What Are Symptoms of Niacin Deficiency and How Do I Fix It?

Recommended Daily Intakes of Niacin
Age	Male	Female
19+ years	16 mg NO	14 mg NO
14–18 years	16 mg NO	14 mg NO
9–13 years	12 mg NO	12 mg NO
4–8 years	8 mg NO	8 mg NO
1–3 years	6 mg NO	6 mg NO
7–12 months	4 mg NO	4 mg NO
Birth to 6 months	2 mg	2 mg

Pregnancy and lactation increase niacin needs. People who are pregnant need 18 mg NE, while those who are breastfeeding need 17 mg NE per day.

You may obtain niacin from foods or supplements containing niacin or tryptophan-containing foods.

However, to convert tryptophan to niacin, you must have adequate levels of iron, riboflavin, and vitamin B6.

How Is a Niacin Deficiency Diagnosed?

If you suspect you have niacin deficiency, it’s essential to have it properly diagnosed.

To be diagnosed with niacin deficiency, a healthcare provider needs to complete a clinical evaluation.

A healthcare provider may ask about your health history and complete a physical exam during the evaluation.

While many signs and symptoms of niacin deficiency will be physically noticeable during a physical exam, others may not be.

Therefore, telling a healthcare provider about any neurological or gastrointestinal symptoms you have experienced that may be related to niacin deficiency is essential.

You may also be asked to provide a diet recall in which you’ll write down all the foods you have recently consumed.

A diet recall can help a healthcare provider pinpoint any gaps in your diet that may be contributing to a nutrient deficiency.

Although you may suspect a niacin deficiency yourself, only a qualified healthcare provider can properly diagnose you with one.

Putting off a trip to a healthcare provider’s office may delay treatment.

Niacin Deficiency Treatment

Niacin deficiency is treatable and may include dietary changes or taking supplements.

The World Health Organization (WHO) recommends treating niacin deficiency with 300 mg per day of nicotinamide for three to four weeks.

You may also need to take a vitamin B-complex supplement or yeast product to treat other possible B vitamin deficiencies.

Besides nicotinamide, nicotinic acid supplements or niacin supplements may also be used to treat niacin deficiency.

However, nicotinic acid and niacin supplements are more likely to cause facial flushing than nicotinamide supplements.

Eating more foods rich in niacin and tryptophan may also help treat niacin deficiency.

Food sources of niacin include:

• Meat, poultry, and fish
• Dairy products
• Eggs
• Enriched grains (bread, cereal, etc.)
• Brown rice
• Legumes
• Peanuts

Your body can convert small amounts of tryptophan to niacin, so eating more tryptophan-rich foods may help treat niacin deficiency. Tryptophan is found in foods like:

• Dairy products
• Fish and poultry
• Eggs
• Seeds
• Peanuts
• Soybeans

If you’ve been diagnosed with niacin deficiency, you should work with a healthcare provider to treat it properly.

Complications of Untreated Niacin Deficiency

If left untreated, niacin deficiency may become dangerous.

Skin sores caused by niacin deficiency may become infected if not treated. Untreated niacin deficiency may also lead to nerve damage, especially in the brain.

Other systems and organs may also be affected by untreated niacin deficiency.

Without treatment, niacin deficiency may cause intractable diarrhea (diarrhea that can’t be stopped), which is a potentially dangerous condition.

The brain and nervous system are especially vulnerable to untreated niacin deficiency.

Pellagrous encephalopathy, characterized by memory loss, disorientation, depression, delirium, and a reduced level of consciousness (stupor), may occur in severe, untreated cases.

Finally, untreated niacin deficiency may cause multiple organ failure and death.

Preventing Niacin Deficiency

For most people, niacin deficiency can be prevented with a well-balanced diet.

Whenever possible, try a food-first approach to reach your niacin needs. Your body typically absorbs nutrients better from food than from supplements.

Both plant and animal foods contain niacin, which means you can get all you need by eating a variety of foods.

Beef, chicken, turkey, and certain fish are high animal sources of niacin.

Brown rice, peanuts, and fortified breakfast cereals are great nonanimal sources of niacin.

To prevent niacin deficiency, regularly consuming all the B vitamins is important.

B vitamins are prevalent in protein foods (meat, eggs, dairy, etc.), leafy green vegetables, legumes, and fortified foods.

A niacin supplement or B vitamin complex may be necessary for some people to treat niacin deficiency.

However, niacin supplements should only be used if a healthcare provider recommends them, as high doses of niacin may cause flushing and other side effects.

If you may be at risk for niacin deficiency, talk with a healthcare provider about ways to help prevent it.

Summary

Niacin is a B vitamin that your body needs for many important functions, including energy production.

Niacin deficiency occurs when you don’t have enough niacin in your body. It may be caused by a poor diet, alcohol abuse, or various health conditions that prevent proper niacin absorption and utilization.

You may be at a higher risk for niacin deficiency if you live in an area with food scarcity or if you have certain health conditions. Signs and symptoms of niacin deficiency vary but may include the “three D’s,” diarrhea, dermatitis, and/or dementia.

Niacin deficiency should be diagnosed and treated by a healthcare provider. Untreated niacin deficiency may lead to severe complications, including death.

Fortunately, niacin deficiency can be prevented with a balanced diet and care from a qualified healthcare provider.