Niacinamide (nicotinamide) and Alzheimer's disease.
Article Type: Report
Subject: Niacinamide (Usage)
Niacinamide (Health aspects)
Alzheimer's disease (Drug therapy)
Alzheimer's disease (Research)
Author: Klotter, Jule
Pub Date: 12/01/2010
Publication: Name: Townsend Letter Publisher: The Townsend Letter Group Audience: General; Professional Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 The Townsend Letter Group ISSN: 1940-5464
Issue: Date: Dec, 2010 Source Issue: 329
Topic: Event Code: 310 Science & research
Product: SIC Code: 2834 Pharmaceutical preparations
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 243290423
Full Text: Niacinamide, also known as nicotinamide, may be an inexpensive way to stave off dementia, nervous system impairment, and other conditions related to aging. This form of vitamin B3, unlike its cousin niacin, does not cause flushing. William Kaufman, PhD, MD, a psychiatrist and clinical researcher, studied the therapeutic effects of nicotinamide during the 1930s. In his 1943 book The Common Form of Niacin Amide Deficiency Disease: Aniacinamidosis, Kaufman listed symptoms of niacinamide deficiency: memory impairment, distractibility, poor concentration, slowed thought processes, poor comprehension, unwarranted anxiety, and personality changes (e.g., inability to cooperate, evasiveness, irritability, intolerance). These symptoms mirror those associated with Alzheimer's disease.

Recently, therapeutic doses of niacinamide actually reversed Alzheimer's disease in a 2008 animal study, performed by University of California-Irvine researchers. Dr. Kim Green and colleagues gave transgenic mice with Alzheimer's disease and healthy control mice a human dose equivalent of 2000 to 3000 mg of niacinamide per day for four months. The vitamin produced cognitive and physiological effects. Memory function and behavior improved in the diseased mice and in the healthy ones, but the effect on the diseased mice amazed the research team. "'Cognitively, they were cured,' said Green. 'They performed as if they'd never developed the disease.'" (J Neurosci 2008;28:11500-11510). The functional change in the Alzheimer's mice correlated with changed physiology. Thr231-phospho-tau, a tau protein considered one of the markers for Alzheimer's, decreased by 60%. Niacinamide had no effect on beta-amyloid, another marker. Mice receiving niacinamide also had more microtubules, which carry information in brain cells. The researchers concluded, "These preclinical findings suggest that oral nicotinamide may represent a safe treatment for [Alzheimer's disease] and other tauopathies, and that phosphorylation of tau at Thr231 may regulate tau stability."

Humans, of course, do not necessarily respond like animal models. In a 2008 interview on NPR's Talk of the Nation Science Friday, Green said that recruiting had begun for a six-month clinical trial with 50 to 70 patients with mild to moderate Alzheimer's disease. The patients would be getting 1500 mg twice a day for six months. Steven S. Schreiber, MD, of UC-Irvine is principal investigator. This study's estimated completion is April 2011, according to the registry at

As with any therapy, dosage can dictate effectiveness. As a water-soluble vitamin, niacinamide enters the bloodstream quickly. Kaufman found that body levels peak about 90 minutes after niacinamide supplementation and return to base level about three hours after ingestion. Before his death in 2000, Kaufman told Dr. David G. Williams that the body cannot absorb more than about 250 mg of niacinamide at one time. He recommended multiple doses of 250 mg taken throughout the day (and night in severe cases of arthritis) for a total daily intake of 1500 to 4000 mg, depending upon severity of the patient's condition. Given this information, the patients in the UC-Irvine study might do better if they took less niacinamide more frequently instead of larger doses just twice a day. Kaufman also found that preservative-free niacinamide was more effective than supplements that contain preservatives.

Niacinamide is a "control," not a cure. The dysfunction - whether it's dementia or arthritis - will return if supplementation is discontinued. Also, niacinamide should not be used as a stand-alone therapy. Kaufman recommended a good diet, exercise, and a multivitamin/mineral along with niacinamide.

Dr. Jonathan V. Wright has recommended niacinamide to his arthritic patients for decades. He says that patients with arthritis usually respond to 1000 mg, taken three times per day, within three to four weeks. Occasionally, a patient will complain of nausea when using niacinamide. Cutting the dose in half, to 500 mg three times a day, usually resolves the problem. "A few of those people who got nauseous with the full amount of niacinamide didn't follow the advice to lower their dose, and, unfortunately their nausea went from mild to severe nausea, and even caused vomiting," Wright says in his newsletter. "Blood tests showed that these patients had elevated liver enzymes, brought on by excess niacinamide (or at least too much for those particular individuals' livers to process). But every case returned to normal within two to three weeks once the person stopped taking niacinamide completely."

Get a grip with niacinamide [Web article]. Dolkar Wellness, Accessed September 15, 2010.

Green KN, Steffan JS, Martinez-Coria H, Sun X, et al. Nicotinamide restores cognition in Alzheimer's disease transgenic mice via a mechanism involving Sirtuin inhibition and selective reduction of Thr231-phosphotau [abstract]. J Neurosci. November 5, 2008:28(45): 11500-11510. Available at: Accessed September 23, 2010.

National Public Radio. Vitamin B3 reverses Alzheimer's in mice [podcast]. Talk of the Nation. November 7, 2008. = 96747179. Accessed September 23, 2010.

Williams DG. The $30 cure for Alzheimer's. Alternatives for the Health-Conscious Individual. February 2009; 12(20): 153-155.

Wright JV. The potential, do-it-yourself treatment for Alzheimer's you can get at your local pharmacy. Nutr Heal. March 2009. Available at: Accessed September 15, 2010.
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