Pharmacologic Use of Niacin

Abstract

Niacin is required for a host of critical redox and adenosine diphosphate-ribosylation reactions in metabolism. Niacin deficiency leads to the distinctive signs and symptoms of pellagra, but these can happen in an unpredictable progression and can be altered in patients with polymorphisms in any of the hundreds of niacin-dependent enzymes. The symptomatology of niacin deficiency is becoming a forgotten knowledge base, and niacin deficiency is likely underdiagnosed. Additionally, high levels of niacin and niacinamide have pharmacological effects distinct from their role as sources of vitamin B3, allowing a wide range of effects on processes such as blood flow and lipid metabolism, which can be used to treat or prevent a variety of disease processes.

CHAPTER 7. The Chemistry and Biochemistry of Niacin (B3)

“…Subclinical niacin deficiency is still present in developing countries and frank deficiency occurs in cancer patients, alcoholics and anorexia nervosa (Kirkland 2007;Prousky et al 2011).…”

“…The clinical expressions of pellagra are diverse (Prousky et al 2011). Diagnosis was, and still is, difficult due to the unpredictable appearance of the different signs and symptoms in individual patients (Prousky et al 2011).…”

“…Niacin in mature cereal grains, particularly in corn, is largely bound and is poorly available; alkali treatment of the grain increases the percentage absorbed. Meat and fish have the scarce free form of niacin and niacinamide but contain high levels of NAD/ NADP, which are available as niacinamide after digestion (Prousky et al 2011). Fortification of flour and cereal products adds up to 20 mg of the free form of niacin per serving to items such as breakfast cereals (Food and Nutrition Board 1998).…”

“…In addition, at pharmacological concentrations, niacin is an effective agent for the treatment of dislipidemias and atherosclerosis (Prousky et al 2011). Furthermore, evidence exists that niacin ameliorates acute migraine, chronic tension-type headaches, depression and schizophrenia (Prousky et al 2011).…”

Antioxidant Alternatives in the Treatment of Amyotrophic Lateral Sclerosis: A Comprehensive Review

“…NA prevents Pellagra (Prousky et al, 2011) and has positive effects on the regulation of lipids (total cholesterol, triglycerides and LDL) (Guille et al, 2008) (Tabla 2). However, produces cutaneous flushing and does not work as NAD + precursor in the majority of cells (Davidson, 2008) (Table 2).…”