A niacin deficiency is a serious, life-threatening condition that is most common in countries where food is scarce. It can also happen if you have certain health conditions or trouble accessing nutritious foods.
This article discusses signs of niacin deficiency and how to increase niacin in your diet.
Niacin Deficiency Symptoms
Symptoms of a slight niacin deficiency can be so mild that you don’t notice them at first. But if this deficiency continues, it can lead to a condition called pellagra. Pellagra has some key characteristics known as “the four Ds,” which generally appear in this order:
Diarrhea Dermatitis (skin irritation) Dementia Death
Signs and symptoms of pellagra can include:
Nausea, vomiting Diarrhea, constipation Bright red tongue Rash that resembles sunburn and may darken in sunlight Blisters, skin sloughing (peeling, shedding) Headaches Insomnia, fatigue Depression, hallucinations, paranoia Suicidal behavior Aggressiveness Memory loss, apathy Loss of appetite
Without treatment, pellagra can lead to death within a few years.
Causes
Niacin is an essential nutrient. In the United States, many common foods are enriched with B vitamins, so niacin deficiency is rare.
How much niacin you need every day depends on your age and sex.
Risk Factors for Niacin Deficiency
It can be challenging to get enough niacin if you don’t have regular access to nutritious foods. The condition that results is called primary pellagra. Secondary pellagra is when you’re malnourished due to conditions such as:
Human immunodeficiency virus (HIV) Alcohol use disorder Anorexia (eating disorder causing an abnormally low body weight) Cirrhosis (late-stage liver disease) Carcinoid syndrome (a rare form of tumor) Hartnup disease (inability to absorb amino acids) Inflammatory bowel disease (IBD)
How to Test for Niacin Deficiency
A healthcare provider may be able to make the diagnosis based on your symptoms. You can confirm this by taking a simple blood test.
Your healthcare provider might also order a urine test. This may involve a random urine sample or a 24-hour urine test. A laboratory analysis can determine if you’re deficient in niacin and other B vitamins.
How to Get More Niacin
Many foods contain niacin naturally. You can also find it in fortified foods like bread and cereals. Some good sources of niacin are:
Meats and meat products, particularly beef liverPoultry, such as turkey and chickenMarinara sauceFish, such as salmon and tunaNuts and legumesWhole grains, enriched bread, rice, cereals
You can take a dietary supplement if you don’t get enough niacin through diet. You can get niacin in multivitamins, B-complex vitamins, and B3 vitamins. A healthcare provider can make a recommendation based on your test results and overall health.
Can You Have Too Much Niacin?
Taking too much niacin should be avoided. Unless your healthcare provider prescribes a higher amount, don’t take more than the upper limit, which is 35 milligrams per day for adults.
Higher doses can cause a reaction called “niacin flush.” Symptoms of niacin flush include redness of the skin (face, arms, and chest), tingling, burning, and itching. Symptoms usually go away within a half hour. While it’s not dangerous, it can be somewhat uncomfortable.
In some cases, flushing is accompanied by other symptoms such as:
HeadacheRashDizzinessBlood pressure changes
Summary
Niacin, or vitamin B3, is essential to life. It provides you with energy and keeps your skin and nervous system functioning. Niacin deficiency, known as pellagra, is serious and life-threatening. Symptoms may be mild initially but can escalate to severe digestive, skin, and nervous system problems. Many foods are fortified with niacin. You can also get niacin by taking dietary supplements. Work closely with your healthcare providers or a dietitian to ensure you get the necessary nutrients.
A Word From Verywell
Over time, symptoms of niacin deficiency get more severe and dangerous. Eating foods rich in niacin can help prevent this from happening. If you already have symptoms of niacin deficiency, see a healthcare provider as soon as possible. A simple blood or urine test can determine if that’s the case. Some dietary changes or supplements can improve symptoms and help you quickly feel better.
