Addendum: Low-Dose Niacin Improves Motor Function in Parkinson’s

“Information is not knowledge. The only source of knowledge is experience. You need experience to gain wisdom.” Albert Einstein

“Don’t listen to the person who has the answers; listen to the person who has the questions.” Albert Einstein

Addendum: In the blog reviewing niacin as a treatment strategy for improving motor function in Parkinson’s (click here to read the blog post), they describe the use of 250 mg/day niacin as low-dose. I have received a couple of emails asking for clarification about this amount and source of niacin; hopefully, this supplement will clarify these issues for everyone?! The topics that I would like to discuss briefly are given below.

-What are Vitamins and their Sources? Vitamins are substances that the human body cannot synthesize. However, vitamins are required for most of our normal physiological processes. We get most of our niacin in many food sources that naturally contain adequate levels, for example, beef, pork, poultry, fish, brown rice, nuts, seeds, legumes, and bananas. Therefore, in a typical human diet (Western-based diet), one would consume far more than the minimum daily requirement for niacin (or vitamin B3). In addition, since niacin is a water-soluble vitamin, we would excrete much of the vitamin before being totally utilized. The Table below gives the recommended dietary allowances for Niacin (NE = Niacin Equivalents).

–What are the Names and Types of Niacin? Niacin is also known as vitamin B3 ; it is one of the water-soluble B vitamins. Niacin is the generic name for nicotinic acid (pyridine-3-carboxylic acid), nicotinamide (niacinamide or pyridine-3-carboxamide), and related derivatives, such as nicotinamide riboside.

Prescription-based niacin is available as the brand-name drugs Niacor and Niaspan, and yes, there are accompanying generic compounds, which generally are much less expensive. One of the drugs is immediate release and the other drug is extended-release. These drugs are sold as 500, 750, and 1,000 mg tablets. The easiest use for the Parkinson’s study would be to cut in half the 500 mg niacin tablets.

Warnings and Concerns: Why is all of this material about prescription niacin and not over-the-counter niacin like sold at local drug stores or Amazon.com, Target, etc.? The concern comes from reading online material dealing with the use of much higher doses of niacin, 500-1000 mg or more/day. These higher doses of niacin are used to lower cholesterol. Several sources on the internet imply that there are contaminants in OTC forms of niacin since they are not regulated by the FDA. Thus, their recommendation is not to be overly trusting about using these forms of niacin in place of FDA-regulated niacin (i.e., the prescription forms). I get that, especially with the potential side effects of niacin on different physiological systems and drugs.

Remember, when I said in the other blog, check it out with your Neurologist (or better yet, your Internist) if you decide you want to try such a treatment strategy with niacin. There is substantial experience treating folks with ‘larger doses’ of niacin for cardiovascular diseases, specifically, to alter cholesterol levels. Therefore, I cannot fully separate out the bias or what in these statements warning folks NOT to buy OTC forms of niacin since they are not DFA-regulated, is this real or what? I just cannot tell from reading today.

Warnings for people with certain health conditions should NOT take niacin: liver disease, kidney disease, diabetes, active peptide ulcer, and gout. Many sites highlight ‘senior-age’ people as processing their drugs at a slower basis and niacin would somehow concentrate the baseline levels and would require one to take ‘lower’ doses of these drugs already being used during niacin treatment. In other words, they suggest your current levels of other systematic drugs would be inappropriately elevated in the presence of much higher doses of niacin (that would be 1000 mg or more/day of niacin). There is no information on 250 mg/day niacin for this study on Parkinson’s.

Closing Thoughts: As with any medical treatment, there is a risk of adverse drug interactions and cross-over influences (this is a reality). Is this true for treating Parkinson’s with, what is considered a low dose of niacin, 250-mg/day to potentially reduce your motor symptoms? Before you ‘try’ niacin, have your care partner and others read these blogs, do some homework and connect with your caring team, and then go talk/email/Zoom/text with your Internist/Neurologist/Movement Disorder Specialist. Make an informed decision following an informed conversation with your physician. Determine for your safety and welfare (a) if niacin is risky for your current treatment scheme (Parkinson’s combined with any other disorder), and (b) if the OTC forms of niacin are safe. Good luck, best wishes, and Happy New Year!

“We are slowed down sound and light waves, a walking bundle of frequencies tuned into the cosmos. We are souls dressed up in sacred biochemical garments and our bodies are the instruments through which our souls play their music.” Albert Einstein

Cover Photo Image by Ingo Jakubke from Pixabay