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.
Where is it found?
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.
Fumaric acid has been used
in connection with the following conditions (refer to the individual
health concern for complete information):
Who is likely to be deficient?
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.
How much is usually taken?
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.
Are there any side effects or interactions?
Kidney disorders have been reported in people taking fumaric acid esters, possibly due to
taking large amounts too quickly.1 2 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.3 4 .
At the time of writing, there were no well-known drug interactions
with fumaric acid.
References:1. 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].
2. 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].
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 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.