What is Pain

Pain is a warning system for our bodies, letting us know that there is a risk of damage happening.

Pain is complex. It might be felt as mild discomfort, severe cramping, constant dull aches or short stabbing sensations.

Pain can be classified as acute pain or chronic pain. Acute pain is short term (less than 3 months) and may include tissue damage from a back injury or ankle sprain. Generally, people with acute pain are encouraged to stay active and gradually get back to doing all everyday things, such as work or physical activity.

Persistent pain lasting three months or more is generally called chronic because in this type of pain tissue damage is not the main issue.

People can experience acute and chronic non-cancer pain in many different parts of their bodies. Some Examples of Chronic pain include:

Nerve Pain

Low Back Pain

Ankle Sprains

Acute Knee Injuries

Period Pain

Headaches

Migraine

Arthritis

 

The Process of Pain

Pain all starts with the stimulus. It could be a mechanical stimulus, such as a heavy object falling on your legs or face! Or it could be a temperature stimulus such as touching a hot item. Our nociceptors send a signal to the brain via our neurons (nerve cells) that there is danger.

Nociceptors are like transducers in a microphone. A transducer converts sound energy into electrical energy. Likewise, nociceptors convert mechanical energy into an electrical signal in our nerves which we call pain.

However, our brain has a filtration mechanism. Our brains can diminish or amplify coming in signals.  This may explain why often, injury is not equal to the amount of pain that is perceived. This is why we often hear people have a different pain threshold. Each person’s brain is trained to amplify or diminish coming in signals!

 

Pain Threshold is a personal experience.

As mentioned above pain is a warning system for our bodies, and it happens and controlled by the brain. Also, pain signals coming to the brain can be diminished or toned down to produce less pain or no pain or they can be amplified or toned up to cause more pain. For example, Pierre and Mary may both hurt their backs, picking something up from the floor. However, Mary may just rub the area and return to her activity and pain is gone within hours. In contrast, Pierre, on the other hand, may stop moving and rest for several hours and take medicine to relieve the pain, and the pain continues for days or weeks!

 

The experience of pain is individual for many reasons that are not just physical – for instance, the type of injury or where the damage has happened.  But can emotional health, for example, feeling low and depressed or excited and alert, can affect how someone feels pain.

Cultural and social expectations can also influence how a person experiences pain.

One thing we all have in common is that wherever the pain is in our bodies, our brains play an important role. The brain takes all the influences described above and mixes them together. The result is the type of pain each individual feels and also how each person responds to the pain. And that will be unique to each of us.

Even though the brain is essential to the way we feel pain, that doesn’t mean pain is ‘all in your head’.

Pain is very real.

 

Chronic Pain

For a lot of people, chronic non-cancer pain has an explainable cause. It could be the result of surgery or an injury or a symptom of a chronic condition like osteoarthritis or migraine.

But sometimes the cause of chronic pain is harder to identify because the brain keeps on producing pain even after the body tissues are restored and out of danger! Some people say it still hurts, and they must have something wrong. But that’s is just it once anything dangerous is ruled out, health professionals can explain that most things in the body are healed as well as they can be by 3 to 6 months. So ongoing pain being produced by the brain is less about structural changes in the body.

So why is the brain producing more pain when clearly the danger is no longer there? The process is complicated, but our brains have a big part to play in diminishing or amplifying these danger signals.

 

Chronic Pain and the Brain 

We are learning that many of the brain regions overlap. The experience of pain overlaps with the same circuits that are involved with your emotions and your cognitions. Stress, anger, tiredness, fighting with your spouse or your boss those same circuits in the brain involved with that negative emotion are directly connected and overlapping with those in pain. That stress, that anger, that frustration all simply amplify your overall experience of pain.

 

Facts about the Brain and Pain

1. 500 areas of the brain are turned on when we were in pain. So this means some of these 500 areas might be responsible for other functions such as hearing or smelling or knowledge etc.… For example, someone with chronic knee pain may feel more pain when he hears a negative comment or may feel less pain when he hears a positive word. If the doctor says “your knee is stuffed mate” it might hurt more or if the doctor says “this is common and many people received treatment and function normally” it may hurt less.
3. Some brain parts overlap, this may explain why you may often hear “there’s a fine line between pain and pleasure”. It is because pain and pleasure are produced by the same part of the brain. This may explain why we seek out and enjoy unpleasant experiences, such as fear-inducing rollercoasters or sad movies!

 

3. There is no pain in the joints or muscles. They only send signals to the brain. The brain decides what hurts or what doesn’t. So the way our brains are trained, from our genes, upbringing, life experiences, etc.. will determine how much pain we feel. This is why a papercut hurts so much and hurt even more while we are at work! This may also explain why people who get attacked by sharks may not feel pain because the brain is in survival escape mode, NOT pain mode.

 

4. We are bioplastic. This means your body will change as you experience chronic pain. Your body will adapt. But the good news is our brains are changeable too. Our brains are continually changing and adapting to everything happening in our lives. The longer you have pain, the brain adapts to be better and better at producing pain. However, all hope is not lost. Although the brains of people with chronic pain have changed, bioplastic changes in the brain will continue to happen until the day you die.

 

5. Our brains act as an immune system. Our immune system will attack a foreign body such as infection such as a virus or bacteria. So our brains too once they receive signals we are in danger they send out pain signals to protect us from the threat.

 

Medicines and Chronic Pain

It’s unlikely that medicines on their own will be able to completely stop chronic pain.

Medical experts recommend them only in combination with treatments such as self-management, physical activity and psychological approaches.

The following medicines can be considered by your doctor when starting to treat chronic pain:

• paracetamol
• non-steroidal anti-inflammatory drugs (NSAIDs)
• antidepressants
• anticonvulsants/antiepileptics.

 

Opioids and Chronic Pain

Opioids can be used to treat acute pain and chronic pain caused by cancer. However, their role in the management of chronic non-cancer pain is limited.

Suppose you have tried the treatments and medicines recommended when starting to treat chronic non-cancer pain but have not had enough improvement. In that case, you may be prescribed an opioid.

Opioids can improve pain and the ability to do day-to-day tasks. But this improvement is small. In fact, it is so tiny that it may not be necessary for people with chronic non-cancer pain.

Harms from taking opioids, such as constipation, nausea and sleepiness, are extremely common.

The longer someone takes opioids, the more likely it is that they will experience side effects and need to increase their dose to achieve the same pain relief (this is called tolerance). Tolerance exposes them to a greater risk of overdose leading to death.

Every day in Australia, there are, on average, 3 deaths, nearly 150 hospitalisations and 14 emergency department admissions because of harm from opioids, with far more deaths and poisoning hospitalisations attributed to pharmaceutical opioids (including codeine and oxycodone) to heroin. While opioids can decrease pain and improve function in a select group of patients, there are still harms from their use.

 

Compounding and Pain

Compounding pharmacists have been helping patients with chronic pain by dispensing customised transdermal pain medications. While avoiding the use of addictive drugs, these medications may be customised to include different types of drugs, in various dosage strengths, that are delivered simultaneously in one application. Compounded medicines using customised delivery systems help patients get the most medication possible. Transdermal pain cream compounding provides analgesics through the skin, for example, which allows for smooth, continuous drug delivery and pain relief. Transdermal treatments also bypass the digestive tract to speed delivery and reduce stomach upset.

 

Compounding can also combine multiple medications such as simple analgesics and opioids in one transdermal cream. This will increase the likelihood of treating the pain and decreasing the chance of side effects such as constipation, fatigue and tolerance.

 

Talk to your health professional.

The aim of the blog to demonstrate pain is complex, and many factors will influence how much pain a person will feel. Discuss with your GP

• Benefits and harms of medicines
• develop a health plan
• discuss treatments that don’t involve drugs and other pain medicines that may help reduce pain and improve your quality of life and ability to do things

 

Tinnitus is the perception of hearing noises that not caused by an external source.

Tinnitus involves the sensation of hearing sound when no external sound is present. Tinnitus symptoms may include these types of phantom noises in your ears:

• Ringing
• Buzzing
• Roaring
• Clicking
• Hissing
• Humming

The phantom noise may vary in pitch from a low roar to a high squeal, and you may hear it in one or both ears. In some cases, the sound can be so loud it can interfere with your ability to concentrate or hear an external sound. Tinnitus may be present all the time, or it may come and go.

Tinnitus is prevalent in Australians. It approximately affects 10% of the population. Every 1 in 10 people will suffer from it.

Tinnitus can be brought on by many factors including age, noise exposure, ototoxic medicines, people that suffer from blood vessels diseases, genetic inclination, jaw disorders, or as a consequence of other diseases, such as inner ear disease or infection.

Both men and women seem to be equally affected, and although tinnitus is more common in the elderly, it can occur at any age.

Causes of tinnitus

The more common causes of tinnitus include:

• exposure to loud sounds
• extreme stress or trauma
• degeneration of the hair cells in the cochlea
• ear problems, such as otosclerosis (abnormal bone growth in the middle ear)
• Meniere’s disease (swelling of a duct in the ear)
• some medications.

Types of Tinnitus

Tinnitus can be categorised as bothersome or non-bothersome. This distinction will influence your doctor’s decision on how to manage your tinnitus. Bothersome tinnitus negatively affects a person’s sleep, concentration, emotional wellbeing and their ability to interact socially.

Management of Tinnitus

If tinnitus is due to an underlying cause such as the build of wax or infection, it is essential to treat the primary source first.

Often tinnitus is associated with symptoms of vertigo, insomnia and psychological disorders such anxiety and depression.

If hearing loss is present, then further examination of the ear is required.

When tinnitus is bothersome, then tinnitus specific management may be needed. These are some strategies used to treat tinnitus

1. hearing aids due to hearing loss.
2. Counselling therapies
3. Education and information about managing the condition.

Other strategies for managing bothersome tinnitus include sound, sleep and relaxation therapy. The evidence base is most vital for a combination of sound therapy and cognitive behavioural therapy-based counselling

Hearing aids & tinnitus

Tinnitus is often associated with hearing loss: 90% of people with tinnitus have some hearing loss. The hearing loss is usually mild and of gradual onset, which may explain why many people are unaware of their hearing loss. Interestingly, some people with audiometrically normal hearing will present with bothersome tinnitus, while those with hearing loss may be unaffected.  People with tinnitus who strain to hear may notice their tinnitus emerge or worsen. Correcting any hearing loss allows the person to listen more efficiently, and generally reduces the level of the tinnitus.

Hearing aids are useful even if the hearing loss is relatively mild and at a level where aids would not usually be considered. Even in the absence of marked hearing loss, hearing aids can provide some relief to people with tinnitus.

Hearing aids amplify peripheral and objective sounds and help manage tinnitus by making the sound less noticeable.

Counselling & Tinnitus

Counselling may be useful for some people with tinnitus. People with tinnitus, especially those who find tinnitus bothersome, need support.

Massage Therapy & Tinnitus

Massage may help to reduce muscular issues such as jaw clenching, tooth grinding, prior injury or muscle tension in the neck. These factors sometimes make tinnitus more noticeable. A therapist may ask the person to tighten muscle or move the jaw or neck in specific ways to see if this changes the sound. If so, tight muscles are part of the problem, and massage therapy may help relieve it.

Sleep & Tinnitus

Sleep can be a significant problem for many people with tinnitus. Tinnitus can impact people to get to sleep and stay asleep. However, there may be other factors that can affect a person’s ability to fall asleep and stay asleep, leading to insomnia.

A person with tinnitus who has difficulty getting to sleep or staying asleep may want to try:

• Identify other causes contributing to sleep problems
• Simple relaxation exercises
• Listening to soft music when in bed including monotonous sounds, such as rain on a roof can stop you focusing on your tinnitus

Factors that contribute to insomnia for a person with tinnitus

Sleep disturbance usually involves a combination of:

• health problems – for example, arthritis, migraines or asthma
• psychological factors – for example, stress or emotional crisis
• drug use – for example, alcohol or sleeping medication
• disturbing environments – for example, an uncomfortable bed or intrusive lighting
• conditioning – for example, the more you associate bed with struggling to get to sleep, the harder it is to relax there.

To successfully improve your sleep patterns, you will need to look at all the contributing factors.

Research has shown that relaxation techniques, such as yoga, meditation, biofeedback and progressive relaxation, can work well. Experiment and find a method that works for you. You might like to try a regular relaxation class or use a self-help relaxation app.

It may also help if you:

• try and get up at the same time every day
• reserve your bed for sleeping – avoid arguments or severe discussions in bed
• avoid naps during the day
• experiment with low-intensity background noises in the bedroom, for example, leave the radio playing softly or play tape recordings of the ocean surf.

When you go to bed for the night, if you are not asleep after half an hour, get up and go into another room. Do something that engages your brain (this does not mean watching TV). Write a list of things to do, plan a holiday or write a letter or email. After about 20 minutes you will be able to go back to bed and go to sleep. The same applies if you wake up in the night.

Remember, don’t go to bed if you don’t feel sleepy. Do something quiet and relaxing until you do feel sleepy.

It may help you to sleep if you avoid eating heavy meals just before bedtime. It is also a good idea to reduce your late afternoon and evening consumption of:

• alcohol
• chocolate
• tea, coffee and caffeinated soft drinks
• cigarettes.

Regular exercise helps you to cope better with stress and reduce fatigue, both of which can make sleeping more difficult or disturbed.

 

Lifestyle & Medications & Tinnitus

There is no evidence that lifestyle changes or medications may help improve tinnitus. However, people with or without tinnitus should be encouraged to follow a healthy diet and to exercise regularly. The use of complementary agents such as ginkgo Biloba, melatonin, zinc is discouraged.

Prevention and Tinnitus

Tinnitus cannot be cured, but in some situations, can be prevented. Tinnitus prevention involves the safe listening of sound to protect hearing. The intensity of sound and the duration and frequency of listening can impact the hearing. Listening to loud, high-frequency sound for long periods can cause hearing loss or tinnitus.

General Advice

People should protect their hearing. If a person is exposed to high levels of noise in their workplace or during recreational activities, it would be best to protect their hearing to reduce the risk of tinnitus.

Best to reduce sound levels to less than 80 decibels and regularly take breaks from noise exposure and use noise-cancelling earplugs where possible.

Conclusion

Tinnitus is a common condition that affects 1 in 10 Australians. Prevention and management strategies will reduce the risk and severity of tinnitus.

Introduction

Many Australians drink Alcohol in amounts that are harmful to their health. This kind of drinking can cause death, disease and injury and is a significant factor in ill health and social harm in Australia.

Alcohol is the most widely used drug in Australia. People drink Alcohol for various reasons and in different social and cultural contexts, but Alcohol can cause harm to the person who drinks and sometimes to others around them.

During the pandemic, some people have been drinking less because they are going less often to pubs. Others are drinking more at home. Of these, some have turned to drink for stress relief and run into significant strife with it.

The New Guidelines and Alcohol Consumption

No level of alcohol consumption can be considered safe for everyone. To reduce the risk of harm from alcohol-related disease or injury for healthy men and women, drink no more than ten standard drinks per week and no more than four standard drinks on any one day. A standard drink is a can or stubbie of mid-strength beer, 100ml of wine, or a 30ml shot of spirits.

However, some people need to take more care. You are at greater risk of alcohol harm if you are engaging in risky activities such as driving or operating machinery, under 18, if you are older than 65, or taking other medicines or drugs.

During pregnancy, no level of drinking is considered safe for the baby.

Drinking heavily can put you at risk of short-term injury or illness. The effects can also accumulate, harming your health over your lifetime.

Alcohol contributes to a significant health burden in Australia. Harms related to drinking result in more than 4,000 deaths and 70,000 hospital admissions every year.

 

Does drinking in moderation have health benefits?

The Short answer is NO!

One of the main reasons the guidelines were changed and aimed at less drinking however studies that mentioned a possible protective effect of low-level alcohol consumption, particularly against coronary heart disease, were scrutinised. The evidence for a protective effect has been challenged by research in recent years. Some researchers dispute its existence.

But at the least, any protective effect is not as strong as previously thought. However, if there was a protective risk against heart disease, some cancers’ increased risk was counterbalanced.

 

The Harmful Effects of Alcohol

Alcohol and the Liver

One of its prominent roles of the liver is to neutralise various toxic substances you consume. For this reason, your liver is particularly vulnerable to damage by alcohol intake.

Liver diseases caused by alcohol consumption are collectively known as alcoholic liver diseases.

The first of these to appear is fatty liver, characterised by increased fat inside liver cells.

The fatty liver gradually develops in 90% of those who drink more than a 1/2 ounce (15 ml) of Alcohol per day and is usually symptomless and fully reversible.

In heavy drinkers, binge drinking may cause your liver to become inflamed. In worst-case scenarios, liver cells die and get replaced with scar tissue, leading to a severe condition called cirrhosis. Cirrhosis is irreversible and associated with many serious health problems. In advanced cirrhosis, a liver transplant may be the only option.

 

Alcohol and Mental Health

Alcohol intake and depression are closely but complexly associated.

While alcohol intake and depression seem to increase the risk of one another; simultaneously, alcohol abuse may be the more substantial causal factor.

Many people facing anxiety and depression drink intentionally to reduce stress and improve mood. While drinking may provide a few hours of relief, it will worsen your overall mental health and spark a vicious cycle.

Because heavy drinking is a significant cause of depression in some individuals, treating the underlying alcohol abuse leads to significant improvements.

 

Alcohol and Weight Gain

On average, one serving of Alcohol contains 100-150 calories, so even a moderate amount of 3 drinks a day can contribute 300+ calories. Mixed drinks that add juice, tonic, or syrups will further drive up calories, increasing the risk of weight gain over time.

Alcohol and Cancer

Alcohol may increase the risk of cancers such as Head and Neck Cancer, Oesophageal Cancer, Liver Cancer, Breast Cancer and Colorectal Cancer.

 

What is Alcoholism?

Alcoholism has been known by a variety of terms, including alcohol abuse and alcohol dependence. Today, it’s referred to as alcohol use disorder.

It occurs when you drink so much that your body eventually becomes dependent on or addicted to Alcohol. When this happens, Alcohol becomes an essential thing in your life.

People with alcohol use disorder will continue to drink even when drinking causes negative consequences, like losing a job or destroying relationships with people they love. They may know that their alcohol use negatively affects their lives, but it’s often not enough to make them stop drinking.

How is it treated?

Treatment for alcohol use disorder varies, but each method is meant to help you stop drinking altogether. This is called abstinence. Treatment may occur in stages and can include the following:

• detoxification or withdrawal to rid your body of Alcohol
• rehabilitation to learn new coping skills and behaviours
• Counselling to address emotional problems that may cause you to drink
• support groups, including 12-step programs such as Alcoholics Anonymous (AA)
• medical treatment for health problems associated with an alcohol use disorder
• medications to help control addiction

 

Treatment of Alcoholism

One of the medications used for alcoholism is currently unavailable in Australia. Should you find this problem or loved one you are trying to help cannot find this medication, a compounding pharmacy may help (www.ecompoundingchemist.com.au). This form of medication treatment deters alcohol use. It prevents Alcohol’s normal metabolism, which causes unpleasant, potentially serious effects, if Alcohol is consumed, e.g. flushing, sweating, nausea, vomiting, palpitations, headache, dyspnoea, chest pain, hypotension, heart collapse, seizures, arrhythmias.

This form of medication treatment is effective if the patient is deterred from drinking by fear of unpleasant effects, and someone is available to supervise daily administration.

Hair loss (Alopecia)

Hair loss known as Alopecia appears in many different ways. It can be temporary or permanent. It can be due to heredity, hormonal changes, medical conditions, medications or a normal part of aging. There are a lot of myths too! We will try to explain in this blog the normal process of the hair cycle. Understanding the normal hair cycle will enable us to differentiate between the different reasons for hair loss and the various treatments available.

Normal Hair Cycle

The hair on the scalp grows about .3 to .4 mm/day or about 6 inches per year. Unlike other mammals, human hair growth and shedding is random and not seasonal or cyclical. At any given time, a random number of hairs will be in one of four stages of growth and shedding: anagen, catagen, telogen and Exogen.

• 1. Anagen (Growing Phase)

The growing phase lasts two to seven years and determines the length of our hair.

• 2. Catagen (Regression Phase)

This stage lasts about ten days. The hair follicle shrinks and detaches from the dermal papilla.

• 3. Telogen (Resting Phase)

The resting phase lasts around three months. Approximately 10-15% of hairs are in this phase. Whilst the old hair is resting, a new hair begins the growth phase.

• 4. Exogen (Shedding Phase)

The Exogen represents the period from when a resting hair reaches its terminal position in the follicle to when it finally detaches. The resting hair is gradually loosened, resulting in the shedding of the hair.

 

Variation in Hair Growth and Thickness

It is essential to realise that “normal” for one person may not be “normal” for another person. Hair growth is no different.

There are 3 “original” ethnic-hair profiles, each with its own characteristics: colour, texture, structure and even implantation in the scalp…

Due to these differences, hair does not grow in the same way or at the same speed in people of different ethnic origins.

Asian hair

Asian hair is usually straight and either dark brown or black. It grows perpendicularly to the scalp. This hair type has the fastest growth rate at approximately 1.4 centimetres per month.

A strand of Asian hair has a somewhat round, even shape.

Nonetheless, Asian hair has the lowest density of the three ethnicities.

Caucasian hair

Caucasian hair can be straight, wavy or curly. Its colour can vary from blond to dark brown. This hair type grows diagonally and at a rate of about 1.2 centimetres per month.

Caucasian hair strands are oval in shape.

Caucasian hair density is the highest of the three ethnic categories and is, therefore, the fullest.

African hair

African hair is generally characterised by tight curls and kinks and grows almost parallel to the scalp. This hair type has the slowest growth rate, 0.9 centimetres per month, due to its spiral structure that causes it to curl upon itself during growth. An African hair strand has a flattened shape.

African hair has a much higher density than Asian hair.

 

Alopecia (Hair Loss)

Alopecia is classically divided into scarring and nonscarring, with scarring alopecia being further divided into primary and secondary. Primary Alopecia arises from a process that originates from the hair follicles, whereas secondary Alopecia, classically referring to secondary scarring alopecia, is due to all other causes. Secondary causes can include surgery, burns or something like that that might cause hair loss secondary to surgery, Sunburns, fungal infections, rashes leading to hair loss.

Primary Alopecia, as mentioned above, can be divided into two categories scarring and non-scarring.

Scarring Alopecia

While there are many forms of scarring alopecia, the common theme is potentially permanent and irreversible destruction of hair follicles and their replacement with scar tissue. Often, the early stages of scarring alopecia will have inflammatory cells around the hair follicles, which, many researchers believe, induces the destruction of the hair follicles and the development of scar tissue. Scarring alopecia almost always burns out. The bald patches stop expanding, and any inflammation, itching, burning, or pain goes away.

This type of Alopecia is rare and leads to permanent hair loss.

Non-Scarring Alopecia

Non-scarring hair loss is more common and consists of 3 types

1.Female/male pattern hair loss (Androgenetic Alopecia),

2. Telogen Effluvium (stress hair loss)
3. Alopecia Areate.

1.Female/Male pattern hair loss (androgenetic Alopecia),

Androgenetic Alopecia or male and female pattern hair loss, which is also very common. The word Androgenetic consists of 2 words, “Androgens” and “Genetic”. So this type of Alopecia is related to androgen hormones such as testosterone, and it is genetic. Often people think that hair loss genetically inherited from the mum’s side of the family, but this is not true. It is more likely to involve multiple genes, and even if both parents have hair, the child can have hair loss from a distant family member!

Unlike telogen effluvium, which characterised by shedding, Androgenetic Alopecia is characterised by gradual thinning of the hair over time and the process we call miniaturisation of the hair follicle. The hair follicle literally becomes smaller and smaller. The Androgenetic Alopecia also characterised by a decreasing duration of the antigen cycle over time. However, the thinning of the hair is also part of aging. So the thinning of the hair is not always due to Androgenetic Alopecia.

Androgenetic Alopecia starts earlier and is more extreme than hair thinning due to aging.

Testing for androgen levels may be helpful to especially men, as it is apparent that their hair is thinning very quickly at a young age.

Some women will have high levels of androgens, such as women who suffer from polycystic ovary who take the pill for birth control or other reasons.

Women should also check for signs of hormone irregularities such as increased facial or body hair growth, thick facial hair, irregular periods or spotting, post-menopausal acne and other hormonal changes peri-menopause and post-menopause. To check the effects of your hormones by symptoms, complete our questionnaire and will help you identify which hormones might be dominant: https://ecompoundingchemist.com.au/menopause/#aboveform

2. Telogen effluvium (stress hair loss)

Telogen effluvium is the most common of the three types of non-scarring Alopecia. It is an acute increase in shedding. As mentioned above, there 4 phases of the hair growth cycle. The 1st phase, the growth phase (antigen), is shortened for whatever reason and prematurely converts to the telogen phase. Usually, 10% converts to the telogen (resting) phase, but during this type of hair loss, up to 30% is converted! Hence, leading to increased shedding of the hair. People may find they are losing clumps of hair each day!

 

What causes telogen effluvium?

Increased hair shedding in telogen effluvium occurs due to a disturbance of the normal hair cycle.

Common triggers of telogen effluvium include childbirth, severe trauma or illness, a stressful or significant life event, marked weight loss and extreme dieting, thyroid problems, anaemia, low Vitamin D, a severe skin problem to the scalp, a new medication or withdrawal of hormone treatment. No cause is found in a third of people diagnosed with telogen effluvium.

Telogen effluvium usually resolves completely without any treatment over several months. The average duration of telogen is approximately 100 days (3 to 6 months), after which period the hair starts growing again. However, depending on the hair’s length, it may take many months for the overall hair volume to return to normal gradually. Telogen effluvium can return, especially if the underlying cause is not treated or recurs, and would be called chronic telogen effluvium if lasting more than six months.

If it does last more than six months, you need to figure out if you have an underlying cause such as thyroid disease that’s not managed or anaemia. Also, certain medications may be the cause, such as Ibuprofen, beta-blockers used for blood pressure, warfarin, lithium, retinoids used for acne and some antibiotics. These are medications you should discuss with your doctor concerning your hair loss.

Another reason for this type of hair loss lasting more than six months is that you may have two kinds of hair loss co-existing, Telogen effluvium and androgenic hair loss.

You should also consider a hair count loss to check if the number of hairs lost each day decreases or increases or stays the same.

If no underlying cause, your doctor may consider medications known as hair re-growth promoters.

3. Alopecia Areata.

The immune system attacks a portion of the hair follicle, mistakenly thinking it is a bacteria or virus. It is resulting in circular areas of complete hair loss. Sometimes there are broad patches or even loss of all hair on the head. Treatments may include anti-inflammatory creams and injections as well as Minoxidil.

Traction Alopecia

Another form of Alopecia worth mentioning is Traction Alopecia. Traction alopecia is hair loss that’s caused by repeatedly pulling on your hair. You can develop this condition if you often wear your hair in a tight ponytail, bun, or braids, primarily if you use chemicals or heat on your hair. Traction alopecia is reversible if you can stop hair pulling. But if you don’t intervene soon enough, the hair loss may be permanent.

This type of hair loss is more common in

• African Americans
• Caucasians
• Ballerinas

Scalp Health

Before starting treatment, a person should examine the health of their scalp. Similar to gardening, before seeding or planting, one should examine the soil. Scalp health is critical if you want the skin where the hairs growing from to be healthy and to be optimised. For example, itching, dandruff and oiliness can all prevent good hair growth. Hence products such as Nizoral Shampoo and Head & Shoulders are often useful.

Alopecia Treatment

The most common treatment is known as hair growth promoters. The most common is topical Minoxidil or Rogaine, and this has the best evidence. It’s been studied for many years in many people and is effective at improving hair growth.

However, it is nonspecific, and it’s not hormonal and its effects, so it can be used for just about any type of hair loss. The women’s strength is 2%, and the Men’s is 5%. If women use more than a 2% solution, they may get side effects such as more hair on their face. However, the minoxidil foam is identical for men and women.

Since Minoxidil has been around for a long time, it has many reviews and opinions. However, it is effective but needs to be used at least for six months before seeing an effect. Also, once you stop using it, it stops working!

Another treatment option is the hair max laser comb. The hair laser max laser may be an option for people who wish not to use too many chemicals. This laser comb is used for 8 minutes, three times per week. HairMax laser combs have been clinically proven to treat hair loss and promote new hair growth in both men and women.

Vitamins and Supplements

Other vitamins and supplements that may be useful include Biotin and Zinc. Biotin has been shown to grow more hair, but it doesn’t thicken the hair, but it is very good for nails also! Zinc is most helpful if patients are low in zinc. Zinc won’t grow the hair, but hair won’t grow if a person is low on zinc.

Other vitamins that need to be normalised include Vitamin A and Vitamin D for optimal hair growth.

Prescription Medications

Oral prescription medications are also available in the Australian market. Hair growth may be marginally stimulated or stabilised (i.e. hair loss stopped or slowed) in mild-to-moderate thinning using prescription medications.

Noticeable hair growth occurs by 3–4 months with the maximal response after 12 months of continuous treatment. The benefit of treatment is lost within 6–12 months of stopping. The response is best when many thin, miniature hairs remain before starting treatment. No benefit is seen where there is no visible hair. Also, hormone therapy may be beneficial for androgenetic Alopecia.

Compounding and Alopecia

Many topical medications mentioned can also be compounded into an oral capsule. Compounding hair loss medications is becoming common in Australia, primarily by dermatologists. However, some of them need a prescription. Different combination of drugs can also be combined into one capsule to increase the effectiveness of the medication.

Topical Minoxidil compounded with the combination of other medications that increase its effect can be advantageous. For example, in combination with Vitamin A analogues, Minoxidil increases the cell turnover of scalp cells, producing more new cells, making Minoxidil more effective.

What is Menopause?

Menopause is when women reach an age where they don’t experience a menstrual period for 12 months. The average age of Menopause is around 51 years. It usually begins between the ages of 45 and 55. Every women’s menopause experience is unique. Symptoms are generally more severe when Menopause occurs suddenly or over a shorter period of time.

Prior to Menopause, periods become irregular, and women start to experience the symptoms of Menopause; this is known as perimenopause. The road to Menopause is rocky.

Menopause can last anywhere from a few months to several years. Conditions that impact the health of a women’s ovary, like cancer and hysterectomy or lifestyle factors such as smoking, tend to increase the severity and duration of symptoms during Menopause.

Because the symptoms and experience of each woman are different, you may consider filling in this symptom score sheet.

https://ecompoundingchemist.com.au/menopause/

 

Hormonal and Cholesterol Changes during Menopause

Hormonal changes occur over a period leading up to and during Menopause. Circulating follicle-stimulating hormone (FSH) and luteinising hormone (LH) levels increase in the blood.

Follicle-stimulating hormone (FSH) is an integral part of the reproductive system. It’s responsible for the growth of ovarian follicles. Follicles produce estrogen and progesterone in the ovaries and help maintain the menstrual cycles in women.

The FSH works with the LH increase in the blood and oestradiol (estrogen type) and progesterone decrease.

Circulating FSH and LH stimulate the body to produce Oestradiol and Progesterone. However, during Menopause, Oestradiol and Progesterone are no longer released as before due to physiological changes. Hence, FSH and LH keep getting manufactured, trying to tell the body to make more Oestradiol and Progesterone!!!

This is why during Menopause, hormone tests check the levels of FSH, LH, Estrogens (Estrone, Oestradiol and Estriol) and Testosterone.

Other hormones that influence Menopause are Testosterone and Dehydroepiandrosterone (DHEA). Total testosterone is usually not altered during Menopause, whereas DHEA declines with age.

Unfortunately, also during Menopause, bad cholesterol (LDL) goes up, and the good cholesterol (HDL) goes down.

 

Symptoms of Menopause

Since circulating hormones levels change during perimenopause and Menopause, this leads to symptoms occurring all over the body. Often, remembering all the symptoms can be overwhelming. To help your discussion with your doctor, we have created a symptom score sheet to consult with your GP.

https://ecompoundingchemist.com.au/menopause/

Some of these symptoms include:

Vascular (Blood Vessels) – Hot flushes and Night Sweats

Genital (Reproductive System) – Vaginal Dryness, Burning Irritation, lack of lubrication, pain during and after sexual intercourse

Urinary System – Incontinence, pain during urination and frequent urinary tract infections (UTIs)

Skeletal System (Bone and Muscles) – Bone loss, osteoporosis, joint and muscle pain.

Skin and Soft Tissue: Decreased collagen content/elasticity, redistribution of fat.

Breast – Breast pain and Breast waste

Psychological – Mood disturbances, Depression, Fatigue, irritability and insomnia

Sexual – Loss of Libido, pain during sexual intercourse

Cardiovascular (Heart) – Narrowing of the blood vessels (Atherosclerosis), Heart Disease

Central Nervous System (Brain) – Dementia, Memory Loss, Parkinson’s disease, Macular Degeneration.

 

Management of Menopause

Hormone replacement therapy is the most effective treatment for troublesome vasomotor symptoms associated with Menopause at any age. Hormone therapy reduces the frequency of hot flushes and the severity of it. Improvements are typically noticed after two weeks after starting hormone replacement therapy. Quality of life, sexual function and other menopause-related symptoms such as joint and muscle pains, mood changes and sleep disturbances may improve with hormone replacement. Hormone replacement is also important in the prevention of bone loss in postmenopausal women.

Hormone replacement therapy significantly lowers the risk of hip, spinal cord bones and other osteoporosis-related fractures in postmenopausal women. However, the benefit of reducing fracture risk appears to be lost within a few years of stopping hormone replacement therapy.

However, Hormone Replacement Therapy should never absolutely be used in women who suffer from breast or endometrial cancer, heart attack, stroke, transient ischaemic attack, active liver disease or undiagnosed vaginal bleeding.

Benefits are more likely to outweigh risks for women with bothersome symptoms before the age of 60 years or within ten years after Menopause.

However, the dose and the choice of hormone replacement therapy needs to be discussed with your general practitioner.

When hormone replacement therapy cannot be used, other options include a particular group of anti-depressants known as SSRIs and other medications that work on the central nervous system.

 

What is Hormone Replacement Therapy?

Hormone Replacement Therapy (HRT), or menopausal hormone therapy (MHT), is medication containing the hormones that a woman’s body stops producing after Menopause. HRT is used to treat menopausal symptoms.

The hormones used in traditional HRT are made from the urine of pregnant horses and other synthetic hormones.

HRT comes in the form of oral tablets and capsules, patches, creams and troches.

 

Risks Vs Benefits and Misinterpretations

A study published in 2002 known as the women’s health initiative study created worldwide concern about the safety of using Hormone Replacement Therapy. However, the design of the study led to many misinterpretations. This is why it is highly recommended to discuss with your doctor the risk of using Hormone Replacement Therapy. For example, many women today avoid using Hormone Replacement therapy, thinking it increases the risk of breast cancer; however, the risk of breast cancer is less than 1 case in 1000 which is the same risk of getting cancer from a sedentary lifestyle, obesity and alcohol consumption. It is worth also noting the chance of getting osteoporosis and bone fractures for not taking hormone replacement therapy at Menopause is 30 in 100!

 

What is Bio-Identical Hormone Replacement Therapy (BHRT)

Bioidentical hormones are man-made hormones derived from plant estrogens that are chemically identical to those the human body produces. Estrogen, progesterone, and testosterone are among those most commonly replicated and used in treatment. Bioidentical hormones come in various forms, including pills, patches, creams and gels.

BHRT is generally used in compounded medications. However, there are concerns about their use due to the lack of regulation.

 

BHRT Myths

Some people often take BHRT because they are “natural”. However, to set the record straight, BHRT is not natural chemicals; they are synthetic, man-made chemicals. However, they are identical to the chemicals our human body produces. Unlike traditional hormone replacement therapy (HRT), they are not identical to the human chemicals, they are obtained from animals such as horses, so they contain animal-like hormones.

 

Non-hormone options

Non-hormonal therapies are used by approximately 50% of women in western societies to manage vasomotor symptoms of Menopause. Many are not supported by high-quality evidence. Non-hormonal options for vasomotor symptoms include cognitive behavioural therapy (CBT), hypnosis, diet and supplements, vitamins, weight loss and acupuncture.

High-quality evidence supports the use of purpose-designed CBT, hypnosis, acupuncture and weight loss for vasomotor symptoms management. The evidence for mindfulness, relaxation, exercise, yoga, paced breathing, dietary supplements and herbal medicine is not as strong. Black cohosh, red clover, St. John’s wort and Ginkgo are not currently recommended.

 

In Summary

The symptoms of Menopause are long and wide, and each woman is different. There are risks and benefits of receiving treatment. Women wishing to start HRT or other therapies should carefully discuss the benefits and risks of treatment with their doctor to see what is right for them, considering their age, medical history, risk factors and personal preferences.

 

What is Coronavirus?

In December 2019. The Chinese authorities notified the world that a virus was spreading through their communities. In the following months, it spread to other countries with cases doubling within days. This virus is a severe acute respiratory syndrome. This virus is named coronavirus 2 (SARs was Coronavirus 1). Coronavirus 2 causes the disease Covid-19 and that everyone simply calls coronavirus.

 

How the Coronavirus Spreads

A virus is really just a hull around genetic material and a few proteins arguably not even a living thing. It can only make more of itself by entering a living cell. It may spread when people cough dropping droplets on surfaces. They could be in the air or on a surface that you touch before touching your eyes, nose, or mouth. That gives the virus a passage to the mucous membranes in your throat. Within 14 days, your immune system may respond with early symptoms like a sore throat, a fever, or a dry cough.

 

The Mechanism by the Coronavirus infects human cells.

A virus infects your body by entering healthy cells. There, the invader makes copies of itself and multiplies throughout your body.

The new coronavirus latches its spiky surface proteins to receptors on healthy cells, especially those in your lungs.

Specifically, the viral proteins bust into cells through ACE2 receptors. Once inside, the coronavirus hijacks healthy cells and takes command. Eventually, it kills some of the healthy cells.

The virus moves down your respiratory tract, which is your airways (mouth, nose, throat, and lungs). Your lower airways have more ACE2 receptors than the rest of your respiratory tract. So COVID-19 is more likely to go deeper than viruses like the common cold.

Your lungs might become inflamed, making it tough for you to breathe. This can lead to pneumonia.

 

How sick does the coronavirus make you?

For most people, the symptoms end with a cough and a fever. More than 8 in 10 cases are mild. But for some, the infection gets more severe. About 5 to 8 days after symptoms begin, they have shortness of breath (known as dyspnea). Acute respiratory distress syndrome (ARDS) occurs a few days later.

ARDS can cause rapid breathing, a fast heart rate, dizziness, and sweating. It damages the tissues and blood vessels in your alveoli, causing debris to collect inside them. This makes it harder or even impossible for you to breathe.

Many people who get ARDS need help to breathe from a machine called a ventilator.

As fluid collects in your lungs, they carry less oxygen to your blood. That means your blood may not supply your organs with enough oxygen to survive. This can cause your kidneys, lungs, and liver to shut down and stop working.

Some people who have COVID-19 also get dangerous blood clots, including in their legs, lungs, and arteries.

Not everyone who has COVID-19 has these severe complications. And not everyone needs medical care. But if your symptoms include trouble breathing, get help right away.

 

How bad is this pandemic?

Fast pandemic is a horrible pandemic and will cost many lives, a slow epidemic will not be remembered by history. This pandemic will only be harmful if it is allowed to spread fast. A fast outbreak begins with a very rapid rate of infection because there are no countermeasures in place to slow it down. Many people get sick at the same time if the numbers get too large, Healthcare Systems become unable to handle eight. There aren’t enough resources like medical staff, nor hospital beds nor equipment like ventilators to deal with it. Luckily in Australia, the pandemic has been slowed down by the fast action taken by the authorities.

 

Fast Pandemic cost lives

A fast pandemic means people will die untreated, and as more healthcare workers get sick themselves the capacity of Health Care Systems Fails, even further. If this becomes the case, then horrible decisions will have to be made about who gets to live and who doesn’t. As seen overseas, the number of deaths rises significantly.

 

Social Behaviour Saves Lives

To prevent such a scenario as a fast pandemic, this means we all need to do what we can to turn this into a slow pandemic. Especially in the early phase so that everyone who gets sick can get treatment and there’s no crunch point with overwhelmed hospitals since we don’t have a vaccine. We have to socially engineer our behaviour to act like a social vaccine. This simply means two things, not getting infected and not infecting others. Although it sounds trivial, the very best thing you can do is to wash your hands with soap. This is actually a powerful tool, the coronavirus is encased in what is basically a layer of fat, soap breaks that fat apart and leaves it unable to infect you. It also makes your hand slippery, and with the mechanical motions of washing, viruses are ripped away. The next thing is social distancing, which is not a pleasant experience. Still, the right thing to do, this means no hugging, no handshakes, and staying at home to protect those who need to be out for society to function from doctors to Cashiers or police officers.

There are quarantines which can mean different things from travel restrictions or actual orders to stay at home. Quarantines are not pleasant to experience and certainly not popular, but they buy us time. So if you are put under quarantine, you should understand why and respect it. None of this is fun. But looking at the big picture, it is a minimal price to pay.

The question of how pandemics end depends on how they start. If the epidemic starts fast with a steep slope, the epidemic ends badly. If the epidemic begins slowly with a not so steep slope, the pandemic end okay and in this day and age, it really is in all of our hands.

 

Flu Vaccination and COVID-19

Health authorities are predicting both the influenza virus and COVIC-19 will co-circulate during the Australian winter months. Both are infections that affect the lung and overlap in symptoms.

People should have the influenza vaccine before the onset of each influenza season. In most areas of Australia, peak influenza season is from June-September. People caring for young, older or vulnerable people should be vaccinated immediately. People aged over 65 or older should almost definitely be immunised with a particular flu vaccine Fluad Quad® boosting immunity. If unvaccinated while influenza viruses circulate, there is benefit in the vaccine, irrespective of time left in the season.

Revaccination later in the same season year is not recommended; however, for some individuals, it may be appropriate such as travellers and pregnant women.

 

Face Masks

Masks use effectiveness is controversial, and its role is limited. Face masks are associated with low adherence and may provide a false sense of security. Individuals not used to wearing a mask will likely touch their faces more frequently and increase the chances of infection.

Disposable respirators (e.g. P2, N95) are designed to protect wearers from infection aerosols. Respirators can filter approximately 94% of particles less than 5 microns in size.

Australian Government states individuals need not wear a face mask unless directly caring for a person with suspected COVID-19.

 

Hand Sanitisers

Handwashing remains the cornerstone of infection control for this coronavirus. However, alcohol-based hand rubs (Sanitisers) (containing between 60-80% v/v ethanol or equivalent) is effective in reducing virus transmission.

The TGA has made exceptions to the regulation of hand sanitisers due to the high demand of hand sanitisers during the pandemic.

The following is posted on the TGA website (https://www.tga.gov.au/hand-sanitisers-and-covid-19)

On 28 March 2020, specified hand sanitiser formulations were excluded from TGA regulation, as long as they only contain particular ingredients in particular quantities in the final formulation, and comply with certain manufacturing practices, and advertisement and labelling conditions. Provided that the exact formulation and other requirements are followed, this formulation is permitted for use in both healthcare facilities and consumer use.

This exclusion will facilitate the urgent and continued supply of large volumes of hand sanitisers in Australia.

The formulations are based on advice by the World Health Organization and similar decisions by the US Food and Drug Administration. The final formulation of the hand sanitiser must contain only the following ingredients:

• EITHER ethanol 80% v/v (pharmacopoeial grade or food standard grade) OR isopropyl alcohol 75% v/v (pharmacopoeial grade) in an aqueous solution;
• sterile distilled water or boiled cold water;
• glycerol 1.45% v/v (pharmacopoeial grade);
• hydrogen peroxide 0.125% v/v (pharmacopoeial grade); and
• does not contain any other active or inactive ingredients, including colours, fragrances or emollients.

There are strict requirements for labelling of these products. Manufacturers must also test the alcohol concentrations of each batch, manufacture under sanitary conditions and maintain production record-keeping. The legislation enabling production of these sanitisers is the Therapeutic Goods (Excluded Goods – Hand Sanitisers) Determination 2020.

The products will continue to be regulated as consumer goods under Australian Consumer Law. Manufacture of this product is not considered compounding.

Introduction

The common cold and influenza (the flu) are viral infections of the upper respiratory tract. They have many overlapping symptoms. Both are acute illnesses, highly contagious and spread by respiratory droplets; and affect people of all ages. Your Pharmacist is ideally placed to assist you in managing your symptoms and provide education to minimise the spread of infection.

 

What is the difference between the common cold and influenza?

The common cold and influenza are caused by different viruses, and only influenza can be prevented by a vaccine.

There are over 200 viruses known to cause the common cold; the most common being rhinoviruses (30–50%), coronaviruses (10–15%) (NOT COVID-19), adenoviruses (5%) and respiratory syncytial virus. In contrast, influenza viruses belong to three types of influenza viruses that infect humans are influenza A, B, and C.

The common cold is the most prevalent, contagious disease in Australia. On average, adults develop between two and four colds each year, while children experience six to eight each year. There is no vaccine available to protect individuals against the common cold.

Colds and flu are both spread by inhaling airborne droplets expelled when an infected individual sneezes or coughs, or by direct contact with

infected secretions from contaminated surfaces.

Viruses of the common cold can survive for 2 hours to 7 days, while influenza viruses can survive for up to 2 days on inanimate surfaces.

 

Symptoms of the common cold and The Flu

Common Cold symptoms develop gradually. They can include a sore throat, nasal congestion and discharge, sneezing, cough, malaise, hoarseness and sometimes a headache and/or low-grade fever. Symptoms can vary between individuals and for different cold infections. In contrast, the symptoms of influenza present abruptly, and can include symptoms of a cold plus fever (≥37.8 °C), muscle aches, joint pain, chesty cough and loss of appetite. Diarrhoea, nausea and vomiting can also occur.

 

Complications of Colds and Flu

While colds and flu are generally self-limiting in healthy individuals, both can lead to complications.  Complications can include, middle ear infections (more common in children), bronchitis, pneumonia and sinus infections. Both can aggravate existing long term conditions such as asthma and chronic obstructive pulmonary disease (COPD).

While the common cold is rarely life-threatening, influenza can be severe and fatal. In Australia over the past five years, on average over 2,000 people have been hospitalised and 378 people have died each year from influenza.

 

Flu Vaccination

Influenza (the flu) is a very contagious infection of the airways. It can especially be severe for babies, people over 65 years of age and pregnant women.

Symptoms of the flu include sudden high fever (102°F/39°C to 104°F/40°C), chills, muscle aches, runny/congested nose, sore throat, dry cough, headache and extreme fatigue. Kids may also have other symptoms such as earaches, diarrhea, throwing up and leg or back pain.

Vaccination is a safe and effective way to protect you from serious disease caused by influenza.

By getting vaccinated against influenza, you can also help protect other people, especially people who are too sick or too young to be treated. The more people who are vaccinated in your community, the less likely the disease will spread, this is also known as “Herd Immunity”

 

One of the worst influenza seasons on record was in 2019, with over 308,000 confirmed cases of influenza in Australia. It was atypical, with the season hitting early and maintaining through the warmer months.

In Australia, influenza is a considerable burden, particularly in 2019, over 800 Australians died as a result of influenza.

 

Vaccination Time

Annual vaccination is recommended before the onset of each influenza season. Optimal protection against influenza occurs after two weeks and continues for the first 3 to 4 months following vaccination. Protection is generally expected to last for the whole season. Those over 65 receive a specially enhanced vaccine.

With the period of peak influenza circulation for the majority of Australia occurring from June to September, April is a suitable month for immunisation to commence. In saying that, it is never too late to vaccinate since influenza can circulate all year round.

People at high risk such as pregnant women, it’s also never too early in the season to vaccinate. It’s also important to note that receiving a second vaccination in a season is not contraindicated. Indeed Australians travelling during the Northern Hemisphere influenza season are strongly recommended to receive the current Australian influenza vaccine two weeks before leaving.

Those who have already received a current Southern Hemisphere influenza vaccine and are travelling later in the

year to the Northern Hemisphere are recommended to receive a second dose of an influenza vaccine within the same year.

 

Flu Vaccine Effectiveness

While vaccinating many of my patients, I realise they have high expectations, such as 100% effectiveness and no side effects! Unfortunately, the flu vaccine is NOT 100% effective, and it may take about 2 weeks to develop immunity following vaccination. But one thing is for sure, the FLU VACCINE will NOT give you the FLU!

The virus’ ability to change and mutate means that while it’s the most effective form of prevention, other measures such as hand hygiene and avoiding crowded areas when unwell, can all reduce transmission. Antivirals are all also available on prescription and can be used for institutional outbreak control as an aide to other measures. Ideally, it should be started within 24 hours after the onset of symptoms.

Adverse effects, such as sore arm and flu-like symptoms, are the most common side effects. There are other possible side effects which are discussed before vaccination. The flu vaccine can also be fatal, but this is rare.

 

Flu Vaccination and Allergy

Previously, the flu vaccination was not recommended for children with egg allergies; however, research has shown that it may be OK for many kids with egg allergies, and there are specific guidelines around this.

If your child has had a reaction to any vaccination before, has had any allergic or hypersensitivity reaction or known allergy to egg (including symptoms such as rash/hives, swelling or difficulty breathing), or has an allergy to any component of the vaccine, you should discuss flu vaccine options with your doctor.

 

Strengthen your immunity

To strengthen your immunity and increase your chances to prevent the cold and flu viruses, you should consider the following.

 

1. Get a flu vaccination
2. Wash your hands
3. Use Humidifiers/Vaporisers
4. Get plenty of sleep
5. Drink lots of water
6. Good nutrition
7. Regular Exercise
8. Spend time outdoors
9. Manage your stress
10. Avoid stimulants such as energy drinks

 

Compounding Options

Compounding Nasal Inhalations and Ointments using ingredients such as Menthol, camphor, eucalyptus oil, and chlorbutol may be an option during the cold and flu season. Traditional compounding formulas have effective multi-symptom relief from aggravating cold symptoms. Compounding is tailored based on the patient’s needs. Ask your Pharmacist for discussion on compounding options if commercial products are not available or suitable.

 

Complementary therapies

Complementary therapies commonly used for colds and flu include echinacea, vitamin C, zinc and probiotics.

 

Echinacea – Current evidence does not support the use Echinacea to prevent or reduce the duration of the cold

 

Vitamin C – A review found that regular supplementation with Vitamin C reduced both cold duration (8% in adults and 14% in children) and severity.

It also reduced the chance of getting a cold in marathon runners, skiers and soldiers who were exposed to extreme physical activity but the not the general public.

 

Probiotics – Low-quality evidence suggests that regular treatment may help reduce the risk of upper respiratory tract infections.

 

Zinc – Evidence suggests that doses of ≥75 mg/day, given in the first 24  hours of symptoms, reduce the duration of symptoms of healthy individuals

[vc_row][vc_column][vc_column_text]Natural supplements include vitamins, minerals, herbs and nutrients. Natural supplements are often grouped under the umbrella of complementary medicines. They have a role in complementing traditional medicines, maintaining health, preventing disease and easing disease. Complimentary Medicine therapy is best done in a partnership with your practitioner, as there are many factors to consider. This blog will discuss four main points:

1. Essential nutrients that our bodies cannot manufacture,
2. Variation in dosing and evidence of complementary medicines,
3. Drug interactions between complementary medicines and conventional medications and
4. Why compounding can be an excellent option for some people.

 

Essential Nutrients

 An essential nutrient is a substance that the body requires but which it cannot produce itself. Vitamins and essential minerals are used continuously by the body for multiple purposes such as

1. energy and metabolism
2. Making and maintaining blood, skin, muscle and bone,
3. Making Genetic material, proteins and enzymes to support cell growth and reproduction.
4. Supporting the body’s physical and cognitive capabilities.

[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Essential Vitamins, Minerals and Fatty Acids include:[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/4″][vc_column_text]Vitamins 

Biotin

Folic acid

Niacin

Pantothenate

Riboflavin

Thiamine

Vitamin A

Vitamin B12

Vitamin B6

Vitamin C

Vitamin D

Vitamin E

Vitamin K[/vc_column_text][/vc_column][vc_column width=”1/4″][vc_column_text]Minerals 

Calcium

Chloride

Chromium

Cobalt

Copper

Iodine

Iron

Magnesium

Manganese

Molybdenum

Phosphorus

Potassium

Selenium

Sodium

Zinc[/vc_column_text][/vc_column][vc_column width=”1/4″][vc_column_text]Fatty Acids 

A-Linolenic Acid (Omega-3)

Linoleic Acid (Omega-6)[/vc_column_text][/vc_column][vc_column width=”1/4″][vc_column_text]Amino Acids 

Isoleucine

Leucine

Lysine

Methionine

Phenylalanine

Threonine

Tryptophan

Valine

Histidine[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Australian Health and Wellness Recommendations

The government recommendation is a minimum of five serves per day of vegetables and two serves per day of fruit to meet the recommended daily amount of vitamins and minerals required to help prevent disease.

Recent national nutrition surveys indicate that most Australians fall short of the recommended intake of many vitamins and minerals. Nutrient shortfalls have health consequences that could impact daily life and overall wellbeing.

The surveys sourced from the Australian Bauru of Statics (ABS) tell us 50% of adults and 68% of children ate sufficient serves of fruit, and 7% of adults and 5% of children ate adequate serves of vegetables. Adults aged 65–74, 60% had a sufficient fruit intake, and 11% had an adequate vegetable intake. Children aged 2–3, 97% ate enough serves of fruit, and 20% ate sufficient serves of vegetables. Overall, 5% of adults had an adequate intake of both fruit and vegetables. Women were more likely to eat enough fruit and vegetables than men (8% compared with 3%).

 

Dosing of Natural products

Many of the supplements available on the market are formulated as compounds called “salts”. For example, Magnesium Oxide is a different “salt” to magnesium citrate or Magnesium Glycinate. Each of these compounds will have an unusual amount of Magnesium in them, known as elemental Magnesium. For example, 1g of Magnesium Oxide will have a different amount of elemental Magnesium compared to 1g of Magnesium Glycinate. To be precise 1g of Magnesium Oxide contains 0.61g of elemental Magnesium (61%) whereas Magnesium Glycinate contains 0.141g (14.1%).

However, this does not mean that you get more elemental Magnesium from taking Magnesium Oxide. Your body will affect different chemicals in different ways, leading to less or more absorption into your bloodstream. Factors such as molecule size, the water solubility of the molecule, pH (acidity), etc.… will determine how much of the mineral will be absorbed. In fact, you are more likely to consume more elemental Magnesium out of Magnesium Glycinate than Magnesium Oxide because Magnesium Glycinate is a better-absorbed form of Magnesium.

 

Dosing and Indications

When you take a mineral or a vitamin, the dose matters. This is because simply a different dose is required for various ailments. For example, if we continue with the Magnesium example, Magnesium is indicated for multiple diseases. Each illness such as cramps, High Blood Pressure, PMS, migraines and others require a different dose of Magnesium.

These are some examples of the dosage required for different ailments.

Night Cramps: 300mg of Elemental Magnesium daily

Migraine Prevention: 300mg of Elemental Magnesium daily with other B Vitamins

High Blood Pressure: 300-600mg of Elemental Magnesium daily

PMS: 260mg of Elemental Magnesium Daily

 

The Evidence of Complementary Medicine

In Complementary medicine, as with all medication, knowledge was initially held by practitioners and based on careful observations collected over time, that education was practised. Eventually, practitioners wrote down their findings and some produced textbooks. However, in the last century with the advance of scientific evidence and research. The expectation of proof has been amplified. Today medications are expected to go through trials in the lab and if successful large-scale testing is performed on large patient numbers before the medicine is available on the market. However, complementary medicines still draw evidence from the traditional method that was gathered from observations by practitioners over the centuries before the scientific advances. However, there are large scale scientific studies with certain complementary medicines. Hence, as the reader can appreciate the level and quality of evidence will vary significantly from one complementary medication to another. Best to ask your practitioner what is the level of evidence before starting a complementary medicine.

 

Benefits

Combined with a healthy diet, the rational use of nutritional supplements may substantially contribute to health promotion and disease prevention at all stages of life. These are some examples:

1. Prenatal multivitamins with minerals are commonly prescribed to address increased nutrient needs during pregnancy and to protect against some birth defects.
2. Calcium and vitamin D help build optimum bone mass during childhood and adolescence and also reduce the rate of bone loss that naturally occurs with aging.
3. Vitamin and mineral supplements have been shown to improve immune function in adults and the elderly.
4. Antioxidant supplements have been shown to have a positive impact on eye health and cognitive function in the elderly.

In addition to treating nutritional deficiencies, nutrients can also be used therapeutically to address the many underlying physical factors that contribute to disease. Nutrients can regulate the levels of essential chemicals in the body, influence hormonal balance, reduce inflammation, improve immune function, reduce levels of toxic elements, reduce oxidative stress, and alter gene expression.

 

Drug Interactions

If there is one thing a patient/consumer should ask their pharmacist about complementary medicines, it is drug interactions. Complimentary medications can interact with conventional prescription or non-prescription medications.

Many different drug interactions could take place between complementary and conventional medications. Still, they can be categorised under 2 categories.

1. What the body does to the medication(s).
2. What the medication(s) does to the body.

 

1.What the body does to the medications drug interactions.

When a person takes a medicine (conventional or complimentary), the body will absorb it into the bloodstream. The body will distribute it to all different body parts. Break it down (metabolism) by the liver to remove any harmful chemicals and then excrete it through the kidney or the liver. As you can imagine, some medications can disturb these processes of absorption, distribution, metabolism and excretion. If a complementary medicine, for example, induces a liver enzyme by making it work harder, this may lead to an increased breakdown of a conventional medication. Such an instance occurs between St. John’s Wort and Digoxin. St. John’s Wort is a complementary medicine used for major depression, but it induces an enzyme called P-gp. P-gp is an enzyme system in the liver responsible for breaking down (metabolising) Digoxin, a medication used for patients with heart failure and heart rhythm disorders. By taking St. John’s Wort with Digoxin, this will lead to a decreased level of Digoxin. Since P-gp is induced by St. John’s Wort leading to a more rapid breakdown of Digoxin. In such cases, the patient may need to stop St. John’s Wort or find an alternative or increase the dose of Digoxin if the doctor wishes to continue the therapy of both medications.

 

2.What the medication(s) does to the body type of interaction.

The reason we take medication is to have a physiological effect on our body. Examples of such ideas may be to lower the blood pressure or dilate our blood vessels or increase the flow of urine etc….

For instance, taking a complementary medicine and conventional medicine which both dilate the blood vessels will have a doubling effect. Such example is Ginkgo Bilboa, a complementary medicine used as an anti-oxidant and Nifedipine, which is a prescription medicine used to lower high blood pressure. They both dilate our blood vessels. Taking them together will lead to a double effect. Having over dilated blood vessels may lead to headaches or a racing heart!

 

Compounding and Nutraceuticals

Compounding of complementary medicines, especially nutrients, can be of great benefit for some patients. Compounding can often reduce the number of capsules required, as multiple nutrients can be incorporated into one capsule or liquid. Compounding can also be used when fillers or sugars or preservatives or allergens need to be removed from a commercial product. Compounding can be of use even when a specific dose is required. Last but not least compounding can be used to adjust flavour and palatability.[/vc_column_text][/vc_column][/vc_row]