Category: Alternative Medicine

Diabetic issues drug in need due to facet influence of fat loss

Dania

BUTLER COUNTY — The ongoing scarcity of Ozempic, a medication employed for the therapy of Variety 2 diabetic issues, has led to complications for folks who just cannot get the medication because of to the high need.

Doctors speculate the off-label use of the drug for pounds reduction — popularized by socialites and famous people who have admitted to having Ozempic or other semaglutide medication this sort of as Wegovy — has fueled this shortage.

“It’s been going on for around a month now,” explained Dr. Miguel Parilo, of Bull Household Diabetes Heart in Oakwood. “The shortage was precise to Ozempic at the greater doses and has progressed to influencing all doses.”

In reaction to the shortage, health professionals had been prescribing people the lower doses to match what pharmacies experienced in stock just before switching clients to other prescription drugs in just the exact class.

“All these when-a-7 days injections of that class are, in some diploma, of small provide, simply because of their off-label use for non-diabetic relevant being overweight,” stated Parilo.

When prescribers use a drugs for an indication other than what the Fda approves it for, that is deemed off-label use, Parilo stated. Ozempic has been approved by the Fda for the procedure of Variety 2 diabetic issues, and a further semaglutide drug, Wegovy, has gotten Fda acceptance for the treatment method of weight problems. Wegovy is the identical compound as Ozempic but a distinct version of the drug.

“Wegovy was made use of extremely liberally. If it results in being in shorter offer, men and women hence begin utilizing Ozempic. Ozempic then turns into in limited source, and then we’re in the predicament that we’re in at this issue,” Parilo explained.

The producer, Novo Nordisk, expects full availability of Ozempic to be again up by mid-March, according to the FDA’s drug shortage databases. For now, neighborhood people employing Ozempic have experienced to adapt by switching to diverse medicines, visiting multiple pharmacies or likely with no the drug.

“We do suspect some of that was staying overprescribed for bodyweight reduction,” stated Justin Coby, a pharmacist and the director of pharmacy at Cedar Treatment Village Pharmacy. “They (people) are having difficulties to uncover merchandise. Almost certainly for the past two to 3 months we’ve struggled to maintain that in stock. We have experienced clients who have had to go with no we’ve had people who had to be switched above to a distinctive merchandise.”

For individuals who get switched to a different drug, it then from time to time leads to the new drug to go into brief source.

Parilo stated it has been inconvenient for his individuals who use Ozempic and impacts their capacity to continue to keep their Style 2 diabetic issues below manage.

“We have to discover an alternate therapy. We often have to use decreased doses of Ozempic, and what transpires in the course of that time period of time is diabetes regulate suffers. The blood sugar measurements and the body weight added

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A organic tactic: What is holistic medicine?

Dania

Centuries of analysis and advancement have long gone into common drugs. Now holistic drugs in on the increase.

Irrespective of other tried using and genuine techniques of health care, some persons seem for out-of-the-box thoughts to take care of them selves.

Holistic medicine boils down to taking a “whole body” method to overall health and medication and generally offers with much more purely natural and self-reliant solutions of wellbeing. 

The Pacific College of Wellness and Science points out that “the human system has a wonderful capability to mend alone, nevertheless lots of people deprive their bodies of that means by only focusing on conventional medicine for most conditions.” The definition provides that holistic drugs will take a total-man or woman tactic to health-related treatment and wellness. As a lot more and a lot more persons want to experience improved with no reliance on prescription drugs, this is an area rising in demand from customers.

A history of the holistic solution

Though the reputation and knowledge of holistic medicine has developed quickly more than the past couple of yrs, it has been a rising follow for many years now. Or even centuries. Holistic medicine can be traced back to the 6th century B.C.E. India, the place a holistic method called Ayurveda was practiced.

Holistic medicine even has connections to the father of present day medicine himself, Hippocrates, who encouraged the self-healing of the human body. 

Common medicine formulated immensely, however, according to the Pacific Faculty of Health and fitness and Science, when in the 1960’s far more and much more persons commenced to move away from traditional prescription drugs and methods and pushed for a extra organic method. 

This public guidance and enthusiasm led to the 1975 Nationwide Meeting on Holistic Wellness in California. Three yrs afterwards the American Holistic Clinical Affiliation was formed. 

Holistic drugs now

Holistic medicine’s recognition has remained stagnant because the 1960s nonetheless, level of popularity surges now more than ever. Immediately after dealing with a daily life-switching pandemic, men and women are exploring for much more nicely-rounded, self-reliant, all-natural ways to their overall health. 

Similar to traditional medicine, there are many dissimilarities in holistic drugs methods, some extra well-identified than other individuals: acupuncture, aromatherapy, chiropractic care, naturopathy, massage remedy, organic medications, homeopathic treatments, mental health counseling, osteopathy, yoga, and extra. 

Holistic medicine normally encompasses a lot much more procedures than conventional medication due to the fact of the “whole body” method. Holistic medicine includes using a look at a lot more than just the physical or surface area-stage issues—attempting to dive deeper into your lifetime behavior, psychological health and fitness, non secular wellness, and much more to very best fix a well being challenge. A person holistic tactic could deal with your power and your mindfulness even though the subsequent could deal with your back soreness through massage therapy. The methods are unlimited. 

One particular holistic therapist specializes in both of individuals procedures in Columbia. Angie Butts is the proprietor of Triple Flame Therapeutic LLC (higher

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As interest in alternative medicine grows, patients with psoriasis weigh benefits, risks

Dania

February 07, 2023

3 min read


Disclosures:
Gelfand reports having financial relationships with AbbVie, Amgen, BMS, Boehringer Ingelheim, GSK, Lilly (DMC), Janssen Biologics, Novartis, NeuroDerm (DMC), Pfizer and UCB (DMC); being co-patent holder of resiquimod for treatment of cutaneous T-cell lymphoma; and serving as the deputy editor of the Journal of Investigative Dermatology and board member for the International Psoriasis Council.


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In this issue of Healio Psoriatic Disease we focus on complementary and alternative medicine for psoriasis.

Joel M. Gelfand

Complementary and alternative medicine (CAM), or “complementary health approaches,” is a group of diverse medical and health care practices and products that are not presently considered to be part of conventional medicine. There are two broad subgroups: 1) natural products, including herbs, vitamins, minerals and probiotics, the latter often sold as dietary supplements; and 2) mind and body practices, including a large and diverse group of procedures or techniques administered or taught by a trained practitioner such as yoga and meditation.

There is broad interest in CAM in the United States, and the National Center for Complementary and Integrative Health at the NIH funds research studies to further understand the risks and benefits of CAM approaches.

As a common, chronic, incurable and stigmatizing disease, there is intense interest in CAM by patients with psoriasis. Complicating matters is that these patients can have prolonged spontaneous remissions and respond to placebo (PASI 75 is about 5% in patients with moderate to severe psoriasis receiving placebo) and therefore anecdotes abound about various CAM treatments improving psoriasis. A 2018 survey conducted by the National Psoriasis Foundation found that 41% of people with psoriasis reported using alternative therapies, with patients who had more severe disease being more likely to seek them out.

While interest in CAM therapy is high, it appears the interest in well conducted, rigorous trials to prove its safety and efficacy is low, as there is a dearth of data to support its use in psoriasis. So, what do patients, and their providers who recommend CAM, have to lose? A lot! First, at best, an unproven therapy may be a waste of precious time and money and may prevent patients from receiving therapies actually proven to work. At worst, patients may experience life threatening harm. Tryptophan is a CAM therapy used for disorders such as insomnia and mood disorders. Dermatologists of a certain generation will recall its association with a scleroderma-like condition called eosinophilia-myalgia syndrome. Herbs and dietary supplements promoted for their supposed weight loss or joint pain benefits, including green tea extract, may cause severe acute liver injury. Specifically turning to psoriasis,

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Interactive Scenario Reports- February 2023

Dania

Case 1

DD is a 67-yr-aged male who has been hospitalized for the previous couple months for complications similar to a poor fall. He experienced formulated high white blood mobile counts, an increasing fever, and other indications of an infection. DD has a documented daily life-threatening sulfa allergy. The team requested empiric cefepime and vancomycin. Two days afterwards, lifestyle results indicated that the bacterium Stenotrophomonas maltophilia was causing the suspected pneumonia. The medical center, anxious about this unheard of bacterium, phone calls the pharmacy for recommendations for remedy.

Problem: What must the pharmacist advocate?

Solution: S maltophilia is a rare, gram-detrimental bacterium that can be life-threatening. It is an emerging worldwide opportunistic pathogen, and it most typically happens as a nosocomial pneumonia an infection but can be a standard colonizer in the respiratory tract. The initial-line remedy is co-trimoxazole simply because of prevalent sensitivity and its solid capacity to take care of S maltophilia. Nevertheless, since of DD’s everyday living-threatening sulfa allergy, co-trimoxazole is contraindicated.1 As a consequence, the pharmacist must suggest levofloxacin (Levaquin), which is a commonly employed 2nd-line agent. Levofloxacin is reported to have similar therapy success prices, but the pointers do not suggest levofloxacin as initial-line remedy because of prevalent, overuse-connected quinolone resistance. Info point out that people who are not quinolone naïve, this kind of as those with cystic fibrosis, have less therapy success when using quinolones when compared with co-trimoxazole.

Scenario 2

ME, a 41-calendar year-aged guy, was identified with HIV approximately 6 several years in the past. His antiretroviral remedy regimen features darunavir/cobicistat (Prezcobix) and dolutegravir (Tivicay). Immediately after reviewing ME’s modern laboratory benefits, the physician diagnoses diabetes and hypertension and prescribes metformin 500 mg twice each day and lisinopril 5 mg everyday. The doctor also suggests life style variations for the patient, which includes a lot more bodily action. ME has trouble breathing and wheezes all through the day, and physical exercise would make it even worse. The medical professional prescribes fluticasone and albuterol for the patient’s persistent bronchial asthma. Around 2 weeks later, the individual offers to the emergency department for considerable fatigue and nausea. On evaluation, the medical doctor notices purple extend marks on ME’s pores and skin and various compact bruises. She also notices that ME has formulated a moon facies and a hump between his shoulders. The medical professional suspects a drug interaction.

Question: What ought to the pharmacist endorse?

Reply: Inhaled corticosteroids (fluticasone) and pharmacokinetic boosters (darunavir/cobicistat) are identified to interact. ME’s reaction originated from a cytochrome P450 3A4 conversation concerning cobicistat and fluticasone. The interaction will increase cortisol concentrations in just the human body when inhibiting its clearance, major to adrenal suppression. As a final result, ME formulated Cushing syndrome.2 Bruising very easily, a fatty hump concerning the shoulders, and moon facies are common displays of the disorder. Clients with HIV are susceptible to a substantial quantity of drug interactions, for the reason that they are likely to establish comorbidities as they age. It is

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POTS rose after covid. Patients face delays in diagnosis and treatment.

Dania

Covid is causing a sharp rise in cases of postural orthostatic tachycardia syndrome, a disorder of the autonomic nervous system that causes rapid heart rate, fainting and dizziness

February 27, 2023 at 6:00 a.m. EST

Angelica Baez uses a motorized chair to get around a park in Sacramento on Feb. 3. Baez developed postural tachycardia syndrome, called POTS, after getting covid in 2020. She quickly becomes fatigued by walking. (Max Whittaker for The Washington Post)

Comment

A life-changing condition called POTS, which can cause fainting, irregular heartbeats and dizziness, particularly among young women, appears to be on the rise as a result of the coronavirus pandemic.

But the condition isn’t well understood, and doctors dismiss many patients as having anxiety, delaying diagnosis. Once diagnosed, many patients face waiting lists as long as two years to get treatment from specialists.

POTS stands for postural orthostatic tachycardia syndrome, a disorder of the autonomic nervous system, which regulates involuntary functions like heart rate, blood pressure and digestion.

“When the autonomic nervous system is not functioning properly, any or all of those things can go a little haywire,” said David R. Fries, a cardiologist and POTS specialist at Rochester Regional Health.

POTS patients typically experience a marked rise in heart rate when standing and a complex combination of symptoms, including dizziness, brain fog, fainting, headache and fatigue, among many others.

There is no known cure for POTS, but physical therapy, medications and diet changes related to salt intake can sometimes help.

Experts say there is a dire shortage of medical professionals who know how to care for patients with POTS. Lauren Stiles, president and chief executive of Dysautonomia International, a nonprofit advocacy group, estimates that the number of people with POTS has at least doubled since the start of the pandemic, while the number of specialists has remained the same and waiting lists are getting longer.

“They were overwhelmed and flooded long before covid,” Stiles said “We need to increase the amount of experts in this because it wasn’t enough before covid, and it’s certainly not enough now.”

POTS symptoms are often diagnosed as anxiety

Symptoms can vary widely, and in some cases, can be debilitating.

Angelica Baez, 25, of Sacramento, got sick with covid in March 2020. Soon after, she developed unusual symptoms, including tingling hands, frequent diarrhea and either feeling extremely cold or extremely hot. But the most debilitating symptom was that she almost constantly felt dizzy. She often felt like she might pass out and had trouble walking long distances.

“My heart started going insane. I could feel it pounding in my chest,” she recalled. “I literally felt like I was going to die.”

Just standing up or walking across the kitchen caused her heart rate to spike to 160 beats per minute, and she frequently rushed to the E.R., worried that she was having a heart attack. She tried consulting various doctors but was dismissed because nothing seemed wrong with her heart or overall health.

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Hormone treatment, choice medicine are not joined to QOL in midlife ladies

Dania

For females at midlife with vasomotor and/or genitourinary indications of menopause, neither hormone therapy nor complementary option medicine (CAM) was linked to an improvement in good quality of life (QOL), in accordance to a secondary assessment of the ongoing Research of Women’s Health and fitness Across the Nation (SWAN) printed in the journal Menopause.

However, treatment method-by-race/ethnicity interaction was substantial for self-described QOL (P = .034 at baseline, P =.044 longitudinal). Between White women of all ages, self-noted QOL was a great deal bigger in hormone-therapy people than in these who used neither remedy (P = .030 95% CI, .01-.21). By contrast, Black females working with hormone therapy only had appreciably lessen self-documented QOL when compared with Black girls utilizing neither treatment method(P = .027 95% CI, −0.40 to −0.02).

“It was not stunning that White gals described better use of hormone therapy and increased QOL than Black gals,” reported Monica Xmas, MD, SWAN’s lead investigator, principal investigator for the examination, and an affiliate professor of obstetrics and gynecology at UChicago Medication in Illinois. “But it was astonishing that Black girls, who have been demonstrated to have extra frequent, severe vasomotor signs for more time period of time, noted reduced QOL with use of hormone treatment.”

Xmas, who is also director of the menopause software and the Middle for Women’s Integrated Health and fitness at UChicagoMedicine, added, “Anecdotally, in my scientific practice over the past 20 years, I have found major racial/ethnic variances in severity and depth of menopausal signs, along with differences in choice for treatment of all those signs or symptoms. There is also a paucity of data on menopause treatment in specified populations.”

Christmas noted that SWAN is an ideal databank since the analyze recruited a massive, racially/ethnically diverse cohort that has been followed for much more than 20 years.

“Women had been asked if they experienced menopausal signs, and if so, did they choose everything to reduce their symptoms,” Xmas informed Present-day OB/GYN®. “Often members of studies are only questioned what prescription remedies they get however, SWAN questioned members about CAM modalities as perfectly.”

In addition, contributors have been questioned about QOL. “This allowed our staff to look into associations involving menopause indications, solutions, and perceived QOL,” Xmas said.

The cross-sectional and longitudinal analyses of QOL provided 2514 girls from SWAN who finished a CAM-use questionnaire and QOL assessments at baseline and each 1 to 2 years from 2002 to 2013. Throughout a mean 7.8 yrs of comply with-up, 29% of the cohort documented employing hormone remedy for a suggest 2.4 years, whereas 32% reported CAM use for a signify 2.1 yrs.

Xmas famous that the CAM/integrative drugs industry is “booming, in spite of absence of efficacy in randomized managed trials. Consequently, clinicians should be counseling patients on the lack of efficacy and attainable harm associated with some of these products and solutions.”

In addition, recognizing racial/ethnic differences when treating menopausal symptoms is paramount, according to Xmas. “Clinicians really should be

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