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People who habitually consume excessive amounts of alcohol can develop a group of related conditions known collectively as alcohol-induced or alcohol-related liver disease. In addition, habitually excessive alcohol consumers can develop a deficiency of niacin (nicotinic acid), a B vitamin that helps the body process dietary fat. In a study published in May 2014 in the journal Alcoholism: Clinical & Experimental Research, researchers from the U.S. and China used laboratory animal experiments to determine if niacin supplements can help ease the impact of a form of alcohol-related liver dysfunction called alcoholic fatty liver disease.
The liver is the body’s primary organ for breaking down alcohol, a toxic substance that can produce wide-ranging damage if not eliminated efficiently. If you consume more alcohol than your liver can break down in any given amount of time, the presence of this substance can directly damage the liver’s cells and trigger the gradual process of alcohol-related liver disease. As a rule, the first stage of this process is fatty liver disease, a condition characterized by the unusual accumulation of fat cells inside the liver. The second stage of alcohol-related liver disease, called alcoholic hepatitis, involves the mild to severe swelling of liver tissue. The third stage, called alcoholic cirrhosis, involves permanent liver tissue scarring. While many people progress through each of these three stages, some individuals experience alcohol-related liver scarring without ever developing alcoholic hepatitis.
Alcoholic fatty liver disease and some cases of alcoholic hepatitis are reversible in people who stop drinking. Most drinkers with a fatty liver are unaware of their condition. In some cases, they have no symptoms; in other cases, they have symptoms that aren’t easy to link directly with excessive alcohol intake. Symptoms associated with advanced alcoholic hepatitis include jaundice, unusual changes in normal consciousness and liver failure. Symptoms associated with alcoholic cirrhosis include unusual itching, jaundice, localized high blood pressure inside the liver and liver failure.
Niacin is also known as vitamin B3. Along with certain other B vitamins, the body relies on the regular intake of this vitamin for efficient food processing. Specifically, niacin plays a critical role in your ability to break down and use the fats you consume in your diet. When given in supplement form, the vitamin is usually used to help the body remove excessive amounts of the fat-related substance LDL cholesterol from the bloodstream, or to lower levels of another bloodborne fat called triglyceride. Doctors can also use supplemental niacin to treat pellagra, a fairly rare condition related to serious dietary niacin deficiency. People affected by alcoholism often develop niacin deficiencies as a result of maintaining a generally poor diet and/or substituting alcohol for food intake.
In the study, researchers from the University of North Carolina at Greensboro, the University of Hawaii Cancer Center and China’s Center for Translational Medicine used laboratory experiments on rats to help determine if people affected by alcoholic fatty liver disease could benefit from supplemental doses of niacin. The researchers also used rat experiments to help determine if having a niacin deficiency worsens the effects of alcoholic fatty liver disease. During the experiments, one group of rats received a supply of alcohol and normal amounts of dietary niacin. A second group of rats received alcohol while being completely deprived of dietary niacin, and a third group received alcohol while receiving 100 times more than the normal dietary amount of the vitamin. A fourth group of rats, acting as a control group, did not receive alcohol or niacin supplementation, but did receive normal amounts of dietary niacin.
The researchers found that, just like in humans, ongoing exposure to alcohol triggered a buildup of fat cells inside the livers of the rats involved in their experiments. They concluded that having a niacin deficiency did not lead to a larger or more rapid accumulation of these cells. However, they did conclude that taking a niacin supplement helped ease the accumulation of alcohol-related fat cells. When they investigated the underlying reasons for niacin’s beneficial effects on fat buildup inside the liver, the researchers concluded that supplements of the vitamin help prevent the liver from generating new fat cells, in addition to helping with the successful breakdown of existing fat cells.
Since the study included rats and not humans, no one knows for sure if the same results hold true for people who chronically abuse alcohol and qualify for an alcohol use disorder (alcohol abuse and/or alcoholism) diagnosis. Further research will be needed to address this issue. No one should start taking niacin supplements without consulting his or her doctor.