Niacinamide Enhances Natural Killer Cells to Beat Carcinomas

STORY AT-A-GLANCE

• According to recent research, nicotinamide, also known as niacinamide (a form of niacin or vitamin B3), enhances natural killer (NK) cells’ ability to defeat blood cancers

• Pretreating NK cells with an unspecified amount of niacinamide upregulated a lymphocyte homing molecule called CD26L, which improved the antitumor functions of the NK cells in several ways

• The combination of niacinamide-enhanced NK cells and monoclonal antibody treatment resulted in complete remission in 11 of 19 patients within 28 days, and three had partial response

• Niacinamide also protects your skin against ultraviolet radiation damage from the sun, thereby reducing your risk of skin cancer

• It’s also been shown to improve survival after cardiac arrest, primarily by restoring tissue NAD+, and can help prevent heart failure

According to recent research,1,2 nicotinamide3 (also known as niacinamide), a form of niacin (vitamin B3), enhances natural killer (NK) cells’ ability to defeat blood cancers.

Scientists have previously tried to use infusions of monoclonal antibodies mixed with NK cells as a novel treatment for blood cancers, with limited success. Now, researchers at the University of Minnesota have discovered that the ability of NK cells to destroy cancer cells can be significantly augmented by pretreating them with niacinamide.

Doing so upregulated a lymphocyte homing molecule called CD26L, which improved the antitumor functions of the NK cells in several ways. Unfortunately, the paper doesn’t specify the dose used to achieve these beneficial effects.

Niacinamide Boosts NK Cells’ Ability to Kill Cancer

As reported by Medical Xpress:4

Niacinamide Restores NAD+ Levels

Another mechanism that can help explain how niacinamide improves the anticancer functions of NK cells is that it boosts the NAD+ (nicotinamide adenine dinucleotide) level in the cells. As explained in the featured study:6

Niacinamide to the Rescue After Cardiac Arrest

That niacinamide boosts NAD+ has also been demonstrated in other studies. For example, a September 2023 animal study in PLOS ONE found that niacinamide improves survival after cardiac arrest, primarily by restoring tissue NAD+. As explained in the abstract:7

The 100 micromolar niacinamide solution used at the start of reperfusion equates to just 12.2 milligrams of niacinamide. But this was in an in-vitro cell study, not a human, and the key point is that this is still a very low dose and in line with the dose I have been recommending to optimize health, of 50 mg of niacinamide up to three times a day.

NAD+ Is Crucial for Optimal Health and Longevity

As detailed in "The Crucial Role of NAD+ in Optimal Health," which features my interview with Nichola Conlon, Ph.D., a molecular biologist and antiaging specialist, NAD+ is one of the most important biomolecules in your body.

It’s involved in the conversion of food to energy, maintaining DNA integrity and ensuring proper cell function, including the maintenance and repair of cells.

Your NAD+ level declines with age, which is thought to be a major contributor to aging and age-related disease. The good news is there’s a simple and inexpensive way to boost your NAD+ level, namely niacinamide supplementation.

While other NAD+ precursors are typically recommended, like NR or NMN, they’re hundreds of times more expensive, and may be less effective. The reason I’m convinced niacinamide is the best NAD+ precursor is because it’s the immediate breakdown product of NAD+.

The rate limiting enzyme in the salvage pathway to restore niacinamide back to NAD+ is NAMPT. As you can see in the graphic below, niacinamide is first converted to NMN before NAD+. This is likely why many promote NMN.

However, the enzyme NMNAT1-3 that converts NMN to NAD+ is not the rate limiting enzyme. NAMPT controls how much NAD+ you make, so flooding your body with NMN is not going to be as useful as using small amounts of niacinamide and activating NAMPT.

Recent animal research8 demonstrated that a low dose of 2.5 mg per kilo of body weight daily for three weeks — which is about 170 mg a day for a 150-pound person — increased cellular NAD+ by 30%. So, taking 50 mg of niacinamide three times a day appears ideal for most.

Niacinamide for Heart Failure Prevention

Niacinamide may also act as a preventive against heart failure9 — again because heart failure is a localized symptom of energy deficiency and mitochondrial dysfunction. When your NAD+ level drops, your ATP level also drops, and this puts stress on the cardiomyocytes in your heart.

Cardiomyocytes are specialized cells in your heart that generate contractive force. Thusly stressed, the cardiomyocytes release pro-fibrotic mediators that further suppress mitochondrial function. Over time, this leads to cell death, collagen deposition and fibrosis, which are hallmarks of heart failure.

Research10 published in February 2023 found that replenishing NAD+ prevented this energetic dysfunction, and therefore the subsequent development of heart failure. Here, the human-equivalent of 3.5 mg per kilo of bodyweight was administered via daily injection for two months, but I believe that oral niacinamide might be just as effective, although you might have to use it for a longer period of time.

Niacinamide in Skin Cancer

Getting back to niacinamide’s potential role in cancer treatment, a 2015 study11 found it helps protect your skin against ultraviolet radiation damage from the sun, thereby reducing your risk of skin cancer.

Three hundred eighty-six participants who’d had two or more nonmelanoma skin cancers in the previous five years were divided into two groups. The treatment group received 500 mg of niacinamide twice a day for 12 months while controls received a placebo.

The participants were evaluated by dermatologists at three-month intervals for 18 months. The primary end point was the number of new nonmelanoma skin cancers (i.e., basal-cell carcinomas plus squamous-cell carcinomas) during the 12-month intervention period.

At 12 months, the rate of new nonmelanoma skin cancers in the treatment group was 23% lower than among controls. They also had a 20% lower rate of new basal-cell carcinomas, and a 30% lower rate of new squamous-cell carcinomas. As a result, the authors concluded:

A 2020 safety and efficacy review of niacinamide also pointed out that:12

General Niacinamide Recommendations

As a blanket recommendation for optimal health, I recommend taking 50 mg of niacinamide three times per day. Niacinamide will only cost you about 25 cents a month if you get it as a powder. Typically, one sixty-fourth of a teaspoon of niacinamide powder is about 50 mg.

The reason I recommend getting it in powder form is because in most supplement brands, the lowest available dose is 500 mg, and that will decrease NAD+ due to negative feedback on NAMPT, which is the opposite of what you’re looking for.

Also note that although niacinamide and niacin are both classified as vitamin B3, niacin will not activate NAMPT like niacinamide, so it is best to use niacinamide. Additionally, niacinamide, unlike niacin, will not cause flushing which is due to a large release of histamine.

Analysis by Dr. Joseph Mercola