Is it Worth Taking Niacin - Vitamin B3 - for Depression and Anxiety?

What is Vitamin B3 (Niacin)?

B3 is one of 8 B vitamins. It is also known as niacin (nicotinic acid) and has two other forms, niacinamide (nicotinamide) and inositol hexanicotinate, which have different effects from niacin.

All B vitamins help the body to convert food (carbohydrates) into fuel (glucose), which is used to produce energy. These B vitamins, often referred to as B complex vitamins, also help the body use fats and protein. B complex vitamins are needed for healthy skin, hair, eyes, and liver. They also help the nervous system function properly.

Niacin also helps the body make various sex and stress-related hormones in the adrenal glands and other parts of the body. Niacin helps improve circulation.

All the B vitamins are water-soluble, meaning that the body does not store them.

Vitamin B3 Deficiency and Overdose

You can meet all of your body's needs for B3 through diet. It is rare for anyone in the developed world to have a B3 deficiency. In the United States, alcoholism is the main cause of vitamin B3 deficiency.

Symptoms of mild deficiency include indigestion, fatigue, canker sores, vomiting, and depression. Severe deficiency can cause a condition known as pellagra. Pellagra is characterized by cracked, scaly skin, dementia, and diarrhea. It is generally treated with a nutritionally balanced diet and niacin supplements. Niacin deficiency also causes burning in the mouth and a swollen, bright red tongue.

Very high doses of B3, available by prescription, have been studied to prevent or improve symptoms of the following conditions. However, at high doses niacin can be toxic. You should not take doses higher than the Recommended Daily Allowance (RDA), except under your doctor's supervision. Researchers are trying to determine if inositol hexanicotinate has similar benefits without serious side effects, but so far, results are preliminary.

Brief Niacin History

One of the most publicized cases of Niacin used as a cure for depression surrounded Bill Wilson (the founder of AA). Bill struggled with chronic depression much of his life, and after being introduced to psychiatrists Humphrey Osmond and Abram Hoffer in the late fifties, he began participating in a study including the use of Niacin for depression.

Bill supported Niacin so strongly, that he attempted to introduce its use to the AA organization, but the idea was fully rejected by the fellowship. Bill published several articles, and detailed his experiences with depression and his cure, in the book, “Pass It On.”

Since the research in the fifties, various nutritionists (and very few enlightened doctors) have prescribed high doses of Niacin for chronic depression. Unfortunately, treatment of serious illnesses with vitamin therapy has become dangerous ground for most doctors to walk on. In fact, in the United States, it is against the law to prescribe nutrition or vitamins to treat cancer patients (promoting natural cures landed Juice Master, Jason Vale in prison).

How to Take It

It is important to recognize that depression and anxiety can actually be enhanced by poor diet and stress. Niacin itself should not be the first treatment if nutrition, exercise and stress are not being addressed. Simply improving your diet, exercising regularly and taking time to meditate or relax, could greatly improve problems with depression and anxiety.

It is also important to note that many prescription medications for emotional illness have their own side effects. Taking these drugs can actually enhance emotional distress, or have other adverse effects.

If depression and anxiety are severe enough however, you should probably seek out medical care from a doctor who is familiar with natural remedies and treatments. Niacin has not been known to cause death, but should be taken in carefully managed doses and supplemented with other vitamins (especially the other B vitamins).

Most doctors will prescribe Niacin in small frequent doses, and slowly increase these doses daily. Large amounts of Niacin will cause your skin to flush, but a slight niacin flush should end in about ten minutes or so and is considered normal. A doctor will most likely suggest that Niacin be taken after each meal in a small dose (such as 25 mg), and may increase that dose each day (such as 50mg at breakfast, then 25mg for lunch and dinner). These doses will not usually exceed 3,000 to 9,000 mg a day, and will be reduced if the patient’s skin continues to flush.

Niacin not only treats depression, but has also been shown to aid with sleeping problems, addiction, arthritis, schizophrenia, and high cholesterol.

Official daily recommendations for niacin in the diet of healthy individuals are listed below.

Generally, high doses of niacin are used to control specific diseases. Such high doses must be prescribed by a doctor, who will have you increase the amount of niacin slowly, over the course of 4 - 6 weeks, and take the medicine with meals to avoid stomach irritation.

* Men 19 years and older: 16 mg (RDA)
* Women 19 years and older: 14 mg (RDA)
* Pregnant women: 18 mg (RDA)
* Breastfeeding women: 17 mg (RDA)

Niacin and Depression: To Flush or Not to Flush

One of niacin's unique properties is its ability to help you naturally relax and get to sleep more rapidly at night. It is also well established, that niacin helps reduce harmful cholesterol levels in the bloodstream. Abram Hoffer, M.D., Ph.D. explains: "Niacin is one of the best substances for elevating high density lipoprotein cholesterol (the "good cholesterol) and so decreases the ratio of the total cholesterol over high density cholesterol."

Another niacin feature is its ability to greatly reduce anxiety and depression. Yet another feature of niacin is that it dilates blood vessels and creates a sensation of warmth, called a "niacin flush." This is often accompanied with a blushing of the skin. It is this "flush" or sensation of heat that indicates a temporary saturation of niacin. When you flush, you can literally see and feel that you have taken enough niacin. The idea is to initially take just enough niacin to have a slight flush. This means a pinkness about the cheeks, ears, neck, forearms and perhaps elsewhere. A slight niacin flush should end in about ten minutes or so. If you take too much niacin, the flush may be more pronounced and longer lasting. If you flush beet red for half an hour and feel weird, well, you took too much. And large doses of niacin on an empty stomach is certain to cause profound flushing.

"With larger initial doses, the flush is more pronounced and lasts longer," says Dr. Hoffer. "But with each additional dose, the intensity of the flush decreases and in most patients becomes a minor nuisance rather than an irritant. Niacin should always be taken immediately after finishing ones meal."

The best way to accurately control the flushing sensation is to start with very small amounts of niacin and gradually increase until the first flush is noticed. One method is to start with a mere 25 milligrams (25 mg) three times a day, say with each meal. The next day, try 50 mg at breakfast, 25 mg at lunch and 25 mg at supper. The following day, one might try 50 mg at breakfast, 50 mg at lunch, and 25 mg at supper. And, the next day, 50 mg at each of the three meals. The next day, 75 mg, 50 mg and 50 mg. Then, 75. 75 and 50, and so on. In this way, you have increased at the easy rate of only 25 mg per day. One would continue to increase the dosage by 25 mg per day until the flush occurs.

It is difficult to predict a saturation level for niacin because each person is different. As a general rule, the more you hold, the more you need. If you flush early, you do not need much niacin. If flushing does not happen until a high level, then your body is obviously using the higher amount of the vitamin.

Now that you have had your first flush, what next? Since a flush indicates saturation of niacin, it is desirable to continue to repeat the flushing, just very slightly, to continue the saturation. This could be done three or more times a day. To get to sleep sooner at night, niacin can be taken to saturation at bedtime, too. You might be asleep before you even notice the flush.

An important point here is that niacin is a vitamin, not a drug. It is not habit forming. Niacin does not require a prescription because it is that safe. It is a nutrient that everyone needs each day. Different people in different circumstances require different amounts of niacin.

Says Dr. Hoffer: "A person's "upper limit is that amount which causes nausea, and, if not reduced, vomiting. The dose should never be allowed to remain at this upper limit. The usual dose range is 3,000 to 9,000 milligrams daily divided into three doses, but occasionally some patients may need more. The toxic dose for dogs is about 5,000 milligrams per 2.2 pounds (1 kilogram) body weight. We do not know the toxic dose for humans since niacin has never killed anyone."

Inevitable physician skepticism and questions about niacin's proven safety and effectiveness are best answered in Orthomolecular Psychiatry, edited by David Hawkins, M.D. and Linus Pauling, Ph.D. This nearly 700-page textbook is the standard reference for details on niacin therapy. Persons with a history of heavy alcohol use, liver disorders, diabetes, or pregnancy will especially want to have their physician monitor their use of niacin in quantity. Monitoring long-term use of niacin is a good idea for anyone. It consists of having your doctor check your liver function with a simple blood test.

Plain and simple niacin may be purchased in tablets at any pharmacy or health food store. Tablets typically are available in 50 mg, 100 mg, or 250 mg dosages. The tablets are usually scored down the middle so you can break them in half easily. You can break the halves in half, too, to get the exact amount you want.

If a niacin tablet is taken on an empty stomach, a flush will occur (if it is going to occur at all) within about 20 minutes. If niacin is taken right after a meal, a flush may be delayed. In fact, the flush may occur long enough afterwards that you forgot that you took the niacin! Do not let the flush surprise you. Remember that niacin does that, and you can monitor it easily.

If you want a flush right away, you can powder the niacin tablet. This is easily done by crushing it between two spoons. Powdered niacin on an empty stomach can result in a flush within minutes. Sustained release niacin is often advertised as not causing a flush at all. This claim may not be completely true; sometimes the flush is just postponed. It would probably be difficult to determine your saturation level with a sustained- or time-released product. They are also more costly.

There is nothing wrong with niacinAMIDE, by the way. That form of vitamin B-3 is frequently found in multiple vitamins and B-complex preparations. Niacinamide does not cause a flush at all. It is less effective in inducing relaxation and calming effects. Niacinamide also does not significantly lower serum cholesterol. This is an important distinction to make when purchasing.

It is a good idea to take all the other B-complex vitamins in a separate supplement in addition to the niacin. The B-vitamins, like professional baseball players, work best as a team. Still, the body seems to need proportionally more niacin than the other B vitamins. Even the U.S. Recommended Daily Allowance (RDA) for niacin is much more than for any other B-vitamin. Many physicians consider the current RDA for niacin of only 20 mg to be excessively low for optimum health. While the government continues to discuss this, it is possible to decide for yourself based on the success of doctors that use niacin for their patients every day.

Diet for B3

For people who despise vitamins and natural supplements, but still thinking about depression prevention measures through diet, it is important to include foods in your daily menu that will increase your Vitamin B3 levels. At the end of the day, you want to make sure you are getting as much as you need so you do not have to rely on supplements.

Top 10 Foods:

1. Chicken. The reason most Americans do not have a problem getting enough niacin is that chicken is the most widely consumed meat, and contains plenty of niacin. A serving of chicken gets you roughly halfway to what you need for the day, which means if you have chicken at one meal and another meat source on this list for the other meal, you should be totally covered. Serving Size (100 grams), Niacin (7.8 milligrams), 172 calories.

2. Bacon. While bacon generally gets a bad reputation for being so high in fat, calories, and cholesterol, it is also relatively high in niacin. As long as you keep your portion sizes reasonable, you can enjoy bacon. Consider going with turkey bacon, as turkey also makes the list and will provide you with a nice dose of niacin as well, while reducing the bad stuff bacon is known for. Serving Size (100 grams), Niacin (11 milligrams), 476 calories.

3. Tuna. Good news if you already consume tuna on a regular basis, it is high in niacin compared to many other foods. It is also a good source of omega-3s as well as protein. There are concerns about the mercury content, so you may not want to rely on tuna for your daily niacin consumption, but it is nice to have once in awhile. Serving Size (100 grams), Niacin (5.8milligrams), 184 calories.

4. Mushrooms. Pick your mushroom and chances are it will go a long way in helping with your niacin needs. The interesting thing about mushrooms is that each type brings its own benefits to the table. Some kinds, like portabella, are known for their texture and heartiness. Others, like shiitake, are getting press for their anti-cancer benefits. Serving Size (100 grams), Niacin (5 milligrams), 38 calories.

5. Broccoli. Broccoli is a superstar food that can do pretty much anything. While it does not contain whopping amounts of niacin, it will contribute to the cumulative total for the day, and provides so many other benefits that it is almost silly not to eat it on a very regular basis. You will be getting extra protein, fiber, and a host of vitamins and minerals with each serving. Serving Size (100 grams), Niacin (0.64 milligrams), 34 calories.

6. Veal. Different cuts of veal will have different amounts of niacin in them, but rest assured knowing that whichever cut you pick it will be high in niacin. You may even end up with two thirds of your daily niacin recommendation met with one serving of veal. While it is not likely to become a regular part of your menu, it will help when you do eat it. Serving Size (100 grams), Niacin (9.42 milligrams), 172 calories.

7. Turkey. It is nice that turkey is high in niacin because it is readily available and is one of the most popular sandwich fillers in the country. Just be sure to go with roasted turkey breast so you avoid nitrates and added sodium that comes in deli meats. Turkey almost covers your daily requirement in one shot. Serving Size (100 grams), Niacin (11.75 milligrams), 104 calories.

8. Broccoli. Broccoli is a superstar food that can do pretty much anything. While it does not contain whopping amounts of niacin, it will contribute to the cumulative total for the day, and provides so many other benefits that it is almost silly not to eat it on a very regular basis. You will be getting extra protein, fiber, and a host of vitamins and minerals with each serving. Serving Size (100 grams), Niacin (0.64 milligrams), 34 calories.

9. Organ Meats. Organ meats might score you some grimaces from your family when you serve it up, but the nutritional content makes it hard to overlook them as a viable food source. They are off the charts in several vitamins and minerals, and niacin is one of them. No matter which organ you go with, or which animal, chances are it will top the niacin charts at over 10 milligrams per 100 gram serving. Serving Size (100 grams), Niacin (most are over 10 milligrams), calories vary.

10. Asparagus. Asparagus is a great vegetable to include on your plate, and can play a part in the bigger niacin picture. It serves as the perfect supplement to other foods higher in niacin. Try serving it next to a main dish containing chicken or beef and it will help round out the nutritional profile and add a bit more niacin to the equation. It is best not to rely on any one food for your vitamin needs, and eat a balanced diet to make sure you are getting everything. Serving Size (100 grams), Niacin (1 milligram), 20 calories.

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