“To be, or not to be, that is the question.” These words of Shakespeare can be applied to subclinical pellagra. Is it a disease? Is it a syndrome? Is it a deficiency? Is it an allergy? Questions like these are frequently asked by the public, the patient, and doctors too. I believe subclinical pellagra is part of the continuum of mental ill health. It starts with complaints of a minor nature, maybe some behavioral disturbances, and may extend on to the frank psychoses. It is a sounder diagnosis than adolescent behavior syndrome, minimal brain damage, and the like.
Definition: Subclinical pellagra is a syndrome characterized by perceptual changes involving all senses, special and/or proprioceptive. There is also an unusual sensitivity to refined carbohydrates. This combination leads to a variety of symptoms which blanket the field of medical complaints. The administration of niacin causes prompt disappearance of special sense dysfunctions, while proprioceptive sense changes are more slowly corrected with dietary and other measures.