
Vitamin B12 Deficiency: Symptoms, Risk Factors and What to Do
Vitamin B12 deficiency symptoms — tingling, fatigue, memory issues and more. Who's at risk in India and how to fix it. Prakash Hospital Noida.
30 Sept 2026
by Prakash Hospital

Understand how Niacin regulates cholesterol, protects against the dreaded disease Pellagra, and discover the top dietary sources in the Indian diet.
Vitamin B3 (Niacin) is a heavy lifter in the human body. Every single part of your body needs it to function because it is a core component of NAD and NADP—two coenzymes involved in over 400 distinct biochemical reactions, primarily related to converting food into cellular energy. But where Niacin truly shines is in the cardiovascular system. In clinical settings, high doses of niacin are used to dramatically improve blood lipid profiles by boosting "good" HDL cholesterol and lowering "bad" triglycerides. Historically, a severe lack of Niacin led to a terrifying and fatal disease called Pellagra, characterized by the "4 Ds": Dermatitis, Diarrhea, Dementia, and eventually, Death. Today, maintaining healthy Niacin levels is crucial for heart health, vibrant skin, and cognitive function.
The Indian Council of Medical Research (ICMR) recommends:
*Your body can synthesize a small amount of Niacin from Tryptophan (an amino acid found in protein). 60mg of Tryptophan = 1mg of Niacin.
Niacin is predominantly found in high-protein foods like meat, poultry, and fish. However, vegetarians can easily meet their requirements through peanuts, legumes, and whole grains.
| Rank | Food Item | Type | Estimated Amount (Per 100g) |
|---|---|---|---|
| 1 | Chicken Breast (Lean) | Non-Veg | ~ 14.8 mg (Extremely High) |
| 2 | Peanuts (Mungfali) | Vegetarian/Nut | ~ 12.0 mg |
| 3 | Rohu/Tuna Fish | Non-Veg | ~ 10 - 18 mg |
| 4 | Mutton / Pork (Lean) | Non-Veg | ~ 6.0 - 8.0 mg |
| 5 | Brown Rice | Vegetarian/Grain | ~ 5.0 mg |
| 6 | Green Peas (Matar) | Vegetarian/Veg | ~ 2.0 mg |
| 7 | Sunflower Seeds | Vegetarian/Seeds | ~ 8.3 mg |
| 8 | Mushrooms | Vegetarian/Veg | ~ 3.6 mg |
| 9 | Potatoes | Vegetarian/Veg | ~ 1.1 mg |
| 10 | Lentils (Dal) | Vegetarian/Legume | ~ 2.5 mg |
Severe deficiency leads to a systemic condition called Pellagra, historically known for the "4 Ds". Even mild deficiency can cause early warning signs.
A severe, sunburn-like rash that appears symmetrically on areas of the skin exposed to sunlight (like the neck, forming a "Casal's necklace").
Inflammation of the entire gastrointestinal tract, leading to a bright red tongue, vomiting, and chronic, severe diarrhea.
Neurological symptoms including confusion, memory loss, depression, and hallucinations as the brain becomes starved of energy.
While you cannot overdose from food, high-dose niacin supplements (often taken for cholesterol management) carry significant medical risks and should never be self-prescribed.
If you have developed a thick, darkly pigmented rash on sun-exposed skin coupled with digestive issues, it is imperative to seek a medical diagnosis immediately to rule out Pellagra or other autoimmune conditions.
Additionally, if you are struggling with high cholesterol and are considering Niacin supplements, do not self-medicate. At Prakash Hospital, our Cardiology and Internal Medicine experts can safely evaluate your lipid profile and liver function to determine if prescription niacin therapy is safe and appropriate for your heart health.
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Crucial for bone health, immune function, and calcium absorption. Endemic deficiency in India.
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