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Stéphane Résimont – Phd. Functional Medicine

Nicotinamide riboside appears to have exactly the same properties as other derivatives of the vitamin B3, but without the side effects of each other. It is the only derivative of B3 which does not inhibits the sirtuin gene. Also known as vitamin B3 or niacin, this PP vitamin plays (such as vitamins B1 and B2) a role in the use of energy by the body (energy metabolism). The body can synthesize vitamin PP from tryptophan (serotonin precursor: natural antidepressant) and therefore has a positive effect on depression, mood swings, eating compulsions sparing tryptophan.

Vitamin PP is particularly present in meat and fish. Nicotinamide-riboside is present in beer and cow's milk (but in small quantities). Vitamin PP is a water soluble vitamin, composed of nicotinic acid (niacin) and its amide, the nicotinamide (niacinamide). Vitamin PP/B3/nicotinamide/nicotinamide-riboside is the precursor of two important Coenzymes: NAD and NADP. These Coenzymes participate in more than 400 enzymatic reactions in the body. Vitamin PP is therefore involved in a large number of functions. It permits the degradation and the use of proteins, lipids and carbohydrates. It plays a role in the formation of red blood cells, blood circulation and oxygen transport to the cells as well in the functioning of the digestive and nervous system.

Vitamin PP deficiency is the main factor of pellagra, manifested by digestive, skin and neuropsychological disorders. Pellagra is manifested by what is called the 3 D disease: dermatitis, dementia and diarrhea, and in the absence of treatment, death can ensue. Symptoms of pellagra result in skin irritation with redness of the face, neck and limbs (rash resembling to an sunburn), muscle weakness, dizziness or vertigo, headache, nausea, vomiting, diarrhea, loss of appetite, inflammation of the lining of the mouth and tongue red and swollen, and psychological disorders (bad mood, irritability, anxiety, depression). This disease is common in populations where corn is the staple food. Corn, like millet and rye, is low in tryptophan (tryptophan can be synthesized from niacin), and the little niacin contained is not absorbed by the body, due to a factor that blocks its release.

Other benefits :

  • Anxiolytic effect (synergy with Apigenin) comparable to the effects of benzodiazepines, administration of an antagonist of vitamin B3 causes a depression of the serotonergic system which the administration of nicotinamide restores; several studies show that supplementation of Nicotinamide has a negative feedback effect on the liver kynurénin pathway, which saves tryptophan in favor of the brain.

  • Helps the metabolism of energy production; a supplementation provides health benefits like hypocaloric diet and physical activity - without neither one nor the other - and is therefore particularly recommended for overweight: stimulation of sirtuins genes (synergy with Resveratrol, CoQ10) while we may have an inhibition with high doses of niacinamide, nicotinamide.

  • Helps normal functioning of the nervous system; deceleration of cognitive decline and 70% reduction of the incidence of Alzheimer's. Supplementation might be beneficial in cases of Alzheimer's disease, to improve cognitive functions, synaptic plasticity and, partly, prevent the production of beta-plate toxic amyloid in the brain (synergy).

  • In psychiatry: used in adolescence schizophrenia and psychiatric disorders.

  • Helps reduce fatigue and asthenia.

  • Positive effect on acne, improves the skin barrier function.

  • Antiaging: nicotinamide improves genome stability. The sirtuin genes and could have an important role in the extension of telomeres: increasing the Hayflick limit

  • First results of studies suggest that combined with other micronutrients, an increased consumption of Vitamin B3/PP/niacin, nicotinamide could reduce the incidence of cancers of the mouth, throat and skin.

  • Also immunostimulatory effects and improves the CD4/CD8 ratio in HIV and survival rate.

  • High cholesterol: niacin is used since the 1950’s to lower the level of blood lipids: reduce LDL ("bad") cholesterol, raise HDL and lower triglycerides. Niacinamide does not lower cholesterol, nicotinamide-riboside does.

  • Prevention of diabetes type 1. In vitro data and animal experiments have left thinking that niacinamide may have a protective effect on pancreatic beta cells.

  • Prevention of type 2 diabetes in obese rats with the use of nicotinamide.

  • Nicotinamide riboside has a protective effect towards deafness induced by acoustic trauma.

Taking high doses of vitamin B3 for therapeutic purposes must be done under medical supervision because of many adverse events reported and the many possible drug interactions. Tests blood to assess the patient's liver function should be done regularly. Except for nicotinamide-riboside

The overall nicotinamide prevention supplementation is justified for all the pathologies associated with DNA damage: diabetes - inflammation - excess iron/copper - autoimmunity - chronic infections - exposure to radiation (flights, scanners ...) - pollution exposure – post radiotherapy / post chemotherapy - aging - degenerative diseases, especially neurodegenerative cancers and diseases.

Contra indications (except for nicotinamide riboside) : taking vitamin B3 is contraindicated in patients suffering from alcoholism. In case of illness or liver dysfunction, consumption of alcohol (more than two drinks per day), gout or gastric ulcer, the medical follow-up must be very tight.

Side effects Taking more than 100 mg per day of niacin might frequently cause a "flush" effect: congestive flushes (vasodilatation) particularly in the face and neck. In addition, these sudden rashes which often improve after two weeks of treatment, can be accompanied by stomach discomfort, itching and a headache. These side effects have sometimes caused high dropout rates in clinical studies. Daily doses of over 1000 mg of niacin per day can sometimes cause a transient increase in liver enzymes, a sign of liver toxicity, but this is very controversial, some authors claiming that the toxicity Hepatic B3 is very rare and reversible. Niacinamide does not cause flushing, but can be toxic to the liver.

Tolerable upper intake To prevent the occurrence of adverse effects, European and US health authorities have set an upper intake tolerable recommended with the adult, the European Union has engaged the figures of 10mg/day of nicotinic acid and 900 mg/ day of nicotinamide. Nicotinamide-riboside is completely devoid of toxicity and side effects, even at doses ten times greater than the effective amount of the product. Dos: Preventive around 500 mg/day - co-therapeutic doses of 500 to 1500 mg/day.

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