When Bill Wilson, the creator of Alcoholics Anonymous (AA), was questioned about how he wished to be remembered at life’s end, he unexpectedly stated that he preferred to be recognised for his contributions to vitamin B3 as a remedy for alcoholism instead of for founding AA.

In 1958, while advocating for Alcoholics Anonymous, Bill participated in a medical conference where he met Dr. Abram Hoffer and discovered his studies on niacin therapy. Fascinated by this information, Bill began consuming 1000 mg of niacin after meals.

This new supplement helped him fully conquer his alcohol urges and alleviated the mood issues that had lingered since his sobriety.

Following this achievement, Bill dedicated himself to vigorously advocating for Hoffer’s findings and the advantages of niacin in treating alcoholism.

In 1965, he carried out a case series involving 30 members of Alcoholics Anonymous who, although sober, continued to experience lingering effects of alcoholism. He applied the same niacin treatment that had proven effective for him personally.

In the initial month, 10 individuals showed signs of recovery, and by the second month, 20 patients were largely free of symptoms.

The importance of vitamin B3

Vitamin B3 is one of the eight B vitamins and is commonly referred to as niacin, or nicotinic acid. It has two additional forms: niacinamide (nicotinamide) and inositol hexanicotinate, each of which impacts the body in unique ways.

All B vitamins play a crucial role in enabling the body to transform food, particularly carbohydrates, into energy in the form of glucose. Collectively known as B-complex vitamins, they also assist in the utilisation of fats and proteins. These vitamins are essential for maintaining a healthy liver, skin, hair, and eyes, as well as ensuring the proper functioning of the nervous system.

Niacin plays a vital role in the production of different hormones associated with sex and stress, particularly in the adrenal glands and other body regions. It also enhances blood flow and has been proven to reduce inflammation. The vitamin is even suggested to help curb sugar cravings.

All B vitamins are soluble in water, which means the body cannot retain them.

B3 deficiency is uncommon in developed countries, but you can fulfil your body’s requirements for B3 through your diet or through B3 supplements. Along with Desistal’s ‘Anti-alcohol Cravings’ supplements, you can use our ‘Liver Formula’ to help raise your B3 levels during alcohol recovery.

In developed countries, deficiency is most commonly associated with chronic alcohol use disorder, gastrointestinal malabsorption, and certain medications (e.g., isoniazid).

Alcoholism and vitamin B deficiency

Individuals who consume alcohol excessively over a prolonged period are especially prone to deficiencies in vitamin B.

The populations most at risk include:

  • Older individuals with a lengthy history of heavy drinking and alcohol dependence;.
  • Those with inadequate nutrition, experiencing weight loss, having low body weight, or suffering from diarrhoea, which indicates possible intestinal malabsorption
  • Individuals showing signs of deficiency in one specific B vitamin, suggesting they may also lack others.

Vitamin B deficiency and depression

It is important to emphasise one other factor that contributes to the psychiatric symptoms frequently seen in pellagra (vitamin B3 deficiency) related to alcohol use disorder. Depression, often associated with reduced serotonin production in the brain, stemming from a lack of available tryptophan due to protein deficiency.

Tryptophan is essential for the body’s synthesis of niacin (vitamin B3) because it serves as a precursor in the metabolic pathway.

While niacin (vitamin B3) is not directly involved in the synthesis of serotonin, it is crucial for the metabolism of tryptophan, which is the precursor to serotonin. A niacin deficiency can indirectly affect serotonin production by competing for the metabolism of tryptophan, potentially reducing the amount available for serotonin synthesis

Vitamin B3 Deprivation and Compulsive Drinking Behaviour

The late John P. Cleary, MD, believed that Alcohol Use Disorder were amongst a category of diseases known as the NAD Deficiency Diseases.

Cleary believed through long-term alcohol use, which leads to a lack of NAD results in diseases or unwanted behaviours and addictions.

The principle treatment for the NAD disease disorder is the administration of optimal amounts of vitamin B3 in order to cover the NAD receptor sites and shut-off the vicious addiction withdrawal cycle.

Why B3 works

Vitamin B3 serves as the building block for nicotinamide adenine dinucleotide (NAD+), which plays a crucial role in energy generation within the body. Niacin, in the form of niacinamide, has been shown to be safe as a supplement, even in high doses of up to three grams daily (Knip 2000).

NAD explained

Nicotinamide adenine dinucleotide (NAD+) plays a vital role in alcoholism as it serves as an essential coenzyme for energy metabolism and cell repair. Excessive alcohol consumption can lower NAD+ levels, resulting in numerous health problems, particularly during withdrawal and recovery.

How to take B3 (thiamine)

The NHS has the following guidance

  • Prescribe oral thiamine 200–300 mg per day (in divided doses) where severe deficiency is
    suspected e.g., while they are undergoing assisted withdrawal, or are drinking very excessively.
  • Prescribe oral thiamine 50 mg per day where mild deficiency is suspected e.g., during the
    maintenance stage following withdrawal, and for as long as malnutrition may be present.
  • Once alcohol abstinence has been achieved most patients resume adequate food intake and
    thiamine supplements should be stopped unless concerns persist about poor nutrition

NAD and liver health

Alcohol abuse can damage the liver, and NAD+ plays a role in liver regeneration and repair. 

Non-alcoholic Fatty Liver Disease (NAFLD)

Nicotinamide adenine dinucleotide (NAD+ ) has been proposed as a potential target to prevent and reverse NAFLD.

NAD+ is an important redox factor which influences how cells respond to changed in their environment, like stress or damage. It is used for energy metabolism and is used as a substrate, which is a molecule that our enzymes react with to carry out essential processes within the liver.

NAD+ is also a precursor for NADPH, which is an important component of the antioxidant defence system. Antioxidants are compounds that protect the body against damage caused by free radicals, unstable molecules that can harm cells and DNA