NIACINAMIDE ?
C. Norman Shealy, M.D., Ph.D.
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Two weeks ago I wrote about the benefit of Niacin in lowering cholesterol and triglycerides as well as raising HDL cholesterol. Another chemical variation of Niacin, Niacinamide (also called Nicotinamide), has far less effect on cholesterol but it has tremendous ?positive effect on mental status, memory and arthritis!
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Niacinamide is one of the mainstays of orthomolecular psychiatry, with benefits in schizophrenia, paranoia and hallucinations, as well as in insomnia. It also has been beneficial in patients with early Parkinsonism. Nicotinamide also offers significant protection of the brain in traumatic brain injury. Niacinamide also reduces homocysteine neuronal toxicity. One of the most interesting effects is that it induces differentiation of embryonic stem cells into insulin secreting cells. ?It also is particularly helpful if used early after onset of Type I diabetes
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Niacinamide does dilate blood vessels, although not as much as Niacin, and helps remove plaque from arteries. Niacinamide also has anti-inflammatory effects. A drug, Nicarandil ?, derived from Niacinamide, has many too many complications for any consideration. And some of those same problems can occur with the large dosages of Niacinamide required to treat psychoses and arthritis. The major “side effects” of Niacinamide are elevation of liver enzymes and diarrhea. Topically Niacinamide reduces yellowing, red blotchiness and hyperpigmentation spots on the skin.
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High dose Nicotinamide (or Niacinamide) was introduced to treat both osteoarthritis and rheumatoid arthritis over 50 years ago. Generally this means 3.5 to 4 grams of Niacinamide daily. If you choose this route, and certainly it is safer than long term NSAID therapy, you should have liver enzymes checked at 6 months, one year and every year thereafter. And if you develop diarrhea, obviously this is not the treatment for you!

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