THE BASICS: Vitamin B3 is an essential vitamin that plays diverse roles in health. In the early 1900s, severe vitamin B3 deficiency, known as pellagra, was common in the American South. Pellagra was characterized by symptoms of the four Ds: diarrhea, dermatitis, dementia, and finally death. At that time, doctors used brewer’s yeast, which contains vitamin B3, to cure pellagra. Today, vitamin B3 is known to play important roles treating mental illness and preventing heart disease.

ALIAS: Vitamin B3 supplements are available in two common forms, niacin and niacinamide. Niacin is also known as nicotinic acid, and niacinamide is sometimes referred to as nicotinamide. Some pharmaceutical companies market “drug” versions of niacin.

HOW VITAMIN B3 WORKS: Vitamin B3 works in several different ways. It improves the metabolism of fats, resulting in a reduction of cholesterol levels. The vitamin provides the chemical foundation of nicotinamide adenine dinucleotide, which plays a central role in breaking down food molecules for energy. It also prevents the oxidation of adrenochrome, a neurotoxic brain chemical that can cause hallucinations.

HEALTH BENEFITS: Vitamin B3 supplements have several important benefits.

• Cholesterol. Doctors discovered more than 50 years ago that the niacin form of vitamin B3 reduces total cholesterol levels. It also has a positive effect on other blood fats. Niacin lowers low-density lipoprotein (LDL) cholesterol, very-low-density lipoprotein (VLDL) cholesterol, lipoprotein A, and triglycerides, each of which is associated with a greater risk of coronary artery disease. Meanwhile, the vitamin increases levels of the “good” high-density lipoprotein (HDL) cholesterol. Still other research indicates that niacin can lower the risk of stroke. A study published in the American Journal of Cardiology found that niacin reduced levels of C-reactive protein, a marker of inflammation and heart attack risk.
• Schizophrenia. In the early 1950s, Abram Hoffer, MD, PhD, and his colleagues discovered that large amounts of vitamin B3 and vitamin C (3 g each) could prevent hallucinations and delusions in people with recent-onset schizophrenia, a type of mental illness. This research led to the first double-blind study in psychiatry, which was published in the prestigious Bulletin of the Menninger Clinic. The vitamins break down a neurotoxin and body-produced hallucinogen called adrenochrome. Vitamin B3 can also block hallucinations in people taking LSD and other mind-altering drugs. Recently, researchers at Johns Hopkins University, Baltimore, discovered that schizophrenic patients have reduced activity of a brain protein involved in regulating vitamin B3 in the brain.
• Alzheimer’s disease. High intake of vitamin B3 may reduce the risk of developing Alzheimer’s disease. Doctors at the Rush Institute for Healthy Aging, Chicago, tracked the health of 3,718 older men and women for 19 years. People who consumed the most vitamin B3 from foods were 80 percent less likely to develop Alzheimer’s, compared with those who consumed little of the vitamin. High intake of vitamin B3 also reduced the risk of non-Alzheimer’s cognitive decline. A recent animal study at the University of California, Irvine found that vitamin B3 turned on brain cells in laboratory mice, improving their memory.
• Gene repair. Vitamin B3 is needed to make a key DNA repair enzyme, called poly (ADP-ribose) polymerase, or PARP. This enzyme and other DNA-repair enzymes help slow the aging process and reduce the long-term risk of cancer-causing mutations. A recent study, published in the British Journal of Nutrition, found that a daily supplemental containing vitamin B3 (50 mg), B2 (10 mg), and coenzyme Q10 (100 mg) increased PARP activity and improved gene repair in women with breast cancer. PARP also helps maintain overall gene stability and boosts the activity of the cancer-suppressing p53 gene.

BACKGROUND CHECK: On rare occasions, large dosages (multigram amounts) of niacin may increase blood sugar and liver enzyme levels. This is usually a temporary change.

GLEANINGS: The niacin and niacinamide forms of vitamin B3 are equivalent in most respects. However, only niacin improves cholesterol levels; niacinamide does not.

HEADS UP: The niacin form of vitamin B3 causes a brief and sometimes intense flushing of the skin, which may last about an hour. The niacinamide form does not cause flushing.

WHAT YOU SHOULD TAKE: Make sure your multivitamin or B-complex supplement contains at least 50 mg of niacin or niacinamide. To lower cholesterol, take 500 to 1,000 mg of niacin daily. For treating recent-onset schizophrenia, physicians have found that 3 g of niacin and 3 g of vitamin C are helpful, though larger amounts may be needed.

Product Examples (from left)

NOW Foods Flush-Free Niacin is specially formulated to avoid the “niacin flush,” a tingling red rash on the skin common after taking high-dose niacin supplements. It contains inositol hexanicotinate, a stable form of niacin that does not cause the skin to flush, but delivers B3 in high doses to help maintain healthful cholesterol levels and lift mood.

Natrol Niacin TR time release Niacin plays an important role in cholesterol metabolism, and no-flush Natrol Niacin TR Time Release can help keep cholesterol levels within the normal range. The timed-release technology of this product allows the body to absorb higher doses of niacin without flushing.

Solgar No-Flush Niacin capsules are made with no animal products, making them ideal for vegetarians and vegans, and they’re kosher. They are sugar-, starch-, and salt-free, and are made without corn, yeast, wheat, or soy.