Fumaric acid is related to malic acid, and, like malic acid, it is involved in the production of energy (in the form of adenosine triphosphate [ATP]) from food.
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Fumaric acid, in the chemically bound form known as fumaric acid esters, has been shown to be effective against psoriasis symptoms.
Fumaric acid , in the chemically bound form known as fumaric acid esters, has been shown in case studies,1 preliminary trials2 , 3 , 4 and double-blind trials5 , 6 , 7 to be effective against symptoms of psoriasis. However, because fumaric acid esters can cause significant side effects, they should be taken only under the supervision of a doctor familiar with their use. Nevertheless, these side effects have been reported to decrease in frequency over the course of treatment and, if they are closely monitored, rarely lead to significant toxicity.8
Only the esterified forms of fumaric acid are used therapeutically, such as fumaric acid monoethylester or fumaric acid di-methylester. Healthy people do not need to supplement with fumaric acid. Those using this substance (either orally or topically) should work with a dermatologist, since determining the optimal intake should be done on an individual basis. Even under these circumstances, supplementing should be started with small amounts (60–100 mg per day) and increased gradually over several weeks until an effect is noted.
Fumaric acid is formed in the skin during exposure to sunlight, as well as being available as an oral supplement and as a preparation for topical use.
No deficiencies of fumaric acid have been reported. However, some doctors suggest that people with psoriasis may have a biochemical defect that interferes with adequate fumaric acid production in the skin.
Kidney disorders have been reported in people taking fumaric acid esters, possibly due to taking large amounts too quickly.9 , 10 Most studies have reported gastrointestinal upset and skin flushing as common side effects; some have also found decreased white blood cell counts with prolonged use.11 , 12.
1. Ameen M, Russell-Jones R. Fumaric acid esters: an alternative systemic treatment for psoriasis. Clin Experiment Dermatol 1999;24:361-4.
2. Mrowietz U, Christophers E, Altmeyer P. Treatment of severe psoriasis with fumaric acid esters: scientific background and guidelines for therapeutic use. Br J Dermatol 1999;141:424-9.
3. Kolbach DN, Nieboer C. Fumaric acid therapy in psoriasis: results and side effects of 2 years of treatment. J Am Acad Dermatol 1992;27:769-71.
4. Altmeyer PJ, Matthes U, Pawlak F, et al. Antipsoriatic effect of fumaric acid derivatives. J Am Acad Dermatol 1994;30:977-81.
5. Nugteren-Huying WM, van der Schroeff JG, Hermans J, Suurmond D. Fumaric acid therapy for psoriasis: a randomized, double-blind, placebo-controlled study. J Am Acad Dermatol 1990;22:311-2.
6. Nieboer C, de Hoop D, Langendijk PN, et al. Fumaric acid therapy in psoriasis: a double-blind comparison between fumaric acid compound therapy and monotherapy with dimethylfumaric acid ester. Dermatologica 1990;181:33-7.
7. Mrowietz U, Christophers E, Altmeyer P. Treatment of psoriasis with fumaric acid esters: results of a prospective multicentre study. German Multicentre Study. Br J Dermatol 1998;138:456-60.
8. Nieboer C, de Hoop D, van Loenen AC, et al. Systemic therapy with fumaric acid derivates: new possibilities in the treatment of psoriasis. J Am Acad Dermatol 1989;20:601-8 [review].
9. Dalhoff K, Faerber P, Arnholdt H, et al. Acute kidney failure during psoriasis therapy with fumaric acid derivatives. Dtsch Med Wochenschr 1990;115:1014-7 [in German].
10. Roodnat JI, Christiaans MH, Nugteren-Huying WM, et al. Acute kidney insufficiency in patients treated with fumaric acid esters for psoriasis. Ned Tijdschr Geneeskd 1989;133:2623-6 [in Dutch].
11. Kolbach DN, Nieboer C. Fumaric acid therapy in psoriasis: results and side effects of 2 years of treatment. J Am Acad Dermatol 1992;27:769-71.
12. Altmeyer P, Hartwig, R, Matthes U. Efficacy and safety profile of fumaric acid esters in oral long-term therapy with severe treatment refractory of psoriasis vulgaris. A study of 83 patients. Hautarzt 1996;47:190-6.
Last Review: 07-08-2014
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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2015.
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