It sounds too simplistic to be true, but addressing vitamin deficiencies may bring new hope for those with schizophrenia. 

Schizophrenia is a devastating chronic illness featuring cognitive impairment. This includes delusions, hallucinations, and apathy. Research estimates that up to 2.3 percent of people suffer from schizophrenia or a related psychotic disorder at some point in their lives. Men are at a higher risk of chronic cases. And both sexes are equally at risk of short-term presentations.

Like other mental illnesses such as depression, it is commonly thought to be caused by a mysterious chemical imbalance only treatable with pharmaceutical drugs. Dissatisfaction with the results and side effects of these drugs, however, is leading to more research on effective prevention and treatment.

Although niacin (vitamin B3) was found in 2017 to be a potential solution to many miscarriages and birth defects, the benefits don’t stop there. New research proposes that niacin supplementation may prevent and relieve schizophrenia too. 

New Research On Niacin And Schizophrenia

A recently published study investigates the link between a mutation of the NAPRT1 gene, which impairs niacin metabolism, and schizophrenia. Previously, researchers found that malnutrition during the first trimester of pregnancy doubles the risk of schizophrenia. NAPRT1 mutations may be responsible for many of these extra cases as they increase niacin requirements.

In fact, people with schizophrenia often don’t experience the “niacin flush” from taking high doses of the vitamin. The niacin flush is an irritating, but passing, sensation of burning or tingling that appears with a red or flushed appearance of the skin. Severe niacin deficiency, or pellagra, also causes psychosis in four to 10 percent of cases. People with NAPRT1 mutations are also less likely to develop the rash typically seen in pellagra, making it resemble schizophrenia. 

Niacin Neglected For Over 60 Years

Knowledge about a possible link between niacin deficiency and schizophrenia is not new. The most popular theory is that a dopamine excess causes the disease. Dr. Abram Hoffer began to research the adrenochrome theory of schizophrenia in 1952.

Adrenochrome is an oxidized form of adrenaline, which is toxic to the brain. This oxidation happens twice to produce adrenochrome, with the second step being irreversible. Studies suggest that the release of oxidative free radicals by immune cells during the inflammatory response plays a major role in adrenaline oxidation. A derivative of niacin, however, could be protective by reversing the first oxidation. 

Early Research

Dr. Hoffer’s early research in 1952 found that giving people with acute schizophrenia one gram of niacin three times daily for a month resulted in an 80 percent recovery rate. Those in the placebo group only had a 33 percent chance of recovery. He then studied patients who continued taking niacin after they went home. They spent half the amount of time in a hospital during future readmissions. This was in comparison to people who never started taking it. 

Subjects with chronic schizophrenia spent at least five years on niacin before seeing any clear benefit. While it was no quick fix, it was worthwhile. Data on 32 people from 1956-1964 showed that those who stuck to niacin supplements spent an average of 79 days in the hospital. Patients who didn’t take them were hospitalized for an average of 691 days. Many taking niacin long-term became fully independent members of society. This, despite years of suffering and having no other success with previous treatments.  

The patients in Dr. Hoffer’s studies were born before flour was fortified with niacin to prevent pellagra. Later trials, which involved people born after universal fortification, did not show significant benefit from taking niacin. However, Dr. Hoffer describes patients making dramatic recoveries on supplementation plans involving niacin in much later case studies.

Those with NAPRT1 mutations or issues causing niacin deficiency such as anorexia, alcohol addiction, inflammatory bowel disease, and iron deficiency may still respond to supplementation. 

MTHFR Mutations: Another Missing Link

Variations of the MTHFR gene affect our ability to activate folate, another vitamin involved in schizophrenia risk. Poor folate metabolism reduces neurotransmitter production, turns up the expression of genes related to psychiatric disorders and allows homocysteine to build up. This works as an intermediate step in amino acid metabolism.

High levels increase oxidative stress and are linked to acute psychosis and brain atrophy (shrinkage) in schizophrenia. Even if you don’t have an MTHFR mutation, you can still have high homocysteine levels. Other causes of high homocysteine are deficiencies in folate, riboflavin (vitamin B2), B6, B12 or choline. Smoking, hypothyroidism, obesity, and diabetes are also causes.

The two major MTHFR mutations are C677T and A1298C. They can impair folate metabolism by up to 80 percent depending on which mutation is present and whether you have one or both copies (we inherit two copies of every gene). Although the C677T mutations generally have more severe effects on cardiovascular and mental health, both types are linked with schizophrenia

The MTHFR A1298C variant often contributes to gastrointestinal problems such as IBS and leaky gut too. Unhealthy gut microbiome and leaky gut are related to neurological disorders including schizophrenia. This is because they increase inflammation and disrupt neurotransmitter production. This means the mutation can also have indirect effects on the brain. A client I treated some time ago, who had both schizophrenia and IBS, turned out to have the A1298C mutation. Their IBS responded well to the low-FODMAP diet, which reduces the production of gas by gut bacteria. Unfortunately, their vegan diet excluded gut-healing bone broth and oily fish. 

Treatment With Vitamins

As for treatment, a review of 18 studies on nutrient supplementation in schizophrenia found some benefit from B vitamins. They were more effective for people who had high homocysteine, low folate or genes that impaired their folate metabolism. These clinical trials used folic acid, the synthetic form of folate which isn’t metabolized well in people with MTHFR mutations.

To solve this issue, another trial tested L-methylfolate, the fully activated form. Activated folate gave significant symptomatic relief, and partly restored structure and function to the prefrontal cortex. This region, responsible for a diverse range of cognitive functions, is overactive and too thin in schizophrenia.

Other Vitamin Deficiencies And Schizophrenia

It’s not only B vitamin deficiencies that have a link to schizophrenia: 

  • Vitamin D: Some research shows a link between low vitamin D and the disease. Up to three times the rate of vitamin D deficiency has been found in patients with psychotic symptoms compared to healthy controls. There is also a higher rate of vitamin D deficiency compared to people with other psychiatric disorders. In a large Finnish study of over 9000 children, supplementing babies with 2000IU per day of vitamin D reduced boys’ risk of the disease by 77 percent. 
  • Vitamin A: One study has found triple the risk of developing schizophrenia after vitamin A deficiency during the second trimester of pregnancy. Additionally, Vitamin A aids the growth, development, and migration of new neurons. 
  • Vitamin C: As a protective antioxidant, vitamin C could also protect against schizophrenia. Two small studies found symptomatic relief with vitamin C supplementation; researchers saw most improvements in the positive symptoms. Schizophrenia was previously linked with impaired vitamin C metabolism

Can I Recover From Schizophrenia?

Recovery is possible in some cases. Dr. Hoffer once stated that, “For schizophrenia, the recovery rate with drug therapy is under 15 percent. With nutritional therapy, the recovery rate is 80 percent.” However, you should not quit your medication cold turkey, even if you notice rapid improvement.

Antipsychotics have value in short-term use. They quickly bring symptoms under control, but must be tapered off slowly. One study found the average success rate of quitting antipsychotics to be 50.5 percent. This was higher among those who withdrew across more than one month. Vitamins act more slowly but work on the underlying causes and deficiencies. Research has shown that both antipsychotics and schizophrenia itself are linked with brain shrinkage. So, it is best to address the underlying causes as soon as possible. 

If you or someone you love has schizophrenia, don’t despair. Nutritional supplementation can go a long way in relieving its debilitating symptoms. Additionally, testing is available for key genes deficiency can impact. 

If you are pregnant or trying to conceive and concerned about mental illness, correct supplementation may help prevent other issues too.

The right nutrients, doses and time to begin tapering off antipsychotics (if possible) are different for each person. So, it is best to seek professional help. 

Alexandra Preston is an Australian naturopath, passionate about empowering others to take charge of their health and healing the planet. Her special area of interest in natural health is antiaging; she also loves the beach and is a semi-professional dancer.

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