Pellagra: Symptoms, Causes, Treatment, Cost, and Side Effects

Pellagra is a vitamin deficiency disease that primarily affects those in the lower socio-economic strata of society. When an individual through their regular diet is not ingesting enough niacin, or vitamin B-3, they develop the disorder pellagra.

Niacin deficiency is the root cause of the dangerous illness pellagra, which can result from either starvation or a niacin absorption issue. It can result in death if untreated. Niacin supplementation works well to treat primary pellagra, while secondary pellagra may be more difficult to cure, depending on the underlying etiology (cause of disease).

In underdeveloped nations where grain is a key food supply or after protracted tragedies like famine or war, primary pellagra caused by an inadequate diet is widespread. Niacin is abundant in maize, but it is bound and cannot be reached without the use of alkaline solutions, and the tryptophan content of corn proteins is minimal. In several African nations, China, and some African nations, pellagra is still endemic.

Niacin is added to numerous foods in modern nations, including bread and cereal, making pellagra uncommon. Even yet, persistent alcohol misuse, anorexia nervosa, and self-imposed diets can all lead to severe dietary restriction, pellagra, and other indications of malnutrition. The most frequent cause of pellagra in industrialized nations is alcoholism.

Dermatitis, diarrhea, dementia, and eventually death are the 4 D's of Pellagra. But not every patient exhibits every symptom. The first symptoms frequently manifest as skin changes in the spring and summer.n

• Extreme photosensitivity on sites of exposed flesh, including the backs of the hands, forearms, face, neck's V, legs, and feetn
• Symmetrical, bilateral, and having a well defined, sharp edgen
• At first glance mimics a sunburn: sudden onset, redness, swelling, and searing discomfortn
• Occasionally present vesicles or bullaen
• Pigmentation, scaling, and persistent rednessn
• Becomes rough, dry, and thickly hyperpigmented Casal necklace: an overly pigmented band or collar around the neckn
• Hyperpigmented plaques and fissuring on the hands and feet, together with pellagrous gloves and bootsn
• Glossitis causes a dry, red, swollen tongue that eventually becomes smooth and atrophic and develops furrows, erosions, and ulcers.n
• Stomatitis causes brittle, red, and sensitive oral mucosa and gums.n
• Angular cheilitis and cheilitisn
• Redness, erosions, and maceration of the genital skinn
• Vaginal mucus is irritatedn
• Loss of appetite, vomiting, abdominal pain can be accompanied by diarrhea

Pellagra has two major types: the first is primary pellagra and the other secondary pellagra.n

Niacin or tryptophan deficiency in the diet might result in primary pellagra. Niacin shortage can result from inadequate tryptophan intake because it is converted to niacin in the body. The majority of people who have primary pellagra reside in underdeveloped nations where corn is a staple meal. Niacytin, a type of niacin found in corn, is difficult for humans to digest and absorb unless it is properly prepared.n

In regions of the world (including some regions of Africa), where people consume a lot of untreated corn, the sickness is prevalent. Tryptophan is scarcely present in maize, while the vitamin niacin is closely bonded to other elements of the grain. If corn is left in limewater for an entire night, the niacin will come out. In Central America, where pellagra is uncommon, tortillas are prepared using this technique.n

Niacin depletion in your body can be caused by:n

• Gastrointestinal conditions that impair absorption, such as cirrhosis of the liver or inflammatory bowel illness.n
• A drinking disorder. Heavy drinking can cause organ damage that results in malabsorption and overall malnutrition, which can lead to pellagra.n
• Surgery to remove the stomach. Intestinal mucosa damage from bariatric surgery can result in a number of micronutrient deficiencies, including pellagra.n
• Anemia due to iron deficiency. Niacin needs iron to be converted and used by your body.n
• Hartnup illness Your body cannot absorb amino acids, which are required to produce vitamins from meals due to this hereditary disease.n
• Cancer syndrome. Active tumor cells that inhibit niacin synthesis are what this condition is defined by.n
• Niacin metabolism in your body can be interfered with by some medications, including antispasmodic and chemotherapy treatments.n
• Niacin levels in your body decrease if you have HIV.

The first step to preventing pellagra involves the consumption of a balanced diet.nNutritional elements and different types of food that are enriched with niacin as well as tryptophan include nutritional yeast, eggs, bran, peanuts, meat, poultry, fish with red meat, cereals (especially fortified cereals), legumes, and seeds.

nIn order to circumvent the development of pellagra in the body, it is imperative to consume the suggested daily allowance (RDA) of niacin.

nNiacin (vitamin B3) is an important nutrition component, the lack of which is one’s daily diet causes pellagra. Pellagra includes the three defining Ds which include the symptoms of dermatitis, dementia, and diarrhea and can result in death. Niacin deficiency can happen due to a plethora of causes such as genetic problems, malabsorptive conditions, and as a reaction to certain medical treatments and drugs.

The patient's medical history and the external manifestation of the 4Ds—dermatitis, diarrhea, and dementia—are used to make the diagnosis of pellagra. The erythema at the areas of sun exposure is bilaterally symmetrical in dermatitis brought on by pellagra.n

A niacin test may also be conducted to check the levels in the body and detect any potential onset of pellagra. When someone has signs of niacin deficiency or is using niacin supplements, a blood test for niacin is sometimes requested to check their levels. This test typically takes 4 to 10 business days to complete.n

At Pristyn Care, you can expect an accurate diagnosis of Pellagra. Following that, our experienced doctors will explain the course of treatment.

Primary pellagra cases are typically treatable with straightforward natural remedies. A medical expert should closely examine cases of secondary pellagra because other medical issues may be present. Whatever the case maybe, seek a proper medical checkup and consultation with a medical practitioner before attempting to treat pellagra at home.n

Some of the readily available treatments that you can try for yourself are:n

• Adding a niacin supplement to your dietn
• Consume a diet high in tryptophan and niacin. Foods such as milk, eggs, liver, mushrooms and peas are rich in niacin.nCure your pellagra related diarrhea n
• Protect your skin from the sun using sunscreens and moisturizers.n
• Use an ointment that won't irritate your wound and can act as an excellent moisture barrier while also keeping out germs if you have damaged skin.

Niacin (vitamin B3) is an important nutrition component, the lack of which is one’s daily diet causes pellagra, which is treated by supplying the missing component. Most people who take niacin tablets see improvements right away. Skin sores and mouth sores are symptoms that may call for urgent medical care. But it is not a disease that will resolve by itself, treatment is required. Pellagra, especially in the brain, can harm nerves if left untreated. Infected skin sores are possible.

The majority of people, especially those in industrialized nations, can obtain enough niacin and tryptophan through a balanced diet. For most people, pellagra prevention is as simple as maintaining a high-protein diet or taking B vitamin supplements, whether you're trying to prevent it from happening in the first place or don't want to get it again.n

In case you have the disease, make sure to eat lots of niacin rich foods such as:n

• Milkn
• Eggsn
• Mushroomsn
• Livern
• Peasn
• Sunflower seedsn
• Avocadon
• Ricen
• Cereals, lentils and other enriched grainsn
• Legumesn
• Peanuts

Niacin (vitamin B3) deficiency causes pellagra, which is treated by supplying the missing component. Most people who take niacin tablets see improvements right away. Skin sores and mouth sores are signs that may require additional medical attention. But it will not go away on its own, treatment is required. Pellagra, especially in the brain, can harm nerves if left untreated. Infected skin sores are possible.

Pellagra isn’t a disease that is treated with medicines in particular. Dietary modifications and a niacin or nicotinamide supplement are used to treat primary pellagra. It might also be administered intravenously. Another type of vitamin B-3 is nicotinamide. Many patients who receive prompt treatment recover completely and see immediate improvement. It could take several months for skin to improve. Primary pellagra typically results in mortality after four to five years if untreated, though.

The underlying cause is typically addressed while treating secondary pellagra. However, niacin or nicotinamide can also be administered intravenously or orally to treat some secondary pellagra patients.It's crucial to keep any rashes moisturized and protected with sunscreen while recuperating from either primary or secondary pellagra.

With supplements, the majority of patients see improvements within a few days. Usually within the first week, gastrointestinal problems are the first to disappear. Within two weeks, mouth and skin lesions start to heal. Some cases of extreme severity could elongate the recuperation period. Dementia and an extreme degree of neurological injury may be irreversible.

With maintenance of proper diet consumption, pellagra can be permanently kept away. Pellagracy is treated by addressing the deficiency in niacin (vitamin B3), which is what causes the condition. When taking niacin tablets, most people experience improvements right away. Mouth sores and skin sores are indicators that you might need more medical care. But treatment is necessary because it won't go away on its own. If untreated, pellagra, particularly in the brain, can damage nerves. Possible skin sores with an infection.

After treatment, the best way to prevent pellagra is to eat a lot of foods high in the chemical niacin. Additionally, you should stop drinking too much alcohol because it prevents the body from properly absorbing niacin. Dairy, fish, mushrooms, legumes, peanuts, and other niacin-rich foods can be included in your daily diet. Although prevention is crucial, you must also practise safety.

Niacin (vitamin B3) is an important nutrition component, the lack of which is one’s daily diet causes pellagra, which is treated by supplying the missing component. It is a type of malnutrition, more specifically, it is undernutrition in the micronutrients. Niacin is essential for healthy cell function throughout your body, and deficiency symptoms can be felt in your skin, mouth, bowels, and brain. Pellagra, if untreated, can be fatal or leave your neurological system permanently damaged.

Primary pellagra, which results from insufficient dietary intake, continues to be a serious issue in people with limited access to food. In the developed world, secondary causes—diseases or chemicals that stop your body from receiving or utilizing niacin—are more likely to be the cause of niacin deficiency.