1000 mg of B3 a day?

[LIVEORDIEHEREIAM]

My dermatologist is pushing me to take 1000 mg of oral Nicotinamide, a form of vitamin B3, a day because it can ward off skin cancer. I am Scandinavian by heritage, red haired, etc. and have had hundreds of sun-induced pre-cancerous spots (actinic keratosis) dealt with in various ways, not always all that successfully. She proposed this when the results of the latest treatment was less than optimal. (New to her office, called Photodynamic Light Therapy)

Diagnosed two and a half years ago with PMR and within a month, also GCA, so began my journey at 20 mg pred and soon up to 60 mg. I'm now at 9 mg. Was at 7mg before having a flair in early this year.

Not being that good at controlling my diet, I now have the classy look of Cushing's Syndrome: skinny with an oversized gut, evidence, if I am getting it right, of a possible liver problem.

I am reasonably sure that pred weakens your liver at best and can actually do serious damage. At 1000 mg a day, B3 is just as hard on the liver or worse.

Anyone else been offered this? I'm hesitant to start it.

[PMRpro Ambassador]

Not sure it is evidence of a liver problem - it is just one of the places that the fat deposits in response to excess corticosteroid in the body.

ncbi.nlm.nih.gov/pmc/articl....

says it is only applicable in populations who have already had a diagnosis of skin cancer - but it does also reduce the development of actinic keratosis.

Niacin IR typically causes hepatotoxicity at doses above 3 g/day - a lot higher than she is suggesting. If she monitors liver enzymes you would be OK one would think,

[LIVEORDIEHEREIAM in reply to PMRpro]

Thanks, PMRPro! I must have misread the dosage that's dangerous! I include a quote from the article you provided the link to just in case another member of the forum might not know that there are other forms of B3 that are not used in this way.

"In addition, the investigators emphasized that nicotinamide is the form of vitamin B3 that should be taken for prevention—not other forms of vitamin B, such as niacin—and that continuous treatment is advised."