The Niacin Factor…
Dear parents,
Please take note!
I'm not a ranter, and I'm not going to rant now, but I AM going to tell you a true story that might be helpful.
For the last couple of months my son Miles has been getting a little flushed and rashy in the face. Since I have very severe food allergies, I wanted to be diligent, and err on the safe side. So, I had him skin tested by a local pediatric allergist for a myriad of food items. Nothing showed up. Totally negative!
Okay, so that's a good thing. We moved on. It seemed to happen after meals or snacks. He would get really flushed and a little rashy on the face. Couldn't pinpoint it. But being a holistic health coach and a mom, I felt determined.
Fast forward to this past Sunday. I slept in. My husband gave Miles breakfast, and then he had an Outshine bar. (popsicle). Okay, I let him have two when I awoke. Then I gave him a vitamin since he had not yet taken it.
My husband ran out to get some house supplies at Lowe’s, and I began to cook up some oatmeal. Miles came stumbling into the living room, looked stressed and said, "I'm hungry. I'm so hungry. My stomach is hurting." Then he dashed up the stairs to the bathroom and was doubled over trying to throw up. He was beet red, clammy, hot as a stove and began to break out in a rash on his arms, back and belly. I started to spin and panic and just then my husband walked through the door and I nervously instructed him to call 911.
Miles was nauseous, itchy, hot, and red and had begun coughing. I was losing my cool. But the EMT arrived quickly and we crisscrossed through traffic and roadwork and made it HUMC Pediatric ER where they monitored him, administered Benadryl and discharged us after a couple of hours when the symptoms had subsided.
Could it have been FIFTHS? (a virus that has gone around schools all winter) A severe allergic reaction? They mentioned a possible low glycemic incident, triggering a histamine reaction.
I have had anaphylaxis. This didn't seem to make sense. One minute he was quietly watching Ninjago and the next minute he was in distress as if someone had flipped a switch.
Moving along. The ER doctor told us not to worry about the cause when we asked for her opinion. She simply stated that they don't focus on the cause, they just treat the symptoms. So sad that this is the way we do things. How can one prevent a situation as horrifying as this from reoccurring if there is so little attention paid to the root of the cause. I was not happy with the statement (I'm never happy about that (anti-holistic approach). The doctor told us to take a load off for the night since we had all been through a lot and Miles was doing better. She told us not to drive ourselves crazy trying to figure it out. "Sorry, sister" was the bubble blurb over my head. She does not know how this mother operates. If my boy isn't feeling well, I am not feeling well, and I will stop at nothing to find out what's happening! I'm guessing most of moms would do the same.
I played back the morning in my mind over and over. He had toast and jelly. The same toast and jelly he always has. He had some Outshine bars but that was almost an hour before this incident. The thing that he ingested just moments before was a vitamin. Could it have been the multi-vitamin?
Perhaps my son did not have enough food in his stomach. Perhaps they changed the formula in the vitamins. I called the pharmacist. She hadn't heard any reports of reactions to prescription multi-fluoride vitamins. I felt suspicious but vowed to readdress in the a.m. after we had all gotten some rest.
The reaction seemed to reoccur around bedtime. Not as extreme, but not great. I called my pediatrician in a partial panic. We gave Miles more children's Benadryl. I slept with one eye open.
On Monday morning I resolved to email the school nurse to alert her of the fact that Miles had lots of Benadryl coursing through him due to the event on Sunday and would probably be feeling less than wonderful most of the day.
When I walked my son to school I noticed that the principal was helping kids out of cars at drop-off as she does nearly every morning. I opted to tell her (in great detail) what had happened so she could keep an eye out, or at least have this on her radar.
What she said next is a testament to her amazing involvement and interest in the wellbeing of each and every student. "Could it have been the vitamin?" She asked. I looked at her incredulously. "What would make you say that?" I asked. I had been suspicious as well.
The principal said that another child in Miles’ school seemed to have had a similar incident very recently. Now the strange thing here is that Miles has been taking these multis for years! The principal said this sounded very much like the other incident and asked if I would like the school to put the other parent in touch with me. Yes! Please! I was so grateful for the suggestion.
In the meantime, I called the pharmacy again. I asked if the vitamins had been changed. Then I asked for the name of the pharmaceutical company. I called them in Texas. I inquired about any ingredients that could potentially cause a severe reaction. The man with whom I spoke mentioned Niacin. A "Niacin Flush.” Talk about an Aha moment! I looked up everything I could about Niacin. Some people get a flush, some get a far worse reaction. In kids it can be severe if they are intolerant. Niacin can have a lot of very beneficial effects if you are not too sensitive to it.
About an hour later a very lovely woman (the mother of the other child who had a reaction) called me and we compared noted and stories. It turned out that she also had thought her daughter had been having several food allergy reactions recently. She also had several face flushing incidents in addition to a severe reaction like Miles had. She had been to the same pediatric allergist (who seemed to help them nail down the Niacin factor). She uses the same pharmacy and her daughter was taking the same vitamins. Their last batch came from the same pharmaceutical company in Texas that noted putting Niacin in the vitamins, which is not a crime. As I had said there are many benefits, if you are not sensitive. The important piece of information here is educating yourself about the contents of the vitamins, which can change from time to time depending on the manufacturer supplying the pharmacy with the product. Pharmaceutical companies are notorious for altering ingredients, and pharmacies will often go with the best deal. My feeling is that changes in the formula as well as possible side effects should be printed on the bottle.
Common Side Effects of Niacin:
· Itching under the skin
· Warmth, redness, or tingly skin
· Mild dizziness
· Sweating or chills
· Nausea, burping, diarrhea
· Leg cramps, muscle pain
· Insomnia
These are COMMON side effects. They can also be more severe as in our case.
Niacin Toxicity
· Flushing of the skin, primarily on the face, arms, and chest *This side effect may occur at doses as low as 30 mg/day.
· Itching
· Nausea
· Vomiting
· Skin rash
· Dry skin
· Headache
· Signs of liver toxicity, including jaundice and elevated liver enzymes
I called the pediatric allergist to confirm all this. I was sure that the culprit was Niacin! He had been alerted of other reactions from children nearby who had taken this specific vitamin and felt that the connection made a lot of sense. He said the pharmaceutical company had changed the formula from Niacinamide (which is a form of B3) to Niacin (which is also a B3 vitamin but is not as benign as Niacinamide. I called the pharmaceutical company again and asked for someone more knowledgeable about the formulations. They said they had never initially used Niacinamide that they had always used Niacin but were now changing the formulas since they had received reports similar to mine. This tipped me off to the fact that we may have been getting a different product in the years leading up to this incident.
Naturally, I called our trusty pharmacists again and they were so helpful. They looked up the manufacturer of the products we had received earlier in the computer. Bingo! They had been using a different manufacturer until recently, which explains the sudden reactions to the same prescription.
Since these vitamins are a generic form of the Poly-vi-flor (which can be cost-prohibitive for many) the pharmacy had been using the generic. The vitamins as we learned had been coming from a different company in the past that never used Niacin. Another company could have been using Niacinamide all along, which does not cause the issue.
There is no supplemental reason for any of the companies to be using Niacin over Niacinamide. Perhaps it's about the money! Most things are.
The pharmaceutical company in Texas that had made the vitamin which caused the problem did say they are rolling out newly formulated vitamins in the next few months with Niacinamide and no Niacin. But what about all the vitamins out there now???
Since I called our pharmacy to alert them of the niacin factor, they are aware, as is our school, our pediatrician and pediatric allergist. But what about all of the other pharmacies, schools, and physicians around the country? Not all children are sensitive to Niacin, but many are. Many adults are also sensitive to Niacin.
I'm working on creating awareness. But I am only one person. Please be aware! Please share! We are okay now but are noticing that many snacky foods like Pepperidge Farms Goldfish crackers, contain niacin.
The more you know, the more mindful you can be. Read packages. Do your own research. Opt for whole foods. Read the fine print. Ask your pharmacist for help. Stay educated. Stay vigilant. When it comes to health you cannot be too sure. It's especially important to keep kids safe because many cannot advocate for themselves. It's a skill that comes with time and practice. Talk to your teachers. talk to other parents. We have to stick together. Comparing notes and spreading awareness is so important! If I hadn't talked with the principal at my school who put me in touch with the other parent, which lead me back to the allergist, pediatrician, pharmacist and pharmaceutical company we might all still be spinning and nervous of another horrifying occurrence.
The bottom line is that Niacin can be very healthful and helpful, if you are not sensitive to it. We are all individual. Think biodiversity. One man’s picnic is another man's poison. What works for some may harm others. This cannot be overstated.
Please email me here Stacie@truebodyandmind.comwith any comments or questions. Thank you for reading and wishing you and yours many blessings, good health and no bad reactions!!!
*Here is some information about Niacin and Niacinamide
(read safety and side effects)