Home » Excess niacin supplements can lead to an increase in strokes and heart attacks: the study in Nature

Excess niacin supplements can lead to an increase in strokes and heart attacks: the study in Nature

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Excess niacin supplements can lead to an increase in strokes and heart attacks: the study in Nature

by Cristina Marrone

Newly published work highlights how high-dose intake of vitamin B3 can increase the risk of cardiovascular disease. That’s where it is found in foods

Exaggerating with niacin (or vitamin B3) supplements may be linked to a higher risk of mortality from cardiovascular diseases, particularly heart attack and stroke. A new study published in warns about the risks of abuse of supplements Nature Medicine by a group of researchers from the Cleveland Clinic in the United States who identified the molecular mechanism by which too much vitamin B can be harmful.

What is niacin and where do we get it from

Niacin (or vitamin B3) is a water-soluble vitamin, that is, one that must be taken regularly with the diet even if our body is still capable of manufacturing it to a lesser extent from an essential amino acid, tryptophan. The vitamin is naturally contained in white meat, spinach, peanuts, beef liver, brewer’s yeast and some fish such as salmon, swordfish and tuna. Niacin plays a fundamental role in cell respiration, promotes blood circulation, protects the skin and is very useful in the food digestion process. Vitamin B3 is also very important for the correct functioning of the nervous system and has an anti-pellagra role, a disease caused by the lack of niacin which leads to skin lesions similar to sunburn, diarrhea and dementia. Today the disease is practically absent in the Western world while it affects endemically some areas of the world such as Africa, South America and some regions of India. In the United States, wheat flours and other cereals have been enriched with niacin for decades now to prevent food shortages: in this way, deaths from pellagra which had increased dramatically after the Great Depression of ’29 have been practically eliminated.

The need for vitamin B3

The daily requirement of vitamin B3 varies depending on sex: 14mg/g for adult women and 18mg/g for adult men. As mentioned, niacin deficiencies are now very rare in the Western world, however large varieties of B3-based supplements are available in pharmacies which promise general well-being, strengthening of the immune system and an inevitable help in slowing down aging. But be careful, overdoing it thinking you are doing good for your health can actually be harmful.

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The niacin paradox

Previous research has shown that niacin can reduce LDL cholesterol (bad cholesterol) levels and increase HDL cholesterol (good cholesterol) levels, as well as decrease triglycerides. The supplement is in fact still used today to control cholesterol, even though statins are much more effective. However, in other studies, such as a meta-analysis published in Journal of The American College of Cardiology, this effect has not been found to be linked to a lower risk of cardiovascular disease. «It has been recognized that niacin has a more complex effect on cardiovascular diseases – note the authors of the new study in Nature – and it is the so-called “niacin paradox”, whereby it reduces LDL cholesterol, but not the risk of cardiovascular events, presumably through cholesterol-independent mechanisms.”

Inflammation of the blood vessels

The American team’s research provided an explanation for this paradox by demonstrating that a degradation product of niacin can promote inflammation of blood vessels. Scientists analyzed plasma samples from 4,325 people from the United States and Europe and found that two metabolites (2PY and 4PY) that form when excess vitamin B3 is taken were associated with a risk of serious cardiovascular events, regardless of factors. of traditional risks. Of the volunteers who participated in the study, 1 in 4 appeared to consume excess levels of niacin and had elevated levels of the metabolite 4PY, which actually appeared to contribute to the development of cardiovascular disease. Elevated blood levels of 4PY have been closely associated with heart attacks, strokes, and cardiovascular events in large-scale clinical trials. Researchers have also shown in pre-clinical studies that 4YP directly triggers vascular inflammation that damages blood vessels, and this condition, over time, can lead to atherosclerosis.

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Vitamin B3 overdose

The study certainly cannot be considered definitive and confirmation is needed on the mechanism of action of niacin, however it is a warning about the effects of excessive doses. Overdose of vitamin B3 can also cause itching, nausea, headache, diarrhea, flushing and upper abdominal pain. Generally, a healthy person who follows a balanced diet does not need supplements: any deficiency can be verified with a simple blood test.

February 28, 2024

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