Vitamins & Minerals

Nicotinic Acid

Optimal Result: 0 - 5 ng/mL.

What is Niacin/Vitamin B3?

Niacin (nicotinic acid) is a water-soluble vitamin that is also referred to as vitamin B3.

Nicotinamide (nicotinic acid amide) is the derivative of niacin that is incorporated into the coenzymes nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP).

Both nicotinic acid and nicotinamide are absorbed from the normal diet. Nicotinamide is the form of vitamin B3 that is commonly found in nutritional supplements and used to fortify foods. Nicotinic acid is available both over the counter and with a prescription as a cholesterol-lowering agent. 

The nicotinamide moiety of NAD and NADP serves as an electron acceptor or donor in biological oxidation-reduction (redox) reactions catalyzed by several hundred different enzymes. NAD serves as the cofactor for enzymes that break down (catabolize) carbohydrates, fats, proteins, and alcohol while NADP supports biosynthetic (anabolic) reactions, including the synthesis of all macromolecules, such as fatty acids and cholesterol.

Nicotinamide has also been shown to serve as a cofactor in adenosine diphosphate (ADP)-ribose transfer reactions that play an integral part in deoxyribonucleic acid (DNA) repair calcium mobilization.

Studies of cultured cells and animal models suggest that ADP-ribose polymer-mediated DNA repair and cyclic ADP-ribose-mediated cell-signaling pathway may play a role in cancer prevention.

The amino acid tryptophan can be metabolically converted into niacin. Vitamin B3, also called niacin and nicotinic acid, is a water soluble B vitamin. It plays a role in releasing energy from carbohydrates and fats, metabolizes proteins, and assists in the production of some hormones and in the formation of red blood cells. Niacin is also thought to prevent and treat diabetes, improve circulation (as inositol hexaniacinate); and relieve arthritis.

The beneficial use of niacin (nicotinic acid, but not niacinamide) to prevent or treat elevated blood lipids and reduce cardiovascular disease risk is documented. 

What does it mean if your Nicotinic Acid result is too low?

Niacin deficiency can result from inadequate dietary intake of niacin and/or the amino acid tryptophan. Tryptophan, obtained from the breakdown of dietary protein, can be converted to nicotinamide by liver enzymes that require vitamin B6, riboflavin, and iron. Deficiencies of these constituents can contribute to the development of niacin deficiency.

- Hartnup's disease, a hereditary disorder that reduces tryptophan absorption, can lead to niacin deficiency. 

- Carcinoid syndrome diverts tryptophan to the increased production of serotonin and can reduce the production of nicotinamide.

- Prolonged treatment with isoniazid has also been associated with niacin deficiency.

- Niacin deficiency can affect the skin, digestive system, and the nervous system. 

Severe niacin deficiency, referred to as pellagra, has been associated with the "four Ds": 
- dermatitis, 
- diarrhea, 
- dementia, 
and ultimately death.

Pellagra dermatitis is characterized by a thick, scaly, darkly pigmented rash that develops symmetrically in areas exposed to sunlight. 

Digestive system symptoms include: 
- vomiting, 
- constipation or diarrhea, 
- and a bright red tongue.

Pellagra can also cause neurologic symptoms, including: 
- apathy, 
- fatigue, 
- depression, 
- headache, 
- disorientation, 
- and memory loss.

What does it mean if your Nicotinic Acid result is too high?

Large amounts of niacin may result in "niacin intolerance" in 15-40% of people who try it and the unpleasant side effect of "skin-flushing" (similar to hot flashes). The RDA for niacin is only 13-18 mg. Vitamin B3 has been used orally and intravenously in connection with various health conditions including; high triglycerides, dysmenorrhea, hypothyroidism, and multiple sclerosis.

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