Effects of vitamin B3

What is vitamin B3

Vitamin B3, also known as niacin, is a type of B vitamins (both water-soluble) and an important precursor to metabolisation-related coenzymes NAD and NADP.

Niacin is involved in more than 400 physiological reactions in the body, such as: antioxidant, DNA manufacturing and repair, cell signaling, glycolysis, pyruvate metabolism, protein, amino acid metabolism, pentose biosynthesis, glycerol metabolism, high energy phosphate bond synthesis and fatty acid metabolism… Let’s wait.

In the early 20th century, Conrad Elvehjem discovered that niacin was an effective treatment for pellagra, which was then endemic in the United States. In the 1940s, to avoid any association with nicotine, the name Nicotinic acid was replaced by Niacin.

Bran, yeast, eggs, peanuts, poultry, red meat, fish, whole wheat grains, beans, and seeds are all rich in niacin/vitamin B3.

The term niacin can be more broadly defined as “niacin, nicotinamide, and bioactive derivatives of nicotinamide. As a nutritional supplement, nicotinic acid has been claimed to lower cholesterol, regulate triglycerides, prevent cardiovascular disease, arthritis… And other potential effects.

What are the empirical effects of vitamin B3

Beneficial for dialysis patients with hyperphosphatemia

Hyperphosphatemia is an important pathophysiological feature of chronic kidney disease patients undergoing maintenance hemodialysis.

Abnormal phosphate metabolism is associated with secondary hyperparathyroidism, severe bone disease and cardiovascular complications.

There are currently three main clinical strategies for the management of hyperphosphatemia in hemodialysis patients:

1. Limit dietary phosphorus intake

2. Phosphate removal by adequate dialysis (dialysis 3 times a week or 3 times a day and/or longer)

3. Use phosphate binders to reduce intestinal phosphate absorption

A meta-analysis of the literature included 8 randomized controlled trials involving 428 patients receiving routine hemodialysis or peritoneal dialysis with blood phosphorus > In patients with 1.5 mmol/L), nicotinamide supplementation (daily dose ranging from 25 mg to 1500 mg/day, followed for 8 to 24 weeks) helped reduce serum phosphorus, parathyroid hormone, and calcium-phosphorus levels.

Regarding adverse events, the niacamide group and the control group experienced symptoms of diarrhea, itching, rash, gastrointestinal symptoms, or flushing. There were no significant differences in adverse events. However, the risk of thrombocytopenia was higher in the nicotinamide group.

nicotinamide has positive effects on phosphorus metabolism in hemodialysis patients. However, due to the small sample size, more high-quality studies are needed to confirm the efficacy and safety of nicotinamide therapy

Beneficial blood lipid regulation

Dyslipidemia, which refers to changes in plasma lipids, especially elevated cholesterol levels, is a major risk factor for cardiovascular disease, but some forms, such as hypertriglyceridemia, are associated with serious diseases of other organ systems, including non-alcoholic fatty liver disease and acute pancreatitis.

Dyslipidemia is associated with both genetic (primary or familial dyslipidemia) and secondary to other diseases (such as diabetes, obesity, or an unhealthy lifestyle), which are more common.

A meta-analysis of the literature (eight randomized controlled trials involving 2110 patients with type 2 diabetes) indicated that niacin supplementation significantly reduced total cholesterol, triglyceride, and LDL cholesterol levels, and increased HDL cholesterol levels.

Nicotinic acid may have a positive effect on lipid regulation, but due to the heterogeneity of included trials and possible publication bias, more studies are needed to confirm the safety of its long-term use at high doses.

Beneficial cardiovascular event

Due to changes in lifestyle and diet patterns, cardiovascular disease has gradually shifted from the elderly population to the middle-aged population, and has become the first non-infectious death factor in the population under 70 years old, accounting for about 37%, with ischemic heart disease and stroke being the most common.

By 2030, more than 22.2 million people will die each year from cardiovascular disease. Currently, low – and middle-income countries account for 75% of cardiovascular disease deaths, resulting in a 7% decline in these countries’ gross domestic product (GDP).

A systematic review of 23 randomised controlled trials with 39,195 participants found that niacin did not reduce the number of fatal, cardiovascular, non-cardiovascular, fatal or non-fatal myocardial infarcts, or fatal or non-fatal strokes.

Nicotinic acid has no significant benefit in cardiovascular disease prevention

Beneficial for erectile dysfunction

Erectile dysfunction occurs due to insufficient blood flow to the penis, which impairs the ability to achieve or maintain an erection suitable for sexual intercourse.

While the incidence of erectile dysfunction increases with age, men of all ages are at risk (approximately 52% of men aged 40 to 70 suffer from these symptoms globally).

Risk factors for ED include heart disease, high blood pressure, hyperlipidemia, diabetes, prostate disease, depression, stress, anxiety, smoking, and use of prescription/recreational drugs.

A 12-week randomized placebo-controlled trial of 160 men with erectile dysfunction and dyslipidemia showed that nicotinic acid supplementation alone improved erectile function, as measured by the International Erectile Function Indicator Scale and the Male Sexual Health Scale.

For patients with erectile dysfunction combined with dyslipidemia, nicotinic acid may provide positive help, but due to the small sample size, more studies are needed to further verify.

Beneficial osteoarthritis

In normal joints, there is cartilage between the bones that acts as a cushion, acting like a shock absorber, allowing flexibility and reducing friction

Osteoarthritis is a chronic inflammatory disease caused by the gradual loss of cartilage with age or trauma, and the lifetime prevalence rate is about 45% (obesity is increased to 60.5%), often causing patients with mobility difficulties, is the main reason for poor quality of life in the elderly.

A preliminary, double-blind, controlled study (12 weeks in 72 patients with osteoarthritis) showed that oral nicotinamide, in addition to improving the total joint impact assessment score and improving joint flexibility, reduced the use of anti-inflammatory drugs.

Oral nicotinamide may have positive effects on osteoarthritis, but the relevant evidence is still insufficient and needs to be further confirmed by more studies.

Slow skin photoaging

Photoaging refers to the premature aging of the skin caused by long-term ultraviolet (mainly sunlight) exposure, and is associated with wrinkles, spots, pigmentation, roughness, loss of color, dryness, telangiectasia, sagging, skin cancer and melanoma.

A double-blind controlled study (12 weeks in 50 women with photoaging features on the face) showed that topical application of 5% Niacinamide lotion helped reduce facial fine lines and wrinkles, and increased elasticity, and other indicators such as pigmentation, dark yellow skin tone, and erythema improved.

The underlying mechanism may be related to the increase of collagen and Glycosaminoglycan synthesis and the decrease of protein glycosylation.

Andy