Niacin Supplements Appear To Help Pd Motor Function
by U.S. Medicine | May 12, 2022
A six-month double-blind, placebo-controlled randomized study was conducted by the Charlie Norwood VAMC and the Medical College of Georgia, both in Augusta, to determine whether low-dose daily niacin supplements would help with those symptoms. Results were published in the journal Biomedicines.1
Researchers assigned 47 PD patients to receive low-dose niacin or a placebo. At the end of the double-blind phase, all participants were dosed with open-label niacin for the next six months. Evaluation of all patients occurred at baseline, after six months, and after one year of treatment.
Defined as the primary outcome measure were Unified Parkinsons Disease Rating Scale III scores, while secondary outcome measures included depression, sleep quality, mental flexibility and cognition, and physical fatigue.
Niacin treatment was well-tolerated by forty-five subjects, the authors reported. The mean change in UPDRS III scores at six months of placebo was -0.05 , and niacin was -1.06 . From six to twelve months when both groups received open-label niacin supplementation, the average UPDRS III scores significantly decreased for the placebo group by 4.58 and the niacin group by 4.63 points.
That led to the conclusion, Low-dose niacin supplementation is a well-tolerated adjunct therapy and may improve motor function in PD when taken over a longer period.
What Does Nad+ Do
NAD+ stands for Nicotinamide Adenine Dinucleotide, and is an essential molecule found in every cell of your body. It is a coenzyme of Vitamin B3 , which means its a small helper molecule that binds to a protein molecule in order to activate an enzyme. Enzymes are responsible for over 5,000 different biochemical reactions throughout the body and NAD+participates in more reactions than any other vitamin-derived molecule.
Mitochondrial Dysfunction Enough To Cause Parkinsons In Mice
Abnormal energy metabolism due to problems in the workings of mitochondria, the organelles that serve as a cells power source, is thought to play a role in both Parkinsons initiation and progression.
Nicotinamide adenine dinucleotide is a molecule essential for proper mitochondria function, and emerging evidence suggests that boosting cellular levels of NAD may have protective effects in neurodegenerative diseases.
NAD can be replenished by supplementing with nicotinamide riboside a modified form of vitamin B3 and a precursor of NAD. Cell and animal studies suggest that NR supplements were neuroprotective in models of amyotrophic lateral sclerosis and Alzheimers disease.
Nicotinamide riboside is also the active ingredient in Niagen, a dietary supplement for healthy aging marketed ChromaDex.
A Norwegian research team led by Charalampos Tzoulis, MD, PhD, at Haukeland University Hospital and the University of Bergen, conducted a Phase 1 study called NADPARK to evaluate whether NR can alter NAD levels and affect metabolism in the brains of people newly diagnosed with Parkinsons and not yet under dopamine-replacing treatment.
We believe that augmenting the brains NAD metabolism will not only target and rectify disease-related processes specific to but may also optimize neuronal metabolism and fortify neurons, rendering them more resilient against age-related stress and neurodegenerative diseases, Tzoulis said.
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Vitamin B3 And Parkinson’s
There are 3 forms of vitamin B3: niacin , nicotinamide, and nicotinamide riboside. All 3 are related and used by the body in the same way.
As the body cannot store this vitamin, having a healthy diet that contains adequate vitamin B3 is essential. Fortunately, it is found in many different foods, including turkey, tuna, cereal, mushrooms and peanuts. But now researchers think, for some people, taking larger doses of certain forms of this vitamin may have beneficial effects in Parkinson’s.
Research carried out in the lab and in fruit flies has previously found that nicotinamide riboside may boost energy in nerve cells and help prevent them being lost in Parkinson’s. It did this by boosting levels of a compound called NAD that is used to generate energy inside cells.
Niacin Enhancement For Parkinsons Disease: An Effectiveness Trial
- 1Department of Interdisciplinary Health Sciences, Augusta University, Augusta, GA, United States
- 2Charlie Norwood Veterans Affairs Medical Center, Augusta, GA, United States
- 3Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, United States
- 4Department of Neurology, Augusta University, Augusta, GA, United States
- 5Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
- 6Department of Undergraduate Health Professions, Augusta University, Augusta, GA, United States
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New Research Supports Niacin For Parkinsons Disease Treatment
New research1 further supports the use of Niacin in the treatment and long-term management of Parkinsons Disease . Parkinsons disease occurs when dopaminergic neurons in the substantia nigra are lost the loss of dopamine causes the neurological manifestations of PD. This loss of dopaminergic function can have various etiologies, but as Dr. Miguel Martins, lead researcher of the study points out,
in some hereditary cases, the main problem is unhealthy mitochondria.
The role of dysfunctional mitochondria in the pathogenesis of PD has been explained before2, as a cascade of events which includes cellular insult leading to a decreased membrane potential and more permeable transitional pores. The increased pore permeability, in turn, leads to a depletion of NAD+ and ultimately cell death.
Parkinsons Disease Is A Neurodegenerative Disorder
If someone you love has been diagnosed with a neurodegenerative disease, this can be difficult to process. Neurodegenerative disorders can be overwhelming, seeming to strip someone of his or her identity. Even though your loved one is physically there, he or she might change so much that he or she is difficult to recognize. One of the most common neurodegenerative disorders is called Parkinsons Disease.
When someone you love has Parkinsons Disease, this can erode the fabric of who that person is. In this manner, Parkinsons Disease has an impact on not only the individual with the diagnosis but also his or her family members and friends. Therefore, it is important to understand how Parkinsons Disease manifests as well as some of the common symptoms.
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Outstanding Questions And Future Perspectives
Recent studies on animals and human clinical trials have expanded our understanding of NAD+ and NAD+-dependent enzymes in neuroplasticity, brain aging, and neurodegenerative disorders. Emerging evidence suggests NAD+ depletion in brain cells is common during aging and is accentuated in many neurodegenerative disorders including AD, PD, HD, and ALS, and that NAD+ augmentation inhibits pathological features in animal models of these disorders . Emerging findings are revealing a critical role for NAD+ in neural resilience and in the molecular mechanisms of the hallmarks of brain aging. Although NAD+ depletion occurs in vulnerable neuronal populations in several major neurodegenerative diseases, it remains to be established whether impaired NAD+-dependent processes occur upstream and/or downstream of the specific proteopathic lesions that define each of the neurodegenerative diseases .
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How Nad Therapy Can Help Parkinsons Disease
Parkinsons disease neurological deterioration and the arising motor dysfunction are triggered by the formation of Lewy body and the death of dopaminergic neuronal within the substantia nigra. Impaired function of the mitochondrial and incorrect cellular metabolism of the reactive oxygen species are the two factors known to cause apoptosis which is related to PD.
What is Parkinsons Disease?
Parkinsons disease is the world second largest neurodegenerative illness among older adults. It is characterized by motor functionality disturbances such as bradykinesia, muscular rigidity, and resting tremors.
The part of the brain responsible for motor control releases a compound known as nicotinamide adenine dinucleotide which is said to ease PA symptoms. In a mouse study of the disease, it has also been clinically proven to reduce the neurons that produce dopamine. NAD is a substance that activates the action of an enzyme.
Research shows that the causative mechanism of Parkinsons disease involves inactive mitochondria, genetics, and oxidative stress. These then trigger an imbalance between the ability of the cells to detoxify free radicals and the production of free radicals. The cellular and the molecular changes that occur destroy dopamine-producing neurons. This is the nerve cell that dies in PA.
Studies show that NAD is crucial in the metabolism of healthy cellular redox and the production of energy in the mitochondrial.
Case Study on NAD Therapy
The Rodent Model
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What The Researchers Found
Results, published in the journal Cell Metabolism, showed that nicotinamide riboside supplements boosted levels of a compound called NAD in the brain compared to the group who took the dummy medication.
The supplement also showed promising signs that it may improve metabolism and reduce inflammation in the brain, which could have protective effects in the brain. And the participants who showed the greatest increase in NAD levels also showed some mild improvements in their Parkinsons symptoms.
These early findings suggest that nicotinamide riboside may have beneficial properties for slowing down the progression of Parkinson’s. The team are already taking these findings forward in a larger, phase 2, trial.
Dr Beckie Port, Head of Research Communications and Engagement at Parkinson’s UK, comments:
“This study builds on previous research that shows the important role vitamin B3 may play in keeping brain cells healthy and working properly.
“While results are needed from larger, longer-term trials, it is exciting that the researchers may find that a relatively inexpensive dietary supplement could help manage some of the symptoms which impact the everyday lives of people with Parkinsons.
“Interestingly, the team found that the supplement may not benefit everyone. But for some, there are promising signs that nicotinamide riboside may have protective effects that could help slow the progression of Parkinson’s.
What The Researchers Did
The team in Norway have conducted the first small scale clinical trial of nicotinamide riboside for people with Parkinsons.
30 people took part in the study with 15 receiving 1000mg of nicotinamide riboside daily for 30 days. The other 15 people were given dummy pills known as a placebo. Importantly, neither the participants nor the researchers knew who was taking the supplement containing nicotinamide riboside.
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Why You Need More Vitamin B3 In Your Diet
Vitamin B3, or niacin, is one of the vitamins needed for human life. While it is necessary for everyone, it may have added value for people with inherited Parkinsons.
In a recent research study from the University of Leicester, scientists examined the effect of niacin-rich foods on fruit flies.
The flies had a genetic mutation similar to the one in people with hereditary Parkinsons. They learned that the high-niacin food prevented the degeneration of neurons in the brains of the flies.
What does this mean for people with Parkinsons?
We cant assume that an animal study will apply to humans. About 75% of the DNA in fruit flies is the same as human DNA, so although flies are good research subjects, the study results are not conclusive.
However, it is still possible that niacin-rich foods could benefit people with Parkinsons disease.
As niacin is already being used in cancer studies, and in treating strokes, we can trust that increasing high-niacin foods in our diet will be safe and may be therapeutic.
It is important to note that the research indicates that natural, food-based sources of niacin/vitamin B3 are preferable, rather than supplement tablets.
How much niacin/vitamin B3 do we need daily?
The recommended daily amount of vitamin B3 for adults is 16mg for men and 14mg for women.
There is no risk of excess or toxicity from foods. However, with use of supplement tablets there is an upper limit of 35mg per day for adults.
Which foods are high in vitamin B3?
Nad Treatment For Alzheimers Disease
If you are a loved one is struggling with Alzheimers disease call us at to get an assessment and see if Dr. Milgram can help with an NAD infusion.
Alzheimers disease is defined as a chronic neurodegenerative disease that is associated with loss of memory, coordination, and spatial awareness, among other things.
NAD is essential to living and is found in every cell of all living things. There is much more NAD in the bodies of babies and growing adults. Declining NAD is due to the inability of our cells to recycle NAD, or to synthesize new NAD. This decline is associated with Alzheimers.
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Available Light Therapy Devices
Because light therapy delivered via the eyes or the skin has minimal side effects, multiple light-emitting devices have already been designed, marketed, and are available for purchase without FDA approval.
These white light and red-light devices are currently marketed for treatment of depression, chronic pain, wrinkles, wound healing, acne, and sleep improvement. There are no white light or red-light therapy devices yet on the market that are designed and marketed specifically for Parkinsons disease.
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Vitamin B3 Supplement Shows Early Promise For Parkinson’s
Researchers in Norway have published results from an early stage clinical study looking at the potential of a dietary supplement for people with Parkinson’s.
The NADPARK study, a phase 1 clinical trial in newly diagnosed people with Parkinson’s, showed promising signs that vitamin B3 supplements may have protective effects on the brain.
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Trial Shows Increasing Brain Nad+ Improves Parkinsons
In clinical study, Norwegian researchers show that supplementation with NAD+ precursor NR improves underlying defects of Parkinsons disease.
- NR supplementation increases brain NAD+ levels and reduces brain activity in regions typically active in patients with Parkinsons disease.
- Changes in brain patterns following NR supplementation were strongly correlated with improved physical performance.
- NR activates genes that repress Parkinsons disease drivers: oxidative stress, mitochondrial dysfunction, and brain inflammation .
Nad+ Synthesis In Cells
Nicotinamide adenine dinucleotide is a fundamental molecule in health and disease, as it is central to several cellular bioenergetic functions. NAD+ is synthesized via three major pathways, including de novo biosynthesis, the Preiss-Handler pathway, and the salvage pathway . While the aspartate pathway is the de novo NAD+ pathway in most photosynthetic eukaryotes, the kynurenine pathway is the only de novo NAD+ synthetic pathway in mammals. The kynurenine pathway starts with the catabolism of the amino acid tryptophan that is converted via two steps to the intermediate kynurenine, which can generate NAD+, kynurenic acid, or xanthurenic acid . The kynurenine pathway modulates neuronal functions as it is involved in the synthesis of two fundamental neuro-transmitters as well as regulates N-methyl-D-aspartate receptor activity and free radical production . The kynurenine pathway exhibits double-edged sword effects on neurons with both neuroprotective metabolites and neurotoxic intermediates, including 3-hydroxykynure-nine that generates free radicals, 3-hydroxyanthranilic acid , and quinolinic acid . While kynurenic acid is an NMDA receptor antagonist, quinolinic acid is an NMDA receptor agonist . The ambient levels of these metabolites are determined by different enzymes, which in the brain are preferentially localized in microglia and astrocytes, suggesting necessary glial cell-neuron communication .
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Is It Beneficial In Parkinsons
There is evidence suggesting that niacin may be useful in Parkinsons. However, the research is still in the laboratory stage and has not been confirmed in humans yet.
In the lab, when fruit flies with Parkinsons are given niacin/vitamin B3, it protects their brain cells from dying. This could be due to its ability of preserving the health of mitochondria, which leads to Parkinsons when damaged.
Mitochondria are tiny structures inside the cell that look like grains in shape. They provide energy to the cell and it is because of this function, they are often known as powerhouse of the cell. When mitochondria lose their functions, the brain develops abnormal changes and prompts diseases like Parkinsons.
The beneficial effects of vitamin B3 were recently shown by a group of researchers at the University of Leicester. They conducted a series of experiments on fruit flies carrying a mutation in the gene called PINK1, which is strongly linked to Parkinsons. People with mutations in this gene usually develop Parkinsons at a young age.
In their experiments, the mutant flies were given two types of food: with and without vitamin B3. It was found that those flies who were on vitamin B3 supplemented diet had increased in the number of healthy mitochondria than those who were on a normal diet.
These results, which were published in the Journal of Biology Open, suggest that increasing dietary intake of niacin by supplementation might be useful in Parkinsonss disease.
Nr Affects Genes Linked To Oxidative Stress Mitochondrial Dysfunction And Brain Inflammation
Since oxidative-induced injury drives Parkinsons disease progression, investigators wanted to see if NR affected any genes responsible for combating oxidative stress. By looking at messenger RNA molecules, intermediate templates for protein formation, Brakedal and colleagues noticed significantly higher levels of the gene KLF2, which upon activation, turns on another protein that serves to guard against oxidative damage. Moreover, this finding demonstrates NRs ability to block one of the key players that promote Parkinsons disease progression.
NR activates genes that hinder Parkinsons disease promoters
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Niacin For Parkinsons Disease
Charlie Norwood VA Medical Center, Augusta, GA
To examine the blood, urine and spinal fluid of persons with Parkinson’s to look for evidence of inflammation and whether 18 months of vitamin B3 supplementation may reduce the inflammation and/or improve PD motor and non-motor symptoms.
thanks for pointing out. the link has been corrected
Is this the right link?
When I opened this link, I go to a landing page that lists several studies, but I cannot open the one re niacin. What am I doing wrong?
Mmm easy enough to test this one on yourself without having to join the trial!
Niacin is cheap. My husbands natural doctor just emailed to say he should try it by starting on 25 mg 3 x per day of the flushing niacin , increase by 25mg each day until flushing is achieved then drop back to the dose the day before flushing occurred. Havent tried it yet as he is already on about 120mg per day of the non flushing niacinamide. I am not sure how interchangeable they are.