Our world is replete with diseases of all sorts, illnesses of all kinds, ailments countless in numbers. Modern medicine views these in isolation, and therefore also attempts to treat them in isolation: we have a headache, we take an aspirin; we have high blood sugar, we take insulin injections; we have high cholesterol, we take statin drugs to disrupt the manufacturing of cholesterol in the liver; we have cancer, we are given toxic poisons that kill our cells and hope the cancer will be weakened; we have arthritis or multiple sclerosis, and we are given immune suppressants because it is thought that our own immune system has turned against us, attacking the very body it is intended to protect. We have no idea why, but this is what we do, and this is also what we believe we should be doing.
In psychiatry, we treat so-called mental illnesses. But because we are even more clueless in this realm of the subtle functioning of the brain and mind than we are of the subtle functioning of the body and its organs, we look for drugs that suppress the behaviours which are symptomatic of the “illness” we have been diagnosed with. It’s very simple: we take uppers and stimulants when we are down and low, and downers and sleeping pills when we are high and excited. Because we all do it, we think it’s perfectly normal.
When we take a close look, we see that there are no diseases, no illnesses, no ailments that are not caused by biochemical imbalances; we see that all of our health problems are rooted in problems in the biochemistry; and we see that the functioning of the body and the functioning of the mind cannot be considered independently, because they are both nothing other than the functioning of the whole body-mind.
Surely a most striking example of this is the now almost forgotten disease condition called pellagra. The name comes from the contraction of the Italian pelle (skin) and agra (sour), and was first used by Francesco Frapolli treating people in the 1880’s in Italy where more than 100 thousand suffered from it. But this wasn’t unique to Italy. The same was true in Spain and in France in the late 19th century. In the US, it reached epidemic proportions in the American south where it was estimated that between 1906 and 1940, more than 3 million were affected, and more than 100 thousand actually died from it.
Can you image that? This many people—millions of people—in quite a restricted region, walking around in manic states, delusional states, paranoid states, seeing and hearing things, talking or even yelling to themselves and others around them, completely incoherent and, in addition, covered in red, sore, flaking and bleeding skin on the arms, neck, and face? What a nightmare it must have been.
In all countries and all cases, pellagra was associated with poor nutrition, and more specifically, associated with corn-based diets in which the maize was not treated with lime in the traditional way. Similarly, in all countries and all cases, it was found that a nutritious diet based on fresh animal foods very quickly resolved the problems that afflicted the sufferers of this disease. So, even in the late nineteenth century, they had figured out how to treat and prevent it. The thing is, though, they didn’t know why if they replaced the corn and starches with meats and vegetables, people got better.
Pellagra would usually first manifest as skin problems: eczema and psoriasis-like irritations and lesions. Then, it brought about anxiety, depression, irritability and anger. And eventually, periods of full blown mania, visual and auditory hallucinations, extreme fear, paranoia, bipolar and schizophrenic behaviours.
Now, if you know someone, if you have been close to someone diagnosed with bipolar disorder, with schizophrenia, with anxiety disorders, depression, or paranoia, you will immediately recognise in this list of symptoms those you saw in this person, surely to different degrees, and surely in the most extreme during a full blown crisis. Without a doubt, at least for bipolar disorder, these symptoms are all present, often simultaneously, and sometimes in close succession.
And do you know what pellagra is? It’s vitamin B3 deficiency.
Yes, pellagra, this terrible disease that caused such awful skin conditions and straight out madness in people, this disease that made these poor people act in ways indistinguishable from those of manic-depressives and schizophrenics, was a simple vitamin B3 deficiency.
When this was understood, niacin fortification was mandated, and the epidemic affecting millions of people in the southern United States was resolved almost instantly. After decades of rampant “mental illness” among so many—so much fear, so much anxiety, so much terror within families and communities, so much pain and suffering, and tens of thousands of deaths—a little added niacin ended this national disaster that was the pellagra epidemic almost overnight. The fact that you have most likely never heard of pellagra goes to show how effective niacin fortification has been in preventing it. But something else happened.
Following the introduction of niacin fortification, half the patients held in psychiatric wards were discharged. Just like that, they got better, and went home. There was at least one psychiatrist who noticed this remarkable coincidence: his name was Abram Hoffer. He wondered why so many got better, but also why only half. What about the other half? Could it be that they just need a little more niacin? Hoffer was an MD, a board-certified psychiatrist, and a biochemistry PhD. He was also the Director of Psychiatric Research for the province of Saskatchewan in Canada, a position he held from 1950, when he was hired and appointed by the department of public health, until 1967, when he opened a private practice.
What he did to check this hypothesis—that maybe more of the psychiatric patients were not mentally ill at all, but just in need of greater amounts of niacin—was to conduct a study. He chose schizophrenics because they are among the most difficult to treat, and also because together with bipolar patients, they have many of the symptoms associated with pellagra. The results were stunning: 80% of the schizophrenics given B3 supplementation recovered. And these results aren’t anecdotal—the word often used in a pejorative or derogatory manner to dismiss important observations or evidence that fall outside the narrow realm of the conventionally accepted. These were the results of the first double-blind placebo-controlled nutrition study in the history of psychiatry.
What double-blind placebo-controlled means is that he took two equally sized groups of people diagnosed with schizophrenia, and then randomly and blindly, both on the patient’s end as well as on his end, gave half of them 3000 mg of flush-less niacin per day in three doses. (Niacin has a flushing effect that would be noticed, but either inositol hexanicotinate or niacinamide can be used instead.) He gave the other half a placebo, which would have been a pill that looked identical, but contained no niacin or anything else that could have any significant effect on them, (like powdered sugar or a starch of some kind). And at the end of the trial, when they looked at which patient got what, they found that 80% of niacin-treated recovered, whereas none in the placebo group showed significant improvements.
Over the years, Hoffer treated thousands of people with remarkable success. With simple vitamin B3 supplementation he continued to successfully treat people suffering from schizophrenia, but also people suffering from attention deficit disorder (ADD), general psychosis, anxiety, depression, obsessive-compulsive disorder (OCD), and bipolar disorder. In fact, he considered pellagra, bipolar disorder, and schizophrenia to be the manifestation of niacin deficiency on different scales, and the sufferers to be niacin-dependent to different extents. Obviously, this is the only natural conclusion he could have drawn given how effectively niacin resolved psychiatric symptoms in these people, but also in light of the fact that each individual seemed to need somewhat different amounts to have these positive effects.
The expression niacin-dependent was used to emphasise that they needed to take it on a daily basis. Naturally, an essential vitamin is not only essential in the sense that it is absolutely needed, but also in the sense that it needs to be consumed regularly because it is not manufactured within the body. Deficiencies develop when the diet lacks in these essential nutrients, and grow more severe as time goes on. When the nutrients are then reintroduced, the deficiencies can be corrected. Some nutrients are abundant, some are rare. Some are easily absorbed, some are not. Some are more easily stored, and some cannot really be stored at all.
In addition, besides the fact that in any given population there is always—for the very same essential nutrient—a range of nutritional needs that vary between individuals based both on their genetic predispositions and on what they do, countless other factors influence and affect the amounts of essential nutrients that each one of us needs to be healthy. These include various kinds of injuries to the body-mind, and in particular to the gut where absorption of nutrients take place, that may have incurred at one point or another from an infection, a virus, a bacteria, a bad diarrhoea we had when we were babies, a childhood disease we don’t even remember, and really anything that could have damaged a specific part of the intestine where a specific family of nutrients are absorbed.
Any such injury could result in a greatly increased need for a particular nutrient that, without knowing about it, could not be supplied in adequate amounts from diet alone, and would inevitably develop into a progressively more severe deficiency whose effects on the body-mind would eventually appear as dysfunctions that would, without a doubt, have physical as well as psychological or psychiatric manifestations. Why? Because there is no body that functions independently of the mind, and there is no mind that functions independently of the body. There is only this single body-mind.
Niacin and B vitamins in general are water-soluble. This means that we pee most of them out, and that we therefore need to have them every day, or nearly, in order to prevent the development of deficiencies. The experience from the last decades of the nineteenth and the first five decades of the twentieth century in Spain, Italy, France, and in the US, showed that a single vitamin deficiency, a simple niacin deficiency, could cause extreme symptoms that included severe psychiatric dysfunctions. It also showed that even very small amounts of B3 added to the otherwise nutrition-less white bread that was eaten as a staple could cure millions of pellagra sufferers, and prevent the disease from developing in the bulk of the population.
Unexpectedly, niacin-fortification coincided with a large number of the psychiatric ward patients getting well enough to go home. This observation prompted a study with niacin supplementation which showed that in 80% of the schizophrenia patients treated with niacin, symptoms disappeared in the same way they had in pellagra sufferers, but with higher doses of niacin. It was also shown that a similarly high cure rate was seen in people suffering from ADD, psychosis, anxiety, depression, OCD, and, in the point we wanted to emphasise in this article, bipolar disorder. In almost all cases, niacin supplementation resolved the dysfunctional behaviours and psychiatric symptoms. What varied were the amounts of vitamin B3 needed to achieve recovery, and the speed with which symptoms would come back upon interruption of the supplementation.
Therefore, whether you are among the lucky people who never were niacin deficient, among the lucky people who need little niacin, or among the less lucky ones who are deficient, who do need more of it than most, or who are suffering from anxiety or depression, schizophrenia or bipolar disorder, doesn’t it make sense to just start taking a little bit of extra B3 each day? Doesn’t it make sense to give your body-mind the amount of vitamin B3 it needs, recognising that for each one of us this amount may be different, that for some it will be a lot more than for others, but resting in complete assurance that no ill effects will come from it, because niacin supplementation is harmless, and that the only disadvantage of it being harmless, even in large doses, is that we need to take it daily?
Given how inexpensive any form of niacin is, shouldn’t we be giving it in large amounts to every patient in every hospital, psychiatric ward, and medical institution? We should, but this will probably never happen. What we can do is take care of ourselves, of those people closest to us like our children and spouses, siblings and parents; of those people we care about like our friends and colleagues; and even of those people who are simple acquaintances who come to us for advice or just to share their concerns about a health issue. And one of the simplest and most effective things we can do to improve our own health and the health of those around us is by taking a little B3 supplement every day. It could just make you feel more relaxed, more focused, calm and at ease, as it does for me, or it could completely transform your world, bringing you from a state of hyper-anxious, paranoid, delusional and hallucinatory mania, back to a relaxed, helpful and trusting, conscientious and reasonable self, giving you the gift of your own life back to yourself.
Could it really be this simple and this amazingly miraculous? No more pellagra, no more schizophrenia, no more bipolar disorder, just with a little B3 supplementation? Well, maybe. You try it, and let us know.