Thursday, March 18, 2010

Vitamin D For Psoriasis



Image : http://www.flickr.com

Oral doses of vitamin D have been considered as a treatment for psoriasis. This was sparked by experiments with cholecalciferol or 1,25 dihydroxyvitamin D3 (1,25 (OH)2D3), the active form of vitamin D made in the kidney, which showed promise in treating widespread psoriasis.

Using a one microgram daily dose of cholecalciferol, Japanese researchers in 1986 managed to treat 13 out of 17 psoriatic patents within three months. But there are risks involved with this therapy.

High doses of vitamin D often leads to hypercalcemia (high blood calcium levels) which is characterized by nausea, vomiting, drowsiness, confusion, high blood pressure, kidney failure, and coma. This was observed in the Japanese study and can occur in those taking 1,000 lUs (international units) or more of vitamin D.

The topical use of cholecalciferol by the same researchers proved to be more beneficial and less toxic. Sixteen out of 19 patients were treated within three weeks with a dose of 0.5 microgram per gram compared to three months with oral doses. Still, the possibility of hypercalcemia remained since vitamin D is absorbed by the skin.

That was until researchers at Leo Pharmaceutical Products in Denmark tried to develop a new form of vitamin D which could clear up psoriatic plaques minus the risks encountered in both oral and topical applications of cholecalciferol. That led to the discovery of calcipotriol.

Calcipotriol is a vitamin D3 derivative which is just as effective as cholecalciferol in controlling rapid cell growth in psoriatic skin yet 100 – 200 times less likely to produce hypercalcemia. Unlike other creams and ointments, it is colorless and odorless and generally well-tolerated by patients.

This vitamin D3 analogue is recommended for the treatment of plaque-type psoriasis and can be used alone or in combination with UVB radiation (which was tackled earlier in this series). The exact mechanism of calcipotriol is unknown but numerous studies have established the efficacy of this drug.

Controlled clinical trials have shown that calcipotriol is just as effective as some steroids and more effective than anthranol (both of which were discussed in this series) in treating plaque-type psoriasis. Patients using the recommended dose of 50 micrograms per gram twice daily for six months have not developed hypercalcemia, making calcipotriol safer than other conven¬tional psoriasis regimens.

The long-term effects of calcipotriol, however, are unknown and its safety in children and pregnant women has not been established. Using more of the drug can also be dangerous. If you go beyond the recommended dose and use more than 100 grams a week, you may suffer from high blood calcium levels.

So far, the only side effect reported is a mild skin irritation that occurs in 10 to 20 percent of patients who use calcipotriol. But this can be controlled by means of careful application. Calcipotriol should not be used on the face and patients are advised to wash away traces of the ointment that accidentally get in other unaffected areas of the skin. If you experience skin irritation, stop treatment and consult a doctor immediately.

[Via http://vitaminebenefit.wordpress.com]

Tuesday, March 9, 2010

Go Fish!

I am a fish, in more ways than one.

Like a fish, I swam.  While there were no hopes for Olympic gold, swimming was a major part of my life. The saying, “You don’t know what you got till you lost it” is true for me in this case.  I recall finding solace in the stillness of being alone in the water, to relax, I sat close-eyed at the bottom of a pool.  In a meditation pose, I try to tune out, for as long as I can hold my breath, the muted sounds coming from above.  

I competed in swimming. When time came that I passed the teen years of hyper metabolism, and I needed to start exercising, swimming was the one form of exercise I liked and could stick with.  Alas, I live to swim another day.

Dermatologists always advise to keep the skin moist with lotions and creams.  The chlorine in the water, dries my skin.  The docile germaphobe in me, thinks of who swam there and if there was something in the water that I could catch more readily because I might have an open lesion I wasn’t aware of.  Too much sun was another no-no.  Only fifteen to 20 minutes a day is recommended.  That is not even enough time to do a warm up, much less swim laps.  As I pass the condo complex’ pool on my way to get the mail, I look at it longingly, and yearn for the day I could get one of those exercise pools and fill it with regular water and Dead Sea salts. 

When I get back in the water, it will probably be like what they say about riding a bike. While my parents still keep trophies and medals won from swim meets of much younger years, I am left trying to remember the feel of water gliding on my skin as I swam laps.  All of that, is resigned to a very distant past, under the chapter of – “Another Version Of Me and All The Things I Used To Do”.

Like a fish, I am scaly.  Depending on the season, the current treatment, and, my stress levels, Psoriasis makes me shed skin faster than people without it.  Normally, skin cells mature and shed from the surface of the body. This process takes about four weeks vs. three to four days for people with Psoriasis. My body’s over-active immune system produces skin too fast, which leaves me with silvery, patches of skin, a.k.a. scales.  

At the first major onslaught of the symptoms, I had a helmet of scales covering my whole scalp.  It looked like dandruff – only the worst you’ve ever seen.  My whole scalp moved when I raised my eyebrows.  At that time, on a two-week tour of several European countries with my family, I could not help but leave my DNA in every hotel room, and in and around every chair I sat in.  Much like Hansel and Gretel leaving crumbs to find their way home, I imagine I left a trail of shed skin everywhere I went.  The “helmet” made my scalp itchy and I had to grit my teeth and bear it, otherwise I might remind you of a dog with a bad flea infestation.  Scratching also loosened the scales’ hold on my skin and would inevitably cause it to pop up, float and dangle from the strands of my hair.

During college, I would speak with the professors in private and request permission to wear a hat in their class.  I told them that I was not trying to be fashionable nor rude but that I had a condition which symptoms, I wanted to hide.  Hats hid the scales on my scalp and the red patches on my forehead.

Like a fish (out of water), I feel out-of-place.  At functions and get togethers, a constant thread of thought fills my head.  Inquiries: Is that red patch on my forehead visible to this person I’m speaking with? Did I put enough concealer on it?  Is the light catching that scaly part near my hairline?  Did I scratch on the way here?  Is there a dandruff on my hair? Is there snow on my shoulders? Did they see the red area when I shook their hand?  It’s unending.

Currently, only a few people know of my condition.  My confidence level is low.  A lady I met at a recent seminar held by the NPF (National Psoriasis Foundation), shared with me stories of how she reacts when someone acts negatively to her skin’s condition.  I realized I do not need to hide, but doubt that I can be confident enough in myself to put people in their place. 

You see, while psoriasis is not the same as having lost one’s eyesight, hearing, a limb, in some cases it is just as debilitating.  As we were taught not to stare and to treat disabled people with consideration and as our equals, so should we regard people with Psoriasis.  However, for as long as there are many like me who suffer in silence, hide the symptoms, and not speak for themselves, there will not be awareness for the disease.  With ignorance comes fear – Is it contagious? No.

While other people, diagnosed or not, with the same skin disorder as I, with symptoms even worse than mine, have accepted themselves, I find it hard.  I am trying.

[Via http://monette77.wordpress.com]