{"id":3319,"date":"2015-08-21T02:08:02","date_gmt":"2015-08-21T06:08:02","guid":{"rendered":"http:\/\/health.glutenfreeworks.com\/2013\/03\/28\/vitamin-b3-niacin-deficiency-3\/"},"modified":"2020-07-11T10:38:42","modified_gmt":"2020-07-11T14:38:42","slug":"vitamin-b3-niacin-deficiency-3","status":"publish","type":"post","link":"https:\/\/glutenfreeworks.com\/health\/vitamin-b3-niacin-deficiency-3\/","title":{"rendered":"Vitamin B3 (Niacin) Deficiency"},"content":{"rendered":"<div id=\"attachment_8950\" style=\"width: 310px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/red-tuna_2533792.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-8950\" class=\"size-medium wp-image-8950\" src=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/red-tuna_2533792-300x199.jpg\" alt=\"SumptuousTuna For Niacin.\" width=\"300\" height=\"199\" srcset=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/red-tuna_2533792-300x199.jpg 300w, https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/red-tuna_2533792.jpg 626w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-8950\" class=\"wp-caption-text\">Sumptuous Tuna For Niacin.<\/p><\/div>\n<h2 style=\"text-align: justify\">What Is Vitamin B3 (Niacin)?<\/h2>\n<p style=\"text-align: justify\"><span class=\"dropcap\">N<\/span>iacin is an essential water-soluble B vitamin that is required by all cells of the body.<\/p>\n<p style=\"text-align: justify\">During digestion of food containing it,\u00a0niacin (the form in food) is changed\u00a0<span style=\"line-height: 1.5em\">in\u00a0the small intestines\u00a0<\/span><span style=\"line-height: 1.5em\">to the active form niacinamide (niacin plus an amide group), which is then absorbed into the bloodstream.\u00a0<\/span><\/p>\n<p style=\"text-align: justify\">Niacinamide is converted by the body into co-enzymes which are present in all cells. These are niacinimide adenine dinucleotide (NAD) and NADP. NADP is formed when the body adds a phosphate to NAD.<\/p>\n<p style=\"text-align: justify\"><strong>Q<\/strong>: How do these enzymes work?<\/p>\n<p style=\"text-align: justify\"><strong>A<\/strong>: These enzymes function in oxidation-reduction reactions essential for release of energy from carbohydrates, fats, and proteins and are needed as components for more than 200 enzymes involved in metabolism.<\/p>\n<p style=\"text-align: justify\">In addition to producing energy, niacinamide is essential for healthy skin and the mucosal lining of the digestive tract, normal functioning of the brain and nervous system, and production of steroid hormones in adrenal glands and hormones in sex glands.\u00a0\u00a0Functions are more fully described below.<\/p>\n<p style=\"text-align: justify\"><span style=\"color: #000000\">Urinary excretion of niacin cannot be detected when vitamin intake is below the required levels. On the other hand, w<\/span>hen intake exceeds saturation in the body, the vitamin and\/or its metabolites are actively excreted into urine to prevent excessive toxicity of the vitamins.<a href=\"#footnote_1_3319\" id=\"identifier_1_3319\" class=\"footnote-link footnote-identifier-link\" title=\"Shibata K, Hirose J, Fukuwatari T. Relationship Between Urinary Concentrations of Nine Water-soluble Vitamins and their Vitamin Intakes in Japanese Adult Males.&nbsp;Nutr Metab Insights.&nbsp;2014 Aug 5;7:61-75. doi: 10.4137\/NMI.S17245. eCollection 2014.\">1<\/a><\/p>\n<h2 style=\"text-align: justify\">What Is Niacin Deficiency In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p><!--more--><\/p>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\"><strong>Relationship between niacin\u00a0deficiency and celiac disease.<\/strong> Niacin\u00a0deficiency is a symptom of celiac disease that results when the level within cells is too low to meet needs of the body for this vitamin which is caused by malabsorption.<\/li>\n<li style=\"text-align: justify\"><strong>Relationship between niacin\u00a0deficiency and features.\u00a0<\/strong>Niacin deficiency is characterized by these features: 1) impaired\u00a0metabolism of foodstuffs for energy; 2) health of oral, esophageal, and gut mucous membranes; 3) production of adrenal steroid hormones; 4) production of the sex hormones estrogen, progesterone and testosterone due to failure to build sterols and fatty acids as required; and 5) altered\u00a0brain and nerve function due to their failed high energy needs.<\/li>\n<li style=\"text-align: justify\"><strong>Relationship between niacin\u00a0deficiency and other nutrients.\u00a0<\/strong>Deficiencies of thiamin (vitamin B1), riboflavin (vitamin B2), and pyridoxine (vitamin B6) commonly accompany or can cause niacinamide deficiency.<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">How Prevalent Is Niacin Deficiency in Celiac Disease?<\/h2>\n<p style=\"text-align: justify\">Niacin deficiency is common in patients with untreated celiac disease.<a href=\"#footnote_2_3319\" id=\"identifier_2_3319\" class=\"footnote-link footnote-identifier-link\" title=\"Murray JA, the widening spectrum of celiac disease. American Journal of Clinical Nutrition. Mar 1999; 69(3):354-365.\">2<\/a><\/p>\n<h2 style=\"text-align: justify\">What Are The Symptoms Of Niacin Deficiency?<\/h2>\n<p><strong>Early niacinamide deficiency includes these symptoms<\/strong>:<\/p>\n<ul class=\"cp_bullet red\">\n<li>Weakness.<\/li>\n<li>Loss of appetite.<\/li>\n<li>Distorted taste.<\/li>\n<li>Indigestion.<\/li>\n<li>Burning of mouth, throat and esophagus.<\/li>\n<li>Abdominal discomfort and distention.<\/li>\n<\/ul>\n<p><strong>Followed by these later symptoms:<\/strong><\/p>\n<ul class=\"cp_bullet red\">\n<li>Nausea.<\/li>\n<li>Vomiting.<\/li>\n<li>Diarrhea.<\/li>\n<li>Dizziness.<\/li>\n<li>Cracking and scaling skin that blisters.<\/li>\n<li>Poor memory.<\/li>\n<li>Change in intellect or reasoning.<\/li>\n<li>Headache.<\/li>\n<li>Anxiety.<\/li>\n<li>Apathy.<\/li>\n<li>Depression.<\/li>\n<li>Tremors.<\/li>\n<li>Urinary discomfort.<\/li>\n<li>Non-infectious vaginitis in females.<\/li>\n<\/ul>\n<p><strong>Severe deficiency causes the disease called pellagra, which is characterized by the classic 3 D\u2019s (dermatitis, dementia, and diarrhea):<\/strong><\/p>\n<div id=\"attachment_5318\" style=\"width: 212px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/Pellagra21.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-5318\" class=\" wp-image-5318\" src=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/Pellagra21-197x300.jpg\" alt=\"In this photo of a man with pellagra, we see advanced skin alterations: peeling, cracking, sloughing, with blistering, and sore mouth. Note the wasted muscles and white fingernails that indicate protein malnutrition. \" width=\"202\" height=\"278\" \/><\/a><p id=\"caption-attachment-5318\" class=\"wp-caption-text\">Pellagra with advanced skin changes: peeling, cracking, with blistering. White nails indicate protein malnutrition.<\/p><\/div>\n<ul class=\"cp_bullet red\">\n<ul class=\"cp_bullet red\">\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\"><strong>Dermatitis<\/strong>:\u00a0worsening redness followed by blisters, crusting and peeling of skin in sun exposed areas, itching, red, wet areas from chafing such as under breasts, in the groin area and armpits, and inflammation of vagina and urethra, deeply pigmented areas over bony prominences such as elbows, scarlet, swollen tongue, and sore mouth;<\/li>\n<\/ul>\n<ul class=\"cp_check red\" style=\"padding-left: 30px\">\n<li style=\"text-align: justify\">\n<p style=\"text-align: justify;padding-left: 30px\"><span style=\"color: #000000\"><strong>Dementia:\u00a0<\/strong><\/span>worsening memory impairment, disorientation, confabulation, and hallucination;<\/p>\n<\/li>\n<li>\n<p style=\"text-align: justify\"><span style=\"color: #000000\"><strong>Diarrhea:<\/strong><\/span>\u00a0watery which may become bloody from ulceration. Other signs are cogwheel rigidity of extremities and sore (black) tongue. Pellagra untreated progresses to death.<\/p>\n<\/li>\n<\/ul>\n<\/ul>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2 style=\"text-align: justify\">How Does The Body Get Niacin?<\/h2>\n<ul class=\"cp_check black\">\n<li style=\"text-align: justify\">Niacin is obtained from the diet.<\/li>\n<li style=\"text-align: justify\">Dietary niacin must be digested to release the absorbable forms, niacinamide and nicotinic acid which are absorbed from the small intestine by carrier-mediated facilitated diffusion.<a href=\"#footnote_3_3319\" id=\"identifier_3_3319\" class=\"footnote-link footnote-identifier-link\" title=\"Kathleen Mahan and Sylvia Escott-Stump, ed. Krause&rsquo;s Food, Nutrition &amp; Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000.\">3<\/a><\/li>\n<li style=\"text-align: justify\">Extra niacin is stored by the liver.<\/li>\n<li style=\"text-align: justify\">Niacin can be made by the body from tryptophan (amino acid), although with low efficiency because conversion of tryptophan to niacin requires adequate levels of tryptophan and adequate levels of co-factors iron, riboflavin, and vitamin B6. Tryptophan-to-niacin conversion can easily be subverted if tryptophan itself, or the co-factors are deficient. Lack of tryptophan is due to avoiding foods that are rich in tryptophan, such as eggs and meat.<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">What Does Niacin Do In The Body?<\/h2>\n<ul class=\"cp_bullet red\">\n<li style=\"text-align: justify\">Essential for energy production from foodstuffs.<\/li>\n<li style=\"text-align: justify\"><span style=\"line-height: 1.5em;text-align: justify\">Required as part of an enzyme to convert met-hemoglobin (which is not able to carry oxygen) to hemoglobin (which properly does carry oxygen in blood).<\/span><\/li>\n<li style=\"text-align: justify\"><span style=\"line-height: 1.5em;text-align: justify\">Acts in the enzyme form NAD (nicotinamide adenine dinucleotide) to accept electrons in metabolic reactions;<\/span><\/li>\n<li style=\"text-align: justify\"><span style=\"line-height: 1.5em;text-align: justify\">Required for healthy skin.<\/span><\/li>\n<li style=\"text-align: justify\"><span style=\"line-height: 1.5em;text-align: justify\">Required to maintain healthy mucosal lining of the digestive tract.<\/span><\/li>\n<li style=\"text-align: justify\"><span style=\"line-height: 1.5em;text-align: justify\">Required for normal brain and nervous system function.<\/span><\/li>\n<li style=\"text-align: justify\"><span style=\"line-height: 1.5em;text-align: justify\">Required for repair of certain key cell processes.<\/span><\/li>\n<li style=\"text-align: justify\"><span style=\"line-height: 1.5em;text-align: justify\">Essential for production of steroid hormones at demand levels from adrenal glands.\u00a0<\/span><\/li>\n<li style=\"text-align: justify\"><span style=\"line-height: 1.5em;text-align: justify\">Essential for production of the hormones estrogen, progesterone and testosterone from sex glands.<\/span><\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">How Does Niacin Deficiency Develop In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\">Niacin deficiency in celiac disease results primarily from malabsorption of this vitamin\u00a0due to inflammation of intestinal lining.<\/li>\n<li style=\"text-align: justify\">Deficiencies of thiamin (vitamin B1), riboflavin (vitamin B2), and pyridoxine (vitamin B6) can cause niacinamide deficiency.<\/li>\n<li style=\"text-align: justify\">As a consequence of low stomach acid.<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\">Does Niacin Deficiency Respond To Gluten-Free Diet?<\/h2>\n<p style=\"text-align: justify\">Yes. Celiac disease-related niacin deficiency responds quickly to a nutritious gluten free diet containing adequate niacin and other B vitamins. Supplementation may be required.<\/p>\n<p style=\"text-align: justify\">However, it was found that the nutritional composition of a gluten free diet in male and female celiac patients in Germany have inadequate nutrient intakes. The average daily micronutrient intake of male and female patients, specifically of vitamin B1, B2, B6, folic acid, magnesium and iron, was significantly lower in celiac patients. Based on these findings, regular (laboratory) monitoring of celiac patients should be recommended.<a href=\"#footnote_4_3319\" id=\"identifier_4_3319\" class=\"footnote-link footnote-identifier-link\" title=\"Martin J, Geisel T, Maresch C, Krieger K, Stein J. Inadequate nutrient intake in patients with celiac disease: results from a German dietary survey.&nbsp;Digestion. 2013;87(4):240-6. doi: 10.1159\/000348850.\">4<\/a><\/p>\n<h2>6 Steps To Correct Niacin Deficiency:<\/h2>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>1<\/strong><\/span><\/span><strong><span style=\"color: #800000\">Meet, or Exceed the RDA (Recommended Dietary Allowances) for Niacin in milligrams (mg) per day<\/span><\/strong><\/em>:<\/li>\n<\/ul>\n<div class=\"box success\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p style=\"text-align: center\">2 mg for infants birth-6 months; 4 mg for infants 7-12 months<\/p>\n<p style=\"text-align: center\">10 mg for children 1-3 years<\/p>\n<p style=\"text-align: center\">15 mg for children 4-8 years<\/p>\n<p style=\"text-align: center\">12 mg for children 9-12 years<\/p>\n<p style=\"text-align: center\">16 mg for teens 14-18 years<\/p>\n<p style=\"text-align: center\">16 mg for adults 19-70 years<\/p>\n<p style=\"text-align: center\">18 mg for pregnancy; 17 mg for breast-feeding women.\n\t\t\t<\/div><\/div>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>2<\/strong><\/span><\/span><strong><span style=\"color: #800000\">Diet &#8211; Include Food Sources Richest in Niacin:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p><strong>Plant sources<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li>Peanuts.<\/li>\n<li>Seeds.<\/li>\n<li>Almonds.<\/li>\n<li>Nutritional gluten-free yeasts.<\/li>\n<li>Lesser amounts are in mushrooms, black-eyed peas, potatoes, spinach, chestnuts, avocado, asparagus, broccoli, and brown rice.<\/li>\n<\/ul>\n<p><strong>Animal sources<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li>Liver (all kinds, but beef is highest).<\/li>\n<li>Liverwurst.<\/li>\n<li>Tuna.<\/li>\n<li>Pork.<\/li>\n<li>Beef.<\/li>\n<li>Chicken.<\/li>\n<li>Trout.<\/li>\n<li>Oyster.<\/li>\n<li>Clams.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\">\n<li><span style=\"color: #800000\"><strong><span class=\"dropcap\">3<\/span>\u00a0Diet &#8211; Avoid, Limit, or Eat Separately These Foods\u00a0That Deplete or Interfere With Absorption:<\/strong><\/span><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<ul class=\"cp_bullet red\">\n<li>Refined sugars.<\/li>\n<li>Refined starches such as white flour used in making bread and baked goods.<\/li>\n<li>Alcohol consumption.<\/li>\n<\/ul>\n\n\t\t\t<\/div><\/div>\n<ul class=\"cp_check green\">\n<li><span style=\"color: #800000\"><strong><span class=\"dropcap\">4<\/span>Monitor Medications That Deplete or Interfere With Absorption:<\/strong><\/span><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p style=\"text-align: justify\">Here are common medications that deplete niacin. Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below. Do not stop prescribed medications without supervision.<\/p>\n<p><strong>FEMALE HORMONES<\/strong>\u00a0disrupt intestinal permeability causing leaky gut.<\/p>\n<ul class=\"cp_bullet blue\">\n<li>Oral Contraceptives (Norinyl\u00ae, Ortho-Novum\u00ae, Triphasil\u00ae, and others) deplete niacin and others.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>5<\/strong><\/span><strong>Manage\u00a0<\/strong><\/span><strong><span style=\"color: #800000\">Nutritional Supplements to Obtain<\/span><\/strong><\/em><em><strong>:<\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<ul class=\"cp_bullet orange\">\n<li style=\"text-align: justify\">Niacinamide is the preferred form of vitamin B3 supplementation. Other B vitamins should also be taken at the same time because these vitamins work together.<\/li>\n<li style=\"text-align: justify\">Niacinamide has no observed toxicity for intakes up to 3,000-9,000 mg daily although this is an extreme amount that would cause the loss of minerals by excretion through the urine.<\/li>\n<li style=\"text-align: justify\">Monitor if there is a history of gout, peptic ulcer, diabetes or liver disease.<\/li>\n<li style=\"text-align: justify\">Natural preparations made from food are superior to synthetic ones\u00a0that are chemically produced.<\/li>\n<li style=\"text-align: justify\">Avoid any preparation that contains these harmful chemicals most of which are derived from benzene (a toxic hydrocarbon, C6H6): benzoic acid, methyparaben (found in breast cancer tissue, in eye drops it damages the eye surface), propylparaben, paraben, polyethylene glycol, propylene glycol (propanediol), polysorbate 60.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>C<\/strong><strong>aution:<\/strong>\u00a0<em>The form Niacin (nicotinic acid) may cause flushing (redness and itching of the skin around the face and neck) at doses above 50 mg whereas, the form Niacinamide does not. Other side effects are possible at higher doses of Niacin, which should be used under supervision of a physician.<\/em><\/p>\n<p style=\"text-align: justify\"><strong>Storage Note<\/strong>:<em>\u00a0Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet or the fridge &#8211; not in the bathroom or on the kitchen table.<\/em>\n\t\t\t<\/div><\/div>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>6<\/strong><\/span><\/span><strong><span style=\"color: #800000\">Other Supplement Interactions With Niacin :<\/span><\/strong><\/em><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<ul class=\"cp_bullet red\">\n<li>Black cohosh may cause liver damage and niacin increases this risk. Check with your pharmacist.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<h2>Medical Research Findings On\u00a0Niacin Deficiency In Celiac Disease and\/or Gluten Sensitivity:<\/h2>\n<h4><strong>RESEARCH STUDY SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\">&#8220;<strong>Inadequate nutrient intake in patients with celiac disease: results from a German dietary survey<\/strong>.&#8221; This study investigating the nutritional composition of a gluten free diet and to compare it with non-gluten free diet in a representative German non-celiac disease population found that male and female celiac patients in Germany have inadequate nutrient intakes.\u00a0Data from 88 patients aged 14-80 years who filled out a prospective 7-day food diary and a questionnaire were analyzed and compared to the DACH reference values and to data from the German National Diet and Nutrition Survey (NVS II).<\/p>\n<p style=\"text-align: justify\">The average daily micronutrient intake of male and female patients, specifically of vitamin B1, B2, B6, folic acid, magnesium and iron, was significantly lower in celiac patients compared to the NVS II. Based on these findings, regular (laboratory) monitoring of celiac patients should be recommended.<a href=\"#footnote_4_3319\" id=\"identifier_5_3319\" class=\"footnote-link footnote-identifier-link\" title=\"Martin J, Geisel T, Maresch C, Krieger K, Stein J. Inadequate nutrient intake in patients with celiac disease: results from a German dietary survey.&nbsp;Digestion. 2013;87(4):240-6. doi: 10.1159\/000348850.\">4<\/a><\/p>\n<h4 style=\"text-align: justify\"><strong>CASE REPORT SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\"><strong>&#8220;A 70-year-old man with isolated weight loss and pellagra like syndrome due to celiac disease.&#8221;<\/strong>\u00a0This case report describes presentation of celiac-disease in a 70 year old man with no prior GI symptoms or positive family history. Triggering of all symptoms followed a recent myocardial infarction and infective endocarditis. Presentation was marked by more than 20% weight loss and pellagra-like lesions despite nearly normal examination and laboratory tests. Symptoms were reversed by giving him intramuscular nicotinic acid (niacin).<a href=\"#footnote_5_3319\" id=\"identifier_6_3319\" class=\"footnote-link footnote-identifier-link\" title=\"Schattner A. A 70-year-old man with isolated weight loss and pellagra like syndrome due to celiac disease.&nbsp;The Yale Journal of Biology and Medicine. Jan-Feb 1999; 72(1):15-8.\">5<\/a><\/p>\n<ol class=\"footnotes\"><li id=\"footnote_1_3319\" class=\"footnote\">Shibata K, Hirose J, Fukuwatari T. Relationship Between Urinary Concentrations of Nine Water-soluble Vitamins and their Vitamin Intakes in Japanese Adult Males.\u00a0<em>Nutr Metab Insights.<\/em>\u00a02014 Aug 5;7:61-75. doi: 10.4137\/NMI.S17245. eCollection 2014.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_1_3319\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_3319\" class=\"footnote\">Murray JA, the widening spectrum of celiac disease. <em>American Journal of Clinical Nutrition.<\/em> Mar 1999; 69(3):354-365.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_2_3319\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_3319\" class=\"footnote\">Kathleen Mahan and Sylvia Escott-Stump, ed. Krause\u2019s Food, Nutrition &amp; Diet Therapy, 10th Edition. Philadelphia, PA. USA: W.B. Saunders Company, 2000.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_3_3319\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_3319\" class=\"footnote\">Martin J, Geisel T, Maresch C, Krieger K, Stein J. Inadequate nutrient intake in patients with celiac disease: results from a German dietary survey.\u00a0<em>Digestion<\/em>. 2013;87(4):240-6. doi: 10.1159\/000348850.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_4_3319\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_5_3319\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_5_3319\" class=\"footnote\">Schattner A. A 70-year-old man with isolated weight loss and pellagra like syndrome due to celiac disease.\u00a0<em>The Yale Journal of Biology and Medicine<\/em>. Jan-Feb 1999; 72(1):15-8.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_6_3319\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>What Is Vitamin B3 (Niacin)? Niacin is an essential water-soluble B vitamin that is required by all cells of the body. During digestion of food containing it,\u00a0niacin (the form in food) is changed\u00a0in\u00a0the small intestines\u00a0to the active form niacinamide (niacin plus an amide group), which is then absorbed into the bloodstream.\u00a0 Niacinamide is converted by &#8230;<\/p>\n","protected":false},"author":7,"featured_media":8950,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[4,144,1682,1131,24,183,159,974,143,73,245],"tags":[1884,603,602,386,445,1205,1210,1208,1209,1211,470,477,1212,1206,468,343,452,1207,437,1509,1203,324,1885,1391,1201,1017,1204,57,530,1202,537,992,879,1213,914,1898,478,76,543],"class_list":["post-3319","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-conditions-2","category-brain","category-malabsorption-disorders","category-nutrient-deficiencies","category-nutrient-deficiency-symptoms","category-skin","category-small-intestine","category-symptoms","category-niacin","category-vitamins","category-water-soluble-vitamins","tag-health-conditions-2","tag-abdominal-distention","tag-abdominal-pain","tag-anxiety","tag-apathy","tag-black-tongue","tag-burning-esophagus","tag-burning-mouth","tag-burning-throat","tag-cracking-skin","tag-depression","tag-diarrhea","tag-diminished-intellect","tag-distorted-taste","tag-dizziness","tag-estrogen","tag-headache","tag-indigestion","tag-loss-of-appetite","tag-low-stomach-acid","tag-mouth-sores","tag-nausea","tag-nutrient-deficiency-symptoms","tag-nutrients-2","tag-pellegra","tag-poor-memory","tag-progesterone","tag-reproductive-2","tag-scaling-skin","tag-skin-sores","tag-sore-tongue","tag-testosterone","tag-tremors","tag-urinary-discomfort","tag-vaginitis","tag-vitamins","tag-vomiting","tag-water-soluble","tag-weakness"],"_links":{"self":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/3319","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/comments?post=3319"}],"version-history":[{"count":48,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/3319\/revisions"}],"predecessor-version":[{"id":16043,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/3319\/revisions\/16043"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media\/8950"}],"wp:attachment":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media?parent=3319"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/categories?post=3319"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/tags?post=3319"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}