Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Vitamin B3 (niacin or niacinamide) has a limited but scientifically plausible role in the support or treatment of peripheral neuropathy. The primary scientific rationale comes from cases in which peripheral neuropathy is caused by severe niacin deficiency, known as pellagra. Pellagra, marked by the classic triad of dermatitis, diarrhea, and dementia, can also present with neuropathic symptoms, and these resolve with niacin supplementation. However, primary peripheral neuropathy unrelated to pellagra (e.g., diabetic neuropathy, chemotherapy-induced neuropathy) does not have strong evidence supporting the use of vitamin B3 for treatment or prevention.

Some small studies and case reports have explored niacinamide in neuropathies, but robust, large-scale clinical trials are lacking. In rare cases, high-dose niacinamide has been associated with improvement in certain types of neuropathy, such as those induced by isoniazid (an anti-tuberculosis medication), but this is not generalizable. Most guidelines do not recommend vitamin B3 supplementation for neuropathy unless a deficiency is present.

In summary, while there is scientific support for vitamin B3 correcting neuropathy due to its own deficiency, there is little evidence it benefits other types of peripheral neuropathy. Therefore, its use is scientifically justified only in cases of deficiency, with an overall low strength of evidence for broader use.

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