Third in the series on chronic malnutrition syndromes, B3 or niacin. Most would be surprised to see niacin deficiencies but a closer look at correlations and associations especially with common autoimmune conditions and mental conditions should give rise to further consideration of how closely gut, immune and various mental conditions correspond to vitamin deficiency pathologies and how remarkably fast these chronic condition symptoms ease with proper nutrition.

Milk is a superfood, time tested and the gold standard for treatment of kwashiorkor, it helps increase levels of B vitamins and absorption and transport of other nutrients. Whole fat mammal milk is one of the best and easiest ways to help combat malnutrition syndromes.

Learn how you can increase B vitamin content in dairy foods with the addition of specific probiotics and by using other fermentation techniques. All of this info can be found throughout the site and in Immune For Life.

Sorry, clicked the wrong button and didn’t feel like splicing them together, new schedule, late and I need sleep. 

A few things I forgot to mention that I admire about the Japanese is their ability to change course and their ability to learn from failure. Many of the functional foods we now rely on and love were the result of Japanese efforts at combatting malnutrition and health issues regarding digestion. I am certain if a quality infant formula is ever developed it will be thanks to the Japanese. Many of our most common, affordable, safe and effective drugs such as Ivermectin were thanks to the Japanese and where would we be without the current knowledge of autophagy. I also notice and appreciate their pursuit of the common good, when discoveries are made they end up not only as drugs but on the store shelves or very accessible, I admire that very much, Gcmaf is but one example. They also don’t shy away from rejecting an unsafe drug or practice. I owe a great deal to the Japanese people and I trust the majority of their research so I hope I don’t forget to mention that next time.

Throughout history vitamin deficiencies are often over looked and in many cases misdiagnosed as other conditions. Malnutrition can’t be alleviated with drugs, can be caused by any chronic drug use and nutrition science isn’t generally taught therefore most remain ignorant of the dangerous effects of malnutrition and consider it to be a thing of the past when in reality malnutrition syndromes are prevalent and present in numerous populations worldwide. These chronic malnutrition syndromes, especially in children have long lasting effects that can be devastating to future health outcomes.

15-40 percent of Americans are deficient in B vitamins and in some populations the incidence is much higher.

Most are also not aware of the effects of malnutrition on embryonic development, this includes the effects of birth control induced malnutrition syndromes. Learn about malnutrition syndromes and don’t miss your chance to correct them.

Did you know?

LAB and bifidobacteria provide an effective way to increase vitamin levels in milk. Some bacterial strains in the genera Lactobacillus and Bifidobacterium provide an additional source of B vitamins (thiamine, riboflavin, cobalamin, folate, and biotin) during dairy fermentation. Deficiencies in vitamin B2 or vitamin B1 can lead to both liver and skin disorders and alterations in brain glucose metabolism.
All of our B-vitamins (B1, B2, B3, B5, B6, B12, folic acid,and biotin are synthesized in the colon by various strains of Bifidobacteria. Several lactic acid bacteria (LAB) species (e.g., Lactococcus lactis, Lactobacillus gasseri, and Lactobacillus reuteri) and Bifidobacterium (e.g., B. adolescentis) produce B vitamins, often in large quantities and are found in fermented foods. L. reuteri was also found to metabolize glycerol, indicating that a LAB might also be able to make B12. Bifido strains of probiotics have been patented to specifically reduce H2S.

Bifido strains of probiotics have been patented to specifically reduce H2S.

The B-complex vitamins include: 

• B1 (thiamine) breaks down carbohydrates. 

• B2 riboflavin (B2) 

• B3 (niacin and niacinamide) maintains normal cholesterol levels. 

• B6 (pyridoxine) helps calm moods. 

• B12 (cyanocobalamin and hydroxocobalamin) promotes mental sharpness. 

• PABA (biotin, choline, folic acid, pantothenic acid, and para-aminobenzoic acid. B9 (folic acid) helps to maintain healthy gene activity, and it also reduces the risk of cardiovascular diseases. 

• In addition, inositol is often considered a B vitamin.

Vitamin B3 Deficiency

Niacin or nicotinamide is a water-soluble vitamin also known as vitamin B3, and it represents the precursor of nicotinamide mononucleotide (NMN) and nicotinamide adenine dinucleotide (NAD+). The ingested niacin is absorbed primarily in the small intestine, but some is absorbed in the stomach. All tissues in the body convert the absorbed niacin into its main metabolically active form, the coenzyme NAD+, which in turn is converted into another active form, the coenzyme nicotinamide adenine dinucleotide phosphate (NADP+), in all tissues except skeletal muscle. Most dietary niacin is in the form of nicotinic acid and nicotinamide, but some foods contain small amounts of NAD+ and NADP+. Cells are also able to convert tryptophan to NAD+, so tryptophan is considered a dietary source of niacin. When NAD+ and NADP+ are consumed in foods, they are converted to nicotinamide in the gut and then absorbed.

It is mainly found in protein-rich foods (e.g., cereals, legumes, meat, and milk) and yeast. The former food sources are high in tryptophan, which can be converted into niacin in the liver (60 mg tryptophan is needed to produce 1 mg niacin). 

Benefits of B3:

  • Reduces the risk of heart disease
  • Decreases the risk of type 1 diabetes
  • Increases cognitive function
  • Improves skin health
  • May improve arthritic symptoms
  • Helps to treat pellagra
  • Improves circulation
  • Reduces signs of ADHD
  • Prevents premenstrual syndrome
  • Improves digestion
  • Improves immunity


  • Weight loss
  • Anorexia
  • Nausea, dyspepsia, abdominal pain
  • Diarrhea
  • Excessive salivation
  • Skin rash
  • Fatigue, headaches, dizziness
  • Irritability
  • Tremors, dementia, anxiety, and depression

Overall, pellagra is a clinical diagnosis and biochemical testing is rarely used. Measurement of urinary N-methylnicotinamide or erythrocyte NAD: NADP (ratio) can be obtained to evaluate the metabolic rate of niacin in the body. Thus, high levels reflect adequate intakes of this vitamin. Physical examination should assess the general health and the mental status (progressive derangement with confusion, or tremors). Head examination should include evaluation of the tongue, looking for a beefy red tongue, with swelling and tenderness. Oral manifestations include gingivitis, stomatitis, and glossitis. Assessment of skin rash which is usually symmetrical and bilateral (including sunburn-like rash, facial butterfly sign, Casal’s collar necklace like-rash in sun-exposed areas, hyperpigmentation, thick dry skin, and eruption with desquamation) and signs of malnutrition (example: weakness, weight loss, muscle wasting, dehydration or edema) are crucial. Cardiac examination may reveal abnormal heart rate and blood pressure. A pulmonary examination may show labored breathing due to weakness in respiratory muscles. Further assessment may include the evaluation of wounds for poor healing. Patients may also have lower extremity swelling.

Who Is at Risk of Vitamin B1 Deficiency?

  • ‌Alcohol intake, use or abuse 
  • Gastric bypass surgery
  • Genetic 
  • Kidney disease
  • Poor diet
  • Poor quality food
  • Pharmaceutical or drug use (all drugs damage mitochondria and affect B vitamin status)

The main etiology of pellagra is consuming a diet deficient in niacin or eating uncooked grains. The latter reason can be explained by the complex form of niacin (bound to polysaccharides and glycopeptides) in raw grains, which limits its bioavailability when ingested. Yet, soaking and cooking the food releases niacin, making it available for absorption. Pellagra could develop in the elderly population due to malabsorption. Other important causes include long-term use of isoniazid (depletes tryptophan), carcinoid syndrome, Hartnup disease, or AIDS (acquired immune deficiency syndrome). It is also reported that gluten-free foods may result in a low intake of niacin. A recent case-study also showed that azathioprine immunosuppressant had induced pellagra in a 50-year old Chinese woman suffering from optic neuritis and transverse myelitis. In another case-study,  pellagra was seen in a 57-year old man who had pulmonary Koch disease, and a history of smoking and drinking. Similarly, a 42-year old smoker and chronic drinker had pellagra. Poor nutrition knowledge, unhealthy lifestyle behaviors, and limited availability or accessibility to food are believed to be the major contributors to insufficient consumption of niacin.

Pellagra was first described 250 years ago by the Spanish physician Don Gaspar Casal in 1763. It is characterized by dermatitis, diarrhea, dementia, and eventually death if not treated by giving niacin. This is why it is called the 3 D syndrome, or 4 Ds disease. However, diarrhea and dementia may not always be present. Recent studies also revealed that niacin deficiency might be associated with Alzheimer, Parkinson, Huntington diseases, cognitive impairment, or schizophrenia. Early diagnosis and treatment are crucial.

Intro for FB – no video this week.

Have you ever wondered why there are calls to re-visit RDA standards for nutrition? Or why mega doses of vitamins are now suggested as appropriate treatment guidelines when such mega doses can be toxic? Nature doesn’t make mistakes. Vitamin D for example, early malnutrition studies actually showed that it (in milk or cod liver oil) took very little vitamin D to achieve optimal benefit and that benefit was not affected by seasonal change but a lack did affect carbohydrate metabolism in as little as 3-4 months. The same is true for B and C vitamins so what is going on here?

Early malnutrition intervention efforts were effective at alleviating classic malnutrition syndromes like Kwashiorkor or other deficiency syndromes like scurvy, rickets and pellagra but today’s research is focused on alleviating bio synthesis problems associated with malnutrition, not just alleviating the malnutrition itself.
Elderly populations received much benefit from greater access to food and more emphasis on proper sanitation in addition to proper microbiota development helping them achieve longevity with less disease but just a few generations later nearly all gains were lost and we are now faced with modern malnutrition syndromes like high calorie malnutrition in which supplementation or diet change alone will not likely address core metabolic issues. 
Cutting edge research regarding vitamins are a recognition and reflection of mal-adaptation not just treatment of classic nutritional  deficiencies. 

Absence of the Healthy Mature Anaerobic Gut Microbiota (HMAGM) leads to deficient energy harvest, vitamin biosynthesis and immune protection. That sentence may be short but it speaks volumes regarding recognition of maladaptation to modern lifestyles in which bio synthesis of vitamins is a key factor for energy production. The energy production they are speaking of is cellular energy, the energy required to maintain life.
In addition it is not just that human biology has changed but so have substances. Processed food always presented problems but today’s refined food contains more sugar/s than earlier versions interfering further with vitamin bio synthesis in essential nutrients like B vitamins.
For later generations this became akin to running at full speed but never being able to catch up let alone win the race.
So in essence it is not just soil depletion, not just a lack of quality food requiring a switch to organic but core metabolic syndromes that we mistakenly believe are merely ‘malnutrition’ when that is not the case. It is also not just other environmental stressors increasing toxicity although toxins also affect energy metabolism.
You can learn more about how to address these foundational factors associated with chronic malnutrition syndromes including high calorie malnutrition in Immune For Life and over at my blog where I just published my latest post on B vitamin deficiencies, the latest being Niacin. The others are, thiamine (the gateway vitamin) and B12, all are crucial for health, especially neuro health. They include a brief over view with some well curated pertinent videos that I think you’ll enjoy more than reading a textbook about malnutrition.
Can maladaptation lead to benefit? Yes, it can and research is recognizing the necessity to help produce vitamins and supplements that address bio synthesis, transport and co-factors and catalysts that are beyond substance replacement. Learning about these new formulas might be of benefit to you.
Thanks for stopping by!

Alternavita: All you need to know (critical info in a nutshell)..... by focusing exclusively on these foundational health and immune development issues up to 90% of chronic conditions can be eliminated.

WHO STATEMENTS: 2017 Millennium Goal

  1. Breastfeeding,
  2. food (security)
  3. and water security (sanitation)

are major protective factors against malnutrition and critical factors in the maturation of healthy gut microbiota, characterized by a transient bifidobacterial bloom before a global rise in anaerobes. Early depletion in gut Bifidobacterium longum, a typical maternal probiotic, known to inhibit pathogens, represents the first step in gut microbiota alteration associated with severe acute malnutrition (SAM). Later, the absence of the Healthy Mature Anaerobic Gut Microbiota (HMAGM) leads to deficient energy harvest, vitamin biosynthesis and immune protection, and is associated with diarrhea, malabsorption and systemic invasion by microbial pathogens. A therapeutic diet and infection treatment may be unable to restore bifidobacteria and HMAGM.


Researchers found that malnourished children’s microbiota failed to follow the healthy pattern they identified in healthy children. The microbiota of malnourished children is immature, lagging in development behind that of their healthy peers. Supplementing these children’s meals with widely used therapeutic foods that increase calories and nutrient density reduces deaths from malnutrition, but it does not fix their persistent microbiota immaturity.

“Perhaps more insidious than slowing growth is malnutrition’s effect on less visible aspects of health, including impaired brain development and dysfunctional immunity, which follow these children throughout their lives”.

The Father of The Microbiome

Dr. Jeffrey Gordon


SIBO can cause severe malabsorption, serious malnutrition and immune deficiency syndromes in children (non breastfed) and adults. 

Prognosis is usually serious, determined mostly by the underlying disease that led to SIBO.



The WHO recommends that immunization or treatment be orally administered due to economic, logistical and security reasons. Furthermore, this route offers important advantages over systemic administration, such as reducing side effects, as the molecules are administered locally and have the ability to stimulate the GALT immune responses  (Levine and Dougan, 1998Neutra and Kozlowski, 2006Bermúdez-Humarán et al., 2011).



For ANY infectious or parasitic disease to start, it is ALWAYS a requisite that the host suffer IMMUNODEFICIENCY. At the same time, infectious and parasitic diseases themselves cause additional IMMUNE SUPPRESSION and more MALNUTRITION. This immune suppression is SECONDARY to the accumulation of free radicals, especially oxidizing species, that occurs during and after infectious and parasitic diseases.

Clinical Aspects of Immunology and Biochem J.


Current IBD Research 2016

Currently available treatments for IBD, which target the systemic immune system, induce immunosuppression, thereby exposing the patient to the risk of infections and malignancy. The interplay between the gut and the systemic immune system determines the final effect on target organs, including the bowel mucosa. Inflammatory bowel diseases (IBD) are associated with an altered systemic immune response leading to inflammation-mediated damage to the gut and other organs.

Clinical & Translational Immunology (2016)
Gastroenterology and Liver Units, Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel

Most importantly, the immune modulatory agents used today for IBD do not achieve remission in many patients.

Not all IBD patients benefit from currently available drugs. Young people with IBD do not want to be on long-term drug therapy. Oral immune therapy, while not yet studied in large cohorts of patients, may provide an answer to this unmet need.

Clinical & Translational Immunology (2016)
Gastroenterology and Liver Units, Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel


Tolerance is the ability of the immune system to ‘see’ and respond appropriately. Without galactose (a necessary sugar) the immune system can not 'see'. Your immune system would not be able to function without galactose Your body wouldn’t know which cells are “good” and what cells are “bad.” Your body wouldn’t know who the invaders were and which ones should be attacked by antibodies. As you will learn the importance of these ‘sugars’ in gut microbiota health is a rapidly expanding field of research, only recently discovered, including HMO's (human milk oligosaccharides).

Why galactose? Milk sugar aka lactose has been shown to be very beneficial for the human body though unlike sucrose, lactose is made up of glucose and galactose. There is no fructose in lactose. It is a healthy disaccharide sugar. Galactose is known as the “brain sugar” and supports brain development of babies and children. Galactose helps triggers long-term memory formation. Galactose has been shown to inhibit tumor growth and stop its spread, particularly to the liver. This beneficial sugar can also enhance wound healing, decrease inflammation, enhances cellular communication, and increases calcium absorption.
What does immune ‘tolerance’ mean in simple language?
Immune tolerance, or immunological tolerance, or immunotolerance, is a state of unresponsiveness of the immune system to substances or tissue that have the capacity to elicit an immune response in a given organism. The Th1 cytokine profile is vital for clearance of certain organisms and ancillary immune activity, and a limiting effect on this cytokine profile may result in reduced chances for overcoming infections especially intra-cellular organisms residing within macrophages. Effective clearance will depend on appropriate macrophage activation (which occurs through IFN≥ release by Th1 and NK cells) and production of nitric oxide. If this pathway is disrupted IFN≥ secretion is blocked, impairing macrophage activation. Persistent blockade of these inhibitory receptors has lead to the breakdown in immune self tolerance, thereby increasing susceptibility to autoimmune or auto-inflammatory side effects, including rash, colitis, hepatitis and endocrinopathies. Many drugs may cause checkpoint blockade toxicity including pharmaceutical drugs termed ‘immuno therapy’ by pharmaceutical companies, these include Mab drugs and cancer treatments. Checkpoint Inhibitor–Induced Colitis: A New Type of Inflammatory Bowel Disease? Madeline Bertha, MD MS, corresponding author1 Emanuelle Bellaguara, MD, Timothy Kuzel, MD, and Stephen Hanauer, MD ACG Case Rep J. 2017; 4: e112. Published online 2017 Oct 11. doi: 10.14309/crj.2017.112 PMCID: PMC5636906 PMID: 29043290

The Elderly

Mammal milk is required for enhanced phagocytosis as shown by research, especially in the elderly. Whole fat mammal milk can actually restore phagocytosis in senescent cells in the elderly. Phagocytosis, by which immune cells ‘eat’ bacteria or infected cells, is one of the mechanisms that help to resist infections. Lactic acid bacteria strains like acidophilus also increases phagocytosis.