7 Things to Know About Vitamin B3 Deficiency

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Jennifer L.W. Fink, RN, BSN on February 6, 2021
  • Yellow pills arranged into the phrase B3
    Why Vitamin B3 Is Essential for Proper Health
    Every single cell in the human body requires vitamin B3 to function properly. Vitamin B3, also called niacin, helps convert food to energy. It also improves circulation, suppresses inflammation, and helps the body make sex and stress-related hormones. Because B vitamins are water-soluble vitamins, they can’t be stored in the body. If a person does not get sufficient amounts of vitamin B3 from food, a deficiency quickly develops. Without treatment, vitamin B3 deficiency can be fatal. Here are some other important facts about vitamin B3 deficiency symptoms and treatment.
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    1. B3 deficiency was a common–but unrecognized–cause of disease in the United States in the early 1900s.
    In the first part of the 20th century, the U.S. Public Health Service sent a doctor to the American South to address a disease epidemic characterized by cracked scaly skin, dementia and diarrhea. Hundreds of thousands of people had already died from this disease, but no one knew what caused it. Most people thought it was a contagious illness, but physicians eventually proved it was caused by a poor diet and later discovered vitamin B 3 was the key.
  • Multi-racial family smiling and enjoying healthy meal together
    2. Vitamin B3 deficiency is now rare in most developed countries.
    By the 1950s, food producers were routinely adding niacin to breads and cereals. As a result, the incidence of vitamin B3 deficiency decreased dramatically. Today, wherever people have access to a wide variety of foods, vitamin B3 deficiency is rare. For most people, eating lean meats, poultry, eggs, fish, dairy products, and other vitamin B3-rich foods, on a regular basis, can prevent vitamin B3 deficiency. However, people who are living in poverty and lack access to healthy foods remain at risk.
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    3. Mouth and skin sores can be symptoms of vitamin B3 deficiency.
    Vitamin B3 deficiency symptoms include fatigue, indigestion, nausea, vomiting, diarrhea, mouth sores, a swollen bright red tongue, poor circulation, and depressed mood. Cracked scaly skin that is highly sensitive to the sun is another symptom of vitamin B3 deficiency. Other symptoms include insomnia, confusion, headache and weight loss. In time, vitamin B3 deficiency can cause delusions, dementia and death.
  • Young Caucasian woman receiving dialysis
    4. Some chronic medical conditions can cause B3 deficiency.
    If you have a digestive disorder that affects your body’s ability to absorb nutrients from food, you’re at increased risk of vitamin B3 deficiency. Crohn’s disease, which affects almost 800,000 Americans, can cause vitamin B3 deficiency. So can Hartnup’s disease, a rare hereditary disorder, and a condition called carcinoid syndrome. People on dialysis and people who have cancer or HIV also have an increased risk of niacin deficiency. Your healthcare provider can help you understand your risk and design a treatment plan to help you avoid developing a deficiency.
  • Close-up of glasses of beer being raised in a toast
    5. Drinking too much alcohol can lead to vitamin B3 deficiency.
    Chronic alcoholism can cause vitamin B3 deficiency because it affects both the intake and absorption of vitamin B3. Drinking excessive amounts of alcohol blunts the appetite, so people who are chronic alcoholics may not be eating enough food to sustain a healthy level of vitamin B3. Over time, chronic alcohol intake also affects the body’s ability to absorb and use niacin. Some doctors routinely prescribe niacin to people with alcohol use disorders.
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    6. Pellagra is a disease caused by severe B3 deficiency.
    Mild vitamin B3 deficiency causes relatively mild symptoms, including indigestion, fatigue and canker sores. Severe, persistent vitamin B3 deficiency causes a disease called pellagra. The symptoms of pellagra include scaly skin, dementia and diarrhea. Without treatment, pellagra can be deadly. Between 1900 and 1950, nearly 90,000 Americans died from pellagra. Today, the disease still affects people who eat mostly corn or sorghum and little else.
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    7. B3 deficiency is easy to treat.
    Adding vitamin B3 to the body can cure vitamin B3 deficiency. If you have a slight B3 deficiency, increasing your intake of niacin-rich foods may be enough to bump your levels up to the normal range. Good sources of niacin include fortified breads and cereals, beets, sunflower seeds, peanuts, tuna, salmon, and beef liver and kidney. Physicians use nicotinamide, a form of niacin, to treat severe vitamin B3 deficiency. Treatment is typically administered daily over a period of about a month. Regular intake of foods containing vitamin B3 is necessary to prevent a recurrence.
7 Things to Know About Vitamin B3 Deficiency | Niacin Deficiency

About The Author

Jennifer L.W. Fink, RN, BSN is a Registered Nurse-turned-writer. She’s also the creator of BuildingBoys.net and co-creator/co-host of the podcast On Boys: Real Talk about Parenting, Teaching & Reaching Tomorrow’s Men. Most recently, she is the author ofThe First-Time Mom's Guide to Raising Boys: Practical Advice for Your Son's Formative Years.
  1. Vitamin B3 Deficiency. British Medical Journal. https://bestpractice.bmj.com/topics/en-us/634
  2. Pellagra and the 4 Ds. Creighton University. http://blogs.creighton.edu/heaney/2013/11/18/pellagra-and-the-four-ds/
  3. Vitamin B3 (Niacin). Icahn School of Medicine at Mount Sinai. https://www.mountsinai.org/health-library/supplement/vitamin-b3-niacin
  4. Pellagra. U.S. National Library of Medicine. https://medlineplus.gov/ency/article/000342.htm
  5. Pellagra. American Osteopathic College of Dermatology. https://www.aocd.org/page/Pellagra
  6. Niacin. Oregon State University. https://lpi.oregonstate.edu/mic/vitamins/niacin
  7. Nutrition Recommendations for Those Who Consume Alcohol. Boulder Medical Center. https://www.bouldermedicalcenter.com/nutrition-recommendations-consume-alcohol/
  8. Prousky, J.E. (2014). The Treatment of Alcoholism with Vitamin B3. Journal of Orthomolecular Medicine 29(3):123-131, Available online at https://www.isom.ca/wp-content/uploads/The-Treatment-of-Alcoholism-with-Vitamin-B3-29.3.pdf
  9. Pellagra and Its Prevention and Control in Major Emergencies. World Health Organization. https://www.who.int/nutrition/publications/en/pellagra_prevention_control.pdf
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Last Review Date: 2021 Feb 6
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