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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by joebob on April 15, 2005, at 12:07:32
a doctor friend of mine just attended a seminar in which a practicing psychiatrist said that w/ 6-10 gms / day he had excellant results with most symptoms and conditions.....
the doc did not find the same results with niacinamide.....
so i am wondering if this is safe and makes sense?any comments appreciated
thanks,
joebob
Posted by LOOPS on April 15, 2005, at 13:15:36
In reply to mega dose niacin for mental health? lar et al, posted by joebob on April 15, 2005, at 12:07:32
well yeah, if you can take the mega flushing from it! I got flushes from just 100mg niacin.
I would also like to find out opinions on niacin vs niacinamide. For instance, most people here will say niacinamide is the safest form to take in high doses, where are niacin might damage the liver (or something like that). HOwever I have read in Michael Lesser's book that it is the other way round - niacin is safer in larger doses (than 1.5g/day) - and that niacinamide and other no-flush niacin forms should be kept to a max of 1.5g/day.
What is the consensus on this? Myself I have not been able to try niacin in high-er dosages as it the flush is too uncomfortable. High dose niacinamide just makes me depressed but is good for an emergency anxiety problem.
Loops
Posted by Larry Hoover on April 15, 2005, at 17:29:04
In reply to Re: mega dose niacin for mental health? lar et al, posted by LOOPS on April 15, 2005, at 13:15:36
> well yeah, if you can take the mega flushing from it! I got flushes from just 100mg niacin.
>
> I would also like to find out opinions on niacin vs niacinamide. For instance, most people here will say niacinamide is the safest form to take in high doses, where are niacin might damage the liver (or something like that). HOwever I have read in Michael Lesser's book that it is the other way round - niacin is safer in larger doses (than 1.5g/day) - and that niacinamide and other no-flush niacin forms should be kept to a max of 1.5g/day.
>
> What is the consensus on this? Myself I have not been able to try niacin in high-er dosages as it the flush is too uncomfortable. High dose niacinamide just makes me depressed but is good for an emergency anxiety problem.
>
> LoopsJust for the record, to go to those high doses of niacin, you need to use the slow-release form, inositol hexanicotinate.....that's inositol (6 hydroxyl groups) with 6 ester bonds to nicotinic acid (niacin), or Niaspan, a proprietary drug (the XR pill type, with niacin as the extended release agent).
There is a risk of liver damage from any high dose niacin, so it should be done under doctor's supervision, with periodic blood draws for liver enzymes.
The risk goes down from extended-release niacin (Niaspan, a prescription drug), to slow-release niacin (sometimes called no-flush niacin; inositol hexanicotinate), to niacinamide (nearly the same as the slow-release), to plain immediate release niacin.
Hepatotoxicity is associated with high methyl-donor stress, and may arise due to depletion of SAMe. One school of thought holds that equimolar (same number of molecules) betaine should be taken with the niacin, to relieve this methyl-donor stress. That would be 1:1, gram for gram, betaine to nicotinic acid. Betaine is really activating for me, so who knows what high dose niacin with betaine feels like.
I base my UL recommendations for daily niacinamide intake (2.0 grams) on toxicity studies compiled by the National Academies of Science (very conservative people) detailed at:
http://www.nap.edu/openbook/0309065542/html/123.html#pagetop
...and other published sources.
Individual vulnerability to adverse reactions to niacin is quite wide. Some people get increases in liver enzymes at 100 mg/day (those are exceptional cases, but they do appear in the literature). Others take 9 grams/day for extended periods, without any adverse effect.
Have a doctor monitor your status....
Lar
Posted by joebob on April 15, 2005, at 19:01:26
In reply to Re: mega dose niacin for mental health? lar et al » LOOPS, posted by Larry Hoover on April 15, 2005, at 17:29:04
are there signs/symptoms to use instead?
i have a ton of in hex nic around here? how much safe to use w/out liver tests?thanks....i knew you would have something very useful to say
joebob
Posted by Larry Hoover on April 15, 2005, at 19:46:52
In reply to doctor monitoring liver not an economic option.... » Larry Hoover, posted by joebob on April 15, 2005, at 19:01:26
> are there signs/symptoms to use instead?
> i have a ton of in hex nic around here? how much safe to use w/out liver tests?
>
> thanks....i knew you would have something very useful to say
>
> joebobOk, according to the literature summary, the symptoms to be concerned about are flushing (the no-flush stuff can do this), vague gastro-intestinal distress, blurry or double vision, and jaundice.
The other stuff can only be detected by bloodwork (glucose tolerance issues, and the liver transaminase enzyme elevations).
Everything is reversible if you substantially reduce, or cut the dose entirely. If you don't, and symptoms persist, you can get into real trouble.
Lar
Posted by LOOPS on April 16, 2005, at 9:55:22
In reply to Re: mega dose niacin for mental health? lar et al » LOOPS, posted by Larry Hoover on April 15, 2005, at 17:29:04
Hey Larry -
is betaine related at all to TMG? Because for me, TMG was THE WORST thing ever (apart from Sam-e, which was also a pretty rough ride). It made me angry, anxious and bored at the same time - the worst combination. ANd that was with a smallish amount. Sam-e made me nuts - completely nuts - whizzing around the house doing a million things, writing too fast, then horrible insomnia with pounding heartbeat.
Learnt my lesson well from that one. I do fine on vitamins usually though. Especially ,regarding the B vitamins, with extra B1 and the P5P. I think it's hard to get enough B1 and also B5, even in a good diet, unless you eat tonnes of beans, cauliflower and mushrooms.
Loops
Posted by Larry Hoover on April 16, 2005, at 13:36:32
In reply to Re: mega dose niacin for mental health? lar et al, posted by LOOPS on April 16, 2005, at 9:55:22
> Hey Larry -
>
> is betaine related at all to TMG?Same substance, different name. In the context of the niacin megadose therapy, it would be presumably all used up by the niacin.
TMG/betaine is very activating for me, too.....I have no idea if the idea really works or not, anyway. There's a mechanism, a biochemical pathway, that suggests this is just the ideal way to avoid liver toxicity on niacin, but as far as I know, it has not been put to the test in a double-blind setting.
Lar
Posted by Spriggy on April 18, 2005, at 12:15:57
In reply to Re: mega dose niacin for mental health? lar et al » LOOPS, posted by Larry Hoover on April 16, 2005, at 13:36:32
I posted this down there before I saw this thread.
My husband took Niacin once ( I don't recall the dosage) and he felt really weird. He said he got very warm/flush inside and the next few days he had reddish hives all up his upper body.
After his experience, I always scared to try it.
This is the end of the thread.
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