Niacinamide (vitamin B3) is pretty awesome for alleviating anxiety as well as mood disorders.
That’s what we’re going to talk about in today’s article – let’s dive right in!
- What is Niacinamide?
- Is Niacinamide An Effective Treatment for Anxiety?
- Niacinamide Has Calming “Benzodiazepine-Like” Properties
- Niacinamide Treats NAD+ Deficiency (Subclinical Pellagra)
- Niacinamide Lowers Lactic Acid In The Body And Brain
- Vitamin B3 As A Treatment for Schizophrenia & Psychosis
- What Is An Effective Dose of Niacinamide For Anxiety or Depression?
- Conclusion – Niacinamide For Anxiety?
What is Niacinamide?
Vitamin B3, a.k.a niacinamide, a.k.a niacin, is one of the essential B vitamins.
This is what it looks like:
Your body can produce niacin from the amino acid tryptophan so technically it’s not an essential vitamin (however the tryptophan → vitamin B3 synthesis isn’t very efficient).
What do you need this kind-of-vitamin for?
Vitamin B3 is a precursor to the coenzymes NAD+ and NADP.
These coenzymes are involved in a bunch of different chemical reactions that take place in the body!
Now this gets a little confusing but bear with me…
The vitamin B3 family includes three members – niacinamide, niacin and nicotinamide riboside – however, all of these vitamins end up being converted to NAD+/NADP so they have more or less the same function in the body.
Niacinamide is generally speaking the preferred form of vitamin B3 as it doesn’t cause the infamous “niacin flush” (red hot and itchy or burning skin caused by taking high doses of niacin).
NAD+ is Essential for Energy Production!
This is pretty much all you need to know about niacinamide:
It helps your mitochondria (the energy factories of the cell) to produce energy!
Remember, niacinamide gets converted into the molecule NAD+ in the body.
NAD+ is a very useful molecule; it functions as a coenzyme and helps transform the energy stored in food to a chemical form of energy that the body can use – called ATP.
*ATP = being the body’s main energy currency.
And for anyone curious, here’s the long and complex explanation of NAD+‘s function:
NAD+ acts an electron carrier in the cell, transporting electrons from the citric acid cycle to the complexes in the electron transport chain so that you can generate energy via ATP synthase:
What Happens During A Vitamin B3 Deficiency?
What happens if you do not have sufficient levels of niacinamide (NAD+)?
Energy production will slow down!
And without adequate energy, the cells that make up your body can not function properly.
An analogy would be trying to make a cake batter with a cake mixer that doesn’t have any batteries.
Okay, that was not a great analogy.
As you can imagine, a niacinamide (NAD+) deficiency – which essentially leads to a systematic energy deficiency – is going to negatively impact many different systems in the body.
The most common symptoms of a severe vitamin B3 deficiency, resulting in a disease called pellagra, are diarrhea, dermatitis, dementia, and death; also known as the ‘the four Ds’.
So a vitamin B3 deficiency is definitely bad news.
I sure don’t want ‘the four Ds’!
Health Benefits of Niacinamide Supplementation
To give you just a few examples of the therapeutic uses for this vitamin:
- Topical (applied on your skin) niacinamide is great for skin health and treating acne!
- Research shows that boosting NAD+ levels can be beneficial in a number of cardiovascular, neurodegenerative and metabolic disorders.
- Niacinamide can reduce neuroinflammation by inhibiting an enzyme called PARP-1 (also improves mitochondrial function by raising NAD+) and may thus be a promsing treatment for Alzheimer’s disease.
- NAD may be a promising treatment for chronic fatigue syndrome (CFS).
- There’s currently an ongoing study on using low dose naltrexone (LDN) together with NAD+ for people suffering from post-COVID-19 syndrome.
I could go on and on but you’re absolutely right…
…this article is about niacinamide and anxiety disorders, which is what we’re going to look at right now!
Is Niacinamide An Effective Treatment for Anxiety?
I found this report where three patients took high doses of niacinamide (2 – 2.5 g per day) for their chronic anxiety.
Did it help?
After a couple weeks of taking large doses of vitamin B3 ALL three of them saw improvements in their anxiety.
One person reported that her anxiety, nervousness, excessive worrying, and panic attacks, completely went away.
Another person said that as soon as she felt anxious she would take niacinamide and it would help:
“I take the niacinamide and I’m fine afterwards.”
Randomized Trials Using Niacinamide for Anxiety?
During my research I also came across this double blind, placebo controlled trial using oral (preformed form) NADH for treating chronic fatigue syndrome.
I thought it was interesting to bring up because the patients who were randomized to the NADH treatment saw a significant decrease in their anxiety levels versus the placebo group!
Vitamin B3 Also Helps With Benzodiazepine Withdrawals?
Here’s another case report where a 34 year old male patient (who had suffered from anxiety for the past 20 years!) started taking 2.5 grams of niacinamide per day.
He had been treating his anxiety using benzodiazepines for the past 4 years and was trying to come off his medication… however when he attempted to stop the Klonopin it caused severe insomnia and bouts of debilitating panic and anxiety.
By taking large doses of niacinamide (2.5 g) spread out 3x per day, he was able to completely wean himself off the Klonopin over a period of 2 weeks!
He reported feeling great and that his chronic anxiety wasn’t a problem any more, and he couldn’t tell any difference between the vitamin B3 and the benzodiazepines!
There was also a study done on 28 patients who had been abusing benzodiazepines (flunitrazepam). They were randomly assigned to either an IV (intravenous) with vitamin B3 or just glucose. Patients who got the vitamin B3 had significantly fewer withdrawal symptoms vs placebo!
So… how exactly does niacinamide calm down anxiety and fear?
Niacinamide Has Calming “Benzodiazepine-Like” Properties
Benzodiazepines, or “benzos”, are a class of powerful anti-anxiety drugs.
Benzodiazepines enhance the effects of GABA – the calming neurotransmitter in the brain – thereby having a calming, anxiolytic, sedative and muscle relaxant effect.
So, these drugs do work for anxiety…
…but they come with side effects.
The problem with benzodiazepines is that they are extremely addictive, and most people have an awfully difficult time stopping them without suffering from terrible withdrawal symptoms, severe insomnia, severe panic attacks, etc.
It would be great if we could get the same effects as benzodiazepines but without the nasty side effects.
Lucky for us there may be such a thing.
What’s super interesting is that (at high doses) niacinamide has benzodiazepine-like effects in the brain!
Quoting from the study above:
“Niacinamide has properties in common with benzodiazepines in its action in spinal cord activity, its anticonflict, anticonvulsant, anti-aggressive, muscle relaxant and hypnotic action. It also seems to influence GABAergic mechanisms without binding to the GABA recpetor itself.“
When mice are given “massive amounts of niacinamide” it has a powerful tranquilizing effect.
So one possible explanation for niacinamide’s anxiolytic properties is that it mimics the effects of benzodiazepines.
This may help explain how the person I mentioned above was able to use vitamin B3 to wean himself off benzodiazepines!
Fun fact: The original founders of AA (alcoholics anonymous) originally encouraged members to take B3 based on Dr Hoffer’s research. Perhaps it was a big part of their success?
Niacinamide Treats NAD+ Deficiency (Subclinical Pellagra)
Your vitamin B3 stores may become depleted over time as a result of exposure to chronic stressors, including but not limited to:
Anything that puts stress on the body increases energy demands, which means an increased needs for nutrients like vitamin B3 (to make NAD+).
This is how severe chronic stress can lead to the disease called pellagra – a severe deficiency of vitamin B3.
The first symptoms of pellagra often present themselves as gastrointestinal issues, and in the three case reports we discusses earlier, all of the patients had some kind of gut issues such as constipation, stomach aches and gas.
(I would venture to say that gut issues are actually a direct cause of anxiety.)
In this article from 1943 Dr. Kaufman states that an insufficiency of vitamin B3 is quite widespread and can cause many non-specific signs and symptoms, including psychological manifestations, and that treating an insufficiency often requires relatively large doses of niacinamide (up to 350 mg).
Which does make sense, because remember, a lack of niacinamide (NAD+) will affect literally every system and organ in the body.
…back to the 3 case reports:
Perhaps these 3 individuals actually suffered from a subclinical form of pellagra that affected both the body and brain?
And by taking large doses of niacinamide this addressed the nutrient (NAD+) deficiency and alleviated any psychological manifestations of pellagra!
Another vitamin that can become depleted from stress is vitamin B1 a.k.a thiamine (you can read about it in this article).
Niacinamide Lowers Lactic Acid In The Body And Brain
You know that burn in your muscles you get during intense exercise?
That’s due to lactate (or lactic acid) buildup.
Now, as it turns out, having high blood levels of lactate isn’t all that great if you’re dealing with anxiety and panic attacks.
Why is that?
So… maybe lactate is acting as an anxiety trigger?
High lactate is a powerful anxiety trigger and can provoke panic attacks in susceptible individuals (related to central noradrenergic activation).
How Niacinamide Lowers Lactate Levels
MELAS syndrome is a mitochondrial disease where energy production fails and there is a resulting build up of lactic acid in the body.
I found this case report where an individuals suffering from MELAS was given 4 grams of niacinamide daily…
…and within three days blood lactate and pyruvate dropped by a whooping 50%!
To make a long complex story short:
Niacinamide improves glucose oxidation and increases the NAD+/NADH+ ratio → the body can get rid off excess lactate (turning it into pyruvate) which helps reduce anxiety levels!
The shortness of breath, or hyperventilation, that is common during a panic attack also increases lactate in the body which makes you feel even more fearful. So taking some niacinamide can be a great tool to help you get out of that vicious circle!
(Breathing in a paper bag works similarly to reduce anxiety by lowering lactate and raising CO2.)
Vitamin B3 As A Treatment for Schizophrenia & Psychosis
Way back in the 1950’s, Dr Abram Hoffer started using high doses of niacin (+3 grams daily) to treat patients with psychosis and schizophrenia.
He conducted several double-blinded RCT trials which showed that vitamin B3 (in the form of niacin) was a highly effective treatment for acute schizophrenia.
Dr. Hoffer reported that early signs and symptoms of a subclinical vitamin B3 deficiency (pellagra) looked a lot like mood disorders such as anxiety and depression.
Below is a video of Abram discussing a case where a girl successfully treated her schizophrenia by taking up to 60 g (!) of niacin per day. After she got well she could then decrease the niacin to a more normal dose of 3 g per day.
“When she reached 60 g all the voices stopped“
It’s kind of amazing just how effective this nutrient seems to be for schizophrenia and bipolar.
A more recent study from 2019 also showed a correlation between a defect in the enzyme NAPRT1 that converts niacinamide to NAD and a higher risk of schizophrenia – supporting Hoffer’s claims.
*It’s been found that patients with schizophrenia have a significantly lower brain pH due to high lactate vs healthy controls.
What Is An Effective Dose of Niacinamide For Anxiety or Depression?
“Hmm… there might be something to this vitamin B3 stuff, maybe I should give it a shot”
I’ll be completely transparent and admit that niacinamide was not a part of my own recovery from anxiety and panic attacks.
I rarely get anxious nowadays (thankfully)… however, I have found vitamin B3 to really help with some other health issues and I get a noticeable mood lift by taking 0.5-1 grams.
How much niacinamide should you take for anxiety relief?
Based on all the evidence we’ve looked at, as well as my personal experience, I think the right approach is “go big or go home”.
There’s something uniquely relaxing about larger doses of vitamin B3 that you just do not get with small amounts.
Practical Recommendations for Supplementing Niacinamide
1) Get a Clean Niacinamide Supplement!
If you’re looking for a good product:
Here’s a clean, i.e no unwanted fillers, 100% niacinamide supplement (Amazon).
But really any good quality vitamin B3 supplement will work equally well. Just make sure it doesn’t contain nasty binders and fillers such as titanium dioxide or talc.
2) Be Conservative.
I would start off with the RDA of about 10-30 mg and see how you feel.
If you do not experience any negative symptoms you can bump up the dose.
3) Take Niacinamide With a Big Meal.
This nutrient is a powerful stimulator of energy metabolism and you will need fuel in the tank, otherwise it can drop blood sugars and cause an unpleasant stress reaction (as I explained in this article).
Hence it’s advisable to take your vitamin B3 with plenty of food and carbohydrates, like a big pile of rice or potatoes or something.
4) Work Yourself up To Higher Doses.
Dr. Hoffer usually recommended taking 3 g daily for his patients with psychiatric illnesses and they usually got relief after a few weeks of treatment, and it was safely used to treat children for long periods without any side effects.
I think 500 – 1000 mg a few times per day (up to 3 g daily) is a good dose for treating anxiety.
There’s been one report of very large doses (9 g per day) causing hepatic toxicity so I think it’s safest to not go above 3 g per day.
Also, a common side effect when you take too much is nausea, which can be fixed by decreasing the dose by 1 g.
Conclusion – Niacinamide For Anxiety?
Is niacinamide the “magic pill” for anxiety and/or depression?
I can’t say for sure whether you’re going to benefit from vitamin B3 supplementation – you will just have to try it out and see what happens.
Honestly sometimes a supplement just doesn’t agree with a person for whatever reason; I can cite all the studies in the world but if it doesn’t work for your body, then it’s just not helpful.
However, as we have discussed, there is some pretty good evidence that large doses of niacinamide can be therapeutic for anxiety, mood issues, panic attacks and depression!
My opinion is that it’s another great tool in the toolbox that can be used to combat anxiety (thiamine + magnesium is another fantastic anti-anxiety tool).
For more information on how to improve your anxiety make sure to check out this informational article I wrote!