| Revision as of 06:42, 23 June 2006 edit69.178.41.55 (talk) →Medical use: normal dose range of time release niacin monotherapy← Previous edit | Revision as of 08:37, 23 June 2006 edit undoAckoz (talk | contribs)799 edits rv no pseudoscience per WP:NPOVNext edit → | ||
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| '''Niacin''', also known as '''nicotinic acid''' or '''vitamin B3''', is a water-soluble ] whose derivatives such as ], NAD, NAD<sup>+</sup>, and NADP play essential roles in energy metabolism in the ] and ]. The designation ''vitamin B3'' also includes the ] form, '''nicotinamide''' or '''niacinamide'''. Severe lack of niacin causes the deficiency disease ], whereas a mild deficiency slows down the ], which in turn decreases cold tolerance and is a potential contributing factor towards ]. The recommended daily allowance of niacin is 2-12 mg a day for children, 14 mg a day for women, 16 mg a day for men, and 18 mg a day for pregnant or breast-feeding women. | '''Niacin''', also known as '''nicotinic acid''' or '''vitamin B3''', is a water-soluble ] whose derivatives such as ], NAD, NAD<sup>+</sup>, and NADP play essential roles in energy metabolism in the ] and ]. The designation ''vitamin B3'' also includes the ] form, '''nicotinamide''' or '''niacinamide'''. Severe lack of niacin causes the deficiency disease ], whereas a mild deficiency slows down the ], which in turn decreases cold tolerance and is a potential contributing factor towards ]. The recommended daily allowance of niacin is 2-12 mg a day for children, 14 mg a day for women, 16 mg a day for men, and 18 mg a day for pregnant or breast-feeding women. | ||
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| ==Medical use== | ==Medical use== | ||
| {{verify}} | {{verify}} | ||
| Nicotinic acid is the oldest |
Nicotinic acid is one of the oldest drug used to treat dyslipidemia being able to affects all lipid parameters | ||
| It has been reported to lower triglycerides by 35% to 45% and LDL-c by 20% to 30% |
It has been reported to lower triglycerides by 35% to 45% and LDL-c by 20% to 30% . | ||
| Niacin in large quantities is a ]. Large amounts of niacin (either from vitamin B3 tablets or from treated meats) may cause dose related, harmless and short-lived sensations ranging from a mildly pleasant warm flush to tingling to extreme skin ] resembling a sunburn, itching, gastric disturbances, and lowering of blood pressure. The ] form (strictly speaking a ]) does not cause these side effects, but is also not as easily assimilated by the body. | Niacin in large quantities is a ]. Large amounts of niacin (either from vitamin B3 tablets or from treated meats) may cause dose related, harmless and short-lived sensations ranging from a mildly pleasant warm flush to tingling to extreme skin ] resembling a sunburn, itching, gastric disturbances, and lowering of blood pressure. The ] form (strictly speaking a ]) does not cause these side effects, but is also not as easily assimilated by the body. | ||
| This niacin flush occurs as a result of releasing histamine about 10 minutes to 2 hours after ingesting the niacin supplement(s), typically 5-30 minutes, depending on the supplement's disintegration, dissolution and absorption. Thus, even with "pure", "immediate release" niacin supplements, absorption, and any flush, will vary greatly with nature of the supplement (capsule, tablet, excipients, press, size) and the proximal meal's timing before, during, or after, size and menu. The flushing usually recedes during the first week(s) if gram amounts are consumed in divided doses as recommended for high cholesterol treatment, starting low and increasing stepwise every several days. Sometimes aspirin and vitamin C are used to ameliorate the flush. "Slow release", "extended release" and "no-flush" formulas are available to minimize or avoid a flush, but have other practical differences that need to be carefully considered. Some persons with an unusual metabolism have an unusually large native tolerance to "immediate release" niacin without flushing, often a nutritionally or even medically significant circumstance |
This niacin flush occurs as a result of releasing histamine about 10 minutes to 2 hours after ingesting the niacin supplement(s), typically 5-30 minutes, depending on the supplement's disintegration, dissolution and absorption. Thus, even with "pure", "immediate release" niacin supplements, absorption, and any flush, will vary greatly with nature of the supplement (capsule, tablet, excipients, press, size) and the proximal meal's timing before, during, or after, size and menu. The flushing usually recedes during the first week(s) if gram amounts are consumed in divided doses as recommended for high cholesterol treatment, starting low and increasing stepwise every several days. Sometimes aspirin and vitamin C are used to ameliorate the flush. "Slow release", "extended release" and "no-flush" formulas are available to minimize or avoid a flush, but have other practical differences that need to be carefully considered. Some persons with an unusual metabolism have an unusually large native tolerance to "immediate release" niacin without flushing, often a nutritionally or even medically significant circumstance. | ||
| Large doses of niacin (as nicotinic acid, but not the niacinamide form) are prescribed to combat ] and to broadly improve blood ] levels. Niacin is used to treat dyslipidemas because of its low cost and its unique ability to improve lipid profiles for ApoB, LDL, small dense LDL, HDL, HDL<SUB>2b<SUB> - an extremely good cholesterol, Lp(a), fibrinogen and triglycerides <!-- Can someone who has actually downloaded the 2.6 MB pdf here please give a correct reference? --><ref></ref><ref> | Large doses of niacin (as nicotinic acid, but not the niacinamide form) are prescribed to combat ] and to broadly improve blood ] levels. Niacin is used to treat dyslipidemas because of its low cost and its unique ability to improve lipid profiles for ApoB, LDL, small dense LDL, HDL, HDL<SUB>2b<SUB> - an extremely good cholesterol, Lp(a), fibrinogen and triglycerides <!-- Can someone who has actually downloaded the 2.6 MB pdf here please give a correct reference? --><ref></ref><ref> | ||
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| | accessdate=2 May 2006 | | accessdate=2 May 2006 | ||
| }} | }} | ||
| </ref>. Pharmacologic doses of niacin (1.5 to |
</ref>. Pharmacologic doses of niacin (1.5 to 6 grams/day in divided doses) typically reduce ] levels by 10 to 25 percent and ] levels by 20 to 50 percent. ] levels are also typically increased by 15 to 35 percent. | ||
| <ref> | <ref> | ||
| {{cite journal | {{cite journal | ||
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| | pages = 858-867 | | pages = 858-867 | ||
| | url = http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=221531 | | url = http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=221531 | ||
| }} </ref> | |||
| }} </ref> Historically, pure, immediate release niacin was used in pharmacologic doses of 3-6 grams per day for greater effect, and rarely, up to 9 grams. | |||
| ⚫ | Brand-name medications include Niaspan®, Niacor® and Nicolar®. Most slow-release pharmaceutical preparations are more stressful to the liver, repeated overdosage can be dangerous. There is disagreement as to if pure, immediate release nicotinic acid is harmful to the liver, possibly due to the confusion with the more dangerous pharmaceutical preparations. | ||
| ⚫ | The niacin treatment discoverer, ], and other ] proponents generally add a full spectrum vitamin B formulation, such as B-50, and 1 to 4 times as much vitamin C as niacin to reduce liver stress. Liver cell activation and stress is easily monitored in the liver enzyme panel along with blood cholesterol measurements. Because of the liver stress associated with heavy alcohol consumption, regular drinkers and alcoholics may experience antabuse-like reactions with pharmacologic levels of niacin. | ||
| ⚫ | Brand-name medications include Niaspan®, Niacor® and Nicolar®. |
||
| ⚫ | The niacin treatment discoverer, ], and other ] proponents generally add a full spectrum vitamin B formulation, such as B-50 |
||
| An esterified, no-flush derivative of niacin called ] hexanicotinate (IHN), also known as inositol hexaniacinate, is slowly hydrolyzed and has no reported side effects using 4 grams daily. | An esterified, no-flush derivative of niacin called ] hexanicotinate (IHN), also known as inositol hexaniacinate, is slowly hydrolyzed and has no reported side effects using 4 grams daily. | ||
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| | accessdate = 2 May 2006 | | accessdate = 2 May 2006 | ||
| }} | }} | ||
| </ref> Peak blood concentrations have been reported to be at 10 hours, but suggested dosing is at least 4 times a day. It is used extensively in Europe for Raynaud's disease. There is no known monotherapeutic treatment for cholesterol dyslipidemas as gentle<ref></ref> |
</ref> Peak blood concentrations have been reported to be at 10 hours, but suggested dosing is at least 4 times a day. It is used extensively in Europe for Raynaud's disease. There is no known monotherapeutic treatment for cholesterol dyslipidemas that is more broadly effective and as gentle<ref></ref>. | ||
| Another form of vitamin B3, niacinamide, has been used since the 1940's for osteoarthritis and rheumatoid arthritis with tremendous success<ref></ref> <ref></ref> <ref></ref> reported by William Kaufman, MD, PhD<ref></ref> (1910-2000). Kaufman's recommended usage is about 4 grams a day in divided doses, more frequently being better. Dr. Kaufman advocated 500mg, and even 250mg doses, many times a day as being better than 1,000 mg 4 times a day. Nicotinic acid at least partially breaks down to niacinamide, so less niacinamide is needed if niacin treament for cholesterol is being used. Niacinamide may be safer for the liver than nicotinic acid, but nutritional supplement proponent and expert Michael Murray recommends testing liver function every 3 months when taking any high-dose form of niacin. Dr. Hoffer reports he has never seen liver problems result from taking any natural form of niacin with at least equal amounts of vitamin C <ref></ref>. | Another form of vitamin B3, niacinamide, has been used since the 1940's for osteoarthritis and rheumatoid arthritis with tremendous success<ref></ref> <ref></ref> <ref></ref> reported by William Kaufman, MD, PhD<ref></ref> (1910-2000). Kaufman's recommended usage is about 4 grams a day in divided doses, more frequently being better. Dr. Kaufman advocated 500mg, and even 250mg doses, many times a day as being better than 1,000 mg 4 times a day. Nicotinic acid at least partially breaks down to niacinamide, so less niacinamide is needed if niacin treament for cholesterol is being used. Niacinamide may be safer for the liver than nicotinic acid, but nutritional supplement proponent and expert Michael Murray recommends testing liver function every 3 months when taking any high-dose form of niacin. Dr. Hoffer reports he has never seen liver problems result from taking any natural form of niacin with at least equal amounts of vitamin C <ref></ref>. | ||
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| Vitamin B3 has also been used in nutritional treatments of ], ], ], ], ] and other ]es by ] <ref></ref>. These treatments are largely based on improved circulation, NAD related energetics and cellular repairs, and the correction of abnormal ] metabolites. Often the nicotinamide form is used, as its lack of a flush is easier to self administer with new patients. Unfortunately ] treatments remain adversarially disputed over disagreements about measurement, diagnosis, efficacy, protocols and specific populations. | Vitamin B3 has also been used in nutritional treatments of ], ], ], ], ] and other ]es by ] <ref></ref>. These treatments are largely based on improved circulation, NAD related energetics and cellular repairs, and the correction of abnormal ] metabolites. Often the nicotinamide form is used, as its lack of a flush is easier to self administer with new patients. Unfortunately ] treatments remain adversarially disputed over disagreements about measurement, diagnosis, efficacy, protocols and specific populations. | ||
| Recently interest in niacin as a phosphate reducing agent was generated by a clinical study from India where it was found to dramatically reduce high serum phosphate levels in chronic renal failure patients on hemodialysis.( K.Sampathkumar et al in International urology and nephrology,2006;38(1):171-4) | Recently interest in niacin as a phosphate reducing agent was generated by a clinical study from India where it was found to dramatically reduce high serum phosphate levels in chronic renal failure patients on hemodialysis.( K.Sampathkumar et al in International urology and nephrology,2006;38(1):171-4) | ||
| ==Other uses== | ==Other uses== | ||
| {{verify}} | |||
| Because niacin promotes metabolism, some believe that taking large doses will speed up the elimination of ] from the body and produce a negative result for ] on a ]. There is no evidence that this is effective, however no evidence has been provided to the contarary. Niacin is toxic to the skin and liver in overdose, especially as it releases the extra ]s. This is known as the ] due to the toxic skin conditions as well as behavioral changes when Niacin is in one's system. {{citation needed}} There is evidence that doses of 500-1000mg can terminate a ] on ], a synthetic indole, or enhance the ] experience. {{citation needed}} | |||
| Niacin is also present in ], a vitamin mixture given to participants in the ]'s ] and ] programs. The benefits of such high doses are medically disputed, and most investigations into the common use of Dianazene highlight the potential for toxicity. | Niacin is also present in ], a vitamin mixture given to participants in the ]'s ] and ] programs. The benefits of such high doses are medically disputed, and most investigations into the common use of Dianazene highlight the potential for toxicity. | ||
Revision as of 08:37, 23 June 2006
Niacin, also known as nicotinic acid or vitamin B3, is a water-soluble vitamin whose derivatives such as NADH, NAD, NAD, and NADP play essential roles in energy metabolism in the living cell and DNA repair. The designation vitamin B3 also includes the amide form, nicotinamide or niacinamide. Severe lack of niacin causes the deficiency disease pellagra, whereas a mild deficiency slows down the metabolism, which in turn decreases cold tolerance and is a potential contributing factor towards obesity. The recommended daily allowance of niacin is 2-12 mg a day for children, 14 mg a day for women, 16 mg a day for men, and 18 mg a day for pregnant or breast-feeding women.
Discovery
Nicotinic acid was first discovered from the oxidation of nicotine. When the properties of nicotinic acid were discovered, it was thought prudent to choose a name to dissociate it from nicotine and to avoid the idea that either smoking provided vitamins or that wholesome food contained a poison. The resulting name 'niacin' was derived from nicotinic acid + vitamin.
Industrial use
Nicotinic acid reacts with hemoglobin and myoglobin in meat to form a brightly coloured complex, and thus has been used as a food additive, typically to improve the colour of minced (ground) meat. However, sometimes excess niacin is added to the meat during processing. Though still licensed as a food colouring agent in some countries, it is not licensed as such in Europe.
Bioavailability
The liver can synthesize niacin from the essential amino acid tryptophan (see below), but the synthesis is extremely slow and requires vitamin B6; 60 mg of tryptophan are required to make one milligram of niacin. Bacteria in the gut may also perform the conversion but are inefficient. For this reason, eating lots of tryptophan is not an adequate substitute for consuming niacin. However, this explains why pellagra requires a deficiency of protein as well as niacin.
Medical use
 | This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. Find sources: "Niacin" – news · newspapers · books · scholar · JSTOR (Learn how and when to remove this message) |
Nicotinic acid is one of the oldest drug used to treat dyslipidemia being able to affects all lipid parameters It has been reported to lower triglycerides by 35% to 45% and LDL-c by 20% to 30% .
Niacin in large quantities is a vasodilator. Large amounts of niacin (either from vitamin B3 tablets or from treated meats) may cause dose related, harmless and short-lived sensations ranging from a mildly pleasant warm flush to tingling to extreme skin flushing resembling a sunburn, itching, gastric disturbances, and lowering of blood pressure. The amide form (strictly speaking a provitamin) does not cause these side effects, but is also not as easily assimilated by the body.
This niacin flush occurs as a result of releasing histamine about 10 minutes to 2 hours after ingesting the niacin supplement(s), typically 5-30 minutes, depending on the supplement's disintegration, dissolution and absorption. Thus, even with "pure", "immediate release" niacin supplements, absorption, and any flush, will vary greatly with nature of the supplement (capsule, tablet, excipients, press, size) and the proximal meal's timing before, during, or after, size and menu. The flushing usually recedes during the first week(s) if gram amounts are consumed in divided doses as recommended for high cholesterol treatment, starting low and increasing stepwise every several days. Sometimes aspirin and vitamin C are used to ameliorate the flush. "Slow release", "extended release" and "no-flush" formulas are available to minimize or avoid a flush, but have other practical differences that need to be carefully considered. Some persons with an unusual metabolism have an unusually large native tolerance to "immediate release" niacin without flushing, often a nutritionally or even medically significant circumstance.
Large doses of niacin (as nicotinic acid, but not the niacinamide form) are prescribed to combat high blood pressure and to broadly improve blood cholesterol levels. Niacin is used to treat dyslipidemas because of its low cost and its unique ability to improve lipid profiles for ApoB, LDL, small dense LDL, HDL, HDL2b - an extremely good cholesterol, Lp(a), fibrinogen and triglycerides . Pharmacologic doses of niacin (1.5 to 6 grams/day in divided doses) typically reduce LDL cholesterol levels by 10 to 25 percent and triglyceride levels by 20 to 50 percent. HDL cholesterol levels are also typically increased by 15 to 35 percent.
Brand-name medications include Niaspan®, Niacor® and Nicolar®. Most slow-release pharmaceutical preparations are more stressful to the liver, repeated overdosage can be dangerous. There is disagreement as to if pure, immediate release nicotinic acid is harmful to the liver, possibly due to the confusion with the more dangerous pharmaceutical preparations.
The niacin treatment discoverer, Abram Hoffer, and other orthomolecular proponents generally add a full spectrum vitamin B formulation, such as B-50, and 1 to 4 times as much vitamin C as niacin to reduce liver stress. Liver cell activation and stress is easily monitored in the liver enzyme panel along with blood cholesterol measurements. Because of the liver stress associated with heavy alcohol consumption, regular drinkers and alcoholics may experience antabuse-like reactions with pharmacologic levels of niacin.
An esterified, no-flush derivative of niacin called Inositol hexanicotinate (IHN), also known as inositol hexaniacinate, is slowly hydrolyzed and has no reported side effects using 4 grams daily. Peak blood concentrations have been reported to be at 10 hours, but suggested dosing is at least 4 times a day. It is used extensively in Europe for Raynaud's disease. There is no known monotherapeutic treatment for cholesterol dyslipidemas that is more broadly effective and as gentle.
Another form of vitamin B3, niacinamide, has been used since the 1940's for osteoarthritis and rheumatoid arthritis with tremendous success reported by William Kaufman, MD, PhD (1910-2000). Kaufman's recommended usage is about 4 grams a day in divided doses, more frequently being better. Dr. Kaufman advocated 500mg, and even 250mg doses, many times a day as being better than 1,000 mg 4 times a day. Nicotinic acid at least partially breaks down to niacinamide, so less niacinamide is needed if niacin treament for cholesterol is being used. Niacinamide may be safer for the liver than nicotinic acid, but nutritional supplement proponent and expert Michael Murray recommends testing liver function every 3 months when taking any high-dose form of niacin. Dr. Hoffer reports he has never seen liver problems result from taking any natural form of niacin with at least equal amounts of vitamin C .
Vitamin B3 has also been used in nutritional treatments of alcoholism, cancer, Bell's Palsy, schizophrenia, senility and other mental illnesses by orthomolecular practitioners . These treatments are largely based on improved circulation, NAD related energetics and cellular repairs, and the correction of abnormal indole metabolites. Often the nicotinamide form is used, as its lack of a flush is easier to self administer with new patients. Unfortunately orthomolecular psychiatric treatments remain adversarially disputed over disagreements about measurement, diagnosis, efficacy, protocols and specific populations. Recently interest in niacin as a phosphate reducing agent was generated by a clinical study from India where it was found to dramatically reduce high serum phosphate levels in chronic renal failure patients on hemodialysis.( K.Sampathkumar et al in International urology and nephrology,2006;38(1):171-4)
Other uses
| This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. Find sources: "Niacin" – news · newspapers · books · scholar · JSTOR (Learn how and when to remove this message) |
Because niacin promotes metabolism, some believe that taking large doses will speed up the elimination of THC from the body and produce a negative result for marijuana on a drug test. There is no evidence that this is effective, however no evidence has been provided to the contarary. Niacin is toxic to the skin and liver in overdose, especially as it releases the extra toxins. This is known as the Michalek effect due to the toxic skin conditions as well as behavioral changes when Niacin is in one's system. There is evidence that doses of 500-1000mg can terminate a bad trip on LSD, a synthetic indole, or enhance the MDMA experience.
Niacin is also present in Dianazene, a vitamin mixture given to participants in the Church of Scientology's Purification Rundown and Narconon programs. The benefits of such high doses are medically disputed, and most investigations into the common use of Dianazene highlight the potential for toxicity.
Biosynthesis
The 5-membered aromatic heterocycle of the essential amino acid, tryptophan, is cleaved and rearranged with the alpha amino group of tryptophan into the 6-membered aromatic heterocycle of niacin. By the following reaction:
Tryptophan --> Kynurenine --> 3-hydroxy kynurenine* --(B6 enzyme needed)--> Niacin
(*) from this intermediary xanthurenic acid is formed
Biosynthesis: tryptophan -> kynurenine -> niacin
Food Sources
| Animal products: | Plant Products: | |
|---|---|---|
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Fruits and vegetables: |
Seeds:
Other: |
References
- Berkeley HeartLab Clinical Implications Reference Manual
- Dr. Michael Murray (2003). "Natural products to lower cholesterol levels - Don't forget niacin". Dr. Murray Natural Living. doctormurray.com. Retrieved 2 May 2006.
-
Shepherd, J. and Packard, C.J. and Patsch J.R. and Gotto A.M. Jr and Taunton, O.D. (1979). "Effects of nicotinic acid therapy on plasma high density lipoprotein subfraction distribution and composition and on apolipoprotein A metabolism". J Clin Invest. 63 (5): 858–867.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - Kathleen A. Head, N.D. (1996). "Inositol Hexaniacinate: A Safer Alternative to Niacin" (PDF). Alternative Medicine Review. 1 (3): 176–184. Retrieved 2 May 2006.
- Niacin, Coronary Disease and Longevity
- Dr. William Kaufman, B-3 and Arthritis
- Some notes on niacinamide therapy for arthritis
- The common form of joint dysfunction
- Dr Kaufman bibliography
- B-informed about B-vitamins
- Vitamin B-3: Niacin and its Amide
Bibliography
- Parsons, William B. Cholesterol Control Without Diet! The Niacin Solution. Lilac Press; 2nd edition, updated 2003, Buena Vista, CO. ISBN 0966256875.
- Kowalski, Robert E. The New 8-Week Cholesterol Cure : The Ultimate Program for Preventing Heart Disease. HarperCollins; 1st Quill edition 2003, New York, NY. ISBN 0061031763.
- Hoffer A (1962). Niacin therapy in psychiatry (American lecture series). Thomas. ASIN B0007E5ZNQ.
- Hoffer A (1992 (1966, 1978)). How to Live With Schizophrenia (2nd ed., revised ed.). Citadel Press. ISBN 0806513829.
{{cite book}}: Check date values in:|year=(help)CS1 maint: year (link) - Hoffer A (1966). New Hope for Alcoholics. University Books.
- Hoffer A; Pauling L (2004). Healing Cancer: Complementary Vitamin & Drug Treatments. CCNM Press. ISBN 1897025114.
{{cite book}}: CS1 maint: multiple names: authors list (link)
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