Signs Of Deficiency:

Mild Deficiency. Many Americans probably suffer from mild niacin deficiency which causes mental fatigue, irritability, weakness, abdominal pains, constipation, skin irritations or infections, or sleeplessness. One reason for widespread niacin deficiency is the American reliance on highly refined, high carbohydrate foods. Niacin, like most B vitamins, metabolizes carbohydrates, so the large amounts of sugars and starches in many processed foods rob the body of niacin needed for other functions. Further, niacin, as other B vitamins, sometimes occurs in bound forms, meaning it is not released from the food to be available to the body. Cereal grains and corn, for example, actually contain considerable niacin, but in an unavailable bound form. Digestive disturbances are also present in early niacin deficiency. The stomach secretes little or no hydrochloric acid, absorption of nutrients is impaired, and the person has excessive gas and poorly formed, foul-smelling stools. Since food cannot be digested efficiently when a niacin deficiency has been present, recovery can be slow. Yogurt in copious quantities is helpful at first, because it supplies predigested protein, along with acidophilus bacteria to restore the normal gut flora, which make niacin and other B vitamins for us.

Pellagra – Early Stages. When there is too little vitamin B-3 in the food, the deficiency disease pellagra develops. The word pellagra is a corruption of the Italian pelle agra, meaning rough skin, and was first used in 1771 by Frapolli. Pellagra is a chronic deteriorating illness which invariably leads to death unless the vitamin B-3 is replaced. The first noticeable symptoms of niacin deficiency are entirely psychological. Victims may feel fearful, apprehensive, suspicious, and worry excessively with a gloomy, downcast, angry, and depressed outlook. They may experience headaches, insomnia, loss of strength, burning sensations all over the body, and oddly enough their sense of humor gets stifled. Their depression may range from “blue Mondays” to the wish to end it all, and just fold up under stress. They may become alienated recluses, who maintain a marginal existence by determinedly avoiding the stress of life. Pupils of the eyes are usually dilated, the eyes and eyelids move slowly, and there is a characteristic dull lifeless stare. There is an anxious or querulous expression around the eyes, which is so marked that it may sometimes be of diagnostic aid. The typical pellagrin is profoundly miserable. In some cases a niacin deficiency may act to dull the moral sensibilities, adversely affecting the individual’s behavior. Whereas in most people niacin deficiency causes depression or inability to concentrate, in others it may be the underlying cause of thoughtless promiscuity, pathological lying, or petty thievery.

Pellagra – Advanced States. Early pellagra produces a characteristic neurotic reaction, and later it produces a psychotic reaction – usually a schizophrenic syndrome. If the disease progresses, the clinical syndrome becomes an organic psychosis which, like all organic psychoses, resembles the senile psychoses. Pellagra in more advanced cases causes appetite loss, canker sores, halitosis, indigestion, muscular weakness, nausea, nervous disorders, skin eruptions, failing vision, hypersensitivity to light, illusions, vertigo, visual and auditory hallucinations, hyper-acute sense of smell, dulled sense of taste, persistent salty taste, persistent and intractable burning sensations in nerve endings usually the soles of the feet, and vomiting in severe cases. In more severe niacin deficiency, dermatitis (inflammation of the skin) develops symmetrically on exposed areas. First becoming slightly reddened, the skin itches and burns intensely, then becomes tense and swollen and eventually atrophies, its color fading to brown. Darkening of the skin, often seen in the elderly, is possibly partially due to niacin deficiency. For most people at least 3 grams of niacin must be used before there is any significant effect in lowering blood fats. Sometimes as much as 6 grams is required, with the slow release preparations being more effective. In a few experiments, it was found that 0.5 grams of slow release (SR) niacin was more effective than 6 grams for the same person. Niacinamide has no effect, for reasons which are still unknown. The earlier a person starts on vitamin supplementation with nicotinic acid or nicotinamide, the less dosage is required. The following dosages are recommended for people who do not feel that whole foods alone provide adequate nutrition. The closer you are to the age of senility, even if not senile, the more you should be taking preventive measures. Age 29-29 100 mg niacin after each meal. Age 30-39 300 mg niacin after each meal. Age 40-49 500 mg niacin after each meal. Age 50 and over 1,000 mg niacin after each meal. You can start with a low dose and gradually work up or begin with the full dose, but beware of an initial flush. If the flush is too irritating, you should start a low dosage and work up to the larger one slowly over a few weeks. A person needing the higher dosage generally will have the fewest side effects when beginning to use the vitamin. The optimum dose for vitamin B-3 is that quantity which is most effective in eliminating symptoms and has minimal or no side effects. This dose is maintained for life, but it may vary up or down. Because water-soluble vitamins such as niacin are excreted rapidly, it is best to divide the daily dosage into at least three doses. The slow release tablet minimizes side effects and reproduces more accurately the slow rate of release of nutrients during the digestion of food.

Pellagra and the Tongue. In mild niacin deficiency, the tip of the tongue is usually reddened from engorgement with blood, and the taste buds on the tongue’s surface are enlarged, giving a stippled appearance, the characteristic “strawberry tip.” Farther back, the tongue is coated white with bacterial growth and debris, often imparting a foul mouth odor. As the deficiency becomes chronic, deep mid-line cracks and crevices appear. Later, the tongue becomes red and swollen all over, accompanied by dental indentations of the margins, lending it a scalloped appearance. Finally, the enlarged taste buds atrophy, with loss of substance, and the tongue surface develops a glossy, bald appearance. The mouth becomes sore, the gums swollen and painful.

Therapeutic Uses: Acne, baldness, diarrhea, halitosis, high blood pressure, leg cramps, migraine headaches, night blindness, hypertension, poor circulation, stress, tooth decay. Therapeutic dose of 50 to 5,000 mg/day. Nicotinic acid is a broad-spectrum hypolipidemic (fat and cholesterol lowering) agent when 3-6 grams per day are used.

Related Diseases: Pellagra, cataracts, diabetes, gout, HIV/AIDS, hypothyroidism, rheumatoid arthritis, vertigo.

Toxicity From Overdose of Animal Or Synthetic Source: Relatively nontoxic. There are temporary (15 minute) side effects: tingling and flushing, both harmless (greater than 100 mg/day). The synthetic form, niacinamide, does not have the tingling and flushing side effects but acne and migraine headaches do not respond as well to niacinamide. Persons taking medication for high blood pressure cannot at the same time take niacin safely, as a full dose may cause a marked drop in blood pressure. Nicotinic acid should also be avoided in active ulcer disease, because of niacin’s acidity. But if the ulcer sufferer needs niacin, potassium nicotinate is reportedly tolerated well. Because niacin raises the uric acid level, it may bring on an attack in those suffering from gout. And since niacin raises blood sugar, diabetics may need to increase their insulin. For the same reason, hypoglycemics (low blood sugar) are often helped with niacin. IHN (inositol hexaniacinate) or “flush-free” niacin appears to be completely safe and without any side effects.

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