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 Field Name  Data Description
Test Name  Niacin Level.
Code  Niacin Level.
CPT Code  84591
Last Modified  4/26/2018 1:55:00 PM
Test Name  Niacin Level.
Synonyms  Niacin, Nicoti, B3, Vitami, Nicotinamide, Nicotinic Acid
Patient Preparation  
Spec. Requirements  Blood
Tube  Red or Lavender-top (EDTA)
Collection Volume  Red 4.0 mL or Lavender-top (EDTA) 2.0 mL
Storage  Frozen only
Routine TAT  
STAT TAT  N/A
Days Test Performed  
Performed by BHS  None
See Availability  
Reference Lab  LabCorp of America
Reference Lab Code  070115 Vitamin B3 (Niacin+Metabolite)
Clinical Use  Measurement of vitamin B3 level as nicotonic acid and nicotinamide. Niacin (nicotinic acid), is a water-soluble vitamin that is also referred to as vitamin B3 [1,2]. Nicotinamide (nicotinic acid amide) is the derivative of niacin that is incorporated into the coenzymes nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP)(1-3). The nicotinamide moiety of NAD and NADP serves as an electron acceptor or donor in biological oxidation-reduction (redox) reactions catalyzed by several hundred different enzymes. NAD serves as the cofactor for enzymes that break down (catabolize) carbohydrates, fats, proteins, and alcohol while NADP supports biosynthetic (anabolic) reactions, including the synthesis of all macromolecules such as fatty acids and cholesterol [1, 2]. Nicotinamide has also been shown to serve as a cofactor in adenosine diphosphate (ADP)-ribose transfer reactions that play an integral part in deoxyribonucleic acid (DNA) repair calcium mobilization [3, 4]. Studies of cultured cells and animal models suggest that ADP-ribose polymer mediated DNA repair and cyclic ADP-ribose mediated cell-signaling pathwaymay play a role in cancer prevention [3, 4]. Both nicotinic acid and nicotinamide are absorbed from the normal diet. Nicotinamide is the form of vitamin B3 that is commonly found in nutritional supplements and used to fortify foods [1, 5]. Nicotinic acid is available both over the counter and with a prescription as a cholesterol-lowering agent [6- 8]. Niacin deficiency can result from inadequate dietary intake of niacin and/or the amino acid tryptophan. Tryptophan, obtained from the breakdown of dietary protein, can be converted to nicotinamide by liver enzymes that require vitamin B6, riboflavin and iron. Deficiencies of these constituents can contribute to the to the development of niacin deficiency [1, 2]. Hartnup's disease, a hereditary disorder that reduces tryptophan absorption, can lead to niacin deficiency [1]. Carcinoid syndrome diverts tryptophan to the increased production of serotonin and canreduce the production of nicotinamide [1]. Prolonged treatment with isoniazid has also been associated with niacin deficiency [1]. Niacin deficiency can affect the skin, digestive system, and the nervous system [1,2]. Severe niacin deficiency, referred to as pellagra has been is associated with the "four D's": dermatitis, diarrhea, dementia, and ultimately death [2]. Pellagra dermatitis is characterized by a thick, scaly, darkly pigmented rash that develops symmetrically in areas exposed to sunlight [2]. Digestive system symptoms include a vomiting, constipation or diarrhea, and a bright red tongue [1,2]. Pellagra can also cause neurologic symptoms including apathy, fatigue, depression, headache, disorientation, and memory loss [1,2].
Reference Range  â€¢ Nicotinic acid: 0.0−5.0 ng/mL • Nicotinamide: 5.2−72.1 ng/mL
Critical Value  
Testing Sample Type  Serum or Plasma
Min Lab Testing Volume  0.5 mL
Special Handling  Freeze
Lab Notes  Collection: Transfer the serum into a LabCorp PP transpak frozen purple tube with screw cap(LabCorp ID 049482). The specimen should be FROZEN immediately and maintained frozen until tested. To avoid delays in turnaroud time when requesting multiple test on frozen specimens, PLEASE SUBMIT SEPARATE FROZEN SPECIMEN FOR EACH TEST REQUESTED. Include the patient's age on the request form. Causes for rejection: Gel-barrier tube; specimen not frozen
Methodology  LC/MS-MS - Liquid Chromatography/Tandem Mass Spectrometry
Limitations  
 

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