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Thank you for entrusting in the compounding services at MD Custom Rx to help meet the unique medication needs of your patients. We are excited to share with you our monthly newsletter and look forward to continuing to be your medication problem solvers. Please don't ever hesitate to let us know how we can be of further assistance to you and your practice.
Sincerely,
John, Dan and Monica |
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Overcoming the Negative Effects of Stress
"The most wonderful time of the year" may unfortunately become "the most stressful time of the year" for many people. One of the body's initial responses to stress is the release of hormones including cortisol that initially help people react or adapt to a stressful situation. Cortisol raises blood sugar and blood pressure, increases the breakdown of protein while inhibiting protein synthesis, interferes with thyroid hormone action and stimulates visceral fat deposition, which can lead to metabolic syndrome. Medical literature has confirmed the correlation between high levels of cortisol secondary to chronic stress (hypercortisolism), and aging, hormone deficiencies and disease development.
Over time, the body may no longer be able to produce the needed amounts of cortisol and patients can ultimately end up with low cortisol levels (hypocortisolism). Fatigue, pain and stress associated with hypocortisolism may result in Chronic Fatigue Immuno-Deficiency Syndrome (CFS), Fibromyalgia and Post Traumatic Stress Disorder (PTSD). Ask our pharmacist for more information about customized integrative therapy for Adrenal Dysfunction.
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Help for Eczema and Psoriasis
High levels of cortisol can also lead to exacerbation of skin conditions such as psoriasis and eczema. We are here to help!
Treatments for eczema (atopic dermatitis) aim to control inflammation, decrease itching, and manage infections that may occur as a result of repeated skin irritation. Common treatments can cause significant side effects; for example, topical corticosteroids used to decrease inflammation and control itching may cause skin thinning and prolong the healing time of damaged skin.
Topical vitamin B12 offers a simple therapeutic approach for eczema. A study showed that topical application of vitamin B12 cream (0.07% cyanocobalamin) reduced the severity and extent of eczema. Both physicians and study participants rated the vitamin B12 cream as significantly superior to placebo, and the treatment was very well tolerated. Avocado oil has been added to improve the formulation so that vitamin B12 cream can be distributed more easily on the surface of the skin, or we can use a specialized base that is easy to apply and cosmetically appealing.
Psoriasis is a common chronic skin disease characterized by recurrent erythromatous skin plaques that exhibit epidermal hyperplasia, variable inflammatory cell infiltrate, and abnormalities of the dermal vascularization. The involvement of angiogenic growth factors such as vascular endothelial growth factor (VEGF), matrix metalloproteinases (MMPs) and inflammatory cytokines such as IFNγ, IL-1, IL-2, TNFα, TGFα and β, IL-6, IL-8, amphiregulin and monocyte chemoattractant protein 1 (MCP-1) have been known to play pathogenic roles in traumatic psoriatic skin. However, anti-angiogenic and anti-inflammatory cytokines regimens might favorably affect the psoriasis disease process. Tranilast is an anti-allergic drug now emerging as anti-angiogenesis and anti-inflammatory effects. In vitro and in vivo experiments have led to the hypothesis that local administration of tranilast may be clinically useful in treating psoriasis.
For patients with localized psoriasis, and for many of those with moderate psoriasis as well, the mainstay of treatment is still topical therapy. Topical regimens, such as combination therapy with topical tacrolimus and salicylic acid, can be helpful. Vitamin B12 cream also has considerable potential as a well-tolerated, long-term topical therapy of psoriasis. Oral vitamin B12 does not appear to be beneficial for psoriasis and is rapidly eliminated by the body.
Dr. Stephen Hsu, a cell biologist in the Medical College of Georgia Department of Oral Biology, has helped to determine that ECGC, which are polyphenols in green tea, help eliminate free radicals which can cause cancer by altering DNA. He also found that polyphenols safeguard healthy cells while killing cancer cells. Hsu and his colleagues have found that when normal skin cells are exposed to EGCG, EGCG reactivated dying skin cells. As part of the body's normal skin renewal process, "cells that migrate toward the surface of the skin normally live about 28 days, and by day 20, they basically sit on the upper layer of the skin getting ready to die," Dr. Hsu said. "But EGCG reactivates them." EGCG has potential benefits for skin conditions such as psoriasis, rosacea, and wrinkles and may potentially accelerate the wound-healing process and prevent scarring. This potential benefit is particularly exciting for people with conditions such as diabetes, which inhibits the wound-healing process.
Methotrexate has been used orally as a treatment for psoriasis by dermatologists for over 30 years, but oral methotrexate can cause serious side effects. Interestingly, researchers from the Department of Dermatology, University of California-San Francisco, and three other locations note that if methotrexate is properly compounded into a topical gel and dosed appropriately, it can provide better results without the bad side effects. Furthermore, published data have indicated that 70% of patients prefer topical therapy for psoriasis. A placebo-controlled double-blind study evaluated methotrexate 0.25% gel applied topically to treat patients with psoriasis vulgaris. After four weeks, 83.3% of patients improved compared to 6.7% of patients who received a placebo. The treatment was well-tolerated by all the patients, with no adverse drug-related symptoms and no dropouts.
A new study has reported that children who take probiotics - "good" bacteria that normally live in our guts - are less likely to develop eczema. Researchers have found that infants on probiotic supplements were 50% less likely to develop eczema, and taking probiotic supplements daily could reduce the risk of eczema in older children by 58%. Study results vary, and one of the reasons is because different types of probiotics are used in various studies and produce different results. The best evidence for improvement of eczema is associated with the probiotic Lactobacillus rhamnosus GG. Lactobacillus rhamnosus GG supplements are available in powdered or chewable forms.
We will work with each physician and patient to customize medications to treat eczema and psoriasis, and meet individual needs. We can also recommend high quality probiotic preparations that are most appropriate for each patient and problem.
References:
Your questions are always welcome.
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