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How alcohol contributes to niacin deficiency Impairs intestinal absorption and hepatic metabolism of niacin Reduces availability of tryptophan for endogenous niacin synthesis Common symptoms and clinical consequences of niacin deficiency Skin photosensitivity or dermatitis Cognitive changes, confusion, or brain fog Fatigue and reduced stress tolerance Digestive disturbances In more severe cases, pellagra (dermatitis, diarrhea, dementia) (34) Clinically, niacin deficiency often presents as cognitive and skin-related symptoms that are misattributed to stress, aging, or unrelated dermatologic issues

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Additional protein factors aid in the initiation, elongation and termination of protein synthesis