Niacinamide (Vitamin B3) For Lowering Stress & Anxiety?

Niacinamide (vitamin B3) is pretty awesome for alleviating anxiety.

How does it work?

That’s what we’re going to talk about in today’s article – let’s dive right in!

What is Niacinamide?

Vitamin B3, also known as niacin or niacinamide, is an essential vitamin.

That is to say, vitamin B3 is an organic compound that that the body needs in small amounts to function properly.

(Your body can actually produce some vitamin B3 from the amino acid tryptophan, so technically it’s a semi-essential vitamin, though the tryptophan → vitamin B3 synthesis isn’t very efficient.)

Anyways:

What do you need this semi-essential vitamin for?

Vitamin B3 is a precursor to the coenzymes NAD+ and NADP. These coenzymes are involved in a bunch of important 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.

Here’s the entire NAD+ molecule with niacinamide circled in red

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).

Niacinamide Is Essential for Energy (ATP) 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/ATP!

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 — ATP.

ATP = the body’s main energy currency.

For anyone curious, here’s the slightly longer 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:

Here you can see the NAD+ molecule delivering electrons in order for ATP to be produced!

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 (ATP), 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, maybe that wasn’t the greatest analogy.

Anyhow…

As you can imagine, a niacinamide (NAD+) deficiency, which basically leads to a systemic energy deficiency, is going to negatively impact many different parts of the body.

And indeed, the 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’!

Some Awesome Health Benefits of Niacinamide Supplementation

Taking niacinamide restores NAD+ levels and enhances your energy production ↑.

To give you just a few examples of the therapeutic uses for this vitamin:

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?

Yup!

After a couple weeks of taking large doses of vitamin B3 ALL three of them saw big 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 May Help 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.

Now:

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.)

Dr. William Kaufman was among the very first doctors who used megadoses of vitamin B3 in his practice to treat his patients with arthritis.

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.

Another vitamin that can become depleted from stress is vitamin B1 a.k.a thiamine (you can read about it in this article).

Now…

…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!

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”

Excellent idea!

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.

Anyways…

How much niacinamide should you take for anxiety relief?

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 by using conservative amounts, about 50-100 mg and see how you feel.

Sometimes this is enough to correct a deficiency and/or shift neurotransmitter in the right direction to alleviate anxiety. If you do not experience any negative symptoms you may choose to bump up the dose.

3. Take Niacinamide With 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 potatoes or something.

4. Try Higher Doses

Dr. Hoffer recommended his patients with psychiatric illnesses to take 3 grams per day and they usually experienced relief after a few weeks of treatment. It was safely used to treat children for long periods without any side effects.

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.

However, if you choose to use niacinamide or niacin for long-term management of anxiety, I think it would be best to stick with doses around the RDA, perhaps 50 mg 1-2x per day.

Conclusion – Niacinamide For Anxiety?

Is niacinamide the “magic pill” for anxiety and/or depression?

Probably not.

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!

Cheers 🙂

4 thoughts on “Niacinamide (Vitamin B3) For Lowering Stress & Anxiety?”

    • Hi Catherine,

      Yes, niacin and niacinamide are very similar and can both work for anxiety! However with the high(er) doses of niacin you may get a so-called ‘niacin flush’ where your skin becomes red and hot and itchy. Some find this a little unpleasant whereas some find it relaxing. Just something to keep in mind 🙂

      Reply
  1. What would be the comparable dosage pet gram of niacinamide/NAD if we’re talking about nasal spray, which often comes in 300mg per spray doses, if we were interested in taking 1 to 3grams of niacinamide daily like the anxiety studies? How long would you say one could use the spray for anxiety? Thanks!

    Reply
    • Hi Moira, sorry for the delayed reply!

      To be 100% honest, I am not sure what the exact “conversion rate” would be between oral niacinamide vs intranasal niacinamide/NAD. Intranasal administration of supplements tends to have a much higher bioavailability vs oral route, so I would probably go with a lower dose, maybe ~ 300mg.

      Hope that was helpful!

      Reply

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