Synopsis

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

Vitamin B3, in the form of nicotinamide (also known as niacinamide), has some scientific rationale for use in certain types of peripheral neuropathy, though the evidence is limited and not robust. The strongest scientific basis for B3 comes from its role in treating or preventing pellagra, a disease caused by severe niacin deficiency, which can include peripheral neuropathy among its neurological symptoms. In such deficiency states, supplementation with vitamin B3 clearly reverses neuropathic symptoms.

Beyond pellagra, there is limited evidence supporting nicotinamide for other forms of peripheral neuropathy. Some small studies and case reports have suggested that nicotinamide may help support nerve health by acting as a precursor to NAD⁺, a molecule involved in cellular energy metabolism and neuronal repair. Animal studies have suggested possible neuroprotective effects, but high-quality clinical trials in humans with diabetic or chemotherapy-induced neuropathy are lacking. Most clinical guidelines do not recommend nicotinamide for neuropathy unless there is evidence of deficiency.

In summary, there is scientific evidence for nicotinamide’s use in neuropathy caused by niacin deficiency, but little evidence for its broad use in other forms of peripheral neuropathy. The overall strength of the evidence is low (2 out of 5), and further research is needed.

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