OPTION A:
If Vitamin B3 (WBC) is low and Vitamin B3 (Serum) is normal/excess:
Short term, status of micro nutrients is optimal, but cellular absorption may be a problem.
Recommend interventions:
- increase dietary intake of nutrient
- increase supplementation dosage
- consider status of synergistic nutrients for cellular absorption
- consider levels of oxidative stress on nutrient depletion
- consider follow-up testing to identify the source of my absorption.
OPTION B:
If Vitamin B3 (WBC) is low and Vitamin B3 (Serum) is low as well:
Short term and long term status of micro nutrients is not optimal, suggesting low dietary intake, and both intestinal and cellular absorption as possible causes.
Recommended interventions:
- Increase dietary intake of nutrient
- Increase supplementation dosage.
- Medications may have an effect on depletion
- Consider follow up testing to identify the source of malabsorption.
How it gets depleted:
Synthesized from tryptophan and uses iron, B6 and riboflavin as cofactors; deficiencies of these companion nutrients may be underlying causes.
Can be depleted by oral contraceptives and statin drugs.
Clinical Manifestations of Depletion:
Symptoms of niacin deficiency include: vomiting, constipation, red tongue, headache, fatigue, and depression.
Severe deficiency of niacin is called pellagra. Pellagra is commonly accompanied by the following 4Ds: dermatitis, diarrhea, dementia, death.
Food Sources:
The most concentrated sources of niacin are in animal products (pork), peanuts/peanut butter, tofu, and eggs.
Also consider food sources high in tryptophan *Enriched grains provide supplemental niacin.
Supplement Options:
- The RDA for niacin is 20 mg/day.
- The UL for niacin is 35 mg/day, but oral administration up to 6g per day has been used without side effects.
- Niacin is often recommended therapeutically for lipid management. Niacin has been shown to lower LDL cholesterol, lipoprotein(a), triglyceride, and fibrinogen levels, while raising HDL levels.
- Flushing can occur at high doses. Aspirin may help reduce flushing. Time release niacin or no-flush niacin is not recommended for therapeutic treatment. Monitor liver function carefully with high dose Niacin supplementation.
Food Sources:
The most concentrated sources of niacin are in animal products (pork), peanuts/peanut butter, tofu, and eggs.
Also consider food sources high in tryptophan *Enriched grains provide supplemental niacin.
Physiological Function:
Niacin is extensively involved in metabolic reduction reactions through NAD-NADPH pathways. Over 200 enzymes in the human body require niacin.
Other important major functions of niacin B include: fatty acid synthesis, ATP synthesis, DNA repair, lower cholesterol/LDL, aids in
circulation.
Vitamin B3 (WBC)
