Pellagra: A Health Crisis Sparked by Niacin Deficiency

Abstract

Pellagra is a systemic disease caused by a severe deficiency of niacin. Primary pellagra is caused by a lack of niacin in the diet. Secondary pellagra can occur when the body is unable to absorb the niacin. In the early part of the 20th century , pellagra was a growing epidemic in the southeastern United States and caused public alarm.Primary pellagra is now seen in America in individuals with alcoholism . In dietary sources, niacin is present in fish, meats, and fortified foods such as cereal, bread, and legumes. During meat processing, nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP) can become hydrolyzed to free nicotinamide. The symptoms of pellagra include diarrhea, skin lesions, dementia.The gastrointestinal symptoms include vomitings, indigestion, abdominal pain etc.The neurological symptoms include memory loss, depression etc. And dermatological symptoms include rashes etc. Classic pellagra responds dramatically to oral administration of nicotinamide niacin 100-300 mg/day in three separate dose.