Dangerous side effects or allergies to niacin

In most cases, Gilbert is diagnosed in the male half of the population aged 12-30 years. In adolescence, an increase in indirect bilirubin may be a consequence of the inhibitory effect of hormones on the enzyme that converts this pigment in the liver.

A provoking factor for the appearance of symptoms can be heavy physical, psycho-emotional stress, fasting, infectious liver diseases, surgery, alcoholism or long-term use of hepatotoxic drugs.

It is not always possible to diagnose the disease at the initial stage due to the lack of pronounced clinical signs. It can occur against the background of hepatitis or after it ends. In this case, the symptoms are regarded as a consequence of liver inflammation.

Diagnosis of Gilbert's syndrome begins with an analysis of complaints and clinical picture. The doctor pays attention to the condition of the skin, since the main manifestation of the pathology is jaundice. Its severity depends on the level of pigment in the bloodstream.

Discoloration is observed in the nasolabial area, on the palms or in the armpits. A person may also complain of nausea, belching, flatulence, constipation, diarrhea and heaviness in the right hypochondrium. All this indicates indigestion.

Given the toxic effect of indirect bilirubin on nerve cells, the patient may experience irritability, inattention, memory loss, and sleep disturbances.

The disease can cause cholelithiasis. The diagnosis is established based on the results of genetic, biochemical tests, as well as instrumental research methods. When palpating (feeling) the abdomen, the doctor detects a slight enlargement of the liver. The gland has a soft consistency and a smooth surface. Its lower edge is painful due to stretching of the organ capsule. Sometimes expansion of the spleen borders (splenomegaly) may be detected.

Treatment is prescribed taking into account the severity of the pathological process, the presence of concomitant diseases and the patient’s allergic predisposition.

Could there be a reaction?

Approximately 1% of the population suffers from drug allergies, and every tenth allergy sufferer is diagnosed with drug intolerance. Such a large percentage is associated with the widespread use of medications, sometimes uncontrolled.

Self-medication leads to a hypersensitivity reaction in the body, which, after the second use of the drug, manifests itself in various symptoms: skin, respiratory, intestinal.

Patients often develop anaphylactic shock, which is why drug allergies rank first in mortality from anaphylaxis.

Attention! Most often, drug reactions occur to antibiotics, hormones, vitamins, NSAIDs, Aspirin, and anesthetics. This significantly complicates the lives of patients, as it forces them to choose an alternative to medications. To prevent a negative reaction, you should stop taking the drug that caused the allergy.

About the drug

Vitamin PP, B3, niacin, nicotinic acid - these are the names of one substance. It was discovered in 1867, but then scientists had no idea about the properties of niacin. Nicotinic acid is a medicine, that is, used for the treatment of diseases. It was first used in the 30s of the 20th century to treat patients with pellagra. This disease is a consequence of poor nutrition, when the body does not receive protein.

Since then, scientists have continued to study vitamin PP and identified its main properties:

• participation in metabolism;
• normalization of fat levels;
• improving the conduction of nerve impulses;
• dilation of capillaries and increased blood circulation.

Now nicotinic acid is prescribed for the following pathologies:

• high cholesterol;
• hypothyroidism;
• Crohn's disease;
• malignant tumors;
• vascular diseases (endarteritis);
• cerebrovascular accident;
• polyneuropathy;
• hypovitaminosis.

Girls also use the drug to improve hair growth. They apply the vitamin from ampoules to the scalp. The effect is achieved by dilating capillaries and improving blood circulation.

Despite many positive properties, niacin can cause allergies, as it is a chemically synthesized substance. Nicotinic acid is obtained from quinoline or beta-picoline by oxidation. Any chemical compound is a potential allergen.

Instrumental studies

To assess the condition of the hepatobiliary tract, the doctor may prescribe an ultrasound examination and duodenal intubation. In addition, to exclude hepatitis and cirrhosis, a biopsy or elastography of the gland is recommended.

Duodenal sounding

The study allows you to analyze the nature of the biological fluid, which consists of bile, gastric, and pancreatic juices. In addition, it is prescribed to assess the functioning of the gallbladder. Specific training includes:

• a light dinner the day before the diagnosis, excluding foods that increase gas formation;
• five days before the study, antispasmodics, laxatives and drugs that stimulate bile flow are discontinued;
• the day before, the patient is injected subcutaneously with 0.5 ml of atropine and given warm water with xylitol to drink.

The study is carried out on an empty stomach in the morning. It can be classical or factional. In the first case, the contents are collected from the duodenum, bladder and ducts. As for the second technique, it consists of five phases and the liquid is collected every 7-8 minutes. This allows you to track the dynamics of bile movement and determine its composition.

The procedure requires a rubber probe that has an olive for collecting material. Typically, with Gilbert's disease, changes in the composition of bile, a disorder of the bladder according to the hyper- or hypotype, as well as a disruption in the functioning of the sphincter of Oddi are observed. The task of the latter is to regulate the flow of enzymatic fluid into the intestine.

Ultrasound

Another useful diagnostic method is ultrasound. It is based on the use of ultrasonic waves, which, when passing through tissues of different densities, are displayed on the screen as shadows of greater or lesser intensity.

The method can be used for both diagnostic and preventive purposes, as it is absolutely harmless and has no contraindications. Preparation for the study includes:

1. exclusion of foods from the diet that increase gas formation;
2. taking sorbents and drugs that reduce flatulence;
3. prescribing laxatives or giving an enema to people suffering from constipation.

An ultrasound examination determines the size, density and structure of the liver. In addition, the condition of the gallbladder and ducts is assessed, and stones are visualized.

Biopsy and elastography

To exclude liver inflammation and cirrhotic changes in the organ, a biopsy is prescribed. It is a method of examining material taken by puncture of the gland. To carry it out, anesthesia and moral preparation of the patient are required, and therefore a more gentle diagnostic method, elastography, is used much more often.

This method is the most informative, painless and safe. The study is carried out using Fibroscan. It allows you to determine the density and elasticity of the fabric.

Elastography allows you to detect the disease at an early stage. The only limitation for this examination is pregnancy, since the effect of waves on the embryo has not been fully studied. As for Gilbert's disease, no structural changes were detected during the study.

Causes

The cause of an allergy is repeated contact with a substance to which sensitization occurred. Theoretically, the reaction can occur in any person. At risk are:

1. People with a hereditary predisposition to allergies.
2. Having serious chronic diseases: diabetes, asthma.
3. Suffering from endocrine disorders.
4. Taking antibiotics and other medications such as hormones for a long time.
5. Those who have constant contact with chemicals (chemical plant workers).
6. Suffering from other types of allergies.
7. Living in areas with poor ecology.

Use of nicotinic acid

In pharmaceuticals, nicotinic acid is used as a vitamin supplement to maintain the vital functions of the body. It has a positive effect on metabolic processes.

Nicotinic acid promotes:

• removing waste and toxins from the body;
• improving liver function;
• increasing the healing of injuries;
• strengthening the vascular system;
• normalization of the gastrointestinal tract;
• reduces cholesterol levels;
• regeneration of epidermal cells;
• strengthening the nervous and vascular systems.

Nicotinic acid has a wide range of uses. It is obtained by oxidizing nicotine, i.e. poison, which in its pure form is used in pest control in agriculture. But nicotinic acid does not have negative effects on the body.

The main causes of allergies to nicotinic acid are:

1. individual intolerance;
2. side effects of the drug;
3. overdose.

Symptoms

The clinical picture of allergies can vary from a minor rash to anaphylaxis. Typically, vitamins cause the following symptoms:

1. Hives. Itchy spots appear on the patient’s body, which merge into large lesions.
2. Toxicoderma. A severe type of skin reaction characterized by the formation of itchy blisters. They then burst, turning into ulcers.
3. Rhinitis. It manifests itself as nasal congestion, copious mucus secretion, and lacrimation.
4. Angioedema (Quincke's edema). The patient's face, lips, tongue, throat, eyelids swell.
5. Intestinal manifestations: abdominal pain, diarrhea.

It is necessary to distinguish true allergies from side effects from taking the drug. When using nicotinic acid in tablets or injections, redness of the face, numbness of the fingers, and slight dizziness are possible. These symptoms disappear some time after administration and are not dangerous.

Complications

Ignoring allergy symptoms is dangerous. Firstly, the pathology can become chronic and bother the patient throughout his life. Secondly, there is a danger of atopic dermatitis or eczema. With toxicoderma, there is a high probability of bacterial infection.

Important! Anaphylactic shock when taking vitamin PP is rare, but the possibility cannot be ruled out. With anaphylaxis, the patient’s heart and lungs are disrupted, and the level of blood clotting increases. The result is coma and death.

Preventive measures

Before use, it is recommended to undergo testing measures to avoid complications.

Do not take niacin in large doses. It is recommended to use small dosages to begin with. It would be a good idea to undergo medical tests to identify concomitant diseases and complications. Niacin is contraindicated for some people.

If the patient has problems with the cardiovascular system, then its use is permissible after the doctor’s approval; it can provoke a stroke and internal bleeding.

Diagnostics

The first thing to do is to diagnose an allergy to niacin. Based on external manifestations or the method of elimination, that is, limiting contact with the allergen - if the symptoms have disappeared or weakened, then the diagnosis is confirmed.

For a more accurate picture, allergy tests are prescribed. They come in two types: cutaneous and provocative. In the first case, allergens are applied to microscratches on the skin. Redness and swelling indicate a positive result.

The provocative test is more dangerous, so it is done in a hospital setting, where it is possible to carry out resuscitation measures.

The patient is given the drug in tablets to drink and the body’s reaction is observed. This test is contraindicated if you have previously had severe allergic reactions. If skin testing is contraindicated, the blood is tested for specific antibodies to the allergen.

Treatment

If the patient has moderate reactions, no medications are prescribed. It is enough to refuse contact with the allergen. You should pay attention to the composition of cosmetics and vitamin complexes, since niacin may be present there.

Until acute symptoms are relieved, you should adhere to a hypoallergenic diet. Citrus fruits, chocolate, sweets, flour products, spices, sauces, eggs, honey, and red fruits are removed from the diet. After recovery, all this is gradually returned to the menu. In case of significant manifestations of allergies, drug treatment is resorted to. The following groups of drugs are used:

1. Antiallergic: Erius, Cetirizine, Claritin, Zodak.
2. Hormonal: Prednisolone, Dexamethasone (for severe systemic reactions).
3. Sorbents: Activated carbon, Laktofiltrum.
4. Anti-inflammatory ointments: Hydrocortisone, Prednisolone, Zinc.

For skin reactions, folk methods help well, for example, rubbing or baths with decoctions of medicinal herbs - calendula, chamomile, string. Herbal teas are also taken orally.

How to treat allergies?

Antihistamines are used for treatment:

To remove toxins and waste, use adsorbents: Atoxil, Enterosgel, activated carbon. We should not forget about following a hypoallergenic diet. Water helps remove allergens from the body; you need to maintain water balance in the body. Drinking coffee is not recommended; it should be replaced with tea, mineral water and rosehip infusions.

To avoid complications, inform your doctor which medications provoke allergies so that they can be replaced with analogues.

Prevention

To prevent a recurrence of allergies, products with nicotinic acid should be avoided. The patient's chart should include a note indicating niacin intolerance. To compensate for the deficiency of vitamin PP, you need to eat foods that contain it: meat, eggs, milk, buckwheat, mushrooms, rye bread.

People prone to allergies must take preventive measures:

1. Use medications only as prescribed by doctors and within the specified dosage.
2. Eat less foods with increased allergenicity.
3. Strengthen your immune system through exercise.
4. Avoid stress.
5. Avoid contact with chemicals.
6. Always carry an antihistamine with you.