The Missing Puzzle Piece to COVID-19?

The Missing Puzzle Piece to COVID-19?

I have gone to some lengths to tout the benefits of vitamin B3, primarily in a two part newsletter titled Feed Your Head: The Legacy of Dr. Abram Hoffer. So, when a colleague told me about a study showing B3 to be of potential benefit for preventing and treating COVID-19, she immediately had my attention. The study, I discovered, was very scientific, that is to say, much of it was over my head, requiring a degree in science to fully comprehend. Nonetheless, I will offer my layman’s synopsis, and leave the link at the bottom for those wishing to examine the more technical details.

I of course wanted to share this material, as an addition to our ongoing collection of articles concerning the virus, and natural approaches to prevention and treatment, but it turned out the study also had other things to say about niacin that were new to me.

The Study

The study we are to examine is called Sufficient niacin supply: the missing puzzle piece to COVID-19, and beyond?, by Dr. Dmitry Kats, and of particular interest to me is the motivation for initiating this study. See, when I was studying nutrition, back in the day, we were assured that there was no relationship between nicotinic acid (vitamin B3) and nicotine. That no longer appears to be true.

According to this study, “motivation for this original investigation into specifically NA (nicotinic acid) supply as COVID-19 treatment was sparked by deduction of the possibility that the counterintuitive link observed with (cigarette/tobacco-nicotine) smoking as being protective against ensuing severe acute respiratory virus 2 (SARS-CoV-2) infection may be explained by the fact that nicotine is oxidized into NA during the combustion process”.  (Clinical reference points for this claim can be found within the link to our study, provided at the end of this article: References:Jan, M. RASUL, et al. “Separation identification and determination of nicotinic acids and nicotinamide in cigarette tobacco and smoke (Part-I).”Journal of Chemical Society of Pakistan.)

That actually makes a lot of sense, since people smoke (in part) to reduce anxiety, and B3 produces the calming neurotransmitter, serotonin.  Our study opens with stating that NA (nicotinic acid/B3) has a unique endothermic biochemical process that induces a “thermodynamic flush to ultimately reverse, restore health from, and/or protect against ensuing inflammatory-induced disease”.

It goes on to suggest that this mechanism (the “thermodynamic flush”) may explain the body of scientific research confirming the therapeutic value of niacin for treating “cardio-metabolic/vascular conditions, renal as well as hepatic damage, pulmonary/lung injury, viral/infectious diseases including influenza and retroviruses like HIV/AIDs, as well as tuberculosis, cancers, arthritic-related conditions characterized with inflammatory damage to tissue, neurodegeneration/dementia/unsuccessful aging, auto-immune disorders, birth defects and pre- or post-natal induced impairment of immune and neurodevelopmental function, mental health disorders, mast cell conditions, genetic disorders, among others”. (Every claim has clinical references.)

Wow. No wonder Dr. Hoffer was taking 4,000 mg of niacin up to his death (at age 92).

How Does Niacin Work?

So, how does niacin accomplish healing in so many areas? Well, according to our study, all these diseases and disorders have the shared motif of involving inflammation, which they define as “downstream kinetic (heat) energy”. This means that our bodies are governed by “an underlying thermodynamic or bio-energetic (i.e., based on balancing of energy transfer into, out, and through the body) mechanism, which niacin works to modulate back towards a state of equilibrium”.

Therefore, this mechanism of balancing out inflammation in the body should also be of benefit when treating COVID-19, given its pathology includes major elevation in pro-inflammatory cytokines (you may recall that one of its most deadly symptoms is the “cytokine storm”), which contributes to “potentially lethal multiple organ dysfunctions”.  And, indeed, both in vitro and in vivo rodent studies have demonstrated a direct reduction in pro-inflammatory cytokines, following treatment with niacin (NA). As well, niacin administration has been found to be highly effective in preventing lung tissue damage resulting as a side effect of Bleomycin, a cancer treatment drug. As a result of the above two facts, authors of a March, 2020 paper in Nature suggested the use of niacin supplementation for treating COVID-19 to be a “wise approach”.

The Flush

Now let’s take a closer look at this “thermodynamic” property of niacin, known as the niacin flush.  Most people find the flushing that occurs following ingestion of niacin to be uncomfortable at best, and unpleasant at worst. As a result, many will use “no-flush” niacin, intermediate release niacin, or niacinamide. (The medical profession still uses time-release niacin, but that form can cause liver damage and should be avoided.). However, this study is adamant that “immediate release” niacin is the only valid form for treating the conditions described above.

The author takes this position because he believes the flush is in fact, a form of “thermodynamic exfoliation of ensuing disease, toxins, and (restoration of) free radical-damaged compounds being H+ (potential energy) pumped out the body”. And only “sufficient oral intake of immediate-release NA is capable of (readily) accomplishing this with potency”.

Let’s have a closer look at how he defines this process: “According to thermodynamic law, the human body sub-system connected to (i.e., dependent on energy transfer from and back out to) the outside-world, functions predominantly under the assumption of sustaining a constant volume and temperature… Herein lies the flush: temperature drop, which represents the transfer from the core to endothelial system up to out of the skin back to the outside environment system, of free radical electrons, ROS, toxins, and damaged organic compounds (all essentially part of inflammatory disease progression)”.

We have always known that niacin can enhance circulation with this flushing effect, but I have never until now realized the anti-inflammatory properties, and the massive detoxification effect of niacin. In fact, I thought the only advantage of taking niacin prior to a detox bath or sauna, was to get blood circulating to the surface of the skin, allowing the sweating to remove a greater amount of toxins. Now it appears that the niacin itself is also part of the detoxification process.

Using Niacin

Regular use of niacin gradually builds up tolerance in the user, so that they will cease to flush. The process is to start with 50 or 100 mg (with food), taken two or three times per day. When one ceases to flush at that dosage, they increase the dose by adding another 100 mg, and continuing taking that amount until flushing no longer occurs. At which point more is added, etc.  Remember, the therapeutic dose for lowering cholesterol is around 1500 mg daily (in divided dose), so if we want the health benefits described above, we want to get to at least that level. Clearly Dr. Hoffer (the pioneer in studying niacin) felt even more was of value, consistently taking 4,000 mg per day, which by that point had no flushing effect on him. And, as we will see, Hoffer was taking an amount of niacin close to the ideal therapeutic amount required (at least for serious ailments, and COVID).

According to the author of this study, the point at which flushing no longer occurs “can be explained as energy flow and its modulation into/out of the body approaching closer towards thermodynamic equilibrium as a result of previous flushes having flushed out inflammatory free radicals/ROS so therefore less remains to flush out with consecutive doses. This represents perhaps the ideal state that should be worked up to and maintained thereafter—in terms of NA dosing—to respectively reverse out and prevent inflammation”.

The study ultimately recommends working up to a 1,000 mg dose, two or three times daily, more for those weighing over 125 kg, and less for those of a small bodyweight, and for children.

Treating COVID

With regards to treating COVID-19, the study indicates one should make every attempt to get into this dosage range as soon as possible after diagnosis, and this dose should be maintained throughout treatment, and continued for a longer period by those showing post-COVID symptomatology (“long-haulers”). If this protocol is followed, it is maintained that health restoration can occur within two days for those with recently detected COVID infection, and within four days for those in the more severe stages of the disease.  In order to gain maximum therapeutic benefit from niacin, this scientist advises that one avoid certain compounds that can inhibit the flush response (aspirin, inositol, pectin from apples or grapefruit), and those substances which interfere with the biochemical processes that niacin initiates (N-acetyl cysteine, glutathione, and 5-HTP).

The study uses the term “abstain”, though that seems extreme to me, as some of these compounds are also of benefit when fighting the virus (NAC, glutathione), and some of us may choose to stay on a high niacin regime for life, and would not want to avoid the other items for ever. I believe if you take the niacin at least an hour away from the other substances, there should be no problem. (If anyone wants to experiment, the most obvious test would be to take an aspirin an hour away from a flushing dose of niacin, and see if one still flushes.)

There are a couple of other things to be aware of in order to enhance the therapeutic properties of niacin. One recommendation is to ensure one remains well hydrated, and has a reasonably good caloric intake (ideally of high quality foods).

Also, since B-vitamins are part of a family, a high intake of one B-vitamin will deplete the body of the other B vitamins. So it is important to also take a B-complex, or a multivitamin, to ensure this does not occur. (NutriPods would serve that function in this case.) Ancillary nutrients recommended to aid niacin in fighting COVID (or any ailment involving inflammation) are vitamin Cvitamin D3, alpha-lipoic acid, magnesium, selenium, and quercetin.


This radical scientist has come to the conclusion that widespread, regular niacin use offers not just “safe and rapidly effective opportunity for eradication of COVID-19”, but also has the capability to create a paradigm-shift in individual and population-level health. I say “radical” because claiming potential “eradication of COVID-19”, is a pretty radical thing to say in today’s environment.

Here is the summary in his own words: “Hypothetically, if the global population was sufficiently supplied with NA dynamically (per the 1-3 g per day regimen)—instead of the only 15-20 mg from diet set by the U.S. Food and Drug Administration and other public health agencies worldwide—then no one may have ever experienced COVID-19.

Nevertheless, even after the fact, we still evidently have the opportunity to efficiently mitigate and even potentially eradicate the pandemic by simply filling this drastic NA void through its supplementation (and maintaining sufficient supply by continuing with the dosage as described in this paper)”.    (Study)

All in all a fascinating study, one that has encouraged me to consider radically upping my intake of niacin.

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