Wednesday 23 May 2012

A-Z of Corticosteroid Withdrawal: Nitric Oxide

I cannot talk about steroid withdrawal without mentioning Nitric Oxide. Most of the symptoms that we experience when we stop using steroid creams are a direct result of the effect of Nitric Oxide on our blood vessels.

Nitric Oxide (chemical symbol NO) is a potent vasodilator, meaning that it dilates, or expands the blood vessels, increasing blood flow. Therefore, Nitric Oxide has many applications in medicine. When angina patients are given nitroglycerin, the medication converts to nitric oxide in the body and dilates the blood vessels. Similarly, Viagra medication works in a similar way by increasing blood flow and dilating the blood vessels.

Dr Marvin Rapaport MD, is a dermatologist who has worked with, and cured, many patients addicted to steroid creams. During his research he found that patients suffering from steroid rebound had abnormally high concentrations of Nitric Oxide in the blood. This was completely different to the results from patients with regular eczema. It is believed that the steroid creams artificially suppress the blood vessels, which is why the skin looks less red when you apply the creams. However, once the steroid cream is stopped, the blood vessels are free to dilate again and the body produces excess Nitric Oxide. This is why we get "red skin syndrome", the red skin being caused by the dilation of blood vessels under the skin. This can be easily illustrated by pressing down hard on the skin. The skin momentarily turns white because the blood vessels are suppressed, just like they are when steroid creams are applied.

Dr Rapaport found that these Nitric oxide levels remained high in patients for many months, and in some cases years, before they finally healed. Once the NO levels were back to normal, the skin returned to its previous, eczema-free state. Dr Rapaport is interested in finding a Nitric Oxide antagonist that could possibly reduce the NO levels quicker in steroid addicted patients and decrease the length of time it takes to recover.

In my own research, I found evidence that dandelion is a natural NO antagonist. Researchers found that the dandelion flower and root can suppress NO levels in the blood. I drink a few cups of dandelion tea every day, but I'm not sure how effective it is!

Most of the distressing symptoms, such as the burning, erythema, oozing and skin discolouration of TSW can be attributed to high NO levels in the body. It is simply a case of waiting it out until the levels return to normal. If steroids have been used for decades on the skin, this process can take many years and the current estimate is 10-15% of the time that steroids were used on the skin. In my case, I used steroid creams for about 15 years, although I used them intermittently for years before that. If my cumulative steroid use was 20 years, it could take me at least 2 years before my skin heals.

In the meantime, I will keep drinking the dandelion tea....

3 comments:

Brit said...

So how much dandelion tea do you think would help?

Louise said...

I like the dandelion and burdock tea by clipper. it tastes nicer than normal dandelion tea.

I tend to drink 3-4 cups a day.

You could always make it yourself if you have them growing in your garden, as i read that the flowers are good at reducing NO levels too.

Unknown said...

Hm this nitric oxide thing confuses me a bit as uv is supposed to increase nitric oxide in the skin but I find uv light therapy is really helping me. I know dr rapaport recommends sun in healing.