1. NIACIN Presented by: Jesika Knitter

2. Also known as… Vitamin B3 Nicotinic Acid A component of the “Vitamin B Complex” Note: Tryptophan is an amino acid that the body converts into niacin during digestion.

3. Water-soluble Vitamin Water-soluble vitamins are not stored in the body Once ingested: vitamin is absorbed, metabolized, and excreted Must be consumed regularly http://paulej.hubpages.com

4. Food Sources dairy products eggs breads sunflower seeds nuts cereals beets yeast lean meats Legumes consume 15 mg per day http://vafoods.org

5. Why is Niacin important Converts carbohydrates into glucose; glucose helps to fuel the body Major component of the digestive system, skin, nerves, eyes, liver, and conversion of food to energy Aids in circulation, production of sex hormones, and stress-related hormones Helps the body to utilize fats and proteins Picture from http://washu.spoonuniversity.edu

6. Pellegra - Niacin Deficiency Pellegra means “Raw Skin” in Italian Reasons for deficiency Lack of nutrient in diet Metabolic disorders Alcoholism Diseases effecting absorption http://itnutrizionista.eu http://www.pennmedicine.org

7. “Flushing” – Niacin Excess Niacin flushing is the vasodilation of blood vessels close to the skin, along with a hot, tingly sensation. Occurs when at least 50 mg of niacin are ingested. http://side-effects-site.com

8. Systemic Implications Too little Pellegra High cholesterol Brittle hair Unhealthy eyes Nerve disorders Too much Liver damage “Flushing” sensation GI disorders Just right Reduces cholesterol Blood vessel dilation

9. Oral Implication of Deficiency Limits antibody synthesis and phagocytosis Hinders metabolic reactions of epithelial and connective tissues Inflammation Vulnerability of oral pathology (candidiasis) Canker sore Bright, beefy tongue

10. Medical Management Increase or decrease niacin intake to recommended dosage of 15 mg/day via diet or supplements If niacin deficiency still occurs – explore metabolic or absorption disorders Question patient about alcohol consumption

11. Dental Hygiene Considerations Patients may present with a bright, beefy tongue May experience burning sensation of the tongue Oral tissue may be inflamed Be cautious of sensitive skin (dermatitis) and/or nerve damage in rare cases Refer to specialist if nerve damage and/or dermatitis is suspected Urge patient to follow diligent homecare Increase recall appointment to manage inflamed tissue

12. Nutritional Counseling Urge patient to keep a food diary Seek nutritional counseling for deficiency Remind patient that niacin needs to be replenished frequently as it is a water- soluble vitamin http://www.wholify.com