I'm a huge fan of dr. hoffer, i've read lots of his books. At one point, my local library had a copy of one of his medical books that was full of case studies and the doses of medications/supplements, diagnoses and results of many of his patients over years of tx. Very interesting to read. Especially the case studies of people with cancer who were referred to him because of depression secondary to their cancers. So many of his depression/cancer patients survived their cancers past 5 yrs, even people with cancers that are usually fatal.

I had a flareup of my arthritis just before Christmas, took a bit of niacin and it cleared right up. I'm really really really sensitive to the niacin flush. I get very itchy from it. I take a 500mg tablet of niacin and chop it up into little pieces and just take one little piece at a time, and that seems to be more than sufficient for my needs. I guess that's a lot less niacin than what the good doctor recommended but it seems to do the trick.

Here in Canada, the flushing niacin is available at any pharmacy but they keep it behind the counter so you have to ask the pharmacist for it. They all seem to have the same ingredients: niacin, microcellulose, magnesium stearate, other inert fillers, no gluten/dairy/artificials.

re lack of niacin in the soil. dr hoffer practiced in victoria bc for a long time. i remember reading about soil analyzation that he had researched on the island. the lower half of the island has no selenium in the soil, so if people were eating a local diet, he would have them supplement selenium. i think it's likely that if the soil in sask was deficient in niacin, it would be mentioned in his writing. iirc he practiced in regina, so food would have been brought in from various places, just like any big city?

i often wonder how dr hoffer's work would be different now with all the advances in functional medicine. i met someone who had been taking megadoses of folic acid, prescribed by dr. hoffer. with what we know about mthfr now, that's something that just isn't done anymore, they tend to go with folinic acid instead.

more reading material:
http://orthomolecular.org/library/jom/index.shtml
http://orthomolecularvitamincentre.com/