1. What is it and where does it come from?

Nicotinic acid is classified as a B-vitamin and belongs to the B-vitamin sub-class known as Niacin (Vitamin B3).

Nicotinic acid is one of two niacin precursors. It is a member of the B-vitamin class, and is also known as niacinimide, 3-pyridinecarboxylic acid, pyridine-beta-carboxylic acid, antipellagra vitamin and pellagra preventive factor.

Nicotinic acid is a water-soluble vitamin that is poorly absorbed by the body. Consequently, it must be supplemented at regular intervals throughout the day for maximum benefit.

Although nicotinic acid is a product of tryptophan conversion, this conversion is inefficient and has a low yield. The most efficient way to obtain sufficient quantities of nicotinic acid is through diet and supplementation. Dietary sources of nicotinic acid include red meat, liver, eggs, fish, nuts, asparagus and milk.

2. What does it do and what scientific studies give evidence to support this?

Nicotinic acid is a digestive aide that helps the body derive energy from carbohydrates, fats and proteins. Because of this, nicotinic acid is a popular ingredient in over-the-counter weight loss or weight control products.

As an ATP catalyst, nicotinic acid enhances muscular energy. As a vasodilator, this ability is further enhanced by the increased delivery of oxygen and food derived nutrients to muscle tissue. Nicotinic acid is an effective muscular recovery agent for this reason.

Serum cholesterol levels are positively impacted by nicotinic acid supplementation. Clinical trials have demonstrated the ability of nicotinic acid to reduce LDL cholesterol levels and protect against hypertension, atherosclerosis and adverse cardiac events.

Nicotinic acid helps to regulate blood glucose levels and prevent the spiking of insulin. It has been found to be an effective addition to an aggressive diabetes program.¹

3. Who needs it and are there any symptoms of deficiency?

Persons free of medical complication can benefit from nicotinic acid supplementation.

Chronically severe nicotinic acid deficiency may result in pellagra - a disease characterized by mental disorder, diarrhea and irritated skin.

Minor deficiency is characterized by canker sores, headaches, nervousness, fatigue, muscular weakness and indigestion.

4. How much should be taken? Are there any side effects?

Dosage will depend on body size and sex. Label recommendations should be strictly followed to avoid adverse reaction.

The U.S. RDA for niacin, which is used for determining percent daily values on nutritional supplement and food labels, is 20 milligrams.

Overdose can result in stomach upset, skin problems, flushing of the skin and increased urination. Excessive administration may result in liver damage.

Nicotinic acid is contraindicated with the following medications:

Alpha 1 blockers: These drugs act to block the uptake of catecholamines to smooth muscle tissue. This results in vasodilatation and allows blood to flow smoothly. Nicotinic acid is a vasodilator, and by using both nicotinic acid and alpha 1 blockers, vasodilaton can reach dangerous levels.

Alpha-glucosidase inhibitors are drugs that result in a slower and lower rise in blood glucose levels throughout the day. These drugs decrease the absorption of carbohydrates from the small intestine. The enzyme alpha glucosidase is responsible for breaking down carbohydrate into glucose. By inhibiting the activity of this enzyme, these inhibitors slow the release of glucose into the blood stream. Nicotinic acid helps the release of energy from carbohydrates, and its use may counter the effects of these medications.

Biguanides are drugs that lower blood glucose levels, and using nicotinic acid in conjunction with these drugs may offset their beneficial effect.

Cholestyramine, Colestipol, Ganglionic blocking agents, Gemfibrozil, HMG-CoA reductase inhibitors or "statins", Meglitinides, Nicotine patch, Nitrates, Aspirin, Ibuprofen, Sulfonylureas, Thiazolidinediones and Warfarin.

Pregnant women, persons with liver conditions, diabetics, and those using anti-hypersensitives should avoid supplementation.

REFERENCES

1. Pan J, Lin M, Kesala RL, Van J, Charles MA. Niacin treatment of the atherogenic lipid profile and Lp(a) in diabetes. Diabetes Obes Metab. 2002 Jul;4(4):255-61.