Negative and Positive Side Effects of Vitamin B3

Introduction

I think the best way to describe the many properties of vitamin B3 is to tell the story of my long love affair with this amazing vitamin. It began in 1951, after Dr. Humphry Osmond, Dr. John Smythies and I had developed the adrenochrome hypothesis of schizophrenia.1 I will not refer to this hypothesis further as it is in relatively good shape and has been adequately reviewed in a series of reports.2-7 We desperately needed a treatment for schizophrenia. Our hypothesis led to the conclusion that large doses (three grams per day) of vitamin B3, niacin or niacinamide, might be helpful in reversing the reaction that produced excess adrenochrome. In 1951, I obtained fifty pounds of pure niacin and fifty pounds of pure niacinamide from Merck and Co., and our hospital pharmacist made it up into 500 mg capsules. The largest dosage in commercial tablets was 100 mg but the fillers in these tablets, given 30 daily, would have made our patients sick. A mental hospital in southern California made a halfhearted attempt to try niacin but was not allowed to use anything stronger than 100 mg. Patients became sick on the 30 tablets daily. Before we could start our pilot trials I had to know something about its toxicity. As I suspected, niacin was nontoxic, but did have some undesirable effects and would have to be used knowing these potential side effects; the same of course applies to food and water.

Niacin and niacinamide were available over the counter in very small doses, the usual vitamin doses. It had been given in large doses to some patients with chronic pellagra. Acute pellagra patients responded very quickly to these small vitamin doses but chronic patients often needed up to 600 mg daily. Over sixty years ago, during the height of the great depression, this dose of pure niacin was very high and was not encouraged. The literature did not contain very much material about toxicity, chiefly because it was considered safe by all the established medical associations who commented on it. Merck prepared comprehensive bulletins outlining its properties. When we started in 1951, only one physician had given the doses we were going to use, (three grams per day). Dr. William Kaufman began to use niacinamide in 1945 for treating diseases of aging including the arthritides. He gave 500 mg four times daily but I did not know this until 1957. We were the second group to go above 600 mg daily. We did that because it had been used in much smaller doses for treating patients with depression. A small proportion responded but most did not. We assumed that had it been therapeutic in lower doses for schizophrenia this would have been reported, and our hypothesis called for enough niacin to absorb methyl groups and thus to decrease the formation of adrenalin and therefore of adrenochrome.

Our first pilot studies were successful...

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"Negative and Positive Side Effects of Vitamin B3"