Orthomolecular Medicine for Everyone. Abram Hoffer, M.D., Ph.D.
and retinal angiospasm. Some researchers have found niacin to be the treatment of choice for embolism. Thus, 100 mg of niacin given intravenously after an embolus in large proximal vessels alleviates the pain within a few minutes. The paleness eases, as do hypothermia and cyanosis. For a few days following, niacin is given intravenously every 2–4 hours, then every 6–8 hours.19 Niacin also helps in treating end arteries (cerebral, spinal, renal, mesenteric, and retinal), but the results are not as dramatic. One of my elderly patients became blind in one eye following an embolus in the retinal artery. On 3,000 mg per day of niacin, this suddenly cleared several weeks later and he regained his vision.
Niacin is also the treatment of choice for abnormal arterial clotting, easing disorders of restricted blood supply caused by blocked arteries. It is helpful for claudication, and it has removed the necessity for amputation following diabetic gangrene.20 It is the best treatment for end artery thrombosis, but again its curative effects are not as dramatic as for thrombosis of the extremities. I have used it for strokes and found it very valuable in restoring brain function. It appears as if surrounding tissues are able to regain function and take over some of the function of destroyed brain tissue.
Vitamin B3 was also found very useful in treating coronary disease. Angina of effort was improved; disorders of the ventricular conduction system were improved, as was coronary insufficiency. However, niacin must not be used in acute infarction with shock, but it can be started once circulation is established when it will limit the area of irreversible ischemic damage.
In one case, a female patient of mine (A. H.) suffered from severe nephritis that her nephrologist declared untreatable. He began to prepare her for dialysis, as there was no hope that anything else would help. Her nephrologist was one of the best known and admired specialists in the field. I advised her to consider using 3,000 mg per day of niacin in consultation with her physician. He dismissed this idea out of hand! However, when she weighed the alternative, she concluded that she would try niacin. Within a month, she was well and has remained well. Animal studies confirm these earlier clinical observations, finding that niacin significantly lowered blood sugar levels in diabetic rats and retarded development of diabetic nephropathy.21
For all vascular conditions, researchers have generally started with niacin given intravenously, using 100 mg injections. Perhaps similar results could be achieved using larger oral doses.
Learning and Behavioral Disorders
Over fifty years ago, R. Glen Green, M.D., noted that children with learning and behavioral disorders were remarkably like children described as having subclinical pellagra. Because they had not developed the typical pellagra skin lesions, Dr. Green called them “subclinical pellagrins.”22 This broad group included the whole spectrum of learning and behavioral disorders. These children respond well to orthomolecular therapy, and vitamin B3 is an important component.23 Further discussion of this topic will follow in Chapter 15.
Diabetes
By keeping lipid levels normal, niacin should protect diabetics against the most dangerous chronic side effect, arteriosclerosis. But it may also have an effect on glucose levels in blood, on glucose tolerance, and on insulin requirements (either increased or decreased).
Researchers found that niacinamide given to young adult insulin-dependent diabetics produced a remission in some. They conducted a double-blind experiment with sixteen newly diagnosed insulin-dependent diabetics, 10–35 years old. One week after starting intensive insulin, the subjects were started on niacinamide or placebo (3,000 mg per day). If insulin was still required after six months, the vitamin was discontinued. Three of the treated group reached two-year remissions, while none of the placebo group were in remission longer than nine months. The researchers concluded that “in type I diabetes, niacinamide slows down destruction of B-cells (pancreatic cells that produce insulin) and enhances their regeneration, thus extending remission time.”24
In an animal experiment, using nonobese diabetic (NOD) mice that had symptoms and histologic changes similar to those of human insulin-dependent diabetic patients, researchers examined the therapeutic effects of large-dose niacinamide administration. Eighteen NOD mice without glycosuria were randomly divided into two groups: nine received subcutaneous niacinamide (0.5 mg/g body weight) injections every day and the other nine were controls. After forty days, all of the mice given niacinamide showed almost normal glucose tolerance and only mild insulitis, while marked glycosuria and severe insulitis were observed in six of the nine control mice. Four of six NOD mice given niacinamide from the first day of marked glycosuria had the glycosuria disappear and showed improved glucose tolerance. The results indicated that niacinamide has preventive and therapeutic effects on diabetes in NOD mice, and suggest the reversibility of B-cell damage, at least in the early stages of diabetes.25
Allergies
Niacin releases histamine from its storage sites, the mast cells. When the histamine levels are reduced, the individual is protected to a major degree against allergic shock reactions. Edwin Boyle, Jr., M.D., found that guinea pigs pre-treated with niacin no longer died from anaphylactic shock.26
Patients with food allergies can tolerate and require much larger doses of niacin. When the offending food is no longer eaten, the amount tolerated and required is reduced sharply. A good rule of thumb is that anyone who requires 12,000 mg of niacin per day probably has one or more food allergies. I (A.W. S.) found this to be personally true: whenever I eat chocolate or artificially colored food products, I can tolerate an unusually high number of grams of niacin per day. When I avoid these substances, the need for niacin drops precipitously.
A few people with severe anaphylactic-type allergic reactions have been treated with a combination of vitamin C and niacin. A young man very fearful of his peanut allergy came to see A. H. In spite of the fact he had done his best to avoid any exposure, he had been in the emergency department of the hospital ten times. The last time, his whole neck and throat had become swollen and he was barely saved. He was started on vitamin C (1,000 mg three times daily) and, after a few days, he was started on very small doses of niacin (50 mg three times daily). The hypothesis was that the circulating ascorbic acid would destroy the histamine released by the small doses of niacin and would gradually decrease the histamine burden on his body. The amount of niacin was increased slowly until he was taking 600 mg three times daily. He did not have to go back to the emergency room. He was advised to continue to avoid peanuts as he had been doing before. Several years later, on an airline flight, the cabin attendants broke out free peanuts for everyone. He became worried but decided not to make a fuss and he remained well. This one case indicates that he was protected by this combination of vitamins. Since the procedure is inherently so safe, it could easily be tried on others.
Many years ago, the Mayo Clinic reported that 75 percent of all migraine headaches responded to niacin.27 Histamine seems to be involved. We also have seen astonishing recoveries from niacin. A most surprising observation was a man who had suffered severe migraines for thirty years. After one month on niacin (3,000 mg per day), he remained migraine-free.
Multiple Sclerosis (MS)
New research confirms that vitamin B3 is a key to the successful treatment of multiple sclerosis and other nerve diseases. Niacinamide, say researchers at Harvard Medical School, “profoundly prevents the degeneration of demyelinated axons and