If you ever noticed that a lot of answers tend to just generate a whole
lot of new questions, that's what we've got going on here. A lot of people have
asked me about nicotinamide riboside. As you know, I do use niacin and
recommend use of niacin - it - vitamin B3, it helps to improve HDL, LDL, several things.
Now a lot of people asked about the side effects with the two biggest side
effects being a temporary increase in the insulin resistance, the other one
being flush. So I decided to - frankly I did not know about nicotinamide riboside.
I have just gotten some samples and I'm taking them and trying them.
Starting to do some research on it and it really starts to raise a lot of
questions but let's just first talk about one of the first articles that
pulled. It's nature Communications Nature magazine. It's one of the best science
magazines in the world and here's the study. March 20, 2018 so very recent,
chronic nicotinamide riboside supplementation is well tolerated in
elevates NAD+ in healthy middle-aged and older adults. So this was a fairly small
study and again we'll get into it in just a minute but it starts to, as I said,
starts to raise some other questions. Well how many forms of niacin are there?
There's NR nicotinamide riboside. Many places indicate the nicotinamide itself
is different from nicotinamide riboside. That's a remaining question. Then you've
got niacin of course and then you've got Nicotinamide Mono Nucleotide or NMN.
Let's go back and just talk a little bit more about the riboside.
Nicotinamide riboside (NR)- what is it? It's a form of vitamin B3
discovered in 1944. It was first seen as a growth factor for H flu. H flu is a - is
a common bacteria that causes some pneumonia and some other things in
humans. Haemophilus influenzae, again it's not the flu virus. It's a different
bacteria. So there's been a lot of study of H flu and it cannot grow on
nicotinamide or niacin. At least that's the - the understanding which implies that
nicotinamide is different. How about nicotinamide? A form of vitamin
B3 discovered in 1936; WHO list of essential medicines.
It's over-the-counter. There's a - deficiency of this item of pellagra.
Pellagra is where all of the vitamin B3 items began to be discovered as a
vitamin. Again back in the early 20th century, back in the 1920s and 30s you
did see people that had pellagra. In medical school you learn them as the
3 DS- dermatitis, diarrhea, and dementia, and as you see here this
gentleman has a severe case of vitamin B3 deficiency and dermatitis. Now back to
NR, the riboside form. What's its major advantage over niacin? Well it
doesn't cause flush. That's the thing. Well there are other methods of managing
flush that's what we've - we've done at PrevMed for years with our patients.
We've just given recommended Enduracin or Rugby Extended Release. A lot of people
say, oh the extended-release is a major problem for the liver.
I don't think so much for these two brands. Again, it's more of a wax matrix
preparation which is just releasing it slowly. It's not any additional chemicals.
One of the additional chemicals that's been tried to decrease flushing
with niacin is lapropria and the evidence would indicate in some of the
studies that lapropria does get rid of the flush but it appears to get rid of
the impact as well. And was it all - well I was trying to remember the names of the
studies. I've covered those in other videos. Other ways of managing the flush
if you take just niacin itself is to take it 10, 15, 20 minutes before a shower.
Take it at night before going to bed. Some people say just get used to it.
Others say, you know what I enjoy that flush. Not a lot of my patients have felt
that way. So back to this - the study that I mentioned in the beginning, so
this study does show a couple of things that are very very helpful.
How big a study was it? It's not that big. It's a crossover design. Meaning that and
they took 60 people. It's randomized. So there's a randomized clinical trial
component. Randomized clinical trials are the top of the line in terms of being
convincing medical evidence. They took a group A placebo first and then NR
next. They took group B and did NR first and then placebo next. That's
what that crossover design means. At the end of the day, what did they see?
It was very well tolerated. No didn't have the issues with flush and it
improved NAD+. So again, a couple of very interesting
positive components. Now as you start looking at the article and getting
deeper, there's a lot of places where they start getting into areas that are
clearly within the longevity space like it doesn't impact Sirtuins therefore
not likely to be used in longevity but it also gets into
discussion and direct comparison to caloric restriction also arterial
dysfunction and blood pressure and rats. So again, there's - I think the jury's
still out at least for me. I'm gonna be continuing to do some more research in
this area. A couple of things I'm going to be looking for is what is the
specific difference if any clinically and chemically between nicotinamide and
nicotinamide riboside and are those differences significant. How about -
does the absence of flushing actual EMP impact metabolic effect? And again as you
know especially you guys that are NR or in an NMN aficionados I'm sure you
can help me out. Please provide some comments. I'm enjoying getting a little
bit deeper on this issue. Again, this is not going to be long and I'm coming to
the end. If you've made it this far, thank you very much for your interest! I'd like
to take a few minutes to plug one of our activities, the cardiovascular
inflammation course. Now, am I trying to make money? hmm It's 30 bucks and I've
spent - I spent over 40 hours doing working on it and we've had dozens of
hours of Caim, our social media director and some other people working on it as
well. So it actually does defray some of our costs for Caim but I don't expect it
to ever, it's not going to be a goldmine for us. Here's my motivation. I want to
make this information available to two people. I'm retired but I don't want to
not work. My legacy goal is to help people understand their risk for heart
attack and stroke. You see I see the vast majority of a 60 and older, 50 and older,
40 and older. In fact, if you go back and look at some of the - the other studies,
maybe over half of US, 30 and older starting to develop some of the major
causes for inflammation. Well let's go back. Wait a minute.
Inflammation, doesn't your doc know that? Unfortunately, most docs don't they've
heard of it. They've - they've got a theoretical acknowledgement of it but
they don't know how to test for it. So one thing you could do by the way is buy
this course for your doctor. If he or she does not know about inflammation and how
to measure it, you can measure it in yourself. Now how do you get through the
course? First this is a - a picture of our homepage PrevMedHeartRisk.com then
you go - so here's the top of that page. Then you just slide on that. It used to
be up in this black banner but Michelle has changed that banner to talk about
our heart attack and stroke conference. It's in Louisville November 8th and 9th.
You can actually get a complete evaluation including CI-MT, the
cardiovascular - all the cardiovascular panel tests, all of the inflammation
resistance basic testing, the details behind lipids, cholesterol etc. You can
get all of that done at once. It's a great way to do it but that's not what
this is about. This is about the inflammation course. This course actually
teaches you and/or your doc something that Time Magazine knew back in '04.
This is the Time Magazine cover from 2004- The Secret Killer, the surprising
link between inflammation heart attacks cancer and Alzheimer's and other
diseases and what you can do to fight it. Now you can get that article. It's not
going to tell you all of these things that you're going to learn from this.
This tells you the details of the testing that is now available for
cardiovascular inflammation. So if you saw what I did, I went to the homepage,
went down to the bottom of the page, clicked on the course and this is
the description of the course. First there's and again overall it looks like
a lot of material. You can cover all of this in less than 2 hours. It goes into -
you give - will give you an introduction to inflammation. We talked then about we
have a video on each of the 4 key inflammation tests that we - that we use
and we would suggest that you use. C-reactive protein, micro albumine creatine ratio,
myeloperoxidase plaque or LP-PLA2. Now it's one thing to know how to test for
it. It's a very different thing to be able to test yourself and we also have a
video on how you can get that done too. So go in and take a look.
Invest 30 bucks. Learn what's involved with cardiovascular inflammation testing
and know your numbers. Thank you for your interest!