She Sat in the Corner | Dr. A. Saul: Niacin for Depression Explained

[Important information you will not likely learn from your doctor. I encourage you to be proactive, and do your own research with the help of a functional medicine doctor or naturopath.]

By Andrew W. Saul as found on DoctorYourself.com.

Andrew Saul discusses niacin (vitamin B-3) therapy for depression, in a 3-minute excerpt from the 2008 Food Matters documentary film.

SHE SAT IN THE CORNER, silently.

The 55-year old woman’s face was in shadow, invariably turned down and towards the wall. And that’s where she stayed, day after day. She had no appetite, and she never spoke to anyone. Her family had tried seemingly everything. Yes, she was under the care of a psychiatrist, and yes, she was on medication.

“Actually, she’s been on a whole lot of different medications,” her daughter told me. “None of them has helped her, and several made her worse. She tried to kill herself several times. Now she seldom moves from her corner, and she never says a word. Is there anything you can do”?

At times like this, what you want is a wand to wave. But life so rarely resembles a Harry Potter story. This was all too real. Maybe the patient was past caring, but her family sure did. As I talked to one of her sons, the living room started to fill with relatives. I don’t know where they all came from; the working-class neighborhood city house must have had a really big kitchen. Presently, all the relatives had created a semi-circle around me waiting to hear something profound, something encouraging, something good. That, or perhaps they were merely intending to hinder any quick escapes if I did not produce.

I felt uneasy, and who wouldn’t? We all feel a little uncomfortable, don’t we now, when face to face with the entire family in an unresponsive, if not downright despairing, situation. But I had been asked to offer an opinion, and the time had come. I suggested the best orthomolecular therapy I knew of: megadose niacin, in multi-gram doses. Then, I mentally braced myself for their reaction.

There was no reaction. Nothing. But they didn’t run off, either.

So I continued. “Because she is so sick, your mother might need an exceptionally large amount of some vitamins, especially C and the B-complex. But her foremost need is for niacin, really large quantities of niacin.”

“How large?” asked a male relative on my left. That question you can count on.

“Thousands of milligrams a day, in divided doses,” I answered. “Possibly even 10,000 milligrams or more, every day.”

They all listened. I got the distinct impression that they were weighing the gravity of what must certainly have felt like a hopeless situation against what must have sounded like a pretty simplistic solution.

But they still did not run off. Some of the family now sat down, on chairs, the old sofa, and on the well-worn gray carpet. There were not enough seats for everybody.

The inquisition shall now begin in earnest, I thought.

Not at all. I was asked a series of intelligent, commonsense questions about the safety and administration of high doses of niacin. As best I could, I explained niacin’s low toxicity and the need for large and divided doses. I told them to expect, at least initially, some pretty strong but harmless “niacin flush” side effects. And, I presented the need to educate their attending doctors as to what the family was now doing.

Finally, I outlined a therapeutic trial based on starting with 1,000 mg/day of niacin, and gradually but steadily increasing the dose by an additional 1,000 mg every day.

“How will we know when to stop increasing the dose?” asked a son-in-law.

“When she responds,” answered his wife. “Right?”

“Yes,” I said. “The goal is to give enough niacin to see good results. You all will be the judges of that.”

“Will she have to keep on taking the niacin forever?” asked a different daughter.

“Yes, but not necessarily as much as she’ll need initially. We first need to see if she responds at all. But if it works, why stop it?”

Everyone nodded. Nobody smiled. Tough crowd.

I left with a distinct feeling that I had contributed precious little to that family’s hopes.

Was I ever wrong. I got a call about two weeks later from a profoundly relieved, and positively delighted daughter.

“Mom is just fine,” she said happily. “She’s sits at the dinner table now. She talks to us, talks like nothing happened. It’s incredible. She’s off all medications. It’s the niacin: it made all the difference in the world.”

“That is wonderful news,” I said. “How much niacin is your mother taking now?”

“11,000 to 12,000 milligrams every day.”

“Do you happen to remember at what level she experienced a niacin flush?” I asked.

“That’s easy to answer,” replied the daughter. “She never flushed at all.”

Wow. 11 or 12 grams of niacin a day and no flush. Makes you think, doesn’t it?

But results are what matters in any therapeutic trial.

A huge amount of niacin, along with the other B-vitamins and vitamin C, had done the job.

A very big job.

“This is great!” said the daughter. “We have our Mom back!”

That was a beautiful moment.

Sometime later that month, the family took the fully mobile and now positively talkative mother to see her psychiatrist. She didn’t need to go, but they all wanted the doctor to see the recovery with his own eyes.

I was not there, but I heard about it afterwards.

“The doctor told all of us that there could be some side effects with that much niacin,” said the daughter. “Especially changes in liver function. Also, he said that Mom’s skin looked slightly darker to him. The doctor said she should not take niacin because of it.” (see note 1)

“None? At all?” I said.

“Right: none. He told her, and the rest of the family, that she should be on medication, not on some vitamin.”

“It is usually the medication that has harmful side effects, not the niacin,” I said. “Abram Hoffer, M.D., and other physicians with extensive experience administering niacin have found that niacin is NOT liver toxic. They report that niacin therapy can increase liver enzymes, but they also point out that this elevation means that the liver is active. It does not indicate an underlying liver pathology. (see note 2)

If your doctor wanted to do monitoring tests, that is one thing. But to take a successful, already working therapy away from a seriously ill patient is quite another.”

It really mystified me then, and it still does today: just why are so many physicians prejudiced against vitamin therapy? Decades ago, Frederick Klenner, M.D., was so frustrated by his colleagues’ flat rejection of megavitamin therapy that he wrote that some doctors would rather see their patients die than use vitamins.

I asked her what the family had decided to do now.

“We’ve already done what the psychiatrist said, and Mom no longer gets niacin. She is back on drugs, three of them.”

The daughter then paused. I knew the worst was yet to come.

“And,” said the daughter, with a choke in her voice, “Now my mom is back in the corner.”

Indeed, this was no Harry Potter story.

It was, I am sorry to say, much more like the medical tyranny illustrated in “One Flew Over the Cuckoo’s Nest.”

When doctors prefer patients to people, we have a problem.

We also have a solution: just say no.

Fire that doctor.

And take your vitamins.

Niacin supplements with flush to consider:

You want the flush. I (Jacque) personally tried KAL 50 mg. to feel the flush and it was much more mild than I thought it would be, so if you are a bit fearful, start with it. Also in 250 mg, 500 mg, and 1,000 mg. doses:

Notes by Abram Hoffer, MD, PhD

Note 1. Occasionally, niacin will increase darkening/tanning of the skin. This is due to the deposition of melanin like pigments.  With continuing niacin treatment, the darkening stops and leaves behind very nice clean normal skin. It is not dangerous at all but has been confused with acanthosis nigricans, which it is not.

Note 2. Niacin is probably not quite as safe as water, but pretty close to it. Patients ask me, “How dangerous is niacin therapy?” I answer them, “You are going to live a lot longer. Is that a problem for you?” There have been no deaths ever from niacin. The LD 50 (the dosage that would kill half of those taking it) for dogs is 5,000 milligrams per kilogram body weight. That is equivalent to over half a pound of niacin per day for a 60 kg human. No human takes 300,000 milligrams of niacin a day. They would be nauseous long before reaching a harmful dose. The top niacin dose ever was a 16-year-old schizophrenic girl who took 120 tablets (500 mg each) in one day. That is 60,000 mg of niacin. The “voices” she had been hearing were gone immediately. She then took 3,000 mg a day to maintain wellness. 85% of those users who reviewed Niacin reported a positive effect.

Note 3: Niacin at 3500 mg daily is also great for alcohol addiction cravings…. (source) and this very helpful guide.

Comment: Pious patients are defined as patients who accept their doctor’s pronouncements as gospel, as writ in stone. These patients are very easy on their physicians because they do not ask embarrassing questions, and they follow faithfully and religiously every advice given to them. Often this works very well if the doctor is up to date and provides the best possible advice. But often it can lead to disaster. I prefer patients who do not believe everything I tell them. Those who will challenge me, who will demand answers to questions that trouble them, are generally much better patients and their response to treatment is more satisfying. There are extreme cases where the health of patients is compromised by the medical advice they have received. The medical profession recognizes this, and it is one reason seeking a second opinion is not frowned upon by good doctors and why specialists are often called upon to help in treatment.

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