Is niacin the problem

[rbdesigndecor]

I was prescribed niacin several months ago to lower my cholesterol.  Weeks later I developed pain in my foot, also had some swelling of my face, hands and feet.  I developed hives that itched, particularly if I exercised.  All of these symptoms would come and go.  I tried Benadryl, and my doctor put me on Medrol dosepack, but still kept me on the Niacin.  Even though the Niacin was discontinued weeks ago, I still have some of the same problems.  Tests for allergy to peanuts and shellfish were negative.  I ate a few shrimp yesterday and exercised, and woke up today with hives that are itching; I feel fatigued and my skin feels uncomfortable.  Could the Niacin I took still be causing this or did the Niacin trigger something in my body?  I was never allergic to shellfish in the past.  What else could be at work here?  

[Bhupinder Kaur, MD]

Hello,

You seem to be having hives (urticaria). Hives (medically known as urticaria) are red, itchy, raised areas of skin that appear in varying shapes and sizes. They have a tendency to change size rapidly and to move around, disappearing in one place and reappearing in other places, often in a matter of hours.

Many cases of hives are "idiopathic," meaning no cause is known. Others may be triggered by viral infections or medications.But you can’t blame niacin as it was discontinued long back.

The mainstay of treatment of hives is antihistamine which may be necessary for prolonged periods (in excess of 6 weeks). Double conventional doses of the non-sedating antihistamines such as Cetirizine(zyrtec) and Loratadine(Claritin) may be needed to get symptom relief. Sedating antihistamines such as Chlorphenamine(benadryl) or Hydroxyzine are used at night to get urticaria control. Short courses of oral cortisone or steroids are taken for short periods (one to three days) to settle more severe symptoms.
You may take Vitamin C along with the prescribed treatment. Vitamin C is a general anti-allergy supplement. It helps stabilize mast cells so they are less likely to release histamine. You can also apply 1%hydrocortisone cream on the effected area.

If the hives don’t go after 6 wks of treatment also, then it can be a case of chronic urticaria which needs further evaluation as it may be due to auto antibodies.Then a consultation of an allergist is required.

I hope that helps. Please do keep me posted on how you are doing or if you have any additional queries. Kind regards.

[rbdesigndecor]

Thanks for your helpful comments.  I have been using antihistamines regularly, and my md prescribed 5 days of prednisone which gave me some relief.  36 hours after discontinuing the prednisone, the symptoms are returning - some hives, foot swelling, etc.  I had blood tests for auto immune problems but they were negative.  I am staying away from shellfish and almost all wheat/gluten.  I guess I need to see an allergist.  Could these symptoms be related to any kind of parasite infestation?