Journal of Cognitive Neuroscience investigates brain-behavior
interaction and promotes lively interchange among the mind sciences.
Contributions address both descriptions of function and underlying brain
events and reflect the interdisciplinary nature of the field covering
developments in neuroscience, neuropsychology, cognitive psychology,
neurobiology, linguistics, computer science, and philosophy.
I was experiencing some reactionsto licorice and looked it up on the internet and found a forum about M.S. that had some alarming things to say -the veracity of the source is unclear... read below: ...............................................
My oldest sis is an acupuncturist ~ in her practice she uses a lot of
herbs based on Chinese & eastern medicine & I just emailed her
to see if she can make up some licorice supplement for me ~ maybe I'll
be able to say at a later date if there's any benefit to it all.
I'm still reading, AND just came to negatives about licorice that I wanted to point out to you: (be careful!)
Special Precautions
Pregnant women should not use licorice at medicinal doses. There
is a danger of high blood pressure or of a hormone imbalance that would
harm the fetus.
People with high blood pressure should avoid the use of licorice, which could aggravate their condition.
Anyone with a heart problem should use licorice only under medical supervision. Potassium depletion caused by licorice is especially hazardous for such patients. Anyone with pre-existing hypokalemia (low potassium) should not take licorice.
People with kidney disease, especially the elderly, may be at increased risk of side effects from this herb.
Gallbladder disease and cirrhosis are considered contraindications for licorice.
Adverse Effects
The consequences of high doses or long-term use of licorice are severe. This herb can cause high blood pressure, low levels of potassium, fluid retention and swelling of the face and limbs, hormonal imbalance, and muscle destruction leading to pain and weakness.
At least one woman experienced loss of libido. Another woman ate too much licorice candy and lost a great deal of potassium; her heart stopped.
Licorice can also change heart rhythms, prolonging QT and PR intervals on an electrocardiogram.
Lethargy and fatigue as well as weakness are part of the picture of licorice toxicity.
Many of the negative symptoms associated with licorice are due to
its ability to inhibit the renin-angiotensin system. Elderly people in
particular are susceptible to kidney problems as a consequence of
licorice.
Paralysis of the legs (and in one case, of all of the limbs) has
been reported. A sixty-four-year-old man developed pulmonary edema,
signaled by fatigue and trouble breathing, after eating four packages of
black Twizzlers licorice candy in three days. This case demonstrates
how quickly a serious reaction can arise.
Licorice can reduce thyroid gland activity and lower the basal metabolic rate.
It appears that individuals vary considerably in their
susceptibility to adverse reactions from licorice. Some people
experience negative symptoms within days, while others may ingest
excessive licorice in candy, chewing gum, chewing tobacco, or herbal
medicine for months or even years before they realize that they are
suffering damaging effects.
Women appear to be somewhat more susceptible than men, and oral contraceptives may increase this sensitivity.
Possible Interactions
Licorice can greatly increase potassium loss due to medicines such as hydrochlorothiazide, Lasix, Hygroton, Lozol, Bumex, and other potassium-wasting diuretics.
Severe potassium loss greatly increases the risk of heart rhythm irregularities, especially in people taking Lanoxin. Amiloride, a potassium-sparing diuretic, is not recommended to counteract the potassium loss caused by licorice.
Because it binds to serum albumin, licorice may interact with other medications that bind to serum albumin as well: ibuprofen, aspirin, and Coumadin. The coumarins in licorice may also potentiate the action of this anticoagulant, possibly leading to unexpected bleeding.
Although it seems like a harmless substance, licorice can cause
potentially serious problems. The glycyrrhizin component is thought to
cause these side effects. Notify your healthcare provider immediately if
you develop any of these serious side effects while you are consuming
real licorice, such as an irregular heart rhythm, muscle weakness, or
allergic reactions.
Does Licorice Cause Side Effects?
Real licorice
products (including some candies, beverages, supplements, and extracts)
can cause significant side effects. However, many "licorice" products
contain little or no real licorice. For instance, red licorice does not
contain any real licorice, and some black licorice products contain
anise flavoring instead of licorice.
(This article covers many, but not all, of the possible side
effects with licorice. Your healthcare provider can discuss a more
complete list with you.)
Serious Side Effects of Licorice
Even though it seems like a harmless substance, licorice can cause some
dangerous side effects. You should immediately report any of these side
effects to your healthcare provider. These side effects include but are
not limited to:
Many of the serious side effects of licorice are thought to be
caused by one specific component of licorice, known as glycyrrhizin.
Deglycyrrhizinated licorice (DGL) products, which have had the
glycyrrhizin component removed, may be less likely to cause these
serious side effects.
Final Thoughts
If you think you are experiencing a licorice
side effect, please let your healthcare provider know. Also, let your
healthcare provider know if you develop something that "just does not
seem right." While it may not be a side effect of licorice, your
healthcare provider will be able to diagnose and treat the problem.
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD
Licorice Drug Interactions
Several medications may cause
potentially negative drug interactions with licorice. Some of these
medications include blood pressure medications, certain diuretics, and
corticosteroids. These licorice drug interactions can result in serious
problems, such as low blood potassium and low blood calcium. To avoid
these problems, talk to your healthcare provider before taking licorice
or licorice supplements with any medications.
An Introduction to Licorice Drug Interactions
Even though it is a dietary supplement, not a "drug," licorice can potentially interact with several medicines. Some of the medicines that may lead to licorice drug interactions include:
- Blood pressure medications
- diuretics,
- Corticosteroids
- Estrogen medications, such as hormone replacement therapy (HRT) or birth control pills - Warfarin (Coumadin®, Jantoven®).
Many of the serious side effects of licorice are thought to be
caused by one specific component of licorice, known as glycyrrhizin.
Deglycyrrhizinated licorice (DGL) products, which have had the
glycyrrhizin component removed, may be less likely to cause these
serious side effects.
Final Thoughts on Licorice Drug Interactions
It is possible that not every drug interaction was discussed in this article. In fact, early research suggests that licorice
may inhibit the liver enzymes from breaking down many different drugs,
causing higher levels of such drugs to accumulate in the body.
Therefore, you should talk with your pharmacist or healthcare provider
about the licorice drug interactions that may apply to you.
Feb 23, 2010 | By
Frank Whittemore
Photo Credit lakritz nah aufnahme image by Lucky Dragon from Fotolia.com
Licorice is more than
just a flavoring of candy. For hundreds of years the extract of the root
of the licorice plant, from which the flavoring is derived, has been
used in traditional medicine and continues to be used today for a
variety of medicinal applications.
In fact, due to potential effects on
the body, licorice candy is now more likely to be flavored with anise.
Gastrointestinal Disorders
Licorice
extract is frequently suggested for treating peptic ulcers and may have
similar results, when used in conjunction with antacids, to that of
some prescription drugs. Licorice may also relieve symptoms of
indigestion and may be helpful in treating gastro-esophageal reflux
disorder, or GERD. Licorice extract is sometimes used together with
peppermint and chamomile to help ease gastrointestinal problems.
Skin Treatments
Topical
application of licorice as a gel or cream has been used to treat skin
ailments such as psoriasis and eczema, according to the University of
Maryland Medical Center. A gargle of licorice and extract mixed with
water can be used as a mouthwash to treat canker sores.
Antivirus Treatment
Licorice
may have applications for the treatment of viral infections, including
herpes simplex virus, viral hepatitis and HIV. Studies are currently
underway to determine if licorice, when used in conjunction with the
medication carbenoxolone, may help to inhibit viral reproduction and
spread.
Upper Respiratory Treatments
Licorice
acts as both an expectorant and cough suppressant and has long been
used for upper respiratory ailments such as sore throats and coughs due
to colds, according to MedlinePlus. In Europe and Asia, licorice extract
is a common ingredient in cough remedies.
“It just shows how effective small
changes in diet can be, and that both drugs and healthier living can
make a real difference in preventing heart disease and stroke.”
Dr Adam Briggs,Lead researcher
Apple-a-day call for all over-50s
By Michelle RobertsHealth editor, BBC News online
If
everyone over the age of 50 ate an apple a day, 8,500 deaths from heart
attacks and strokes could be avoided every year in the UK, say
researchers.
Apples would give a similar boost to cardiovascular health as
medicines, such as statins, yet carry none of the side-effects, the
University of Oxford researchers say in the BMJ.
They base their assumptions on modelling, not direct scientific study.
Any fruit should work, but getting people to comply could be challenging.
More than two-thirds of adults do not eat the recommended five portions of fruit and veg a day, population surveys suggest.
And although nine in 10 of us do manage to eat at least one
portion a day, Dr Adam Briggs and colleagues, from the British Heart
Foundation Health Promotion Research Group at Oxford University, say we
would all benefit from eating more.
By their calculations, if adults of all ages could manage to
eat an extra portion of fruit or veg a day, as many as 11,000 vascular
deaths could be averted each year.
The Victorian mantra of "an apple
a day" to keep the doctor away is particularly important for the
over-50s, who are at increased risk of vascular diseases, say the
researchers.
They analysed the effect on the most common causes of
vascular mortality - heart attacks and strokes - of prescribing either a
statin a day, which lowers cholesterol, or an apple a day to people
over 50. Assuming at least seven in every 10 complied with the advice, statin drugs could save 9,400 lives and an apple a day 8,500 lives a year, they calculate.
The
data their work rests on comprises a large body of medical trials and
observations involving hundreds of thousands of patients.
Dr Briggs said: "The Victorians had it about right when they came up with their brilliantly clear and simple public health advice, 'An apple a day keeps the doctor away' "It just shows how effective small changes in diet can be, and that both drugs and healthier living can make a real difference in preventing heart disease and stroke."
"While no-one currently prescribed statins should replace them for apples, we could all benefit from simply eating more fruit."
Dr Peter Coleman, of the Stroke Association, said everyone stood to benefit from eating a balanced diet.
"Apples have long been known as a natural source of antioxidants and chemical compounds called flavanoids, all of which are good for our health and wellbeing. "This
study shows that, as part of a healthy diet with plenty of fresh fruit
and veg, a daily apple could help to reduce the risk of stroke and heart
disease. "
The
British drug maker GlaxoSmithKline will no longer pay doctors to
promote its products and will stop tying compensation of sales
representatives to the number of prescriptions doctors write,
its chief executive said Monday, effectively ending two common industry
practices that critics have long assailed as troublesome conflicts of
interest. The announcement appears to be a first for a major drug company — although others may be considering similar moves — and it comes at a particularly sensitive time for Glaxo. It is the subject of a bribery investigation in
China, where authorities contend the company funneled illegal payments
to doctors and government officials in an effort to lift drug sales.
Andrew Witty, Glaxo’s chief executive, said in a telephone interview
Monday that its proposed changes were unrelated to the investigation in
China, and were part of a yearslong effort “to try and make sure we stay
in step with how the world is changing,” he said. “We keep asking
ourselves, are there different ways, more effective ways of operating
than perhaps the ways we as an industry have been operating over the
last 30, 40 years?”
For
decades, pharmaceutical companies have paid doctors to speak on their
behalf at conferences and other meetings of medical professionals, on the assumption that the doctors are most likely to value the advice of trusted peers.
But the practice has also been criticized by those who question whether
it unduly influences the information doctors give each other and can
lead them to prescribe drugs inappropriately to patients.
All
such payments by pharmaceutical companies are to be made public next
year under requirements of the Obama administration’s health care law.
Under the plan, which Glaxo said would be completed worldwide by 2016, the company will no longer pay health care professionals to speak on its behalf about
its products or the diseases they treat “to audiences who can prescribe
or influence prescribing,” it said in a statement.
It will also stop providing financial support directly to doctors to attend medical conferences,
a practice that is prohibited in the United States through an
industry-imposed ethics code but that still occurs in other countries.
In China, the authorities have said Glaxo compensated doctors for travel
to conferences and lectures that never took place.
Mr. Witty declined to comment on the investigation because he said it was still underway.
Glaxo will continue to pay doctors consulting fees for market research because
Mr. Witty said it was necessary for the company to gain insight from
doctors about their products, but he said that activity would be limited
in scope. A Glaxo spokesman said that each year the company spends
“tens of millions” of dollars globally on the practices that it was
ending, but declined to be more specific.
Glaxo is among the
largest drug companies in the world, reporting global third-quarter
sales of 6.51 billion pounds, or $10.1 billion, a 1 percent rise from
the same period a year ago. Sales fell markedly in China as the
investigation proceeded.
The move won qualified praise from Dr.
Jerry Avorn, a professor at Harvard Medical School who has written
critically about the industry’s marketing practices.
“It’s a modest acknowledgment of the fact that learning from a doctor
who is paid by a drug company to give a talk about its products isn’t
the best way for doctors to learn about those products,”
Dr. Avorn said. But he noted that Glaxo would continue to provide what
the company described in a statement as “unsolicited, independent
educational grants” to continue educating doctors about their products.
He said that in the past the grants had often been provided to
for-profit companies that rely on such payments from drug companies,
raising questions about whether they were providing truly independent
information.
Mr. Witty said while the
details were still being worked out, the company intended to provide
such grants to respected educational institutions and medical societies.
“I’d like to look for those sorts of partners, and I do not envision
these partners being companies or pseudo-companies,” he said.
Glaxo is first among its peers to announce a plan to end paid-speaker
programs, but it is not the only one considering such a move, said
Pratap Khedkar, who oversees the pharmaceutical practice at ZS
Associates, a global sales and marketing firm.
He said a
handful of drug makers were weighing similar actions for several
reasons, including concerns about the reaction to the required
disclosure of such payments that will begin next fall under a provision
of the health care law. Glaxo and several other major companies already
report many such payments, but Mr. Khedkar said the new requirements may
go farther than what some companies are reporting, and will be
accessible on a searchable government website.
Previously, “It wasn’t really made public in some big, splashy way,” he said.
Jeff Francer, vice president and senior counsel at the Pharmaceutical
Research and Manufacturers of America, the industry trade group, said
many other companies were looking for ways to better reach increasingly
busy doctors — who may not have time to travel to a conference in the
first place — and Glaxo’s actions represent just one example.
“Of course all of our companies are looking for ways in which they can
refine their relationship with physicians to make sure they’re making
the best use of physicians’ time,” he said. Beginning in 2015, Glaxo will also no longer compensate sales representatives based on the number of prescriptions doctors write, a standard practice that some have said pushed pharmaceutical sales officials to inappropriately promote drugs to doctors.
In 2012, Glaxo paid a record $3 billion in fines to resolve charges that it had marketed drugs for unapproved uses. It is one of several major companies to have settled such cases in recent years.
Glaxo said its sales representatives worldwide would instead be paid
based on their technical knowledge, the quality of service they provided
to clients to improve patient care, and the company’s business
performance. The company made such changes in the United States in 2011 —
and is required to continue the new program under a corporate integrity
agreement with the Justice Department — but will now extend the
practices to its global business.
Mr. Khedkar said some other
companies were also experimenting with ways to compensate sales
representatives, but they must tread carefully.
“You remove the
incentive to do anything inappropriate, but you also remove the
incentive to do what is appropriate, which is to promote the on-label
use of your product,” he said.
Mr. Witty said the experience in
the United States had been positive and had improved relationships with
doctors and medical institutions.
Dr. Raed Dweik, the new
chairman of the innovation management and conflict of interest committee
at the Cleveland Clinic, said he hoped other companies would follow
suit.
“As a physician, I periodically meet with these sales
reps and they usually come in armed with information about me that I
don’t even know,” he said, like the number of prescriptions he writes
for the drug company’s product. “I feel that’s not really a comfortable
interaction to have.”
A
version of this article appears in print on December 17, 2013, on page
A1 of the New York edition with the headline: Glaxo to Stop Paying
Doctors To Boost Drugs.
(My doctor suggested synthroid as a possible help for fatigue...)
When a person’s thyroid hormone level
gets too low nearly every system in the body is affected. An underactive
thyroid (hypothyroidism) can set off a wide range of symptoms that can
include fatigue, depression, weight gain, constipation, and dry skin.
Get your copy of Thyroid Disease
Many people diagnosed with a thyroid condition are
surprised that such a tiny gland can have such a profound impact on
overall health and well-being. But the thyroid gland plays an enormous
role in human health. Throughout life, this busy gland is constantly
producing hormones that influence metabolism. When disease causes your
thyroid gland to slack off and underproduce thyroid hormone, or overwork
and produce too much of it, you'll know something isn't right. This
Special Health Report will help you recognize the symptoms and find the
right treatment before you experience the long-term effects of this
common condition.
While typical of an underactive
thyroid, all those symptoms could be easily attributed to other medical
problems. And in people over 60, symptoms of hypothyroidism can be more
confusing. Any of the following health issues in a person over 60, alone
or in combination, could mean an underlying thyroid problem.
Unexplained high cholesterol. High
cholesterol is sometimes the only evidence of an under active thyroid in
an older person. Because this may be the only symptom, a high
cholesterol level warrants a thyroid evaluation.
Heart failure. Some of the effects of low
thyroid hormone levels — for example, reduced blood volume, weaker
contractions of the heart muscle, and a slower heart rate — may
contribute to heart failure. (Heart failure describes a condition in
which the heart doesn’t pump blood effectively to the muscles and organs
of the body). Symptoms of heart failure include breathlessness,
swelling in the ankles, weakness, and fatigue.
Bowel movement changes. An older person
with hypothyroidism might have constipation because of decreased
movement of stool through the bowels. Less often, an older person will
have frequent bouts of diarrhea, which is more typically a symptom of an
overactive thyroid. Persistent or severe diarrhea in an older person
always warrants a call to the doctor.
Joint or muscle pain. Vague joint pain is
a classic symptom of hypothyroidism. It sometimes is the only symptom
of hypothyroidism in an older patient, although many experience an
overall muscular aching, particularly in large muscle groups.
Mental health concerns. As with younger
people, depression is common among older people with an underactive
thyroid. The difference is that in older people it can be the only
symptom. An older person could also develop other psychiatric symptoms
including delusions or hallucinations.
Dementia. Debilitating memory loss —
often but not always, accompanied by depression or some kind of
psychosis — can also occur as the only symptom of hypothyroidism. If you
or a loved one is being evaluated for dementia, be sure that thyroid
tests are part of the work up.
Problems with balance. Abnormalities in
the cerebellum at the back of the brain that occur with an underactive
thyroid may lead to walking problems in older people.
If you or someone you love is living
with thyroid disease, learn how to take control of your condition and be
an active participant in your care by purchasing Thyroid Disease, a Special Health Report from Harvard Medical School.
Harvard Medical School offers special reports on over 50 health topics.
Visit our website at http://www.health.harvard.edu to find reports of interest to you and your family.
Hypertonia is a condition in which there is too much muscle tone
so that arms or legs, for example, are stiff and difficult to move.
Muscle tone is regulated by signals that travel from the brain to the
nerves and tell the muscle to contract.
Hypertonia happens when the
regions of the brain or spinal cord that control these signals are
damaged. This can occur for many reasons, such as a blow to the head,
stroke, brain tumors, toxins that affect the brain, neurodegenerative
processes such as in multiple sclerosis or Parkinson's disease, or
neurodevelopmental abnormalities such as in cerebral palsy.
Hypertonia
often limits how easily the joints can move. If it affects the legs,
walking can become stiff and people may fall because it is difficult for
the body to react quickly enough to regain balance. If hypertonia is
severe, it can cause a joint to become "frozen," which doctors call a
joint contracture.
Spasticity is a term that is often used
interchangeably with hypertonia. Spasticity, however, is a particular
type of hypertonia in which the muscles' spasms are increased by
movement.
In this type, patients usually have exaggerated reflex
responses.
Rigidity is another type of hypertonia in which the muscles
have the same amount of stiffness independent of the degree of movement.
Rigidity usually occurs in diseases such as Parkinson's disease, that
involve the basal ganglia (a deep region of the brain).
To distinguish
these types of hypertonia, a doctor will as the patient to relax and
then will move the arm or leg at different speeds and in a variety of
directions.
Treatment
Muscle relaxing drugs such as baclofen, diazepam, and dantrolene
may be prescribed to reduce spasticity.
All of these drugs can be taken
by mouth, but baclofen may also be injected directly into the
cerebrospinal fluid through an implanted pump.
Botulinum toxin is often
used to relieve hypertonia in a specific area of the body because its
effects are local, not body-wide.
People with hypertonia should try to
preserve as much movement as possibly by exercising within their limits
and using physical therapy.
Drugs that affect the dopamine system
(dopamine is a chemical in the brain) such as levodopa/carbidopa, or
entacapone, are often used to treat the rigidity associated with
Parkinson's disease.
The Dana Foundation
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