Anxiety and Depression Part Deux

Again I want to emphasize that I do think depression is real and I know anxiety is real too. They are an ever growing part of many people’s lives. I also want tor re-emphasize that there is no “silver bullet” for either. Like so many other things in life it takes time and usually a multifaceted approach. I guess a good analogy would be trying to fix an old pick up truck that isn’t running by just putting gas in it. Sometimes having enough gas isn’t the problem. Spark plugs may need to be changed, a new seal here or there, a new battery, maybe a new starter or all of the above are required or maybe more. This is the thing that irks me so much about a lot of medical practice. I know not all docs are trying to treat numbers or just brush things off as irrelevant, but it is becoming increasingly difficult to find a person who will spend time with you rather than getting you out the door so they can see the next patient. Money talks I guess.

So lets get the ball rolling. Lets start with anxiety. I want to introduce you to my new friend. His name is niacin or vitamin B3. Niacin was the third b vitamin discovered, hence the “3”, and it’s actual name is nicotinic acid. It sounds very similar to nicotine, although I’m not recommending nicotine for anxiety (even though you smokers out there know it works) for obvious reasons.

First let me discuss the different forms of niacin. There are 3 main forms that can easily be purchased over the counter. There is (in no particular order): niacin, niacinamide, and inositol hexanicotinate. All 3 are effective forms and interchangeable in the body for use. Niacin is known for causing the “flush” where a person can become as red as a lobster and feel like they’re having a hot flash. Niacinamide doesn’t seem to have this problem except in a few cases of people who take it. Niacinamide also is more responsible for nausea than niacin, although all three forms can cause it. Inositol hexanicotinate and niacin will affect blood lipids while niacinamide will not. Inositol hexanicotinate is also more expensive.

Let me also digress for a moment and discuss the flush. I know people who will not take niacin because of the flush. They can’t stand the feeling of it. It can feel like a sunburn. It starts at the top of the head a works its way down the body. I first experienced the flush this way. The top of my head began to tingle, and then the heat rushed down my face and neck, continued down my arms and before I knew it I looked like I had been out in the sun naked all day long in the middle of summer. It lasted for about 30 minutes before calming down. I had what I can only describe as a runner’s high afterward. I felt good. I felt calm and I wanted to do it again. Some people will not want this, I don’t mind it. The reason is as follows;

The flush will begin to subside as you continue to take niacin, especially if taken after a meal, which is what I recommend. I still flush after some doses, and don’t flush after others, but the flush I get now is mellow by comparison to the first one I had. I personally take about 750mg of niacin right now after meals and the flush continues to be less and less. If you take it with no food in the stomach, you are in for an experience. The more you take it though, the less pronounced the flush will become. I really don’t mind it at all. My wife’s flushes vary in intensity as well, but they are much less intense than the first time it happened. All I can really recommend is give it a try. If you don’t like it, try the niacinamide. Do take niacin after a meal. The other thing is start small and go slow. try 50mg twice a day and move from there. After a few days, increase to 75mg twice a day. Keep increasing by small amounts. You will feel the flush at some point if you didn’t from the start. Have a doctor who knows how to use niacin to help you if possible. If not, then try the niacinamide. As for me, I’m staying on the niacin.

For anxiety try taking some niacin (in any form) a few times day with meals. Since it is a water soluble vitamin what doesn’t get used will likely be tossed out with your urine so keeping a saturated level is easier with multiple doses. In other words 250mg 8 times a day is better than 1gm twice a day. Some people won’t be able to take it 8 times a day simply because it’s hard to remember and we all have busy lives, but divided is more useful if possible. It does seem to have a calming effect. It may not work overnight (although there are case reports where people do feel better that way), but keep on it. I would also note that taking niacin should be accompanied by a B-complex. The best reason why is that they work together as a team. You can’t play baseball with just a pitcher, you need everyone. You can take a B-complex with the niacin at meals. If you have a B-100, you could split it in two and take 1/2 in the morning and the other half in the evening with meals.

Anxiety can lead to depression and a host of other problems. Bill W., the founder of Alcoholics Anonymous, suffered from depression. When introduced to niacin he started taking 1gm three times a day with meals. In two weeks, he was feeling better. He liked it so much that he began recommending it to all of the AA members and many of them began to see improvements in their mood and depression levels. 30 friends in all were started on the vitamin. 10 were better withing a month, 10 more withing 2 months, and the remaining 10 in the third month. Imagine had they all been put on antidepressants. I wonder how well they would’ve done then? Probably not so well.

Dr. Abram Hoffer, one of the pioneers in niacin therapy, remarked how the vitamin seemed to increase the sedative effect of phenobarbital, an anti-convulsant. He studied how it affected agitation and anxiety, with positive results. To read more about this I recommend the book Niacin:The Real Story. You can also look at where there are many studies published, not only about niacin, but other vitamin therapies. I know that my story is just a simple anecdotal report, but I will say again that I feel more calm when I take niacin. I don’t think I’m an overly anxious person, but I do notice a difference. Another thing to look at is a good multivitamin. Some people who are deficient in minerals like zinc or selenium can have problems with depression. I will try to address that in another post. In the meantime, despite what big pharma will have you believe regarding vitamin use, a good multivitamin is a good investment, but like I said, look for one with minerals and non-synthetic vitamins (again something I will address in another post).

One study looked at niacinamide in sleeping patterns in adults. Patients taking 500 mg twice daily during one week, 1,000 mg twice daily during the second week, and 1,000 mg three times daily during the third week experienced more REM sleep, less awake time at night, and more sleep efficiency. The benefits were lost when discontinued. Sleep is always a great help in reducing anxiety and depression. I might add that it helps me get to sleep, but doesn’t put me to sleep like zolpidem (Ambien) would.

Niacin is not a silver bullet as I’ve said, but I thinks it’s very useful. Here’s another option. A supplement that I recommend for heart disease treatment or prevention that may benefit anxiety is fish oil. That’s right, that tasty fishy oily substance that provides us with those wonderful omega-3 fatty acids. In a trial involving college students, researchers looked at anxiety and depression in two groups, one on fish oil and the other on placebo. After 12 weeks what they found was “compared to controls, those students who received n-3 showed a 14% decrease in lipopolysaccharide (LPS) stimulated interleukin 6 (IL-6)production and a 20% reduction in anxiety symptoms, without significant change in depressive symptoms”. (my emphasis added)¬†It didn’t seem to affect depression but anxiety was reduced. That was 12 weeks. I wonder if a longer period of time would have helped. My suspicion is that it would, but it needs to be tested. Another thing to note is that it was 2.5gm of omega-3 per day. Keep that in mind when taking fish oil. 1 or 2 gel caps probably isn’t going to cut it.

You can find the link to the study here:

Vitamin C is a great way to reduce cortisol levels and adrenaline in the blood. Cortisol is known to hammer you body in large quantities. Bodybuilders know this is especially true when trying to retain lean muscle. Cortisol tells the muscles to break down. Vitamin C reduces those levels. In one study of marathon runners, vitamin C was given to runners at 500mg/day and 1500mg/day for 7 days before, during, and 2 days after a race. The blood was drawn and showed that the higher dose group had significantly less cortisol.2

Another vitamin c trial looked at subjects and their responses to stress. Subject were given 3gm/day vitamin divided over 3 doses. Blood pressure, subjective stress levels, and salivary cortisol recovery was better than in placebo.3 Vitamin C is also a great combo with niacin for schizophrenia. We might cover that at a later time.

Another thing I will add before making this post mind numbingly long is this; look at your point of view. One of the best pieces of advice I ever got was from a very wise woman I met in Spain. She was actually Norwegian and not Spanish. She told me the following, “If there is a problem and you can fix it don’t worry about it. If there is a problem and you can’t fix it then don’t worry about it”. How true it is! Worrying about every little things becomes tedious and monotonous and yet so many of us, including myself, do it over and over to the point we stress ourselves out over everything and we don’t chill. Sometimes a good hose down would probably benefit all of us from time to time, and with really cold water. Learn to look at things differently. If you have a flat tire on the side of the road and you can fix it, then fix it rather than stressing that you have to fix it and be grateful you have your spare. If you have to call someone to come haul you to a shop, then do it and don’t worry that you have to or are doing it. I know this requires practice, but the more you practice something like this the more it becomes¬† habit and the less you will stress, saving your heart, mind and strength.

So give niacin a shot. Give it some time and build up to a good dose. Try to get to up to 1-3 grams a day. Do so with the help of a practitioner who knows about niacin. Try some higher dose vitamin c and maybe some fish oil and for the love, quit worrying about everything. Remember that like all things, time and energy must go into something to be done right. A baby doesn’t pop out of the womb in a week nor does a diabetic reverse diabetes in a month. The body has an amazing capacity to heal itself with the right nutrients and attitude but it takes some time. If these things don’t help in a week or month keep at it. And remember there is not silver bullet to anything.


The Brute

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability  for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.

1.Robinson CR, Pegram GV, Hyde PR, et al. The effects of nicotinamide upon sleep in humans.Biol Psychiatry1977;12:139-143

2.Peters, E. M., et al. “Vitamin C supplementation attenuates the increases in circulating cortisol, adrenaline and anti-inflammatory polypeptides following ultramarathon running.” International journal of sports medicine 22.7 (2001): 537-543.

3.Brody, Stuart, et al. “A randomized controlled trial of high dose ascorbic acid for reduction of blood pressure, cortisol, and subjective responses to psychological stress.” Psychopharmacology 159.3 (2002): 319-324.