fully employed.
Niacin Therapy for Schizophrenia, Psychotic Disorders, and Bipolar Disorder
One of the most famous uses of niacin therapy is in the treatment of schizophrenia, as well as for other psychotic disorders like schizoaffective disorder, delusional disorder, and others. These conditions are considered to be niacin dependent disorders, rather than niacin deficient disorders. Pellagra is a niacin deficiency, while schizophrenia is a niacin dependency; the symptoms of these two conditions are remarkably similar, yet a person with pellagra needs only a small to moderate amount of niacin in order to recover, while a schizophrenic needs much higher doses and will likely need to take niacin for many years (or even the rest of their lives) in order to maintain health.Research suggests that schizophrenia patients, and other people with conditions like bipolar disorder and psychosis, may have genetic variations that necessitate megadoses of niacin. Specifically, polymorphism in the HM74 and HM74A genes means that patients with psychotic disorders need more niacin in order for their brains and nervous systems to function correctly. The HM74 and HM74A genes produce G-coupled niacin responsive receptors, and the low number of HM74A receptors specifically that’s seen in patients with psychosis may mean that more niacin is needed throughout the day than in the average person.
It’s also worth noting that patients with schizophrenia flush significantly less in response to high-dose niacin treatment than normal, healthy patients. This decreased flush response indicates a potential genetic error that may inhibit the conversion of the amino acid tryptophan to NAD (nicotinamide adenine dinucleotide).
Another way through with high-dose niacin therapy works to treat schizophrenia and other psychotic disorders is through the reduction of adrenochrome production in the brain. Adrenochrome is an oxidized byproduct of adrenaline, and has LSD-like effects on the body when present in high enough quantities. Adrenochrome reduction through high-dose niacin treatments therefore can reduce schizophrenia symptoms such as paranoia and hallucinations in particular.
Niacin is also known to be an antihistamine, and thus can work to treat psychosis by reducing allergic reactions in the brain. Some experts also believe that schizophrenia and other related conditions may be caused, at least partially, by “cerebral allergies”. These cerebral allergies are most widely accepted to be caused by certain foods, such as high sugar foods, commercial wheat products, beef and cow’s milk, and junk foods in general. Cerebral allergies may cause symptoms like:
- Learning disabilities
- Coordination deficits
- Abnormal EEG scores
- Speech impairment and other neurological issues
- Short attention span
- Impulsivity
- Hyperkinesis
- Extreme mood swings
- Perceptual motor deficits
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Niacin Therapy for Autism
High-dose niacin therapy may also be effective in the treatment of autism in children and adults, especially in cases where ASD is accompanied by other conditions like depression/anxiety, chronic fatigue, psychotic disorders, migraines, or skin problems.One study found that pediatric patients with autism spectrum disorder, schizophrenia, bipolar disorder, and depressive disorder all exhibited a decreased flushing response when given a dose of niacin that would normally produce a flush. The children with autism exhibited a response that was closer to that seen in the healthy control subjects in the study, but nevertheless, the flushing response in the ASD patients was still decreased in comparison. As we already discussed above in the section about niacin for schizophrenia, this decreased flushing response suggests a potential genetic abnormality in specific niacin-responsive receptors in the brain. Thus, this particular study indicates that high-dose niacin therapy may have similarly positive effects in treating autism, since autistic individuals may be somewhat niacin dependent.
Some research indicates that 2-weeks of supplementation with NADH, the active form of vitamin B3, improved glutathione levels, NADH levels, and ribose levels, as well as methylation in patients with autism. ASD symptoms didn’t improve over the course of 2 weeks of treatment, however longer term supplementation with NADH (or niacin) may have beneficial effects on symptoms, especially when combined with other essential nutrient therapies. High-dose niacin therapy may have similar benefits in terms of increasing glutathione levels and improving methylation ability in autistic patients since niacin is converted to NADH in the body.
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Niacin Treatment for Alcoholism and Substance Abuse
Niacin is an ideal supplement to include in any natural treatment protocol for alcoholism or substance abuse, including for addiction to tobacco. In fact, one of the co-founders of Alcoholics Anonymous, Bill Wilson, first administered niacin successfully to both himself and AA group members suffering from fatigue, depression, anxiety, tension, and other similar symptoms. Wilson found that 3000mg of niacin taken daily dramatically reduced or entirely eliminated these symptoms in recovering alcoholics within just 1-2 months of treatment. Dr. Abram Hoffer, an expert in high-dose niacin therapy, found this nutrient therapy to be especially useful in the treatment of schizophrenia coupled with alcoholism, and has been found to have a 90% success rate in treating alcoholic, schizophrenic patients.Niacin therapy has also been used to treat delirium tremens (DT), a severe alcohol withdrawal symptom that includes shaking, confusion, and hallucinations. One successful treatment protocol for delirium tremens involved the combined use of niacin and vitamin C (ascorbic acid) for alcoholics admitted to treatment who were either already having DT symptoms, or who were pre-delirious. Upon admission to treatment, the patients received 500mg of IV niacin, 3000mg of oral niacin, and 2000mg of oral vitamin C. From the first day of treatment until recovery, they took niacin orally after each meal (for a total of 3000mg of niacin per day), along with 3000mg of vitamin C per day. Some patients also received a sedative. Even without sedatives though, many patients who received this nutrient therapy protocol recovered completely within 24-48 hours, and were communicative and cooperative within only a few hours after the first administration of niacin and vitamin C.
Niacin therapy can also be administered in cases of drug-induced delirium tremens or to prevent and/or treat postoperative delirium, especially in patients who take statin drugs.
Niacin is also known as nicotinic acid, and is closely related to nicotine, the addictive substance found in tobacco. As a close relative of nicotine, niacin can help relieve cravings and other problems associated with nicotine addiction when taken in appropriate, therapeutic doses of 3000mg or above. In fact, niacin and nicotine are so closely related that some experts consider nicotine to be a kind of “analog” for niacin, meaning that it can occupy the same receptors in the body as niacin and serve a similar purpose in some cases. However, since nicotine is actually poisonous (and not niacin), it does more harm than good.
People who are nutritionally deficient in niacin to begin with may be at a higher risk of getting addicted to nicotine, and have trouble quitting, unless they correct this deficiency. A good example of this is in schizophrenia; people with schizophrenia are known to be niacin dependent, and tend to get addicted to nicotine more easily than other people without a niacin dependency or deficiency. In addition, research has indeed shown that supplementing with high-dose niacin can make it significantly easier to quit a nicotine addiction, making this nutrient an important supplement for anyone trying to break this particular addiction.
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Below is a list of other health problems that may benefit from high-dose niacin therapy:- Skin conditions
- Acne
- Psoriasis
- Skin lesions
- Epidermolysis bullosa
- Dermatitis
- Arthritis
- High cholesterol levels
- Chronic fatigue
- Depression/Anxiety
- LSD antidote
- NOTE: Intravenous administration of just 100mg of niacin or niacinamide can relieve most or all of the effects of LSD within minutes.
- Dementia and senility
- Post electroconvulsive therapy (ECT) amnesia
- Cardiovascular disease
- Juvenile diabetes
- Cancer
- Delirium
- Cataracts
- Cholera and diarrhea
- Detoxification
- Erectile dysfunction
- Hartnup disease
- Huntington’s disease
- Migraines
- Multiple sclerosis
- Nephritis
- Parkinson’s disease
- Alzheimer’s disease
- Pemphigus
- Post-traumatic stress disorder (PTSD)
- Raynaud’s disease
- Trigeminal neuralgia
Niacin Dosing Guidelines
In children, niacin can be given according to the following dosing guidelines as a maintenance or starting dose:- Ages 0-12 months: 6-7mg/day
- NOTE: This dosing number is based on the average amount of niacin that is present per 32 ounces of infant formula designed for babies up to 1 year old.
- Ages 1-3 years: 10mg/day
- Ages 4-8 years: 15mg/day
- Ages 9-13 years: 20mg/day
- Ages 14-18 years: 30mg/day
Children suffering from severe health problems, such as autism or schizophrenia, may need a higher dose in order to experience positive effects from niacin therapy. A total daily dose of up to 45mg/kg of bodyweight (given in divided doses throughout the day) can be given in these cases. Start with a lower dose and work your way up to assess your child’s response to niacin therapy. Some children may flush, others won’t flush at all, so pay close attention as you begin to administer niacin.
In adults, the starting dose of niacin for high-dose niacin therapy is 3000mg/day of regular niacin, given in 3-6 divided doses over the course of a day. Some people with schizophrenia, however, have been known to take up to 10 times this amount to help them manage their condition successfully. Many people choose to start with a smaller amount of niacin and work their way up to this full 3000mg/day dose in order to avoid major flushing.
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Managing the Niacin Flush
I’m including some special information about the niacin flush here because, indeed, it can be quite intense for some people at first. Without knowing anything about the flush, it can make a person nervous in some cases. However, with a little bit of knowledge, you’ll realize that the flush isn’t scary at all, and it actually a good sign that the niacin is doing its job.The first thing to remember when you experience a niacin flush is that the sensation you’re experiencing is vasodilation, or the feeling of your blood vessels opening to allow the blood to flow more quickly and smoothly through your body. This can be uncomfortable, but it’s extremely normal and in fact desirable, since improved blood flow means that nutrients and resources will be able to reach all areas of the body more efficiently. Some people, such as arthritis patients, may appreciate the feeling of a mild to moderate flush, but a lot of people don’t like the sensation much. The good news is that, most of the time, the niacin flush will disappear entirely or be minimal, even with high doses of niacin, within a week or two.
Taking niacin after a cold meal, and drinking it with a cold drink, can help reduce the intensity of the niacin flush. When you take niacin with or immediately after a meal, this is ideal not only because it can reduce the intensity of flush symptoms, but also because it can help increase the absorption and utilization of the niacin. With each dose of niacin you take, the flush symptoms will minimize until you experience little to no flushing, even with high doses of niacin. Most people experience a niacin flush from a dose of 100mg, though a few people might experience a flush with only 25-50mg of niacin. In any case, continue to increase your total daily dose bit by bit until you reach a therapeutic dose of niacin.
Follow the adult protocol below to begin administering high-dose niacin therapy at home (adjust the doses accordingly to follow this protocol with a child):
- For the first 2 days, start by giving 100mg of niacin, 3 times per day. Give one dose after each meal.
- For the second 2 days, give 250mg of niacin, 3 times per day after meals. If this is comfortable, continue to step 3.
- Give 500mg of niacin, 3 times per day after meals. This is a total daily dose of 1500mg of niacin each day. When the flush is tolerable, continue onward.
- Give 750mg of niacin each day, 3 times per day after meals. This totals 2250mg of niacin per day.
- When the flush has become tolerable, finally increase to 1000mg of niacin taken 3 times per day after meals.
Having a flush does NOT mean that you’ve “overdosed” on niacin (in reality, especially if you take niacin in divided doses, it would be fairly difficult to truly overdose on this water-soluble nutrient). If, however, a patient receiving high-dose niacin therapy suddenly experiences nausea and/or vomiting, or a loss of appetite in the case of children, this can be a sign that the person has gone somewhat beyond their optimal niacin dose. Reduce the dose to an amount just below the point where the patient may experience nausea, vomiting, or appetite loss; this is the patient’s “optimal” niacin dose and should be maintained during treatment.
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Resources:
• Hoffer, Abram (n.d). Vitamin B-3: Niacin and Its Amide. Retrieved May 31, 2024 from: https://www.tpauk.com/main/article/vitamin-b3-niacin-therapy-as-used-by-abram-hoffer-m-d/
• Brain Hub (n.d). Brain Allergies. Retrieved June 2, 2024 from: https://brainhub.com.au/brain-allergies/#:~:text=The%20occurrence%20of%20psychiatric%20symptoms,certain%20nutrients%20in%20the%20diet.
• Qing, Ying, et. al. (2022). Attenuated niacin skin flushing response in children and adolescents with mental disorders: A transdiagnostic early warning marker. Retrieved June 2, 2024 from: https://www.sciencedirect.com/science/article/pii/S0920996422002894
• Freedenfeld, Stuart H., et. al. (2011). Biochemical Effects of Ribose and NADH Therapy in Children with Autism. Retrieved June 24, 2024 from: http://triggered.stanford.clockss.org/ServeContent?url=http://www.la-press.com/redirect_file.php?fileType%3Dpdf%26fileId%3D3580%26filename%3D2665-AUI-Biochemical-Effects-of-Ribose-and-NADH-Therapy-in-Children-with-Autism.pdf%26nocount%3D1
• NeuroNeeds (n.d). Niacin (also known as vitamin B3, one form of which is niacinamide). Retrieved June 24, 2024 from: https://www.neuroneeds.com/niacin-also-known-as-vitamin-b3-one-form-of-which-is-niacinamide/
