VitalX Blend

Niacinamide (nicotinamide)

• In ONTRAC (2015), a phase 3 trial of 386 people who had had at least two nonmelanoma skin cancers, oral nicotinamide (500 mg twice a day in the trial) for 12 months cut the rate of new nonmelanoma skin cancers by 23 percent compared with placebo, with no benefit after treatment stopped (PMID: 26488693).
• ENDIT (2004) studied 552 relatives of people with type 1 diabetes, and 5 years of oral nicotinamide did not prevent or delay diabetes (hazard ratio 1.07) (PMID: 15043959).

Niacin (nicotinic acid)

• In AIM-HIGH (2011), which enrolled 3,414 patients with cardiovascular disease on statins, extended-release niacin (1,500 to 2,000 mg a day in the trial) raised HDL cholesterol but did not reduce cardiovascular events, and the trial was stopped for lack of efficacy (PMID: 22085343).
• HPS2-THRIVE (2014) enrolled 25,673 adults with vascular disease; extended-release niacin with laropiprant did not reduce major vascular events (13.2 against 13.7 percent) and increased serious adverse events (PMID: 25014686).

Thiamine

• In a 2016 randomized, double-blind pilot trial of 88 patients with septic shock, intravenous thiamine (200 mg twice a day in the trial) did not lower lactate at 24 hours, the primary endpoint; in the 35 percent of patients who were thiamine deficient, lactate was lower and mortality over time decreased (PMID: 26771781).
• In a safety study of intravenous thiamine, reactions followed 1.1 percent of 1,070 intravenous doses in 989 emergency patients (PMID: 2757284).

Pantothenic acid

• In 8 healthy men, a week of oral pantothenic acid with cysteine did not change muscle coenzyme A, fuel use or exercise performance (PMID: 22052867).
• In a pilot study of 60 orthopedic surgery patients, intravenous dexpanthenol, an alcohol derivative of pantothenic acid, was associated with a dose-related shortening of the time to the first bowel movement after surgery; the authors called the study preliminary (PMID: 22964703).

Folic acid

In the MRC Vitamin Study, a randomized double-blind trial in 1,817 women who had had a pregnancy affected by a neural tube defect, folic acid taken by mouth around conception cut recurrence by 72 percent, while a mixture of other vitamins (A, D, B1, B2, B6, C and nicotinamide) showed no significant protective effect (PMID: 1677062).

Riboflavin

In a randomized trial of 55 people with migraine, riboflavin (400 mg a day in the trial) for 3 months reduced attack frequency and headache days compared with placebo, with 59 percent of patients on riboflavin and 15 percent on placebo improving by at least half (PMID: 9484373).

Biotin

The SPI2 phase 3 trial of 642 people with progressive multiple sclerosis found that high-dose oral biotin did not significantly improve disability or walking speed (12 against 9 percent improved) and caused inaccurate laboratory results (PMID: 33222767).

Choline and inositol

Intravenous choline chloride lowered liver fat in small trials in patients on long-term intravenous nutrition (PMID: 11531217). A 2023 meta-analysis of 26 randomized trials in polycystic ovary syndrome found that oral inositol made a regular menstrual cycle 1.79 times as likely as in the control groups, with very low certainty of evidence; the result came from pooling the 2 trials that reported it against a folic acid placebo or a diet-only control group (PMID: 36703143).

Thiamine given by injection

The FDA label for thiamine hydrochloride injection warns that serious hypersensitivity and anaphylactic reactions can occur, especially after repeated doses, and that deaths have resulted from intravenous or intramuscular thiamine. The label also lists itching and sweating, warmth, hives, weakness, nausea, restlessness, throat tightness, angioedema, cyanosis, pulmonary edema and bleeding into the gut, tenderness and hardening at the site after intramuscular use, and aluminum in the product that can reach toxic levels with prolonged use when kidney function is impaired (thiamine hydrochloride injection label, ANDA 080556, FDA, version of 9 January 2026). In a prospective study of 989 emergency patients given 1,070 intravenous doses of 100 mg, 12 reactions occurred (1.1 percent): 11 cases of transient local irritation and 1 case of generalized itching (PMID: 2757284). In the United Kingdom, available data indicated 10 anaphylactic reactions to a parenteral thiamine-containing vitamin product across an estimated 5.4 to 6.7 million patient-days of treatment (PMID: 31565743). The FDA label for Infuvite Adult, a multivitamin infusion, also lists allergic reactions to thiamine and anaphylaxis (Infuvite Adult label, FDA, version of 6 November 2024).

Folic acid given by injection

The FDA label for folic acid injection reports allergic sensitization after oral and injected folic acid, and warns that folic acid above 0.1 mg a day may hide pernicious anemia, because blood counts can recover while nerve damage progresses (folic acid injection label, ANDA 089202, FDA, version of 14 October 2024).

Oral trials

• In HPS2-THRIVE, 25,673 adults with vascular disease took extended-release niacin with laropiprant or placebo for a median of 3.9 years; the combination did not reduce major vascular events and increased serious adverse events such as serious disturbances of diabetes control (3.7 percentage points more than placebo), new diabetes, infections and bleeding (PMID: 25014686). Niacin flushing comes from prostaglandin release in the skin (PMID: 19691622).
• For niacinamide, no noteworthy differences in adverse events between nicotinamide and placebo were found in a 386-patient skin cancer trial (PMID: 26488693), and serious adverse events did not differ in a 552-person diabetes prevention trial (PMID: 15043959).
• In 6 healthy adults taking 10 mg of biotin a day for a week, 9 of 23 biotin-based immunoassays gave falsely high or falsely low results (PMID: 28973622). In a 642-patient multiple sclerosis trial of high-dose biotin, the treatment caused inaccurate results on laboratory tests that use biotinylated antibodies despite mitigation steps (PMID: 33222767).
• A 55-patient migraine trial recorded two minor adverse events (diarrhea and frequent urination) with riboflavin and one (abdominal cramps) with placebo (PMID: 9484373).