Here Are the Top 7 Vitamins for Stroke Recovery Based on the Latest Clinical Evidence by Flint rehab

 And your doctor has been incompetent for how long in not prescribing these? Your board of directors is so incompetent they can't recognize incompetent staff and fire them? Your resposibility to fix this!

• (vitamin D 31 posts to May 2012)
• Vitamin B12 (17 posts to December 2011)
• vitamin B6 (3 posts to January 2019)

• vitaminB9 (1 post to June 2019)
• niacin (9 posts to December 2012) When I was on this drug in a clinical trial it flared up my eczema so bad I quit the trial.

• vitamin B3(6 posts to April 2018)

• vitamin E(20 posts to April 2011)

• vitamin C(9 posts to March 2014)

Here Are the Top 7 Vitamins for Stroke Recovery Based on the Latest Clinical Evidence

Medically reviewed by Andrea Reinkensmeyer, MA, MSOTR/L — written by Flint Rehab.

Recovering from a stroke is a complex journey that involves healing both the body and the brain. Rehabilitation exercises, therapy, and consistent practice are often the foundation of progress. However, nutrition can also play a meaningful supporting role in recovery. After a stroke, the brain undergoes a process called neuroplasticity, which allows it to reorganize and form new neural connections. This is how survivors relearn skills like moving an arm, speaking clearly, or walking again. While therapy provides the stimulus for these changes, the body still needs the right nutrients to support brain repair, energy production, and cellular recovery. This is where vitamins and nutrients may help. Research suggests that stroke survivors often have lower levels of several important nutrients, including vitamin B12, vitamin C, vitamin E, and omega-3 fatty acids, which may influence recovery and overall health. In this article, we’ll explore seven vitamins and nutrients that have shown promise in stroke recovery based on clinical and scientific research. We’ll also explain how each one supports brain health and what current studies suggest about their potential benefits. As always, remember that any vitamins or supplements MUST be discussed with your healthcare professional(And you actually think your doctor will know ONE DAMN THING ABOUT THIS! Wow! How quaint!) before starting them, especially after a stroke. Jump directly to a section by tapping any of the links below:Why Vitamins Can Matter for Stroke Recovery

1. Vitamin D

2. Vitamin B12 (Cobalamin)

3. Vitamin B6 (Pyridoxine)

4. Vitamin B9 (Folate)

5. Vitamin B3 (Niacin)

6. Vitamin C

7. Vitamin E

What Is the Best Multivitamin for Stroke Recovery?

How to Safely Add Vitamins to Your Stroke Recovery Plan

Why Vitamins Can Matter for Stroke Recovery

After a stroke, the body enters a period of intense repair. Brain tissue may have been damaged, neural pathways disrupted, and muscles weakened due to lack of use. And during this time, the body requires increased nutritional support.

However, several factors can contribute to nutritional or vitamin deficiency after stroke including:

• Reduced appetite or swallowing difficulties
• Changes in diet during hospitalization
• Increased metabolic demand during healing
• Reduced mobility and sunlight exposure

And importantly, researchers have found that poor nutritional status can negatively affect rehabilitation outcomes, while adequate nutritional support may improve motor recovery, cognition, mood, and daily function.

In other words, vitamins are not a “magic cure”, vut when combined with therapy, exercise, and medical care, they may help create a more supportive environment for recovery.

Now with that said, let’s explore the best science backed vitamins and nutrients for stroke recovery!

1. Vitamin D

Vitamin D is one of the most widely studied nutrients in stroke recovery. Often called the “sunshine vitamin,” it plays a role in muscle function, immune health, and neurological activity.

Low vitamin D levels are common among stroke survivors, especially those who spend less time outdoors during recovery.

What the Research Says

Research studies show that vitamin D is one of the best vitamins for stroke recovery.

Low levels of vitamin D are associated with worse outcomes after ischemic stroke, which accounts for 87% of all strokes in America. Furthermore, vitamin D deficiency is associated with stroke risk factors like hypertension, obesity, and diabetes.

Fortunately, after supplementing with vitamin D, “there is a significant improvement in stroke outcomes after 3 months.”

Getting enough vitamin D can also provide neuroprotective, neuromuscular, and osteoprotective benefits which can reduce cognitive and functional impairments in individuals after a stroke.

By getting your daily dose of vitamin D, you can reduce your risk of another stroke while aiding your brain’s recovery.

Potential Benefits

• Improving muscle strength
• Supporting brain cell signaling
• Reducing inflammation
• Enhancing rehabilitation outcomes

How To Get More Vitamin D

• Fatty fish (salmon, sardines)
• Egg yolks
• Fortified dairy products
• Sunlight exposure

2. Vitamin B12 (Cobalamin)

Vitamin B12 is essential for nerve health and brain function. It helps produce myelin, the protective coating around nerves that allows signals to travel efficiently through the nervous system.

Because stroke affects the nervous system directly, adequate B12 levels may be especially important during recovery.

What the Research Says

Clinical research shows that B-vitamin supplementation (including B12, B6, and folic acid) can reduce levels of homocysteine, a compound associated with increased stroke risk and vascular damage.

Lowering homocysteine may help protect blood vessels and reduce the risk of recurrent stroke.

In addition, supplementing with vitamin B12 in individuals that are deficient may enhance stroke recovery by boosting the function and development of the brain and nerve cells. This encourages neuroplasticity, which is the brain’s ability to reorganize itself, create new neural pathways, and rearrange existing ones.

Potential Benefits

• Support nerve repair
• Improve cognitive function
• Reduce fatigue
• Maintain healthy blood cells

How To Get More Vitamin B12

• Fish and seafood
• Eggs
• Dairy products
• Fortified cereals

3. Vitamin B6 (Pyridoxine)

Vitamin B6 works closely with B12 and folate to regulate homocysteine levels in the blood. Elevated homocysteine is associated with vascular damage and may increase the risk of stroke and cardiovascular disease.

By helping regulate this compound, B6 may support healthier circulation.

What the Research Says

A large scale double blind study examining B-vitamin combinations found that supplementation significantly reduces homocysteine levels, which may reduce stroke recurrence risk in certain populations. And while the the exact impact on recovery outcomes varies between studies, maintaining adequate B-vitamin levels remains an important part of neurological health.

Potential Benefits

• Support neurotransmitter production
• Improve brain metabolism
• Maintain vascular health

How To Get More Vitamin B6

• Bananas
• Chickpeas
• Poultry
• Potatoes

4. Vitamin B9 (Folate)

Folate is another key B vitamin that works together with B6 and B12 to regulate homocysteine. This vitamin also plays an important role in DNA synthesis and cell repair, which are essential during neurological recovery.

What the Research Says

Meta-analyses involving tens of thousands of participants show that folic acid supplementation may reduce stroke risk by roughly 10–11% in some populations. Although most research focuses on prevention, maintaining adequate folate levels may still support vascular health and recovery processes.

Potential Benefits

• Support blood vessel health
• Assist cellular repair
• Improve circulation

How To Get More Vitamin B9 (Folate)

• Spinach
• Lentils
• Avocados
• Asparagus

5. Vitamin B3 (Niacin)

Vitamin B3, also known as niacin, plays an important role in energy production and cellular repair. It helps convert food into usable energy and supports the health of the nervous system, skin, and digestive system.

After a stroke, the brain requires large amounts of energy to support healing and neuroplasticity. Because of this, nutrients that help maintain cellular metabolism may be particularly valuable during recovery.

Niacin is also involved in the production of NAD (nicotinamide adenine dinucleotide), a molecule that plays a key role in cellular energy and repair processes throughout the body, including the brain.

What the Research Says

Some experimental and clinical studies suggest that niacin may support neurological recovery after stroke. For example, several early studies found that niacin and niacin-like compounds may promote neuroplasticity and blood vessel growth in the brain, which could help improve functional recovery in the weeks and months following a stroke.

Additional studies of adult male rats have shown that niacin treatment can stimulate angiogenesis (the formation of new blood vessels) and increase levels of brain-derived neurotrophic factor (BDNF), a protein that helps neurons grow and form new connections.

These mechanisms may help explain why researchers are interested in niacin as a potential supportive therapy for stroke recovery. However, while these results are promising and suggest Vitamin B3 may play a supportive role in neurological healing, more large scale human trials are still needed.

Potential Benefits

• Supporting cellular energy production
• Promoting blood vessel growth in the brain
• Supporting neuroplasticity and nerve repair
• Improving circulation

How To Get More Vitamin B3

• Chicken and turkey
• Tuna and salmon
• Peanuts
• Brown rice
• Mushrooms
• Whole grains

6. Vitamin C

Vitamin C is a powerful antioxidant that helps protect the body’s cells from damage caused by oxidative stress. After a stroke, the brain can experience increased inflammation and oxidative damage as it responds to the injury. Because brain cells are particularly sensitive to this type of stress, antioxidants may play an important supportive role during recovery.

Vitamin C also contributes to the production of collagen, which helps maintain the health of blood vessels. Healthy blood vessels are important for delivering oxygen and nutrients to the brain, especially during the healing process.

Additionally, vitamin C supports immune function and helps the body repair damaged tissues, both of which can be valuable during rehabilitation.

What the Research Says

Several studies have explored the relationship between vitamin C levels and stroke outcomes. Research has found that individuals with higher vitamin C levels tend to have a lower risk of stroke, suggesting this nutrient may play a protective role in vascular health.

In addition, experimental studies suggest vitamin C may help reduce oxidative damage and inflammation in the brain following a stroke. By neutralizing harmful free radicals, vitamin C may help protect neurons and support the brain’s recovery environment.

While vitamin C is not a standalone treatment for stroke, maintaining healthy levels may help support overall brain health and recovery when combined with rehabilitation and medical care.

Potential Benefits

• Protecting brain cells from oxidative damage
• Supporting healthy blood vessels
• Reducing inflammation
• Helping repair damaged tissues

How To Get More Vitamin C

• Oranges and citrus fruits
• Strawberries
• Kiwi
• Bell peppers
• Broccoli
• Brussels sprouts

7. Vitamin E

Vitamin E is another antioxidant that helps protect cells from oxidative damage. Because the brain is highly sensitive to oxidative stress, maintaining adequate antioxidant levels may be beneficial during recovery.

What the Research Says

Some experimental studies suggest vitamin E may help reduce oxidative damage in brain cells and support neuronal survival following a stroke. By neutralizing free radicals, vitamin E may help create a healthier environment for the brain to heal and reorganize itself during neuroplasticity.

However, the relationship between vitamin E and stroke is complex. While moderate dietary intake of vitamin E from foods appears beneficial for overall cardiovascular health, high-dose vitamin E supplements have produced mixed results in clinical research. Some studies have suggested that very high doses may increase the risk of hemorrhagic stroke (bleeding in the brain) in certain individuals.

For this reason, vitamin E supplementation should always be discussed with a physician, especially for stroke survivors who may be taking medications such as blood thinners or other cardiovascular treatments.

Potential Benefits

• Protect brain cells
• Support immune function
• Reduce oxidative stress

How To Get More Vitamin E

• Almonds
• Sunflower seeds
• Spinach
• Avocados

What Is the Best Multivitamin for Stroke Recovery?

After learning about individual nutrients, many stroke survivors wonder whether taking a daily multivitamin might be the easiest way to support recovery.

The truth is that a multivitamin can sometimes help, but it should never replace a balanced diet or medical care. Instead, it can serve as a nutritional safety net that helps fill potential gaps in your diet.

What to Look for in a Multivitamin After Stroke

If you and your doctor decide that a multivitamin makes sense for your recovery plan, it helps to choose one that includes nutrients that support brain and vascular health.

Look for a multivitamin that includes:

• B vitamins (B6, B12, and folate) for nerve health and homocysteine regulation
• Vitamin D for muscle function and neurological health
• Vitamin C for antioxidant support
• Vitamin E for cellular protection
• Magnesium or zinc for metabolic and neurological function

Many high-quality multivitamins contain these nutrients in balanced amounts that stay close to recommended daily intake levels. Remember to always discuss any multivitamin or supplement you are considering taking with your doctor beforehand!

Important Reminder: Vitamins Are Only One Piece of Your Stroke Recovery Plan

One thing to remember when considering vitamin supplementation post stroke — it’s important to keep your expectations realistic. Vitamins alone cannot restore lost function after stroke.

Recovery primarily comes from consistent rehabilitation and repetitive practice, which stimulate the brain to form new neural connections.

Vitamins and proper nutrition simply help support that process by ensuring the brain and body have the resources needed for repair.

How to Safely Add Vitamins to Your Stroke Recovery Plan

Before taking any supplements, speak with your doctor or healthcare provider!

Some vitamins can interact with medications commonly prescribed after stroke, including blood thinners so this cannot be overstated that you need to talk with your healthcare provider to see what is appropriate for you!

A healthcare professional can help determine:

• Whether you actually have a deficiency
• The safest dosage
• Possible medication interactions

Supporting Your Brain’s Ability to Recover After Stroke With the Right Vitamins

Stroke recovery often requires patience and persistence. Some days may feel slow, while others bring surprising breakthroughs and that is completely normal.

While vitamins and nutrition can support the healing process, the most powerful driver of recovery remains repetition and consistent therapy because the brain changes when it is challenged repeatedly through movement, practice, and engagement.

So as you focus on healthy nutrition, remember to also keep moving, practicing, and giving your brain the stimulation it needs to rebuild. Progress may take time, but with the right support and persistence, meaningful improvements are possible.

We hope you enjoyed this article and subscribe to our newsletter for weekly articles just like this delivered straight to your inbox — subscribe here.

How excess niacin may promote cardiovascular disease

When I was on this drug in a clinical trial it flared up my eczema so bad I quit the trial.

Ask your competent? doctor if this use of niacin for Alzheimer's prevention is more important that the risk of heart disease. S/he has had two years to figure out what human trials have been done and their results. If they don't know that; you don't have a functioning stroke doctor!

Intake of FDA-Approved Drug Modulates Disease Progression in Alzheimer’s Model

 March 2022

The latest here:

How excess niacin may promote cardiovascular disease

At a Glance

• A metabolite of niacin (vitamin B3) was associated with elevated risk of heart attack and stroke, likely due to inflammation in arteries.
• The findings suggest new measures that may prevent or treat cardiovascular disease and raise concerns about the health effects of too much niacin.

Niacin, also known as nicotinic acid or vitamin B3, is found in many foods and supplements. The study suggests that too much may be harmful.Danijela Maksimovic / Shutterstock

Cardiovascular disease (CVD) is disease of the heart and blood vessels. CVD is a leading cause of death in the United States for both men and women. Despite advances in prevention and treatment, it remains widespread. This suggests that there may be risk factors that are not yet recognized.

To investigate, an NIH-funded research team, led by Dr. Stanley Hazen at the Cleveland Clinic, searched for products of metabolism that might contribute to CVD risk. The results appeared in Nature Medicine on February 19, 2024.

The team analyzed blood plasma from more than 1,100 people for molecules associated with major adverse cardiac events, such as heart attacks and strokes. They identified two such molecules, 2PY and 4PY. Both of these are produced when the body breaks down excess niacin.

Niacin, also known as nicotinic acid or vitamin B3, is an essential part of the diet. Many countries require that staple foods like cereals, flour, oats, and grains be fortified with niacin to prevent deficiency. In the United States, niacin must be added to “enriched” foods. The recommended amount of niacin is 14–18 mg/day for adults.

High–dose niacin (1,500–2,000 mg/day) was also one of the first cholesterol-lowering drugs. But studies found that niacin, unlike newer cholesterol-lowering drugs, did not lower the risk of heart attack or stroke. Researchers hadn’t understood why.

The researchers examined 2PY and 4PY levels in two other groups, one American and one European, totaling more than 3,000 people. They confirmed that elevated levels of either molecule were associated with increased risk of major cardiac events. People with 2PY or 4PY levels in the top 25% had 1.6-2 times the risk of major cardiac events over the next three years as those with levels in the bottom 25%, even after controlling for other CVD risk factors.

Levels of both 2PY and 4PY were associated with variants in a gene called ACMSD. The team found that levels of another protein, called VCAM-1, were also associated with ACMSD variants. Furthermore, VCAM-1 levels correlated with 2PY and 4PY levels.

VCAM-1 is known to help white blood cells stick to the walls of blood vessels as part of the inflammatory response. This contributes to the formation of plaque in arteries. Injecting mice with 4PY, but not 2PY, increased the amount of VCAM-1 on the walls of blood vessels and the number of stuck white blood cells.

These findings suggest that excess niacin may be a risk factor for CVD. When excess niacin is broken down into 4PY, this breakdown product activates inflammatory pathways that are known to promote plaque formation in arteries. This may increase the risk of major cardiac events.

“Niacin’s effects have always been somewhat of a paradox,” Hazen says. “Despite niacin lowering cholesterol, the clinical benefits have always been less than anticipated based on the degree of LDL [cholesterol] reduction. This led to the idea that excess niacin caused unclear adverse effects that partially counteracted the benefits of LDL lowering. We believe our findings help explain this paradox.”

The study results could lead to better assessment of CVD risk. They also highlight the importance of further research on the health effects of supplemental niacin.

—by Brian Doctrow, Ph.D.

High levels of niacin linked to heart disease, new research suggests

 

When I was on this drug in a clinical trial it flared up my eczema so bad I quit the trial.

Ask your competent? doctor if this use of niacin for  Alzheimer's prevention is more important that the risk of heart disease. S/he has had two years to figure out what human trials have been done and their results. If they don't know that; you don't have a functioning stroke doctor!

Intake of FDA-Approved Drug Modulates Disease Progression in Alzheimer’s Model

 March 2022

The latest here:

High levels of niacin linked to heart disease, new research suggests

High levels of niacin, an essential B vitamin, may raise the risk of heart disease by triggering inflammation and damaging blood vessels, according to new research.

The report, published Monday in Nature Medicine, revealed a previously unknown risk from excessive amounts of the vitamin, which is found in many foods, including meat, fish, nuts, and fortified cereals and breads.

The recommended daily allowance of niacin for men is 16 milligrams per day and for women who are not pregnant is 14 milligrams per day.

About 1 in 4 Americans has higher than the recommended level of niacin, said the study’s senior author, Dr. Stanley Hazen, chair of cardiovascular and metabolic sciences at the Cleveland Clinic’s Lerner Research Institute and co-section head of preventive cardiology at the Heart, Vascular and Thoracic Institute.

The researchers currently don’t know where to draw the line between healthy and unhealthy amounts of niacin, although that may be determined with future research.

"The average person should avoid niacin supplements now that we have reason to believe that taking too much niacin can potentially lead to an increased risk of developing cardiovascular disease,” Hazen said.

Currently, Americans get plenty of niacin from their diet since flour, grains and cereals have been fortified with niacin since the 1940s after scientists discovered that very low levels of the nutrient could lead to a potentially fatal condition called pellagra, Hazen said.

Prior to the development of cholesterol-lowering statins, niacin supplements were once even prescribed by doctors to improve cholesterol levels.

To search for unknown risk factors for cardiovascular disease, Hazen and his colleagues designed a multipart study that included an analysis of fasting blood samples from 1,162 patients who had come into a cardiology center to be evaluated for heart disease. The researchers were looking for common markers, or signs, in the patients’ blood that might reveal new risk factors.

The research resulted in the discovery of a substance in some of the blood samples that is only made when there is excess niacin.

Meat in grocery store (Burke/Triolo Productions / Getty Images)

That finding led to two additional “validation” studies, which included data from a total of 3,163 adults who either had heart disease or were suspected of having it. The two investigations, one in the U.S. and one in Europe, showed that the niacin breakdown product, 4PY, predicted participants’ future risk of heart attack, stroke and death.

The final part of the study involved experiments in mice. When the rodents were injected with 4PY, inflammation increased in their blood vessels.

The results are “fascinating” and “important,” said Dr. Robert Rosenson, director of metabolism and lipids for the Mount Sinai Health System in New York City.

The newly detected pathway to heart disease might lead to the discovery of a medication that could reduce blood vessel inflammation and decrease the likelihood of major cardiovascular events, he added.

Rosenson hopes that the food industry will take note and “stop using so much niacin in products like bread. This is a case where too much of a good thing can be a bad thing.”

The new information could influence dietary recommendations for niacin, said Rosenson, who was not involved with the Cleveland Clinic research.

Scientists have known for decades that a person’s cholesterol level could be a major driver of heart disease, said Dr. Amanda Doran, an assistant professor of medicine in the division of cardiovascular medicine at the Vanderbilt University Medical Center.

Even when patients’ cholesterol levels were brought down, some continued to have a high risk of heart attacks and stroke, Doran said, adding that a 2017 trial suggested that the increased risk might be related to blood vessel inflammation.

Doran was surprised to learn that niacin could be involved in driving up the risk of heart disease.

“I don’t think anyone would have predicted that niacin would have been pro-inflammatory,” she said. “This is a powerful study because it combines a variety of techniques: clinical data, genetic data and mouse data.”

Finding the new pathway may allow future researchers to discover ways to reduce blood vessel inflammation, Doran said.

“It’s very exciting and promising,” she said.

This article was originally published on NBCNews.com

Intake of FDA-Approved Drug Modulates Disease Progression in Alzheimer’s Model

 With your excellent chance of getting dementia, you'll want your doctor to be following this closely. Do not self treat,

Your risks of dementia, has your doctor told you of this?

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.`    

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018

Where are the  protocols to prevent your dementia?

 

When I was on this drug in a clinical trial it flared up my eczema so bad I quit the trial.

The latest here:

Intake of FDA-Approved Drug Modulates Disease Progression in Alzheimer’s Model

Summary: Niaspan, an FDA-approved drug, limits disease progression in lab models of Alzheimer’s disease.

Source: Indiana University

Indiana University School of Medicine researchers have found that niacin limits Alzheimer’s disease progression when used in models in the lab, a discovery that could potentially pave the way toward therapeutic approaches to the disease.

The study, recently published in Science Translational Medicine, investigates how niacin modulates microglia response to amyloid plaques in an Alzheimer’s disease animal model.

Gary Landreth, Ph.D., Martin Professor of Alzheimer’s Research, and Miguel Moutinho, Ph.D., postdoctoral fellow in Anatomy, Cell Biology and Physiology, led the study.

“This study identifies a potential novel therapeutic target for Alzheimer’s disease, which can be modulated by FDA-approved drugs,” Moutinho said. “The translational potential of this strategy to clinical use is high.”

Niacin, which sustains metabolism throughout the body, is mainly obtained through a typical diet; it also can be taken in supplements and cholesterol-lowering drugs. The brain, however, Moutinho found, uses niacin in a different manner.

In the brain, niacin interacts with a highly-selective receptor, HCAR2, present in immune cells physically associated with amyloid plaques. When niacin—used in this project as the FDA-approved Niaspan drug—activates the receptor, it stimulates beneficial actions from these immune cells, Landreth said.

Niacin, which sustains metabolism throughout the body, is mainly obtained through a typical diet; it also can be taken in supplements and cholesterol-lowering drugs. Image is in the public domain

“After the Alzheimer’s disease animal models received niacin, they ended up with fewer plaques and they have improved cognition,” Landreth said, “and we directly showed that these actions were due to the HCAR2 receptor.”

Past epidemiology studies of niacin and Alzheimer’s disease showed that people who had higher levels of niacin in their diet had diminished risk of the disease, Landreth said. Niacin is also currently being used in clinical trials in Parkinson’s disease and glioblastoma.

To further their research into niacin and the brain, Landreth and Moutinho are collaborating with Jared Brosch, MD, associate professor of clinical neurology, who is applying for a clinical pilot trial to study the affects of niacin and the human brain.

About this neuropharmacology and Alzheimer’s disease research news

Author: Press Office
Source: Indiana University
Contact: Press Office – Indiana University
Image: The image is in the public domain

Original Research: Open access.
“The niacin receptor HCAR2 modulates microglial response and limits disease progression in a mouse model of Alzheimer’s disease” by Miguel Moutinho et al. Science Translational Medicine

 

 

Eczema patients face increased risk of accidental injury

My eczema exploded upon taking Niacin as part of a clinical research trial. I never did take any drugs to combat it. I pretty much controlled it by applying coconut oil on it for a week.
http://www.feinberg.northwestern.edu/news/2014/10/Silverberg-accident-prone-eczema.html
Intense itching and dry, irritable skin aren’t the only problems adults with eczema face. They are at greater risk of accidental bone fractures and other injuries, a new Northwestern Medicine study has found.
This is the first study to find adult eczema is a risk factor for fractures and other injuries.
The increased odds of accidental injury could be directly related to the side effects of steroids and sedating antihistamines commonly prescribed to treat the skin disorder or the under-treatment of severe cases, study authors suggest.
“Many eczema patients who are prescribed medication for itch are often given sedating antihistamines or steroids, but those medications may come at a price,” said Jonathan I. Silverberg, MD, PHD, MPH, assistant professor in Dermatology, Medical Social Sciences and Preventive Medicine and senior author of the study. “Sedatives cause fatigue, and steroids can lead to bone density problems and osteoporosis.”
The study, published Oct. 29 in the journal JAMA Dermatology, validates what Dr. Silverberg sees regularly at the Northwestern Multidisciplinary Eczema Center.
“Last month three of my patients with eczema cancelled at the last minute because of injuries,” he said. “One fell and almost got hit by a bus, another was hit by a car and then another missed her appointment because she was in a car accident. You can't make this stuff up.”
More than 10 percent of adults have eczema, which also is called atopic dermatitis. A third of those people report a moderate- to-severe form of the skin condition. The itch eczema patients experience can be maddening.

More at link.

3 Things to Know About Niacin and Heart Health

I was in the American clinical trial, but because I got the maximum dose I got the maximum side effects of blowing up my eczema into a scratching bleeding red mess. I dropped out of the trial just as they were closing it down.
http://well.blogs.nytimes.com/2014/07/16/3-things-to-know-about-niacin-and-heart-health/

Cardio Notes: Niacin and Stroke Risk

I was in this AIM-HIGH trial and dropped out just as it was shutting down. I believe that the niacin totally flared up a patch of eczema on my leg, causing me to scratch it until it bled.
But see what your doctor thinks.
http://www.medpagetoday.com/Cardiology/Strokes/40725?

Muscle, skin and gastrointestinal problems cause a quarter of patients with heart disease and strokes to stop treatment in HPS2-THRIVE trial

I was in the earlier trial - (AIM-HIGH) study  - that just had the niacin, no flushing blocker, I quit the trial I was in because of the exacerbation of existing excema I had on my leg. I was scratching at it until it bled.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=128784&CultureCode=en
The largest randomised study of the vitamin niacin in patients with occlusive arterial disease (narrowing of the arteries) has shown a significant increase in adverse side-effects when it is combined with statin treatment.
Results from the HPS2-THRIVE study (Heart Protection Study 2 – Treatment of HDL to Reduce the Incidence of Vascular Events), including the reasons patients stopped the study treatment, are published online today (Wednesday) in the European Heart Journal [1].
Niacin has been used for decades to help increase levels of “good” HDL cholesterol and to decrease levels of “bad” LDL cholesterol and triglycerides (fats) in the blood in people at risk of cardiovascular problems such as heart disease and stroke. However, it has a number of side-effects including flushing of the skin. Another drug, laropiprant, can reduce the incidence of flushing by blocking the prostaglandin D2 receptor that is involved in the process. Therefore, the HPS2-THRIVE study investigated whether combining extended-release niacin with laropiprant (ERN/LRPT), given in addition to an LDL cholesterol-lowering statin, simvastatin, could reduce the risk of cardiovascular problems in people at high risk due to existing occlusive arterial disease.
A total of 25,673 patients from China, the UK and Scandinavia were randomised between April 2007 and July 2010 to receive either 2g of extended release niacin plus 40 mg of laropiprant or matching placebo. In addition, all participants received intensive LDL cholesterol-lowering therapy with simvastatin (with or without ezetimibe). Researchers from the Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU) at the University of Oxford (UK), who were responsible for designing and conducting the trial and analysing the results, followed the patients for an average of 3.9 years.
By the end of the study, 25% of patients taking ERN/LRPT had stopped their treatment, compared with 17% of patients taking placebo.
Jane Armitage, Professor of Clinical Trials and Epidemiology & Honorary Consultant in Public Health Medicine at the CTSU, said: “The main reason for patients stopping the treatment was because of adverse side-effects, such as itching, rashes, flushing, indigestion, diarrhoea, diabetes and muscle problems. We found that patients allocated to the experimental treatment were four times more likely to stop for skin-related reasons, and twice as likely to stop because of gastrointestinal problems or diabetes-related problems.
“We found that, in the trial as a whole, participants in the experimental arm had a more than four-fold increased risk of myopathy (muscle pain or weakness with evidence of muscle damage) compared with the placebo group. This is highly significant. It appeared that this effect was about three times greater among participants in China than those in Europe, for reasons that are not clear. In the placebo arm (i.e. those on statin-based treatment alone), the statin-related myopathy was more common among participants in China than those in Europe. Therefore – in combination with the greater effect of ERN/LRPT on myopathy in China – the excess number of cases of myopathy caused by ERN/LRPT (though low in both regions) was over ten times greater among participants in China than those in Europe (0.53 percent per year compared to 0.03 percent per year).”
Dr Richard Haynes, Clinical Coordinator at the CTSU, said: “This is the largest randomised trial of extended release niacin treatment and it provides uniquely reliable results on adverse side-effects and the ability of patients to tolerate them. Although 25 percent of patients stopped the treatment early, 75 percent continued on it for approximately four years. Currently, we are analysing the final data on the cardiovascular outcomes from the trial, and once we have these we will know whether or not the benefits of the treatment outweigh the myopathy, skin and gastrointestinal problems.”
The researchers will be presenting full results on the cardiovascular outcomes at the annual meeting of the American College of Cardiology in March and these will be published in another paper afterwards [2].
The co-principal investigator of the study, Dr Martin Landray, Reader in Epidemiology and Honorary Consultant Physician at the CTSU, said: “Previous research had suggested that improving cholesterol levels in high-risk patients might translate into a 10-15 percent reduction in major vascular events such as heart attacks and strokes. In the HPS2-THRIVE study, 3,400 of the 25,673 participants suffered a major vascular event over an average of four years of follow-up. This means the study has excellent statistical power to discover the effectiveness or otherwise of the treatment.”
In an accompanying editorial [3], Professor Ulf Landmesser, of the University Hospital Zurich (Switzerland), points out that although the study showed an increase in myopathy, it also showed that the ERN/LRPT substantially lowered LDL cholesterol and triglycerides by nearly 20%. He writes that these observations “raise important questions as to why niacin/laropiprant did not reduce major cardiovascular events”, and he wonders whether laropiprant “is really biologically inert with respect to atherosclerosis and thrombosis”.
He concludes that “niacin has failed as a valuable ‘partner’ of statin therapy in lipid-targeted approaches to further reduce major cardiovascular events in high-risk patients”. He continues: “At present, statin therapy has been clearly shown to reduce vascular events effectively and is reasonable well tolerated in most patients. We will still have to wait for the results of … ongoing studies to see whether another lipid-targeted intervention can further reduce vascular events in addition to statin therapy.”

Notes:
[1] “HPS2-THRIVE randomized placebo-controlled trial in 25 673 high-risk patients of ER niacin/laropiprant: trial design, pre-specified muscle, and liver outcomes and reasons for stopping study treatment”, by Richard Haynes, Lixin Jiang, Jemma C. Hopewell, Jing Li, Fang Chen, Sarah Parish, Martin J. Landray, Rory Collins, and Jane Armitage, The HPS2-THRIVE Collaborative Group. European Heart Journal. doi:10.1093/eurheartj/eht055
[2] In December 2012 the pharmaceutical company Merck, which manufactures ERN/LRPT under the trade name Tredaptive and which funded the HSP2-THRIVE study, issued a statement saying the trial had failed to meet its primary endpoint and that “the combination of extended-release niacin and laropiprant to statin therapy did not significantly further reduce the risk of the combination of coronary deaths, non-fatal heart attacks, strokes or revascularizations compared to statin therapy.” ERN/LRPT is not approved for use in the USA, and on January 11, Merck announced that it was “taking steps to suspend the availability of TREDAPTIVE™ (extended-release niacin/laropiprant) tablets worldwide.”
[3] ”The difficult search for a ‘partner’ of statins in lipid-targeted prevention of vascular events: the re-emergence and fall of niacin”, by Ulf Landmesser. European Heart Journal. doi:10.1093/eurheartj/eht064