Pellagra is a disease that affects your digestive system, skin, and nerves, resulting in dermatitis, diarrhea, and mental disorders. The most common cause of pellagra is not having enough niacin (primary pellagra). Other causes of pellagra are associated with digestive disorders that reduce the absorption of niacin in your body.

Niacin is also known as nicotinic acid, or vitamin B3. In the United States, individuals most at risk for developing pellagra are alcoholics or those who consume large amounts of sugar or refined carbohydrates resulting in malnutrition.

Both alcoholism and not consuming enough green vegetables, seafood, meat, and eggs commonly cause primary pellagra. Secondary pellagra occurs when sufficient niacin is consumed but not taken up and used by the body. Secondary pellagra is often caused by gastrointestinal diseases that prevent absorption of niacin. Because tryptophan is needed to make niacin, low levels of tryptophan may also lead to pellagra.

The signs and symptoms of pellagra can be constant or occur periodically. Pellagra varies among individuals. Some people with pellagra have mild symptoms, such as fatigue, while others may develop severe depression and anxiety. Fortunately, pellagra can be treated with nutritional supplementation to resolve deficiencies in niacin. Lifestyle changes can reduce your risk for pellagra and include limiting alcohol intake, eating a well-balanced diet, not smoking, and always taking all medications and supplements as prescribed.

In some cases, if left untreated, pellagra can lead to dementia, anxiety or depression.

Common symptoms of pellagra

You may experience pellagra symptoms daily or just once in a while. At times any of these common symptoms can be severe:

•    Abdominal cramping

•    Confused or delusional thinking

•    Depression

•    Diarrhea

•    Difficulty with memory, thinking, talking, comprehension, writing or reading •    Headache

•    Loss of appetite

•    Malaise or lethargy

•    Mucus membrane inflammation

•    Nausea with or without vomiting

•    Skin lesions that are scaly and sore

•    Weakness (loss of strength)

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