Posted on 02/20/2024 3:52:33 PM PST by nickcarraway
— Americans consume too much vitamin B3, researchers suggest
Niacin metabolism was associated with incident major adverse cardiovascular events (MACE) and may be linked to the pathogenesis of heart disease via inflammatory pathways, researchers said.
In a metabolomics study of stable cardiovascular patients, two terminal metabolites of niacin -- N1-methyl-2-pyridone-5-carboxamide (2PY) and N1-methyl-4-pyridone-3-carboxamide (4PY) -- were associated with an up to twofold increased risk of cardiovascular disease (CVD) independent of traditional risk factors, reported Stanley Hazen, MD, PhD, of Cleveland Clinic, and colleagues.
Moreover, both metabolites have genetic links to vascular inflammation, they noted in Nature Medicineopens in a new tab or window.
"Niacin, which is fortified in food staples, contributes to NAD [nicotinamide adenine dinucleotide] synthesis and has been shown to provoke increased circulating 2PY and 4PY when present in excess, such as when provided as an over-the-counter supplement or as a pharmacological agent for cholesterol lowering," Hazen's group noted.
Ultimately, the findings "raise the question of whether a continued mandate of flour and cereal fortification with niacin is warranted," they wrote.
Adults need to consume at least 15 mg per day of niacin, also known as vitamin B3 or nicotinic acid, to avoid niacin deficiency syndromes such as pellagra, Hazen and team said. Niacin fortification of wheat flour and other cereals has been mandated for decades, accompanied by a near elimination of pellagra-induced deaths in the U.S. since the Great Depression.
"However, over the past half century, with consumption of increasing amounts of processed and 'fast' food (much of which includes refined fortified flour and cereals), intake of dietary niacin has continued to increase to levels encroaching on excessive," the authors noted.
Niacin has also been used as an over-the-counter supplement, with some believing that it reduces cholesterol levels. However, its actual health benefits are questionedopens in a new tab or window in the current statin era, while evidence that niacin reduces CVD events eludes researchers. Current clinical guidelines no longer recommend niacin to prevent CVD.
"In summary, the present studies, combined with recent randomized clinical trials with niacin in the modern era of high-potency statins, suggest a possible explanation for the 'niacin paradox' -- the observation that the LDL [low-density lipoprotein] lowering induced by niacin fails to achieve the expected reduction in CVD risks," Hazen and colleagues wrote.
The researchers conducted an untargeted metabolomics analysis of fasting plasma from a prospective discovery cohort of stable participants undergoing elective diagnostic cardiac evaluations, with a total of 1,162 patients. Participants were recruited at quaternary referral centers and had a high prevalence of CVD and cardiometabolic disease risk factors.
The associations between 2PY and 4PY and 3-year MACE were supported by U.S. (n=2,331) and European validation cohorts (n=832).
Based on phenome-wide association analysis of the genetic variant rs10496731, there was evidence for increased VCAM-1, a known contributor to vascular inflammation and atherogenesis, as a potential biological mechanism for association of 2PY and 4PY levels with increased risk of MACE.
Hazen's group acknowledged that their studies left room for residual confounding, and that measurement of 2PY and 4PY in the validation cohorts was performed only once.
"The translatability of our findings to both community-based cohorts with lower overall CVD and metabolic disease risk and alternative ethnicities requires further study," the group wrote.
Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow
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garbage
My doctor prescribed niacin for me 25 years ago for slightly elevated cholesterol. I stopped taking it when I got the “niacin flush,” a horrible red burning rash that covered my face, neck and chest.
That’s weird. Usually, you get the flush initially, then it goes away. Did you up your dosage?
I have been experimenting with Niacin and the flush it creates. The purpose is to see what stops the prostaglandin issue as it pertains to how I process drugs.
I have read so much about this and pros and cons of Niacin.
The niacin flush is similar to issues I have on a minor scale which tells me perhaps prostaglandins are a problem with me. The weird thing is that the place on my body that gets the reddest is my knees.
I can see where it might cause problems in some people.
bump for later
Try Niacinamide.
I once had constipation lasting weeks. The normal solutions had no effect. Doing research, I found that niacin would help constipation. I immediately went and bought some, and took it. Within about 14 minutes, my upper body got really red and flush.
My wife wanted me to go to an emergency room. But emotionally, I felt great, and after an hour, the flush eased. And the constipation was resolved. Then I read about niacinamide, a non-flush version of niacin.
I have doubts about the article and its results. Drug companies and food companies would love to eliminate the required nutritional additives to processed foods.
I began taking Niacin in pure powder form back in 1984. Small amounts at first - slowly and gradually increased until I got to my desired dosage.
I’ve found that the flush effect is diminished greatly by taking an aspirin tablet 20 minutes beforehand. Actual aspirin, not Tylenol or Advil, The low dosage aspirin worked for me.
Start low and slow.
Were you taking it for cholesterol?
Big Pharma propaganda. Ignore.
Another good one but less well known is that B1 can quell much mental disturbance and replace psych meds.
I took it several years ago for the same reason. I had the same reaction - severely - everywhere - from head to toe - in the middle of the night. “never again” after that. One of the most unpleasant experiences I have ever gone through.
Going after B1 now
A lot of people freak out when taking Niacin and go to the emergency room.
If you dont know what it can do to you it can be pretty frightening to have your body go crazy.
It seems the body will get used to it if you keep at it and the reaction will get less.
I started taking iron cuz I read it would help your energy level.
Lordy, never have been that constipated!
Story at a glance:
Niacin (vitamin B3) deficiency, called pellagra, is characterized by diarrhea, mental confusion and scaly skin sores; it is often confined to people who have problems absorbing the vitamin from food
Niacin flush, a common side effect in doses 100 mg and above, is harmless; it starts on your face and may travel to your chest and arms, disappearing after 30 minutes to two hours
Niacin has significant side effects when taken consistently, but may be used safely once or twice weekly in combination with exercise and sauna to detoxify your body during weight loss
(Discussion of niacin flush)
Snip......"Long-Term Use of Sustained Release Niacin Supplements Is Dangerous While the niacin flush is harmless, long-term use of niacin does have significant side effects that may be dangerous. The sustained release form of niacin may be hepato toxic, causing irreparable damage to your liver. However non-sustained release forms do not cause this problem and are safe. Research also finds long-term use of niacin, prescribed for nearly 50 years at high doses to reduce cholesterol levels, has been linked with an increased risk of death and no association with a reduction in heart attacks or strokes.
While high doses have been found to reduce cholesterol, an increase in cholesterol is not the causative factor behind heart attack and stroke. The increased risks in study participants associated with high doses of niacin included excessive bleeding, gout, development of diabetes in those who didn't have it when thestudy began, liver problems, excessive infections and loss of blood sugar control in diabetics.
Macular edema has also been noted in people using niacin in doses more than 1500 mg per day. The effect of maculopathy occurred from one to 36 months after high-dose niacin was initiated. Cystoid macular edema causes painless vision loss, resulting inblindness. It has also been noted in patients taking lower doses of niacin. In one study,the effects of maculopathy reversed when the supplement was discontinued." ....snip
Read to see if I comprehend why.
I’ve been taking Niacin for about 6 months now for the same thing. But I purchased the “non-flush” variety of Niacin so I haven’t had that problem. “knock on wood”
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