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Vitamin B3, Niacin, Niacinamide


Niacin

Metabolism
Niacin is rapidly absorbed in the proximal small intestine by passive diffusion

Chemistry
Niacin is synthesized from tryptophan with B1, B2 and B6
60 mg of tryptophan yields 1 mg of niacin

Biochemistry
essential componnet of NAD (redox reactions)
essential component of NADPH (fatty acid and steroid synthesis)
involved in the pentose phosphate shunt (ribose synthesis)
coenzyme for dehydrogenases (alcohol detoxification and others)
niacin is a precursor of glucose tolerance factor
NADH is an activated form of the B vitamin niacin.

Functions
niacinamide protects islet cells from oxidative damage
Niacin causes release of histamine

Requirements
RDA - 13-18 mg, pregnancy 15 mg, lactation - 18 mg
Optimal - 100 mg

Sources
beef liver, tuna, light meat chicken, swordfish, salmon, halibut

Toxicity
flushing and nausea are usually the first sign of toxicity
avoid time release form - has caused liver toxicity
contraindicated with Xoloft and other SSRI's

Deficiency
Pellagra
chronic wasting disease
dermatitis, diarrhea, dementia, and death
dermatitis is due to photosensitivity
diarrhea from widespread inflammation of the mucous surfaces
EENT
inflammation of mucous membranes
beefy red tongue
Neurology
irritability, headaches, insomnia
Dermatology
dermatitis
Gastroenterology
glossitis, stomatitis, diarrhea, proctitis, abdominal pain, dysphagia
Psychology
mental depression
Gynecology
vaginitis, amenorrhea
Endemic disease
The endemic disease is usually associated with a high intake of maize
(American corn) or of millet (sorghum, jowar)
Hartnup disease
an inherited disorder in which several amino acids including tryptophan
are absorbed poorly from the diet

Therapeutics, niacin
Endocrine
diabetes mellitus - precursor of GTF (niacin only)
Cardiology
hypercholesterolemia (niacin only) - large doses
Neurology
insomnia, migraines
multiple sclerosis, Bell's palsy, trigeminal neuralgia, tardive dyskinesia
Gynecology
dysmenorrhea
Psychology
smoking cessation


Therapeutics, niacinamide
Metabolism
crosses the blood brain barrier more readily than niacin
Musculoskeletal
osteoarthritis - improves joint mobility
Neurology
alzheimer's disease - NADH may increase dopamine production
Psychology
schizophrenia - 1g qd x 2 yrs
theory - may reduce toxic affects of hallucinogenic adrenochrome
anxiety - associated with hypoglycemia and diabetes
depression - reduces tryptophan depletion
Dermatology
acne - 4% topical cream shown to be more effective than clindamycin
Endocrinology
diabetes mellitus - protects islet cells and ATP generation


Therapeutics, inositol hexoniacinate IP-6
Biochemistry
niacin bound to six phosphates, does not cause flushing
Vascular
Raynaud's - gentle, long-term vasodilation
intermittent claudication

 

 

 

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