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B3: A Little Bit of Magic (November 2015)

Skin Cancer Prevention
In late May, Bill and I stumbled upon the closest thing to a “happy pill” that we’d ever experienced. It’s a specific form of vitamin B3 (niacinamide/nicotinamide) taken in relatively large quantities. We started taking it solely for skin cancer prevention (medical journal article below), which I mentioned to our naturopath (ND). She said “It’s good for anxiety” and Bingo! it suddenly all made sense.

Wonderful Mental Side-Effects
I had noticed that I was abruptly and uncharacteristically calm when things happened that normally would have pushed my buttons one to two weeks after I started taking the niacinamide. Events that might have sent me into a tailspin with irritation, anger, or frustration were brushed off with “Oh well.” It was really sweet but I didn’t understand the source of the dramatic shift until the ND’s comment about anxiety.
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Since taking the niacinamide, Bill is no longer disturbed by big drop-offs

I thought Bill had seemed more calm and cheery too, but he didn’t perceive a shift until we encountered his “buttons.” Bill is prone to anxiety at the airport when we go through all the checkpoints and also becomes anxious on mountain trails with steep drop-offs. A couple of weeks after starting on the special form of B3, we encountered both situations and neither caused a ripple in him—he instantly was convinced that it was the B3 that was defusing his anxiety. And much to his surprise, he concluded that his now-former fear of heights had been entirely fueled by non-specific, background anxiety. In addition, the niacinamide axed his pattern of disruptive rumination.

The B3 doesn’t directly make us happy, but does so indirectly. Inexplicably, it seems to drain much of the energy out of negative emotions like anxiety, irritation, and anger for us. And since we spend less time mired in negative emotions, our sense of well being is greater. The more time spent feeling calm and contented made more room to experience joy when the good stuff came along.

Skin Improvements
My brother commented that his actinic keratoses had all disappeared after he’d been taking the supplement for a few months. Bill and I immediately felt around after hearing this and discovered that ours weren’t entirely gone, but were almost gone. My brother was taking 2-3 g/day whereas we were taking 1 g/day. In addition, a few other of my superficial skin abnormalities had receded and some dark patches had lightened. And a few months later, I was convinced that the skin on our faces looked significantly better. It seemed that our skin color was a little lighter and more uniform.

Pain Relief
When a friend cleared taking the niacinamide for skin cancer prevention with her naturopath, the ND recommended 1-3 g/day for pain relief. Indeed, her decades-old, chronic hip and back pain was noticeably diminished on 1 g/day. Neither of us have noticed any such effects on pain but neither of us have chronic pain.

Other Comments
A 50-ish friend who is so far unhappily being unsuccessful in conquering her body’s recent vulnerabilities, commented that “It’s the most effective supplement I’ve ever taken.” Her observations echoed ours: a pleasant increase in her sense of wellbeing and a very welcome improvement in the texture of her sun-damaged skin.

Another person reported a “moderate reduction in obsessive worrying.”

A friend whose husband had just said “Good-bye” to a small part of his ear in May, a bit that was removed because of basal cell carcinoma, was relieved to learn that the niacinamide could reduce the risk of recurrences. This was especially good news since he was struggling to comply with wearing a broad-brimmed hat as a preventative measure.

Another friend who had 2 basal cell carcinomas removed in October was pleased to learn that she could decrease her odds of more occurrences by taking niacinamide.

The Dark Side
The only negative side effect I have seen mentioned online was liver toxicity in one person taking 9 grams a day. Naturopaths have apparently been using this form of B3 for a number of years to wean patients off of drugs like Valium. They generally encourage their patients to increase their dose to the point of causing vomiting, then back it down a little. I’ve seen 6 grams/day mentioned in those situations.

A friend abruptly stopped taking the niacinamide after she passed out. She believed the episode was due to an interaction of the niacinamide with her high blood pressure medication. When she consulted her physician, he took her off of the prescription drug. Understandably, she wasn’t willing to try the niacinamide again.

Another friend developed a first case of severe gout after several months on 1500mg/day. After I heard this, I searched and searched online and I saw nothing authoritative that linked niacinamide with triggering gout though niacin is known to do so. She of course isn’t taking any chances with the niacinamide and immediately stopped taking it.
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For us, this has been the most readily available B3 product

I’m surprised that I have been taking 1g/day of niacinamide for 6 months without any ill effects because it’s usually me that gets sick from medications that seemingly have no side effects. My working model is that my body doesn’t readily clear many medications and so they build-up to toxic levels, but so far, so good with this supplement.

A medical report out in late October suggests that the niacinmamide suppresses, rather than eradicates, the actinic ketoses and skin cancer lesions. That means that if you stop taking it, the little buggers that have been brewing may make their presence known. (See report below).

What To Buy
Look for nicotinamide or niacinamide, which I believe are the same compound. What you don’t want is niacin, which is also a form of B3. Perhaps it also as the same effect, but we haven’t used it, it’s not what was used in the study, and its known to cause flushing and gout. We take 500 mg twice a day because that was the amount used in the skin cancer study.

We’ve been buying the Nature’s Way product at Fred Meyer/Kroger which sells for about $8/100 capsules of 500 mg. We have been lucky however to pick it up during their occasional 2 for 1 sales.

The Medical Reports:
Vitamin B3 Helps Prevent Non-Melanoma Skin Cancers in High-Risk Adults
By Amy Orciari Herman
Edited by
- Andre Sofair, MD, MPH, and
- William E. Chavey, MD, MS

Nicotinamide (a form of vitamin B3) reduces the incidence of non-melanoma skin cancers (NMSCs) in high-risk adults, according to study results released on Wednesday and scheduled for presentation at the American Society of Clinical Oncology's annual meeting later this month.

Nearly 400 adults in Australia who had at least two NMSCs in the past 5 years were randomized to receive oral nicotinamide (500 mg) or placebo twice daily for a year. During the study, the average number of new NMSCs was significantly lower with nicotinamide (1.77 vs. 2.42). Significant reductions were observed for both squamous cell and basal cell carcinomas. In addition, the number of actinic keratoses, which can turn cancerous, was significantly lower among nicotinamide recipients as early as 3 months. Adverse events did not differ between the groups.

The authors conclude that nicotinamide is "widely accessible as an inexpensive over-the-counter vitamin supplement and presents a new chemopreventive opportunity against NMSCs that is readily translatable into clinical practice."

Study abstract (Free)
New York Times story (Free)
Note: as of July 2020 these 2 links are no linger accessible.


B3 to the Rescue
Hensin Tsao, MD, PhD
[DermatologyGeneral Medicine | Summary and Comment | Subscription Required]
Reviewing Chen AC et al., N Engl J Med 2015 Oct 22; 373:1618
Oral nicotinamide effectively reduced the development of new nonmelanoma
skin cancers and actinic keratoses in high-risk patients.
Note: as of July 2020 this link no longe accessible.

Nicotinamide, a form of vitamin B3 available without prescription, has been
shown in various studies to mitigate some of the deleterious effects of
ultraviolet (UV) radiation. The mechanism of action occurs through stopping
UV-related ATP depletion and glycolytic blockade. Australian investigators
performed a randomized, placebo-controlled trial of oral nicotinamide (500
mg twice daily) in high-risk skin cancer patients (those with at least 2
nonmelanoma skin cancers [NMSCs] in the previous 5 years).
The primary endpoint was the number of new NMSCs (squamous cell and basal
cell carcinomas [SCCs and BCCs]), that developed during the treatment
period (12 months). They also assessed the number of new actinic keratosis
during the treatment period, the number of new NMSCs in the 6 months after
treatment, and drug-related adverse effects. The rate of all new NMSCs was
23% lower in nicotinamide recipients than placebo recipients at 12 months,
a statistically significant decrease. Individual rates of SCCs, BCCs, and
actinic keratosis also decreased, but benefits subsided when treatment
ended. Adverse effect rates were similar in nicotinamide and placebo
This is an encouraging study using the relatively safe and simple agent
nicotinamide for skin cancer prevention. The authors have previously
reported a beneficial effect of nicotinamide in reducing actinic keratosis
(J Invest Dermatol 2012; 132:1497). It is interesting to note that NMSCs,
especially SCCs, were reduced while on treatment but increased in the
nicotinamide group after the trial ceased. The reason for the SCC rebound
is unclear. Perhaps the cancers were suppressed but not eradicated and
subsequently returned to their normal progression after treatment ended.
These results are reminiscent of effects of other oral suppressive
therapies, such as retinol, acitretin, and isotretinoin, which come with
greater side effects than the 1000-mg nicotinamide per day given here.

Chen AC et al. A phase 3 randomized trial of nicotinamide for skin-cancer
chemoprevention. N Engl J Med 2015 Oct 22; 373:1618.
NEJM Journal Watch General Medicine, November 6, 2015 online