My last post on niacinamide and Alzheimer’s (it’s supposed to reverse Alzheimer’s de-mentiaThe Coenzyme nicotinamide adenine dinucleotide (NADH) has been used as medication in 17 patients suffering from de-mentia of the Alzheimer type in an open label trial. In all patients evaluated so far, an improvement in their cognitive dysfunction was observed. Based on the minimental state examination, the minimum improvement was 6 points and the maximum improvement 14 points with a mean value of 8.35 points. The improvement on the basis of the global deterioration scale (GDS) was a minimum of 1 point and a maximum of 2 points with a mean value of 1.82. The duration of therapy was between 8 and 12 weeks. No side effects or adverse effects have been reported from the patients or their caregivers during the observation period which is, in some patients, more than a year. This open label trial represents a pilot study from which no definitive conclusion can be drawn. A double-blind placebo controlled study is necessary to demonstrate the clinical efficacy of NADH. The planning and the fulfillment of all requirements for such a study are in progress.) ended with a contradiction: niacinamide has been found to help neurodegenerative diseases like Alzheimer’s by inhibiting SIRT1, yet SIRT1 expression is associated with increased longevity and cognitive health.
[Note on this post: some links expand with further information when you mouse over them]
I can’t stand contradictions, so I’ve been digging through scientific abstracts trying to find how both of these facts can be true, and I also embarked on an experiement with niacinamide to see if any interesting information would pop up to help clear up the above contradiction.
Upon learning that niacinamide (aka nicotinamide, aka NAD–which switches to and from NADH in the body) is a crucial co-enzyme in glucose metabolism, and knowing that one of the markers of Alzheimer’s Disease is lowered glucose metabolism in the brain, I set up an experiment using four family members to see if oral niacinamide would alter the glucose metabolism in any of the subjects, and if so, what the implications were for the SIRT1 expression/inhibition contradiction. Since SIRT1 is important in keeping a steady supply of glucoseHomeostatic mechanisms in mammals respond to hormones and nutrients to maintain blood glucose levels within a narrow range. Caloric restriction causes many changes in glucose metabolism and extends lifespan; however, how this metabolism is connected to the ageing process is largely unknown. We show here that the Sir2 homologue, SIRT1—which modulates ageing in several species1, 2, 3 —controls the gluconeogenic/glycolytic pathways in liver in response to fasting signals through the transcriptional coactivator PGC-1. A nutrient signalling response that is mediated by pyruvate induces SIRT1 protein in liver during fasting. We find that once SIRT1 is induced, it interacts with and deacetylates PGC-1 at specific lysine residues in an NAD+-dependent manner. SIRT1 induces gluconeogenic genes and hepatic glucose output through PGC-1, but does not regulate the effects of PGC-1 on mitochondrial genes. In addition, SIRT1 modulates the effects of PGC-1repression of glycolytic genes in response to fasting and pyruvate. Thus, we have identified a molecular mechanism whereby SIRT1 functions in glucose homeostasis as a modulator of PGC-1. These findings have strong implications for the basic pathways of energy homeostasis, diabetes and lifespan. in the body (by producing it in the liver during fasting hours), if niacinamide works to tone down glucose spikes and even out the curve, it may be the reason SIRT1 is inhibited with use of niacinamide.
Below are the graphs representing four family members’ glucose levels after a high-glycemic breakfast. Each graph shows at least three days without niacinamide and three days with 500mg niacinamide taken just before a high-glycemic breakfast (to force a spike). A normal curve
after a high-sugar/carb breakfast would be a spike within 45 minutes with a gradual decline to normal glucose after two hours.
Below the graphs is a multiple choice question: which one of these four graphs represents an 81-year-old woman with advanced Alzheimer’s weighing 90 lbs with no history of diabetes in the family? (The other three are her children). If you suspect you know the answer, please vote and add your comments at the end of the post. (Note: handheld finger prick glucometers are not as accurate as laboratory tests on whole blood samples, so the above results should be taken with a grain of skepticism). Mouse over the thumbnails for a larger picture.



Glucose, Niacinamide, and Alzheimer’s
The answer to the above is *.family member 3
Hopefully readers will catch that this is a trick poll. In asking it, it is assumed that glucose readings from finger pricks can reveal Alzheimer’s. As far as I know, it can’t. Consequently, from these glucose tests I can gather nothing about whether or how niacinamide affects cognition in Alzheimer’s. Yes, Mom’s metabolism is a little quirky . Should this be worrysome to her kids, given that Alzheimer’s is linked to the mother’s phenotypeBrain imaging studies using 2-[ (18) F]fluoro-2-deoxy-D-glucose positron emission tomography ((18)F-FDG PET) have shown that NL individuals with a maternal history of LOAD, but not with a paternal family history, express a phenotype characterised by a pattern of progressive reductions of brain glucose metabolism, similar to that in AD patients. As maternally inherited AD may be associated with as many as 20 per cent of the total LOAD population, understanding the causes and mechanisms of expression of this form of AD is of great relevance.? The niacinamide seems to tone down the spikes and drops, but there is no clear correlation between peripheral metabolism and cognition. Besides, all three offspring have different body metabolisms as shown in the graphs above, yet we’re all going somewhat batty at about the same rate (our minds are not nearly as sharp as they used to be). If Mom’s Alzheimer’s is due to her quirky peripheral metabolism, what accounts for her children’s faltering cognition? And if cognitive failure occurs with all kinds of body metabolisms, then niacinamide’s role in cognition via its effect on metabolism would be difficult to establish (you’d need a lab that could do the above test with brain metabolism, not body metabolism).
At the cellular level, metabolism is dependent on NAD and other enzymes. A breakdown of metabolism at this level could be due to a deficiency in niacinamide, but also to other causes, e.g., an abnormal zinc/copper ratio.Cellular Level Hypoglycemia: This is energy starvation at the level of brain cells. The person may have a normal GTT but presents the same hypoglycemic reactions. This may be caused by a dysfunction in enzymes involved with glucose metabolism, usually as a result of an abnormal zinc/copper ratio. Zinc is a coenzyme in the break down of glucose to simpler biochemical substances, before being used as energy inside brain cells. High copper levels depress zinc levels and vice versa. Other coenzymes and vitamins are also involved in glucose metabolism inside the mitochondria. Perhaps a combination of niacinamide and PBT2the effectiveness of PBT2 lies in a unique combination of complementary activities. PBT2 acts to detoxify A-beta by disarming it of copper and zinc and returns these crucial metals to neurons. Dr. Cherny showed that by returning these metals to neurons, important cell signaling pathways are activated that prevent neuronal death and promote neuronal function. In addition, data was also presented linking the neuroprotective qualities of PBT2 with beneficial effects evident in an animal model of Huntington’s Disease could be used in Alzheimer’s therapy (cover as many bases of the Krebs Cycle
as possible)?
It is possible that the niacinamide in our experiment accounts for Mom’s more subdued behavior as a result of toning down the spikes and crashes in glucose levels. Mood disorders and mental illnesses have been associated with wild glucose swings, and the effect this vitamin had on Mom’s demeanor seems to fit this hypothesis.
Besides testing the effect of niacinamide on glucose metabolism over a few days, the experiment with niacinamide extended over a three month period. Out of this period there are other tentative conclusions drawn. Stay tuned for a future post titled Does Alzheimer’s Take Guts? The Niacinamide Experiment Part 2.
It will be especially interesting to see the results of a clinical trial of niacinamide on Alzheimer’s subjects in progress at U.C. Irvine.
Points to ponder
It is true that AD attacks the brain’s default networkYet another line of inquiry involves the brain’s default network: a system of cells that is always turned on at some level. It includes the hippocampus, the brain’s memory center, but also other areas, and is the brain’s mind-wandering mode — the part that is active when, for instance, you’re driving in your car and you start thinking about what you will make for dinner. That brain system, scientists find, is exactly the network that is attacked by Alzheimer’s, and protecting it in some way might help keep the brain healthier longer. [...] The default network is costly for the brain to run, using huge amounts of glucose, Dr. Raichle said. And one indication that a person is getting Alzheimer’s is that in scans, the brain’s glucose use is markedly lower. The observation that Alzheimer’s attacks the default network, then, explains the observation that a low use of glucose by the brain is associated with Alzheimer’s disease. (see also: Alzheimer’s and the Brain’s Default Network) which needs enormous amounts of glucose to function. But I don’t know if brain glucose levels are the same as body glucose levels in Alzheimer’s, so I can’t draw conclusions from the effect of niacinamide on peripheral glucose levels for how niacinamide affects that aspect of Alzheimer’s.
Studies show connections between hyperinsulinemia, Diabetes and Alzheimer’s Disease:
Insulin can cross the blood brain barrier from the periphery to the central nervous system and compete with Aβ for insulin degrading enzyme (IDE) in the brain, including the hippocampus (Farris et al., 2003). Insulin is also produced in the brain, and may have alternatively have a beneficial effect in amyloid clearance (Reger et al., 2006). Peripheral hyperinsulinemia may inhibit brain insulin production which, in turn results in impaired amyloid clearance and a higher risk of Alzheimer’s disease (Reger et al., 2006).
Brain metabolism links Alzheimer disease to maternal genes:
In the current issue of Neurology®, Mosconi et al. 1 use FDG PET to demonstrate a critical link between a maternal family history of Alzheimer disease (AD) and a pattern of regional metabolic abnormalities similar to that identified in patients with clinically diagnosed AD. By contrast, significant metabolic abnormalities (at baseline or follow-up) were not evident in subjects with a paternal history of AD nor in those without a family history of disease. Given that mitochondrial DNA is inherited maternally in humans, the authors speculate that their data are compatible with mitochondrial dysfunction as the root cause of AD. This mechanism has likewise been hypothesized for other common neurodegenerative conditions.
CONTINUED IN Does Alzheimer’s Take Guts? The Niacinamide Exeriment Part 2
Related Material
Nicotinamide-Adenine Dinucleotide (NADH) in Parkinson’s Disease and Alzheimer’s Disease.
A bunch of articles that correlate a mother’s AD to child’s decreased brain metabolism.
“Glucose Metabolism in the Brain”
“Relationship Between Reduced Nicotinamide Adenine Dinucleotide Phosphate Oxidase Subunit p22phox Gene Polymorphism and Obstructive Sleep Apnea-Hypopnea Syndrome in the Chinese Han Population”
“PET Scan Glucose Use Correlation With Beta Amyloid Deposition Over Time in Alzheimer’s Disease”

Yesterday Bloomberg Businessweek published an article titled 


















Marta,
I was going to say the 3 due to the one high outlyer, but then on closer examination, thot probably there is no significant dif if you´d done a statistical analysis. Make another thicker line for the averages at each time just to see how they vary.
Pero me gustó el trabajito.
Hello, you have taken on a task that most don’t bother looking at, the contradictions of research into the causes/cure of alzheimer’s disease. Most don’t take the time to acknowledge other contradictory results, most have no interest in replicating their studies, or following or asking for replication of their “hot, new” findings. Brain chemistry research has advanced way way beyond anyone’s ability to explain what results mean in terms of larger pictures of how the brain works and how that comprehensive model can be reduced to how alzheimer’s and/or other forms of dementia begins.
MOney, grants drive research and its focus seems very fickle. The reductionist model of curing disease doesn’t work with the brain. It can’t work until we understand and can agree on what the big picture looks like. Of course the current model of hit and miss and get back in line for another grant to find another hit might by accident stumble across a cure, if indeed it is curable in any sense of the word.
The world of alzheimer’s research is so filled with “ifs”. There are unstated assumptions about the validity and reliability of diagnosis, staging of the disease, variables that must be controled for and those that should, and those that can’t, the reliability and validity of the measures used to test the effectiveness of this or that research (why don’t all the measures they carefully select ever all agree on direction and degress?).
When I was in graduate school we had to pick apart studies of this or that to prove to the instructor how smart we were, how we would have done it, how it should ahve been done. I tire of pointing out the gaping holes in the research desigins, the theories, the measures of what passes for “breakthroughs” in the press release that is attached to the request for more funding.
This feeds, creates, reinforces the cruelest of false hopes in the hearts and minds of those confronted by the symptoms of dementia – if only we spent more faster we could be cured in our lifetimes.
Richard Taylor
Thanks for the observations, Richard. I have to believe researchers are in part motivated by the sincere desire to end suffering, so I have to honor that part of the researcher’s heart. It seems humans are both blessed and cursed with enormous amounts of information today. How simple things were when we couldn’t see into the cell. Huge strides were made thanks to the explosion of scientific knowledge. But now we’re into hyper-explosion of knowledge, and it’s almost as though we know less than we did before. Do we give into paralysis because there is too much to process, or do we allow for fumbling in our attempt to move forward?
I think the taste we’ve acquired for media doesn’t help the research world (we want answers NOW). The solution? Read widely for yourself; think for yourself; question. No single person can cover it all, so encourage others to do the same and then SHARE discoveries. But mainly, get on your knees and pray that God in His wisdom guides us to find the thread that will lead to a cure (I do have hope).
Marty
Hi There–
Excellent research. Thanks!
I was wondering if you’ve heard anything about using galactose supplementation in Alzheimer’s? The idea is that Alzheimer’s patients don’t have a working insulin protein, so that even when glucose is at normal levels in the blood, the glucose can’t get into brain cells. However, brain cells are one of the only cells in the body that can ALSO use the sugar galactose for fuel. Galactose enters the brain via a different non-insulin-dependent protein, so doesn’t have the same issues as glucose. The idea is that some of the symptoms of Alzheimer’s are due to energy starvation. So the idea that I’ve read… and that some people are trying… is to supplement galactose.
I was wondering if you knew anything more about this idea?
Thanks!
-Greg
[...] Alzheimer’s and Glucose Metabolism: the Niacinamide Experiment Part 1 [...]
Nice wonderful interesting report by Marty and discussion by all here on this vitamin’s research which for personal need I hope proves extremely worthwhile and helpful!!! Nice report!!!
1. My 89-year old dad in Florida has had Alzheimers for 4 or 5 years now. When I visited him in December of 2009, I found him almost vegetative with no long or short-term memories. He was still mobile however and could still communicate but with much difficulty. I read about a study done in south Florida using caffeine supplements and immediately started him on the treatment of 500 mgs per day. His personal doctor however refused to assist when I asked that his beta-amyloid protein levels be monitored for improvement (which was the finding in the study). He instead pushed my mother to consider hospice for him but she flat out refused. Well my father’s condition began to improve noticeably over the next couple of months and we all feel he is much better now, 1 1/2 years later – especially when you consider that this disease is degenerative. For him to actually improve is a double plus. Now we’ve had him on niacinamide for the last 2 1/2 months as well as the caffeine supplements (which are just ordinary No-Doze pills). Mom says he is communicating with her much better during the day and he interacts much better with people than just a couple of months ago. Between the caffeine reducing his beta-amyloid levels (which is my presumption based on observation without the benefit of blood tests) and niacinamide reducing his tau protein level, I feel we’re doing very well on both fronts. I’m also giving him coral calcium and vitamin D3. I strongly believe there is a connection between Alzheimer’s and sunlight deprivation – especially in the sunshine state of Florida where people ironically avoid being out in the heat and sun. I believe ultra-violet radiation from the sun is as much a basic necessity as is food, air and water to all life on earth. I think this accounts for the symptoms of Sundowner’s Syndrome as my father does tend to slip away in the evenings. We’ve started taking him outdoors into the sun now and are getting some remarkable results. Although he can walk, he tires after about 10 minutes due to his general lack of exercise over the last 4 years. My sister took along his wheel chair just in case he became too tired to make it back home on foot. She did finally end up pushing him down to the park when he said he wasn’t ready yet to return home. But on the way back, he decided to push her for a while in the wheel chair! Unbelievable!!! Not only that but he was talking up a storm and asking endless questions once they got back into the house. It was as though he’d been energized from his outdoor experience. Unfortunately my 83-year old mom has 2 very painful knee replacements and so she doesn’t want to take my father outside much, so he doesn’t get much sunlight except when my sister visits. He has also had 2 bouts with skin cancer recently on his face and mom is terrified of exposing him to direct sunlight. But according to Dr. Bob Barefoot, sunlight is not the cause of skin cancer but rather the cure for it. He cites the ever-increasing numbers of skin cancer patients since the advent of sun-blockers. I’m inclined to believe him since seeing a live microscopic demonstration of vitamin D destroying cancer cells on the 700 Club a few years back. Sunlight of course is the most abundant source of vitamin D. I believe that older people who spend less and less time in the sunlight are turning themselves into prime candidates for both cancer and Alzheimer’s Disease. I am however a bit disappointed in the niacinamide cure even though there has been improvement. I was told to expect a 4-month recovery period but I was just hoping to see even more impressive results after 2 1/2 months. Still, as I said, when you consider this is a degenerative disease, any improvement is a double plus and deserves patience. By the way, I couldn’t manage the 12 250mg doses every 90 minutes the treatment calls for (which might be why we’re getting slower results). I mean an 18-hour/day regimen is just too difficult and leaves no time for you or your loved one to rest. I went instead with time-release niacinamide but was careful to contact the manufacturer for disbursement and absorption rates. I finally found one that delivered what I thought I needed. The calculations of the dosages were quite difficult but I finally arrived at a good, well-timed program that requires only 4 pills per day during realistic hours. The price was also excellent at around just $30 for the whole treatment period. How could I not try it for that price? If anyone wants to know the details of my father’s treatment, I’m glad to share them if you write me at jskrepak@mail.com. Put “Alzheimers” in the subject line so I don’t mistake your message for SPAM and delete it. If you don’t hear from me immediately, that means something did not get through my E-mail filter, so keep writing until I eventually get your message. I don’t want to miss out on helping you because of a stupid E-mail SPAM filter. Don’t worry, I’m not asking for money – just the good feeling of helping someone else out. I think with enough input from everyone, we can get to the bottom of what’s causing this terrible disease. Lab mice are okay but there’s nothing like real human experiences to speed things along. By the way, my dad’s doctor, isn’t pushing for hospice any more, in fact he’s not saying much at all. I think he’s just too proud to admit he was wrong. I can’t stand fatalists. – John
John, thanks for the details on your treatment regime for your father. I was going to tell you that we saw a real change in Mom at the 4-month mark after starting her on niacinamide. I didn’t know that was the expected recovery period. So our case confirms your research. Where, by the way, did you read of niacinamide? I’m shocked at the dosage. We give Mom 250mg twice a day only. Does the research every say to taper off after a while? Curious.
I am SO glad your Dad is improving. I feel the same way with Mom. Not only has she stopped declining, she’s improving in so many ways. People comment just by looking at her. She’s noticeably more “there” and it’s a joy to have her in our lives.
I could go on forever, but I’d rather hear from more people about their experience w/ “natural” treatments.
BTW, I’ve heard that the reason people who use sunscreen still get cancer is that sunscreen keeps them out in the sun much longer. It IS the sun that’s causing it.
The research came from the Dr. Kim Green of the University of California, Irvine where they adminstered 3000 mgs per day (the maximum FDA approved allowance). I heard of their research through Dr. David Williams’s newsletter this February but he was already talking about it 2 years before that. Here’s Williams’s link to save you time: http://www.alternative-medicine-digest.com/alzheimers-treatment.html
Still not in agreement on the skin cancer question however, not after seeing vitamin D destroy cancer cells on national TV. Here’s a very informative video on the subject from the University of California: http://www.youtube.com/watch?v=TQ-qekFoi-o
And here is the greatest video of all-time with Bob Barefoot. Don’t miss this one: http://tvcurebooks.com/002/barefoot/watch-the-show.html
Does anyone know the results of the UC Irvine test on Niacinamide?
Thanks for all your comments. Please emal me if yousee fit.