Niacin-dependent
July 26, 2011 | 40,00 EUR | answered by Dr. med. Ralf Berg
I have become addicted to Niacin, specifically to a daily dose of about 120 mg.
To my knowledge, Niacin is converted by the body into NADH, a substance involved in the synthesis of one or more neurotransmitters (serotonin dopamine).
The half-life is one hour, so very short. At a relatively high dose, this can apparently lead to strong dose fluctuations if the daily intake is limited to three individual doses. Despite a constant daily dose, I feel something like withdrawal. I assume it is similar to chain smokers who become restless again after 30 minutes. My attempts to quit in the past 5 weeks have failed even with medication because I was then too exhausted and felt nerve pain impulses. I tried without medical advice.
My questions:
1. Can it be assumed in my case that I have become dependent on Niacin?
2. If you doubt this, how do you explain the symptoms I have described?
3. How should I proceed if I want to reduce the Niacin dose on an outpatient basis (at home)?
4. Although I take the initial dose again and the symptoms should disappear, which is not the case now, is this due to the short half-life?
5. After the usual 30-day withdrawal therapy in the clinic, the withdrawal-like symptoms may continue because the neurotransmitters that have been affected are missing, and it takes weeks (months) for the body to ramp up production of neurotransmitters?
6. Is there a substitute or a sustained-release Niacin?
7. A distributed supply from hour to hour is probably pointless, as the body constantly craves the maximum dose I have taken daily (temporarily) as indicated in the attachment?
8. Which practice/clinic (also private), institution can you recommend to me?
9. If you have knowledge in this regard, how much time should I expect on average to gradually reduce everything tolerably (clinic, outpatient)?
Thank you for your prompt response.
Best regards
Dear Seeker,
Your questions have been unanswered for several days now. I have also looked into your question and conducted some research. However, little information has been found, especially regarding your main question: the possibility of Niacin dependency from a medical and scientific perspective. While the substance as a provitamin, its metabolism, and the consequences of a Vitamin B deficiency are well described, nothing can be said about overdose/dependency. Since all B-group vitamins, including Niacin, are water-soluble, it is generally assumed that any excess is promptly removed by the kidneys (renal elimination) (hence the short half-life in the blood). It would be different if you were suffering from a higher grade of chronic kidney insufficiency.
In conclusion, I cannot imagine that your symptoms, which you describe so accurately, are solely attributable to Niacin. Unfortunately, there are many rare, sometimes insidious neurological diseases that can disrupt serotonin or dopamine balance in the brain. I would advise you to consider and investigate this possibility before attempting further withdrawal attempts. I am not a neurology expert, and it is possible that if initial diagnostics (EEG, blood tests, neurological examination) were inconclusive, a knowledgeable neurologist may refer you to a specialized neurological clinic. (Usually, the neurological departments of university hospitals or hospitals providing maximum care conduct such detailed investigations).
Regarding your last question about how to gradually reduce your dosage as an outpatient, I also recommend seeking assistance from a neurologist/psychiatrist for ongoing support (which may also be done on an outpatient basis). There are powerful and numerous psychotropic medications that could influence serotonin and dopamine levels in the brain in one way or another, making it easier to skip doses. If you still require a recommendation, I suggest reducing the dose by 10% every 4 days. However, to reiterate: overall, I believe that you may be suffering from a mild form of neurological dysfunction (latent depression, conversion syndrome, hidden anxiety syndrome, etc.).
With warm regards and best wishes,
Dr. R.C. Berg
