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Erin Baas KNH 413 Medical Nutrition Therapy Nutrient What is the nutrient? My medical nutrition therapy nutrient is niacin, or vitamin B3, is used by the body to convert carbohydrates into energy. It also aids in keeping the nervous system, digestive tract, skin, hair, and eyes healthy. (http://www.mayoclinic.com/health/niacin/CL00036) What is the RDA/DRI for the nutrient? The DRI’s for niacin are based on age, gender, and other factors such as pregnancy. Women who are pregnant need to consume higher amounts of niacin. Infants should consume 2-4 mg/day. Children 1-3 years old should consume 6 mg/day, 4-8 years old should consume 8 mg/day, and 9-13 years should consume 12 mg/day. Males age 14 and older should consume 16 mg per day. Females age 14 and older should consume 14 mg/day. (http://www.nlm.nih.gov/medlineplus/ency/article/002409.htm) How is the nutrient metabolized? Niacin is water-soluble and is therefore not stored in the body. Any leftover amounts of the vitamin leave the body through the urine. This is why a continuous supply of niacin is needed in one’s diet. As many as 200 enzymes require niacin coenzymes, NAD and NADP, to accept or donate electrons for redox reactions. These redox reactions are how living organisms derive most of their energy. (http://www.nlm.nih.gov/medlineplus/ency/article/002409.htm) (http://lpi.oregonstate.edu/infocenter/vitamins/niacin/) What are food sources of the nutrient? Foods rich in niacin include dairy products, eggs, enriched breads and cereals, fish, lean meats, legumes, nuts, and poultry. (http://www.nlm.nih.gov/medlineplus/ency/article/002409.htm) What disease states alter the nutrients metabolism? Pellegra, which is niacin deficiency, can occur because of an inadequate dietary intake of niacin and/or tryptophan. Other nutrient deficiencies may also contribute to a niacin deficiency. For example, individuals with Hartnup’s disease, which is a hereditary disorder resulting in defective tryptophan absorption, can develop pellegra. (http://lpi.oregonstate.edu/infocenter/vitamins/niacin/) What are the tests or procedures to assess the nutrient level in the body? The amount of niacin in the body can be assessed through a simple saliva testing process. A sample of saliva is collected by a specially designed swab. The sample can be shipped to a reputable laboratory for results and interpretation. (www.testcountry.org/niacin-deficiency-testing.htm) What is the drug –nutrient interactions? Niacin is usually given along with statins or other medications to individuals who have high LDL cholesterol levels and low HDL levels. Medications that may interact with niacin therapy or with absorption and metabolism include sulfinpyrazone. This medication is used for the treatment of gout, but it promotes excretion of uric acid from the blood to urine. Niacin may inhibit this affect when an individual is taking this drug. Niacin supplementation is also recommended throughout a long-term treatment of tuberculosis. Without supplementation, pellegra-like symptoms can occur. (http://lpi.oregonstate.edu/infocenter/vitamins/niacin/) How is the nutrient measured? Niacin is measured in milligrams. Also, 1 mg of niacin can be synthesized from the ingestion of 60 mg of tryptophan. (http://lpi.oregonstate.edu/infocenter/vitamins/niacin/) What is the Upper Tolerable Limits? Flushing of the skin on the face, arms, and chest may occur at doses as low as 30 mg/day. This flushing side effect, however, is rare so the tolerable upper intake level for niacin is 35 mg/day. This will help individuals to avoid any flushing side effects. (http://lpi.oregonstate.edu/infocenter/vitamins/niacin/) What are the physical signs of deficiency? A deficiency of niacin causes pellegra. Symptoms of pellegra include digestive problems, inflamed skin, and mental impairment. (http://www.nlm.nih.gov/medlineplus/ency/article/002409.htm) What are physical signs of toxicity? Depending on the form of niacin, whether it is fast-acting or longer acting, high doses can cause temporary flushing of the skin. This flushing of the skin is not harmful. If a person experiences this, they should speak to their doctor to find the right dosage. Taking an aspirin can also help to prevent flushing, along with avoiding hot drinks and alcohol. Other possible side effects of too much niacin include upset stomach, headache, dizziness, liver damage, and increased blood sugar. (http://www.mayoclinic.com/health/niacin/CL00036/NSECTIONGROUP=2)