2.  First recognized in 1735, pellagra was the scourge of Europe and then the United States for two centuries.  Still seen occasionally in scattered populations of southern Africa, Egypt and India.  After American corn was introduced to Europe, food calories yielded per acre increased greatly over that yielded by rye and wheat.  Cornmeal became the main energy source for poor people.  Where corn went, pellagra followed.

3.  Clinically, pellagra is identified by the “four D’s.” dermatitis dementia diarrhea death

4.  Pellagrins are hypersensitive to sunlight.  Sun-exposed areas at first become red and thick with hyperkeratosis and scaling.  Followed by inflammation and edema, which eventually leads to de-pigmented, shiny skin alternating with rough, brown, scaly areas.  With repeated episodes of erythema, the skin becomes paper-thin and assumes a parchment- like texture.

5.  Because niacin is not available for metabolic processes, neurons in the brain degenerate with development of dementia.  Clinical symptoms: insomnia, anxiety, unjustified aggression and depression, are of the manic-depressive type.  Pellagrins can have unpredictable behavior.

6.  Often referred to as “the springtime disease,” pellagra increased in the spring when the new crops were not yet ready and cornmeal was large part of the diet.  Main protein in corn lacks two essential amino acids.

7.  A heat resistant preparation from liver was first used to treat pellagra.  It was found that the active ingredient is nicotinic acid (first named niacin) which can be synthesized by oxidizing nicotine from tobacco plants.  In 1935, it was found that nicotinic acid occurs throughout animal life associated with an enzyme.

8.  Derived from amino acid tryptophan.  Sources include yeast, meats, liver, fish, whole-grain products, peas, beans, nuts.  Functions: Essential component of NAD and NADP, coenzymes in oxidation-reduction reactions. In lipid metabolism, inhibits production of cholesterol and assists in triglyceride breakdown.

9.  Of the 20 amino acids in the human body, ten are essential amino acids:  Isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine (not synthesized at all) and arginine, histidine (inadequate amounts – especially for young)

10.  Niacin (Vitamin B 3 ) and Vitamin B 6 are part of B-family vitamins  They have multiple forms (different function!!!)  Tryptophan is the amino acid which gets converted into 5-HTP (a neurotransmitter) and Serotonin  Serotonin is then converted into Melatonin  Serotonin is a neurotransmitter that affects mood and appetite  Melatonin facilitates sleep

11.  B 6 is converted to a co-enzyme used in a WIDE variety of biochemical reactions  B 6 is found in vegetable and greens  Niacin (B 3 ) is found naturally in the husks of seeds such as brown rice  Niacin is also synthesized by the body from tryptophan using B 6  It takes about 60 mg Tryptophan to make 1 mg Niacin (daily requirement: 14-16 mg per day)

12.  Niacin (and some of its forms) are converted to NAD and NADP which are necessary for catabolism of fats, carbohydrates, proteins and alcohols  Niacin in available in a wide variety of foods  It has been added to bread flour since the 1930’s to prevent pellagra

13.  The body uses Tryptophan for many reactions  About 7% of tryptophan one consumes is available to be converted to Serotonin and Niacin  Tryptophan + Vitamin B6 → Niacin  Tryptophan → 5-HTP → Serotonin  Serotonin is converted to Melatonin

14.  Your body prioritizes what it needs  You need Niacin more urgently than Serotonin  If you are not getting enough Niacin, you will often end up being deficient in Serotonin and Melatonin because the body will switch to making Niacin  Enriched foods may or may not have the proper form of Niacin  Niacinamide is cheaper and more stable and it will prevent pellagra

15.  Niacinamide (as opposed to Nicotinic acid) does not trigger the switch in pathways back to making Serotonin once Niacin needs are met  If the deficiency is being met with Niacinamide enriched foods, your body will continue to use up available tryptophan for Niacin synthesis as if you still have a niacin deficiency  This could leave you with a lower amount of Serotonin and a decrease in available B 6.  A balanced diet DOES make a difference!