NAD/niacinamide

[MsCindy]

One small warning: Niacinamide isn't for everyone. There are many, many people who have very bad reactions to it. I have a homozygous MTHFR gene mutation, which makes niacinamide toxic to me, and in fact, when I try it, it makes me feel nauseated, exhausted, and sick for at least 24 hours, even at tiny doses. As much as 40% of the population has one MTHFR gene mutation, so the potential for bad reactions to niacinamide does exist for a lot of people. If it makes you feel bad instantly, you'll know you're one of them. Bredesen does always say we each have to find what works for us! I'm finding that out!

[MsCindy]

In episode 43 of Chris Masterjohn's podcast, he says that niacin and nicotinamide riboside tax the methylation system. (It's at 48:20 in the recording.) I have been taking the Thorne Niacel product that contains 250 mg of Niagen per capsule, but I'm planning to cut that to 100 mg per day to avoid methylfolate depletion, since I'm heterozygous for MTHFR C677T.

I'm homozygous for MTHFR 1298, and I can't tolerate even 10mg of niacinamide in any form I've tried. I didn't realize this was my problem. I just kept trying niacinamide in smaller and smaller doses over the course of a year, and each time had a very fast, very bad reaction. Then I read a lot of reviews online from other people who had similar reactions, so I just gave up trying to use it. It wasn't until I found out I had double MTHFR gene mutations and I dug into research on this that I finally understood why my inability to make the MTHFR enzyme made this and other B vitamins toxic to me.

I've never been able to take B vitamins any time in my life. They make give me raging insomnia and my skin burns like it's on fire. So that means no multi-vitamins. I've finally had to face that they're all going to be toxic for me because of the B vitamins. But methylation is important for so many reasons, so I've been doing a lot of research.

I finally found a workaround to accomplish the methylation via a circuitous route using large doses of choline in 3 different forms along with creatine and glycine. It's too early to tell if it's working, but so far at least I'm sleeping (which is miraculous for me!) and I feel much, much better. If there's anyone else out there with similar issues, I'll be happy to share more.

[Walker44]

Just a side note on the topic of niacin, the pseudocereal buckwheat is chock-full of it. I try to eat some every day.

[ChipW]

I have a MTHFR mutation. I take niagen daily at 250-500mg with a couple days break ever couple weeks. I also take methylated B's and masterjohns recommended creatine, choline and glycine. I feel really good and haven't noticed any problems. My last bloodwork however had a homocysteine of 12, highest its ever been. I thought it may be the metformin, which i dropped. Next blood work is in February. If the niagenrather then the metformin is the cause of my high homocysteine, it should still be high. I will report back

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[Josiah]

I've been taking Basis by Elysium Health - a combination of nicotinamide riboside (NR) and pterostilbene. This firm takes itself very seriously and has actually conducted a double blind study. I'm probably paying more than I need to.

[Hboroughs]

Wow - I am very confused as to what form of niacin is best to take and this thread really has me scratching my head! I am a 3/4. Had SdLDL reading of 39 last summer (that is main marker my FM dr tracks). I gave up cheese and red meat and recently had new labs done with an sdLDL reading of 32, so that was an improvement. In order to get the reading under 30 I am considering the niacin. I tried the “flush” niacin - what a disaster! Horrible flushing and shot my blood sugar through the roof. I am now about to try the niacinimide based on the Gundry protocol. This thread has me questioning that though. I am heterogyzous for one of the MTHFR genes. I am on bioidentical HRT for menopause hell, but have to watch my progesterone carefully as my blood sugar can be an issue (Ha1c currently 5.5 so not horrible but not perfect either). My homocysteine is 8.8 (I take a B-vitamin complex).

I wonder if I shouldn’t be using the NR instead of the niacinimide, but I know this group really respects Dr Gundry and he likes the niacinimide. But now I am concerned about the SIRT1 (which I had never heard of before!), my insulin response, the negative effect on exercise (which I do 6 days a week) and my methylation. That seems like a lot of downside for the lowering of sdLDL.

I don’t imagine there is a consensus yet as to the best form of niacin (if any) to mitigate AD/CVD risk, but would love to hear more about what others are using and what their labs have shown.

I am new to the forum and really blown away by the expertise this group has. Thanks to all of you.

[fxmedcoach]

Hboroughs welcome to the forum!! Sometimes it can be so confusing knowing what to do and what not to do, can't it?! Are you working with a Bredesen trained or Functional Medicine (FM) trained provider? Having such a provider on your team can be so helpful to "peeling the onion" and finding out what works best for you.

The Primer has some great information on lipids that might provide you with more insight -- viewtopic.php?f=33&t=1418&start=10#p15813. Also you can do a search for "sdLDL" or "niacin" to see what other discussions have been had on this topic. And still more information on lipids can be found on the Wiki page --https://wiki.apoe4.info/wiki/Cholestero ... ng_statins.

I am sure others will come along and provide their insight regarding niacin to mitigate AD/CVD risk. Glad you found the group and were able to share your particular situation and concerns.

[Hboroughs]

Hboroughs welcome to the forum!! Sometimes it can be so confusing knowing what to do and what not to do, can't it?! Are you working with a Bredesen trained or Functional Medicine (FM) trained provider? Having such a provider on your team can be so helpful to "peeling the onion" and finding out what works best for you.

The Primer has some great information on lipids that might provide you with more insight -- viewtopic.php?f=33&t=1418&start=10#p15813. Also you can do a search for "sdLDL" or "niacin" to see what other discussions have been had on this topic. And still more information on lipids can be found on the Wiki page --https://wiki.apoe4.info/wiki/Cholestero ... ng_statins.

I am sure others will come along and provide their insight regarding niacin to mitigate AD/CVD risk. Glad you found the group and were able to share your particular situation and concerns.

Thank you for this reply. Yes I am working with a FM doctor. She is a great partner, but certainly the information on this site goes beyond her APOe4 knowledge.

I tried the Niacinimide for a few days. I experienced "agitation" and an elevated blood sugar. Went from the mid 80's to the mid 100's. I will work on other ways to reduce my sdLDL as I am not willing to trade elevated blood sugar for it, especially since my sdLDL is 32 right now and not in an ultrahigh spot. Possibly I should try the NR? I wonder if I can tolerate any form of Niacin.

I did also try the Relora as recommended on this site. It has definitely improved my sleep. A full night of sleep has eluded me in spite of BHRT. The Relora deepened my sleep, although I have still been wakening once or twice with hot flashes (as usual). Waking up in the morning has been more difficult and I feel some lasting tiredness during the day. I am going to try to drop back to one pill instead of 2. I am super sensitive to supplements/medication so 2 was probably just too much for me.

Thank you again for the reply.

[fxmedcoach]

I had this link in my files that you might find interesting and could be something to discuss with your FM provider -- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5575230/. I personally like Berberine for lowering elevated cholesterol, and my husband has used it with great success after only a couple of weeks. This link I'm sharing suggests Berberine and other possible nutriceuticals that have been shown to lower lipids.

[Hboroughs]

Thank you for the mention of berberine. I have tried that in the past for glucose control. It made me feel terrible for some reason, my prior FM dr said he thought maybe "myochondrial dysfunction" was my issue. Not sure what that even means. Another example of me having the opposite effect expected when trying a supplement.

What are your thoughts on berberine and gut health. I feel that I have read conflicting information in this regard. Some say its great for gut health, others say it acts as a natural antibiotic and should not be used indefinitely.