Vitamin C

General Information

Ascorbic acid is a water-soluble vitamin found in fruits and vegetables such as citrus fruits and green peppers. It occurs as a white or slightly yellow crystal or powder with a slight acidic taste. It is an antiscorbutic product. On exposure to air and light it gradually darkens. In the dry state it is reasonably stable in air, but in solution it rapidly oxidizes. Ascorbic acid is a free radical, an antioxidant scavenger, and plays a major role in oxidation-reduction reactions. Ascorbic acid is a cofactor for enzymes involved in the biosynthesis of collagen (essential for tissue maintenance and repair), carnitine, and neurotransmitters. Humans cannot synthesize ascorbic acid endogenously and a lack of dietary intake can lead to scurvy. Vitamin C is most frequently used as a nutritional supplement. It also is used as an adjunct treatment of idiopathic methemoglobinemia and with deferoxamine in the treatment of chronic iron toxicity. Ascorbic acid has been used for a variety of ailments including the common cold, gum infections, acne, depression, fertility, and cancer; however, these claims have not been substantiated and vitamin C is not recommended for these purposes (see Mechanism of Action). Ascorbic acid was approved by the FDA in 1939.


Mechanism of Action

Ascorbic acid is necessary for collagen formation (e.g., connective tissue, cartilage, tooth dentin, skin, and bone matrix) and tissue repair. It is reversibly oxidized to dehydroascorbic acid. Both forms are involved in oxidation-reduction reactions. Vitamin C is involved in the metabolism of tyrosine, carbohydrates, norepinephrine, histamine, and phenylalanine. Other processes that require ascorbic acid include biosynthesis of corticosteroids and aldosterone, proteins, neuropeptides, and carnitine; hydroxylation of serotonin; conversion of cholesterol to bile acids; maintenance of blood vessel integrity; and cellular respiration. Vitamin C may promote resistance to infection by the activation of leukocytes, production of interferon, and regulation of the inflammatory process. It reduces iron from the ferric to the ferrous state in the intestine to allow absorption, is involved in the transfer of iron from plasma transferrin to liver ferritin, and regulates iron distribution and storage by preventing the oxidation of tetrahydrofolate. Ascorbic acid enhances the chelating action of deferoxamine during treatment of chronic iron toxicity (see Interactions). Vitamin C may have a role in the regeneration of other biological antioxidants such as glutathione and α-tocopherol to their active state.

Ascorbate deficiency lowers the activity of microsomal drug-metabolizing enzymes and cytochrome P-450 electron transport. In the absence of vitamin C, impaired collagen formation occurs due to a deficiency in the hydroxylation of procollagen and collagen. Non-hydroxylated collagen is unstable, and the normal processes of tissue repair cannot occur. This results in the various features of scurvy including capillary fragility manifested as hemorrhagic processes, delayed wound healing, and bony abnormalities.

Currently, the use and dosage regimen of vitamin C in the prevention and treatment of diseases, other than scurvy, is unclear. Although further study is needed to recommend vitamin C therapy for the following ailments, recent data indicate a positive role for vitamin C for: overall increased mortality; the prevention of coronary heart disease (especially in women); management of diabetes mellitus; reducing the risk of stroke; management of atherosclerosis in combination with other antioxidants; osteoporosis prevention; reducing the risk of Alzheimer disease in combination with vitamin E; and the prevention of cataracts. In humans, an exogenous source of ascorbic acid is required for collagen formation and tissue repair.

Storage

Store this medication in a refrigerator at 36°F to 46°F (2°C to 8°C). Keep all medicines out of the reach of children. Throw away any unused medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.

References

  • Simon JA, Hudes ES. Relation of serum ascorbic acid to serum lipids and lipoproteins in US adults. J Amer Clin Nutr 1998;17:250-5.
  • Simon JA, Hudes E, Tice JA. Relation of serum ascorbic acid to mortality among US adults. Am Coll Nutr 2001;20:255-63.
  • Simon JA, Hudes ES. Relation of serum ascorbic acid to serum lipids and lipoproteins in US adults. J Amer Clin Nutr 1998;17:250-5.
  • Osganian SK, Stampfer MJ, Rimm E, et al. Vitamin C and risk of coronary heart disease in women. J Am Coll Cardiol 2003;42:246-52.
  • Cunningham JJ. The glucose/insulin system and vitamin C: implications in insulin-dependent diabetes mellitus. J Am Coll Nutr 1998;17:105-8.
  • Yokoyama T, Chigusa D, Kokubo Y, et al. Serum vitamin C concentration was inversely associated with subsequent 20-year incidence of stroke in Japanese a rural community. The Shibata study. Stroke 2000;31:2287-94.
  • Carr A, Zhu BZ, Frei B. Potential antiatherogenic mechanism of ascorbate (vitamin C) and a-tocopherol (vitamin E). Circ Res 2000;87:349-54.
  • Jialal I, Fuller CJ. Effect of vitamin E, vitamin C, and beta-carotene on LDL oxidation and atherosclerosis. Can J Cardiol 1995;11SupplG:97-103.
  • Hodis HN, Mack WJ, LaBree L, et al. Serial coronary angiographic evidence that antioxidant vitamin intake reduces progression of coronary artery atherosclerosis. JAMA 1995;273:1849-54.
  • Leveille SG, LaCroix AZ, Koepsell TD, et al. Dietary vitamin C and bone mineral density in postmenopausal women in Washington State, USA. J Epidemiol Community Health 1997;51:479-85.
  • Zandi PP, Anthony JC, Khachaturian AS, et al. Reduced risk of alzheimer disease in user of antioxidant vitamin supplements. Arch Neurol 2004;61:82-8.
  • Jacques PF, Taylor A, Hankinson SE, et al. Long term vitamin C supplement use and prevalence of early age-related lens opacities. Amer J Clin Nutr 1997;66:911-6.
  • Padayatty SJ, Sun H, Wang Y, et al. Vitamin C pharmacokinetics: implications for oral and intravenous use. Ann Intern Med 2004;140:533-7.
  • Rossig L, Hoffmann J, Hugel B, et al. Vitamin C inhibits endothelial cell apoptosis in congestive heart failure. Circulation 2001;104:2182-7.
  • Tanaka H, Matsuda T, Miyagantani Y, et al. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration. Arch Surg 2000;135:326-31.
  • Standing Committee on the Scientific Evaluation of Dietary Reference Intakes – Panel on Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids and the Subcommittee on Upper Reference Levels of Nutrients, Food and Nutrition Board, Institute of Medicine (IOM). Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. 2000.The National Academy of Sciences Press, Washington DC.
  • Standing Committee on the Scientific Evaluation of Dietary Reference Intakes – Panel on Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids and the Subcommittee on Upper Reference Levels of Nutrients, Food and Nutrition Board, Institute of Medicine (IOM). Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. 2000.The National Academy of Sciences Press, Washington DC.
  • Cenolate® (ascorbic acid, vitamin C injection) package insert. North Chicago, IL: Abbott Laboratories; 2002 Sept.
  • Desferal® (deferoxamine mesylate for injection USP) package insert. East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2002 Oct.
  • Sestili MA: Possible adverse health effects of vitamin C and ascorbic acid. Semin Oncol. 1983;10:299.
  • Campbell GD, Steinberg MH, Bower JD. Ascorbic acid-induced hemolysis in G-6-PD deficiency. Ann Int Med 1975;82(6):810. Letter.
  • Hays GL, Bullock Q, Lazzari EP, Puente ES. Salivary pH while dissolving vitamin C-containing tablets. Am J Dent. 1992;5:269-271.

Glutathione

GLUTATHIONE – essential molecule required for detoxification. Glutathione acts by assisting the body’s machinery in the removal of harmful destructive oxygen containing molecules.

  1. GENERAL INFORMATION

Glutathione (GSH) is composed of three amino acids combined to produce a peptide that is both a powerful antioxidant and performs several critical roles in the body. According to researchers this peptide is so essential to optimum health that the level of Glutathione in cells could possibly be used to predict how long an organism lives.1, 2

Glutathione catalyzes glutathione S-transferases (GST) and glutathione peroxidases (GPx). Thus, playing a role in detoxification by eliminating toxic electrophilic molecules and reactive peroxides. Glutathione plays a crucial role in a detoxification system that is fundamental in plants, mammals, and fungi.3

Aside from its detoxification role it is important for a variety of essential cellular reactions. Its presence in the glyoxalase system, is fundamental to DNA and RNA nucleotide reduction. Glutathione is also a constituent in the regulation of protein and gene expression, exchange reactions including thiol to disulfide ratios involve glutathione.4

Glutathione can exist intracellularly in either an oxidized (glutathione disulfide) or reduced (glutathione) molecular state. The ratio of reduced glutathione to glutathione disulfide has been shown to be critical in cell survival, this system is very tightly regulated.

Deficiency of glutathione puts the cell at risk for oxidative damage. An imbalance of glutathione is present in many pathologies including cancer, neurodegenerative disorders, cystic fibrosis (CF), HIV and aging.

While Glutathione is vitally essential to maintaining a healthy immune system, it isn’t classified as an essential nutrient; this is because the body does create its own supply from the amino acids:

  • L-cysteine
  • L-glutamic acid
  • Glycine

One of the reasons why Glutathione is so important for optimum health is that it’s present in every cell in the body. One way antioxidants like glutathione help maintain good physical health is by neutralizing free radicals, which can cause cellular damage through oxidation. Since glutathione is naturally present within all types of cells, it is in a prime position to do this. It’s considered one of the most important antioxidants in the human body.5

2. MECHANISM OF ACTION

Glutathione is an essential molecule required for detoxification.

Glutathione acts by assisting the body’s machinery in the removal of harmful destructive oxygen containing molecules.

During the body’s normal functioning an excess of oxygen containing molecules are produced, these molecules are typically very reactive with other molecules they come in contact with. In modern biochemistry these are referred to as reactive O2 species.

Reactive O2 species molecules include peroxide (H2O2) and superoxide anions (O2 with unpaired electron) these molecules are very toxic to the cell. The toxicity can be explained by the tendency of these molecules to bind or destroy important biomolecules.

The body has a natural system to remove these reactive O2 species. These systems metabolize and scavenge for reactive oxygen species, in a controlled and precise fashion.

The system that removes these toxic reactive oxygen species includes a host of enzymes:

  • Glutathione peroxidase (GPX): GPX detoxifies peroxides with glutathione acting as an electron

donor in the reduction reaction, producing glutathione disulfide as an end product. GPX is a 80 kDa protein that is composed of four identical subunits. It is expressed throughout the entire body, individual isoforms are present in specific tissues. When the body is in a state of excess oxidative stress the expression of this enzyme is induced. Abnormal expression has been associated with a wide variety of pathologies, including hepatitis,6 HIV,7 and a wide variety of cancers, including skin,8 kidney,9 bowel,10 and breast.11 Glutathione reductase (GR)- catalyzes reduction of glutathione disulfide is by requires NADPH producing two glutathione molecules as an end product. GR is a member of the flavoprotein disulfide oxidoreductase family and exists as a dimer.12 Expression of GR is upregulated during periods of increased oxidative stress, to prepare for reactive oxygen species removal. The level at which regulation takes place is at the transcriptional level as well as at the post-translational level. Down regulation of GR production and activity are thought to be associated with cancer and aging.13

  • Catalase: is involved in detoxification of reactive oxygen species.
  • Superoxide dismutase (SOD): is involved in the removal of superoxide species.

Immune Function: Glutathione plays a significant role in immune function.14 It encourages the T-cell function that’s essential for a healthy immune system15 and protects from environmental toxins.

Additionally, glutathione is essential in a broad range of metabolic processes:16,17

  • Glutathione acts to neutralize a toxic metabolic byproduct: Methylglyoxal
  • Glutathione is involved in the protein disulfide bond rearrangement that is necessary for the synthesis of one third of the body’s proteins
  • It protects the body from the oxidative damage caused by glutathione peroxidase by acting as a helper molecule for certain enzymes
  • The liver uses Glutathione to help detoxify fats before the gallbladder emits bile, supporting healthy digestion

Detoxification: Glutathione may also be crucial in the removal and detoxification of carcinogens, and according to recent studies18 alterations in this metabolic pathway, can influence cell survival profoundly. Glutathione may be responsible for several vital roles within a cell besides antioxidation: 18

  • Maintenance of the redox state (chemical reactions in which the oxidation state of atoms are modified)
  • Modulation of the immune response
  • Detoxification of foreign bacteria and viruses

Chronic Disease: Research has demonstrated that glutathione deficiency may be a factor in many chronic conditions; HIV/AIDS, Alzheimer’s, Parkinson’s disease, asthma, different cancers, cataracts, macular degeneration, open angle glaucoma, diabetes, and many diseases of the liver, kidneys, lungs, and digestive system.19

Depletion Due to Aging and Alcohol Consumption: Glutathione plays a major role in the detoxification of ethanol (consumed as alcoholic beverages) and people who routinely drink will experience Glutathione depletion.20 Aging is another factor; as the body ages glutathione levels may drop below the level necessary to maintain healthy immune function (among other processes).20

Depletion may also Caused by Other Factors: Besides alcohol consumption and the aging process, there are other factors that can deplete levels of Glutathione:21,22,23,24

  • Acetaminophen
  • Aspartame
  • Benzopyrenes (tobacco smoke, fuel exhaust, etc.)
  • Many household chemicals (detergents, fabric softeners, air fresheners, mothballs, cleaners, bleach, etc.)

Fertility: In a study of eleven infertile men, suffering from dyspermia associated with various andrological pathologies – Glutathione was observed to exert a significant effect on sperm motility. Glutathione appeared to have an observable therapeutic effect on certain andrological pathologies that cause male infertility.25

Atherosclerosis: In one study, ten patients with atherosclerosis were administered glutathione which resulted in a significant increase in blood filtration, in addition to a significant decrease in blood viscosity and platelet aggregation. Consequently, Glutathione infusion was determined to be an effective method of decreasing blood viscosity while increasing blood filtration.26

Dermatological Properties: In a three-month study of female subjects, the women taking Glutathione showed significantly improved skin elasticity and amelioration of wrinkles compared to test subjects who received a placebo.27

3.STORAGE

Store this medication in a refrigerator at 36°F to 46°F (2°C to 8°C). Keep all medicines out of the reach of children. Throw away any unused medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.

REFERENCES;

  1. Richie JP Jr, Leutzinger Y, Parthasarathy S, Malloy V, Orentreich N, Zimmerman JA. Methionine restriction increases blood glutathione and longevity in F344 rats. FASEB J. 1994 Dec;8(15):1302-7.
  2. Cascella R, Evangelisti E, Zampagni M, Becatti M, D’Adamio G, Goti A, Liguri G, Fiorillo C, Cecchi C. S-linolenoyl glutathione intake extends life-span and stress resistance via Sir-2.1 upregulation in Caenorhabditis elegans. Free Radic Biol Med. 2014 Aug;73:127-35. doi: 10.1016/j.freeradbiomed.2014.05.004. Epub 2014 May 15.
  3. Anderson, M.E., Glutathione Injections: an overview of biosynthesis and modulation. Chem Biol Interact, 1998. 111-112: p. 1-14.
  4. P., M. and C. G.P., Glutathione reductase: regulation and role in oxidative stress, in Oxidative stress and the molecular biology of antioxidant defenses. 1997, Cold Spring Harbor Laboratory Press
  5. Lu, Shelly C. “REGULATION OF Glutathione SYNTHESIS.” Molecular aspects of medicine 30.1-2 (2009): 42–59. PMC. Web. 2 Oct. 2017.
  6. Downey, J.S., et al., The LEC rat possesses reduced hepatic selenium, contributing to the severity of spontaneous hepatitis and sensitivity to carcinogenesis. Biochem Biophys Res Commun, 1998. 244(2): p. 463-7.
  7. Banki, K., et al., Molecular ordering in HIV-induced apoptosis. Oxidative stress, activation of caspases, and cell survival are regulated by transaldolase. J Biol Chem, 1998. 273(19): p. 11944-53.
  8. Shisler, J.L., et al., Ultraviolet-induced cell death blocked by a selenoprotein from a human dermatotropic poxvirus. Science, 1998. 279(5347): p. 102-5.
  9. Okamoto, K., et al., Formation of 8-hydroxy-2′-deoxyguanosine and 4-hydroxy-2-nonenal-modified proteins in human renal-cell carcinoma. Int J Cancer, 1994. 58(6): p. 825-9.
  10. Chinery, R., et al., Antioxidants reduce cyclooxygenase-2 expression, prostaglandin production, and proliferation in colorectal cancer cells. Cancer Res, 1998. 58(11): p. 2323-7.
  11. Lee, Y.J., et al., Glucose deprivation-induced cytotoxicity and alterations in mitogen-activated protein kinase activation are mediated by oxidative stress in multidrug-resistant human breast carcinoma cells. J Biol Chem, 1998. 273(9): p. 5294-9.
  12. P., M. and C. G.P.,Glutathione reductase: regulation and role in oxidative stress, in Oxidative stress and the molecular biology of antioxidant defenses. 1997, Cold Spring Harbor Laboratory Press
  13. Hauser, R.A., et al., Randomized, double-blind, pilot evaluation of intravenous glutathione in Parkinson’s disease. Mov Disord, 2009. 24(7): p. 979-83.
  14. Dröge W, Breitkreutz R. Glutathione and immune function. Proc Nutr Soc. 2000 Nov;59(4):595-600.
  15. Chang WK, Yang KD, Chuang H, Jan JT, Shaio MF. Glutamine protects activated human T cells from apoptosis by up-regulating glutathione and Bcl-2 levels. Clin Immunol. 2002 Aug;104(2):151-60.
  16. Oxidative Medicine and Cellular Longevity.Volume 2013 (2013), Article ID 972913, 10 pages http://dx.doi.org/10.1155/2013/972913.
  17. pubchem.ncbi.nlm.nih.gov/compound/124886?from=summary#section=Related-Compounds
  18. Balendiran GK1, Dabur R, Fraser D. The role of glutathione in cancer. Cell Biochem Funct. 2004 Nov-Dec;22(6):343-52.
  19. Ballatori, Nazzareno et al. “Glutathione Dysregulation and the Etiology and Progression of Human Diseases.” Biological chemistry 390.3 (2009): 191–214. PMC. Web. 2 Oct. 2017.
  20. Vogt, Barbara L., and John P. Richie. “Glutathione Depletion and Recovery After Acute Ethanol Administration in the Aging Mouse.” Biochemical pharmacology 73.10 (2007): 1613–1621. PMC. Web. 2 Oct. 2017.
  21. Dimova S, Hoet PH, Dinsdale D, Nemery B. Acetaminophen decreases intracellular glutathione levels and modulates cytokine production in human alveolar macrophages and type II pneumocytes in vitro. Int J Biochem Cell Biol. 2005 Aug;37(8):1727-37. Epub 2005 Apr 26.
  22. Abhilash, M., Varghese, M.V., Paul, M.V.S. et al. Comp Clin Pathol (2015) 24: 927. https://doi.org/10.1007/s00580-014-2013-8
  23. Romero DL, Mounho BJ, Lauer FT, Born JL, Burchiel SW. Depletion of glutathione by benzo(a)pyrene metabolites, ionomycin, thapsigargin, and phorbol myristate in human peripheral blood mononuclear cells. Toxicol Appl Pharmacol. 1997 May;144(1):62-9.
  24. National Research Council (US). Multiple Chemical Sensitivities: A Workshop. Washington (DC): National Academies Press (US); 1992. Considerations for the Diagnosis of Chemical Sensitivity.
  25. Lenzi A1, Lombardo F, Gandini L, Culasso F, Dondero F. Glutathione therapy for male infertility. Arch Androl. 1992 Jul-Aug;29(1):65-8.
  26. Coppola L, Grassia A, Giunta R, Verrazzo G, Cava B, Tirelli A, D’Onofrio F. Glutathione (Glutathione) improved haemostatic and haemorheological parameters in atherosclerotic subjects. Drugs Exp Clin Res. 1992;18(11-12):493-8.
  27. Weschawalit, Sinee et al. “Glutathione and Its Antiaging and Antimelanogenic Effects.” Clinical, Cosmetic and Investigational Dermatology 10 (2017): 147–153. PMC. Web. 2 Oct. 2017.

B-Complex

General Information

Vitamin B-Complex Injection is a sterile solution for intramuscular or slow intravenous injection comprised of vitamins which may be categorized as belonging to the vitamin B complex group. B-Vitamins are water soluble , which means your body does not store them.   B-Complex Vitamins contain the following:

  • B1 (thiamine): Thiamine plays an essential role in metabolism by helping convert nutrients into energy.
  • B2 (riboflavin): Riboflavin helps convert food into energy and also acts as an antioxidant.
  • B3 (niacin): Niacin plays a role in cellular signaling, metabolism and DNA production and repair.
  • B5 (pantothenic acid): Like other B vitamins, pantothenic acid helps your body obtain energy from food and is also involved in hormone and cholesterol production.
  • B6 (pyridoxine): Pyridoxine is involved in amino acid metabolism, red blood cell production and the creation of neurotransmitters.
  • B7 (biotin): Biotin is essential for carbohydrate and fat metabolism and regulates gene expression.
  • B9 (folate): Folate is needed for cell growth, amino acid metabolism, the formation of red and white blood cells and proper cell division.
  • B12 (cobalamin): Perhaps the most well-known of all the B vitamins, B12 is vital for neurological function, DNA production and red blood cell development.

Indications

In disorders requiring parenteral administration of vitamins, i.e. pre- and post-operative treatment, when requirements are increased as in fever, severe burns, increased metabolism, pregnancy, gastrointestinal disorders interfering with intake or absorption of vitamins, prolonged or wasting diseases, alcoholism and where other deficiencies exist.

Storage

Store this medication in a refrigerator at 36°F to 46°F (2°C to 8°C). Keep all medicines out of the reach of children. Throw away any unused medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.

Lipo B (MIC) Injection

Overview of Lipo-B (MIC) Injection

General Information

Lipo-B injection contains a mixture of compounds that may aid in the reduction of adipose tissue (fat). The mixture of compounds individually may be effective, however in combination they may exhibit more lipotropic activity than when administered alone in a synergistic fashion. Injection of this mixture of lipotropic compounds may be more effective than oral supplementation, this is due to the increased bioavailability of parenteral exposure.

These lipotropic agents are structurally and functionally closely related to the B-vitamins, or are involved in the homeostasis of energy production from fat. These compounds are often employed together in the hope of potentiating fat-loss, thus while the MIC mixture and B vitamin(s) are often injected separately, they are part of the same overall injection cycle. The non-vitamin compounds (MIC) that are injected into the body stimulate the liver into optimizing the process of metabolism, elevate the movement of and utilization of fat, and provide the needed metabolic environment of the body for a fatty acid (fat) mobilization and utilization.

Lipotropic compounds are used to increase the potential for release of fat deposits in some parts of the body. The lipotropic agents included in this injection are:

Methionine: 

Methionine helps the liver maintain the optimal ability to process fatty acids.1 Methionine is a major constituent of S-adenosylmethionine which has been shown to be associated in genetic regulation and activation of certain genes.2 Methionine contributes to methyl donation to histones that activate certain genetic processes that may be involved in the increase in lean tissue. Although indirectly linked to lipolysis, it is believed that the increase in lean tissue increases resting metabolic rate, therefore increasing the overall required calories that must be obtained from storage or dietary intake. Methionine, via S-adenosylmethionine, has been shown in animal models to increase CNS activity, therefore increasing the caloric requirements required by the CNS3 The downstream effects of this may ultimately lead to increased caloric requirements for the entire organism. Although studies have not been replicated.4 in humans, there may be an association due to the similarity in pathways shared between organisms.

Inositol: 

Inositol is a sugar-like molecule, referred to as a sugar alcohol. Even though very similar in molecular structure to glucose, this molecule does not exhibit the traits that simple carbohydrates exhibit. Contrary to simple carbohydrates, this sugar alcohol has been shown to not actively increase adipose storage. In fact, Inositol has been found to decrease fatty acid synthase activity, a multi-enzyme protein that catalyzes fatty acid synthesis. This set of enzymes ultimately enables the body to produce triglycerides fat molecules that reside in adipose tissue (body fat).3

Inositol may be effective in reducing insulin resistance, a common condition associated with increase adiposity (body fat).5 Insulin resistance, a condition to which your body becomes resistant to the activities of the hormone insulin. This condition leads to excess blood glucose levels and a host of symptoms and dysfunctions. A chemical called Inositol phosphoglycan is known to regulate the body’s sensitivity to insulin signaling. Inositol phosphoglycan structurally incorporates Inositol, thus inositol is required for this molecule to exert its regulating behavior.

The proper functioning and sensitivity to insulin is found in most healthy individuals, and is essential in maintaining overall health. Excessive exposure to blood glucose ultimately leads to insulin resistance and poor nutrient transport. Inositol may be effective in reducing this condition while at the same time reducing fatty acid (fat) synthesis.

Choline: 

Choline is a simple molecule usually classified as a B vitamin. The B vitamin class is usually involved in the generation of energy and support of metabolism. Choline is an important precursor to the neurotransmitter acetylcholine. This neurotransmitter is involved in a host of activities, one of which includes muscular function and contraction. Acetylcholine is a fundamental neurotransmitter that enables the communication between neurons. Increased neural communication results in increased CNS activity which ultimately leads to increased energy expenditure. Energy expenditure requires nutrient input, either from stored energy (fat), or dietary nutrients. Choline exist in a delicate balance and homeostasis with methionine and folate. When these nutrients are not in balance adverse health effects may be present. Along with the increase in CNS activity comes increased cognitive ability, reported by many users. Choline may be effective as a nootropic, or a substance with ability to increase cognition. Increased neural cognition is thought to be due to choline’s role as a precursor to acetylcholine.

The supplementation of choline has been shown to reduce serum and urinary carnitine.4 The reduction of carnitine in these fluids may indicate carnitine has been partitioned in tissues that utilize it as a fatty acid mitochondrial transport. When carnitine is used in the mitochondria it transports fatty acids to the location which they are broken down and used as energy. It has also been reported that molecular fragments of fat have been found in urine after carnitine and choline supplementation, which may be due to incomplete fatty acid oxidation and the removal of the subsequent byproducts.4 This means, choline supplementation may increase the utilization of carnitine and increase the removal of fatty acids, even though all fatty acids are not burned as energy. The fragments of fatty acids not burned as energy are extruded in the urine as molecular fragments.

B12 (Cyanocobalamin): 

Cyanocobalamin is an essential nutrient known as vitamin B12. This version of B12 contains a functional cyano. Cyanocobalamin is a form of vitamin B12, it is the most widely used form of vitamin B12. The vitamin B12 is fundamental in many biological processes, many of which are important to the survival of the organism. Vitamin B12 is involved in processes including DNA synthesis, fatty acid and amino acid metabolism.

B12 is purported by its users and practitioners to help speed up overall metabolic processes and create a greater feeling of overall energy and well-being. Individuals may be deficient in vitamin B12, these individuals must supplement B12. Deficiency is present for a variety of reasons including dietary deficiency and poor dietary absorption. The human body is incapable of producing vitamin B12 on its own, B12 must be consumed in the diet. Consumption of vitamin B-12 may be an effective agent to speed up metabolism, especially if the individual has a deficiency.

What is This Medicine Used For

Lipotropic injections are used to help release fat deposits in some parts of the body. Some of these areas include the stomach, inner thighs, neck, buttocks and hips. Lipotropic, or fat burning, substances include methionine which helps the liver remove fat; inositol, similar to methionine; choline, which distributes cholesterol and prevents it from getting deposited in one part of the body. In some cases, a combination of these may be given. Injections can be administered up to twice a week. B12 is purported by its users and practitioners to help speed up the overall metabolic processes and create a greater feeling of overall energy. Because lipotropics directly aid fat breakdown and are closely related to B vitamins, when used together they are thought to intensify each others’ effects. They are usually injected separately, but as part of the same overall injection cycle. The amino acids that are injected into the body stimulate the liver into optimizing the process of metabolism. These injections boost the metabolic power of the body. The injections are only effective temporarily. As soon as the effect of these substances wears out, the body starts returning to normal gradually.

Storage

Store this medication at 68°F to 77°F (20°C to 25°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.

  • 1.Best, C.H. and J.H. Ridout, The lipotropic action of methionine. J Physiol, 1940. 97(4): p. 489-94.
  • 2.Jones, P.A. and D. Takai, The role of DNA methylation in mammalian epigenetics. Science, 2001. 293(5532): p. 1068-70.
  • 3.Young, S.N. and M. Shalchi, The effect of methionine and S-adenosylmethionine on S-adenosylmethionine levels in the rat brain. J Psychiatry Neurosci, 2005. 30(1): p. 44-8.
  • 4.Hongu, N. and D.S. Sachan, Carnitine and choline supplementation with exercise alter carnitine profiles, biochemical markers of fat metabolism and serum leptin concentration in healthy women. J Nutr, 2003. 133(1): p. 84-9.
  • 5.Corrado, F., et al., The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet Med, 2011. 28(8): p. 972-5.
  • 6.Solomon, L.R., Disorders of cobalamin (vitamin B12) metabolism: emerging concepts in pathophysiology, diagnosis and treatment. Blood Rev, 2007. 21(3): p. 113-30.

Treatment of Alzheimer’s with Glutathione

Evidence suggests that glutathione therapy can improve cognitive impairment and also function in preventive capacity.

Glutathione (GSH) is a major antioxidant used by the body to prevent cellular and tissue damage associated with cognitive impairment.  Studies suggest the depletion of GSH  in the hippocampal regions in mild cognitive impairment (MCI) and AD patients compared to healthy old subjects.

B12 Vitamin Injection

What is a B12 Injection?

A B12 injection is an injectable form of vitamin B12, a micronutrient that is required to maintain good health. Vitamin B12, also known as Cobalamin, is a water-soluble micronutrient or vitamin that the bacteria in the stomach naturally produce. This vitamin is necessary for the body’s ability to form red blood cells, replicate DNA and to grow tissues. It also is required for Myelin to form, a fatty substance that protects nerve cells as well as to lower levels of Homocysteine, which reduces the risk for developing heart attacks and strokes.

Why is it Used?

When people are having difficulty creating or absorbing vitamin B12 naturally, a physician will recommend a B12 injection. Symptoms of vitamin B12 deficiency include: tiredness and fatigue, difficulty breathing, pale skin, poor memory, disorientation, confusion, white spots on the skin, appetite issues, headache, nerve shocks along the body, headaches and random facial pains, random tingles and sores in the mouth corners.

Physicians may also suggest that the patient consume more foods containing Cobalt, the substance that the stomach bacteria rely on in order to create vitamin B12. If improving consumption of cobalt-containing foods is not helping, physicians may recommend B12 supplement injections.

What Conditions Does it Treat?

Vitamin B12 has been successful in treating a variety of medical conditions. The most popular reason a B12 injection is used is for a deficiency, which is condition in which b12 levels in the blood are too low. This vitamin is also used for weight loss, Alzheimer’s disease (memory loss), boosting energy and the immune system, sleep disorders, diabetes, male infertility and to slow the aging process. B12 has been known to help with mental disorders, osteoporosis, AIDS, asthma, allergies, inflammatory bowel disease and some cervical and other cancers as well.

Tammoima Gichana PharmD, MBA, MB(ASCP),RPh.

Our amazing Dr. Tammoima explains anxiety

Anxiety involves feeling uneasy, anxious or nervous, due to stress or trauma, real or imagined. Typically, anxiety is a normal health issue that goes away once a negative situation is completed. Anxiety can even be positive, helping to improve coping or alertness. But when anxiety remains, this mental illness is called an anxiety disorder. Typically lasting for at least six months, these disorders can affect mental health, relationships and quality of life.

Anxiety is actually a group of disorders that all share some level of excessive, persistent, irrational panic and dread. Generalized anxiety disorder (GAD) involves ongoing excessive worry and tension, often with no apparent reason. With obsessive compulsive disorder (OCD), irrational, reoccurring thoughts and uncontrollable compulsions can occur. Post-traumatic stress disorder (PTSD) develops after trauma or terrifying events. PTSD patients may have frightening, long-lasting thoughts and memories. Phobias, excessive, inappropriate fear of an object, situation or activity, are uncontrollable. A phobia can cause extreme stress and anxiety, as people try to avoid their fear. Those with social anxiety disorder worry and feel self-conscious about normal social situations. With separation anxiety disorder (SAD), children have anxiety when separated from loved ones. Panic disorders (anxiety attack, panic attack) are sudden episodes of intense panic or fear, often without reason. A panic attack rarely lasts more than 30 minutes, but can be severe, and you may be worried that another anxiety attack will occur.

Causes and Risk Factors of Anxiety

The exact cause of anxiety and mental illness is not completely understood. Mental health researchers suggest a combination of several factors, including environmental stress, trauma and heredity, may be at fault. Severe or long-lasting stress may actually cause chemical imbalances to the brain and its structures, altering memory and mood. But other underlying health issues shown may also cause anxiety, including: muscle cramps/spasms, thyroid conditions, tingling and burning sensations, tumors, asthma, diabetes and heart disease.

Stress is a major risk factor for anxiety, whether due to illness, big events or smaller life situations. Women are twice as likely to be diagnosed with anxiety. Children who have endured abuse or trauma have greater chances of anxiety, as well. Your risks may be higher if blood relatives, including one or both parents, have an anxiety disorder. While drug and alcohol use causes anxiety, it also masks mental health issues, and should be treated first. If anxiety goes untreated or advances, insomnia, headaches, grinding teeth (bruxism) and digestive or bowel problems can develop. Nearly half of all anxiety patients are diagnosed with depression, as well.

Symptoms, Signs and Testsof Anxiety

Often, anxiety symptoms and signs first indicate physical or mental health illnesses. Anxiety symptoms may include: feeling apprehensive or powerless, increased heart rate, rapid breathing, feeling weak or tired, sweating, dizziness, stomach discomfort, chest pain, startling easily, muscle tension, sleep issues, nightmares and sexual problems. Anxiety disorders may have specific symptoms, such as panic attacks unreal, disconnected feelings and emotional numbness, or recurring, upsetting thoughts and compulsions occurring with obsessive compulsive disorder (OCD). As anxiety may have a medical cause, doctors give physical exams and blood tests. Patients fill out psychological questionnaires, and discuss medications or alcohol/drug use. Mental health professionals diagnose stress, trauma and anxiety with criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM). Anxiety disorders are diagnosed, along with other mental health problems. Depression is diagnosed in about half of anxiety patients.

Treatment, Drugs and Preventionof Anxiety

When anxiety remains, it becomes a mental issue requiring treatment. Typically, anxiety is treated with psychotherapy, medications, or both. Effective drugs enable patients to lead productive, fulfilling lives, although doctors may need to determine optimal treatments. Doctors typically prescribe antidepressants, such as fluoxetine (Prozac) and paroxetine (Paxil, Pexeva). These medications, which influence brain chemicals (neurotransmitters), are thought to play a role in anxiety disorders. Doctors may also prescribe benzodiazepines (sedatives), such as clonazepam (Klonopin) or diazepam (Valium), but they can be habit-forming. Beta-blockers can prevent the physical symptoms of social phobia and other anxiety disorders, as well.

Psychotherapy with mental health professionals is effective, allowing patients to identify stress sources. Its also helpful to discuss mental health issues with trusted friends or loved ones. Anxiety and related mental illnesses can be treated through lifestyle changes. Physical activity is important, and regular exercise incorporating healthy, fun activities reduces stress. Proper sleep and relaxation, along with daily leisure time, eases anxiety and stress. A well-balanced, healthy diet, including vegetables, fruits, whole grains and fish, reduces anxiety, while fried, sugary and processed foods should be avoided. Those with anxiety should limit caffeine, and completely avoid alcohol (and other sedatives), nicotine and drugs. Discuss with your doctor whether any drugs or medications you’re taking may cause anxiety.

 

 

Tammoima Gichana PharmD, MBA, MB(ASCP),RPh.

 

Causes, Risk Factors and Complications of ADHD

ADHD stands for attention deficit hyperactivity disorder and is a condition of mental health that provides the individual with difficulty in holding attention combined with hyperactivity and behavior that is impulsive in nature. Though the condition is most associated with children, it is also common to find the condition in many adults. The condition and symptoms can persist into the adult years, and in some individuals the disorder is not diagnosed until later years.

Causes, Risk Factors and Complications

Often ADHD is passed down from one generation to the next making it a hereditary disorder. The individual suffering with the condition might express signs early on in life that are missed or misdiagnosed as bad behavior or laziness. Some of the things that might put a person at risk for developing the disorder include things such as drug or alcohol abuse during the woman’s pregnancy, exposure to toxins like lead paint or pipes, or if you are born prematurely. You have a greater chance of suffering from ADHD if you have other family members with mental illness or ADHD.

There are many complications involved for those individuals dealing with ADHD in their lives. Performance in school and work can be hindered because of the inability to focus on the topic at hand and follow through to the end. Poor relationships can also become a result of ADHD in adults and children. It is also easy to see how a person with ADHD can be in trouble with the law, suffer from drug or alcohol abuse and go through severe financial stress. In addition, individuals with ADHD are often at greater risk for mental and physical health that is poor in nature.

Signs, Symptoms and Tests

It can be easy to misdiagnose ADHD, particularly in children, as the symptoms appear to be similar to basic childhood actions and laziness. It is important to note that many adults suffer from ADD which is attention-deficit disorder without the hyperactivity. Some of the symptoms include trouble with focus on daily tasks, difficulty completing projects or tasks, disorganization in general, restlessness, mood swings, impulsivity, low frustration tolerance, inability to cope well with stress, quick temper and inability to sustain stable relationships.

A doctor can provide you the individual with a number of tests that will give them feedback to be used in the evaluation of ADHD. This information is broken down into sections of inattention and hyperactivity/impulsivity. The individual should answer yes to six or more signs and symptoms that are designated by the Diagnostic and Statistical Manual of Mental Disorders (DSM) put out by the American Psychiatric Association. If six in each category of the questionnaire ring true to the individual they can be considered ADHD.

Treatment, Drugs and Prevention

There are a series of approaches to take when dealing with treatment of ADHD in children and in adults. These often include a medication such as a stimulant combined with psychological counseling. The medication choices often include Concerta, Metadate, Exedrine, Ritalin and some others newer to the field. These stimulants work to balance the brains neurotransmitters. Some other options for treating the ADHD with medications is the use of atomoxetin, better known as Strattera and Wellbutrin. There are some individuals that can not take the stimulants because of health problems or because of past drug addiction.

Counseling will help the individual learn how to cope with some of the things that can trigger the behavior. In addition, you will learn how to prevent or reduce such things as impulsive behavior and how to be better organized, handle time management better, improve self-esteem and improve relationships with those around you. This is all important for developing a lifestyle free of ADHD symptoms and drama.

 

 

Tammoima Gichana PharmD, MBA, MB(ASCP),RPh.

 

What you need to know about obesity

Obesity is a term used for children and adults who are at an unhealthy weight. It is not the same as being overweight and is a higher level of carrying too much weight compared to your height. It is considered a chronic medical condition with excessive body fat and poses a number of threats to your health. Obesity is often defined more specifically by being over a certain body mass index (BMI). Everyone has a unique BMI that shows where you are on a scale of underweight to morbidly obese.

Being obese is somewhere in the middle of the scale where your BMI is 30 or more. Someone who is overweight is between 25 and 29.9 on the BMI scale while someone morbidly obese is 40 or over. According to MedicineNet.com, over 30% of adults in the United States are currently obese and 20-25% of children are obese. While these statistics are startling, the good news is you have different treatment options. Weight management is done with weight loss programs, weight loss medications, home treatment and even surgery if you require it.

Risk Factors of Obesity

There are many complications associated with being obese and medical conditions you could develop as a result of the added fat. The first thing you should be aware of is that obese increases your risk of dying at a younger age. Around 300,000 deaths each year are related to obesity. If you are obese, you could become resistant to insulin, develop diabetes or heart disease, have any number of cardiovascular problems, get high blood pressure, high cholesterol, have a stroke or heart attack, and increase your risk of getting cancer, osteoarthritis, sleep apnea, gallstones and gout.

Some people are at a higher risk for developing obesity than others. Children who are born to parents who are obese are at a higher risk because it can be genetic. Also, children who are overweight starting at a young age have a higher risk of maintaining the condition through adulthood. Also, if you are African American or Hispanic, you fit a high-risk category as it is more common with these nationalities. Additionally, having an eating disorder, mental health disorder, polycystic ovary syndrome (PCOS), Cushings syndrome or hypothyroidism, you have a risk of becoming obese.

Symptoms, Signs and Tests of Obesity

If you suspect you may be obese, you should consult a doctor right away. The sooner you get help with losing weight; the better off you will be in the long run. Since many complications and adverse health effects are associated with being obese, losing weight and becoming healthy should be your top priority. Your doctor will check your current weight and height to calculate your body mass index, take measurements and ask you a series of questions about medications youre taking, your lifestyle, what you eat on a typical day and your medical history. A series of tests will also be performed to determine if a medical condition may be the source of your obesity, such as lower-than-average metabolism, diabetes, hypothyroidism or PCOS. Your doctor will also want to calculate how much body fat you have compared to your muscle mass.

Body Mass Index

Body mass index (BMI) as mentioned previously is used to determine whether someone is at a healthy weight, overweight, underweight or in the obese category. It actually goes all the way up to morbidly obese and super obese. BMI is calculated using your current weight and your height in inches. This is a screening tool that helps doctors find out how much your weight is affecting your overall health. A BMI of 18.5 or less is underweight, 18.6 to 24.9 is healthy, 25 to 29.9 is overweight, 30 to 39 is obese, 40 to 49 is morbidly obese and 50 or more is super obese.

Signs of Obesity

Another way to determine whether or not you are obese is by looking at other signs you might have. Many people who are obese tend to have joint and muscle pain, dizziness, frequent headaches, gastrointestinal issues, heart palpitations, sleep apnea, fatigue, shortness of breath and the inability to be physically active without becoming exhausted. However take these signs with a grain of salt; they arent enough to diagnose obesity and may occur in people overweight or who are at a healthy weight. The best way to find out if you are obese and the cause of the extra weight is to have a physical exam by a doctor. They will help you with weight control and to start a weight loss program that is right for you.

Treatment, Drugs and Prevention of Obesity

There are many different methods of treatment for obesity, including medical and drug treatment, home treatment, surgery and going to a local weight loss center. Medical treatment is necessary for some obese individuals who are not able to lose weight on their own. Medical treatments include surgery and weight loss drugs.

Weight Loss Surgery

The two most common types of weight loss surgery are gastric bypass surgery and laparoscopic gastric banding, with a third less common option being a sleeve gastrectomy. These surgeries have their pros and cons and you should speak to your doctor about the risks and benefits. Keep in mind if you decide to get weight loss surgery, it is a long process and requires you to stick to a healthy diet and fitness routine after the surgery. It is not a quick-fix and requires a lifelong commitment.

Anti-Obesity Medications Injections

You can also get treated with medications, including anti-obesity medications and appetite suppressant drugs. One medication that helps with weight loss is actually an injection; called the lipotropic B12 injection. This is a fat-burning injection that includes B12 vitamins and amino acids. It will help your body burn fat more quickly and speed up your metabolism. You can also start an HCG diet, which uses pharmaceutical grade Human Chorionic Gonadotropic (HCG) which is a hormone that is naturally produced in women. This diet uses HCG to control your metabolism and lose weight in the process.

Another injection to help with treating obesity is the L-carnitine injection which is a supplement that can help transport fat into cells for producing more energy. It also speeds up your metabolism and helps promote weight loss. Finally, there is an FDA-approved appetite suppressant called Phentermine. This is a pill available in 37.mg pills that will help you improve your mood and control your appetite. Side effects from taking Phentermine include insomnia, high blood pressure, headache, constipation and nervousness.

Weight Loss Program

Perhaps one of the best treatment options is joining a weight loss program offered by a medical center or weight loss center. These programs combine different types of treatments for obesity, including learning about proper nutrition, exercise and fitness programs and treating underlying conditions causing obesity such as mental health disorders or eating disorders.

Home Treatment Methods

Not all obesity treatments are medical, though you should consult your doctor before starting a new diet, weight loss program or exercise program. The basics of home treatment for obesity are changing your lifestyle to become healthier and more conscious of what you eat. Consider your eating habits. Eat small portions of healthy, nutrient-rich food. Work closely with a dietician to decide what foods you should eat; aim for fresh fruits and vegetables, nuts and seeds, lean dairy, lean meats and healthier ways to prepare foods. You shouldnt eat less than 1,200 calories a day regardless of your weight. If you have issues with emotional overeating, find new and healthier ways to handle stressful situations so you can avoid binge eating. Start a fitness routine where you are getting at least 3-5 days of physical exercise. Combine cardio with weight training to help control your obesity and lose weight. Its important not to begin exercise before being examined by a medical professional.

 

 

Tammoima Gichana PharmD, MBA, MB(ASCP),RPh.

 

Dr. Tammoima’s view on Eating Disorders

Eating disorders refers to a group of conditions that involve the preoccupation with weight and food that distracts from everyday life. There are a number of eating disorders; however, the most common are anorexia nervosa, bulimia nervosa, compulsive eating or binge eating disorder and ED-NOS or eating disorder not otherwise specified. Eating disorders cause serious problems that can have both emotional and physical ramifications. At their most severe, these disorders can be life-threatening. They can affect both men and women of all ages.

Causes, Risk Factors and Complications of Eating Disorders

There is no exact cause known for eating disorders. When you look at them as a psychological illness, it makes sense why there might be numerous causes that depend on the individual. Some of the possible causes thought to be responsible for eating disorders include: biology, psychological health, emotional health and societal issues. There also seems to be some hereditary link in eating disorders as people who have first-degree relatives with eating disorders seem more likely to develop one too.

Some of the most common risk factors for eating disorders include: being female, a teenager or young adult, family history of eating disorders, emotional and psychological disorders, obsession with dieting and transitions or big life changes. Certain people such as actors, athletes, models and dancers tend to be more prone to eating disorders because they are expected to meet certain requirements for weight and physical appearance.

Eating disorders actually produce a wide variety of different complications, and some of them can be life threatening. Severe eating disorders and long lasting eating disorders can cause some of the most severe complications. Some complications of eating disorders include: high or low blood pressure, kidney damage, severe tooth decay, digestive issues, bone loss, stunted growth, suicidal thoughts, absence of menstruation, depression, heart problems, organ failure and death. Because these complications are so serious, seeking professional medical help for this type of problem is absolutely essential.

Signs, Symptoms and Testsof Eating Disorders

The symptoms associated with eating disorders are unique to each individual eating disorder. Symptoms of anorexia nervosa, for example, focus on refusal to eat, denying hunger, intensely fearing weight gain, distorted self-image, excessive working out, fear of eating out, thin appearance, difficulty sleeping, menstrual irregularities and dehydration just to name a few. The symptoms associated with bulimia nervosa include: eating to discomfort, binge eating, self-induced vomiting, excessive exercise, laxative use, going to the bathroom immediately after eating, dehydration, damaged gums and teeth and abnormal bowel function. The symptoms of binge-eating disorder involve: eating excessive amounts of food without trying to purge the food afterward through exercise or vomiting. Other symptoms of eating disorders in general can include: frequently eating alone, feeling that the eating is out of control, eating too quickly, eating to the point of pain or discomfort and eating much more than one should during a meal or a snack.

Treatment, Drugs and Prevention of Eating Disorders

Treatment for eating disorders will rely on the type of eating disorder being experienced. A typical eating disorder treatment plan will include nutrition education, psychotherapy and medical treatment. It is important to attain and maintain a healthy weight as well as understand healthy nutrition habits. Psychotherapy and counseling are also important in order to prevent a recurrence of the eating disorder. Some medications can also be used to control urges, but there is no real medical cure for eating disorders.

 

 

Tammoima Gichana PharmD, MBA, MB(ASCP),RPh.