Nicotinamide (vitamin B3, also known as niacinamide) has been explored in recent years for its potential neuroprotective properties, including possible benefits in neurodegenerative diseases like Multiple Sclerosis (MS). Preclinical studies, particularly in animal models of MS (such as experimental autoimmune encephalomyelitis, EAE), have shown that high doses of nicotinamide can delay the onset and reduce the severity of disease symptoms. The proposed mechanisms include enhancement of DNA repair, reduction of neuroinflammation, and support of NAD⁺-dependent cellular processes critical for neuronal survival. Some research (e.g., Kaneko et al., 2006, Proc Natl Acad Sci USA) points to nicotinamide’s ability to protect axons and prevent demyelination via boosting NAD⁺ levels.

Despite these promising findings in laboratory settings, direct clinical evidence in humans with MS remains very limited. There are currently no large, well-designed randomized controlled trials demonstrating efficacy or safety for nicotinamide supplementation in MS patients. Thus, while there is a scientific rationale and some preliminary experimental evidence, the overall level of support is still low, and routine use is not currently recommended by clinical guidelines. Nicotinamide is not part of traditional MS treatments, and its use is not based on historical precedent but rather emerging scientific exploration.