What is pellagra, and how does it affect the body?

Question

I recently came across the term pellagra, and I was surprised to learn that it’s caused by a deficiency of niacin (vitamin B3). I don’t fully understand how it develops or why it leads to such serious symptoms.

What exactly is pellagra, and why does a lack of niacin cause such severe health problems? I read that it affects the skin, digestion, and nervous system—does that mean it can lead to long-term damage if left untreated? Also, why do some people develop pellagra while others don’t? Is it mainly due to poor diet, or are there other factors like alcoholism or certain diseases that prevent the body from absorbing niacin?

What are the early symptoms of pellagra, and how can it be diagnosed? Does it always cause the "three Ds"—dermatitis, diarrhea, and dementia? Also, how quickly can pellagra be reversed with the right diet or treatment?

If anyone has experienced pellagra, what was the cause, and how was it treated? Did dietary changes alone help, or were supplements necessary?

Dr Sujal Patil · Accepted Answer

Pellagra is a condition caused by a deficiency in niacin (vitamin B3), which plays a crucial role in many bodily functions, including metabolism and nervous system health. Here's a breakdown:

What Is Pellagra?
Pellagra occurs when the body doesn’t get enough niacin, or the body can't absorb or process it properly. It mainly affects the skin, digestive system, and nervous system, leading to serious symptoms.

Causes:
Poor Diet: The most common cause is a diet low in niacin-rich foods (like meat, fish, poultry, and whole grains).
Alcoholism: Chronic alcohol consumption can prevent the body from absorbing niacin and other nutrients.
Certain Diseases: Conditions like malabsorption disorders (e.g., Crohn’s disease) and HIV/AIDS can also hinder the absorption of niacin.
Symptoms of Pellagra:
The classic symptoms are called the “three Ds”:

Dermatitis: Skin changes, including redness, rough patches, and sensitivity to sunlight.
Diarrhea: Digestive problems leading to diarrhea.
Dementia: Cognitive decline, confusion, and other neurological symptoms.
If left untreated, pellagra can cause long-term damage, especially to the nervous system, leading to irreversible mental deterioration and physical health issues.

Diagnosis & Treatment:
Diagnosis: It's typically diagnosed through blood tests, clinical symptoms, and dietary history.
Treatment: Pellagra can be reversed with niacin supplements and dietary changes. Foods rich in niacin or tryptophan (which the body converts to niacin) should be added to the diet. It often improves quickly with proper treatment.

What is pellagra, and how does it affect the body? - #14685

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