Vitamin B3 Prevents Pain From Chemo

There’s good news for cancer patients who suffer from nerve pain caused by chemotherapy drugs: Researchers say vitamin B3 relieves or even prevents such pain.

While chemotherapy is the go-to for cancer treatment, there are negative side effects: Many anti-cancer drugs cause chemotherapy-induced nerve damage and pain (also known as chemotherapy-induced peripheral neuropathy, or CIPN). A team led by Marta Hamity, assistant research scientist, and Donna Hammond, professor of anesthesia and pharmacology at the University of Iowa, used a standard test to assess the pain caused by CIPN.

After female rats received the breast and ovarian cancer chemotherapy drug paclitaxel (in amounts corresponding to human treatment), the team measured the rats’ increased sensitivity to pain in their feet. Untreated rats did not withdraw their feet when light pressure was applied. However, treatment with paclitaxel made the rats sensitive to touch.

The rats were given 200 milligrams (per kilogram of body weight) of vitamin B3 (nicotinamide riboside), daily for seven days before chemotherapy was started, and continued for 24 days after the chemotherapy ended, which prevented the hypersensitivity to touch in the rats. This protective effect lasted for at least two weeks after the vitamin B3 supplementation stopped.

Vitamin B3 boosts levels of an important cell component called nicotinamide adenine dinucleotide (NAD+). Previous animal studies, including work from the University of Iowa, have shown that increasing NAD+ levels with vitamin B3 can protect against many types of nerve damage. The new study found that the vitamin B3 supplement increased levels of NAD+ in the rats’ blood by about 50 percent.

“Chemotherapy-induced [pain] can both hinder continuation of treatment and persist long after treatment has ended, severely affecting the quality of life of cancer patients,” said Hamity, who was first author on the study. “Our findings support the idea that [vitamin B3] could potentially be used to prevent or mitigate CIPN in cancer patients, resulting in a meaningful improvement in their quality of life and the ability to sustain better and longer treatment.”

Hammond was encouraged by the results, but stressed more study is necessary. “The preclinical literature is rife with drugs that alleviate chemotherapy-induced [pain] but that fail to do so under rigorous clinical testing,” she said. “We believe we are using a model that is more clinically relevant, but the true test of that will not be made until the clinical trial is done.”

The findings were published in the Journal of the International Association for the Study of Pain (PAIN).