Understanding Which Vitamin is Known as an Anti Pellagra Vitamin

January 4, 2026 •

3 min read

According to the Centers for Disease Control and Prevention (CDC), the discovery of niacin's link with pellagra and nutritional improvements led to its virtual elimination in the U.S. by the 1950s. Niacin, also known as Vitamin B3, is the vitamin known as an anti pellagra vitamin.

Quick Summary

Niacin, or Vitamin B3, is the vitamin known as an anti-pellagra vitamin because a deficiency causes the disease. It is a vital nutrient for cellular energy and DNA repair, and its deficiency leads to symptoms affecting the skin, digestive system, and brain. Treatment involves supplementation and addressing underlying causes.

Key Points

Niacin is the anti-pellagra vitamin: Also known as Vitamin B3, niacin's deficiency is the direct cause of the systemic disease pellagra.
Pellagra presents as 'the four Ds': The classic symptoms include dermatitis, diarrhea, dementia, and potentially death if left untreated.
Primary pellagra is dietary: This form is caused by low intake of niacin or its precursor tryptophan, often from corn-heavy diets without proper preparation.
Secondary pellagra is due to malabsorption: Conditions like alcoholism, GI disease, and certain medications prevent the body from absorbing or utilizing niacin effectively.
Dietary fortification ended epidemics: The discovery of niacin as the cure led to food fortification programs, making primary pellagra rare in many parts of the world.
Treatment is effective and rapid: Supplementing with niacin, often as nicotinamide, typically resolves symptoms within days or weeks.

What is Pellagra and the Role of Niacin?

Pellagra is a disease resulting from a severe deficiency of niacin, also known as Vitamin B3. The name "pellagra" comes from Italian words meaning "rough skin," which describes one of its primary symptoms. Niacin is a crucial water-soluble vitamin that helps the body convert food into energy. It is vital for numerous metabolic processes due to its role in coenzymes like NAD and NADP. Tissues with high energy needs, such as the skin, digestive tract, and brain, are most affected by niacin deficiency. Niacin is called the anti-pellagra vitamin because supplementing it can treat the condition.

The Classic Symptoms of Pellagra

Pellagra is characterized by the "four Ds":

Dermatitis: Sun-exposed skin develops symmetrical, scaly rashes, often called the "Casal necklace" on the neck.
Diarrhea: This includes inflammation of the digestive tract, a red and painful tongue, and chronic diarrhea.
Dementia: Neurological issues like confusion, memory loss, and behavioral changes occur.
Death: Without treatment, pellagra can be fatal within a few years.

Causes of Primary vs. Secondary Pellagra

Pellagra can be classified as primary or secondary, depending on the cause.

Primary Pellagra

Primary pellagra results from a diet low in niacin or tryptophan. Historically, this was common in areas where corn was a staple food without proper preparation. Nixtamalization, an alkaline process, releases the niacin in corn, a technique used by ancient cultures. Food fortification has significantly reduced primary pellagra in many regions.

Secondary Pellagra

Secondary pellagra happens when the body cannot absorb or use niacin effectively, even with adequate dietary intake. Causes include chronic alcoholism, malabsorption disorders like Crohn's disease, liver cirrhosis, certain medications (e.g., isoniazid), and genetic conditions like Hartnup disease.

Niacin Sources, Treatment, and Prevention

Treating pellagra involves niacin replacement and addressing the underlying cause. This can include a balanced diet and nicotinamide supplements. Recovery usually occurs quickly once treatment starts.

Comparison of Pellagra Causes and Treatment


Feature	Primary Pellagra	Secondary Pellagra
Cause	Insufficient dietary intake of niacin and/or tryptophan.	Impaired absorption or metabolism of niacin and/or tryptophan.
Dietary Factor	Often associated with diets high in untreated corn and low in protein.	Can occur even with adequate niacin intake from food.
Associated Conditions	Malnutrition, food scarcity.	Chronic alcoholism, gastrointestinal disease, certain medications, genetic disorders.
Treatment Focus	Dietary supplementation and nutritional education.	Supplementation alongside treatment for the underlying medical condition.
Prevention	Balanced diet, food fortification, and nixtamalization of corn.	Managing underlying health issues and avoiding trigger medications.

Excellent Food Sources of Niacin

A diet rich in niacin is the best preventative measure. Good sources include various meats, fish like tuna and salmon, legumes, fortified grains, seeds, and dairy products.

The Anti-Pellagra Vitamin in History

The history of discovering niacin as the anti-pellagra vitamin is notable. In the early 20th century U.S., where corn-based diets were prevalent, pellagra was widespread. Dr. Joseph Goldberger's dietary studies showed it was a deficiency, not an infection. In 1937, Conrad A. Elvehjem isolated nicotinic acid and proved its effectiveness in curing pellagra, leading to food fortification programs that drastically reduced its incidence.

Conclusion

In summary, niacin, or Vitamin B3, is recognized as the anti-pellagra vitamin. A deficiency leads to pellagra, marked by the four Ds: dermatitis, diarrhea, dementia, and potentially death. While fortification has reduced primary pellagra, secondary causes like malabsorption or chronic alcoholism still exist. Identifying symptoms and ensuring sufficient niacin intake is vital for prevention and treatment. For further information, the Cleveland Clinic offers resources on pellagra.

Frequently Asked Questions

Niacin's primary function is to act as a coenzyme, specifically NAD and NADP, which are essential for converting food into energy and for fundamental cellular processes like DNA repair.

The initial symptoms often include digestive issues like glossitis (red tongue), nausea, and diarrhea, which can precede the more visible skin manifestations.

Pellagra became rare primarily due to the fortification of staple foods like cereals and bread with niacin, ensuring that most people get an adequate intake of the vitamin.

Diagnosis is often based on clinical symptoms and a patient's dietary history. A positive response to niacin supplementation can also help confirm the diagnosis.

Yes, primary pellagra can be cured by replenishing the body's niacin stores, typically with oral or intravenous niacin supplements. Recovery from symptoms usually begins within days of treatment.

Good dietary sources of niacin include beef liver, poultry, fish like tuna and salmon, peanuts, legumes, and fortified grain products.

Nicotinic acid and nicotinamide are both forms of Vitamin B3 and are collectively called niacin. However, nicotinamide is often preferred for treatment as it does not cause the skin flushing side effect associated with nicotinic acid.