Pellagra is not something doctors come across very often, which is great as it’s a debilitating disease that can be fatal if not treated. It’s caused by a deficiency of niacin, vitamin B3.
It can often be recognised by the presentation in the patient of dermatitis, diarrhoea and dementia, which are often followed by death. These are the 4D’s that doctors look for when considering the condition.
Endemic in Italy in the 17th century it is named from the Italian pelle agra, which means sour skin, and refers to the horrific dermatitis victims of the condition suffer from.
In 1915 pellagra reached epidemic proportions in the southern US states and this prompted the government to employ a doctor, Joseph Goldburger to resolve the issue. Goldberger found resistance at every level. Southern doctors were suspicious of a Jewish Northern doctor and even when he made the connection between pellagra and diet he was ignored.
He went as far as actually ingesting pellagra to prove it wasn’t caused by a germ or virus but still he made no headway with the establishment. It was only after conducting experiments on prisoners, (who would be pardoned if they lived) that people started to take notice. He altered their diet and actually induced pellagra in the group,several of whom died.
Sadly Goldburger died before the food causing the problem was found, even though he knew it was linked to the amount of maize consumed in the southern states.
The traditional way of preparing maize involves nixtamalization,  the corn was treated with lime. (lime, not limes) This makes niacin, B3 nutritionally available to the body. When the cultivation of maize spread the value of treating it with lime was not understood and the practice was abandoned thus leaving the consumers of the corn no access to the niacin available in it.
As corn became more plentiful it’s price dropped and people began to eat more and more of it. The population of the southern states were high consumers and they paid the price with over 100,000 people affected and over 1300 deaths in the first few months of 1913 alone. In all over 3 million Americans were affected and over 100,000 deaths were caused by the disease between 1904 and 1939.
Research continued after Goldbergers death and it found that twice the number of females as males are affected and this is probably due to oestrogen inhibiting the amino acid tryptophan which enables niacin absorption.
Eating foods with bio-available niacin relieves the symptoms of pellagra very quickly, and this is easy to do with such a wide variety of foods available to us today. Should that food supply be diminished this may not be the case.
Anything that stops the supply of simple basic foodstuffs that contain niacin will cause a resurgence of this awful disease. This is evident in areas such as Zimbabwe, Nepal, Angola and Sudan where strife and adverse weather has diminished the food supply and left the populations relying on untreated corn as a staple food.There has been a rise in pellagra in these places since 2002 with the World Health Organization showing a niacin deficiency of almost 30% in females and 6% in children. The incidence of clinical pellagra rather than just naiacin deficiency is also rising in many of these areas.
Niacin can be found in foods that provide protein, something that may well be lacking in the diets of the majority of people in a post-collapse world. Most preppers store nuts, dried fruits and legumes all of which contain niacin but the population at large do not and this will invariably lead to problems. The best sources of niacin are beef, game, lamb, poultry and seafood. Some fruits and veggies are a valuable source, namely mushrooms and mangoes but even those only offer a small percentage of the recommended daily amount.
The symptoms are diverse: High sensitivity to sunlight,cardiomyopathy, aggressive behaviour, stomach pain, dermatitis, weakness, mental confusion,diarrhoea and later dementia, coma and death. Left untreated the disease gets worse and worse causing death on average in about 4 years. Prior to that the victims will be extremely debilitated and can die of infections when the dermatitis becomes infected if medical help is not available
It would be extremely wise to stock up on B3 supplements and B3 rich foods prior to any collapse. Pellagra is a slow and painful death, a death that sadly millions of people may face in the future.