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Dr. Jonathan Wright details niacinamide

October 13th, 2022

Since 1976, Jonathan Wright, M.D., has written about the latest natural healing discoveries in his books, newsletter, and magazine articles, as well as teaching his techniques at yearly medical conferences. The medical director of Tahoma Clinic in Washington State, he is a well-known researcher, author, and speaker on natural approaches to disease and wellness.

Ed.– Jonathan Wright, M.D., has kindly allowed the reprint of this article from his excellent newsletter called Green Medicine.

Niacinamide and niacin are both B vitamins and our bodies aren’t designed to make vitamins, however, niacinamide can be made by the body! Of course, they are found in foods and all the ‘health food stores’ – so we can buy them as part of our efforts to stay healthy for as long as we can! So, what’s this about our own bodies making niacinamide, one of the B vitamins?

When vitamins were first discovered many years ago, niacinamide and niacin were two vitamins very clearly identified as not being made inside the human body, but they were identified as essential to human health and longevity. However, there have been changes published since then: For example, Professor Gregory Oxenkrug at Tufts University Medical Center in Boston, wrote in a book titled; Tryptophan Metabolism: Implications for Biological Processes Health and Disease that the amino acid tryptophan- if digested and absorbed well, (which is more likely before age 50 and less likely after that age ) can be metabolized with the help of pyridoxal-5-phosphate, (the ‘active’ form of vitamin B6) into niacinamide adenine dinucleotide (NAD), which also helps ‘power’ any cell in the body which needs more energy by making more ATP (adenosine triphosphate), the human bodies’ so-called ‘energy molecule.’

Professor Oxenkrug also wrote that; “aging, obesity, depression, Parkinson’s disease and Schizophrenia” and treatment with anti-psychotic drugs are “highly associated with insulin resistance (IR) and type-2 diabetes mellitus (T2D).” If you, or any member of your family has had type-2 diabetes, then you (unfortunately) are much less likely to internally synthesize niacinamide from tryptophan, even if digestion and assimilation of nutrients appears to be functioning well!

Note: Chapter 7 of this same book is titled; Diabetes and Tryptophan Metabolism (written by Ugur Unluturk and Tomis Erbas).

Dementia prevention with niacinamide

Dementia is among the greatest risks to those of us who cannot, or no longer can internally synthesize niacinamide. Researchers at the University of California in Irvine genetically engineered experimental animals to develop dementia identical to human Alzheimer’s. How could the researchers detect signs of early Alzheimer’s in experimental animals? When these experimental animals could no longer run the maze to find their food, the researchers biopsied their brains and (no surprise) they identified beta-amyloid, tau protein and neurofibrillary tangles, all early signs of Alzheimer’s dementia in both humans and animals.

The animals were then given relatively large quantities of niacinamide- equivalent to 3 grams per day in humans. It took a little time, but the experimental animals all regained the ability to run the maze and find food. At the next brain biopsy, most of the (literal) garbage mentioned before, that accumulates in Alzheimer’s disease, had very significantly diminished. This is extremely important if you or an older family member have had type-2 diabetes, as humans with that genetic heritage CANNOT internally synthesize niacinamide at all, according to Professor Oxenkrug.


If you have this family tendency towards type-2 diabetes, it’s not only important to take your total of 3 grams of niacinamide, (1 gram thrice daily) to lessen your ‘down-the-road’ chances of diabetes, but it’s also very important to check with your physician about any signs of prediabetes type-2, you may not know about.

Self-testing for pre-diabetes and gestational diabetes

One of the potential ways to self-test is with a 24-hour urine collection test. Nearly everyone knows that this is one of the best ways to test for ‘BHRT’ (bio-identical hormone replacement therapy), but not everyone knows that this test can be used for early detection of type-2 diabetes using the category ‘metabolic disorders’ (which is just a polite way to say on-the-road to type-2 diabetes).

If one is indeed on-the-road to type-2 diabetes, what appears in the metabolic disorders part of the 24-hour urine test are very often xanthurenic acid and kynurenic acid.

  • Xanthurenic acid (XA) is a tryptophan metabolite and is high in serum (and urine) in gestational diabetes.
  • Xanthurenic acid binds to insulin, impeding its action.
  • Vitamin B6 (most effective as P5P also termed pyridoxal-5-phosphate) lowers xanthurenic acid.
  • In two 1970s research studies, 86% and 100% of women with gestational diabetes normalized their blood sugar in two weeks.
  • Gestational diabetes increases autism risk for the unborn child; vitamin B6 eliminates that extra risk.

No, I’m not kidding! If you’re a pregnant woman who never had any sort of diabetes before you became pregnant and then developed high blood sugar only after becoming pregnant, (gestational diabetes), you can safely eliminate it all by yourself within two to three weeks. You might have the remedy at home already! If not, a trip to your favorite natural food store or compounding pharmacy, or other on-line source will equip you to eliminate gestational diabetes almost every time! And of course, speak with your physician skilled and knowledgeable in Nature’s approach to health care.

Of course, if you’re a man, you’ll never have this problem. However, your wife, sister, or daughter might, so keep this information in mind in case it’s ever needed. One of many reasons gestational diabetes should be eliminated as rapidly as possible was discovered recently and published in the Journal of the American Medical Association just last year. What is this reason? Autism! Here’s what the researchers wrote, “…. exposure to maternal gestational diabetes mellitus diagnosed by 26 weeks’ gestation was associated with risk of autism spectrum disorder in offspring.” (3) Yes, that’s extra risk for the child of developing autism! But even though in gestational diabetes blood and urine sugar is higher than normal, gestational diabetes is not type-2 or even type-1 diabetes mellitus.

To make this point clear to everyone, gestational diabetes should be re-named diabetes mellitus xanthurenica to clearly identify its cause: excess serum xanthurenic acid. When this re-naming occurs, even conventional medicine might quit treating gestational diabetes with a ‘diabetic diet’ and insulin and treat the cause! Here’s what ‘WebMD’ says is the cause of gestational diabetes (4): “During pregnancy, the placenta… releases hormones that help your baby grow. Some of these make it harder for your body to make or use insulin. This is called insulin resistance…to keep your blood sugar levels steady, your pancreas must make… as much as three times more [insulin] than usual. If it can’t make enough extra insulin, your blood sugar will rise, and you’ll get gestational diabetes.” And here’s what the American Diabetes Association tells women (5): “Treatment for gestational diabetes always includes special meal plans and scheduled physical activity. It may also include daily blood glucose testing and insulin injections.”

Let’s send a note to WebMD and the ADA: “Read the medical research!” What causes gestational diabetes was well researched between the 1940s and 1975, when a report (6) summarized the earlier research and then explained that gestational diabetes is caused by excessive amounts of xanthurenic acid, usually present in blood in very low levels. All this xanthurenic acid combines with insulin molecules and blocks its activity. The ‘xanthurenic acid-insulin complex’ can’t activate insulin receptors nearly as well as insulin alone does, and blood sugar rises.

Type-2 diabetes, type-1 diabetes and gestational diabetes

Back to the causes of diabetes mellitus type-2 and type-1. In type-2 the cause is overproduction of insulin in response to carbohydrates (and dairy). As a prior issue of Green Medicine explained, overproduced, chronically high insulin causes insulin resistance, which in turn leads to even more insulin secretion to overcome that resistance, which leads to even more insulin secretion. This back and forth upward trending interplay (more insulin, more resistance, even more insulin, even more resistance, and so on) goes on and on, (unless carbs and dairy are significantly restricted) until the insulin resistance is so strong it can’t be completely overcome, no matter how much insulin there may be. Blood sugar then goes too high, and it’s diagnosed as type-2 diabetes.

This known cause of type-2 diabetes is very different than the cause of diabetes mellitus xanthurenica! The cause of type-1 diabetes is much simpler. For a variety of reasons, the insulin-producing cells (islet cells) become weak and die. When that happens, insulin levels go lower and lower, until there’s very little insulin, or even none, that’s type-1 diabetes. Again, a very different cause from diabetes mellitus xanthurenica. But doesn’t everyone’s body chemistry make xanthurenic acid? (After all, it’s a metabolite of tryptophan). Indeed, 100% of us have this body chemistry. So why don’t we all have gestational diabetes even if we’re not pregnant? The reason is that levels of xanthurenic acid are relatively low in most of us, (unless we’re deficient in a certain B-vitamin named pyridoxal-5-phosphate or P5P) so there’s not very much xanthurenic acid-insulin complex formed. What’s different during pregnancy? Among other things, it’s a combination of ‘genetic’ causes and those really-high-estrogen levels that women’s bodies make when pregnant. But why does all that extra estrogen cause only a minority of women’s bodies to make lots more xanthurenic acid and develop gestational diabetes, when most women’s bodies don’t do that? That’s the genetic part.

Women who develop gestational diabetes have ‘weakness’ in the enzymes that metabolize tryptophan into serotonin and melatonin, but no weakness in the enzymes that metabolize tryptophan into xanthurenic acid. Without the pregnancy levels of estrogen ‘putting pressure’ on these weak enzymes, they can perform as they do in most women metabolizing tryptophan much less into xanthurenic acid and much more into many other molecules we’ve all heard about, including serotonin and melatonin.

With the high pregnancy levels of estrogen, the weak enzymes falter, and metabolize much more tryptophan than usual into xanthurenic acid, and related molecules. If there’s much more xanthurenic acid, there’s much more ‘insulin-xanthurenic acid complex’ formed, and impairment of insulin activity.

With enough insulin impaired, gestational diabetes is the result. But a woman can’t stop being pregnant (for many months, anyway), and she can’t change her genetics, so she can’t really rid herself of gestational diabetes, returning to normal blood sugar levels, (while reducing her baby’s risk of autism, too) within two to three weeks, can she? Yes, she can! To understand how, a refresher about what many of us learned in high school and college chemistry about how enzymes change one molecule into another. The ‘key’ is that enzymes never work alone. They’re always aided by co-factors, which are almost always ‘essential’ (necessary to life) vitamins and minerals.

Without those co-factors, the enzymes can’t function, and ultimately, we die. That’s why they’re defined as ‘essential!’ Weak enzyme function can frequently be strengthened by adding in more co-factors A key co-factor for the enzymes that metabolize tryptophan into serotonin and melatonin is vitamin B6. Next, the results that women with gestational diabetes achieved by taking extra vitamin B6 to strengthen their genetically weak enzymes.

In 1975, fourteen pregnant women were diagnosed with gestational diabetes by the standard glucose tolerance test. All the women took vitamin B6 (as pyridoxine), 100 milligrams daily for two weeks, after which repeat testing found that twelve of the fourteen (86%) no longer had the problem! (7) In 1977, different researchers reported almost identical results in the same length of time for thirteen women. (8) All took vitamin B6 (as pyridoxine), 100 milligrams daily. Glucose tolerance tests were done before and after. All fourteen women (100%) had ‘statistically significant’ improvements in their glucose tolerance tests. The researchers wrote: “…. low vitamin B6 levels appear to alter metabolic pathways which result in a lowering of the biologic activity of endogenous insulin.”

In English: vitamin B6 strengthened specific weak enzymes so that less xanthurenic acid was available to ‘complex’ with insulin, blocking its activity. Better blood sugar control was regained. The 1975 and 1977 research was done more than two decades after several groups of researchers (9,10,11,12) had confirmed in the early 1950s that vitamin B6 returned levels of xanthurenic acid to normal.


For the technically inclined, all the 1950s research and much more was reviewed in a 1960 publication titled: The Effect of Vitamin Supplementation on the Urinary Excretion of Tryptophan Metabolites by Pregnant Women (13). This last publication confirmed that pyridoxine lowers xanthurenic acid.

And a last fact: Textbooks of laboratory medicine in the 1940s told us that higher than usual xanthurenic acid in urine is a diagnostic for vitamin B6 deficiency! It’s 2022, yet despite all this fifty- to eighty-year-old basic science and clinical research demonstrating the cause and cure of gestational diabetes, it’s still rarely being applied! But you—yes that’s you, if you want to prevent gestational diabetes or cure yourself of it- can apply this extensive science, safely prevent, or cure gestational diabetes yourself, and at the same time reduce your child’s risk of autism! To eliminate Gestational Diabetes use Pyridoxal Phosphate and not Pyridoxine! Don’t use the ‘pyridoxine’ form of vitamin B6. That’s the ‘inactive’ form of vitamin B6, which does not ‘activate’ the receptors for this vitamin. Most- but not all- humans can activate pyridoxine, but we have no way, (without testing) to know if you are in the pyridoxine activating group, or not. (It’s quite possible that the 14% whose gestational diabetes didn’t disappear in the 1975 research summarized above were ‘poor activators’ of pyridoxine). To make sure the pyridoxine does its job it’s best to use the active form, i.e., pyridoxal-5-phosphate (or P5P), fortunately its available nearly everywhere supplements are sold, usually in a 50-milligram size. Don’t stop using your pregnancy multiple vitamin-mineral as it contains the rest of the B-complex vitamins which back up the pyridoxal-5-phosphate. Check with Your Natural Medicine doctor if you have any doubts at all about doing this!

Towards the anticipated delivery date

Vitamin B6 in both forms can inhibit the production of prolactin (14), the hormone necessary for normal lactation and nursing. Work with a physician skilled and knowledgeable in natural and nutritional medicine to help you determine, (possibly while checking your own blood sugar) a P5P ‘tapering schedule’ so you can nurse your child normally. This physician will also be able to tell you about botanicals used for centuries by to improve lactation should they be needed.

Niacinamide for the prevention and treatment of osteoarthritis, glaucoma, and energizing every cell in our bodies

Decades ago, William Kaufman M.D., published a book titled; The Common Form of Joint Dysfunction, which was all about the successful elimination of joint pain in all but four of three hundred fifty-four osteoarthritis sufferers.

All but four had complete elimination of all joint pain by taking a total of 3 grams of niacinamide daily. It took nearly a month to notice much pain relief at all; after four months, nearly everyone’s osteoarthritis pain was eliminated, and did not return if the niacinamide was continued. In the last few years ‘stem cell therapy’ for osteoarthritis has become the preferred treatment by many surgeons, but of course it’s partially a surgical procedure which (fortunately) uses one’s own stem cells instead of un-natural treatment material and is of course considerably more costly.

How does the niacinamide do this? Very likely by promoting the formation of ATP (adenosine triphosphate) a major ‘energy molecule’ in every cell in our bodies. Since all our joint cartilage cells ‘take much more beating’ than most cells do every day, it’s very likely that the ‘re-energization’ of cartilage cells is more important to good joint cartilage cell maintenance than it is to many other cells in our bodies. Since reading Dr. Kaufman’s book decades ago, I have had no need to refer anyone for joint replacement surgery, as everyone has reported, (as noted above) disappearance of all osteoarthritis pain within the four months specified by Dr. Kaufman.

Niacinamide protects against glaucoma

A title from a recent research publication: Nicotinamide (which is the same molecule as niacinamide but contains no nicotine) provides neuroprotection in glaucoma by protecting against mitochondrial and metabolic dysfunction. How does it do that? As noted repeatedly (sorry about that) by causing the formation of ATP (adenosine triphosphate, the energy molecule needed by every cell in our bodies, in this case in our eyeball cells, which (as many, many cells do) need maximum possible energy production.

Niacinamide extends longevity

Greater longevity might be expected with any natural molecular substance that promotes production of ATP energy in every cell in our bodies. Bit of a surprise: A Harvard Professor- David Sinclair-somehow managed to patent niacinamide, (even though it’s been present in Nature for as long as Nature has existed). The patent was even assigned to Harvard University. Here is the patent title and a few details: “Methods and Compositions for extending the lifespan and increasing the stress resistance of Cells and Organisms.” Inventors: David A. Sinclair, West Roxbury Massachusetts Kevin J. Bitterman, Boston, Massachusetts Assignee: President and fellows of Harvard University, Cambridge, Massachusetts.

It should be apparent to all how important niacinamide is to optimal potential good health and longevity, particularly as we all get older. And it’s important to all of us at all ages if we’re hoping for maximal possible ATP energy in our brains, eyes, hearts, and anywhere else in our bodies. Remember, it’s very, very likely our bodies make less and less niacinamide as we age.

Final word

Yes, it’s possible to take too much niacinamide! I really like working with engineers with their health concerns, as engineers are very meticulous. Over three decades ago, I told an engineer suffering from osteoarthritis about Dr. Kaufman’s work, advised him to follow Dr. Kaufman’s recommendation about taking one gram of niacinamide thrice daily. He asked if Dr. Kaufman ever reported adverse or overdose effects; I told him that Dr. Kaufman told us that ‘low-grade nausea’ was and is an indicator of too much niacinamide for that person. Didn’t see him again for several months when he came in about another health concern, but first reported that his joint pain had been completely gone for several months. However, after three weeks he started having a little ‘low-grade’ nausea, so he decided to continue since his pain was much less. However, he also reported that the low-grade nausea got a bit worse and cause him to “barf into the toilet” twice before he cut the dose back to a total of 2500 milligrams a day, which was not associated with any nausea, so he decided to stay at that quantity, particularly as he reported his overall energy levels were much improved from what they were before he first started the niacinamide. He has continued the lower quantity with no other problems; the osteoarthritis pain remains gone.

Other niacinamide functions

In 1979, an article titled; Nicotinamide is a brain constituent with benzodiazepine like actions was published (15) by the pharmaceutical research department of F. Hoffman-La Roche & Company, Ltd. ‘Benzodiazepines’ is the fancy pharmaceutical company word for the patented medicines Librium®, Valium®, and other tranquilizers. Of course, being pharmaceutical company employees, they “got it exactly backward.” Since niacinamide has been present in humans and animals for as long as humans and animals have been on planet Earth, a more accurate title would have bee; Benzodiazepines are patented artificial molecules with niacinamide-mimetic activity. Mimetic (meaning mimicking, but not exactly duplicating) is the most accurate description for the activity of these un-natural molecules.

As soon as this 1979 article was published, any physician who really is striving for the best health effects, (with of course minimal if any adverse effects) should have switched all their Librium®, Valium® or other un-natural patent medicine medication treatments to Nature’s original molecular substance- nicotinamide!

Even in 2022, these un-natural patent medications are still recommended by some physicians instead of Nature’s molecule, niacinamide.

Remember, too much niacinamide for any one person results in low-grade nausea which always means having to cut back the dose to the 24-hour total that does not cause any nausea.

Conclusion; niacinamide and aging

As you’ve likely assumed already, the older we are, the more we need to take the maximum daily 24-hour quantity of niacinamide so we can energize our bodies as much we can every day, without causing low-grade nausea. Of course, some (but not all) of us can make enough niacinamide in our own bodies when we’re younger, but as we grow older, we’re likely to internally synthesize less and less niacinamide with time; I have seen reports of zero, and near zero in ‘older’ individuals. But no, I am not going to write that niacinamide is a ‘longevity’ molecule, (there’s so-far no research reporting that) but it is an energizing molecule at all ages, particularly as we all get older.


1 Springer International Publishing Switzerland. 2015.

2 Van Zant F, et al. Normal Range of Acidity from Youth to Old Age. Archives of Internal Medicine 1932;49(3):345.

3 Xiang A, et al. Association of Maternal Diabetes with Autism in Offspring. JAMA 2015;313(14):1425-1434.

4 diabetes-guide/what-causes-gestational diabetes #1


6 Kotake Y, Ueda T, et al. The Physiological Significance of the Xanthurenic Acid-Insulin Complex. J Biochem. 1975;77:685-687.

7 Bennink HJ, Schreurs WH. Improvement of oral glucose tolerance in gestational diabetes by pyridoxine. Br Med J. 1975 Jul 5;3(5974):13-5.

8 Spellacy WN, Buhi WC, Birk SA. Vitamin B6 treatment of gestational diabetes mellitus: Studies of blood glucose and plasma insulin. Am J Ob Gyn 1977;127(6):599-602.

9 Sprince H, Lowy RS, et al. Studies on the urinary excretion of “xanthurenic acid” during normal and abnormal pregnancy: A survey of the excretion of “xanthurenic acid” in normal nonpregnant, normal pregnant, pre-eclamptic, and eclamptic women. Am J Obstet Gyn. 1951;62:84.

10 Vandelli, I. The use of vitamin B. (pyridoxine) for suppressing the elimination of xanthurenic acid in pregnant and non-pregnant women following the oral intake of a measured quantity of tryptophan. Acta vitamin. (Milano) 1951;5:55.

11 Wachstein M, Gudaitis A. Disturbance of vitamin B6 metabolism in pregnancy. II. The influence of various amounts of pyridoxine hydrochloride upon the abnormal tryptophane load test in pregnant women. J Lab Clin Med. 1953;42:98.

12 Wachstein M, Lobel S. Abnormal tryptophan metabolites in human pregnancy and their relation to deranged vitamin B, metabolism. Proc Soc Exp Biol (N.Y.) 1954;86:624.

13 Brown RR, Thornton MJ, Price JM. The Effect of Vitamin Supplementation on the Urinary Excretion of Tryptophan Metabolites by Pregnant Women. J Clin Invest. 1961.

14 Ren S-G, Melmed S. Pyridoxal Phosphate Inhibits Pituitary Cell Proliferation and Hormone Secretion. Endocrinology. 2006;147(8):3936-3942.

15 Mohler H, Polc, Cumin, et al. Nicotinamide is a brain constituent with benzodiazepine like actions. Nature. Vol 278. 5 April 1979.


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