Niacin (vitamin B3) deficiency (pellagra)

Overview

A shortage usually develops slowly over months from a poor diet, trouble absorbing nutrients, heavy alcohol use, or some medicines and surgeries.

Supplements can fix it, but more is not always better.

Symptoms

Common signs:

• Rash on sun-exposed skin
• Rash on sun-exposed skin with diarrhea or confusion, or low niacin (vitamin B3)

Less common

• Diarrhea
• Confusion
• Sore tongue

Look up a symptom: New confusion or not acting like themselves

When to get medical care

Causes

Low intake, poor absorption, alcohol, some medicines.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• Heavy alcohol use
• Weight-loss surgery
• Restricted diets
• Older age

Diagnosis

A blood test usually confirms it.

Questions you may be asked

• Diet, alcohol use, stomach or weight-loss surgery
• Medicines

The exam

A physical exam.

Tests

Tests, if needed:

• Blood test:

Treatment

Replacing the nutrient usually brings fast improvement.

Self-care

• Eat a varied diet with the foods listed above
• Take supplements as directed by your clinician
• Limit alcohol
• Ask about checks if you've had weight-loss surgery

Shots or high-dose supplements for severe shortages.

Prevention

To prevent a shortage:

• Eat a balanced diet
• Ask about supplements in pregnancy or after surgery

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• A registered dietitian can help plan meals.

Living with it

Support groups and helplines

• Genetic and Rare Diseases Information Center (GARD): Free NIH information on rare diseases, including where to find experts and patient groups.
• National Organization for Rare Disorders (NORD): Patient groups, help finding care, and aid programs for rare diseases.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

Most people recover fully once levels are restored.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

• A list of your medicines and supplements
• Notes on when symptoms started and what makes them better or worse

Questions to ask

• Should I take a supplement, and how much?
• What caused the shortage?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Niacin (vitamin B3) deficiency (pellagra)