This is how to take niacin without
hurting your liver.
Hi. I'm Dr. Chris Masterjohn of
chrismasterjohnphd.com. And this is
Chris Masterjohn Lite, where the name of the game is
"Details? Shmeetails. Just tell me what works!"
And today we're going to talk about how
to protect your liver when you're taking niacin.
In the last few episodes, I've
been talking about taking niacin for
controlling cholesterol. And it's not
just this case where we're concerned
about liver toxicity. In fact all forms
of niacin have potential toxicity to the
liver. It's just the case that most
people who experience liver toxicity
with niacin are using niacin for the
purpose of controlling their cholesterol
because the doses at which niacin
causes liver toxicity are doses at which
the only reason to take niacin at that
high of a dose is to control your
cholesterol. So, the way we want to
approach this is to supply the things
that are depleted when niacin causes
liver toxicity. Chief among them is
methyl groups because the way that
niacin causes liver toxicity is by
depleting the methyl group supply of the liver.
If you don't know what a methyl group is, check out
chrismasterjohnphd.com/methylation as an
introduction to methyl groups and what
they mean for your health. Signs of liver
toxicity that you want to watch out for
when taking high-dose niacin are
elevated liver enzymes, jaundice, nausea,
vomiting, and headache. These signs have
generally been reported with very high
doses, but some of the lowest doses to
show these signs are 750 milligrams of
nicotinic acid or 3000 milligrams of
nicotinamide, also known as niacinamide.
Most cases though involve 3 to 9
grams or more of nicotinic acid, and in
the case of niacinamide, most cases of
toxicity involved over 10 grams a day.
What I recommend for controlling the
loss of methyl groups is that if you're
taking nicotinic acid or nicotinamide,
also known as niacinamide, you want to
match one-to-one with trimethylglycine.
For example, 1000 milligrams of
nicotinic acid would be matched with a
1000 milligrams of trimethylglycine.
1000 milligrams of niacinamide
would be matched by 1000
milligrams of trimethylglycine.
Trimethylglycine is also known as just TMG.
If you're taking nicotinamide
mononucleotide, also known as NMN, or
nicotinamide riboside, also known as NR,
you can cut the dose of TMG in half.
If you were taking 1000
milligrams of one of those, you would
take 500 milligrams of TMG. And the
reason is simply that a molecule of
nicotinamide mononucleotide or
nicotinamide riboside is approximately
twice as big as a molecule of nicotinic
acid or niacinamide, and as a result, when
you're thinking about 1000
milligrams, you're actually talking about
half as many molecules for NMN and NR,
and that's why you can take half the
dose of the TMG. The main form of niacin
that people will take to control
their blood cholesterol levels is
nicotinic acid. In fact, this is the only
effective form to control your blood
lipids. If you're taking niacin for blood
lipids, it's probably just called niacin
in the bottle, and that is nicotinic acid.
When you're taking nicotinic acid, a
portion of that is detoxified with the
amino acid glycine. Then a portion is
converted into nicotinamide, which is
detoxified with methylation. Because some
unknown quantity is going to be
detoxified using glycine, we also want to
protect the liver from the loss of
glycine, since that might make a partial
contribution to the liver toxicity and
since more people need more glycine than
they get, so why not make up for whatever
we're losing when we're taking high-dose
niacin. When you're taking niacin in the
form of nicotinic acid, in addition to
the TMG as just discussed, you also want
to take half the dose as a glycine.
For example, if you were taking 1000
milligrams of nicotinic acid, you would
want to take 500 milligrams of glycine.
Or if you wanted to get that glycine
from collagen or gelatin, you could
triple it. So for 1000 milligrams of
nicotinic acid, you would take 1.5 grams of
collagen or gelatin. Using these
combinations does not guarantee complete
freedom from toxicity, and so you don't
want to use these as a means of being
careless. In particular, if you have a
history of liver disease, diabetes, if you
have active peptic ulcers, gout,
cardiac arrhythmia, irritable bowel disease,
migraines, or alcoholism, all of those
conditions make it a higher probability that you could
experience liver toxicity from nicotinic
acid, and so those are conditions where
you probably shouldn't be using
high-dose niacin even if you take
precautions to prevent toxicity.
However, barring those conditions, I think
it makes sense that even though the
likelihood of toxicity is not very high
and even though it's very rare when
taking less than 3 grams a day, it still
makes sense to make up for the things
that you're losing. Because even if
losing methyl groups for example
or losing glycine isn't necessarily
going to lead to liver toxicity at
1000 milligrams of nicotinic acid a
day, it still will be better for your
health to make sure that in net you are
not losing glycine and you're not
losing methyl groups because you lose
less--you use glycine and methyl groups
for many things that support your health.
So pairing all forms of niacin with
trimethylglycine and pairing nicotinic
acid specifically with the TMG and the
glycine is in my view the best way to
reduce the risk of any kind of harm to
Signing off, this is Chris Masterjohn of
chrismasterjohnphd.com. This has been
Chris Masterjohn Lite.