From the Guidelines
Vitamin B3 (niacin) deficiency is primarily caused by inadequate dietary intake, particularly in diets lacking essential nutrients, as well as certain medical conditions and medications that impair absorption and utilization of niacin. The primary causes of niacin deficiency include dependence on a corn-based diet, general malnutrition, chronic alcoholism, and general malabsorptive states such as prolonged diarrhea 1. Severe niacin and/or tryptophan deficiency leads to a variety of clinical symptoms, including diarrhea, dermatitis, and dementia, collectively known as “pellagra” or “the three D disease” and even death (four D) if not recognized and treated promptly 1. Some key factors that contribute to niacin deficiency include:
- Inadequate oral intake
- Poor bioavailability from grains
- Defective tryptophan absorption
- Carcinoid tumors
- Metabolic disorders
- Long-term use of chemotherapeutic treatments 1 The major risk factor for niacin deficiency is the ongoing consumption of a diet that relies mostly on non-fortified refined grains and grain products 1. Certain populations are at risk of niacin deficiency even in the context of supplemented food products, such as elderly people, pregnant women, and cancer patients undergoing treatments that induce DNA damage 1. Higher doses of niacin may be required when there is suspicion of niacin deficiency from at-risk clinical history and/or presence of signs or symptoms 1.
From the Research
Causes of B3 Deficiency
- A deficiency of nicotinamide or its precursor tryptophan can cause pellagra, a disease characterized by dermatitis, diarrhoea, and dementia 2
- Dietary deficiency diseases, such as those found in chronic alcoholics, can lead to B3 deficiency 2
- Certain medical conditions, including carcinoid syndrome and HIV infections, can also increase the risk of B3 deficiency 2
- Certain drugs, such as fluorouracil, isoniazid, chloramphenicol, and mercaptopurine, can contribute to B3 deficiency 2
- There is no direct evidence in the provided studies to suggest that other factors, such as thermal, acid, or guanidinium hydrochloride denaturations, are related to B3 deficiency 3