Jim was 21 when his parents took him to Andrew Saul, a nutrition researcher and author. A psychiatrist had diagnosed him with schizophrenia. His behavior included punching walls, threatening his family, and sleeping only an hour each night. After the state hospital discharged him, his parents had to manage his care at home.
Saul observed that Jim’s skin was scaly, his face covered in acne, and his diet lacked essential nutrients. The combination of skin problems, confusion, and digestive issues resembled pellagra, a disease caused by niacin deficiency. He remembered Abram Hoffer, a Canadian psychiatrist who treated psychotic patients with large doses of niacin and vitamin C.
Hoffer’s method usually involved 3,000 milligrams of niacin and 10,000 milligrams of vitamin C each day. In extreme cases, he increased the niacin to 20,000 milligrams. Saul told Jim and his parents that niacin, or vitamin B3, could have a calming effect at these levels. Since niacin is a nutrient rather than a drug, Hoffer found no toxicity in humans even at high doses.
The most noticeable side effect was flushing—a temporary redness or itching in the face and neck from increased blood flow. Saul recommended taking niacin with meals to lessen the reaction. He also mentioned that high doses might affect liver function tests, though Hoffer believed this reflected increased liver activity, not harm. Adding lecithin or vitamin C could reduce the effect.
The family decided to proceed. Saul cautioned that Jim might need more niacin than the standard dose due to his severe symptoms. While the recommended daily allowance for niacin is 20 milligrams, Hoffer’s research suggested much higher amounts were necessary for psychiatric conditions. Saul noted that this allowance was already 20 times higher than for other B vitamins, indicating its importance.
A rapid and unexpected recovery
Two weeks later, Jim’s father called Saul with news. After starting the supplements, Jim’s behavior began to change. He settled into a normal sleep pattern. Then, one morning, he walked into the dining room and said, “Good morning, Dad.” It was the first time in years he had spoken normally.
Weeks later, Jim visited Saul alone. He admitted he had stopped taking the niacin because he preferred his illness. Some people, Saul explained, resist getting better. But Jim had a solution: when symptoms returned, he took a hot bath and swallowed a bottle of niacin. “Then I feel fine,” he said.
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Saul accepted the method. If it worked, there was no need to question it.
Hoffer’s work in the 1950s connected psychosis to pellagra-like symptoms. Pellagra was widespread in the rural South, where diets depended on milled corn, which lacks tryptophan—a niacin precursor. Symptoms included weakness, confusion, skin problems, and, in severe cases, insanity. Hoffer concluded that schizophrenia was a condition tied to vitamin deficiency, not just a mental health issue.
Niacin’s safety record was strong. Hoffer noted that people cannot take so much niacin as to hurt themselves, because they would become nauseated first. The RDA of 20 mg/day of niacin is low, illustrating its importance compared to other B vitamins.
Jim’s experience wasn’t isolated. Saul’s book, Doctor Yourself, describes other cases where high-dose niacin and vitamin C led to significant improvements in mental health. The approach remains debated, however. Mainstream psychiatry rarely considers nutritional deficiencies as a primary cause of severe psychiatric disorders. Most treatments focus on medication rather than high doses of vitamins.
For Jim, the results were clear. His symptoms didn’t just improve—they disappeared. The reason his treatment worked isn’t widely studied. Families in similar situations might find answers in vitamins instead of prescriptions.
Saul doesn’t claim niacin works for everyone. But for some, it may be the missing piece. The difficulty lies in convincing more doctors to explore alternatives—and more patients to try them.
