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Health Options
Alan Titchenal & Joannie Dobbs
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Niacin cures now-rare skin condition
In the early 20th century, great misery was caused by the disease pellagra. "Raw skin" is the literal meaning of pellagra because a severe skin irritation occurred in victims. The dermatitis was followed by diarrhea, dementia, and even death in some cases. Finally, in 1937, the cure for this mysterious disease was identified to be the vitamin niacin.
Today, pellagra is uncommon in most countries. But the disease does show up as a consequence of some modern medical conditions and it continues to be a serious problem in countries with very limited food supplies.
Question: Who gets pellagra today?
Answer: Modern-day pellagra is showing up in some cases of anorexia nervosa. People with this condition eat little food and may completely avoid specific foods. Also, pellagra cases are being observed in people who strictly avoid several types of foods. This type of eating behavior can occur when someone associates many types of foods with their health problems and greatly restricts their diet.
Many cases of pellagra are reported in humanitarian emergencies often due to wars. Even two years after the war in Angola, researchers were reporting pellagra to be a common problem.
Q: What foods are rich in niacin?
A: Recommended intake for adults is about 15 milligrams per day. Three ounces of light meat chicken, tuna, or swordfish provide about 10 milligrams. The same amount of most other fish, lean red meat, and dark meat chicken parts contain about 5 milligrams. A cup of cooked brown rice or enriched noodles has about 3 milligrams and a slice of whole grain bread or enriched white bread delivers about one milligram. Breakfast cereals fortified with niacin commonly contain 5 to 20 milligrams per typical one-ounce serving.
Q: Why is high-dose niacin sometimes used to treat people with cardiovascular disease?
A: One form of niacin, called nicotinic acid, is given in extremely high doses of 1,000 to 4,000 milligrams per day to medically treat high-risk cholesterol levels. This treatment typically raises blood levels of the "good" HDL cholesterol and lowers the "bad" LDL cholesterol.
A side effect of taking these high doses of nicotinic acid is a flushing sensation, with reddening of the skin and burning, tingling, and itching sensations shortly after taking a high dose. Medical supervision is absolutely required because of interactions with many other medications and a potential for liver damage.
To avoid the niacin flushing effect, the Institute of Medicine recommends that adults keep niacin consumption below 35 milligrams per day.
Alan Titchenal, Ph.D., C.N.S. and Joannie Dobbs, Ph.D., C.N.S. are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii-Manoa. Dr. Dobbs also works with University Health Services.