Pellagra is one of the multiple health problems caused by vitamin deficiencies. Vitamins are highly underrated in this fast-food world and it is common in developing countries.

This disease is caused by the deficiency or absence of vitamin B3, also known as niacin. It can be fatal if left untreated as it causes diarrhea, dementia, and dermatitis, hence the second name of pellagra; three Ds.

Symptoms of Pellagra

The three main symptoms of pellagra are:

  • Dementia
  • Dermatitis and

This is why it is also known as the “three Ds”. The body parts that show the most symptoms of niacin deficiency are the nerves, skin, and digestive system.

Dermatitis caused by vitamin B3 deficiency is characterized by:

  • Rashes on the face, feet, lips, and hands
  • A rash known as “Casal necklace” or “Casal collar” can also form around the neck. The affected area might look like sunburn and become sensitive to light.
  • Red, inflamed, and flaky skin
  • Discolored areas on the skin which can range from red to brown
  • Cracked, scaly, thick, inflamed, and crusty skin, especially around the corners of the mouth. This is known as Cheilitis.
  • Burning and itchy patches of skin
  • Angular palpebritis, a condition characterized by redness and cracking in the corners of the eyelid.

Nerve (neurological) symptoms appear earlier but they are quiet difficult to diagnose. So, in some cases, the disease progresses until it gets to the stage of dementia. Neurological symptoms of pellagra are:

  • Delusions or disorientation
  • Anxiety and restlessness
  • Headaches
  • Memory loss
  • Mood swings, irritability, and confusion
  • Depression
  • Delusion
  • Apathy
  • Psychosis in some cases

Gastrointestinal symptoms of pellagra are:

  • Nausea and vomiting
  • Diarrhea at least three times a day
  • Loss of appetite
  • Abdominal pain
  • Indigestion
  • Swelling of the tongue and oral ulcers

Symptoms of alcohol-induced pellagra are:

  • Exaggerated responses to threats and startle
  • Stiff muscles that are difficult to use
  • Intermittent confusion

Other signs and symptoms are:

  • Difficulty eating and drinking
  • Sores on the gums, tongue, and lips

Types of Pellagra

There are 2 types of pellagra; primary and secondary pellagra.

Primary Pellagra

This is caused by wrong diets or diets deficient in Niacin (vitamin B3) and tryptophan. The body converts the amino acid tryptophan into niacin.

A deficiency of tryptophan can also cause vitamin B3 deficiency.

People who eat corn as a staple food are prone to niacin deficiency and pellagra because corn contains niacytin. This is a form of niacin but humans cannot digest and absorb it until the corn is properly prepared.

Primary pellagra can cause death in 4 to 5 years if it is left untreated.

Secondary Pellagra

This type occurs due to a digestive problem when the gut is unable to absorb nutrients. Pellagra can occur when your boy can’t absorb niacin even if you eat a diet rich in niacin.

Excessive intake of alcohol is a risk factor for this. The majority of people with alcohol use disorder suffer from secondary pellagra. Alcohol promotes malnutrition by preventing the body from absorbing nutrients like vitamin B3.

It also prevents the body from converting certain proteins (amino acid tryptophan) into niacin thus increasing your risks of the three Ds.

Alcohol-induced pellagra is difficult to diagnose because it has the same symptoms as alcohol-withdrawal delirium. So, the best thing you can do for yourself is to quit taking alcohol.

Factors that affect your gut and impair digestion and absorption and cause secondary pellagra are:

  • Hartnup disease,
  • Carcinoid tumors
  • Liver cirrhosis
  • Ulcerative colitis, Crohn’s disease, and other gastrointestinal problems
  • Some medications like immunosuppressive drugs, isoniazid for TB, and anti-convulsants
  • Eating disorders
  • End-stage cancers
  • Dialysis
  • HIV, anorexia, homelessness, and other conditions that cause malnutrition

Potent Ways to Handle Pellagra Naturally



This is the first step you have to take to heal your gut. This will handle problems related to absorption and digestion. A digestive cleanse will help you achieve this.

This will set the right conditions for your digestive system to function properly and absorb nutrients well. A digestive cleanse can be done by taking laxative herbs or a colon cleanse formula.

You can also do regular enemas to help your body expel the wastes and toxins.

Change of diet

Nutritional deficiencies happen when people replace healthy foods with junk and fast foods. A change of diet will help supply your body with niacin, tryptophan, and other essential nutrients.

This will correct the deficiency and help relieve the symptoms of pellagra.


Quality supplements can be taken to help increase the levels of niacin and tryptophan in your body. Nicotinamide is another form of vitamin B3 that can be prescribed for you.

Supplementation can hasten recovery if the condition is diagnosed and treated early. Most people start feeling better after a few days of supplementation.

Your skin will improve after several months. Secondary pellagra also responds well to supplementation.

Intravenous application

In severe cases of this disease, supplements can be given intravenously to hasten recovery and remedy the situation. Intravenous application is usually carried out when absorption problem and diarrhea would interfere with the supplement.

Treat the Underlying causes

This is most effective when handling secondary pellagra. You have to treat the underlying cause of this deficiency before your body can absorb niacin (vitamin B3).

Increase your intake of water

Water is the best remedy for most diseases. It removes harmful toxins and wastes substances from the body by bringing them out of the body in the form of sweats or urine.

This will relieve the inflammation going on inside the body. Water also increases the absorption of nutrients. Drink at least 3 liters of water daily to make the treatment effective.

Natural Sources of Niacin (vitamin B3) and Tryptophan

Vitamin B3/Niacin is an essential mineral. This means you must get it from your foods because your body cannot produce it.     This micronutrient is needed for optimum metabolism.

It is also a powerful antioxidant and it boosts the proper functions of the nervous system. Vitamin B3 is a water-soluble nutrient, thus, surplus is excreted through the urinary system. It is not stored in the body, so this is one of the reasons why you need a daily intake of niacin-rich foods.

Top natural sources of niacin are:


The liver from grass-fed animals is one of the best sources of niacin. 3 ounce of grass-fed beef liver contains 14.7 mg of niacin. This is 71% of men’s RDA and 100% of women’s RDA.

Chicken liver is also a good source of Niacin, it provides 73% of men’s RDA and 83% of women’s RDA. Aside from niacin, liver is also packed full of other nutrients like choline, B-vitamins, proteins, and iron.


Poultry birds are rich in niacin, most especially chicken breasts and turkey. 3 ounces of cooked chicken breasts contain 11.4 mg of niacin. Chicken thighs contain half this amount.

Aside from niacin, chicken is an excellent source of lean protein and has low calories. Turkey, on the other hand, contains less niacin when compared to chicken but it is rich in tryptophan.

The human body converts tryptophan into niacin. The tryptophan in turkey can produce roughly 1 mg of niacin and turkey contains 6.3 mg of niacin.

Tryptophan is also used in making serotonin, a powerful mood regulator, and the sleep hormone, melatonin.

Oily fish

Tuna is a rich source of niacin and a good alternative for people who don’t eat meat. 165 grams of tuna provides 21.9 mg of niacin and this passes the RDA recommendation for both sexes.

Aside from niacin, oily fish is also high in omega-3 fatty acids, selenium, vitamin B12, vitamin B6, and proteins. The drawback of tuna is that it has a high risk of mercury toxicity.

You can eat a serving of tuna once a week to reduce the amount of mercury entering your body. This is safer for most people.

Wild-caught salmon is another rich source of niacin. 3 ounces of salmon gives men 51% of the RDA and women 61% of their RDA. It is also rich in omega-3 fatty acids which reduces inflammation and the risks of autoimmune diseases and heart disease.


This is a very inexpensive way to increase your level of vitamin B3. One anchovy gives you 5% of your RDA. You can get half of your niacin requirement each day by eating 10 anchovies.

These tiny fishes are also rich in selenium. This important nutrient reduces your risks of cancers.


Lean beef is a good source of niacin, it is also rich in proteins, zinc, selenium, B12, and protein. 85 grams of lean beef contains 6.2 mg of niacin.

Grass-fed beef is better than commercially-raised beef as it contains more omega-3 fatty acids and fewer antibiotics and growth hormones. It also contains more antioxidants than grain-fed beef.


Lean pork is also rich in niacin as well. 3 ounces of roasted pork contains 6.3 mg of niacin. It is also rich in thiamine, also known as vitamin B1. This is a key nutrient for healthy body metabolism.


Vegetarians will find peanuts very important since they don’t eat meat and animal products. Peanut is one of the richest plant sources of vitamin B3.

2 tablespoons of peanut butter contain 4.3 mg of niacin. They are also rich in vitamin E, manganese, phosphorous, magnesium, vitamins B6 and E, monounsaturated fats, and proteins.

They also reduce your risks of cardiovascular diseases and type II diabetes.

Whole wheat

Whole wheat and its products like whole wheat bread and whole wheat pasta contain a high amount of vitamin B3. The outer layer of wheat kernels known as bran is rich in vitamin B3.


White potatoes with or without the skin are rich sources of niacin. One large baked potatoes contain 4.2 grams of vitamin B3.


A medium-sized avocado contains 3.5 mg on niacin. They are also rich in healthy (monounsaturated) fats, minerals, vitamins, and fiber.


This is one of the best vegetarian sources of niacin. A cup of mushrooms (70 grams) gives you 2.5 mg of niacin. You can grow your mushrooms under sunlamp or buy them from a reputable health store.

Brown rice

A cup of brown rice contains 21% of the RDA for women and 18% of the RDA for men. Brown rice is also rich in thiamine, magnesium, selenium, fiber, manganese, vitamin B6, and phosphorus.

Green peas

Another good vegetarian source of vitamin B3 and the niacin in green peas are highly absorbable. A cup of green peas contains 3 mg and peas are also rich in fibers and antioxidants.

Other niacin-rich foods are:

  • Asparagus
  • Sunflower seeds
  • Watercress
  • Oranges
  • Alfalfa
  • Ginger
  • Burdock
  • Lysine-rich foods
  • Blueberry
  • Broccoli
  • Oats
  • Gumweed
  • Fenugreek seeds
  • Coriander leaves
  • Parsley

They can be used in cooking, eaten raw, boiled as a tea, and also taken as smoothies.

Recommended Daily Allowance for Niacin

If you want to prevent this condition, you should include niacin-rich foods in your diet daily. The RDA for niacin is:

  • 6 to 16 mg daily for people under the age of 18
  • Pregnant and breastfeeding mothers need 18 mg daily
  • Adults need 14 to 16 mg daily

How to Take Care of Yourself While Treating Pellagra

While you are treating pellagra naturally and being on your new diet, there are ways you can look after your skin and alleviate skin problems.

Aloe vera

Aloe vera is a common herb with powerful healing properties. It is one of the best natural remedies for skin problems. This wonderful herb is rich in antioxidants, antiseptic, and anti-inflammatory properties.

Ingest aloe vera juice and apply the gel topically on the affected skin part. The gel should be applied three times daily and you sleep with it on your skin all through the night.

There are glycoproteins and polysaccharides in this gel that will help the skin heal and repair itself. They also ease swellings and inflammation.

Lavender essential oil

Lavender essential oil is good for topical applications. It alleviates burning, itching, and other skin symptoms because it is rich in antioxidants and anti-inflammatory properties.

This essential oil treats and prevents outbreaks and scaly skin. Sprinkle some of the oil on the affected skin part.

Coconut oil

Apply coconut oil to get relief from skin symptoms. This powerful oil helps the skin heal and rejuvenate. The affected skin part should always be moist with coconut oil.


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