Diarrhoea niacin

Oxidation of nicotine with chromic acid led to the isolation of pyridine-3-carboxylic acid, which was given the trivial name nicotinic acid. We now find that nicotinic acid derivatives, especially nicotinamide, are biochemically important. Nicotinic acid (niacin) is termed vitamin B3, though nicotinamide is also included under the umbrella term vitamin B3 and is the preferred material for dietary supplements. It is common practice to enrich many foodstuffs, including bread, flour, corn, and rice products. Deficiency in nicotinamide leads to pellagra, which manifests itself in diarrhoea, dermatitis, and dementia. 

The classical niacin deficiency disease is pellagra, which is characterized by symptoms including diarrhoea, dermatitis, dementia and eventually death. High-protein diets are rarely deficient in niacin since, in addition to the preformed vitamin, such diets supply sufficient tryptophan to meet dietary requirements. Large doses of niacin can cause the dilation of capillaries, resulting in a painful tingling sensation. 

In 1937, it was discovered that a nicotinic acid (niacin) deficiency leads to pellagra (a form of dermatitis, which occurs endemically where unprocessed millet and maize (Amer corn) are the staple food), and can also cause diarrhoea and dementia, or be even fatal. A daily dose of ten to twenty milligrams of nicotinic acid can prevent these deficiency signs. In the body, niacin is converted into the corresponding amide, an integral part ofthe nicotinamide nucloeotides (NAD, NADP). Niacin is produced industrially for animal feed by nitric acid oxidation of 5-ethyl-2-methylpyridine. 

Deficiency diseases pellagra (from the Italian rough skin ) occurs if diet Is deficient in BOTH niacin and tryptophan such as maize-based diets (dermatitis, diarrhoea, dementia)... 

Niacin deficiency, named Pellagra, is characterized by diarrhoea, dermatitis, dementia and death, which usually appear in this order. The clinical expressions of pellagra are diverse (Prousky et al. 2011). Diagnosis was, and still is, difficult due to the unpredictable appearance of the different signs and symptoms in individual patients (Prousky et al. 2011). Pellagra can be divided into primary and secondary forms. Primary pellagra results from inadequate niacin and/or tryptophan in the diet. Secondary pellagra occurs when other diseases or factors affect niacin requirements. 

Niacin requirements are also affected by diseases or conditions interfering with niacin absorption and/or processing, such as prolonged diarrhoea, chronic dialysis treatment, chronic colitis (particularly ulcerative colitis), cirrhosis of the liver, tuberculosis of the gastrointestinal tract, malignant carcinoid tumour and chronic alcoholism (Food and Nutrition Board 1998). Substantial individual differences (about 30%) in the conversion efficiency of tryptophan to niacin have been reported (Horwitt et al. 1981). 

Niacin deficiency leads to unwanted multisystemic problems that are often associated with dermatological changes. Pellagra is a condition in which niacin deficiency causes a symmetrical pigmented rash, thickened skin and superficial scaling which are found in sun-exposed body areas. The classic triad of niacin deficiency are the three D s—dermatitis, diarrhoea and dementia (Hegyi et al. 2004). Some of the effects on the central nervous system include depression, anxiety, restlessness and poor concentration. In addition, alcoholic individuals with poor nutrition can develop pellagroid encephalopathy (Cook et al. 1998). The role of niadn deficiency in cardiovascular disease and lipid metabolism remains to be fully explored. 

Niacin is a water-soluble vitamin that has been available as a lipid-lowering medication and in prevention of atherosclerosis for half a century (Ganji et al. 2003 Olsson 2010). Numerous studies have documented its beneficial effects on reducing cardiovascular disease (CVD) (Olsson 2010). Clinically, the most well-known effect of niacin deficiency is pellagra which, as noted above, is manifested by dermatitis, diarrhoea and dementia (Bodor and Offermanns 2008 Ganji, et al. 2003). In this chapter we look at the effects of niacin on human physiology and its consequent effects on disease states. 

Niacin is quickly absorbed through the stomach and intestine and severe deficiency is associated with diarrhoea, dementia and dermatitis. 

Pellagra A syndrome complex characterized by the three D s—dementia, dermatitis and diarrhoea—due to deficiency of vitamin B3 or niacin. 

NAD and NADP, which are important in redox reactions, are derivatives of niacin. Niacin is found in cereals in very small amounts, and is especially poor in maize. Pells ra is caused by niacin (B group) deficiency. It affects the skin, GI tract and the CNS. Remember the three Ds dermatitis, diarrhoea and dementia Pellagra can be cured by increasing the protein content of the diet, because nicotinic acid (niacin) can be formed in the body from tryptophan. Untreated deficiency causes death. 

Deficiency in animals affects the skin and digestive tract. Ruminants on green fodder usually do not require extra niacin, but niacin supplements improve milk yield in cows. Pellagra is a disease resulting from a combined deficiency of niacin and tryptophan. The symptoms of pellagra include dermatosis, dementia, diarrhoea and nervous disorders. Pellagra is rarely seen in industrialized countries and is associated with alcohol abuse. In other parts of the world where maize is the major staple diet, pellagra persists. 

The most marked indication of niacin deficiency is pellagra, where the skin is reddened as if sunburned on exposed surfaces along with cracking and shedding of the skin, inflammation of the tongue and diarrhoea. Pellagra was quite common in previous centuries in areas where... 

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