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Niacin deficiency is a consequence of a diet low in both niacin and the amino acid tryptophan, a precursor for the vitamin. Low plasma tryptophan is a non-specific indicator, meaning it can have other causes. The signs and symptoms of niacin deficiency start to revert within days of oral supplementation with large amounts of the vitamin. [23] [24]
Independently of clinical symptoms, blood level of tryptophan or urinary metabolites such as 2-pyridone/N-methylnicotinamide ratio <2 or NAD/NADP ratio in red blood cells can diagnose pellagra. The diagnosis is confirmed by rapid improvements in symptoms after doses of nicotinamide (250–500 mg/day) or nicotinamide enriched food. [7]
Example of a label showing the amount of niacin (Vitamin B3), and specifying to be niacinamide in the ingredient section.. The United States Government adopted the terms niacin and niacinamide in 1942 as alternate names for nicotinic acid and nicotinamide, respectively, and encouraged their use in nontechnical contexts to avoid the public’s confusing them with the nearly unrelated (and toxic ...
According to the World Health Organization, an alternative mean of expressing urinary N1-methyl-nicotinamide is as mg/g creatinine in a 24-hour urine collection, with deficient defined as <0.5, low 0.5-1.59, acceptable 1.6-4.29, and high >4.3 [11] Niacin deficiency occurs before the signs and symptoms of pellagra appear. [6]
Tea and toast syndrome is a form of malnutrition commonly experienced by elderly people who cannot prepare meals and tend to themselves. The term is not intrinsic to tea or bread products only; rather, it describes limited dietary patterns that lead to reduced calories resulting in a deficiency of vitamins and other nutrients.
Pellagra, a similar condition, is also caused by low nicotinamide; this disorder results in dermatitis, diarrhea, and dementia. [ citation needed ] Hartnup disease is a disorder of amino acid transport in the intestine and kidneys; otherwise, the intestine and kidneys function normally, and the effects of the disease occur mainly in the brain ...
Diagnosis is typically made based on clinical suspicion and a low zinc level in the blood. Any level below 70 mcg/dL (normal 70-120 mcg/dL) is considered zinc deficiency. However there is a paucity of adequate zinc biomarkers , and the most widely used indicator, plasma zinc, has poor sensitivity and specificity . [ 53 ]
Liver disease or kidney disease: Niacin can accumulate in people with liver or kidney problems, potentially worsening their condition. [ 1 ] Bleeding disorders : Inositol nicotinate may slow blood clotting, increasing the risk of bleeding for individuals with clotting disorders or those undergoing surgery.