Si può desiderare di provare un trattamento naturale disfunzione erettile come un diverso per i problemi di costruzione. Al giorno d oggi ci sono diverse terapie sul mercato, ma un trattamento naturale disfunzione erettile è stato confermato qualche ora e ora di nuovo per dare risultati efficienti e permanenti. Cos è la disfunzione sessuale? L incapacità di sviluppare o sostenere una costruzione abbastanza lungo per fare l amore è chiamato disfunzione erettile, ED https://farmacia-senzaricetta.it/ o (maschio) problemi di erezione. Tutti gli uomini possono avere problemi di costruzione di volta in volta e gli scienziati considerano ED essere presenti se si verificano problemi di costruzione almeno il 25% del tempo. Alcuni fatti duri: ED Può essere dovuto a problemi emotivi. Stress, pressione, giltiness, depressione, bassa autostima e ansia prestazioni può essere la causa dei vostri problemi di costruzione. La ricerca ha confermato che il 90 per cento della disfunzione erettile è fisica in origine, non emotiva. L impotenza colpisce la maggior parte degli uomini durante la loro vita e può essere dovuto a troppo colesterolo, problemi cardiaci, diabete, ipertensione, fumo o alcol. Alcuni rimedi possono essere la ragione. Le questioni legate al movimento sono collegate. Se ti occupi dei tuoi problemi di movimento, hai piu possibilita di risolvere questo problema. Qui ci sono 5 consigli facili su come aumentare la circolazione: 1. Mangia i pasti giusti. Questo ti rendera il flusso sanguigno ovvio. Una grande parte di rimanere sani e anche mantenere il flusso sanguigno ovvio è legato al vostro piano di alimentazione quotidiana e quello che si mangia. Una buona cura per la disfunzione erettile è mangiare un piano a basso contenuto di grassi e grande alimentazione di fibre. Mangiare fibre tutti i giorni e questo viene scoperto in prodotti cerealicoli cereali integrali, frutta e verdura. Evitare il più possibile pasti pronti o pasti non sani. 2. Wonder herbal rimedi. Molti rimedi vegetali per ED eseguire bene come possono migliorare il movimento. Hanno molto meno reazioni avverse rispetto ai farmaci convenzionali e si svolgono in modo efficiente per migliorare hardons e la forza, troppo. Erbe naturali come Ginkgo Biloba sono utilizzati come una strategia per ED. Gli specialisti di erboristeria credono anche che le spezie o le erbe come noce moscata, portano al movimento intorno al corpo, tra cui il pene. 3. Vitamine naturali vitali. Gli scienziati sanitari hanno scoperto che una mancanza di supplemento è tipico tra gli uomini con ED in particolare vitamina A. Se si ha una mancanza del nutriente ossido di zinco, Questo è stato confermato per portare alla disfunzione erettile. Queste inadeguatezze derivano dal fatto che molti valori nutrizionali in quello che mangiamo piano non sono sufficienti. Aggiungere al vostro fabbisogno di nutrienti aumenterà la circolazione del sistema e migliorare questa condizione. Gli integratori alimentari sono completamente naturali, quindi non dovrete preoccuparvi dei rischi di reazioni avverse. Inoltre, queste vitamine naturali sono utili per il vostro benessere over-all. Oltre a questi vantaggi benessere, disfunzione erettile vitamine naturali e integratori costano molto meno di farmaci rimedi. 4. Esercitare. Fai una mossa e non un tablet vibrante. Camminare farà di più per migliorare e sostenere hardons di qualsiasi altra compressa chimica nel lungo periodo. Il fitness fisico manterrà bassi livelli di pressione e mantenere grandi stadi di movimento. Andando per un 20-30 minuti di movimento rapido ogni giorno, può affrontare questo problema e può sostenere la vostra libido senza l uso di qualsiasi farmaco. 5. Sottolineare. Questo è il peggior attaccante per problemi di erezione. Scopri diversi metodi per riposare. Alcuni metodi tipici per riposare includono la lettura di un libro, la meditazione, un bagno rilassante o allenamenti di respirazione. Sto solo imparando alcuni semplici allenamenti di respirazione che possono migliorare significativamente il movimento nel reparto pantaloni. Una naturale disfunzione erettile soluzioni di trattamento stanno diventando sempre più popolare con gli uomini. Questi rimedi a base di erbe sono preferiti perché non hanno reazioni avverse e sono confermati essere efficiente come il farmaco. La maggior parte degli uomini combattere parlano dei loro problemi, in particolare la disfunzione erettile come c è poca discussione sui problemi di erezione. La verita e che ED ha un impatto su piu di dieci milioni di uomini solo negli Stati Uniti. Non siete soli e l aiuto è disponibile.
10620_2008_353_54_2-web 406.408
Severe Hepatotoxicity Due to Hydroxycut: A Case Report
Received: 13 April 2008 / Accepted: 15 May 2008 / Published online: 26 July 2008Ó Springer Science+Business Media, LLC 2008
31–103 U/l), total bilirubin of 18.1 mg/dl (normal 0.2–1.1mg/dl), conjugated bilirubin of 9.0 (normal 0.0–0.2 mg/dl),
A 28-year-old male was transferred to our institution with 3
albumin level of 4 g/dl (normal 3.7–5.1 g/dl), prothrombin
weeks of fatigue, dyspnea on exertion, jaundice, and dark
time of 12.8 s (normal 9.2–10.6 s), normal complete blood
urine. In an effort to lose weight, he had been taking Hy-
count, normal electrolyte panel, and normal estimated
droxycut, two tablets, two to three times per day (which is
glomerular filtration rate. Aminotransferase levels and
within the manufacturer’s suggested dosing), from 3
prothrombin time began to decline immediately after
months prior to admission up until the development of
admission and bilirubin peaked on hospital day 2 at 22.4
symptoms. Additionally, for soreness associated with his
mg/dl. Acetaminophen level was undetectable. Tests for
aerobic exercise program, he took an over-the-counter
viral hepatitis were negative. Ferritin was markedly ele-
pain-reliever containing acetaminophen 250 mg, aspirin
vated at 9519 ng/ml (normal 10–210 ng/ml). HFE
250 mg, and caffeine 65 mg, four tablets per day for the 10
genotyping was negative for H63D or C282Y mutations.
days leading up to the development of his symptoms. He
Antinuclear antibody titer was 1:40 (normal, \1:40),
was not a heavy drinker of ethanol, drinking 2–3 beers per
smooth muscle antibody titer was 1:20 (normal, \1:20),
week. Physical examination was unremarkable and without
liver kidney microsomal antibody was negative, and solu-
stigmata of chronic liver disease. Laboratory analysis
ble liver antigen antibody was negative. Serum copper
revealed a serum aspartate aminotransferase of 1049 U/l
level was 96 mcg/dl (normal 70–140 mcg/dl) and cerulo-
(normal range 7–36 U/l), alanine aminotransferase of 2272
plasmin was 31 mg/dl (normal 18–54 mg/dl). Twenty-four
(normal 4–45 U/l), alkaline phosphatase of 152 U/l (normal
hour urine copper level was 290 mcg/dl (normal 3–50 mcg/dl). Slit-lamp examination for Kaiser-Fleischer rings wasequivocal. Abdominal ultrasound with Doppler and com-
Recent reports have identified an association between hepatotoxicity
puted tomography (CT) scan with intravenous contrast
and the weight loss supplement Hydroxycut (MuscleTech,
were both normal. The patient’s liver function tests con-
Mississauga, Ontario, Canada). Here we report a case of severe
tinued to improve and he was discharged on hospital day 9.
hepatotoxicity associated with Hydroxycut and summarize thepublished data identifying an association between the herbal
compounds in Hydroxycut and hepatotoxicity.
Though the markedly elevated 24-h urine copper level and
Division of Digestive Diseases, David Geffen School
slit-lamp examination equivocal for Kaiser-Fleischer rings
of Medicine at UCLA, 1629 Veteran Avenue, Apt. 5,
suggested the possibility of underlying Wilson disease, the
Los Angeles, CA 90024, USAe-mail: [email protected]
normal serum copper and ceruloplasmin levels, lack ofunderlying cirrhosis, lack of supportive family history, lack
of concomitant neurological or psychiatric disturbance, and
UCLA Department of Medicine, Division of Digestive Diseases,
lack of hemolysis all argued against this diagnosis. In the
Box 957302, 200 Medical Plaza Suite 214, Los Angeles,CA 90095-7302, USA
end, it was felt that the patient’s elevated urinary copper
level was due to his marked cholestasis and that his pre-
predominant polyphenol or catechin within this extract,
epigallocatechin-2-gallate (EGCG), may be the causative
agent ]. An in vitro study suggested that high concen-
This is the third reported case of hepatotoxicity associ-
trations of EGCG were cytotoxic to rat liver cells [
ated with Hydroxycut. The first case demonstrated a
However, this manuscript concluded that the oral bio-
predominantly hepatocellular injury pattern on liver func-
availability of EGCG in green tea extracts was probably
tion tests with peak alanine aminotransferase 3962 U/l that
too low to produce serum levels approaching the levels that
resolved after 4 weeks, while the other demonstrated a
were cytotoxic to the rat liver cells. Because of this, it has
predominantly cholestatic pattern of injury (confirmed on
been further proposed that the hepatotoxicity associated
liver biopsy) that resolved after 2 months In both cases,
with green tea extract may be an idiosyncratic and/or
the patients were taking three tablets three times per day.
hypersensitivity-type reaction or that an undetected com-
The manufacturer’s list of active ingredients in Hy-
pound contaminating the extract may be the causative
droxycut is shown in Table [Of the ingredients listed,
extracts of Garcinia cambogia, Gymnema sylvestre, and
Finally, we cannot rule out an interaction between the
green tea (Camellia sinensis) have been associated with
compounds in Hydroxycut and the acetaminophen the patient
cases of severe hepatotoxicity. In the one case associated
was taking concomitantly. Although we found no studies
with Garcinia cambogia and Gymnema sylvestre, the patient
directly investigating this possibility, one might speculate
had taken a 7-day course of two dietary weight-loss sup-
that one or more of the compounds in Hydroxycut could
plements, one of which contained both Garcinia cambogia
induce or stimulate the CYP2E1 cytochrome system, lead to
and Gymnema sylvestre, the week prior to becoming jaun-
diced This particular case progressed to fulminant
(NAPQI), and thus accentuate acetaminophen-induced
hepatic failure and death. The authors speculated that a
hepatotoxicity, much like chronic ethanol consumption.
synergistic interaction between the weight-loss supplements
Caution should be exercised by consumers using the
and chronic use of a leukotriene antagonist inhibitor, a class
weight-loss supplement Hydroxycut. There is evidence that
of medicine that has been associated with severe hepato-
extracts of Garcinia cambogia, Gymnema sylvestre, and
toxicity, resulted in her fulminant and ultimately fatal
green tea (Camellia sinensis) contained in Hydroxycut may
be associated with severe and even fatal hepatotoxicity.
There have been at least 11 case reports associating
green tea extract (Camellia sinensis extract) with severe
hepatotoxicity In all cases, except two whichrequired liver transplantation there was eventual
1. Stevens T, Qadri A, Zin NN (2005) Two patients with acute liver
recovery after cessation of the supplement containing the
injury associated with use of the herbal weight-loss supplement
extract. In one case there was some suggestion of
Hydroxycut. Ann Intern Med 142(6):477–478
causation, as the patient rechallenged herself with the same
supplement and again presented with severe hepatotoxicity.
3. Actis GC, Bugianesi E, Ottobrelli A, Rizzetto M (2007) Fatal
The mechanism of the potential toxicity of green tea
liver failure following food supplements during chronic treatment
extract is unclear. There has been speculation that the
4. Bonkovsky HL (2005) Hepatotoxicity associated with supple-
ments containing Chinese green tea (Camellia sinensis). Ann
5. Porcel JM, Bielsa S, Madronero AB (2005) Hepatotoxicity
associated with green tea extracts [electronic letter]. Accessed at
6. Garcia-Moran S, Saez-Royuela F, Gento E, Lopez Morante A,
Arias L (2004) Acute hepatitis associated with Camellia thea and
Orthosiphon stamineus ingestion. Gastroenterol Hepatol 27:559–560.
7. Thiolet C, Mennecier D, Bredin C, Moulin O, Rimlinger H, Ni-
zou C et al (2002) Acute cytolysis induced by Chinese tea.
Oolong tea extract (as Camellia sinensis)
8. Vial T, Bernard G, Lewden B, Dumortier J, Descotes J (2003)
Acute hepatitis due to exolise, a Camellia sinensis-derived drug.
Other ingredients: hydroxypropyl cellulose, microcrystalline
cellulose, polyvinlypyrrolidone, croscarmellose sodium, vegetable
9. Gloro R, Hourmand-Ollivier I, Mosquet B, Mosquet L, Rousselot
stearine, magnesium stearate, coating, silica, acesulfame-
P, Salame´ E et al (2005) Fulminant hepatitis during self-medication
with hydroalcoholic extract of green tea. Eur J Gastroenterol
13. Molinari M, Watt KD, Kruszyna T, Nelson R, Walsh M, Huang
WY et al (2006) Acute liver failure induced by green tea extracts:
10. Abu el Wafa Y, Benavente Ferna´ndez A, Talavera Fabuel A,
case report and review of the literature. Liver Transpl 12:1892–
Pe´rez Ramos MA, Ramos-Clemente JI (2005) Acute hepatitis
induced by Camellia sinensis (green tea). Med Intern 22(6):298
14. Schmidt M, Schmitz HJ, Baumgart A, Gue´don D, Netsch MI,
11. Duen˜as Sadornil C, Fabregas Puigtio´ S, Dura´ndez R (2005)
Kreuter MH et al (2005) Toxicity of green tea extracts and their
Hepatotoxicity due to Camelia sinensis. Med Clin (Barc)
constituents in rat hepatocytes in primary culture. Food Chem
12. Pedros C, Cereza G, Garcia N, Laporte JR (2003) Liver toxicity
of Camellia sinensis dried etanolic extract. Med Clin (Barc)121:598–599. doi:
Scottish Tourism Alliance Notes STA Council Meeting 16 January 2013 EICC, Edinburgh Council Members Present: Linda Battison, Gordon Watson, Henk Berits, Fiona Bewers, Lee Cousins, Ian Fordham. Sue Gruellich, Robert Kidd, Keith Legge, Willie Macleod, Marion Oates, Alasdair Smart, David Smythe, Mike Story, Stewart Walker, Caroline Warburton, Jeanette Wilson, Robin Worsnop. Board Mem
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