Supplements for Glaucoma – Should We Recommend Nicotinamide?

When it comes to glaucoma, most treatments today focus on lowering eye pressure. But what if there was a way to protect the optic nerve itself—keeping the retinal ganglion cells healthier and stronger, even when pressure control isn’t enough?

That’s where nicotinamide, also known as niacinamide or vitamin B3, has sparked interest.

Green and white capsules spill out of a white bottle, highlighting a common form of medication.

What Is Nicotinamide for Glaucoma?

Nicotinamide is a form of vitamin B3 found in every living cell. It plays a crucial role in energy production, helping the body convert nutrients into ATP—the fuel that keeps our cells running.

Our bodies can make it from the amino acid tryptophan, but levels of NAD+ (its active form) naturally decline with age. This drop is linked to cellular stress and dysfunction, including in sensitive tissues like the retina. Nicotinamide for glaucoma.

Why Does This Matter for Glaucoma?

In glaucoma, retinal ganglion cells slowly die, leading to vision loss. Researchers are now studying whether boosting NAD+ with nicotinamide supplements could protect these cells from damage.

Animal studies have shown promising results: oral nicotinamide provided strong, dose-dependent protection to retinal ganglion cells—particularly their dendrites, the branches that connect them to other neurons.

Importantly, nicotinamide does not lower eye pressure. Instead, it supports the health and metabolism of optic nerve cells, making it a potential add-on to traditional treatments.

What Do the Clinical Trials Say?

A clinical trial in Sweden is currently testing nicotinamide in glaucoma patients. Participants are receiving:

• 1.5 g daily for 6 weeks

• then 3.0 g daily onwards

So far, these doses are considered safe, with a low risk of liver toxicity. To be cautious, researchers monitor liver function before treatment and after two months.

Should You Take It Now?

The science is exciting—but still evolving. Nicotinamide looks like one of the most promising neuroprotective supplements for glaucoma, yet it hasn’t been fully proven in large, long-term clinical trials.

If you’re considering vitamin B3 supplementation for glaucoma:

• Talk to your ophthalmologist first—especially about dosing and safety.

• Don’t stop your current glaucoma treatments like drops, laser, or surgery.

• Think of it as “support,” not a replacement for established care.
  

The Bottom Line

Nicotinamide could represent a powerful new way to protect vision—working at the cellular level to keep retinal ganglion cells healthy. While we’re not at the point of recommending it universally, ongoing research may soon change how we approach glaucoma care.

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Bibliography / References

1. Hui F, Tang J, Williams PA, et al. Niacinamide and Neuroprotection: The Glaucoma Holy Grail. Int J Mol Sci. 2023;24(3):2140. https://pmc.ncbi.nlm.nih.gov/articles/PMC9905873/

2. Tribble JR, Hui F, Casson RJ, et al. Oral nicotinamide provides robust, dose-dependent structural and metabolic neuroprotection of retinal ganglion cells in experimental glaucoma. Acta Neuropathol Commun. 2024;12:35. https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-024-01850-8

3. Singh S, Gupta A, Kaur J. Nicotinamide: Bright Potential in Glaucoma Management. Cureus. 2024;16(5):e61542. https://pmc.ncbi.nlm.nih.gov/articles/PMC11352092/