Niacinamide benefit and side effects, also known as the amide of vitamin B3
Does it help with arthritis or skin health?
February 1 2017

Vitamin B3 is made up of niacin (nicotinic acid) and its amide, niacinamide.

Q. Is niacin the same as niacinamide?
   A. Both of them are called vitamin B3, however, they have different chemical structures. Niacin is the same as nicotinic acid, which may cause flushing, a feeling of warmth on the face and neck with a high dosage.

Niacinamide is the amide form of niacin, which does not cause flushing.

Niacinamide content in food
Niacinamide is found in many foods, including yeast, meat, fish, milk, eggs, green vegetables, and cereal grains.

Niacinamide made from tryptophan
Nicotinamide, also known as niacinamide and nicotinic acid amide, is the amide of nicotinic acid (vitamin B3). Dietary Tryptophan is able to convert to niacin in the body.

Vitamin B complex
Niacinamide is often found in combination with other B vitamins including thiamine, riboflavin, pantothenic acid, pyridoxine, cyanocobalamin, and folic acid.

Niacinamide and arthritis 
Q. A friend of mine recently told me that it was effective in treating his arthritis, which i remember was quite a problem for him in years past. I haven't yet found anything conclusively supportive or damning in regards to the use of niacinamide for arthritis. The main support of it's use in this direction is a study done by a Dr. William Kaufman which I've been unable to obtain so far. Though there are many articles on niacinamide, i haven't been able to find the studies themselves.
   A. We found on clinical study regarding the role of niacinamide and arthritis.

The effect of niacinamide on osteoarthritis: a pilot study.
Inflamm Res. 1996. Jonas WB, Rapoza CP, Blair WF. Office of Alternative Medicine, National Institute of Health, Bethesda, MD, USA.
Seventy two patients with osteoarthritis were randomized for treatment with niacinamide or an identical placebo for 12 weeks. Global arthritis impact improved in subjects on niacinamide and worsened by 10% in placebo subjects. Pain levels did not change but those on niacinamide reduced their anti-inflammatory medications by 13%. Niacinamide reduced erythrocyte sedimentation rate by 22% and increased joint mobility by 4.5 degrees over controls. Side effects were mild but higher in the niacinamide group. This study indicates that niacinamide may have a role in the treatment of osteoarthritis. Niacinamide improved the global impact of osteoarthritis, improved joint flexibility, reduced inflammation, and allowed for reduction in standard anti-inflammatory medications when compared to placebo. More extensive evaluation of niacinamide in arthritis is warranted.

Nicotinamide and sun exposure
Oral nicotinamide protects against ultraviolet radiation-induced immunosuppression in humans.
Carcinogenesis. 2009. Yiasemides E, Sivapirabu G, Halliday GM, Park J. Yiasemides E, Sivapirabu G, Halliday GM, Park J, Damian DL. Dermatology, Sydney Cancer Centre, Bosch Institute, University of Sydney at Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
Cutaneous immunity, which is a key defence against the development of skin cancers, is suppressed by even small doses of ultraviolet (UV) radiation. Preventing this UV-induced immune suppression may therefore reduce the incidence of skin cancer. Nicotinamide (vitamin B3) has immune-protective and cancer-preventive effects against UV radiation in mice, and we have shown previously that topical nicotinamide is immune protective in humans. Using the Mantoux model of skin immunity in healthy volunteers, we compared oral nicotinamide to placebo (both administered for 1 week) in a randomized, double-blinded, crossover design against the effects of solar-simulated ultraviolet (ssUV) radiation on delayed-type hypersensitivity to tuberculin purified protein derivative. Discrete areas of the back were irradiated with low doses of ssUV daily for three consecutive days. Immunosuppression, calculated as the difference in Mantoux-induced erythema of irradiated sites compared with unirradiated control sites, was determined in volunteers taking oral nicotinamide and placebo. Significant immunosuppression occurred in an UV dose-dependent manner in the presence of placebo. Oral nicotinamide, at doses of either 1500 or 500 mg daily, was well tolerated and significantly reduced UV immunosuppression with no immune effects in unirradiated skin. Oral nicotinamide is safe and inexpensive and looks promising as a chemopreventive supplement for reducing the immunosuppressive effects of sunlight.

Review and biochemistry
The vitamin nicotinamide: translating nutrition into clinical care.
Molecules. 2009; Maiese K, Chong ZZ, Hou J, Shang YC. Division of Cellular and Molecular Cerebral Ischemia, Wayne State University School of Medicine, Detroit, Michigan, USA.
Nicotinamide, the amide form of vitamin B(3) (niacin), is changed to its mononucleotide compound with the enzyme nicotinic acide/nicotinamide adenylyltransferase, and participates in the cellular energy metabolism that directly impacts normal physiology. However, nicotinamide also influences oxidative stress and modulates multiple pathways tied to both cellular survival and death. During disorders that include immune system dysfunction, diabetes, and aging-related diseases, nicotinamide is a robust cytoprotectant that blocks cellular inflammatory cell activation, early apoptotic phosphatidylserine exposure, and late nuclear DNA degradation. Nicotinamide relies upon unique cellular pathways that involve forkhead transcription factors, sirtuins, protein kinase B (Akt), Bad, caspases, and poly (ADP-ribose) polymerase that may offer a fine line with determining cellular longevity, cell survival, and unwanted cancer progression.