Niacin Deficiency

10 Common Niacin Deficiencies, Causes, Treatments, Diagnosis And Recommended Daily Allowance

Niacin deficiency is brought about when your body cannot get enough or simply cannot absorb this vital vitamin. Niacin is a vitamin B3 sometimes called nicotinic acid plays a vital role in the body.

Basically, dietary deficiency of this vital vitamin is unlikely in developed countries because most food products are fortified with this vitamin.

Vitamin niacin deficiency symptoms are known as “three D’s”: Dermatitis (skin pigmented rash), Diarrhea (gastroenteritis), and Dementia (widespread neurologic deficits particularly cognitive decline)

Since vitamin B3 is essential in energy production, a deficiency with this nutritional vitamin can lead to body weakness and lack of appetite. It can also lead to skin infections

It also helps your body to convert food/carbohydrates into glucose, assist in metabolizing fats and proteins and keep your nervous system working properly.

The nervous system functioning of the body partly depends on the availability of this vital vitamin in the human body.

It also helps your body to make sex- and stress-related hormones and improves circulation and cholesterol levels. You can see how important this vitamin is, the deficiency can cause a lot of adverse effect in your body

What is Niacin Deficiency?

Niacin deficiency occurs when a person has inadequate intake or has impaired absorption of niacin or tryptophan. Secondary deficiency can also occur due to other medical conditions particularly alcoholism, cirrhosis and diarrhea.

Prolonged use of tuberculosis drug – isoniazid (Laniazid, Nydrazid) – can also cause deficiency of this vital vitamin, Read major benefits of niacin here.

10 Common Deficiencies of this vital vitamin

Niacin takes part in numerous metabolic processes within your body; lack of it or reduced levels can have serious impacts on your health.

Identifying the symptoms of deficiency of this vital vitamin helps you to treat any medical condition that may arise from it.

Below are some of the deficiencies that tend to occur when you have inadequate of this nutritional vitamin in your body.

  • Lesion on your skin

Do you have lesions on your skin? If you recently started having lesion on your body particularly the skin you could be probably suffering from the deficiency of this nutritional vitamin.

The lesions appear more visible on places that experience more pressure. It is even worse when you expose your skin to the sun.

The way these are distributed on the body is more relevant for identifying the deficiency of this vital vitamin than the shape of the lesions.

When they affect the hands and take the shape of a glove, the condition is called pellagrous glove. If they affect the legs and feet and look like a boot, you have what is known as pellagrous boot.

  • Mucous membrane swelling

Mucous membrane swelling is a symptom which affects your mouth, vagina and urethra tongue can cause pain in the mouth, increased salivation, edema of the tongue, and ulcers.

When you get such symptoms, you should seek proper medication from health experts fast.

  • Central Nervous System Problems

Lack of Vitamin B3 component in your diet puts your central nervous system at risk.

When the amount of niacin in the body is not sufficient, you expose your body to serious central nervous problems such as: memory impairment, depression/anxiety, paranoia, confusion among others. It is important to talk to a physician once you notice these symptoms.

  • Pellagra

Pellagra is caused when a deficiency of this vital vitamin gets severe. Sometimes, when tryptophan gets converted into niacin in a defective way in your body, pellagra is caused.

This disease is mainly characterized by erythema, nervous disorder and gastrointestinal disturbances

This disease is often characterised by diarrhoea or dermatitis. If you experience a severe case of pellagra you become depressive and your muscles become weak: a condition known as neurasthenia.

Secondary stage of pellagra sets in when there is adequate niacin in your body but the absorption and processing in the body is inhibited by the following:

  • Excessive consumption of alcohol
  • If you experience prolonged diarrhea
  • Liver diseases such as cirrhosis
  • Tumors
  • Metabolic disorder such as the hartnup disease

The pellagra disease symptoms affect the skin, gastrointestinal and central nervous system.

Your skin should tell if you have pellagra or not. The early signs of pellagra on skin include: The skin becomes reddish and scales tend to develop superficially exposed on the skin, you may develop skin rash with a clear distinction showing the affected and the unaffected part, in some cases due to the rash on the skin, there may be itching or burning sensation.

Pellagra causes neurological impairment. The early signs of neurological imbalance include feeling of apathy and slight depression.

You might experience headache, anxiety, restlessness, delusions and psychosis too. If this condition goes untreated, the patients become weak and may eventually die.

  • Weak Metabolism

Deficiency of this vital vitamin has huge effects on metabolism and central nervous system. Weak metabolism and immunity lead to feeble defense against attack of virus and you end up catching cold and flu quite often.

  • Skin Disorders

Deficiency of this vital vitamin can induce various skin disorders like inflamed skin, scaly or cracked skin and itchy skin.

A severe sort of deficiency of this vital vitamin can cause swelling and blisters on your skin. There may also be bleeding from the blisters.

The bleeding leads to black crusts on the surface of the skin. Slowly, the crusts are changed into thick pigmentation. This kind of skin disorder mainly develops on the backside of the hands

  • Psychiatric Troubles

Some of the psychiatric troubles caused due to deficiency of this vital vitamin in your body include anxiety, irritability, lack of concentration and apathy.

Sometimes, the deficiency triggers more serious types of symptoms like tremor, psychosis, paranoia, dementia, mania and disorientation.

These symptoms are shown when central nervous system gets affected due to deficiency of this vital vitamin.

  • Defective Gastrointestinal Tract

Deficiency of this vital vitamin has been linked to cause gastrointestinal problems such as the pharynx and oesophagus. If you start experiencing burning sensation along the guts, your body has insufficient Vitamin B3.

In addition you may have also experienced pain or discomfort in the abdomen, constipation, diarrhea, nausea and vomiting.

This is an indication of deficiency of this vital vitamin in your body. Some people tend to have bloody stool which can be attributed to ulceration of the bowel.

As niacin takes part in more than 50 metabolic processes within the body, its deficiency may have serious effects on your health.

In order to prevent such effects, you need to identify the signs of its deficiency, so you can treat the problem as soon as it appears.

  • Glossitis

Glossitis or inflammation of the tongue is an important symptom shown by deficiency of this vital vitamin in your body.

People passing through the deficiency can have deep red or discolored tongue. Starting from the tongue, the ulcer slowly spreads throughout the mouth and causes pain

Glossitis can cause small bumps on the surface of your tongue called papillae to disappear, your papillae play a role in how you eat.

Severe tongue inflammations that result in swelling and redness can cause pain and change the way you eat or speak.

  • Stomatitis

Severe deficiency of vitamin B3 can result in stomatitis which is an inflammation of the mucous membrane of mouth which disrupt from eating, talking and sleeping.

It can occur anywhere in the mouth including the inside of the cheeks, gums, tongue, lips and palate. Types of stomatitis include;

  • Canker sore

A canker sore, also known as an aphthous ulcer, is a single pale or yellow ulcer with a red outer ring or a cluster of such ulcers in your mouth.

  • Cold sores

Also called fever blisters, cold sores are fluid-filled sores that occur on or around the lips. They rarely form on the gums or the roof of the mouth.

Cold sores later crust over with a scab and are usually associated with tingling, tenderness, or burning before the actual sores appear.

  • Mouth irritation

The irritation can be caused by biting your cheek, tongue or lip, wearing braces or another type of dental apparatus, chewing tobacco, burning one’s mouth from hot food or drinks, having gum disease (gingivitis) or other type of the mouth infection etc.

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What causes the deficiency of this vital vitamin

Inadequate intake of this nutritional vitamin into in your diet may result to deficiency of this vitamin or commonly referred to as pellagra. It can also be caused by lack of other important nutrients in your body.

Similarly individual who are prone to malnutrition are associated with niacin deficiency. The lack of niacin in the body today is linked to the problems that affect the absorption of this vital vitamin in the blood stream.

If you have a Poor digestive system, you are likely to have inadequate of this vital vitamin in your body since the absorption is equally affected.

If you started taking alcohol recently you ought to quit. Alcohol is the most common cause of this vitamin deficiency.

Alcoholism leads to inadequate diets which translate to nutritional deficiencies such as Vitamins. The liver is a vital organ that manufactures this nutritional vitamin in your body.

Too much consumption of alcohol impairs the liver and reduces the production of this nutritional vitamin making it inadequate in your body.


Deficiency this vital vitamin is diagnosed through clinical evaluation. Diagnosis may be straightforward when the clinical picture of this vital vitamin deficiency is evident.

However, the clinical presentation may not be specific. After noticing these symptoms and report to your health care provider, a diagnosis needs to be performed.

It is very important to talk to a doctor about these symptoms, as only a professional is able to discern between deficiency of this vital vitamin and another similar problem.

For example, the symptoms affecting the central nervous system may also indicate a thiamin deficiency

Often, differentiating the symptoms is quite difficult. A history of inadequate niacin or tryptophan intake can help confirm diagnosis.

In addition, laboratory tests can also help to confirm the diagnosis, especially if it is unclear. A urine test may be done to determine the deficiency of this vital vitamin.

Treatment for the deficiency of this vital vitamin

A normal diet should be enough to supply the necessary requirements of this vital vitamin by the body. How much should you take to correct the depletion of niacin and restore it back?

If you have the deficiency of great vitamin, you probably need to consider taking a recommended daily dose will work well for you.

The amount recommended to restore the level of niacin is 16 milligrams per day for women whereas for men is 14 milligrams taken daily. Consider including in your diet food such as red meat, poultry products, cereals, fortified bread, fish and fruits.

You can as well visit your doctor to check whether you have an underlying medical condition that affects the absorption of this great vitamin in your body.

Niacin supplements such as multivitamins or mineral supplements are recommended to help raise the level of this nutritional vitamin.

Usually these supplements contain about 20 milligrams of this vital vitamin. This amount is good enough to help rectify the deficiency. It is important to take supplements approved by the FDA for treating inadequacy of this great vitamin

Under the supervision of a doctor, high doses of over-the-counter or prescription niacin or nicotinic acid can be used to treat high cholesterol, including high triglycerides.

However, too much of this vital vitamin or nicotinic acid can be harmful. Avoid taking more than your doctor prescribes or recommends

Recommended daily allowance of niacin

In order to avoid the deficiency, recent studies confirmed that the recommended daily allowance of this vital vitamin in adults is 6.6 niacin equivalents per 1000 kcal daily and not less than 13 niacin equivalents when there is an intake of less than 2000 kcal.

On the basis of those numbers, the “reference man” (3200 kcal) would need an intake of 21.1 niacin equivalents, and the “reference women” (2300 kcal) an intake of 15.2 niacin equivalents per day.

For children of 6 months or older, the same recommended intake of 6.6 niacin equivalents per 1000 kcal daily is accepted.

Younger infants necessitate 8 niacin equivalents per 1000 kcal, which can be fulfilled via breastfeeding by well-nourished mothers.

There is no evidence that pregnancy or lactation increase the requirement for this vital vitamin above the recommended intake.

Still, the United States National Research Council issued a recommendation for an additional 5.0 niacin equivalents daily for lactating women, based on the loss of 1.5 mg of this vital vitamin per 850 ml of breast milk and the additional energy invested to support lactation.

Bottom Line

A niacin deficiency can cause pellagra, which can be life-threatening and three D’s”: Dermatitis (skin pigmented rash), Diarrhea (gastroenteritis), and Dementia (widespread neurologic deficits particularly cognitive decline).

Evidence shows that this nutritional vitamin is useful for lowering blood lipid levels and increasing HDL cholesterol, it is also good for the treatment of skin conditions and prevention of Alzheimer’s disease. This deficiency is uncommon in western world.

It is important not to self-diagnose the deficiency of this vital vitamin, because some vitamins can be toxic if taken incorrectly, see your doctor or dietician for advice.

You can prevent or reduce this deficiency by eating foods rich in niacin or supplementing with caution because there are some severe side effects that can occur, including liver damage.

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