Pellagra

Pellagra is a disease which is caused by deficiency of nicotinic acid, a vitamin of the B complex. Pellagra occurs when the food is mainly composed of corn or sorghum. The present therein bound form of nicotinic acid ( Niacytin ) can not be utilized by the body. This disease was widespread prior knowledge of the contexts in poor regions of southern Europe and the Americas. In the countries of origin of maize this was alkaline processed for human consumption ( Nixtamalisation ), whereby the nicotinic acid was available.

History

Corn was brought to the discovery of America by Christopher Columbus as one of the first plants to Europe, where it spread rapidly due to high crop yields. Soon occurred in areas with high maize consumption on a strange disease that was named after the symptom pellagra, rough skin '.

" The little medical knowledge and first guess that pellagra is caused by hypothetical toxins in maize, by contagion or by genetic predisposition, led for years to great pellagra epidemics in Europe and the United States. "

The relationship of pellagra and high maize consumption has been suggested in the 18th century. Explanations of that time were:

• Moldy corn
• Poisoned corn
• Infection
• Heredity

Only Joseph Goldberger and colleagues demonstrated the beginning of the 20th century that both the so-called pellagra of man and the black tongue disease of the dog by malnutrition arises, fine ( Conrad Elvehjem 1937) by a Nicotinsäuremangel. Nowadays pellagra usually occurs only in poor areas of Africa or in extreme miscarriage or malnutrition, for example, anorexia, on. The discovery that pellagra is treatable with brewer's yeast, resulted in the affected areas in an abrupt reduction in the number of inmates of mental hospitals. By analogy, the doctors Abram Hoffer and Humphry Osmond translated into the so-called mega- vitamin therapy, a high dose nicotinic acid in the treatment of schizophrenia. They assumed that if that occurred as part of a pellagra symptoms of schizophrenia disappear by treatment with nicotinic acid, this might also influence schizophrenia from other causes. Your considerations led to the orthomolecular psychiatry, a form of orthomolecular medicine, which is not part of modern evidence-based medicine due to lack of proof of efficacy, however.

Cause

General: One-sided, nicotinsäurearme diet. Specifically: Cardinal diet with alkaline untreated or unroasted corn, or main diet with sorghum, since only one for the human body (without chemical modification or cleavage of the molecule ) is not usable form of nicotinic acid is herein contained, the Niacytin which the unchanged human body can not be recorded.

Follow

Nicotinic acid is required for a number of oxidation and reduction processes ( hydrogen transfer ) in the body. The consequences of a deficiency are diseases such as pellagra, which are manifested in itching, redness of the skin, inflammation of the lining of the digestive tract, painful thickening of the skin, as well as brown staining and damage to the central nervous system.

Symptoms and course of disease

Features include:

• Diarrhea
• Dermatitis (skin disease)
• Dementia ( organic brain syndrome).

"Under body aches, fatigue, headache, and fever occur mainly intestinal disturbances, nervous symptoms such as tremors, paralysis, convulsions and mental disorders, as well as appearances on the part of the skin on; in severe cases can lead to death in weeks the clinical picture, but most of the course extends over years. " Lesions typically form in the sunlight exposed areas ( hands, forearms, face, neck ). The mental illnesses are associated with the lack of tryptophan.

Treatment

Since there is a deficiency in pellagra, it can be effectively treated by the administration niacinhaltiger food. These include liver, meat, fish, whole-grain cereals and whole grain bread, and vegetables. In addition, the treatment can be carried out by a direct administration of nicotinic acid or brewer's yeast. As nicotinic acid, is water soluble, it can not be stored long, but is discarded. The body can, however, form the essential amino acid tryptophan, nicotinic acid. Therefore, a Nicotinsäuremangel is often treated with doses of tryptophan.

The daily Nicotinsäurebedarf is about 5 mg (children ) to 20 mg ( in adults).