Also known as nicotinic acid or nicotinamide, niacin is one of the eight vitamin B. It is required for the conversion of carbohydrates into glucose, metabolism of fats and proteins. It also helps in keeping the nervous system working properly. Pellagra is a condition which develops due to chronic niacin deficiency, commonly known as vitamin B3.
The condition can be categorized as primary and secondary, depending upon the factors affecting it. Pellagra is generally observed in the developing countries where the poverty rate is very high, which causes lack of nutrition. When the diet lacks niacin (B complex vitamins) or tryptophan (amino acid), or the body is not able to absorb these nutrients, it results in this condition.
The causes of this condition have been divided into primary and secondary, depending on their severity.
Causes of Primary Pellagra
- The deficiency of vitamin B3 can affect all the cellular and biochemical functions of the body.
- Lack of tryptophan, which is an essential amino acid, can also result in this condition. Vitamin B3 can be produced from amino acids or tryptophan. Tryptophan is the amino acid that cannot be synthesized by the human body. Hence, it has to be taken from food like groundnuts and beans.
Causes of Secondary Pellagra
- The presence of leucine (an amino acid) in a large quantity interferes with the metabolism of tryptophan, which results in its deficiency.
- If chronic diarrhea is not diagnosed and treated on time, then it may affect the digestion and absorption mechanism of the human body. This can lower the concentration of tryptophan or niacin in the body, thereby causing this disease. Abdominal pain, bad appetite, vomiting, and nausea are some of the common problems that affect the gastrointestinal system. It can even lead to malnutrition as eating and drinking becomes quite difficult.
- Age factor is also responsible for this disease. Elderly people are more prone to this condition because of weak digestive system.
- Gastrointestinal disease or acute addiction to alcohol may also cause this disease in some cases.
- Due to this vitamin B deficiency, one may experience awful effects on the neurological system as well. The initial signs of this disease are depression and apathy that may not be very prominent. It is accompanied by other symptoms like confusion, restlessness, anxiety, disorientation, psychosis, headache, and irritability. The person starts giving very slow or late reactions, and in some cases, prolonged unconsciousness might be observed.
Secondary pellagra could also be caused due to ulcerative colitis, diarrhea, chronic alcoholism, liver cirrhosis, and carcinoid tumor. The prolonged use of certain medications can also cause this condition. This condition generally affects the skin, gastrointestinal system, and the nervous system.
Clinical features of this disease are redness of the skin along with scaling in areas that are in direct contact with the sunlight, friction, and heat. They may appear very similar to sunburn and may give rise to itching and burning sensations. The affected areas might become scaly, thick, hard, and cracked, and blackened cuts may appear because of the bleeding. Lesions known as Casal's necklace may appear in areas like the neck, feet, face, arms, hands, and lower legs. Tongue, gums, and lips might also become sore.
Other than these symptoms, some people may become highly sensitive to light, and might also show aggressive behavior. Some might get affected by insomnia. If the symptoms like mental confusion and depression go untreated for very long, then it might develop into dementia. Musculoskeletal symptoms might also be observed, and the affected person might develop stiffness in the arms, legs, and other body parts.
One needs a diet rich in vitamins and minerals for proper functioning of the human body. Follow a healthy diet to prevent such nutritional deficiency.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.