Why should Viagra concern women? When women go through menopause, the hormonal changes they experience often lead to a drop in libido and less interest in sex. It's nature taking its course - just another phase in the female life cycle. It's the way we're built and programmed, biologically speaking.So what do we do about Viagra and the other ED (erectile dysfunction) drugs that are now commonplace and marketed directly to men in TV commercials and magazine ads? It's an important question to ponder, because as every woman knows, it takes two to tango. Viagra's impact on men's sex lives also impacts women's sex lives.Meika Loe has pondered this very question in her book, The Rise of Viagra: How the Little Blue Pill Changed Sex in America. And the answers she's uncovered are disturbing. Loe, who is Assistant Professor of Sociology & Anthropology and Women's Studies at Colgate University, has also written extensively about sex and senior women.Loe spoke to About.com about Viagra (marketed by Pfizer) and how women's sexuality has been affected by the introduction of these ED drugs. Viagra is marketed to aging men whose female counterparts are going through their own sexual crisis - menopause. These women want less sex but their partners now want more.
Isn't this counter-intuitive? Doesn't this turn the bedroom into a battlefield at a time when women are already vulnerable (e.g., empty nest syndrome, feeling less attractive as we age, physical changes due to menopause including hair loss and weight gain, etc.) I recently visited my ob/gyn, and upon hearing about my research, she volunteered that many of her women patients have complained that Viagra has not helped their sex lives. The introduction of the pill has made sexuality, among other things, intercourse-focused and thus less satisfying.I hear this kind of thing over and over. My analysis of syndicated advice columns after Viagra's debut in 1998 revealed many negative responses among women. Women writing to Dear Abby, for example, were either no longer interested in sex (and thus Viagra created new unwelcome pressure to be sexually active again), or fearing their husbands were having affairs in the context of their new found sexual potency, and/or experiencing sometimes painful physiological effects of reigniting their sex lives later in life.It seems that Viagra raised quite a few questions for married women about marital obligation, for example. Then again, there were other letters that reflected excitement about husbands feeling healthy and confident after a period of impotence, so the response to Viagra in the population is quite complex.I would have liked to see an explosion of people communicating about sexuality after Viagra's release, but in our pill-for-everything culture, we tend to let the pill do the work and forget that it may not be an end-all be-all. Viagra tended to just exacerbate or throw light on already existing problems in relationships.It should be telling that at this point, almost 10 years after Viagra's debut, only 50% of men who received prescriptions for Viagra end up refilling their prescriptions.
It's not simply about a man being able to have pleasurable sex. It's also about power and dominance, virility despite aging. It's a way for men to deny that they are past their sexual peak. What are the long-term implications for a society that has Viagra in its drug arsenal?
Viagra was the harbinger of things to come in the form of the pharmacology of aging and sexuality (sexual medicine is in expansion mode post-Viagra).All of this is due to a combination of, among other things, changing demographics (e.g. aging population), direct to consumer advertising/ consumer-based medicine (Viagra being one of the first drugs to be advertised directly to the consumer) and pharmaceutical expansion.It is important to see that Viagra's popularity fits in a particular cultural moment in our history, and there will be/have been plenty of other products to follow (including medications) that emphasize the holy triumvirate: youth, vitality, and performance.In short, as a sociologist I see Viagra as a cultural product and thus a window onto our culture. It helps us see where we are when it comes to sexuality (and our ambivalence), gender (masculinity and sexual performance packaged together), medicine (quick-fix and lifestyle enhancement emphasis more than ever), and aging (we’re uncomfortable with it but do we all want to be 18 again?).Pfizer has helped to reinforce these traditional and not-so-traditional ideals with Viagra and it has been fascinating to see how successful they have been here and around the world with this youth, vitality, and performance-based message.Again, now that the initial curiosity factor has disappeared, it is unclear how successful sexual dysfunction medication really is. Viagra has spurred several like products – Cialis and Levitra. But the refill rate on all three is low.Viagra is certainly sociologically significant as it has highlighted many social problems in the way we do health and gender and sexuality in our society. Is Viagra use common within the general population - men of all ages? How does this affect behavior or alter men and women's sexual intimacy?
It is difficult to find demographic information about who uses Viagra, but in Internet chatrooms, doctors' offices, pharmacies, etc. you find men of all ages interested in discussing the drug.I spoke with young men who had purchased Viagra out of insecurity - a 'just in case' situation where they felt they had to live up to some social standard their first time and had purchased the pills (or borrowed them) to have some assurance of adequate performance.I also spoke with men in their 80s who felt like it gave them 'life' again.
The main types of anti-inflammatory drugs for better asthma control are steroids or corticosteroids. Other anti-inflammatory treatments include leukotriene modifiers and immunomodulators.
What Are Inhaled Steroids? Inhaled steroids are the mainstay treatment for controlling asthma. The use of inhaled steroids leads to:
Better asthma control Fewer symptoms and flare-ups Reduced need for hospitalization Note that while inhaled steroids help prevent asthma symptoms, they do not relieve asthma symptoms during an attack. Dosages of inhaled steroids in asthma inhalers vary.
Inhaled steroids need to be taken daily for best results. Some improvement in asthma symptoms can be seen in 1 to 3 weeks after starting inhaled steroids, with the best results seen after 3 months of daily use.
Inhaled steroid medications for better asthma control include:
Advair (a combination drug that includes a steroid and a long-acting bronchodilator drug) Arnuity Ellipta Asmanex Dulera (a combination drug that also includes a long-acting bronchodilator drug) Flovent Pulmicort Qvar Symbicort (a combination drug that includes a steroid and a long-acting bronchodilator drug) Inhaled steroids come in three forms: the metered dose inhaler (MDI), dry powder inhaler (DPI), and nebulizer solutions.
It used to be that men had the upper hand when it came to confidence in the bedroom.
But health experts say ever-younger men are increasingly turning to Viagra in a bid to keep up with modern women inspired by the strong female characters in films such as Sex And The City, starring Sarah Jessica Parker.
Relationship therapists are also seeing a rise in the number of men in their 30s asking about the impotence drug, traditionally prescribed to those more than two decades older.
Experts believe the men feel increasingly emasculated by today's women.
They claim that women, following the example of television and film characters, are more vocal about their desires and demand a higher level of stamina and imagination in the bedroom.
The pressure is causing an increasing number of men to experience 'performance anxiety' and, in extreme cases, is leading to diagnoses of erectile dysfunction, requiring specialist treatment. Dr John Tomlinson, a former GP and trustee of the Sexual Dysfunction Association, said he was hearing from an ' enormous' number of 18- to 40-year-olds worried about sexual problems.
He suggested advertising - such as David Beckham's Armani underwear campaign - glamorises the well-toned male body, which men find daunting because they assume it is what women expect.
He said: 'Men may feel emasculated by modern women and feminism has taken its toll. But most of the problems are psychological. I'm sure many of these men are fuelling the counterfeit drugs industry by buying their Viagra online, so the real picture is likely to be bigger than GPs are reporting.'
There are no official figures for the number of young men taking Viagra because it is not routinely recorded by doctors. Many also opt to seek treatment privately. BUPA said it could not provide data on consultations. However, health experts agreed the average age for men seeking the drug is falling.
Dr John Dean, a specialist in sexual medicine, said when Viagra was introduced ten years ago, it would have been unusual to treat men in their 30s. Now, however, it is common, he said.
Peter Baker, of the Men's Health Forum website, said it is 'well-known' among health professionals that younger men are turning to Viagra.
Relationship experts said the prevalence of pornography in society also left men with unrealistic expectations.
Sex therapist Denise Knowles, of counselling service Relate, said: 'Pornography affects how men see themselves and how they think women will see them. Further pressure comes from the myth that men should know what to do in the bedroom and that women are difficult to satisfy.'
Nearly 6.5 million tablets of Viagra - launched by drugs firm Pfizer in 1998 - were issued in England in 2007, costing the NHS £35million. Research in 2004 found that taking the drug recreationally could affect fertility.
Rafael Palmeiro seems an unlikely Viagra pitchman. The Texas Rangers slugger is only 37 and won't admit to having erection problems, yet he recently agreed to appear in ads promoting the drug. The deal has made people wonder whether Palmeiro really represents men witherectile dysfunction, or whether Pfizer, the company that makes Viagra, wants to persuade young men to try it for fun.
It's true thaterectile dysfunctionis more common in older men, but many potential Viagra users are hardly senior citizens: About 40% of 40-year-old men in the U.S. have some degree oferectile dysfunction. Most Viagra users today, according to Pfizer, are in their early to mid 50s. So it makes sense that the company would want to reach more men around Palmeiro's age.
Urologist Myron Murdock, medical director of the Impotence Institute of America, says these men are likely to use Viagra because sexual performance is a high priority for them.
A younger man, Murdock says, "wants his V-12 Jaguar working just perfectly," whereas an elderly gent may be content with less dependable erections. What's more, the sexual partners of younger men "are more demanding of their performance," Murdock says.
Pfizer denies that it's promoting Viagra for recreational use. "We've consistently opposed that," says spokesman Geoff Cook. Nevertheless, Murdock says it's fine to pop the little blue pill to "optimize" your sexual performance.
We assume all young men have normal sexual functioning, "but they're really not normal," Murdock says. Hardening of thearteries, which restrictsbloodflow to thepenis, can begin during the teen years, so that by the time a man is in his 20s, his ability to get and keep an erection has already begun to decline. Murdock says many men who seek Viagra for recreational use actually have minor erectile dysfunction.
There's also some evidence that Viagra can shorten the time it takes a man to recover aftersexand be ready for another round. This is called the "refractory period." Normally it lasts 20 minutes or longer. One study, published in the journalHuman Reproductionin January 2000, found that Viagra shortened the refractory period by about 10 minutes inhealthy men.
Some of most commonly prescribed and abused drugs in America belong to a drug family called the phosphodiesterase 5 inhibitors. But you probably know them better as Viagra (sildenafil), Cialis, and Levitra. Unless you never watch TV, it's almost impossible to miss their commercials.
Viagra and the other phosphodiesterase 5 inhibitors are meant to be taken only by men who have erectile dysfunction (ED). Since Viagra was introduced in 1998, the number of men diagnosed with ED has gone up by 250 percent.
Risk factors for ED include older age, obesity, diabetes, heart disease, and high blood pressure. The problem is that men without issues are using these medications. "We are seeing more and more young men without any risk factors for ED asking for ED drugs. They look a lot like the young men dancing around in the TV advertisements, probably too healthy to have ED,” said Rowena DeSouza, MD, associate professor of surgery at the University of Texas Health Science Center at Houston and director of urology at Lyndon B. Johnson Hospital.
Recreational ED Drug Use and Abuse “Men who are doctor shopping for these drugs and getting more refills than they need are using them not to get an erection, but to get a longer erection. That is recreational use, not appropriate use,” said Dr. DeSouza.
A review of 46 articles on phosphodiesterase type 5 inhibitor abuse was published in the journal Current Drug Abuse Reviews in 2011. One reason cited for abuse was easy access to ED drugs. A search for Internet drug stores found over six million hits at 7,000 Internet pharmacies. Only 4 percent of the sites were in proper compliance, according to the Verified Internet Pharmacy Practice Sites program.
Another concern with getting ED drugs at online pharmacies is that the drugs may be fake, contaminated, expired, ineffective, or unsafe to use.
The Dangers of Misusing ED Drugs “These drugs have known risks that all men need to know about. They can be misused if men are not aware of the dangers,” said DeSouza. Even if you have ED, you can potentially misuse a phosphodiesterase 5 inhibitor and increase cardiovascular risks if you:
Also take medications for chest pain called nitrates Have active coronary heart disease Have congestive heart failure Have low blood pressure Take several medications for high blood pressure Have exercise intolerance The Dangers of Abusing ED Drugs “One important danger that men need to know about if they are using ED drugs recreationally is drug dependence. Men who take the drugs for longer and larger erections may find that they actually develop ED without the drugs. This could mean having to use more aggressive treatments like injections or implants to treat ED in the future,” warned DeSouza.
Reports of dangers from ED drug abuse run the gamut from unsafe sex practices and a heightened sexually transmitted infection (STI) risk to fatal drug interactions. They include these specifics:
A five-fold increase in unsafe sex among men who have sex with men A two-fold increase in STIs Dangerous and potentially fatal mixing of ED drugs with club drugs such as ketamine and amyl nitrite A 2011 survey on recreational use of ED medications published in the journal Archives of Sexual Behavior included responses from 1,994 men attending 497 colleges across the country. Four percent of these men admitted to using ED drugs recreationally. A majority of the recreational users mixed ED drugs with illegal drugs and engaged in risky sexual behaviors. Recreational use was associated with substance abuse and a higher number of sex partners.
“It is hard to know how many men are using ED drugs recreationally,” said DeSouza. "Studies are hard to do because they rely on self-reporting. Men who want to use these drugs can often get them by answering questions about erectile dysfunction appropriately when they talk to a doctor. They know the symptoms of ED."
The Bottom Line on ED Drugs: Be Informed Don’t merely focus on the beautiful, happy people in the ED ads on television. Listen to the voiceover about side effects and contraindications. “If you have not been properly evaluated by your doctor and properly prescribed an erectile dysfunction drug, you should not be taking one,” warned DeSouza.
Ask your doctor if you are healthy enough to use Viagra or the other ED drugs. Make sure you know the side effects. Tell your doctor about any other drugs you take. Drug interactions are possible with lots of common drugs including drugs for blood pressure, angina, blood thinners, and seizures.
And, by the way, an erection that lasts four hours is not a good thing. It is painful and dangerous.
Viagra and the other phosphodiesterase 5 inhibitors are great drugs for the right men. They may induce an erection in over 80 percent of men with ED. Many millions of men have used these drugs safely and appropriately.
But if you don’t have ED, you don't need them. If you are concerned about ED, talk with your doctor -- searching for Viagra on the Internet can have disastrous consequences.
Thursday, April 16, 2015
Steroids vs Supplements
As controversies and legal intervention have swelled up regarding the use ofsteroidsfor body-building and athletic purposes, alternatives havebeenmade available to satisfy the demand of the fitness-conscious market. Nowadays, a wide array of body-building supplements is easily available in health stores. Although most of these supplements have no approved therapeutic claims, they are deemed rathereffectiveand safe as opposed to steroids.
Steroids or anabolicsteroidsare artificial variants of the masculine-type hormone, testosterone. These drugs are originally intended to treat medical conditions involving musculoskeletal growth, inflammation of body parts, and reproductive dysfunction. They are often administered by ingestion, injection or topical application. Despite the steroid’s remarkable contribution in medicine, it has been prone to abuse over time. Some body-builders and athletes have been speculated to have used the drug for its distinctive protein synthesis capacity, particularly for the purpose of increasing muscle mass and improving strength and endurance to gain advantage in their respective fields. Over the years, lawful prohibition has been appropriated to the issue. Furthermore, high dosages and prolonged use of steroids pose long-term side-effects both physiologically and mentally. It can weaken the immune system and may potentially cause liver damage and even cancer. It eventually limits the body’s natural capacity to produce the much-needed hormone and may eventually entail premature termination of skeletal and muscular growth. Psychologically, it is most likely to result in uninhibited aggression, depression, rapidmoodswings, and irritation. Excessive anabolic steroids may cause the male testes to shrink, reducing sperm count, and the female’s menstrual cycle to go out of track. Weight gain, hair loss, skin problems are just some of the most conspicuous effects.
Conversely, supplements are a mixture of nutrients and natural ingredients thataimto increase compound levels in the body, which isn’t attained by mere food-consumption. Body-building supplements somehow adhere to the maingoalsof anabolic steroids ‘“ that is to increase muscle mass, strength and endurance- but with less health risks. Most supplements in the market deliver noticeable results without the drawbacks of the infamous, and needless to say illegal, anabolic steroids. Supplements come in a variety of forms such as powdered, tablet and capsule. They are as well classified depending on the nutritional benefits. Closest to the effects drawn from anabolic steroids are those of Ginseng, creatine monohydrate, protein and fat-loss supplements.Ginsengprovides necessary compounds to alleviate the fatigue associated with prolonged activity, increasing energy and endurance. Creatine monohydrate chiefly promotes muscle mass development. Protein supplements, commonly in powder form, contain amino acids crucial in accelerated muscle recovery and growth. Fat-loss supplements, on the other hand, expedite burning of unnecessary fat to then increase lean muscle mass. Clinical studies have shown that most bodybuilding supplements, especially Creatine, Amino Acids, L-Glutamine, Methoxyisoflavone and Ecdysterone, and Nitric Oxidecan are safe despite efficient anabolic-like results. However, nutritionists and fitness experts alike recommend proper diet, regular exercise and physical training for these supplements to reach their optimum potentials.
Summary
1. Artificial steroids or anabolic steroids are drugs intended to replenish insufficient testosterone supply in the body. Supplements are nutrient-rich products that fill in the body’s further nutritional requirements that aren’t satisfied by food alone.
2. Both steroids and supplements increase muscle mass, strength and endurance.
3. Most supplements are made from natural ingredients and are proven safe and effective. Steroids, in contrast, are derivations of the masculine-hormone testosterone and poses adverse physiological and mental effects in the long run.
4. In some countries, steroids are illegal for athletic or bodybuilding use. They are however acquired only with proper prescription and for medical purposes. Supplements are widely available in health shops and can be used without legal or medical restrictions.
Credit card fraud takes place every day in a variety of ways. You can’t always prevent it from happening, but you can create some obstacles and make it tougher for someone to get hold of your cards and card numbers. Treating your credit cards and account numbers like cash — that is, very carefully — is one way to head off potential misuse.
Theft, the most obvious form of credit card fraud, can happen in a variety of ways, from low tech dumpster diving to high tech hacking. A thief might go through the trash to find discarded billing statements and then use your account information to buy things. A retail or bank website might get hacked, and your card number could be stolen and shared. Perhaps a dishonest clerk or waiter takes a photo of your credit card and uses your account to buy items or create another account. Or maybe you get a call offering a free trip or discounted travel package. But to be eligible, you have to join a club and give your account number, say, to guarantee your place. The next thing you know, charges you didn’t make are on your bill, and the trip promoters who called you are nowhere to be found.
What Can You Do?
Incorporating a few practices into your daily routine can help keep your cards and account numbers safe. For example, keep a record of your account numbers, their expiration dates and the phone number to report fraud for each company in a secure place. Don’t lend your card to anyone — even your kids or roommates — and don’t leave your cards, receipts, or statements around your home or office. When you no longer need them, shred them before throwing them away.
Other fraud protection practices include:
Don’t give your account number to anyone on the phone unless you’ve made the call to a company you know to be reputable. If you’ve never done business with them before, do an online search first for reviews or complaints.
Carry your cards separately from your wallet. It can minimize your losses if someone steals your wallet or purse. And carry only the card you need for that outing.
During a transaction, keep your eye on your card. Make sure you get it back before you walk away.
Never sign a blank receipt. Draw a line through any blank spaces above the total.
Save your receipts to compare with your statement.
Open your bills promptly — or check them online often — and reconcile them with the purchases you’ve made.
Report any questionable charges to the card issuer.
Notify your card issuer if your address changes or if you will be traveling.
Don’t write your account number on the outside of an envelope.
Report Losses and Fraud
Call the card issuer as soon as you realize your card has been lost or stolen. Many companies have toll-free numbers and 24 hour service to deal with this. Once you report the loss or theft, the law says you have no additional responsibility for charges you didn’t make; in any case, your liability for each card lost or stolen is $50. If you suspect that the card was used fraudulently, you may have to sign a statement under oath that you didn’t make the purchases in question
If Visa offered you a credit card with an annual percentage rate of 391%, would you take it? It sounds like a joke, but to the recipients of one of the most sinister and underhanded lending practices in the marketplace, it's truly no laughing matter. The typical story goes something like this. Jim is strapped for cash, several of his bills are due (or past due), and payday isn't for another week. So rather than get hit with late fees or hurt his credit any worse than it already is, Jim decides to seek out what is known as a payday loan. He figures, "it's just like an advance on money that's coming my way anyway, right? Why not?" So Jim takes a walk to his local payday loan center and writes a postdated check for $575 for a $500 loan. Two weeks from now, he'll have to allow the check to be cashed, pay back the full amount of the check by some other means (such as cash), or pay another fee to extend the loan. Can you guess what $75 on a two-week loan for $500 works out to be in annual interest? That's right, 391% APR-- and what's worse, that's actually the low end of the spectrum when it comes to these types of loans. Payday loans have been known to reach upwards of 700+% APR (often the highest rates come from online lenders) with averages usually in the four to five hundreds. As an example, California's average is 460%.
Once is Rarely Enough
If Jim only had to do this kind of thing once, it might be painful but at least it would be over quickly. The problem, however, is that using this kind of loan often creates a cycle of debt that can't be easily undone. The average borrower spends $793 to pay off a $325 loan because he or she ends up needing to take out more payday loans just to pay off the original, either because of a lack of funds available or because two weeks just isn't enough time to regroup.
According to the Washington State Department of Financial Institutions, one in four payday borrowers in that state took out loans between 10 and 19 times a year. The Very Definition of Usury Payday loans often fall directly under the definition of usury, which is the act of lending money at an unreasonably high interest rate, as dictated by the state. Now, of course, many states have allowed payday loans, or payday lenders have used lending loopholes to their advantage, but certainly a loan with an APR in the three-digit realm can't be considered anything except "unreasonable." As an interesting point of reference, the Roman Empire had a 12% cap on interest rates. The ancient Chinese had a 36% cap. The American colonies had caps between five and 12%. And between 1900 and the late 1970's, most U.S. states had usury caps between 18 and 42%. So historically we are way over the limit and into what amounts to legalized loan sharking. What Choice Do You Have? The argument for payday loans is that they serve competition and may be the only alternative for people with severe credit problems. For those people, these loans could be the only thing standing in the way of bouncing checks or having to pawn their personal items. But if you know someone like Jim or have been tempted to take out a payday loan yourself, consider these alternatives: A small loan from your credit union or small loan company. A loan from family or friends. An advance on pay from your employer. A cash advance on a credit card (though it may have a higher interest rate than your other sources of funds). A local, community-based organization may make small business loans to individuals. Ask your creditors for more time to pay your bills. Find out what they will charge for that service - as a late charge, an additional finance charge, or a higher annual interest rate. Try working out a debt repayment plan with creditors and developing a budget. Find out if you have, or can get, overdraft protection on your checking account. The fees can be high but may still be lower than those of payday loans. Contact your local consumer credit counseling service. There are non-profit groups in every state that offer credit guidance to consumers and these services are available at little or no cost. Your employer, credit union, or housing authority may also offer credit counseling programs. No matter what you choose, it's extremely important to shop carefully, compare offers, and look for the option with the lowest APR. Buyers Beware
Between 2000 and 2004, the number of payday lender locations skyrocketed from 10,000 to 22,000. As of last month, University of Utah law professor Christopher Peterson said, nationally, there are now more payday lenders than McDonalds, Burger King, J.C. Penneys and Target stores combined. The numbers are scary and several consumer watchdog organizations have released strong warnings against payday loans. The FTC posted a "Consumer Alert," the Consumer Federation of America set up www.paydayloaninfo.org as an educational resource, the United States Defense Department has a program in place that warns military service personnel against them, and our nation's capitol has effectively outlawed the practice by capping the interest rate at 24% (Payday Loan Consumer Protection Act). The moral of the story? Stay away from payday loans. No matter how bad your financial troubles may seem now, they can always be worse. Disclaimer: All information posted to this site was accurate at the time of its initial publication. Efforts have been made to keep the content up to date and accurate. However, Credit Karma does not make any guarantees about the accuracy or completeness of the information provided. For complete details of any products mentioned, visit bank or issuer website.
Are you getting enough vitamin B12? Many people don’t, and that deficiency can cause problems.
Vitamin B12 does a lot of things for your body. It helps make your DNA and your red blood cells, for examples.
You can get vitamin B12 from your diet, or from supplements. Exactly how much you need depends on your age.
assorted vitamins
Quiz: What Do You Know About Vitamin B12 Deficiency? Slideshow: A Visual Guide to Anemia Causes of Vitamin B12 Deficiency Vitamin B12 deficiency can happen if you have certain conditions, such as:
Atrophic gastritis, in which your stomach lining has thinned Pernicious anemia, which makes it hard for your body to absorb vitamin B12 Surgery that removed part of your stomach or small intestine, including weight loss surgery Conditions affecting the small intestine, such as Crohn's disease, celiac disease, bacterial growth, or a parasite Heavy drinking Immune system disorders, such as Graves' disease or lupus Long-term use of acid-reducing drugs You can also get vitamin B12 deficiency if you're a vegan (meaning you don't eat any animal products, including meat, milk, cheese, and eggs) or a vegetarian who doesn't eat enough eggs or dairy products to meet your vitamin B12 needs.
Babies born to mothers who are vegetarians may also not get enough vitamin B12.
Symptoms of Vitamin B12 Deficiency A deficiency of vitamin B12 can lead to vitamin B12 deficiency anemia. A mild deficiency may cause only mild, if any, symptoms. But if untreated, it may cause symptoms such as:
Weakness, tiredness, or light-headedness Rapid heartbeat and breathing Pale skin Sore tongue Easy bruising or bleeding, including bleeding gums Stomach upset and weight loss Diarrhea or constipation If you think you have symptoms of vitamin B12 deficiency, you can ask your doctor for a blood test to check on that.
If pernicious anemia or a problem with absorption is the cause, you'll need to replace vitamin B12, usually by injection, or by prescription.
If the issue is that you don't eat animal products, you can change your diet or take supplements.
For most people, treatment resolves the problem. But any nerve damage that happened due to the deficiency could be permanent.
Preventing Deficiency Problems Most people can prevent vitamin B12 deficiency by eating enough meat, poultry, seafood, dairy products, and eggs.
If you don't eat animal products, or you have a medical condition that limits how well your body absorbs nutrients, experts recommend taking a B12-containing multivitamin and eating breakfast cereal fortified with vitamin B12.
If you're using vitamin B12 supplements, let your doctor know, so he or she can make sure they won't affect any medicines you're taking.
What are the best foods for your skin and the best ways to get the vitamins and other nutrients your skin needs?
You know that you need to nourish your skin to keep it as healthy as possible. But are you getting enough of the right nutrients from the foods you eat? Could you benefit from taking a supplement or trying an antioxidant-packed lotion?
"The beauty of the skin is that you can affect it from both inside and out," says dermatologist Doris Day, MD, author of Forget the Facelift: Turn Back the Clock with a Revolutionary Program for Ageless Skin.
What You Eat Matters
Eating plenty of fruits and vegetables rich in antioxidants is good for your whole body, including your skin. Antioxidants such as beta-carotene and vitamins C, E, and A can curb the damage caused by unstable molecules known as free radicals. These molecules can harm skin cells and cause signs of aging. One of the best ways to get more antioxidants is to eat a wide variety of fruits and vegetables. "I recommend going for as much variety and color as possible in your diet," Day says. "Try snacking on blueberries, strawberries, grapefruit, kale, spinach, and different kinds of peppers." She also suggests adding a little tomato paste, which contains an antioxidant called lycopene, to stir-fried vegetables, brown rice, or quinoa. Another good idea is to stock your grocery cart with foods that are high in omega-3 fatty acids, including wild salmon, sardines, fortified eggs, and walnuts. "Omega-3 fatty acids help keep the top outer layer of the skin strong and intact so that external toxins and pollutants are kept out," says dermatologist David E. Bank, MD, director of the Center for Dermatology, Cosmetic and Laser Surgery in Mount Kisco, N.Y. What About Supplements?
The ideal way to get the nutrients you need for a radiant complexion is eating a healthy, balanced diet. But Bank suggests taking an over-the-counter daily multivitamin with minerals to boost your nutrient intake if you're not eating a balanced diet. It's also a good idea if you spend a lot of time outdoors or are exposed to high levels of air pollution and secondhand smoke.
Too much of any good thing is a bad thing. Too much vitamin D can cause an abnormally high blood calcium level, which could result in nausea, constipation, confusion, abnormal heart rhythm, and even kidney stones.
It's nearly impossible to get too much vitamin D from sunlight or from foods (unless you take way too much cod liver oil). Nearly all vitamin D overdoses come from supplements.
The Institute of Medicine's Food and Nutrition Board's old 1997 recommendations suggested that 2,000 IU per day of vitamin D is safe for adults and that 1,000 IU per day is safe for infants up to 12 months of age. Many observers expected a drastic increase in the IOM's 2010 update.
That didn't exactly happen. The IOM committee did increase its "upper level intake" -- that is, the boundary at which it feared vitamin D would become unsafe. That dose is 4,000 IU/day for adults, 3,000 IU/day for kids ages 4-8, 2,500 IU/day for kids ages 1-3, 1,500 IU/day for infants ages 6-12 months, and 1,000 IU/day for infants ages 0-6 months.
But some recent studies suggest that healthy adults can tolerate more than 10,000 IU of vitamin D per day. John Jacob Cannell, MD, executive director of The Vitamin D Council, notes that the skin makes 10,000 IU of vitamin D after 30 minutes of full-body sun exposure. He suggests that 10,000 IU of vitamin D is not toxic.
According to the National Institutes of Health, 25-OHD levels that are consistently over 200 ng/mL are "potentially toxic."
The IOM committee found no conclusive evidence that increased vitamin D levels confer increased health benefits, "challenging the concept that '
Answers from Katherine Zeratsky, R.D., L.D. Vitamin C (ascorbic acid) is an essential nutrient. Still, it's possible to have too much vitamin C.
Vitamin C is a water-soluble vitamin that supports normal growth and development. Vitamin C also helps your body absorb iron. Because your body doesn't produce or store vitamin C, it's important to include vitamin C in your diet.
For most people, a large orange or a cup of strawberries, chopped red pepper or broccoli provide enough vitamin C for the day. Any extra vitamin C will simply be flushed out of your body in your urine.
For adults, the recommended dietary reference intake for vitamin C is 65 to 90 milligrams (mg) a day, and the upper limit is 2,000 mg a day. Although too much dietary vitamin C is unlikely to be harmful, megadoses of vitamin C supplements may cause:
Diarrhea Nausea Vomiting Heartburn Abdominal bloating and cramps Headache Insomnia Kidney stones Remember, for most people, a healthy diet provides an adequate amount of vitamin C.
Viagra (sildenafil) is used for the treatment of erectile dysfunction. It is a phosphodiesterase-5 (PDE5) inhibitor. Side effects of Viagra (sildenafil) include warmth or redness in the face, neck, or chest; stuffy nose; headaches, stomach pain, nausea, diarrhea, and an inability to differentiate between the colors green and blue. Loss of hearing, ringing in the ears and dizziness are other potential side effects.
The recommended dose of Viagra is 25-100 mg taken 30 minutes to 4 hours before sexual activity. Viagra increases the effects of blood pressure lowering medications. It also increases the blood pressure lowering effects of nitrates (for example, isosorbide dinitrate) that are used primarily for treating angina. Patients taking nitrates should not receive Viagra. Viagra should not be combined with Revatio or other PDE5 inhibitors (for example, Levitra [vardenafil], Cialis [tadalafil]). Tagamet (cimetidine), erythromycin, ketoconazole, Sporanox (itraconazole), and Posicor (mibefradil) can cause marked increases in the amount of Viagra in the body. Patients taking these medications should be observed carefully if Viagra is used.
Our Viagra Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Viagra in Detail - Patient Information: Side Effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of sildenafil.
Stop using sildenafil and call your doctor at once if you have a serious side effect such as:
sudden vision loss; ringing in your ears, or sudden hearing loss; chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling; irregular heartbeat; swelling in your hands, ankles, or feet; shortness of breath; vision changes; feeling light-headed, fainting; or penis erection that is painful or lasts 4 hours or longer. Less serious side effects may include:
warmth or redness in your face, neck, or chest; stuffy nose; headache; memory problems; upset stomach; or back pain. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Read the entire detailed patient monograph for Viagra (Sildenafil Citrate) Learn More » Viagra Overview - Patient Information: Side Effects SIDE EFFECTS: Dizziness, headache, flushing, or stomach upset may occur. Vision changes such as increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Sexual activity may put extra strain on your heart, especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex, stop and get medical help right away: severe dizziness, fainting, chest/jaw/left arm pain, nausea.
Rarely, sudden decreased vision in one or both eyes (NAION) may occur. This effect may or may not be caused by sildenafil. If this serious problem occurs, stop taking sildenafil and get medical help right away. You have a slightly greater chance of developing NAION if you have heart disease, diabetes, high cholesterol, certain other eye problems ("crowded disk"), high blood pressure, if you are over 50, or if you smoke.
Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur. Stop taking sildenafil and get medical help right away if these effects occur.
In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Read the entire patient information overview for Viagra (Sildenafil Citrate) Learn More » Viagra FDA Prescribing Information: Side Effects (Adverse Reactions) SIDE EFFECTS
Clinical Trials
VIAGRA (sildenafil citrate) was administered to over 3700 patients (aged 19-87 years) during pre-marketing clinical trials worldwide. Over 550 patients were treated for longer than one year.
In placebo-controlled clinical studies, the discontinuation rate due to adverse events for VIAGRA (sildenafil citrate) (2.5%) was not significantly different from placebo (2.3%). The adverse events were generally transient and mild to moderate in nature.
In trials of all designs, adverse events reported by patients receiving VIAGRA (sildenafil citrate) were generally similar. In fixed-dose studies, the incidence of some adverse events increased with dose. The nature of the adverse events in flexible-dose studies, which more closely reflect the recommended dosage regimen, was similar to that for fixed-dose studies.
When VIAGRA was taken as recommended (on an as-needed basis) in flexible-dose, placebo-controlled clinical trials, the following adverse events were reported:
TABLE 2. ADVERSE EVENTS REPORTED BY ≥ 2% OF PATIENTS TREATED WITH VIAGRA (sildenafil citrate) AND MORE FREQUENT ON DRUG THAN PLACEBO IN PRN FLEXIBLE-DOSE PHASE II/III STUDIES ADVERSE EVENT PERCENTAGE OF PATIENTS VIAGRA N=734 REPORTING EVENT PLACEBO N=725 Headache 16% 4% Flushing 10% 1% Dyspepsia 7% 2% Nasal Congestion 4% 2% Urinary Tract Infection 3% 2% Abnormal Vision† 3% 0% Diarrhea 3% 1% Dizziness 2% 1% Rash 2% 1% †Abnormal Vision: Mild and transient, predominantly color tinge to vision, but also increased sensitivity to light or blurred vision. In these studies, only one patient discontinued due to abnormal vision. Other adverse reactions occurred at a rate of > 2%, but equally common on placebo: respiratory tract infection, back pain, flu syndrome, and arthralgia.
In fixed-dose studies, dyspepsia (17%) and abnormal vision (11%) were more common at 100 mg than at lower doses. At doses above the recommended dose range, adverse events were similar to those detailed above but generally were reported more frequently.
The following events occurred in < 2% of patients in controlled clinical trials; a causal relationship to VIAGRA (sildenafil citrate) is uncertain. Reported events include those with a plausible relation to drug use; omitted are minor events and reports too imprecise to be meaningful:
Body as a whole: face edema, photosensitivity reaction, shock, asthenia, pain, chills, accidental fall, abdominal pain, allergic reaction, chest pain, accidental injury.
Special Senses: sudden decrease or loss of hearing, mydriasis, conjunctivitis, photophobia, tinnitus, eye pain, ear pain, eye hemorrhage, cataract, dry eyes.
Urogenital: cystitis, nocturia, urinary frequency, breast enlargement, urinary incontinence, abnormal ejaculation, genital edema and anorgasmia.
Post-Marketing Experience
Cardiovascular and cerebrovascular
Serious cardiovascular, cerebrovascular, and vascular events, including myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, hypertension, subarachnoid and intracerebral hemorrhages, and pulmonary hemorrhage have been reported post-marketing in temporal association with the use of VIAGRA (sildenafil citrate) . Most, but not all, of these patients had preexisting cardiovascular risk factors. Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of VIAGRA (sildenafil citrate) without sexual activity. Others were reported to have occurred hours to days after the use of VIAGRA (sildenafil citrate) and sexual activity. It is not possible to determine whether these events are related directly to VIAGRA (sildenafil citrate) , to sexual activity, to the patient's underlying cardiovascular disease, to a combination of these factors, or to other factors (see WARNINGS for further important cardiovascular information).
Special senses
Cases of sudden decrease or loss of hearing have been reported postmarketing in temporal association with the use of PDE5 inhibitors, including VIAGRA (sildenafil citrate) . In some of the cases, medical conditions and other factors were reported that may have also played a role in the otologic adverse events. In many cases, medical follow-up information was limited. It is not possible to determine whether these reported events are related directly to the use of VIAGRA (sildenafil citrate) , to the patient's underlying risk factors for hearing loss, a combination of these factors, or to other factors (see PATIENT INFORMATION).
Other events
Other events reported post-marketing to have been observed in temporal association with VIAGRA (sildenafil citrate) and not listed in the clinical trial adverse reactions section above include:
Nervous: seizure, seizure recurrence, anxiety, and transient global amnesia.
Urogenital: prolonged erection, priapism (see WARNINGS), and hematuria.
Special Senses: diplopia, temporary vision loss/decreased vision, ocular redness or bloodshot appearance, ocular burning, ocular swelling/pressure, increased intraocular pressure, retinal vascular disease or bleeding, vitreous detachment/traction, paramacular edema and epistaxis.
Non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including permanent loss of vision, has been reported rarely post-marketing in temporal association with the use of phosphodiesterase type 5 (PDE5) inhibitors, including VIAGRA (sildenafil citrate) . Most, but not all, of these patients had underlying anatomic or vascular risk factors for developing NAION, including but not necessarily limited to: low cup to disc ratio ("crowded disc"), age over 50, diabetes, hypertension, coronary artery disease, hyperlipidemia and smoking. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors, to the patient's underlying vascular risk factors or anatomical defects, to a combination of these factors, or to other factors (see PATIENT INFORMATION).
