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Nicorette Cartridges

Sunday, March 9, 2008







Giving up smoking is a nightmare for so many of us. Even though the new non-smoking laws are in place, it is difficult for most smokers to go out of an evening and completely ignore their cravings and relax. Nico Pipe Is a unique substitution for smokers every where. These Inhalators are tobacco, tar, chemical and smoke free and provide an ample nicotine hit when ever you need it. These inhalators are sleek and discreet. They fit nicely in between the fingers, allowing you to mimic the way you would behave when holding a cigarette. These inhalators are made from aluminium and look smooth and more elegant compared to the plastic white inhalators currently available. Nico Pipes are slightly weighty and feel nicer to hold and are not so easy to lose as the lighter, plastic versions. NicoPipe is currently available in four fabulous colours, so go ahead and accessorize! Please note - This product is not classed as a pharmacy product. However, it does contain a nicotine cartridge, which does have to be sold under pharmaceutical supervision. Therefore, you will have to answer some quick and simple questions as to why you will be using Nico Pipe. Many thanks for your understanding.






Nico Pipe - Silver











The Nico Pipe Inhalator is an excellent replacement to cigarettes, for those who are trying to cut down or quit and those who may be restricted by the non-smoking law.
Light weight and smooth to the touch.
Sleek and beautifully crafted.
Helps to wean yourself off tobacco.
Simple to use.
Can be used when ever you want, where ever you want.
Uses normal nicotine



Nico Pipe comes in two parts which can be unscrewed. Once opened, the nicotine cartridge is popped into the pipe and then screwed closed to pierce the cartridge. Then it is ready to go. Simple! All you need to do is take a drag of the Nico Pipe in the same way you would inhale the smoke from a cigarette. One refill cartridge will last for approximately 20 minutes of continuous intake. Depending on your smoking habits, you may only need to use 2 or 3 cartridges a day. Do not use any more then 12 cartridges a day



Round yellowish/ochre coloured self-adhesive patch containing per sq cm: Nicotine 1.75mg
Treatment of nicotine dependence as an aid to smoking cessation
Smoking must be stopped completely during treatment
TTS20 average absorption 14mg/24 hours

Nicotinell Liquorice 4mg Gum Extra Strength


Nicotinell Liquorice. 4mg Chewing Gum. Nicotine. Extra Strength. 96 pieces. Helps you to stop smoking. Sugar Free. Nicotinell Liquorice flavour gum provides an effective aid to combat the unpleasant withdrawal symptoms caused by giving up smoking. Nicotinell 4mg gum is particularly useful for heavier smokers who are more likely to experience severe withdrawal symptoms, and for those who have previously failed to stop smoking with nicotine replacement therapy

Omron Step Counter Active Steps HJ109


pedometer

Motion sensitivity adjustment
7 day memory
Calorie counter
Clock
Suitable for aerobic exercise

Omron Step Counter HJ005E



Monitors every step taken showing total results on large LCD display
Lightweight and easy to use
Belt clip

Dymatize Creatine Monohydrate

Saturday, March 8, 2008


LA Muscle ZMax Compound


90 Tablets
Following extensive research and development, LA Muscle gives you what is probably the best product you will ever use for all-round gains.
ZMAX Compound contains a unique combination of Magnesium Aspartate, Zinc Monomethionine and vit B6. ZMAX Compound contains the correct dosages as shown in scientific tests to significantly increase Testosterone levels.
Zinc is an anabolic element which promotes muscle growth, tissue repair, increases Testosterone, IGF1 and GH. Magnesium promotes muscles strength, endurance and is necessary for the metabolism of carbohydrates and protein.
High Strength ZMAX Compound contains a whopping 200mg of pure standardised potency Tribulus Terrestis herb. This super-herb increases Testosterone levels resulting in increased muscle mass, strength, endurance and boosts in your sex drive.
High Strength ZMAX Compound also contains 150mg of Acetyl Carnitine (ALC) per tablet. This unique supplement is a strong Testosterone booster. ALC will accelerate muscle growth, recovery and strength gains. ALC will also improve your sleep and your mood.
As good as ZMAX Compound is, please do not take it for extended periods. Take it for 2 months on and 1 month off. You can take ZMAX with Norateen II and/or Anaboteen for even better results. Two XST tablets taken with ZMAX will take ZMAX's powers to a whole new level

Veromax For Women 30 Tablets

Veromax for women has been formulated by Nutritional experts specifically to help maintain female sexual wellbeing. The ingredients of Veromax include Jujube Dates and a range of amino acids as well as Korean Ginseng root and Ginko Biloba Leaf. These ingredients have been chosen in order to help maintain healthy blood circulation, thought to be important for female sexual wellbeing. Veromax is easily added to your daily regimen and requires no special timing or preparation. It is designed for men of all ages. Veromax works with the body to promote the body's own natural sexual health. Ingredients Jujube Dates (Zizyphi Fructis) extract, Siberian Ginseng Root powder, Soy isoflavones, Gingko Biloba Leaf powder, L-Arginine HCI, L-Alanine, Glutamic Acid, L-Lysine HCI, calcium carbonate, microcrystalline cellulose, croscarmellose sodium, stearic acid, silica, magnesium stearate, hydroxypropyl methylcellulose.

Pjur Intimacy Pack

New! from Pjur comes the handy pack for safe, comfortable lovemaking wherever you are... Always keep one handy - be prepared! Intimacy Pack contains:
2 Pjur® Super Sensitive Condoms.
2 Pjur® Lubricant Sachets. Pjur lubricant is a silicon-based lubricant that will enhance any lovemaking experience.
2 Smint® breath mints.
1 moisturised soft Pjur® cleaning towel -without alcohol.
Handy pocket/handbag size pack.
Ideal for holidays and weekends away.

Pjur Superhero Spray for Men 20ml

New! from the makers of Pjur Woman comes this specially formulated spray to help prolong love-making without the use of Lidocaine. Used externally on the penis the liquid refreshes the genital area, increases suppleness and reduces hypersensitivity, thus helping to prevent pre mature ejaculation
Lidocaine and Benzocaine free! So, if you have a known sensitivity to this local anaesthetic Pjur Superhero could be a suitable alternative.
Handy 20ml spray. Ingredients: propylene glycol • panthenol • aloe vera • menthol • lauromacrogol •

Eyedew Sparkling


Eyedew is the secret weapon the make-up artists and celebrities could not live without. A couple of drops of this little beauty in your peepers and you won't believe how bright and sparkly your eyes become. Eyedew Sparkling brightens all eye colours.


The Braun Cordless Steam Pro Straighter, for unsurpassed styling on the go! Features:
Platinum Power Technology; sensor controlled, for express heat up and a professional high temperature.
Ceramic Coated Floating Plates; for easy gliding and a straight, glossy finish.
Steam Booster; steam on demand. Adds moisture back into the hair, whilst setting your style in place for longer lasting results.
Cordless; to use on the go!
Uses long lasting Braun blue energy cells.

Philips Wet & Dry Angel Shaver

Ideal for teenage girls! No excuses for slow shaving in the shower with this shaver from Philips which has been specially designed for young women. Easy-to-use and convenient this shaver has a small shaving head consisting of a straight trimmer to catch longer hairs and a rounded foil and trimmer to complete the shave for a smooth finish.
Waterproof so can be used in the bath or shower.
Uses x2 AA batteries
Comes with cleaning brush.

Veet Cold Wax Strips x20


Based on natural ingredients Veet ready to use wax strips: a convenient and easy way to ensure effective and long-lasting hair removal Easy and effective: The reday to use strips adhere well to theh hair to ensure a soft and perfectly smooth skin, so youo don't need to depilate for up to 4 weeks Gentle formula: Based on natural ingredientsand especially formulated for sensitive skin, the Veet cold wax strips leave your skin soft and moisturised Water rinsable residues: Thanks to its sugar based wax formula, residues can be easily rinsed off wth water, for a convenient use Pack contains: 20 reusable single strips in 2 sachets 1 leaflet


Compact Chrome Lighted Mirror.
Normal and triple magnifying side.
Surrounding light.
Flip-over mirror.
Brilliant chrome finish.
Operates with AA batteries (not included).
Additional adaptor for mains power included.

Revlon Lighted Make-up Mirror 9415U


Lighted make-up mirror
4 replaceable bulbs in corner of frame
Storage drawer in base
Regular and 3x magnifying sides
Wall mountable
Mains operated via adaptor
2 year guarantee

Revlon Deluxe Make-Up Mirror 9405




Double sided make-up mirror
Soft, glare free lighting around the edge of mirror
Regular and 3x magnifying sides
Replaceable bulbs
Height adjustable stand
Mains operated

Tribuvar contains a high Tribulus Terrestris (45% Furostanol saponins) extract. Tribulus Terrestris is a perennial plant, which grows predominately in


Tribuvar contains a high Tribulus Terrestris (45% Furostanol saponins) extract. Tribulus Terrestris is a perennial plant, which grows predominately in India and Africa Tribulus Terrestris is known to contain pharmacological active metabolites like phytosterols, flavonoids and glycosides. Tribulus has been used widely as a natural resource in the treatment of sexual dysfunction and various urinary disorders. According to clinical medical research, some of the active sterols in the Tribulus Terrestris plant are purported to maintain natural testosterone levels by increasing luteinizing hormone (LH) production. LH regulates testosterone production through the stimulation of the leydig cells and high levels of LH coincide with free or unbound testosterone levels. With the increase of the body's natural endogenous unbound testosterone levels, athletes now supplement with Tribuvar™ to promote protein synthesis by maintaining a positive nitrogen balance. Tribuvar™ will also stimulate faster recuperation and recovery from exercise. For years, some of the worlds most well known athletes of the Soviet Union supplemented Tribuvar™ extensively with success. It's natural and good safety profile makes Tribuvar™ the number one sought after dietary supplement with no contraindications such as toxicity and side effects. Supplement Facts Servings Per Container: 90 Bulgarian Tribulus Terrestris Extract (45% Furostanol Saponins) 500mg Other Ingredients: Micro Crystaline Cellulose, Barley Flour, Titanium Dioxide, Red #4. Recommended Use: Use 1-2 Capsules three to four times daily, preferably with meals. Warning: Not for use by children. Do not use this product if you have prostate cancer or prostate problems. Persons suffering from or at risk for any disease should consult a health practitioner before using this product. Not intended for use by persons under the age of 18. CAUTION- Do not use this product if you are at risk or are being treated for high blood pressure, heart, kidney, thyroid or psychiatric disease, anxiety, depression, seizure disorder or stroke. Before beginning any program of weight loss, consult your health care practitioner

Stud 100 - Desensitizing Spray for Men 12g



You can improve your sexual confidence with Stud 100. The delay spray for men, containing Lidocaine 9.6% w/w, that prolongs sexual pleasure for men and women. Over-rapid ejaculation affects most men at some point in their lives. Stud 100 is quick acting, safe and effective. More importantly, strictly controlled clinical trials and surveys prove that Stud 100 does work.
Stud 100's active ingredient is Lidocaine, a well-known anaesthetic. It delays ejaculation by reducing the sensitivity of the penis, significantly prolonging intercourse and providing greater satisfaction for both partners.
Stud 100 can be used with both latex and non-latex condoms: Stud 100 has been tested with leading brand condoms and meets the BSI Test Protocol.
Do not apply to broken or inflamed skin, or use if your partner is pregnant. If you have, or have had, liver or kidney problems ask your doctor before using the spray. Not recommended for use in the elderly.
Directions: Spray on the head and shaft of the penis, normally between 5 and 15 minutes before intercourse. Use the minimum effective number of sprays, which will vary from 3 to 8 depending upon the individual. Each can contains 120+ metered doses. Do not use more than 24 sprays in 24 hours

men fertility test


In addition to carrying out the fertility sex below there is plenty you can do to help you and your partner have a better chance of conceiving. Give yourself a health check because aspects of your current lifestyle may be affecting your fertility... Tips for your partner female fertlity
Smoking: can significantly lower your sperm count and damage the sperm that is produced. Try and cut down or give up altogether. See our range of products: smoking cession
Alcohol: the maximum number of units per week for a man is 21, but it is advisable to drink less if possible as alcohol is known to kill off the sperm-generating cells in the testes.
Diet and Fitness: increase your intake of fresh fruit and vegetables and reduce your intake of salt and fatty foods. Recommended minerals and vitamins to help with male fertility are: Zinc which is vital for viable sperm count, motility and a high percentage of live sperm in the semen. (Remember that Zinc is lost through ejaculation so include this in your daily diet.) Vitamin C also helps increase sperm motility; Vitamin E boosts general fertility; Omega-3 found in fish oil or flaxseed oil encourages healthy sperm and reproductive tissue. Vitamin B12 is essential for the process of cell division. We provide a selection of easy-to-swallow supplements to help you towards a better diet:
STDs: such as Chlamydia can effect the production of sperm. You may have become infected some years ago from a previous partner without suffering any noticeable symptoms so it is worth checking at this stage that you are free from any infection that might prevent or impede conception... click here for a chalymedia kit test which can be done at home

Vega Prostate Formula x30



Vega Prostate Formula provides specific vitamins and herbs that promote the health of the prostate gland and the urinary tract. Men over the age of 50 are more predisposed to prostate problems. This formula has been designed to help and protect men with specific prostate problems including prostatitis (acute inflammation) and benign prostatic hypertrophy (BPH), where the gland gradually enlarges over time. Vega Prostate Formula contains Saw Palmetto, extensive research has shown this herb to be one of the most effective long-term treatments for BPH. Recommended for:
Men over the age of 50 who want to maintain good prostate and urinary health.
Men who wish to protect against or treat prostatitis and BPH.
x30 V-Caps™ (green, two-piece vegetable cellulose capsule).

belladonna

Friday, March 7, 2008


Belladonna is an herb that has been used for centuries for a variety of indications, including headache, menstrual symptoms, peptic ulcer disease, inflammation, and motion sickness. Belladonna is known to contain active agents with anticholinergic properties, such as the tropane alkaloids atropine, hyoscine (scopolamine) and hyoscyamine.
There are few available studies of belladonna alone for any indication. Most research has evaluated belladonna in combination with other agents such as ergot alkaloids or barbiturates, or in homeopathic (diluted) preparations. Preliminary evidence suggests possible efficacy in combination with barbiturates for the management of symptoms associated with irritable bowel syndrome. However, there is currently insufficient scientific evidence regarding the use of belladonna for this or any other indication.
Common adverse effects include dry mouth, urinary retention, flushing, papillary dilation, constipation, confusion and delirium. Many of these effects may occur at therapeutic doses.


Atropa belladonna , atropa belladonna-AE, beladona, belladone, belladonnae herbae pulvis standardisatus, belladonna herbum, Belladonna Homaccord, Belladonna Injeel, Belladonna Injeel Forte, belladonna leaf, belladonna pulvis normatus, belladonnae folium, belladonna radix, belladonne, deadly nightshade, deadly nightshade leaf, devil's cherries, devil's herb, die belladonna, die tollkirsche, divale, dwale, dwayberry, galnebaer, great morel, herba belladonna, hoja de belladonna, naughty man's cherries, poison black cherries, powdered belladonna, Solanaceae (family), solanum mortale, solanum somniferum, stryshon, strygium, tollekirsche, tollkirschenblatter.

Evidence



Airway obstruction
Belladonna can cause relaxation of the airway and reduce the amount of mucus produced. However, due to lack of high-quality human research in this area, there is not enough evidence to form a clear conclusion.
C
Ear infection
Little reliable research is available on the use of belladonna for ear infections. Other therapies have been shown effective and are recommended for this condition.
C
Headache
The available studies of belladonna in the treatment of headache are not well designed and do not show a clear benefit. More studies are needed to test the ability of belladonna alone (not in multi-ingredient products) to treat or prevent headache.
C
Irritable bowel syndrome
Belladonna has been used historically for the treatment of irritable bowel, and in theory its mechanism of action should be effective for some of the symptoms. However, of the few studies that are available, none clearly show that belladonna alone (not as part of a mixed product) provides this effect.
C
Nervous system disorders
The autonomic nervous system, which helps control basic body functions like sweating and blood flow, is affected in several disorders. To date, human studies have shown no benefit from belladonna in treating these disorders.
C
Premenstrual syndrome (PMS)
Bellergal® (a combination of phenobarbital, ergot, and belladonna) has been used to treat PMS symptoms. More studies are needed before a strong recommendation can be made.
C
Radiation therapy rash (radiation burn)
There is a lack of reliable scientific evidence available for the effectiveness of belladonna for rash after radiation therapy. Further study is needed before a recommendation can be made.
C
Menopausal symptoms
Bellergal® (a combination of phenobarbital, ergot, and belladonna) has been used historically to treat hot flashes. However, in human studies belladonna supplements have not shown effectiveness.
D
*Key to grades A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use; F: Strong scientific evidence against this use.


Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Abnormal menstrual periods, acute infections, anesthetic, anxiety, arthritis, asthma, bedwetting, chicken pox, colds, colitis, conjunctivitis (inflamed eyes), diuretic (use as a "water pill"), diverticulitis, earache, encephalitis (inflammation of the brain), excessive perspiration (sweating), eye disorders (dilation of the pupils), fever, flu, glaucoma, gout, hay fever, hemorrhoids, inflammation, kidney stones, measles, motion sickness, mumps, muscle and joint pain, muscle spasms (excessive unintentional muscle movements), nausea and vomiting during pregnancy, pain from nerve disorders, Parkinson's disease, pancreatitis, peritonitis, poisoning (especially by insecticides), rash, scarlet fever, sciatica (back and leg pain), sedative, short bowel syndrome, sore throat, stomach ulcers, teething, toothache, ulcerative colitis, urinary tract disorders (difficulty passing urine), warts, whooping cough


The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
A traditional dose of belladonna leaf powder is 50 to 100 milligrams taken by mouth, with a maximum single dose of 200 milligrams (0.6 milligrams of total alkaloids, calculated as the ingredient hyoscyamine) and a maximum daily dose of 600 milligrams. A traditional dose of belladonna root is 50 milligrams, with a maximum single dose of 100 milligrams (0.5 milligrams of total alkaloids, calculated as hyoscyamine) and a maximum daily dose of 300 milligrams. A traditional dose of belladonna extract is 10 milligrams, with a maximum single dose of 100 milligrams (0.5 milligrams of total alkaloids, calculated as hyoscyamine) and a maximum daily dose of 150 milligrams. The expert German panel, the Commission E, suggests these doses mainly for the treatment of "gastrointestinal spasm." For tincture of belladonna (composed of 27 to 33 milligrams of belladonna leaf alkaloids in 100 milliliters of alcohol), informal reports suggest either a total dose of 1.5 milligrams daily (divided into 3 doses daily with a double dose at bedtime) or a dose of 0.6 to 1 milliliters (0.18 to 0.3 milligrams of belladonna leaf alkaloids) taken 3 to 4 times daily.
For headache, studies have used the combination product Bellergal® (40 milligrams phenobarbital, 0.6 milligrams ergotamine tartrate, 0.2 milligrams levorotatory alkaloids of belladonna), taken by mouth twice daily.
Homeopathic doses often depend on the symptom being treated and the style of the prescribing provider. Dosing practices may therefore vary widely. Usually, a homeopathic product is diluted several times. For example, belladonna may be diluted by 100 (one teaspoon belladonna added to 99 teaspoons water) in the first round, and this new, dilute mixture may be diluted 30-fold (1 teaspoon of the dilute mixture added to 29 teaspoons water).
A belladonna plaster produced by Cuxson Gerrard (England) containing 0.25% belladonna alkaloids (hyoscine 2%, atropine 1%) has been used topically (applied to the skin) for muscle and bone aches. Long-term use may cause a rash at the site of the plaster.
Children (younger than 18 years)
Informal reports describe a typical dose of 0.03 milliliter for each kilogram of weight, taken by mouth three times daily. Another dose that has been used is 0.8 milliliter for each square meter of body surface area, taken by mouth three times daily (27 to 33 milligrams of belladonna leaf alkaloids in 100 milliliters). The maximum dose is reported as 3.5 milliliters in a day. Safety and effectiveness have not been proven.
Death in children may occur at 0.2 milligram of atropine for each kilogram of a child's weight. Since 2 milligrams of atropine are often found in a fruit, just two fruits may be deadly for a small child.
Homeopathic doses often depend on the symptom being treated and the style of the prescribing provider. Dosing practices may therefore vary widely. Usually, a homeopathic product is diluted several times.

Safety


The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Allergies
Belladonna should be avoided in people who have had significant reactions to belladonna or anticholinergic drugs, or who are allergic to belladonna or other members of the Solanaceae (nightshade) family such as bell peppers, potatoes, and eggplants. Long-term use of belladonna on the skin can lead to allergic rashes.
Side Effects and Warnings
In smaller doses, belladonna is traditionally thought to be safe, but may cause frequent side effects such as dilated pupils, blushing of the skin, dry mouth, rapid heartbeat, confusion, nervousness, and hallucinations. Based on animal study, belladonna alkaloids may inhibit cognitive function and gastrointestinal motility. High doses can cause death.
In children, death can be caused by a small amount of belladonna. Several reports of accidental belladonna overdose and death are reported. Belladonna overdose can also occur when it is applied to the skin. Belladonna overdose is highly dangerous and should be treated by qualified medical professionals. Because belladonna can slow the movement of food and drugs through the stomach and gut, the side effects may go on long after the belladonna is swallowed.
Belladonna may cause redness of the skin, flushing, dry skin, sun sensitivity, hives and allergic rashes, even at dilute concentrations. A very serious, potentially life threatening rash called Stevens-Johnson syndrome, has been reported. Other side effects reported are headache, hyperactivity, nervousness, dizziness, lightheadedness, drowsiness or sedation, unsteady walking, confusion, hallucinations, slurred speech, exaggerated reflexes, convulsions, or coma. The eyes may be dilated or sensitive to light, and vision may be blurry. If pieces of belladonna are put into the eye, the pupils may be dilated permanently. Belladonna may also cause photosensitivity.
Cases report hyperventilation, coma with the loss of breathing, rapid or abnormal heart rate, and severe high blood pressure. Others report dry mouth, abdominal fullness, difficult urination, decreased perspiration, slow release of breast milk while nursing, muscle cramps or spasms, and tremors. Belladonna should be avoided in those with difficulty passing urine, enlarged prostate, or kidney stones, dry mouth, Sjögren syndrome, dry eyes, or glaucoma. Belladonna should be used cautiously with a fever. People with myasthenia gravis (a disorder of nerves and muscles) or Down's syndrome may be especially sensitive to belladonna.
Older adults and children should avoid belladonna, as there are many reports of serious effects in these age groups. Belladonna should not be combined with prescribed anticholinergic agents. People with heart disease, who have had a heart attack, fluid in the lungs, high blood pressure, or abnormal heart rhythms should avoid belladonna. Because belladonna can affect the activity of the stomach and intestines, people who have had ulcers, reflux, hiatal hernia, obstruction of the bowel, poor movement of the intestines, constipation, colitis, or an ileostomy or colostomy after surgery should avoid belladonna.
Pregnancy and Breastfeeding
Belladonna is not recommended in pregnancy and breastfeeding because of the risks of side effects and poisoning. Belladonna is listed under category C according to the U.S. Food and Drug Administration (FDA category C includes drugs for which no thorough studies have been published). In nursing women who use belladonna, belladonna ingredients are found in breast milk, therefore endangering infants.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Belladonna may slow the movement of food and medication through the gut, and therefore some medications may be absorbed more slowly. Many prescribed medications can interact with anticholinergic drugs that have similar effects to belladonna. A qualified healthcare professional, including a pharmacist, should be consulted prior to taking belladonna.
Atropine is an ingredient in belladonna. Theoretically, drugs that interact with atropine may also interact with belladonna. Some antidepressant medications (tricyclic drugs) can interact with belladonna. The effects of the drug cisapride, used to increase the movement of food through the stomach, may be blocked. Medications that can increase heart rate, especially procainamide, can cause an exaggerated increase in heart rate if given with belladonna. The use of alcohol with belladonna can cause extreme slowing of brain function.
Interactions with Herbs and Dietary Supplements
Belladonna may slow the movement of food and medication through the gut, and therefore some supplements may be absorbed more slowly. The use of belladonna with supplements that have anticholinergic activity such ad Jimson weed ( Datura stramonium ) may increase its effects and worsen its side effects.

Methodology
This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Paul Hammerness, MD (Harvard Medical School); Chris Tonelli, MA (Emmanuel College); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration); John Wylie, Jr, MD (Harvard Medical School).

fish oil


Dietary sources of omega-3 fatty acids include fish oil and certain plant/nut oils. Fish oil contains both docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), while some nuts (English walnuts) and vegetable oils (canola, soybean, flaxseed/linseed, olive) contain alpha-linolenic acid (ALA).
There is evidence from multiple studies supporting intake of recommended amounts of DHA and EPA in the form of dietary fish or fish oil supplements lowers triglycerides, reduces the risk of death, heart attack, dangerous abnormal heart rhythms, and strokes in people with known cardiovascular disease, slows the buildup of atherosclerotic plaques ("hardening of the arteries"), and lowers blood pressure slightly. However, high doses may have harmful effects, such as an increased risk of bleeding. Although similar benefits are proposed for alpha-linolenic acid, scientific evidence is less compelling, and beneficial effects may be less pronounced.
Some species of fish carry a higher risk of environmental contamination, such as with methylmercury


-linolenic acid (ALA, C18:3n-3), alpha-linolenic acid, cod liver oil, coldwater fish, docosahexaenoic acid (DHA, C22:6n-3), eicosapentaenoic acid (EPA, C20:5n-3), fish oil fatty acids, fish body oil, fish extract, fish liver oil, halibut oil, long chain polyunsaturated fatty acids, mackerel oil, marine oil, menhaden oil, n-3 fatty acids, n-3 polyunsaturated fatty acids, omega fatty acids, omega-3 oils, polyunsaturated fatty acids (PUFA), salmon oil, shark liver oil, w-3 fatty acids.
Note: Should not be confused with omega-6 fatty acids




High blood pressure
Multiple human trials report small reductions in blood pressure with intake of omega-3 fatty acid. DHA may have greater benefits than EPA. However, high intakes of omega-3 fatty acids per day may be necessary to obtain clinically relevant effects, and at this dose level, there is an increased risk of bleeding. Therefore, a qualified healthcare provider should be consulted prior to starting treatment with supplements.
A
Hypertriglyceridemia (fish oil / EPA plus DHA)
There is strong scientific evidence from human trials that omega-3 fatty acids from fish or fish oil supplements (EPA + DHA) significantly reduce blood triglyceride levels. Benefits appear to be dose-dependent. Fish oil supplements also appear to cause small improvements in high-density lipoprotein ("good cholesterol"); however, increases (worsening) in low-density lipoprotein levels (LDL/"bad cholesterol") are also observed.It is not clear if alpha-linolenic acid significantly affects triglyceride levels, and there is conflicting evidence in this area.The American Heart Association has published recommendations for EPA + DHA. Because of the risk of bleeding from omega-3 fatty acids, a qualified healthcare provider should be consulted prior to starting treatment with supplements.There is growing evidence that reducing C-Reactive Protein (CRP) is beneficial towards favorable cardiovascular outcomes, although additional research is pending in this area. The data on fish oils and CRP levels is mixed.
A
Secondary cardiovascular disease prevention (fish oil / EPA plus DHA)
Several well-conducted randomized controlled trials report that in people with a history of heart attack, regular consumption of oily fish or fish oil/omega-3 supplements reduces the risk of non-fatal heart attack, fatal heart attack, sudden death, and all-cause mortality (death due to any cause). Most patients in these studies were also using conventional heart drugs, suggesting that the benefits of fish oils may add to the effects of other therapies.
A
Primary cardiovascular disease prevention (fish intake)
Several large studies of populations ("epidemiologic" studies) report a significantly lower rate of death from heart disease in men and women who regularly eat fish. Other epidemiologic research reports no such benefits. It is not clear if reported benefits only occur in certain groups of people, such as those at risk of developing heart disease. Overall, the evidence suggests benefits of regular consumption of fish oil. However, well-designed randomized controlled trials which classify people by their risk of developing heart disease are necessary before a firm conclusion can be drawn.
B
Protection from cyclosporine toxicity in organ transplant patients
There are multiple studies of heart transplant and kidney transplant patients taking cyclosporine (Neoral®), who were administered fish oil supplements. The majority of trials report improvements in kidney function, and less high blood pressure compared to patients not taking fish oil. Although several recent studies report no benefits on kidney function, the weight of scientific evidence favors the beneficial effects of fish oil.
B
Rheumatoid arthritis (fish oil)
Multiple randomized controlled trials report improvements in morning stiffness and joint tenderness with the regular intake of fish oil supplements for up to three months. Benefits have been reported as additive with anti-inflammatory medications such as NSAIDs (like ibuprofen or aspirin). However, because of weaknesses in study designs and reporting, better research is necessary before a strong favorable recommendation can be made. Effects beyond three months of treatment have not been well evaluated.
B
Angina pectoris
Preliminary studies report reductions in angina associated with fish oil intake. Better research is necessary before a firm conclusion can be drawn.
C
Asthma
Several studies in this area do not provide enough reliable evidence to form a clear conclusion, with some studies reporting no effects, and others finding benefits. Because most studies have been small without clear descriptions of design or results, the results cannot be considered conclusive.
C
Atherosclerosis
Some research reports that regular intake of fish or fish oil supplements reduces the risk of developing atherosclerotic plaques in the arteries of the heart, while other research reports no effects. Additional evidence is necessary before a firm conclusion can be drawn in this area.
C
Bipolar disorder
Several studies in this area do not provide enough reliable evidence to form a clear conclusion.
C
Cancer prevention
Several population (epidemiologic) studies report that dietary omega-3 fatty acids or fish oil may reduce the risk of developing breast, colon, or prostate cancer. Randomized controlled trials are necessary before a clear conclusion can be drawn.
C
Cardiac arrhythmias (abnormal heart rhythms)
There is promising evidence that omega-3 fatty acids may decrease the risk of cardiac arrhythmias. This is one proposed mechanism behind the reduced number of heart attacks in people who regularly ingest fish oil or EPA + DHA. Additional research is needed in this area specifically before a firm conclusion can be reached.
C
Colon cancer
Omega-3 fatty acids are commonly taken by cancer patients. Although preliminary studies report that growth of colon cancer cells may be reduced by taking fish oil, effects on survival or remission have not been measured adequately.
C
Crohn's disease
It has been suggested that effects of omega-3 fatty acids on inflammation may be beneficial in patients with Crohn's disease when added to standard therapy, and several studies have been conducted in this area. Results are conflicting, and no clear conclusion can be drawn at this time.
C
Cystic fibrosis
A small amount of research in this area does not provide enough reliable evidence to form a clear conclusion.
C
Dementia
Well-designed clinical trials are needed before omega-3 fatty acids can be recommended for the prevention of cognitive impairment or dementia.
C
Depression
Several studies on the use of omega 3 fatty acids in depression, including positive results in postpartum depression, do not provide enough reliable evidence to form a clear conclusion or replace standard treatments. However, based on one recent study, omega-3 fatty acids may have therapeutic benefits in childhood depression. Promising initial evidence requires confirmation with larger, well-designed trials.
C
Dysmenorrhea (painful menstruation)
There is preliminary evidence suggesting possible benefits of fish oil/omega-3 fatty acids in patients with dysmenorrhea. Additional research is necessary before a firm conclusion can be reached.
C
Eczema
Several studies of EPA for eczema do not provide enough reliable evidence to form a clear conclusion.
C
IgA nephropathy
There are conflicting results from several trials in this area.
C
Infant eye / brain development
Well-designed research is necessary before a clear conclusion can be reached.
C
Lupus erythematosus
There is not enough reliable evidence to form a clear conclusion in this area.
C
Nephrotic syndrome
There is not enough reliable evidence to form a clear conclusion in this area.
C
Preeclampsia
Several studies of fish oil do not provide enough reliable evidence to form a clear conclusion in this area.
C
Prevention of graft failure after heart bypass surgery
There is limited study of the use of fish oils in patients after undergoing coronary artery bypass grafting (CABG). Additional evidence is necessary before a firm conclusion can be drawn in this area.
C
Prevention of restenosis after coronary angioplasty (PTCA)
Several randomized controlled trials have evaluated whether omega-3 fatty acid intake reduces blockage of arteries in the heart following balloon angioplasty (percutaneous transluminal coronary angioplasty/PTCA). The evidence in this area remains inconclusive.
C
Primary cardiovascular disease prevention (α-linolenic acid [ALA])
Additional research is necessary before a conclusion can be drawn in this area.
C
Psoriasis
Several studies in this area do not provide enough reliable evidence to form a clear conclusion.
C
Schizophrenia
There is promising preliminary evidence from several randomized controlled trials in this area. Additional research is necessary before a firm conclusion can be reached.
C
Secondary cardiovascular disease prevention (α-linolenic acid [ALA])
Several randomized controlled trials have examined the effects of alpha-linolenic acid in people with a history of heart attack. Although some studies suggest benefits, others do not. Additional research is necessary before a conclusion can be drawn in this area.
C
Stroke prevention
Several large studies of populations ("epidemiologic" studies) have examined the effects of omega-3 fatty acid intake on stroke risk. Some studies suggest benefits, while others do not. Effects are likely on ischemic or thrombotic stroke risk, and very large intakes of omega-3 fatty acids ("Eskimo" amounts) may actually increase the risk of hemorrhagic (bleeding) stroke. At this time, it is unclear if there are benefits in people with or without a history of stroke, or if effects of fish oil are comparable to other treatment strategies.
C
Ulcerative colitis
It has been suggested that effects of omega-3 fatty acids on inflammation may be beneficial in patients with ulcerative colitis when added to standard therapy, and several studies have been conducted in this area. Better research is necessary before a clear conclusion can be drawn.
C
Appetite / weight loss in cancer patients
There is preliminary evidence that fish oil supplementation does not improve appetite or prevent weight loss in cancer patients. Further study is warranted.
D
Diabetes
The available scientific evidence suggests that there are no significant long-term effects of fish oil in patients with diabetes. Most studies in this area are not well designed.
D
Hypercholesterolemia
Although fish oil is able to reduce triglycerides, beneficial effects on blood cholesterol levels have not been demonstrated. Fish oil supplements appear to cause small improvements in high-density lipoprotein ("good cholesterol"); however, increases (worsening) in low-density lipoprotein levels ("bad cholesterol") are also observed. Fish oil does not appear to affect C-reactive protein (CRP) levels.
D
Transplant rejection prevention (kidney and heart)
There are multiple studies of heart transplant and kidney transplant patients taking cyclosporine (Neoral®), who were administered fish oil supplements. The majority of trials report improvements in kidney function (glomerular filtration rate, serum creatinine), and less hypertension (high blood pressure) compared to patients not taking fish oil. However, several recent studies report no benefits on kidney function, and no changes have been found in rates of rejection or graft survival.
D
*Key to grades A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use; F: Strong scientific evidence against this use.


Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Acute myocardial infarction (heart attack), acute respiratory distress syndrome (ARDS), age related macular degeneration, aggressive behavior, agoraphobia, AIDS, allergies, Alzheimer's disease, anticoagulation, antiphospholipid syndrome, attention deficit hyperactivity disorder (ADHD), anthracycline-induced cardiac toxicity, bacterial infections, breast cysts, breast tenderness, chronic fatigue syndrome (postviral fatigue syndrome), chronic obstructive pulmonary disease, cirrhosis, common cold, congestive heart failure, critical illness, deficiency (omega-3 fatty acid), dermatomyositis, diabetic nephropathy, diabetic neuropathy, dyslexia, dyspraxia, endocrine disorders (glycogen storage diseases), exercise performance enhancement, fibromyalgia, gallstones, gingivitis, glaucoma, glomerulonephritis, gout, hay fever, headache, hepatorenal syndrome, hypoxia, ichthyosis (skin disorder), immunosuppression, inflammatory conditions (Behcet's syndrome), joint problems (cartilage repair), kidney disease prevention, kidney stones, leprosy, leukemia, malaria, male infertility, mastalgia (breast pain), memory enhancement, menopausal symptoms, menstrual cramps, methotrexate toxicity, multiple sclerosis, myopathy, nephritis (autoimmune), neuropathy, night vision enhancement, obesity, osteoarthritis, osteoporosis, otitis media (ear infection), panic disorder, peripheral vascular disease, pregnancy nutritional supplement, premature birth prevention, premenstrual syndrome, prostate cancer prevention, protection from isotretinoin drug toxicity, psychological disorders (borderline personality disorder), Raynaud's phenomenon, Refsum's syndrome, retinitis pigmentosa, Reye's syndrome, seizure disorder, Sjogren's syndrome, suicide prevention, systemic lupus erythematosus, tardive dyskinesia, tennis elbow, ulcerative colitis, urolithiasis (bladder stones), vision enhancement, weight loss.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older):
Average dietary intake of omega-3/omega-6 fatty acids: Average Americans consume approximately 1.6 grams of omega-3 fatty acids each day, of which about 1.4 grams (~90%) comes from α-linolenic acid, and only 0.1-0.2 grams (~10%) from EPA and DHA. In Western diets, people consume roughly 10 times more omega-6 fatty acids than omega-3 fatty acids. These large amounts of omega-6 fatty acids come from the common use of vegetable oils containing linoleic acid (for example: corn oil, evening primrose oil, pumpkin oil, safflower oil, sesame oil, soybean oil, sunflower oil, walnut oil, wheatgerm oil). Because omega-6 and omega-3 fatty acids compete with each other to be converted to active metabolites in the body, benefits can be reached either by decreasing intake of omega-6 fatty acids, or by increasing omega-3 fatty acids.
Recommended daily intake of omega-3 fatty acids (healthy adults): For healthy adults with no history of heart disease, the American Heart Association recommends eating fish at least two times per week. In particular, fatty fish are recommended, such as anchovies, bluefish, carp, catfish, halibut, herring, lake trout, mackerel, pompano, salmon, striped sea bass, tuna (albacore), and whitefish. It is also recommended to consume plant-derived sources of α-linolenic acid, such as tofu/soybeans, walnuts, flaxseed oil, and canola oil. The World Health Organization and governmental health agencies of several countries recommend consuming 0.3-0.5 grams of daily EPA + DHA and 0.8-1.1 grams of daily α-linolenic acid. A doctor and pharmacist should be consulted for dosing for other conditions.
Children (younger than 18 years):
Omega-3 fatty acids are used in some infant formulas, although effective doses are not clearly established. Ingestion of fresh fish should be limited in young children due to the presence of potentially harmful environmental contaminants. Fish oil capsules should not be used in children except under the direction of a physician.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Allergies
People with allergy or hypersensitivity to fish should avoid fish oil or omega-3 fatty acid products derived from fish. Skin rash has been reported rarely. People with allergy or hypersensitivity to nuts should avoid alpha linolenic acid or omega-3 fatty acid products that are derived from the types of nuts to which they react.
Side Effects and Warnings
The U.S. Food and Drug Administration classifies low intake of omega-3 fatty acids from fish as GRAS (Generally Regarded as Safe). Caution may be warranted, however, in diabetic patients due to potential (albeit unlikely) increases in blood sugar levels, patients at risk of bleeding, or in those with high levels of low-density lipoprotein (LDL). Fish meat may contain methylmercury and caution is warranted in young children and pregnant/breastfeeding women.
Omega-3 fatty acids may increase the risk of bleeding, although there is little evidence of significant bleeding risk at lower doses. Very large intakes of fish oil/omega-3 fatty acids ("Eskimo" amounts) may increase the risk of hemorrhagic (bleeding) stroke. High doses have also been associated with nosebleed and blood in the urine. Fish oils appear to decrease platelet aggregation and prolong bleeding time, increase fibrinolysis (breaking down of blood clots), and may reduce von Willebrand factor.
Potentially harmful contaminants such as dioxins, methylmercury, and polychlorinated biphenyls (PCBs) are found in some species of fish. Methylmercury accumulates in fish meat more than in fish oil, and fish oil supplements appear to contain almost no mercury. Therefore, safety concerns apply to eating fish but likely not to ingesting fish oil supplements. Heavy metals are most harmful in young children and pregnant/nursing women.
Gastrointestinal upset is common with the use of fish oil supplements. Diarrhea may also occur, with potentially severe diarrhea at very high doses. There are also reports of increased burping, acid reflux/heartburn/indigestion, abdominal bloating, and abdominal pain. Fishy aftertaste is a common effect. Gastrointestinal side effects can be minimized if fish oils are taken with meals and if doses are started low and gradually increased.
Multiple human trials report small reductions in blood pressure with intake of omega-3 fatty acids. Reductions of 2-5 mmHg have been observed, and effects appear to be dose-responsive (higher doses have greater effects). DHA may have greater effects than EPA. Caution is warranted in patients with low blood pressure or in those taking blood-pressure lowering medications.
Although slight increases in fasting blood glucose levels have been noted in patients with type 2 ("adult onset") diabetes, the available scientific evidence suggests that there are no significant long-term effects of fish oil in patients with diabetes, including no changes in hemoglobin A1c levels. Limited reports in the 1980s of increased insulin needs in diabetic patients taking long-term fish oils may be related to other dietary changes or weight gain.
Fish oil taken for many months may cause a deficiency of vitamin E, and therefore vitamin E is added to many commercial fish oil products. As a result, regular use of vitamin E-enriched products may lead to elevated levels of this fat-soluble vitamin. Fish liver oil contains the fat-soluble vitamins A and D, and therefore fish liver oil products (such as cod liver oil) may increase the risk of vitamin A or D toxicity.
Increases (worsening) in low-density lipoprotein levels ("bad cholesterol") by 5-10% are observed with intake of omega-3 fatty acids. Effects are dose-dependent.
Mild elevations in liver function tests (alanine aminotransferase) have been reported rarely.
Skin rashes have been reported rarely.
There are rare reports of mania in patients with bipolar disorder or major depression. Restlessness and formication (the sensation of ants crawling on the skin) have also been reported.
Pregnancy and Breastfeeding
Potentially harmful contaminants such as dioxins, methylmercury, and polychlorinated biphenyls (PCBs) are found in some species of fish, and may be harmful in pregnant/nursing women. Methylmercury accumulates in fish meat more than in fish oil, and fish oil supplements appear to contain almost no mercury. Therefore, these safety concerns apply to eating fish but likely not to ingesting fish oil supplements. However, unrefined fish oil preparations may contain pesticides.
It is not known if omega-3 fatty acid supplementation of women during pregnancy or breastfeeding is beneficial to infants. It has been suggested that high intake of omega-3 fatty acids during pregnancy, particularly DHA, may increase birth weight and gestational length (254). However, higher doses may not be advisable due to the potential risk of bleeding. Fatty acids are added to some infant formulas.

Interactions


Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
In theory, omega-3 fatty acids may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Based on human studies, omega-3 fatty acids may lower blood pressure and add to the effects of drugs that may also affect blood pressure.
Fish oil supplements may lower blood sugar levels a small amount. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.
Omega-3 fatty acids lower triglyceride levels, but can actually increase (worsen) low-density lipoprotein (LDL/"bad cholesterol") levels by a small amount. Therefore, omega-3 fatty acids may add to the triglyceride-lowering effects of agents like niacin/nicotinic acid, fibrates such as gemfibrozil (Lopid®), or resins such as cholestyramine (Questran®). However, omega-3 fatty acids may work against the LDL-lowering properties of "statin" drugs like atorvastatin (Lipitor®) and lovastatin (Mevacor®).
Interactions with Herbs and Dietary Supplements
In theory, omega-3 fatty acids may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba , and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Based on human studies, omega-3 fatty acids may lower blood pressure, and theoretically may add to the effects of agents that may also affect blood pressure.
Fish oil supplements may lower blood sugar levels a small amount. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Omega-3 fatty acids lower triglyceride levels, but can actually increase (worsen) low-density lipoprotein (LDL/"bad cholesterol") levels by a small amount. Therefore, omega-3 fatty acids may add to the triglyceride-lowering effects of agents like niacin/nicotinic acid, but may work against the potential LDL-lowering properties of agents like barley, garlic, guggul, psyllium, soy, or sweet almond.
Fish oil taken for many months may cause a deficiency of vitamin E, and therefore vitamin E is added to many commercial fish oil products. As a result, regular use of vitamin E-enriched products may lead to elevated levels of this fat-soluble vitamin. Fish liver oil contains the fat-soluble vitamins A and D, and therefore fish liver oil products (such as cod liver oil) may increase the risk of vitamin A or D toxicity. Since fat-soluble vitamins can build up in the body and cause toxicity, patients taking multiple vitamins regularly or in high doses should discuss this risk with their healthcare practitioners.

Methodology

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Serguei Axentsev, MD, PhD, D.Sci. (Natural Standard Research Collaboration); Rawan Barakat, PharmD (Massachusetts College of Pharmacy); Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Steve Bent, MD (University of California San Francisco); Cynthia Dacey, PharmD (Natural Standard Research Collaboration); Cathi Dennehey, PharmD (University of California San Francisco); Paul Hammerness, MD (Harvard Medical School); Paul Knaus, PharmD (Northeastern University); Mojisola Sekoni, PharmD (Massachusetts College of Pharmacy); Elizabeth Sheehan, PharmD (Northeastern University); Michael Smith, MScPharm, ND (Canadian College of Naturopathic Medicine); Philippe Szapary, MD (University of Pennsylvania); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration).

zinic


Zinc formulations have been used since Ancient Egyptian times to enhance wound healing, although the usefulness of this approach is only partially confirmed by clinical data of today.
Zinc is necessary for the functioning of over 300 different enzymes and plays a vital role in an enormous number of biological processes. Zinc is a cofactor for the antioxidant enzyme superoxide dismutase (SOD) and is in a number of enzymatic reactions involved in carbohydrate and protein metabolism.
Its immunologic activities include regulation of T lymphocytes, CD4, natural killer cells, and interleukin II. In addition, zinc has been claimed to possess antiviral activity. It has been shown to play a role in wound healing, especially following burns or surgical incisions. Zinc is necessary for the maturation of sperm and normal fetal development. It is involved in sensory perception (taste, smell, and vision) and controls the release of stored vitamin A from the liver. Within the endocrine system, zinc has been shown to regulate insulin activity and promote the conversion thyroid hormones thyroxine to triiodothyronine.
Based on available scientific evidence, zinc may be efficacious in the treatment of (childhood) malnutrition, acne vulgaris, peptic ulcers, leg ulcers, infertility, Wilson's disease, herpes, and taste or smell disorders. Zinc has also gained popularity for its use in prevention of the common cold.
The role for zinc is controversial in some cases, as the results of published studies provide either contradictory information, and/or the methodological quality of the studies do not allow for a confident conclusion regarding the role of zinc in those diseases.


Atomic number 30, Indian tin, pewter, zinc acetate, zinc acexamate, zinc aspartate, zinc carbonate, zinc citrate, zinc chloride, zinc gluconate, zinc methionate, zinc methionine, zinc monomethioine, zinc oxide, zinc picolinate, zinc sulfate, Zink, ZN, Zn.
Brands used in clinical trials: A-84, Acexamate, Articulin-F, Astra, Herpigon, Nels Cream, Orazinc®, Solvezink, Virudermin Gel®, Zeta N, Zicam Nasal Gel, Zincolak, Zincomed, Zineryt, Zinvit-C250.




Diarrhea (children)
Multiple studies of children in developing countries found that zinc supplementation in malnourished children with acute diarrhea may reduce the severity and duration of diarrhea, especially in children with low zinc levels.
A
Gastric ulcers
The healing process of gastric ulcers may be enhanced through treatment with zinc, although further studies will be needed to determine to which extent zinc may be beneficial for patients with this condition. Most studies report no or few adverse effects associated with its use.
A
Sickle cell anemia (management)
There is strong scientific evidence to suggest that zinc may help manage or reduce symptoms of sickle cell anemia. Most of these studies reported increased height, weight, immune system function and testosterone levels, and decreased numbers of crises and sickled cells following zinc treatment.
A
Acne vulgaris
Based on high quality studies, topical or systemic use of zinc seems to be a safe and effective treatment for acne vulgaris; however some studies report no or negative effects of zinc. Additionally, many studies used combination treatments.Several studies identify a positive correlation between serum zinc levels and severity of acne, however others did not, and it remains to be determined to which degree internal zinc levels may correlate with the severity of acne.
B
Attention-deficit hyperactivity disorder (ADHD)
One study has shown a correlation between low serum free fatty acids and zinc serum levels in children with attention deficit hyperactivity disorder. Two other studies found that zinc supplements reduced hyperactive, impulsive and impaired socialization symptoms, but did not reduce attention deficiency symptoms. Zinc supplementation may be a more effective treatment for older children with higher body mass index (BMI) scores.
B
Down's syndrome
In several studies, zinc supplements seemed to counteract hypothyroidism and slightly reduce the number of infections in children with Down's syndrome. However, zinc did not seem to improve depressed immune systems. Additional human research is needed before a firm conclusion can be made.
B
Fungal infections (scalp)
Evidence from two human trials suggests that zinc pyrithione shampoo may be an effective treatment for tinea versicolor fungal infections of the scalp. No side effects were noted. Additional research is needed before a strong recommendation can be made.
B
Herpes simplex virus
Lesser quality studies have been conducted to assess the effects of zinc (topical or taken by mouth) on herpes type I or II. Several of these studies used combination treatments or permitted the continued use of other medications, so the exact role of zinc in those studies is unclear. However, the positive results obtained in most trials suggest that zinc may represent a safe and effective alternative treatment for herpes type I and II, and should encourage further research into the topic using well-designed studies.
B
High cholesterol
Zinc may improve serum cholesterol levels in hemodialysis patients. There is some evidence that zinc may improve cholesterol ratio of HDL "good cholesterol" versus LDL "bad cholesterol" which would be considered a positive effect. Well-designed clinical trials are needed before a recommendation can be made.
B
Immune function
Zinc appears to be an essential trace element for the immune system, but research on the effect of zinc supplementation on immune function is scant and mostly focuses on patients with specific diseases. Zinc gluconate appears to exert beneficial effects on immune cells, improving CD3 and CD4 counts and increasing CD4/CD8 ratios in children. There are relatively few studies that examine zinc levels and the effects of zinc supplementation on the health of the elderly population. Further research is needed before a recommendation can be made.
B
Plaque/gingivitis
A few studies have reported significant reduction in plaque accumulation following treatment with zinc rinses and dentifrices. Preliminary research suggests that zinc citrate dentifrice may reduce the severity and occurrence of supragingival calculus formation. However, more well-designed studies are needed to confirm such benefits. More research might help to determine zinc's potential efficacy in other dental applications.
B
Wilson's disease
Wilson's disease is an inherited disorder of copper metabolism characterized by a failure of the liver to excrete copper, leading to its accumulation in the liver, brain, cornea, and kidney, with resulting chronic degenerative changes. Preliminary research suggests that zinc treatment may be effective in maintenance of Wilson's disease. Relatively few cases of adverse effects have been reported, including one case report presenting a fatality, however, it is unclear whether or not the death was caused by zinc. Several studies have been conducted by the same authors, resulting in possible bias. More well-designed trials are needed to confirm these early results.
B
Alopecia (hair loss)
A few studies that examined the efficacy of zinc in treating alopecia report contradictory results. Additional information is needed before a conclusion can be made.
C
Anorexia
Reports of zinc's effectiveness in treating symptoms of anorexia nervosa, observed in young adults are based on small, non-randomized studies, but all agree on the beneficial effects of zinc. Well-designed trials with a larger number of participants are needed to confirm these results.
C
Bad breath
Chewing gum containing zinc seemed to reduce bad breath (halitosis) in preliminary study.
C
Beta-thalassemia (hereditary disorder)
One small study notes that children with beta-thalassemia who took oral zinc supplements for one to seven years increased in height more than those who did not take zinc. Additional information is needed to confirm these findings.
C
Boils
In one study, patients with recurrent boils (furunculosis) treated with zinc found their furuncles did not reappear. Well-designed clinical trials are needed to confirm this potential benefit.
C
Burns
Study results of zinc sulfate supplements given to burn victims to increase healing rate yield mixed results. Further research is needed before a recommendation can be made.
C
Chronic prostatitis (CP)
One study suggests that zinc supplements taken with antibiotics may be more effective than antibiotics alone in reducing pain, urinary symptoms, quality of life and maximum urethra closure pressure for patients with chronic prostatitis. Further research is needed to confirm these results.
C
Closed head injuries
One poorly designed study indicates that zinc supplementation may enhance neurological recovery in patients with closed head injuries. Further research is needed to confirm these results.
C
Cognitive deficits (children)
One study indicates that daily supplementation with zinc may be of limited usefulness for improving cognition in lead-exposed schoolchildren. Further study may be warranted in this area.
C
Common cold
There are contradictory results regarding the efficacy of zinc formulations in treating duration and severity of common cold symptoms. Although zinc might be beneficial in the treatment of cold symptoms, more studies are needed to clarify which zinc formulations may be most effective, which rhinoviruses are affected by zinc, and if nasal sprays provide a useful alternative application route for zinc treatment. A recent study found no significant differences between zinc nasal spray and placebo.Negative results may be the cause of too using doses of zinc that are too low or the presence of compounds like citric or tartaric acid, which may reduce efficacy due to chelating of the zinc ion.
C
Crohn's disease
Preliminary research of zinc supplements in patients with Crohn's disease has yielded positive results. Well-designed clinical trials are needed to confirm these results.
C
Dandruff
Shampoo containing 1% of zinc pyrithione has been shown to reduce dandruff in some people.
C
Diabetes (type 1 and type 2)
Diabetic patients typically have significantly lower serum zinc levels compared with healthy controls. Based on one randomized, controlled trial, zinc supplementation for type-2 diabetics may have beneficial effects in elevating their serum zinc level, and in improving their glycemic control that is shown by decreasing their HbA1c% concentration. Further study is needed before a recommendation can be made.
C
Diabetic neuropathy (nerve damage)
Oral zinc supplementation may improve glycemic control and severity of peripheral neuropathy. Further research is needed before a recommendation can be made.
C
Diaper rash
Zinc may reduce the incidence of diaper rash and have a preventative effect.
C
Eczema
There is conflicting data regarding the correlation of zinc serum levels and eczema. One study noted zinc might have caused an increase in itching after several weeks of supplementation. Additional information is needed to help clarify these results.
C
Exercise performance
Zinc may improve exercise performance in athletes with low serum zinc or zinc deficiencies. Additional evidence is needed before a recommendation can be made.
C
Gilbert's syndrome
Gilbert's syndrome is a common, often inherited disorder that affects processing by the liver of the greenish-brown pigments in bile (called bilirubin). The resulting abnormal increase of bilirubin in the bloodstream can lead to yellowing of the skin (jaundice) but the liver itself remains normal. It is more common in men than women and is named after a French gastroenterologist. Zinc sulfate supplementation seemed to decrease serum unconjugated bilirubin levels in a small study. Well-designed clinical trials are needed to confirm these results.
C
Hepatic encephalopathy
Hepatic encephalopathy is abnormal brain function caused by passage of toxic substances from the liver to the blood. Three small randomized, double-blind trials of zinc for this indication have yielded conflicting results.
C
Hepatitis C viral infection (chronic)
Two studies have shown that zinc in combination with interferon or interferon and ribavirin for hepatitis C viral infection patients did not show significant benefits, except for lower incidence of gastrointestinal side effects in one study. Further study may be warranted in this area.
C
HIV/AIDS
Patients with HIV/AIDS, especially in those with low zinc levels, may benefit from zinc supplementation. Some low quality studies cite reduction in infections, enhanced weight gain and immune system function, including increased CD4 and CD8 cells. However, other low quality studies conflict with these findings. Further research is needed before a conclusion can be drawn.
C
Incision wounds
Although zinc is frequently cited as having beneficial effects on incision wound healing, few studies have investigated this use. Further research is needed before a recommendation can be made.
C
Infertility
Many studies report beneficial results of zinc supplements on infertility, as expressed in improved sperm quality and number, although this effect may depend on the cause of infertility. A minor increase in abnormal spermatozoa in subfertile males taking zinc was noted in one study. Additional information is needed before a firm conclusion can be drawn.
C
Kidney function
Preliminary study shows a potential improvement in uremic patients taking zinc supplements. Further research is needed to confirm these results. Zinc supplementation may be recommended only in the patients with proven zinc deficiency, but for all chronic renal failure patients it is questionable.
C
Kwashiorkor (malnutrition from inadequate protein intake)
Short-term zinc supplementation may increase weight gain and decrease infections, swelling, diarrhea, anorexia and skin ulcers in children with extreme malnourishment.
C
Leg ulcers
There are conflicting findings regarding the potential benefit of zinc for healing leg ulcers. All studies, however, reported no or few adverse effects.
C
Leprosy
A few studies have examined the efficacy of zinc treatment in leprosy. Studies of zinc taken by mouth report positive results, while one study of topical zinc reports negative results. Further research is needed before a conclusion can be drawn.
C
Liver cirrhosis
People with alcoholic liver cirrhosis may be deficient in zinc. Preliminary studies suggest that zinc may benefit these patients. Further evidence is needed to confirm these findings.
C
Lower respiratory infections in children
Results from large clinical trials suggest that supplementation with zinc may reduce the incidence of lower respiratory infections. Some studies suggest these effects to be only apparent in boys, and not girls. A trend toward increased respiratory infections in children has been noted in one study. A recent study does not support the use of zinc supplementation in the management of acute lower respiratory infections requiring hospitalization in indigenous children living in remote areas. Due to conflicting results, further research is needed before a conclusion can be drawn. Future studies could examine whether these adult populations have a similar response.
C
Macular degeneration
Most studies examining the relationship between dietary zinc intake over many years and macular degeneration have not reported positive correlations. However, one large well-designed, randomized study, which examined the efficacy of zinc supplements in preventing loss of visual acuity, found zinc supplements to be beneficial in preventing the occurrence of age related macular degeneration. Since study results are conflicting, additional well-designed clinical trials are needed before a recommendation can be made.
C
Malaria
Results are contradictory for the effect of zinc on malaria symptoms. Some randomized, double-blind clinical trials suggest no effect of zinc supplementation on the severity of malaria. Other studies suggest that zinc supplementation may reduce the number of stays in hospital and death rate due to P. falciparum infection. Further well-designed, randomized and controlled trials are required to address these discrepancies.
C
Muscle cramps (cirrhosis)
The results of one case series suggest that zinc supplementation may improve muscle cramps in patients with cirrhosis. Further research is needed to confirm these results.
C
Parasites
In a few studies of varying quality, patients with cutaneous leishmaniasis were injected with zinc sulfate intralesionally. One study found zinc sulfate was better than meglumine antimoniate for the first four weeks, but no statistical differences were observed after six weeks. Zinc may decrease the severity of infection and re-infection of S. mansoni , but does not seem to prevent initial infection. More research should be done in this area to examine how zinc affects the S. mansoni life cycle and whether this data can be extrapolated to other species of Schistosoma .The effects of zinc on the rate of parasitic re-infestation have been examined in children. No significant effect of zinc treatment was found. Due to conflicting results in this area, more research is needed before zinc can be recommended for the treatment of parasites.
C
Poisoning (arsenic)
Results from one study show that a combination of spirulina extract plus zinc may be useful for the treatment of chronic arsenic poisoning with melanosis and keratosis. More research is needed to confirm the effects of zinc alone.
C
Pregnancy
According to one review, there is no evidence to suggest that zinc supplementation offers benefits during pregnancy, although there is a possible reduction in labor complications and pre-term deliveries. However, results from individual studies suggest a possible benefit of zinc supplementation on blood pressure during pregnancy. Further research is needed before a conclusion can be drawn.
C
Psoriasis
There are only a few studies that examine the efficacy of zinc treatment on symptoms of psoriasis, including psoriasis induced arthritis-like symptoms. One trial noted a reduction in pain and joint swelling. Other studies do not support a role for zinc in alleviating the symptoms of psoriasis. Further, well-designed clinical trials are required to clarify these results.
C
Radiation-induced mucositis
Radiation has the potential side effect of mucositis, which is inflammation of mucous membranes inside of the mouth, nose and throat. Two trials suggest that zinc may lower the degree of mucositis in patients on radiation. Further research is needed to confirm these results.
C
Rheumatoid arthritis
The majority of trials do not show significant improvements in arthritis symptoms following zinc treatment. Interpretation of some data is difficult by because patients in the studies were permitted to continue their previous arthritis medication and most studies used a small number of participants. Well-designed clinical trials are needed before a decision can be made.
C
Skin damage caused by incontinence
Preliminary evidence suggests that topical zinc oxide oil may help manage perianal and buttock skin damage in incontinent patients. Further research is needed to confirm these results.
C
Stomatitis
Zinc sulfate has been studied for the treatment of recurrent aphthous stomatitis (RAS). Study results conflict and no clear conclusion can be drawn at this time.
C
Taste perception (hemodialysis, cancer)
Results from studies investigating the potential role of zinc in treating taste and smell disorders are contradictory. Well-designed research is needed to determine if zinc contributes to the treatment of taste and smell disorders.
C
Tinnitus
Studies on the efficacy of zinc in treating tinnitus yield contradictory results based on subjective findings. Further research is necessary before a conclusion can be drawn.
C
Trichomoniasis
Little research is available on the efficacy of zinc for the treatment of trichomoniasis, a sexually transmitted disease (STD). One very small study suggests that a zinc sulfate douche and the prescription antibiotic metronidazole may effectively treat patients with recalcitrant trichomoniasis. However, more well-designed human studies are necessary before a firm conclusion can be drawn.
C
Viral warts
One study suggests that zinc sulfate may be an efficacious therapy option for recalcitrant viral warts. Well-conducted studies are needed to confirm these early results.
C
Celiac disease
In a very small study, oral zinc supplements did not seem to improve the clinical condition of patients with unresponsive celiac syndrome.
D
Chronic inflammatory rheumatic disease
In a small study, zinc supplementation did not seem to have a beneficial effect on symptoms of patients with chronic inflammatory rheumatic disease.
D
Continuous ambulatory peritoneal dialysis (CAPD)
Zinc supplementation did not improve the nutritional status in patients on CAPD based on one well-designed trial.
D
Cystic fibrosis
Zinc supplementation does not seem to affect clinical status, growth velocity or lung function in children with cystic fibrosis.
D
Inflammatory bowel disease
One small study found that zinc supplementation does not seem to improve inflammatory bowel disease.
D
Pneumonia (children)
One study found that zinc supplementation does not seem to lessen the duration of tachypnea, hypoxia, chest indrawing, inability to feed, lethargy, severe illness, or hospitalization in children.

Sexual Abuse Treatment Program

The Department of Health Children’s Medical Services Sexual Abuse Treatment Program (SATP) provides a statewide comprehensive, community-based, family-centered treatment system for assisting families who have experienced sexual abuse. A combination of group, family and individual counseling for child sexual abuse survivors and their families is provided to reduce the trauma caused by the child sexual victimization, assist the family to recover from the victimization, prevent further child sexual victimization from occurring and enable families to have healthy, non-abusive relationships.

Child sexual abuse includes the victimization of a child by sexual activities, including molestation, indecent exposure, fondling, rape and incest. For the purposes of the Sexual Abuse Treatment Program, primary victims will always be the children who have directly suffered the abuse. Secondary victims are minor children, usually siblings, receiving treatment as a result of his/her own reaction/exposure to the abuse directed against a primary victim.
A child who is sexually abusedand whose abuse has generated a Florida Abuse Hotline and/or law enforcement report, is eligible for therapeutic services provided by the Sexual Abuse Treatment Program. The Child Protection Team, the Department of Children and Families, law enforcement and community agencies primarily refer children and their families. Individuals and other professionals may also make direct referrals. The Sexual Abuse Treatment Program operates on the premise that the provision of specialized treatment services to children and families will help prevent long term psychological effects of sexual abuse victimization. The program promotes support of the child victim, increased insight, and encouragement of healthy family relationships. Family members are involved in a treatment plan designed to change the overall interactions within the family system to prevent further abuse. A combination of individual and group counseling is utilized to reduce the trauma of child sexual abuse and to promote healthy family functioning. The program promotes support of the child victim, increased insight, and the encouragement of healthy family relationships.
Chapter 39.305, Florida Statutes, requires the development of a model plan for community intervention and treatment of intrafamilial sexual abuse in conjunction with the Departments of Health, Children and Families, Law Enforcement, Education, and Corrections; the Attorney General, the State Guardian Ad Litem Program, representatives of the judiciary, and professionals and advocates from the mental health and child welfare communities.
What are the Services Provided?
Prompt Intake Services
Multidisciplinary Assessments
Treatment planning
Specialized individual and group therapy for child survivors, siblings and non-offending caregivers
Crisis Intervention
Case Management/Interagency Coordination
Personal Safety Education
Prevention/Community Education
Peer Support
Outreach
Community Resources Referral