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Sunburn Question

Posted: Mon Jul 05, 2010 6:01 pm
by prauly
This is really more of a 'drug' related question, but none of the 'drug' threads seemed to fit.

I was recently diagnosed (2+ weeks ago) and started daily Copaxone injections just under 2 weeks ago. We went on vacation last week and I got the WORST sunburn that I have ever had on Tuesday. I am very fair skinned and didn't use sunscreen, only some SPF in my daily moisturizer. However, I was not outside for an unusual length of time.

I feel the need to add that, in addition to the Copaxone, I had a 5 day course of IV Solumedrol that ended the Friday before the sunburn day (Tuesday). I had asked multiple sources about sensitivity to the sun after a course of solumedrol but the Neurologist's PA, the Pharmacist, the website of the pharm company, AND my Dermatologist all said not to worry about sun sensitivity. BUT - here I sit almost one full week after the initial sunburn in so much pain that I need to medicate with Benedryl and possibly Ativan. I just slathered on vaseline, because all of the other creams and ointments just 'sting/burn'.

I want to avoid this in the future, but cannot figure out the cause. I used to get my 'annual sunburn' and would be fine in a couple/few days. This has been almost 7 days and I am even more uncomfortable now than on the first day. I think that it is too much of coincidence that I started 2 major meds just before vaca.....

Re: Sunburn Question

Posted: Tue Jul 06, 2010 12:22 am
by NHE
prauly wrote:BUT - here I sit almost one full week after the initial sunburn in so much pain that I need to medicate with Benedryl and possibly Ativan. I just slathered on vaseline, because all of the other creams and ointments just 'sting/burn'.
Whenever I've gotten a sunburn, I've found that using a vitamin C cream helps to relieve the redness from the burn. This treatment is discussed in many of the books by Dr. Nicholas Perricone. The rationale behind the treatment is that the vitamin C will help to reduce the inflammation caused by the burn. I've used a product by Jasön called "ester C crème" though Dr. Perricone recommends using one that contains ascorbyl palmitate (which is vitamin C linked to a fat) since it will enter the skin more readily. Note that creams containing ascorbyl palmitate are usually more expensive and the Jasön ester C crème usually does the trick for me though I haven't had to deal with a burn as intense as yours.

I hope that this helps.

NHE

Posted: Tue Jul 06, 2010 1:57 am
by prauly
I am on my way to Whole Foods right now! Thank you.....!

Posted: Tue Jul 06, 2010 4:53 am
by jimmylegs
vitamin C can also up your body's natural interferon.

some old links but no time for more...:
http://content.karger.com/ProdukteDB/pr ... /000136908 http://www3.interscience.wiley.com/jour ... 1&SRETRY=0

on to the drugs:

copaxone = photosensitivity infrequent but not rare. 1/100 - 1/1000.

http://dailymed.nlm.nih.gov/dailymed/ar ... hiveid=837
copaxone (glatiramer acetate) injection
[Aventis Pharmaceuticals Inc.]
Other Adverse Events Observed During Clinical Trials
Glatiramer acetate was administered to 979 individuals during premarketing clinical trials, only some of which were placebo-controlled. During these trials, all adverse events were recorded by the clinical investigators, using terminology of their own choosing. To provide a meaningful estimate of the proportion of individuals having adverse events, similar types of events were grouped into standardized categories using COSTART dictionary terminology. All reported events occurring at least twice and potentially important events occurring once are listed below, except those already listed in the previous table, those too general to be informative, trivial events, and other reactions which occurred in at least 2% of treated patients and were present at equal or greater rates in the placebo group. Additional adverse reactions reported during the post-marketing period are included.

Events are further classified within body system categories and listed in order of decreasing frequency using the following definitions: Frequent adverse events are defined as those occurring in at least 1/100 patients; Infrequent adverse events are those occurring in 1/100 to 1/1000 patients; Rare adverse events are those occurring in less than 1/1000 patients.

Body as a Whole:

♦ Frequent: Injection site edema, injection site atrophy, abscess, injection site hypersensitivity.
♦ Infrequent: Injection site hematoma, injection site fibrosis, moon face, cellulitis, generalized edema, hernia, injection site abscess, serum sickness, suicide attempt, injection site hypertrophy, injection site melanosis, lipoma, and photosensitivity reaction.
***

here is the solu-medrol entry (no photosensitivity text)
http://dailymed.nlm.nih.gov/dailymed/dr ... fm?id=9785

so, bringing it back to why... are your eyes sensitive to light also? or is it mainly the skin pain? if eyes are sensitive, think about B2. if only skin, consider B3.

i can't find anything to suggest that copaxone depletes B3. so we can't necessarily blame it for causing a B3 deficiency. but the fact that you need the copaxone might point to a pre-existing B3 problem, perhaps one that has developed over the last year for some reason. ...i do notice the vasodilation effect of copaxone, which is the same as what you get when you take B3 (that would be straight niacin not niacinamide).

so it does look connected.. but complex, like everything else. without spending too much time on this, i'm guessing that you may want to look at your daily B3 intake over the last while and decide whether it has been enough. or if there's anything else that might cause gradual B3 depletion over time.

http://www.whfoods.com/genpage.php?tnam ... nt&dbid=83
What factors might contribute to a deficiency of vitamin B3?
Intestinal problems, including chronic diarrhea, inflammatory bowel disease, and irritable bowel disease can all trigger vitamin B3 deficiency. Because part of the body's B3 supply comes from conversion of the amino acid tryptophan, deficiency of tryptophan can also increase risk of vitamin B3 deficiency. (Tryptophan deficiency is likely to occur in individuals with poor overall protein intake.) Physical trauma, all types of stress, long-term fever, and excessive consumption of alcohol have also been associated with increased risk of niacin deficiency.


i had low protein intake for 15 years ... not to mention we all have to deal with stress! - i fixed the protein problem so at least part of the issue is in the past :)

i have used B3 to good effect, but haven't felt that i needed it in quite some time now (a few years). i couldn't say exactly how it helped but it was part of that big (modified, oral) klenner protocol that gave me back my hands.

HTH,
jimmylegs

PS: interesting trivia...
In America, the term 'redneck' actually comes from a vitamin B deficiency that causes heightened susceptibility to sunburns. Interestingly, most Americans are, today, deficient in B vitamins as well, which is why they are so easily susceptible to sunburns. As explained in Staying Healthy With Nutrition by Dr. Elson Haas, M.D.:
For a long period of history, the niacin deficiency disease, pellagra, was a very serious and fatal problem. Characterized as the disease of the "three Ds," pellagra causes its victims to experience dermatitis, diarrhea, and dementia. The fourth D was death. As described previously, the classic B3 deficiency occurs mainly in cultures whose diets rely heavily on corn and where the corn is not prepared in a way that releases its niacin (JL comment: seen food Inc. lately?). One of the first signs of pellagra, or niacin deficiency, is the skin's sensitivity to light, and the skin becomes rough, thick, and dry (pellagra means "skin that is rough" in Italian). The skin then becomes darkly pigmented, especially in areas of the body prone to be hot and sweaty or those exposed to sun. The first stage of this condition is extreme redness and sensitivity of those exposed areas, and it was from this symptom that the term "redneck," describing the bright red necks of eighteenth-and nineteenth-century niacin-deficient fieldworkers, came into being.

Posted: Tue Jul 06, 2010 5:33 pm
by prauly
WOW. You are truly a fount of MS information. :)

I do not have any issues with my eyes being sensitive to light; at this point, it is only the skin. I know that my B12 is low, but have never been told that my B3 is an issue. However -- I'm not sure. I will certainly check my records.

Thank you for the Copaxone details around photosensitivity, I assumed that it was was the Solu-medrol. I will certainly wear the strongest SPF I can fine from this day forward.

Thanks Jimmy!

Posted: Wed Jul 07, 2010 5:22 am
by jimmylegs
hey there prauly,

okay sounds like it's not primarily a B2 issue then.

oh really, what is your B12 level? you want to aim for 500 pmol/L or so, minimum. so that you're not just going on hematological criteria, but also cognitive.

i imagine your docs have probably not tested niacin (B3) - although it is interesting that some patients take statins for their ms.. and niacin is a known natural alternative to statins, for other non-MS reasons.

the 1970s klenner protocol for MS recommends B3 (niacin form, not niacinamide) as a very small part of the whole protocol.. but here is the niacin part:
100mg to 3 grams, thirty minutes before meals and at bed hour, and also during the night if awake – whichever dose will produce a strong body flush. Niacin dilates the blood vessels, even those that have been compressed by scar tissue, allowing a greater amount of nutrient material to reach the cell laboratory or factor comprising muscles and nerves. ... Hot fluids taken at the same time as the niacin will enhance the flush...
JL comment :!: 8O :!: i had not noticed this next bit before!!!:
..The lack of constant flushing in Multiple Sclerosis is disappointing but not hopeless
i can guess part of the answer - research from the 80s i think, found that fatty acid deficiency results in absent niacin flush reaction. the latest (August 2010..?!):
http://tinyurl.com/255wrky


please don't neglect that B3 idea.. it may not just be the copaxone, or if it is, maybe it is affecting your B3 status. if they do similar things in the body, the copaxone might be tying up some sort of receptor that your body needs for B3 absorption. maybe this is why some people react with photosensitivity - if they had low B3 status to start, then taking the drug pushes them over the edge and they go 'redneck' hehehe.

all hypotheses of course.

last of all, SPF will block your natural D3 production of course, so you might want to make sure your D3 levels stay sufficient - 100-150 nmol/L is a good range to be in.. - upper end of the range would be more like 250, beyond that there could by hypercalcaemia issues.

ciao!
JL