Subclinical Pellagra and Idiopathic Hypogeusia

To the Editor.—  Idiopathic hypogeusia with dysgeusia, hyposmia and dysosmia cannot be called a new syndrome or a new disease. Frostig and Spies mentioned these psychosensory disturbances in 1939.¹They are but a part of a very old disease which causes the perception to change—perceptual dysfunction, as result of a vitamin B₃ deficiency. The disease is subclinical pellagra and the cure is niacin.Subclinical pellagra is a deficiency syndrome characterized by the presence of perceptual changes affecting any or all of the special and properioceptive senses, associated with neurasthenia. It is due to a deficiency of or an increased demand for niacin, the administration of which causes prompt disappearance of the symptom complex.²Henkin et al have discovered changes in perception involving only two of the special senses—taste and smell. I would predict that 90% of these cases could fulfill the criteria for subclinical pellagra. In my