Niacin (vitamin B3, nicotinic acid), Niacinamide
Vitamin B3 is made up of niacin (nicotinic acid) and its amide, niacinamide, and can be found in many foods, including yeast, meat, fish, milk, eggs, green vegetables, and cereal grains. Dietary tryptophan is also converted to niacin in the body. Vitamin B3 is often found in combination with other B vitamins including thiamine, riboflavin, pantothenic acid, pyridoxine, cyanocobalamin, and folic acid.
Source: http://www.mayoclinic.com/health/niacin/NS_patient-niacin
Evidence
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Key to grades
Grading rationale
High cholesterol (niacin)
 Niacin is a well-accepted treatment for high cholesterol. Multiple studies show that niacin (not niacinamide) has significant benefits on levels of high-density cholesterol (HDL or “good cholesterol”), with better results than prescription drugs such as “statins” like atorvastatin (Lipitor®). There are also benefits on levels of low-density cholesterol (LDL or “bad cholesterol”), although these effects are less dramatic. Adding niacin to a second drug such as a statin may increase the effects on low-density lipoproteins. The use of niacin for the treatment of dyslipidemia associated with type 2 diabetes has been controversial because of the possibility of worsening glycemic control. Patients should check with a physician and pharmacist before starting niacin.
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Pellagra (niacin)
 Niacin (vitamin B3) and niacinamide are U.S. Food and Drug Administration (FDA)-approved for the treatment of niacin deficiency. Pellagra is a nutritional disease that develops due to insufficient dietary amounts of vitamin B3 or the chemical it is made from, tryptophan. Symptoms of pellagra include skin disease, diarrhea, dementia, and depression.
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Atherosclerosis (niacin)
 Niacin decreases blood levels of cholesterol and lipoprotein (a), which may reduce the risk of atherosclerosis (“hardening” of the arteries). However, niacin also can increase homocysteine levels, which may have the opposite effect. Overall, the scientific evidence supports the use of niacin in combination with other drugs (but not alone) to decrease cholesterol and slow the process of atherosclerosis. More research is needed in this area before a firm conclusion can be drawn.
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Prevention of a second heart attack (niacin)
 Niacin decreases levels of cholesterol, lipoprotein (a), and fibrinogen, which can reduce the risk of heart disease. However, niacin also increases homocysteine levels, which can increase this risk. Numerous studies have looked at the effects of niacin, alone and in combination with other drugs, for the prevention of heart disease and fatal heart attacks. Overall, this research suggests benefits of niacin, especially when combined with other cholesterol-lowering drugs.
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Age-related macular degeneration (AMD)
 Niacin may benefit the choroidal blood vessels, which underlie the region of the retina called the macula. Age-related macular degeneration (AMD) may result from disrupted blood flow in the choroidal vessels. Studies suggest that niacin may be used to treat AMD, but more well-designed studies are needed.
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Alzheimer’s disease/ cognitive decline
 Dementia can be caused by severe niacin insufficiency, but it is unclear whether variation in intake of niacin in the usual diet is linked to neurodegenerative decline or Alzheimer’s disease (AD). Further research is needed before a conclusion can be drawn.
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Diabetes (Type 1/Type 2)
 Niacinamide may prevent diabetes or delay the need for insulin. More research is needed to determine if niacinamide delays or prevents the onset of insulin dependence in individuals with type 1 diabetes. Niacin has been used to treat dyslipidemia associated with type 2 diabetes. However, this treatment has been controversial because it may worsen glycemic control. Patients should seek medical advice before starting niacin.
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Headaches
 There is not enough information about the treatment or prevention of headaches with niacin. More research is needed.
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High blood phosphorous level (hyperphosphatemia)
 Niacinamide may reduce the high serum phosphate levels in hyperphosphatemia. However, more research is needed before niacinamide can be used to treat hyperphosphatemia.
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Osteoarthritis (niacinamide)
 Preliminary human studies suggest that niacinamide may be useful in the treatment of osteoarthritis. Further research is needed before a recommendation can be made.
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Skin conditions
 Niacinamide has been used in skin care products, including moisturizers, anti-aging products, and rosacea treatments. The benefits of niacinamide in skin care needs to be further studied before recommendations are made.
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Type 1 diabetes mellitus prevention (niacinamide)
 Niacinamide (not niacin) does not appear to delay the development of diabetes mellitus (type 1). Evidence is mixed and more study is needed in this area.
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Source: http://www.mayoclinic.com/health/niacin/NS_patient-niacin/DSECTION=evidence
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About Dr. Timothy Durnin
Dr. Durnin is the owner of Lansing Chiropractic Clinic and Wellness Medical, S.C. He is a second generation Chiropractic Physician with over 27 years of clinical experience. Presently serving as co-admitting staff at Olympia Fields Osteopathic Hospital, (Now St. James Olympia Fields), for several years and writing many newspaper articles on wide ranges of neuromusculoskeletal pathologies and treatments, he is now in private practice serving the needs of south Chicago.
He has been featured in many local newspapers for his extensive knowledge in neuromusculoskeletal disorders. He is a member: Phi Theta Kappa honorary fraternity, American Chiropractic Association, American Association of Spine Physicians, Illinois Chiropractic Society, Who's Who in America, Presidential Cabinet Member of the National Univerisity of Health Sciences and Board Certified in AMA Impairment Ratings, Medical Director Life extension Laser and a member of the Lansing Chamber of Commerce. Dr. Durnin is also a member of over 40 Qualified Credentialed Health Plans.
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The most significant function of Niacin is in Cellular respiration where niacin combines with adenine to form NADH. NADH accounts for most of cellular energy production of the Electron Transport Chain and the production of ATP. Break the Niacin link with a deficiency and the energy requirements of the cell are seriously limited and metabolic processes become morbid.
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