Nicotinic acid in the body. Nicotinic acid: symptoms and treatment of overdose Avitaminosis of nicotinic acid

A nicotinic acid(for many it is associated with cigarettes, nicotine, and something very harmful), in fact, very useful. Moreover, this name hides vitamin B3 or niacin, also known as nicotinamide or PP. Regarding the latter, experts explain the name as deciphering a certain code - a pellagra warning.

After all, vitamin B3 is responsible for the health of the skin (about vitamins in psoriasis), although the beneficial properties of nicotinic acid also apply to metabolic processes in the body.

Niacin takes part in the redox processes occurring in your body, has a vasodilating property, takes part in tissue respiration, protein and carbohydrate metabolism, improves the secretion of gastric juice. Vitamin B3 is also indispensable for a healthy nervous system.

For the latter, he plays the role of an invisible guardian, who is responsible for ensuring that you always keep yourself in control and do not lose your composure in any, albeit the most critical, situation.

Nicotinic acid helps prevent the occurrence of pellagra - a disease of rough skin. Without it, the processes of synthesis of genetic material and protein metabolism do not take place.

Today, vitamin B3 is also one of the most effective means when it comes to normalizing blood cholesterol, improving the functioning of the cardiovascular system and increasing blood circulation, lowering blood pressure and preventing cardiovascular disease.

The action of nicotinic acid

• the use of the drug according to the instructions normalizes metabolic processes and restores the structure of neural fibers well;
• drugs based on vitamin PP improve blood circulation in the cerebral cortex and the whole body;
• dilates blood vessels, thereby improving oxygen metabolism in the body;
• improves human immunity;
• promotes the elimination of toxins from the body.

Medicinal properties of nicotinic acid, indications for use

Use the drug Acidum nicotinicum, despite the fact that it belongs to the group of vitamins, should only be prescribed by a doctor. Often nicotinic acid is used for cosmetic purposes for hair, skin and the whole body. It can also improve vision and memory.

The main indications for the use of the drug nicotinic acid are:

• impaired vision;
• occupational intoxication, alcohol and food;
• deterioration of cerebral circulation, and blood supply to the limbs;
• ischemic stroke;
• noise in ears;
• manifestations of osteochondrosis;
• any form of hemorrhoids;
• disorders in the liver;
• impaired metabolism, especially lipid metabolism;
• pellagra (niacin deficiency);
• diabetes;
• increased acidity of gastric juice;
• migraine.

What distinguishes vitamin B3 from many drugs is its ability to supply oxygen to the blood and promote skin rejuvenation.

An adult needs 15-27 mg of nicotine per day for men, 13-20 mg for women. If necessary, it can be increased to 3-5 g per day, but only as directed by a specialist.

Children aged 6-12 months need nicotinic acid in the amount of 6 mg per day. From 1-1.5 years - 9 mg per day. From 2 years to 4 - 12 mg. From 5 to 6 years -15 mg. From 7 to 10 years - 17 mg. From 11 to 13 years old - 19 mg. From 14 to 17 years - 21 mg of the drug.

Among the products that contain vitamin PP, the leading positions are occupied by beef liver, then quail meat, pine nuts and black tea. Next come tuna, nutmeg, turkey, chicken and rabbit meat. Duck meat also contains nicotinic acid, but in an amount two times less than previous meat products.

Wheat porridge, mushrooms (champignons) and dry thyme contain nicotine in small quantities.

Nutritionists to compensate for the lack of this compound are advised to lean on buckwheat, fish, peas, dairy products, walnuts, eggs.

When heated above 100 degrees, the content of niacin in products decreases by 10-40%, depending on the time of heat treatment.

Symptoms of deficiency and overdose of nicotinic acid

The symptoms of a lack of a substance can be very different, from the appearance of spots on the face (similar to a sunburn), ending with blisters and blisters on the body, which can later leave scars on the skin. There may also be damage to the mucous membranes, including the tongue and gums. Perhaps a manifestation of general weakness and lethargy.

Often there are rashes on the skin of a dark red color, the skin becomes dry and rough. Frequent urge to the toilet (diarrhea about 10 times a day). Loss of appetite and weight loss.

Sometimes there is insomnia and decreased attention. Often, with a lack of nicotinic acid in the body, a person slows down thinking, memory deteriorates.

Symptoms that indicate a deficiency of nicotinic acid become more pronounced in the warm season, namely in spring and summer.

With an overdose of nicotinic acid, there may be a feeling of acute pain in the stomach, dizziness and nausea, clouding of consciousness, and even fainting. Sometimes there is a violation of vision and hearing.

Such symptoms are usually observed when taking nicotinic acid 500 mg or more once in its pure form. In case of an overdose of nicotine, you must contact an ambulance. And before her arrival, open the windows to ensure the flow of fresh air into the room. Give the victim water or milk to drink.

Nicotinic acid is produced in tablets and ampoules.

The tablet form of the vitamin is often used for the prevention and long-term treatment of many diseases. It is prescribed twice a year to patients suffering from poor circulation and venous insufficiency, with thrombophlebitis and trophic ulcers.

Taking nicotinic acid tablets is usually prescribed several times a day, 1 tablet each. Those who have increased acidity are recommended to take tablets after meals and drink milk or mineral water.

Why are nicotinic acid injections prescribed? Vitamin B3 injections are usually used by people with high acidity, and suffering from various forms of hemorrhoids and with impaired blood circulation.

Unlike tablets, injections do not irritate the gastric mucosa, and are evenly distributed throughout the body in the shortest possible time.

The liquid dosage form of nicotinic acid is administered in ampoules up to twice a day subcutaneously, intramuscularly or intravenously. It is recommended to take the drug in autumn and winter.

Contraindications to the use of nicotinic acid

• stomach ulcer;
• allergy to the components of the drug;
• you can not inject nicotine intravenously if a person is prone to jumps in blood pressure;
• gout, excess of the normal level of uric acid in the blood;
• atherosclerosis;
• cirrhosis of the liver;
• pregnancy and lactation;
• severe glaucoma;
• with bleeding in any location.

It is necessary to keep in mind the side effects of nicotinic acid:

• lowering blood pressure;
• short-term redness of the face or upper body;
• a quickly passing sensation of heat;
• with problems with the stomach, worsening of the situation;
• sometimes there is a short-term dizziness.

Adding cottage cheese to the diet facilitates the manifestation of "side effects".

How to take nicotinic acid

Unless otherwise stated directly by your doctor, nicotinic acid tablets are drunk three times a day after meals on a tablet (50 mg). The maximum single dose is 2 tablets (100 mg), daily - 300 mg. month course.

Injection drug is prescribed in a course of 10-14 procedures 1 or 2 times a day. Usually I repeat it twice a year if there are indications (treatment of osteochondrosis, for example).

With rapid intravenous administration, the sensations are similar to those that occur with the introduction of calcium chloride - fever, redness of the face, upper shoulders, chest. Feelings last for about 10-15 minutes.

Therefore, the drug should be administered slowly and after meals.

Electrophoresis is a therapy in which drugs are injected through the skin using weak electrical impulses.

Indications for the appointment of electrophoresis are: diseases of the spine and joints, respiratory tract, diseases of the gastrointestinal tract, genitourinary system, in violation of the motor functions of the body, as well as diseases in the field of dentistry. Quite a lot of drugs can be administered through the skin using electrophoresis. No exception and nicotinic acid.

The most popular prescription using nicotine is the Ratner prescription, in which a vitamin PP preparation is used in combination with aminophylline. This mixture is prescribed for the treatment of inflammatory processes in the body. Regular courses of electrophoresis - 10 procedures.

One of the main advantages of this method is the complete activation of the active substances and their introduction in an ionized form. Current pulses also increase the immune response to external stimuli. Electrophoresis with vitamin PP contributes to the accumulation of substances in cells, therefore, the effect persists for a long time.

Nicotinic acid for skin care

Nicotinic acid for the face is used in cosmetology to improve skin condition, treat acne and prevent early aging. The tool contains in its composition the substances necessary to maintain not only beauty, but also the health of the body.

Useful properties of the drug

Nicotinic acid for the face is a complex of vitamins of group B and PP. They play an important role in metabolic processes and affect the condition of the skin and hair. These substances are found in food, but most often they are not enough in the daily diet. Nicotinic acid has nothing to do with toxic nicotine from tobacco products.

After the age of 20 years, the need for vitamins PP and group B increases significantly. If up to 12-14 years old it is enough to use 10-13 mg per day, then by the age of 20 this figure reaches 20 mg per day. Therefore, by the age of 30, a constant lack of these trace elements begins to appear on the outside.

For cosmetic purposes, tablets and ampoules with the active substance are used. They are used internally and externally. The main useful properties of the drug:

• improves blood microcirculation, contributing to the active supply of nutrients to skin cells;
• helps to eliminate inflammatory processes;
• affects skin color, improving it, removes pigmentation;
• removes excess fluid from the body, relieves swelling of the face;
• protects from aggressive sunlight;
• participates in redox processes;
• promotes the production of a number of enzymes that affect the state of the dermis;
• participates in the synthesis of hormones necessary for skin health;
• normalizes the work of the sebaceous glands, eliminating acne;
• prevents the development of tumor neoplasms;
• restores elasticity and firmness to flabby facial skin, smoothes fine mimic wrinkles.

Substances that are the basis of nicotinic acid are also found in medicinal plants. There are many of them in sage, rosehip, ginseng, burdock root, hops and other natural "healers". The combination of herbal raw materials and a concentrated preparation enhances the therapeutic and cosmetic effect.

Nicotinic acid for facial skin is used as an additive to various cosmetic products. It is added to masks, serums, lotions. When taking a complex of vitamins inside, one must strictly adhere to the recommendations of a doctor or cosmetologist. Tablets are taken in the usual way with water. A liquid drug in ampoules is injected into the body.

On average, the course of therapy is no more than two weeks. These vitamins are often prescribed in periods before and after plastic surgery, as they accelerate the process of tissue repair and help to quickly relieve inflammation of injured skin areas.

With an overdose of vitamins B and PP, unpleasant consequences can occur. Signs of excessive accumulation of these trace elements in the body are:

• skin rashes similar to allergies;
• redness of some parts of the body - hands, head, neck, chest;
• fainting;
• numbness of fingers and toes;
• dizziness;
• nausea.

There are no special contraindications to the use of acid as an additional ingredient in external agents. But, it should be treated with caution by those who suffer from allergic reactions.

Before trying out a complex of vitamins, it is advisable to test for skin sensitivity to its components. To do this, apply it to a small area of ​​​​skin on the arm and wait 20-30 minutes. If no reaction follows, then you can safely use nicotinic acid for cosmetic purposes.

Masks with nicotinic acid

For the preparation of masks, it is better to use vitamins in ampoules. They can be purchased at any pharmacy at an affordable price. Before applying the mask, the face is treated with a cleanser. The procedure should be carried out no more than 2 times a week.

Recipes for effective masks:

1. To improve the color and condition of the skin. 2 ampoules of vitamins, 1 tablespoon of ginger juice. Mix and apply on face with a cotton swab. Wash off with warm water after 20 minutes.
2. Whitening. 1 tablespoon of kefir, 1 teaspoon of acid. Stir, apply on the face, excluding the mouth and eyes. Wash off after 15 minutes.
3. Nutritious. 2 teaspoons of regular moisturizer, 1 ampoule of vitamins. Combine the ingredients into a homogeneous mixture and apply to the skin before going to bed. You may not rinse.
4. Moisturizing. 1 teaspoon of honey, 1 teaspoon of grape or olive oil, 1 ampoule of nicotinic acid. Combine honey with oil and heat in a water bath until a warm liquid state. Add vitamins to the mixture. Before applying, the face can be steamed so that nutrients penetrate deep into the epidermis through open pores. Keep the mask for 30-40 minutes, then rinse with warm water.
5. Cleansing. 10 grams of cosmetic clay (white or blue), 10 grams of lemon juice, 1 ampoule of vitamins. Dilute citrus juice with water in a ratio of 1:1. Mix it with nicotinic acid. Add clay, mix. You should get a consistency like sour cream. Apply to face for 30 minutes.
6. Pull-up. Take in equal proportions hyaluronic and nicotinic acids. Mix. Apply to skin with cotton pads. Wash off after 20 minutes with cool water.
7. From freckles and age spots. 1 tablespoon honey, 3 tablespoons lemon juice, 5 drops acid. Mix all. Apply to the face twice a day for 20 minutes for 7 days.
8. For aging dry skin. Take 1 teaspoon of glycerin, vitamin A, tocopherol, mineral water. Combine them in one cup and heat in a water bath. Add 1 ampoule of vitamins to the mixture. Soak a gauze pad with the product and apply on the face for 30 minutes. Cover your eyes with cotton pads.
9. Moisturizing and toning. Boil oatmeal in milk. Mix 1 tablespoon of cooked porridge with 1 tablespoon of softened banana and 10 drops of nicotinic acid. Distribute everything evenly over the face. Wait until the mask dries (20-30 minutes), then rinse off.
10. Anti-aging. 1 egg white, 1 teaspoon of honey, half a teaspoon of vitamins, 2 tablespoons of overripe banana pulp. Mix everything and apply on face for 15 minutes.

Nicotinic acid and acne treatment

Nicotinic acid is used in the treatment of acne, as well as during the recovery of the skin after an illness. Numerous reviews testify to the fact that the tool helps. To eliminate acne and blackheads based on the vitamin complex, you can prepare a variety of cosmetics.

Recipes for problem skin with inflammation:

1. Mask for oily problem skin. Mix 1 tablespoon of calendula with 1 tablespoon of birch buds. Pour them with water and boil until a strong broth is formed. Heat 1 teaspoon of coconut oil in a water bath. Mix 3 tablespoons of herbal decoction, oil and 1 ampoule of nicotinic acid. Soak a gauze or cotton pad in the mixture and apply on the face. When dry, repeat the steps until the mixture is finished.
2. Acne lotion. Pour 1 teaspoon each of nettle, sage and chamomile into a porcelain dish. Boil herbs in boiling water and leave for 30 minutes. Strain and add 2 ampoules of vitamins. Wipe face with lotion 2 times a day. Store in the refrigerator for up to 7 days. Read more:
3. Acne mask. Mix 1 tablespoon of aloe juice and 2 ampoules of nicotinic acid. Apply to face with a cotton pad. Wash off after 20 minutes.
4. Mask for enlarged pores and blackheads. 2 dessert spoons of fresh low-fat cream, 1 teaspoon of lemon juice, 2 teaspoons of fresh raspberry pulp, 1 ampoule of vitamins. Mix everything well and apply on face for 15-20 minutes.

This is due to the fact that people eat improperly processed food, which loses all its beneficial properties, or there are any disturbances in the absorption and assimilation of this vitamin in the gastrointestinal tract. What are the main signs of a lack of nicotinic acid? The most basic signs of a lack of nicotinic acid, or vitamin D, are: disruption of the gastrointestinal tract, manifested in constipation and diarrhea; damage to the skin and mucous membranes, which can lead to dermatitis, cracks in the mouth and lips, and so on; disorders of the central nervous system, which can lead to dementia. On the part of the nervous system, signs of an insufficient amount of vitamin B3 in the body are insomnia, fears and increased anxiety, anger at others, irritability from any noise and sound, inability to focus on anything, aggressive behavior, loss of a sense of humor, emotional instability, rapid fatigue. Often, the symptoms of a lack of vitamin PP are taken by others as a manifestation of senile insanity. Signs of vitamin B3 deficiency often occur in 13% of people over 60 years of age. With a lack of vitamin B3, the brain primarily suffers. This vitamin is just as important for the brain as calcium is for bones. Without it, the brain is not able to function normally, and with its deficiency, a person loses memory, the ability to associate, and cannot sleep normally.

Studies have shown that one of the symptoms of vitamin B3 deficiency is weight gain and obesity. This is because this vitamin helps to eliminate even very dense deposits of cholesterol and other fats on the walls of blood vessels. In addition, it removes unnecessary and toxic metabolic products from the body.

The skin is also affected. Peeling or pigmentation of the skin is observed, especially in areas exposed to ultraviolet rays, inflammation of the tongue, its swelling and redness. In addition, there are burning sensations in the hands and feet. Also, sometimes deficiency symptoms can include low sex drive and anemia. Thus, if you begin to notice at least a few of the signs listed above, you need to immediately change your diet by adding as many foods containing vitamin B3 to it as possible. If this does not help, we recommend that you consult a doctor who will prescribe medication for you.

If you do not pay attention to the appearance of these signs of attention, the normal functioning of your body will be disrupted, which will lead to the development of serious diseases.

Nicotinic acid (niacin) is a biologically active substance that enters the human body with food. If cells and tissues are deficient in the vitamin, then the work of all vital systems is disrupted, immunity is reduced, and the appearance worsens. Synthesized vitamin PP is used to replenish niacin in the form of tablets and solution for parenteral administration. An overdose of nicotinic acid can be triggered by non-compliance with medical recommendations and improper storage.

Characteristic features of the drug

Nicotinic acid refers to vitamins that are actively involved in redox processes. With the participation of niacin in the human body, the synthesis of enzymatic compounds occurs, the metabolism of carbohydrates and lipids in tissues is regulated.

Vitamin PP overdose is often diagnosed in people trying to lose weight. The ability of nicotinic acid to speed up metabolic processes is used by women for weight loss. As a rule, this leads to poisoning, excruciating headaches and severe depression.

The solid form of niacin is a white, odorless, finely crystalline powder with a slightly sour taste. Poorly bred in cold water, when boiled, it almost immediately goes into solution. Nicotinic acid is found in many foods, such as:

• rye bread, buckwheat, beans;
• meat, kidneys, liver;
• mushrooms, beets, pineapple, mango.

Vitamin retains its properties after boiling and freezing. Artificial nicotinic acid was obtained almost 200 years ago. For this, nicotine was oxidized with chromic acid.

Pharmacological action of nicotinic acid

Often, an overdose of a biologically active substance occurs due to the desire of patients to achieve the maximum therapeutic effect as soon as possible. Nicotinic acid has the ability to accumulate in tissues, so it is used exclusively for course treatment. After conducting laboratory tests, the doctor will select an individual dosage and determine the period of use of the tablets necessary for therapy.

Despite the fact that the drug belongs to vitamins, intoxication with nicotinic acid leads to serious consequences for the body. Keep the medicine out of the reach of small children, because they are always interested in neat bottles of pills.

In pharmacology and medicine, nicotinic acid is used not only for the treatment of pathologies, but also for the prevention of relapses of chronic diseases, the prevention of beriberi. Niacin has a positive effect on the human body:

• Normalizes metabolic processes of fats and carbohydrates.
• Participates in the transmission of nerve impulses.
• Improves metabolism in cells and tissues.
• Restores blood circulation in damaged areas of internal organs and the brain.
• Reduces blood pressure, dilates blood vessels.
• Normalizes oxidative processes and oxygen metabolism.

The ability of nicotinic acid to speed up metabolism and quickly be excreted from the body is used to treat poisoning with poisons or toxic compounds. Solutions of vitamin PP are used for detoxification therapy in case of an overdose of narcotic substances and ethyl alcohol.

Rational use of vitamin PP

An overdose of niacin develops when the rules for handling drugs are not followed.. Cases of acute poisoning with nicotinic acid, which develops with external use of the drug for parenteral administration, have become more frequent. Young women who suffer from excessive hair loss in the postpartum period rub the undiluted solution on the scalp at night. As a rule, an unexpected effect awaits them in the morning:

• excruciating headache;
• nausea, vomiting;
• weakness, unsteadiness of gait due to a sharp drop in pressure;
• burnt itchy scalp.

Hair loss in nursing mothers is due to the resulting hormonal imbalance. This condition is temporary - it cannot be eliminated with ordinary vitamins, especially with such an unusual use.

Nicotinic acid is not consumed on an empty stomach. In the absence of food, there is a risk of an overdose of the drug, since the vitamin is characterized by a high degree of absorption. In addition to the symptoms of intoxication, there is a risk of irritation and ulceration of the mucous membrane of the gastrointestinal tract.

The drug is used in the drug therapy of the following diseases:

1. Osteochondrosis of the cervical and thoracic spine, including as a solution for electrophoresis.
2. Strokes of ischemic etiology.
3. Atherosclerosis.
4. Pellagra (pathology with a deficiency of nicotinic acid).
5. Circulatory disorders in the legs, trophic ulcers.
6. Liver diseases.
7. Glucose intolerance.

For preventive purposes, nicotinic acid is used to correct twilight vision, in the treatment of hemorrhoids. The pharmacological preparation improves memory, increases the production of pepsin, enzymes and gastric juice in hypoacid gastritis.

Chronic overdose of nicotinic acid with long-term treatment can be prevented. To do this, the doctor prescribes periodic delivery of biochemical blood and urine tests. If the level of vitamin PP and its decay products is exceeded in biological samples, the number of tablets taken is reduced or the frequency of their use is reduced.

Clinical picture of overdose

In the event of an overdose especially dangerous is the property of the drug to sharply reduce blood pressure. In hypotensive patients, this condition causes dizziness, fainting, deep coma, which can result in the death of a person. Dangerous symptoms of poisoning also include:

• a significant rise in temperature, flushes of blood to the face and upper body;
• vomiting, nausea, decreased intestinal motility;
• allergic reactions due to a decrease in the functional activity of the liver;
• profuse sweating, migraines, emotional instability;
• decrease in tactile, muscular, tendon reflexes;
• difficulty swallowing food, dry mucous membranes;
• slurred speech.

An overdose of vitamin PP can occur when it is used as the main ingredient in anti-aging masks. The ability of nicotinic acid to provoke a rush of blood to the face is used by women to renew the upper layer of the epidermis. Niacin penetrates into the bloodstream, accumulates in tissues and causes intoxication.

Nicotinic acid and its derivatives in significant concentrations can have a depressive effect on the central nervous system. First, a person has increased motor activity, an increase in strength, and then a state similar to a narcotic one develops (lethargy, drowsiness, apathy).

First aid

After the first signs of an overdose appear, a doctor should be called. There is no antidote for nicotinic acid, therefore, treatment will be aimed at eliminating the symptoms of poisoning. How to help the victim:

1. Lay on side, calm down.
2. Drink strong sweet tea, give any adsorbents or enterosorbents.

It makes sense to cleanse the stomach during intoxication with nicotinic acid if the pills have been taken recently. Niacin is quickly absorbed by the tissues of the internal organs and is also rapidly excreted from the body.

(B 3 , PP, niacin, nicotinamide) is a vitamin that accompanies about 500 biochemical processes in the human body. It is a therapeutic and restorative agent with a wide spectrum of action.

For the first time this substance was obtained by the researcher Huber in 1867 during the oxidation of nicotine with chromic acid. Nicotinic acid acquired its modern name in 1873, when Hugo Weidel (Ger. Hugo Weidel; 1849-1899) obtained this substance by oxidizing nicotine with nitric acid. However, nothing was known about the vitamin properties of nicotinic acid.

Why does the body need nicotinic acid?

Niacin is involved in the production of enzymes responsible for the synthesis of energy from the food consumed. It provides nutrition to cells, stimulates the processing of nutrients, the exchange of amino acids, and accompanies redox reactions in the human body.

Along with other vitamins of this family, B 3:

• regulates in tissues, blood;
• normalizes ;
• neutralizes the harmful effects of free radicals.

Vitamin PP helps prevent the development of heart failure in humans. It helps to reduce the level of malignant cholesterol, which provokes blockage of blood vessels, and increases the amount of benign. Niacin stimulates a reduction in the number of lipoproteins that cause thrombosis.

Provitamin nicotinamide is used in therapy to treat arthritis and diabetes. It has a positive effect on the joints, increasing their mobility, reducing pain. Vitamin B 3 stimulates the functioning of the pancreas, which allows you to reduce the dosage of insulin in the treatment of diabetes.

Niacin has a sedative effect on the body. It is used to correct nervous and emotional disorders with excessive anxiety, depression,.

What are the signs of a lack of nicotinic acid and how are they diagnosed?

The daily requirement for a person is at least 13 mg of niacin per day. Its exact amount depends on the calorie content of the food consumed. There are 6.6 mg of vitamin PP per 1000 kcal. It is found in many plants (greens, cereals), meat and other livestock products.

Lack of vitamin B 3 can be observed in 2 categories of people:

• vegetarians / raw foodists who receive less of it from animal proteins;
• alcohol-dependent individuals who have impaired metabolism and the mechanism of absorption of nutrients.

Niacin deficiency is indicated by:

• dryness, roughness, itching of the skin, rashes in the form of watery vesicles;
• discomfort in the oral cavity (redness and swelling of the tongue, the appearance of ulcers on the mucous membrane, gums);
• loss of appetite, diarrhea;
• insomnia, general malaise, muscle weakness;
• fatigue, decreased concentration, depression or excessive irritability.

These are the main symptoms of pellagra - a disease that occurs with an acute deficiency of vitamin PP and tryptophan-containing proteins. The main signs of this disorder are dermatitis, diarrhea, dementia.

Diagnosis for a niacin deficiency includes:

• collection of data for the formation of an anamnesis of the disorder (the appearance and nature of symptoms, analysis of nutritional value, checking for the presence of gastrointestinal diseases);
• examination by a dermatologist of the human skin;
• laboratory tests of urine in order to detect methylnicotinamide in it;
• additional consultations of other specialists (nutritionist, gastroenterologist).

The lack of vitamin PP is compensated by eating foods with a high content of it, taking multivitamin complexes.

What diseases are treated with nicotinic acid?

Deficiency of B 3 in the body provokes the development of pellagra (metabolic disorders), so the vitamin plays an important role in the treatment of this disease. It is also taken for diseases of the liver, gastrointestinal tract. It increases the resistance of pancreatic cells to negative influences, which is prevention.

The ability to regulate cholesterol metabolism makes vitamin PP an indispensable tool for multiple atherosclerosis,. It is effective in the treatment of inflammation of the mucous membranes (stomatitis), skin diseases (dermatitis, eczema, psoriasis, lupus).

Reduces pain and improves joint mobility. Therefore, it is used in the treatment of osteoarthritis.

The detoxifying effect of niacin makes it possible to use it in the treatment of sulfonamide poisoning, as a restorative agent for long-term use of antimalarial and anti-tuberculosis drugs. And the sedative effect of nicotinamide provitamin increases the effect in the treatment of conditions such as anxiety, depression, alcoholism, schizophrenia.

In what form is it produced and in what dosage should it be taken for children and adults?

Preparations containing nicotinamide provitamin are presented as:

• tablets;
• ampoule solution.

Tableted drugs are taken orally, three times a day, after meals. For an adult, the maximum dose is up to 0.1 g / day, for children - up to 0.03 g / day.

Ampoule vitamin B 3 is injected. For injections, a 1% solution of the drug is used, which is prescribed 1-2 rubles / day, 0.1-0.05 g each. For children, the dose of the drug is determined based on body weight (an average of 0.003 g per 1 kg of weight). The therapeutic course is individual and is 3-5 weeks.

What foods contain nicotinic acid?

Food sources of the antipellagric vitamin are:

• liver (pork, beef), chicken meat, eggs, cheese, seafood;
• vegetables (carrots, potatoes, tomatoes, collards, celery, asparagus), cereals (wild rice, bulgur, lentils), legumes, mushrooms (mushrooms, shiitake), fruits (raspberries, mangoes, bananas, avocados, melons);
• nuts (peanuts, hazelnuts, pistachios);
• herbs (nettle, mint, sage), herbs (sorrel, parsley, fennel).

Niacin is also synthesized in the human body. Its production is carried out with the help of the amino acid tryptophan, which is found in animal proteins.

What drugs contain nicotinic acid?

Vitamin PP is present in medicines in 2 forms that have a similar therapeutic effect:

1. . It is found in Niacinamide, Nicotinamide, Niconacid.
2. Acidum nicotinicum. This is the active ingredient present in Apelagrin, Niacin, Nicoverine, Nicotinic acid (Bufus, Vial), Enduracin.

These drugs are presented in tablet, injectable form.

How does nicotinic acid affect hair?

The benefit of vitamin B3 for hair is that it dilates blood vessels. This ensures the penetration of the drug into the scalp, nourishing the hair follicles. To strengthen the hair, a ready-made ampouled solution of nicotinamide is used. In liquid form, it quickly enters the cells of the skin and hair follicles, accelerating their metabolism. And local application of the drug allows you to quickly achieve the effect.

Tip: Apply a small amount to your wrist first to avoid an allergic reaction.

The drug is used after washing, gently rubbing in a circular motion into the scalp and root zone of the hair. For one procedure, 1 ampoule of the drug is consumed, the recovery course is 1 month.

Attention: after applying the vitamin, the scalp may turn slightly red - this is a normal reaction. It indicates that the remedy has begun to act.

Video How to grow hair? Nicotinic acid for hair growth.

Nicotinic acid and pregnancy

The annotation to the drug states that it is not used during pregnancy. However, its use in this period is necessary if:

• found to be deficient in the vitamin. In 3, gastrointestinal bacteria are produced, but with the growth of the fetus, it becomes insufficient in the woman's body. This causes pigmentation, dryness and keratinization of the skin, hair loss, psycho-emotional disorders;
• diagnosed drug or nicotine dependence of the mother;
• the functioning of the placenta is impaired. Vitamin PP eliminates vasospasm, improving blood circulation. It restores the activity of the placenta, providing nourishment to the fetus with oxygen and nutrients;
• The patient has pathology of the biliary tract and liver. At the same time, the content of niacin in the body decreases, its reserves must be replenished.

With the help of nicotinamide provitamin, acute appendicitis in pregnant women can be diagnosed. The inflammatory process in this process can go unnoticed, causing premature termination of pregnancy. After the introduction of the drug, pain in the uterus disappears, but in appendicitis - no. A diagnostic test using nicotinamide provitamin allows you to identify the disease in a timely manner.

Is it possible to lose weight with nicotinic acid? Myth and reality

It is not a fat burner. But it helps to cleanse the body, normalize metabolic processes, stimulate the secretion of gastric juice, which should regulate the process of digestion. Due to the removal of toxins, lowering the amount of cholesterol in the blood, the body is cleansed and saturated with useful substances.

Taking niacin for weight loss, detoxification should be done carefully, adhering to certain rules:

• the daily intake of the vitamin should not exceed 1 g. An increase in dosage may adversely affect the functioning of the liver;
• capsule and tablet preparations are taken after a meal, drinking plenty of non-carbonated water or milk. This is especially true if a person has increased acidity;
• the drug should not be used by hypertensive patients, people suffering from gastric ulcers, liver diseases;
• the appointment and duration of the drug should be controlled by a doctor;
• while using the drug, you should eat a balanced diet, follow.

Attention: after taking this drug, a person may have a slight increase in body temperature, redden face. This reaction is normal. The drug should be discontinued if side effects such as dizziness, itching occur.

The opinion of Dr. Komarovsky on the use of nicotinic acid

The well-known pediatrician Yevgeny Komarovsky devoted an entire subsection to nicotinamide in the third part of his Handbook for Sane Parents. In it, he describes the mechanism of the effect of the vitamin on the human body, the form of release, indications for use, and its food sources.

The pediatrician recommends taking nicotinamide with acetone in children. This medicine regulates the metabolism of glucose, due to the lack of which this syndrome occurs. To normalize the child's condition, an ampouled 5% drug should be taken orally at the rate of 0.1 ml per 1 kg of weight.

The doctor notes the benefits of vitamin PP for pregnant and lactating mothers. However, he recommends taking it, like other vitamins, only in case of a deficiency in the body, an unbalanced diet, receiving it from products of natural origin, and not medicines.

Can there be an overdose of nicotinic acid? What are its consequences?

An overdose of vitamin PP is impossible if its source is natural products and dietary supplements. Exceeding the dose occurs only with prolonged use of the ampouled drug in large volumes. Signs of excess substance in the body are:

• itching of the skin.

Recommendation: while taking the drug, the patient may experience a decrease in concentration, a slowdown in psychomotor reactions. During this period, it is better for him to give up driving a car, performing actions that require concentration.

VIDEO Nicotinic acid for hair growth, weight loss, application and other useful properties

Nicotinic acid and its derivatives - nicotinamide, nikethamide constitute a group of water-soluble vitamins PP. These chemically and biologically related compounds in the body are easily converted into each other, therefore, they have the same vitamin activity. Other names for nicotinic acid are niacin (an obsolete name), vitamin PP (anti-pellagric), nicotinamide.

In clinical practice, nicotinic acid and nicotinamide are used as medicines. However, the pharmacotherapeutic properties of these drugs are different.
Nicotinic acid has the following effects:

• vasodilating effect (“ignition effect”), cardiotrophic, increases blood microcirculation;
• has an anticholesterolemic effect - reduces the breakdown of fats;
• has a hepatoprotective and detoxifying effect, however, in high doses with prolonged use of nicotinic acid, fatty degeneration of the liver occurs;
• is a neurotropic drug;
• improves the functioning of the heart and blood vessels.

Nicotinic acid has a positive effect on fat metabolism, lowers cholesterol in the blood of patients with atherosclerosis, dilates blood vessels (when taking doses above 75 mg), helps with dizziness, and eliminates ringing in the ears.

Nicotinic acid preparations are used for the prevention and treatment of pellagra, with neuritis, hepatitis, chronic vascular disease with a primary lesion of the arteries of the legs (endarteritis).

Nicotinic acid prevents heart attacks, reduces depression, relieves headaches, improves the functioning of the digestive tract. It acts positively in mild forms of diabetes mellitus, peptic ulcer of the stomach and duodenum, enterocolitis, sluggishly healing ulcers and wounds, and infectious diseases.

The role of nicotinic acid in biological processes

The biological role of nicotinic acid is associated with its participation in the construction of two coenzymes - NAD (nicotinamide adenine dinucleotide) and NADP (nicotinamide adenine dinucleotide phosphate), which are part of the most important redox enzymes. Coenzymes (coenzymes) are organic natural compounds necessary for the catalytic action of enzymes. Coenzymes perform the function of carriers of electrons, atoms from one substrate to another.

Vitamin PP attaches to proteins and together with them creates several hundred different enzymes. Enzymes of nicotinic acid form a "bridge" through which hydrogen atoms are sent to the "furnace". Trillions of “furnaces” are fired up in the cells of the body and help release energy from carbohydrates, fats and proteins that come with food.

Nicotinic acid is directly involved in the processes of biological oxidation and energy metabolism. Being a component of NAD and NADP, it promotes the release of energy from food, DNA synthesis, and regulates the processes of cellular respiration.
Nicotinic acid is involved in the following biological processes:

• cellular respiration, cellular energy;
• circulation;
• carbohydrate, fat, protein metabolism;
• mood;
• cardiac activity;
• control over cholesterol;
• muscles;
• connective tissue;
• production of gastric juice;
• functions of the digestive tract.

Nicotinic acid increases the use of vegetable proteins in the body, normalizes the secretory and motor function of the stomach, improves the secretion and composition of pancreatic juice, and normalizes liver function.

Almost all of the nicotinic acid present in the cells and body fluids is in the form of nicotinamide.

Products containing nicotinic acid

The main natural source of nicotinic acid in the human body are products of animal origin:

• animal organs - liver, kidneys, muscles, heart;
• some types of fish - sardine, mackerel, tuna, salmon, halibut, swordfish, cod.

Cereal grains, wholemeal bread, rice and wheat bran, dried apricots, mushrooms, almonds, green peas, tomatoes, sweet red peppers, potatoes, soybeans are rich in nicotinic acid. An excellent source of replenishing the lack of nicotinic acid is baker's yeast, brewer's yeast.

Table 1 shows the products in which nicotinic acid is contained in the largest amount.
Table 1

The vitamin value of products depends not only on the amount of nicotinic acid content, but also on the forms in which it exists. So, in legumes, it is in an easily digestible form, and from cereals (rye, wheat), the vitamin is practically not absorbed.

In animal tissues, nicotinic acid is mainly found in the form of nicotinamide, in plants - as nicotinic acid. Vitamin PP is absorbed in the small intestine and consumed by the body.

Nicotinic acid is one of the most stable in terms of storage, cooking, preservation of vitamins. The high temperature during cooking and frying has almost no effect on its content in the product. Resistant vitamin PP and the effects of light, oxygen, alkalis. It practically does not lose biological activity during freezing and drying of products. With any treatment, the total loss of nicotinic acid does not exceed 15 - 20%.

Partially, nicotinic acid can be synthesized from the essential amino acid tryptophan. However, this process is efficient – ​​only one vitamin molecule is formed from dozens of tryptophan molecules. However, foods rich in tryptophan (milk, eggs) can compensate for insufficient dietary intake of nicotinamide.

Daily requirement for a vitamin

Nicotinic acid children and adolescents require daily:

• 5 - 6 mg at the age of up to a year;
• 10 - 13 mg for children from 1 year to 6 years;
• 15 - 19 mg at the age of 7 to 12 years;
• 20 mg for adolescents 13 to 15 years of age.

Adults need about 6.6 mg of the vitamin for every 1,000 calories consumed. That is, the daily requirement for nicotinic acid for adults is 15-25 mg.
An increased need for vitamin PP is needed:

• those who are engaged in heavy physical labor;
• elderly people;
• patients who have recently suffered severe injuries and burns;
• people who use alcohol and drugs;
• people suffering from debilitating chronic diseases, including malignant tumors, pancreatic insufficiency, cirrhosis, sprue;
• with nervous strain;
• young children born with metabolic disorders (congenital disorders caused by abnormalities in the chromosome set);
• pregnant and lactating women.

The loss of nicotinic acid leads to excessive consumption of sugar, sweets, sugary drinks. Nicotine reduces the absorption of vitamin PP. Therefore, people who are addicted to nicotine may also need additional nicotine intake.

Long-term use of large doses of leucine can lead to a deficiency of tryptophan and nicotinic acid.

Hypovitaminosis and hypervitaminosis

With insufficient intake of nicotinic acid in the body, a person develops the following early symptoms of hypovitaminosis: general fatigue, lethargy, apathy, decreased performance, insomnia, loss of appetite, weight loss, headaches, disorders of consciousness, memory loss, indigestion, irritability, depression.

Secondary deficiency of nicotinic acid occurs in a number of diseases of the gastrointestinal tract, neuritis, allergic dermatosis, poisoning with lead, benzene, thallium.

Late symptoms of acid deficiency - pellagra disease.

In mammals, the state of hypervitaminosis (super-high doses of vitamin PP) could not be induced. Stocks of nicotinic acid do not accumulate in tissues. Its excess is immediately excreted in the urine. An increased content of nicotinic acid may be accompanied by an unpleasant sensation of "skin heat".

Diagnosis of the provision of the body with nicotinic acid

An indicator of the provision of the human body with vitamin PP is the excretion with urine of the main products of the metabolism of nicotinic acid - N-methylnicotinamide and methyl-2-pyridone-5-carboxyamide. Normally, 7-12 mg is excreted in the urine per day.

A decrease in the level of acid excretion with urine indicates an insufficient supply of the body with vitamin PP and the possibility of developing vitamin deficiency. The concentration of metabolites of nicotinic acid and nicotinamide sharply increases with their excessive intake into the body.

Of particular value is the study of the quantitative content of N-methylnicotinamide after loading with nicotinic acid or nicotinamide. This is the only criterion for determining the body's availability of this vitamin. The level of vitamin PP itself or its coenzyme forms in the blood cannot be decisive, since even with severe pellagra their content differs little from that in healthy individuals.

Laboratory tests to detect nicotinic acid deficiency are urinalysis No. 1 for methylnicatinamide and urinalysis for 2-pyridone / No. 1 for methylnicatinamide.

Test results are not always conclusive.

Chemical methods for the quantitative content of nicotinic acid include the reaction for the determination of nicotinic acid with bromine cyanide.

Nicotinic acid and nicotinamide in cardiovascular diseases

One of the main causes of cell damage and death during oxygen starvation (acute ischemia) is the developing lack of energy supply. It is associated both with increased energy consumption (operation of detoxification systems, activation of transport adenosine triphosphates), and with insufficient formation of biological molecules that are able to accumulate and transfer energy during the reaction due to damage to mitochondrial membranes and others.

The concentration of substances involved in energy metabolic processes changes dramatically. With ischemia in the brain at the molecular level, a cascade of physiological and pathophysiological reactions develops:

1. Decreased blood supply to the brain. Accordingly, the delivery of oxygen from the bloodstream to the cells decreases. And since oxygen is involved in the reactions of energy generation, oxygen starvation develops - a hypoxic state. The cell loses the ability to oxidize a number of energy substrates.
2. The increase in oxygen deficiency is accompanied by a decrease in the content of adenosine triphosphate (ATP) - an energy source.
3. At the last stages of oxygen starvation, the level of energy deficiency becomes sufficient to trigger the main mechanisms that lead to disruption of vital activity and cell death.
4. The concentration of adenosine monophosphate (AMP) is rapidly increasing. And this is an additional mechanism for the destruction of cell membranes.
5. Violation of energy metabolism develops rapidly. This leads to necrotic cell death.
6. A change in the state of membrane structures and receptors triggers a single molecular mechanism aimed at the response of brain tissue to a damaging effect. An acute decrease in cerebral blood flow (cerebral ischemia) activates a complex of genetic programs that lead to a consistent transformation of the hereditary information of a large number of genes.
7. The first reaction of the brain tissue to a decrease in cerebral blood flow is a decrease in the synthesis of messenger RNA and proteins - the poly(ADP-ribosyl)ation reaction - protein modification. This reaction involves the enzyme poly(ADP-ribose) polymerase (PARP).
8. The donor of ADP-ribose is nicotinamide dinucleotide (NAD). The enzyme poly(ADP-ribose)-polymerase (PARP) begins to consume nicotinamide very actively (500 times stronger), greatly reducing its content inside the cell. And since nicotinamide dinucleotide regulates vital processes in the cell, its deficiency causes cell death by necrosis.

The use of drug protection of the brain reduces the risk of cerebral ischemia during the period of temporary cessation of blood flow through the carrier vessel. For this, drugs are used that inhibit (inhibit) the activity of the cellular enzyme poly(ADP-ribose) polymerase. A sharp drop in the level of nicotinamide is prevented, cell survival is increased. It reduces tissue damage associated with ischemic stroke and myocardial infarction.

Among the active inhibitors (substances that suppress the course of enzymatic processes) is nicotinamide. In structure and action, it is close to nicotinic acid, participates in redox processes in the body. Nicotinamide has a high selective effect on the poly(ADP-ribose) polymerase enzyme. It also has a number of non-specific effects:

• acts as an antioxidant;
• affects the metabolic processes of glucose, lipids and nucleotides;
• inhibits the overall synthesis of DNA, RNA and protein.

Nicotinamide prevents the development of severe metabolic disorders in the brain, activates the energy metabolism systems in the cell, helping to maintain the energy status of the cell.

Combined preparations containing nicotinic acid are widely used for cerebrovascular accidents, myocardial infarction, obstructive endarteritis, Raynaud's disease, that is, in all cases where increased microcirculation and collateral (bypass) circulation is actually the only way to preserve the functional abilities of tissues.

Experimental and clinical data show that vitamin PP relaxes spasmodic coronary vessels; therefore, nicotinic acid is successfully used in the composition of Nikoverin and Nikoshpan preparations for angina pectoris.

By activating specific enzymes - tissue fibrinases, nicotinic acid increases the activity of the blood to dissolve intravascular blood clots.

Nicotinic acid lowers blood cholesterol

One of the preventive measures associated with acute disorders of cerebral circulation is the reduction of blood cholesterol levels. Nicotinic acid prevents the release of fatty acids and thus lowers blood cholesterol levels.

As a lipid-lowering agent, nicotinic acid has been used since 1955. In a large dose, it has a diverse effect on lipid metabolism:

• inhibits the breakdown of fats in adipose tissue, which limits the delivery of free fatty acids to the liver, as a result, inhibits the hepatic synthesis of triglycerides and very low density lipoproteins (VLDL);
• increases the breakdown of VLDL in the blood;
• reduces the content of low-density lipoproteins (LDL) in the blood, depleting their precursors - very low density lipoproteins;
• increases the level of high density lipoproteins (HDL).

Nicotinic acid in doses of 3–6 g per day reduces the amount of cholesterol, low density lipoproteins by 15–25% after 3–5 weeks of therapy, reduces the level of triglycerides (fat molecules) of very low density lipoproteins by 20–80% after 1–4 days , increases the content of high-density lipoprotein cholesterol by 10 - 20%, prevents the appearance of lipoprotein (a).

Patients tolerate nicotinic acid much better when it is used in dosage forms with prolonged action. These are Nicobid Tempules (microencapsulated tablets with fast and slow release), Slo-Niacin (compound of nicotinic acid with polygel), Enduracin (tropical wax matrices containing nicotinic acid).

Taking only nicotinic acid in a daily dose of 3 g or in combination with other drugs leads to a decrease in the incidence of non-fatal myocardial infarction, stroke, and the need for surgical intervention on the heart and blood vessels. In patients receiving nicotinic acid, there are signs of regression of coronary atherosclerosis, a decrease in the frequency of progression of atherosclerotic lesions.

Cardiotrophic action of nicotinic acid

With repeated use of nicotinic acid in the damaged myocardium, the content of pyruvic and lactic acids decreases, while the content of glycogen and adenosine triphosphate increases.

Improving microcirculation by expanding capillaries increases myocardial oxygen enrichment. As a result of the normalization of biochemical processes, the contractile activity of the myocardium also improves (the cardiotonic effect of nicotinic acid).

Nicotinic acid potentiates the action of herbal medicines, which in therapeutic doses have a cardiotonic and antiarrhythmic effect - cardiac glycosides. The drugs are used to treat heart failure. Especially effective is the use of nicotinic acid in combination with digitalis glycosides.

Hepatotropic effect of vitamin PP

Nicotinic acid affects liver function. The hepatotropic effect is expressed in stimulation of the secretion and excretion of bile, stimulation of the glycogen-forming and protein-forming functions of the liver.
Nicotinic acid is shown:

• with various professional intoxications - poisoning with aniline, benzene, carbon tetrachloride, hydrazine;
• with household poisoning;
• with drug intoxication with barbiturates, anti-tuberculosis drugs, sulfonamides;
• with toxic hepatitis.

Under the action of nicotinic acid, the detoxification ability of the liver is enhanced - the formation of paired glucuronic acids, which are formed in the process of detoxification, increases; toxic metabolic products and external toxic compounds are replaced.

Neurotropic action of nicotinic acid

Neurotropic drugs are called drugs that have an effect on the central and peripheral nervous system. Nicotinic acid is involved in the biosynthesis of hormones that affect the human psyche.

The "happiness hormone" serotonin is formed from tryptophan. Serotonin affects a person and his mood. Since nicotinic acid is absolutely indispensable for the production of energy in the cells of the body, when it is deficient, a significant proportion of tryptophan is converted into nicotinic acid. The more tryptophan is used for energy, the less tryptophan is left for calming nerves and good sleep. Lack of serotonin leads to insanity, poor concentration, depression, nervousness up to depression, hallucinations, and sometimes schizophrenia.

Nicotinic acid is the only vitamin that is indirectly involved in hormonal metabolism in the human body. Its neurotropic properties are manifested by increased inhibitory processes. Strengthening of inhibitory processes under the action of nicotinic acid has a beneficial effect on the body as a whole: efficiency increases, the number of inadequate reactions decreases.

Nicotinic acid is used in the treatment of neurotic and psychotic conditions, alcoholic delirium (disorder of consciousness), chronic alcoholism. It potentiates the action of neuroleptics and barbiturates, weakens the action of caffeine and phenamine.

Nicotinamide refers to mixed-action drugs with a wide range of applications. It is part of the drug Cytoflavin. This is a balanced complex of components, an effective combination of which has a synergistic regulatory effect on all major metabolic pathways in the central nervous system, which are more or less impaired during cerebral ischemia.

Cytoflavin reduces the degree of neurological deficit and accelerates the recovery of functions in ischemic stroke. The drug affects the main pathophysiological processes that occur during ischemic damage to the neuronal structures of the brain:

• restores antioxidant protection factors;
• activates energy-forming processes and reactions;
• inhibits oxidative stress reactions, increasing the ability of cells to utilize glucose and oxygen;
• stimulates protein synthesis within cells.

Due to these numerous effects, there is an improvement in coronary and cerebral blood flow, stabilization of metabolic activity in the cells of the central system, which is clinically manifested by a decrease in the existing neurological deficit and restoration of impaired functions.

Nicotinamide is part of the combined metabolic drug Cocarnit (manufactured by World Medicine, UK). The drug is indicated for the symptomatic treatment of a complication of diabetes mellitus - diabetic polyneuropathy.

Nicotinamide improves nerve conduction and blood flow in the nerves in diabetes mellitus, reduces lipid oxidation, the formation of free radicals and secondary products of lipid oxidation. The drug has multiple effects and low toxicity at high doses in the treatment of patients, which is confirmed by the results of numerous studies.

Pellagra (nicotinic acid deficiency): symptoms and treatment

Pellagra (from the Italian pelle agra - rough skin) is a disease associated with insufficient intake or incomplete absorption of nicotinic acid by the body. The basis of the disease is a violation of the energy of cells and their ability to actively divide.

In the past, pellagra developed where corn became a staple food. In this cereal culture, nicotinic acid is contained in a hard-to-digest form, it is poor in tryptophan, from which the vitamin is able to be synthesized. The main regions of the origin of pellagra were the south of Europe, Africa, Latin America, and the southern states of the United States. In Tsarist Russia, the disease occurred in Bessarabia (Moldova), to a lesser extent in Georgia.

The main reason for the development of nicotinic acid deficiency in the inhabitants of our country are chronic diseases of the gastrointestinal tract (enteritis, colitis) associated with impaired absorption.

Causes of the disease

The cause of the disease is not only the low content of nicotinic acid in food, but also:

• insufficient content of tryptophan;
• high content of leucine in food, which inhibits the synthesis of the NADP conferment in the body;
• low levels of pyridoxine conenzymes;
• the presence in grain products of niacithin and niacinogen, as well as related forms of nicotinic acid that are not absorbed by the body.

In children, pellagra usually develops with an unbalanced diet with a predominance of carbohydrates. In very rare cases, the disease develops in children who are breastfed, as a result of an insufficient content of vitamins in the diet of a nursing mother.

Pathological processes occurring during the disease

Pellagra affects the skin, organs of the gastrointestinal tract and the nervous system. The severity of the processes depends on the stage and form of the disease.
Changes in the skin are manifested in the form of extensive areas of red-brown color, overflowing with blood, with sharp boundaries of the lesion. The skin swells, thickens. In the later stages of the disease, atrophy of the epidermis occurs.

Erosions or ulcers appear in the oral cavity. Edematous bright red tongue with painful ulceration later becomes varnish. In the integumentary epithelium of the pharynx and esophagus, the mucous membrane of the small and large intestine, atrophic changes occur.

The stomach, pancreas and liver are reduced in size. The mucous membrane of the stomach is anemic, with single hemorrhages, the folds are poorly expressed. The secretion of the digestive glands is suppressed, achilia occurs - the absence of hydrochloric acid and the enzyme pepsin in the gastric juice. In the liver, fatty degeneration of its working cells of hepatocytes is observed.

In the brain and spinal cord, as well as in the peripheral nervous system, dystrophic changes in neurocytes with signs of neuronophagy are found - damaged or degeneratively altered nerve cells are destroyed and removed from the body with the help of phagocytes - cells of the immune system.

Significant metabolic disorders and the functions of many organs leads to dystrophic and degenerative changes in almost all organs and tissues. Kidneys, lungs, heart, spleen are affected.

Symptoms of pellagra

Pellagra occurs in school and adolescence, in early childhood - very rarely. Mostly adults aged 20-50 years get sick.
The clinical picture of pellagra is characterized by three main manifestations:

• dermatitis - skin lesions in symmetrical areas exposed to sunlight (hence the name of the disease);
• - disorder of the gastrointestinal tract;
• - mental disorder with memory loss, dementia, delirium.

Symptoms of the disease usually come on by the end of winter. Patients weaken 3-5 times a day and more often. Stools free of blood and mucus, watery, with a putrid odor.
Then there is a burning sensation in the mouth and severe salivation. Swollen, cracked lips. Ulcers appear on the gums and under the tongue. Language changes are characteristic. At first, its back is covered with a black-brown coating, the edges and tip are bright red. Gradually, the redness passes to the entire surface of the tongue, it becomes smooth and shiny.
Then pellagric erythema appears: in open areas (face, neck, rear of the hands and feet), the skin turns red, swells and itches under the action of sunlight. Sometimes blisters form, which burst and leave a weeping. After a few days, pityriasis peeling occurs. With a decrease in inflammation on the affected areas of the skin, persistent grayish-brown pigmentation remains, depigmentation of the vitiligo type is less common.

The function of peripheral nerves and the central nervous system is impaired. There is dizziness, headaches. Apathy is replaced by depression. Psychosis, psychoneuroses develop, in severe cases hallucinations occur, convulsions occur, mental retardation develops.

In early childhood, the classic symptoms of pellagra are less pronounced. Inflammation of the tongue, disorders of the gastrointestinal tract, and redness of the skin predominate. Mental changes are rare.

The most severe complication of pellagra is (organic brain damage) with psychotic reactions.

Disease diagnosis

The diagnosis is based on the characteristic clinical manifestations of the disease, data on the nature of nutrition, biochemical studies. Pellagra is characterized by the content of NI-methylnicotinamide in daily urine below 4 mg, the content of nicotinic acid is below 0.2 mg. The content of other B vitamins in the blood and urine decreases.

Treatment

All patients with fresh and recurrent manifestations of pellagra are subject to hospitalization.

Treatment of patients with insufficient intake of nicotinic acid includes a diet rich in vitamin PP, containing a sufficient amount of protein. In mild forms of beriberi, vitamins are prescribed in tablets. Patients suffering from insufficient absorption of nutrients in the small intestine, they are injected.
The recommended daily dose for treatment is 300 mg of the vitamin, divided into 2 to 3 doses. Treatment continues for 3 to 4 weeks.

Therapeutic doses of nicotinic acid are preferably administered as nicotinamide, which has significantly fewer side effects than nicotinic acid.

For mental disorders, low doses of antipsychotics (chlorpromazine, frenolone, triftazin) are prescribed in combination with antidepressants (amitriptyline) and tranquilizers (seduxen), which are administered intramuscularly or intravenously. In cases of development of an organic psychosyndrome, high doses of thiamine or nootropil are prescribed in the form of repeated courses.

Since pellagra shows signs of deficiency of other B vitamins, as well as the amino acid tryptophan, the treatment plan includes the introduction of a complex preparation of vitamin B.

After the start of treatment, the symptoms of gastrointestinal upset disappear after a few days. Signs of dementia and dermatitis improve significantly during the first week of therapy. If pellagra has become chronic, a longer period of treatment is required for recovery, but the appetite and general physical condition of the patient improve rapidly.

Prevention

A varied balanced diet with a sufficient content in the diet of foods rich in nicotinic acid, enrichment of corn flour and cereals, wheat flour of the highest and first grades with nicotinic acid, health education of the population.

Secondary pellagra

Cases of pellagra are described in patients suffering from diseases of the digestive system with anachlorhydria (lack of hydrochloric acid) with cancer of the esophagus, ulcers, cancer and syphilitic lesions of the stomach and duodenum, chronic ulcerative colitis, tuberculosis, after dysentery, after operations on the organs of the digestive system, in chronic alcoholism, treatment of tuberculosis with isoniazid.

Nicotinic acid preparations

In clinical practice, nicotinic acid itself and its derivatives, the slow-release forms Niaspan and Enduracin, are used. In the United States, a fixed combination of nicotinic acid and lovastine is used - Advicor. Sustained release forms of nicotinic acid are better tolerated, but are less effective in lowering lipids.

Nicotinic acid: instructions for use

pharmachologic effect

Nicotinic acid is a specific antipellagric agent (vitamin PP). It improves carbohydrate metabolism, has a vasodilating effect, including on the vessels of the brain, and has hypolipidemic activity. Nicotinic acid 3-4 g per day (large doses) reduces the content of triglycerides and low-density lipoproteins in the blood, reduces the ratio of cholesterol / phospholipids in low-density lipoproteins. Has detoxifying properties.

Dosage forms

Nicotinic acid is available in the form of tablets and injections.
Subcutaneous and intramuscular injections of the vitamin are painful. Intravenous solution must be administered slowly, as a strong decrease in blood pressure may occur.

Compound

One tablet contains: nicotinic acid 0.05 g - active ingredients; glucose, stearic acid - excipients.
One milliliter of solution for injection contains: nicotinic acid 10 mg - active substance; sodium bicarbonate, water for injection - excipients.

Indications

Prevention and treatment of pellagra (avitaminosis PP).

Complex therapy of ischemic disorders of cerebral circulation, obliterating diseases of the vessels of the extremities (obliterating endarteritis, Raynaud's disease) and kidneys, complications of diabetes mellitus - diabetic polyneuropathy, microangiopathy.

Liver diseases - acute and chronic hepatitis, gastritis with low acidity, neuritis of the facial nerve, various intoxications (professional, drug, alcohol), long-term non-healing wounds and ulcers.

Contraindications

The drug is contraindicated in the following cases:

• hypersensitivity to the components of the drug;
• peptic ulcer of the stomach and duodenum in the acute stage;
• severe arterial hypertension;
• gout;
• hyperuricemia, nephrolithiasis, liver cirrhosis, decompensated diabetes mellitus;
• pregnancy and breastfeeding period.

Method of application of nicotinic acid and dosing

Used as directed by a doctor.
Nicotinic acid tablets are taken orally after meals.
As an antipellagric agent is prescribed:

• adults - nicotinic acid 0.1 g 2 - 4 times a day (maximum daily dose - 0.5 g);
• children - from 0.0125 to 0.05 g 2 - 3 times a day, depending on age.

The course of treatment is 15 - 20 days.
Adults with ischemic disorders of cerebral circulation, spasms of the vessels of the extremities, gastritis with low acidity, neuritis of the facial nerve, wounds and ulcers are recommended to prescribe nicotinic acid in a single dose of 0.05 - 0.1 g, in a daily dose - up to 0.5 g. treatment - 1 month.

Side effects

Allergic reactions, dizziness, redness of the face, a feeling of a rush to the head, paresthesia (feeling of numbness, loss of sensitivity, crawling, tingling) are possible. In this case, the dose should be reduced or the drug discontinued.

With prolonged use of nicotinic acid in high doses, the development of fatty degeneration of the liver, hyperuricemia, an increase in the activity of hepatic transaminases and alkaline phosphatase, and a decrease in glucose tolerance are possible.

Overdose

An overdose is unlikely.
Nicotinic acid in individuals with individual intolerance can cause redness of the face and upper half of the body, dizziness, a feeling of a rush of blood to the head, urticaria, paresthesia. These phenomena go away on their own and do not require special treatment.

Control of therapy, warnings

To prevent complications from the liver with prolonged use of nicotinic acid in high doses, it is recommended to include foods rich in methionine (cottage cheese) in the diet or use methionine, lipoic acid, essentiale and other lipotropic agents.

With caution, nicotinic acid should be used for gastritis with high acidity, peptic ulcer of the stomach and duodenum. During treatment with a vitamin, especially in large doses, liver function should be carefully monitored.

Interaction with other drugs

Consultation with a doctor is necessary if nicotinic acid is to be used simultaneously with other drugs.

pharmaceutical incompatibility. Do not mix with thiamine chloride solution (destruction of thiamine occurs).

Potentiates the action of fibrinolytic agents, antispasmodics and cardiac glycosides, enhances the toxic hepatotropic effect of alcohol.

Care must be taken when combined with antihypertensive drugs (possibly increased hypotensive action), anticoagulants, acetylsalicylic acid due to the risk of hemorrhages.

Reduces the toxicity of neomycin and prevents the decrease in the concentration of cholesterol and high density lipoproteins induced by it. Weakens the toxic effect of barbiturates, anti-tuberculosis drugs, sulfonamides.

Oral contraceptives and isoniazid slow down the conversion of tryptophan to nicotinic acid and thus may increase the need for nicotinic acid.

Antibiotics can increase the flushing caused by nicotinic acid.

Nicotinic acid is released without a doctor's prescription.

Nicotinamide

Indications for the use of nicotinamide - hypovitaminosis and avitaminosis PP, as well as conditions of increased body need for vitamin PP:

• inadequate and unbalanced nutrition (including parenteral);
• malabsorption, including against the background of dysfunction of the pancreas;
• rapid weight loss;
• diabetes;
• prolonged fever;
• gastrectomy;
• Hartnup's disease;
• diseases of the hepatobiliary region - acute and chronic hepatitis, cirrhosis;
• hyperthyroidism;
• chronic infections;
• diseases of the gastrointestinal tract - hypo- and anacid gastritis, enterocolitis, colitis, celiac enteropathy, persistent diarrhea, tropical sprue,;
• malignant tumors;
• diseases of the oropharyngeal region;
• prolonged stress;
• pregnancy (especially with nicotine and drug addiction, multiple pregnancy);
• lactation period.

Nicotinamide is not used as a vasodilator. Nicotinamide does not have a lipid-lowering effect.

Due to the neutral reaction of the solution, nicotinamide does not cause a local reaction when injected. Unlike nicotinic acid, the drug does not have a pronounced vasodilating effect, therefore, when using nicotinamide, the inflammation phenomenon is not observed.

The drug is administered orally and by injection.

Nicotinic acid for hair

When applied to the scalp, nicotinic acid expands the peripheral blood vessels, increasing blood circulation, improves the transport of oxygen and beneficial trace elements, enhances metabolic processes in the tissues, which prevents hair loss and stimulates their accelerated growth.

Instructions for use of the hair solution indicate that when using nicotinic acid, baldness stops, hair becomes thicker, acquires shine and silkiness. Also, nicotinic acid maintains normal hair pigmentation, being a prophylactic against gray hair.
The nicotinic acid that is part of the product with regular use:

• awakens dormant hair follicles and promotes hair growth by stimulating microcirculation;
• restores and regenerates damaged bulbs;
• prevents hair loss by strengthening the roots and counteracting the compaction of collagen around the hair root;
• promotes the production of melanin - a pigment that makes curls shiny, retains their color, prevents premature graying.

The preparation does not dry the skin in case of repeated use, which is proved by dermatological tests.

How to use nicotinic acid: open the dropper tube immediately before use. Apply the contents of the tube directly after washing on the scalp, evenly distributing the acid over the entire surface with massaging movements. Do not wash off the applied product.

Slight tingling and redness of the scalp after application of the product is due to increased microcirculation and is normal.

Apply nicotinic acid 1 time in 3 days. The recommended course is 14 procedures. It can be repeated every three months.

Despite all the advantages, nicotinic acid has not found wide application in clinical practice. This is due to the many side effects that accompany the intake of vitamin PP in high doses.