Who Found Niacin, and How Pellagra Became a Lesson in Diet
Niacin's story begins with pellagra, a killer across the American South. Joseph Goldberger showed in 1915 that diet caused it, and later work tied niacin to NAD, the coenzyme used by more than 400 enzymes.
The history of niacin begins with Joseph Goldberger, who showed in 1915 that pellagra was a diet problem rather than an infection. Pellagra had been devastating the American South for about a decade. In 1915, Mississippi's State Board of Health reported that the disease had caused more deaths the previous year than typhoid fever, smallpox, measles, scarlet fever, influenza, epidemic meningitis and polio combined, according to Jon Harkness's 1996 history in *Public Health Reports* ([PubMed](https://pubmed.ncbi.nlm.nih.gov/8837636/)). Pellagra began with skin eruptions and ended in mental deterioration and death. A common belief held that it was infectious. Goldberger, a Public Health Service physician, had seen it in Southern asylums and orphanages, and he suspected the monotonous "three-M" diet of poor Southerners: meat fat, meal and molasses. ## How a prison test answered the germ theory In February 1915, Goldberger and his assistant G. A. Wheeler began a test at the Rankin Prison Farm outside Jackson, Mississippi. Governor Earl Brewer offered pardons to men who took part. Eleven men ate a restricted southern diet with no milk, lean meat, eggs or legumes, starting April 19. By October 30, Goldberger wrote that five "great big, vigorous men" had pellagra. The eleven men received pardons on November 1. The infection objection came next. In 1916, Goldberger and his associates, including his wife, injected, swallowed or inhaled blood, feces, urine and skin scrapings from pellagra patients. None of them developed the disease. The participants called these sessions "filth parties" ([PubMed](https://pubmed.ncbi.nlm.nih.gov/8837636/)). ## Which nutrient was missing? Goldberger showed the diet could produce and cure pellagra. He did not name the missing nutrient. A 2012 history of riboflavin says Elvehjem's group in Wisconsin later identified nicotinic acid as the pellagra-preventing part of the B2 complex, after the 1935 work that separated riboflavin from the anti-pellagra factor ([DOI](https://doi.org/10.1159/000343111)). A 2012 historical review of niacin, biotin and pantothenic acid adds that Goldberger also ran experiments on black tongue in dogs as an animal model ([DOI](https://doi.org/10.1159/000343115)). ## A 1942 naming fight Nicotinic acid was first made in 1867 by oxidizing nicotine, so it carried nicotine's name. A 1942 JAMA piece titled "Niacin and Nicotinic Acid" said the name implied too strongly a link to nicotine, and that "acid" suggested a corrosive like battery fluid. It argued that a poor name handicaps a useful product ([DOI](https://doi.org/10.1001/jama.1942.02830100053014)). ## Why niacin makes you flush The NIH says 30 to 50 mg or more of nicotinic acid typically causes flushing. The face, arms and chest turn red as small blood vessels under the skin widen, with burning, tingling and itching. A 2006 mouse study found that epidermal Langerhans cells are essential for the flush and express the enzymes that form the vasodilating prostaglandins D2 and E2 ([DOI](https://doi.org/10.1124/mol.106.030833)). Nicotinamide does not flush. Our [article on whether NR causes the flush](/health/nad-longevity-complete-guide/does-nr-cause-niacin-flush) takes up the nicotinamide riboside question. ## From niacin to NAD The NIH says all tissues convert absorbed niacin into NAD, the main active form, and more than 400 enzymes need it. Some tryptophan also becomes NAD, which is why tryptophan counts as a niacin source. That tryptophan step depends on riboflavin, vitamin B6 and iron. A 2008 review by Bogan and Brenner calls nicotinamide riboside a newly identified NAD+ precursor ([DOI](https://doi.org/10.1146/annurev.nutr.28.061807.155443)). Our [NR monograph](/ingredients/nr-nicotinamide-riboside) and the [history of NAD from 1906 to NMN trials](/health/nad-longevity-complete-guide/history-of-nad-from-1906-to-nmn-trials) cover the route in more detail. Whether food can raise NAD is the question in our [research page on diet, tryptophan and niacin](/research/can-diet-raise-nad-tryptophan-niacin). ## How cholesterol entered the story In 1955, Altschul, Hoffer and Stephen published "Influence of nicotinic acid on serum cholesterol in man" in *Archives of Biochemistry and Biophysics* ([DOI](https://doi.org/10.1016/0003-9861(55)90070-9)). The title frames the question: what nicotinic acid does to serum cholesterol in men. The NIH notes that some formulations are labeled extended-release to minimize flushing. ## Bottom line Treat niacin as a diet-first vitamin with a documented history. The NIH says frank pellagra is very rare in the United States, though some people have marginal niacin status. If you are considering nicotinic acid in supplement doses, expect flushing at 30 to 50 mg or more, and ask a clinician before you start. ## Frequently asked questions ### What was pellagra, and why did it strike whole communities? Pellagra began with skin eruptions and ended in mental deterioration and death, according to Harkness's 1996 history. In 1915, Mississippi's State Board of Health said it had caused more deaths the previous year than seven other diseases combined. Goldberger blamed the monotonous "three-M" diet of poor Southerners: meat fat, meal and molasses. Whole communities shared that diet, which is why the disease hit them together. ### How did Goldberger show that diet, not germs, caused pellagra? In 1915, Goldberger and G. A. Wheeler fed eleven men at the Rankin Prison Farm a restricted diet with no milk, lean meat, eggs or legumes. Governor Earl Brewer had offered pardons for taking part. By October 30, five men had pellagra. The eleven were pardoned on November 1. In 1916, Goldberger's associates swallowed or injected material from patients, and none of them developed the disease ([PubMed](https://pubmed.ncbi.nlm.nih.gov/8837636/)). ### When was niacin shown to cure the disease? Goldberger's 1915 work showed diet could cure pellagra but did not name the missing nutrient. Elvehjem's group in Wisconsin later identified nicotinic acid as the pellagra-preventing factor, after the 1935 separation of riboflavin from the anti-pellagra factor. Harkness notes that other researchers later identified the deficiency as niacin. The sources we could verify give no year for that identification, so this page gives none. ### Why does niacin cause a flush? The NIH says 30 to 50 mg or more of nicotinic acid typically causes flushing, because small blood vessels under the skin widen. The flush comes with burning, tingling and itching. The NIH calls it an unpleasant side effect rather than a toxic one. A 2006 mouse study linked it to epidermal Langerhans cells and the prostaglandins D2 and E2. Nicotinamide does not cause flushing. ### How does the body make NAD from niacin, tryptophan, and NR? According to the NIH, the body converts absorbed niacin into NAD, and some tryptophan also becomes NAD. The tryptophan route needs riboflavin, vitamin B6 and iron. A 2008 review by Bogan and Brenner names nicotinamide riboside as a newly identified NAD+ precursor. Our NR monograph covers that route in more detail, and our NAD longevity guide covers the NAD side. ### Why did the name niacin replace nicotinic acid? Nicotinic acid was first made in 1867 by oxidizing nicotine, so it carried nicotine's name. A 1942 JAMA piece said the name implied too strongly a link to nicotine, and that "acid" suggested a corrosive like battery fluid. The abstract frames the problem as furthering the distribution of foods, and argues that a poor name handicaps a useful product ([DOI](https://doi.org/10.1001/jama.1942.02830100053014)). ## Next reads - [Our NAD longevity guide](/health/nad-longevity-complete-guide) covers the NAD side of this story. - [Who found vitamin B12](/blog/history/history-of-vitamin-b12-from-liver-cure-to-cobalamin) follows another vitamin whose treatment came 22 years before the vitamin was isolated. ### Related reading - [the B-complex story, from one factor to eight](/blog/history/history-of-the-b-complex-from-one-factor-to-eight) - [the riboflavin story, from yellow pigment to FAD](/blog/history/history-of-riboflavin-b2-from-yellow-enzyme)