Pellagra
Jamaica Phan
Bio 200
March 6, 2012
What is it?
-Pellagra is a systemic disease caused by vitamin B3 (niacin) deficiency.
-Tryptophan can be converted to niacin.
-There are two types:
1. Primary Pellagra: Caused by the deficiency of niacin rich foods.
2. Secondary Pellagra: This occurs when there is a sufficient amount
of niacin being taken in but something prevents the body from
absorbing and processing the vitamin. Such as:
-liver cirrhosis
-alcoholism
-prolonged diarrhea
-Pellagra is a vitamin deficiency (dietary and not genetic).
Functions and Needs of Niacin
-Niacin is a member of the B-complex vitamins.
-Water soluble (niacin is lost with diarrhea because of this).
-Functions as either nicotinic acid or nicotinamide.
-Extremely important for energy production.
-Important for processing fats in the body.
-Niacin is often used by the synthetic pathways in the cell.
-Adult RDA of Niacin:
-14 to 16 milligrams per day
-Upper level of Niacin:
-35 milligrams per day of the nicotinic acid form
Symptoms of Pellagra
-The symptoms can vary in intensity from person to person.
-Symptoms may occur alone or in combination.
-Known as the disease of the four “d’s” dermatitis, dementia, diarrhea, and
death.
-CNS symptoms:
-psychosis, depression, paranoia, impaired consciousness.
-Mucous membrane symptoms:
-Mostly affects the mouth but can affect the vagina and urethra. Glossitis and
stomatitis.
-GI symptoms:
-During early deficiency may include burning sensation of the pharynx and
esophagus, and abdominal discomfort. Later symptoms include nausea and
vomiting.
-Skin Symptoms:
-Includes skin rashes, lesions, and thickened skin
Population Distribution
“Pellagra is the only dietary deficiency disease ever to reach epidemic
proportions in the United States” (Contemporary Nutrition pg. 313).
History in the United States:
People at risk for Pellagra today:
-Existed in Europe for about two
centuries before having any recognition
in the U.S.
-First reported in 1902
-Occurred in huge epidemic proportions
in the South.
-Pellagra was at it’s peak in 1912.
-There was an estimation of 25,000
cases of Pellagra since 1907 with a 40%
mortality rate.
-Rare in Western Societies
-In the U.S., alcoholics are at risk.
-Populations who use corn as a
main source of energy.
-Developing Countries
-Common in India, Africa, and
China
-Does not show age or gender
preferences
Treatments of Pellagra
-First step is prevention by eating foods rich with niacin (and tryptophan).
-Foods rich in niacin are poultry, beef, tuna, breakfast cereals,
asparagus, coffee, yeast and other.
-Foods rich in tryptophan are milk, eggs and other.
-Returning niacin and tryptophan (if needed) back to normal levels.
-Niacinamide given orally: 300 to 500 milligrams each day (with
consultation with medical professional).
-Through injection:100 to 250 milligrams two to three time daily
(with consultation with medical professional).
-High protein diet supplemented with B-group vitamins are needed for
complete recovery.
-Skin lesions may be treated with topical emollients.
-Caution: High amounts of Niacin is toxic to the body and can cause serious
consequences.
Three Day Breakfast Plan
mg
Three Day Lunch Plan
Three Day Dinner Plan
Question Time
1. What are the two types of Pellagra?
-Primary and Secondary
2. What are the four “D’s” of the Pellagra
symptoms?
-diarrhea, dermatitis, dementia, and death
3. What is the adult RDA of Niacin?
-14 to 16 milligrams per day.
Resources
Food Composition Table. Boston: McGraw-Hill Higher Education, 2009. Print.
Johnson, Larry E. "Niacin: Vitamin Deficiency, Dependency, and Toxicity: Merck Manual Professional." The
Merck Manuals. Merck Sharp & Dhome Corporation, Apr. 2007. Web. 28 Feb. 2012.
<http://www.merckmanuals.com/professional/nutritional_disorders/vitamin_deficien
cy_dependency_and_toxicity/niacin.html>.
"Pellagra." - Modern Medical Guide. Web. 28 Feb. 2012.
<http://www.modernmedicalguide.com/pellagra/>.
"Pellagra." - Symptoms, Causes, Treatments. Health Grades Inc., 2 May 2011. Web. 28 Feb. 2012.
<http://www.bettermedicine.com/article/pellagra>.
Wardlaw, Gordon M., and Anne M. Smith. "Vitamins." Contemporary Nutrition. New York: McGraw-Hill, 2009.
312-315-476. Print.