Figure 4.

Nicotinamide: the devil may be in the dosage. Too low and symptoms of pellagra emerge, even if rarely diagnosed as the rash may frequently not be expressed. Higher doses than usually recommended may be necessary for individuals carrying certain mutations and when under genotoxic or infectious or traumatic stresses that require temporary boosts of repair circuits. Too high a dose chronically from supplemented food-stuffs or too much meat causing nicotinamide overload (an experiment whose long-term effectiveness or toxicity has never been monitored) may express itself phenotypically in many ways covering many common diseases, as does pellagra.