Abstract
Hypersensitivity to vitamins is a rare side effect of an overall very safe class of drugs/nutrients. Vitamins are defined as essential organic nutrients that cannot be synthesized by human beings, while a combination of vitamins is often referred to as “dietary supplements.” Typically, they are sold to consumers over the counter without a medical prescription. Hence, they are widely overused by patients/consumers, and, usually, suspected adverse reactions to the nonessential vitamins and supplements will lead to a pragmatic lifelong avoidance and only rarely to a thorough allergy workup. Possibly, this has led to an underreporting of the true rate of hypersensitivities to vitamins.
In general, intramuscular application causes more true hypersensitivity reactions than the intravenous route. Often, the oral way is tolerated even in true drug allergy to vitamins. There are a few immediate (type I) hypersensitivity reactions to the vitamin B complex that is often used in varying combinations of vitamin B1/B2/B6 and B12. Vitamin K1 can also cause severe immediate reactions, while when used topically, it is a known strong contact allergen (type IV).
History, skin test (prick, intradermal, patch tests), and rarely provocation tests are the method of choice for evaluating vitamin hypersensitivity.
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Wöhrl, S. (2022). Vitamins and Supplements. In: Bircher, A.J., Maibach, H.I., Brockow, K., Barbaud, A. (eds) Cutaneous Drug Hypersensitivity. Springer, Cham. https://doi.org/10.1007/978-3-030-82743-4_34
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