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Pellagra is a disease that occurs when a person does not get enough niacin (one of the B complex vitamins) or tryptophan (an amino acid).


Pellagra is caused by having too little niacin or tryptophan in the diet. It can also occur if the body fails to absorb these nutrients. It may develop after gastrointestinal diseases or with alcoholism, HIV/AIDS, or anorexia.

The disease is common in parts of the world where people have a lot of corn in their diet.


Symptoms of pellagra include:

  • Delusions or mental confusion
  • Diarrhea
  • Nausea (sometimes)
  • Inflamed mucus membranes
  • Scaly skin sores

Exams and Tests

Your health care provider will perform a physical exam. You will be asked about the foods you eat.

Tests that may be done include urine tests to check if your body has enough niacin. Blood tests may also be done.


The goal of treatment is to increase your body's niacin level. You will be prescribed niacin supplements. You may also need to take other supplements. Follow your provider's instructions exactly on how much and how often to take the supplements.

Symptoms due to the pellagra, such as skin sores, will be treated.

If you have conditions that are causing the pellagra, these will also be treated.

Outlook (Prognosis)

People often do well after taking niacin.

Possible Complications

Left untreated, pellagra can result in nerve damage, especially in the brain. Skin sores may become infected.

When to Contact a Medical Professional

Call your health care provider if you have any symptoms of pellagra.


Pellagra can be prevented by following a well-balanced diet.

Get treated for health problems that may cause pellagra.

Alternative Names

Vitamin B3 deficiency; Deficiency - niacin; Nicotinic acid deficiency


Brown TM. Pellagra: an old enemy of timeless importance. Psychosomatics. 2010;51:93-97. PMID 20332283 www.ncbi.nlm.nih.gov/pubmed/20332283.

Crook MA. The importance of recognizing pellagra (niacin deficiency) as it still occurs. Nutrition. 2014;30:729-730. PMID 24679717 www.ncbi.nlm.nih.gov/pubmed/24679717.

Kumar N. Neurologic presentation of nutritional deficiencies. Neurol Clin. 2010;28:107-170. PMID 19932379 www.ncbi.nlm.nih.gov/pubmed/19932379.

So YT, Simon RP. Deficiency diseases of the nervous system. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier; 2012:chap 57.

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Update Date 11/2/2014

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