Pellagra are of two types primary and secondary pellagra Primary pellagra can be caused by lack of tryptophan or niacin in diet .Tryptophan can be converted to niacin in the body so not getting enough tryptophan can cause niacin deficiency. Secondary pellagra occurs when our body can’t absorbs niacin .The general causes which prevent our body from absorbing niacin are: GI diseases ,such as ulceration colitis & crohns disease, Alcoholism, cirrhosis of liver , eating disorders, certain medications, including immunosuppressive drugs & anticonvulsants
Risk factors includes staple diet, which is poor in niacin ( Indian millet, maize or jowar ) , human immunodeficiency virus ((HIV ) , Eating disorders, medications such as (carbamazepine,isoniazid, pyrazinamide, carbidopa, chloramazepine, phenobarbital, phenytoin), alcohol abuse etc .
3 D’s ( dermatitis, dementia & diarrhoea) niacin deficiency is mostly noticeable in our body parts like gastrointestinal track and our skin Dermatitis causes rashes on lips, face, hands & feets & sometimes around the neck , which is known as casal necklace. The others symptoms includes: burning patches of skin, itchy,red, flaky skin , discoloration ranges from red to brown. Scaly , crusty, thick or cracked skin , apathy, depression etc
Biochemical tests to confirm the diagnosis are urinary N’ - methyl nicotinamide or red cell NAD, blood counts, hypoproteinemia, higher levels of serum calcium, serum porphyrin levels , serum porphyrin levels , liver function test results.
Pellagra can be cured by a good diet containing adequate amount of protein, tryptophan and /or niacin as well as other members of B- complex group of vitamins. A moderately severe case requires nicotinic acid or amide in doses of 100 - 300 mg/day orally. Mental symptoms respond within 24 -48 hours and dermal lesions required t3-4 weeks of therapy. Most cases of pellagra require riboflavin and pyridoxine particularly for neurological manifestations. Oral therapy is satisfactory in all cases except in those with very severe diarrhea.
Pellagra can be prevented by the following measures: • Consuming sorghum with good quality proteins. • Replacing sorghum with other serials. • Distribution of yeast and niacin tablets as public health program. • Fortifying bread with niacin. • Developing low leucine strains of sorghum. • Including groundnuts in everyday diet.
Do's & Don’t's
|Consume foods rich in niacin (B3)
|Avoid excessive alcohol consumption
|Eat a balanced diet with whole grains, meat, fish
|Don't rely solely on a few food groups
|Include vegetables like mushrooms, avocados
|Avoid prolonged exposure to sunlight
|Seek medical attention for symptoms
|Don't self-diagnose and delay medical consultation
|Take niacin supplements if prescribed
|Don't ignore symptoms of pellagra
|Protect skin from direct sunlight
|Avoid diets lacking in essential nutrients
If you suspect you or someone else is experiencing Pellagra, it is crucial to seek immediate medical attention by calling emergency services or consult with a Nutritionist.