RELEVATE Nutrients

Nicotinamide (B3)

Key Food Groups: Poultry, Fish

Vitamin B3: Role in Brain Health

Vitamin B3 has powerful antioxidant properties related to binding and eliminating damaging free radicals in neurons. Vitamin B3 is taken in through the diet and converted to an active form called nicotinamide adenine dinucleotide (NAD), which plays a central role for metabolism in all tissues of the body, including the brain.1 Studies indicate NAD may play a key role in neuroprotection by maintaining the integrity of the blood-brain barrier2 and by slowing down the degeneration of neuronal axons (neuron cell projections used in communication and exchange). Without sufficient NAD, there may be a risk of axonal degeneration as we age, which is known to lead to peripheral neuropathies associated with neurodegenerative diseases like Alzheimer’s disease and Parkinson’s disease.3,4

Intake Deficiency and Relevance

About 400 metabolic reactions in the body depend on NAD, more than any other vitamin-derived cofactor in the body NAD may be depleted at a higher rate than normal due to various acute and chronic stresses, such as from the workplace, unhappy relationships, and smoking and other toxic exposures, which may lead to a need for additional B3 intake, especially as we age and the damage from life stresses accumulates.1

The quintessential medical condition that arises from B3 deficiency is called pellagra and is characterized by “the 3 D’s”: dermatitis, diarrhea, and dementia.5 Unfortunately, B3 deficiency is most common amongst the older population (especially adults over the age of 60), suggesting a potential reduction of intake with age. Research is indicating that decreased NAD levels contribute to destructive aging processes that may lead to neurodegenerative diseases. However, appropriate intake of B3 may contribute to lessening neuronal damage from aging and protecting the blood-brain barrier, which is critical to denying the entry of pathogens and toxins into the brain, while allowing the entry of needed nutrients.3

RELEVATE’s Form of Vitamin B3

Nicotinamide is the form of vitamin B3 used in RELEVATE. Its benefits are that it is almost completely absorbed, converts to NAD in an efficient 2-step reaction (vs 3-step for the standard niacin form), and it does not produce unwanted flushing of the skin like niacin.1 The recommended dietary intake of vitamin B3 is based on preventing pellagra;6 these recommendations are intended to prevent overt deficiency disease, but it is worthy to note that the recommendations may not address levels needed for optimal health – these may be higher, depending on a person’s lifestyle and stress levels.

Concluding Thoughts to Consider

It is unclear why B3 intake or absorption decreases with age; however, prospective observational studies link greater B3 intake with a lower risk of Alzheimer’s disease and reduced rate of cognitive decline,7 which suggests that greater B3 intake could be beneficial as we age. Evidence also suggests that nicotinamide alleviates oxidative stress,3,7 and recent studies are uncovering new mechanisms in which B3 and NAD contribute to neuroprotection.4,8 This suggests an exciting path for B3 in brain health that is just beginning.


Cited References

  1. NIH Office of Dietary Supplements. Niacin: Fact Sheet for Health Professionals. National Institutes of Health, Office of Dietary Supplements (2019).
  2. Maiese, K., Chong, Z. Z., Hou, J. & Shang, C. Y. The Vitamin Nicotinamide: Translating Nutrition into Clinical Care. Molecules 14, (2009).
  3. Verdin, E. NAD+ in aging, metabolism, and neurodegeneration. Science (80-. ). 350, 1208 LP – 1213 (2015).
  4. Hou, Y. et al. NAD+ supplementation normalizes key Alzheimer’s features and DNA damage responses in a new AD mouse model with introduced DNA repair deficiency. Proc. Natl. Acad. Sci. 115, E1876 LP-E1885 (2018).
  5. Bogan, K. L. & Brenner, C. Nicotinic Acid, Nicotinamide, and Nicotinamide Riboside: A Molecular Evaluation of NAD+ Precursor Vitamins in Human Nutrition. Annu. Rev. Nutr. 28, 115–130 (2008).
  6. Higdon, J., Drake, V. J., Delage, B. & Meyer-Ficca, M. Niacin. Oregon State University, Linus Pauling Institute, Micronutrient Information Center (2018). Available at:
  7. Morris, M. C. et al. Dietary niacin and the risk of incident Alzheimer’s disease and of cognitive decline. J. Neurol. Neurosurg. Psychiatry (2004). doi:10.1136/jnnp.2003.025858
  8. Xie, X. et al. Nicotinamide ribose ameliorates cognitive impairment of aged and Alzheimer’s disease model mice. Metab. Brain Dis. 34, 353–366 (2019).