Glaucoma is a progressive eye condition that affects 80 million people globally and can lead to permanent visual disability and total blindness if left untreated. Traditional treatments like eye drops, laser therapy, and surgery may slow the deterioration of the optic nerve by reducing eye pressure. Preliminary studies now suggest that a simple B vitamin called nicotinamide with pyruvate may be able to help.* A current study to evaluate this therapy (NCT05695027) is currently recruiting patients and evaluating this therapy in a long-term (21-month) study.

About glaucoma

Glaucoma causes progressive, irreversible damage to the optic nerve, typically from elevated eye pressure, though it commonly happens under normal eye pressure, as well. The optic nerve acts like a cable that transmits visual signals from the retina to the brain. When this cable is impaired, visual signals can get derailed.

• Symptoms of glaucoma often arise only after severe nerve damage and visual impairment. 
• People over 50 years of age, Blacks and Hispanics are at higher risk for open-angle glaucoma. 

The role of nicotinamide

Research has revealed, however, that glaucoma progression may be slowed or even halted if damaged RGCs can be saved from destruction. Several studies suggest that supplementation with a form of vitamin B3, namely nicotinamide and pyruvate, may help achieve this.

• At the cellular level, the body’s production of a substance called nicotinamide adenine dinucleotide (NAD+) is a key factor in mitochondrial energy production.
• The compound also helps to protect nerve cells by reducing inflammation and oxidative stress.

Scientists have noted that retinal ganglion cells (RGCs) seem to prefer nicotinamide over other forms of vitamin B3 and tryptophan for regenerating NAD+.

Supportive research

Multiple studies suggest that supplementing with nicotinamide can raise NAD+ levels inside the eye and improve vision in people with glaucoma.

In one animal study, 93% of test subjects didn’t develop glaucoma when given a dose of nicotinamide (2,000 mg/kg/day). In another, a team of international investigators found that nicotinamide could protect the retina and optic nerve against glaucoma, with RGCs protected against metabolic damage by the B vitamin.

• In a small human clinical trial in Clinical & Experimental Ophthalmology, 57 glaucoma patients received 1.5 grams (1,500 mg) of nicotinamide daily for six weeks, then 3 grams for another six weeks. After three months, patients improved in both nerve cell function and visual field testing versus placebo.

A large, 21-month international study called VBIGS (“The Vitamin B3 in Glaucoma Study”) is currently underway to investigate whether or not long-term nicotinamide use can slow vision loss and produce other glaucoma-related benefits.

What it means

Besides eye pressure reduction, evidence is mounting that visual function can also be improved with therapeutic doses of nicotinamide and pyruvate. Widely accessible and affordable, nicotinamide has been shown to be safe in the higher amounts needed for treating glaucoma.

According to study authors, if VBIGS is successful as of its projected completion in 2026, nicotinamide could become standard glaucoma treatment alongside blood pressure reduction.

A current study to evaluate this therapy (NCT05695027) is currently recruiting patients and evaluating this therapy in a long-term (21-month) study.

*Pule, D. (2023). Can Glaucoma Be Treated With A Simple Vitamin? Longevity. https://longevitylive.com/anti-aging/can-glaucoma-be-treated-with-a-simple-vitamin

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