HCG & weight loss - again!!

I just got a call yesterday from some supplier trying to sell me HCG drops to prescribe to gullible unsuspecting patients. When I told her I did not believe HCG caused any weight loss, she chided me & told me that lots of other doctors are prescribing it. Well, I'm not part of that group & here's a bit of free advice for everyone out there desperate to lose weight - it's not the homeopathic dose of HCG that makes you lose weight, it's the 500cal/day diet that you have to stick to as part of the "HCG programme" that makes you lose weight. In spite of what I tell some of my clients about this con job, they still fork out thousands to other people for this "programme" & don't give any credit to their fitness trainers!! God forbid, do doctors with genuine tertiary qualifications actually buy these placebo (probably water) drops from these "entrepreneurs"?! In case anyone thinks I'm a lone ranger with this opinion,here's some evidence to back up what I'm saying. Happy reading! Human chorionic gonadotrophin and weight loss. A double-blind, placebo-controlled trial. Bosch B, Venter I, Stewart RI, Bertram SR. Source Department of Medical Physiology and Biochemistry, University of Stellenbosch, Parowvallei, CP. Abstract Low-dose human chorionic gonadotrophin (HCG) combined with a severe diet remains a popular treatment for obesity, despite equivocal evidence of its effectiveness. In a double-blind, placebo-controlled study, the effects of HCG on weight loss were compared with placebo injections. Forty obese women (body mass index greater than 30 kg/m2) were placed on the same diet supplying 5,000 kJ per day and received daily intramuscular injections of saline or HCG, 6 days a week for 6 weeks. A psychological profile, hunger level, body circumferences, a fasting blood sample and food records were obtained at the start and end of the study, while body weight was measured weekly. Subjects receiving HCG injections showed no advantages over those on placebo in respect of any of the variables recorded. Furthermore, weight loss on our diet was similar to that on severely restricted intake. We conclude that there is no rationale for the use of HCG injections in the treatment of obesity.

Celebrity Bad Science: Dried Placenta Pills and Oxygen Shots

By Kate Kelland LONDON (Reuters) Dec 28 - Pop guru Simon Cowell carries pocket-sized inhalable oxygen shots, America's "Mad Men" actress January Jones favors dried placenta pills, and British soap star Patsy Palmer rubs coffee granules into her skin. Celebrities rarely shy away from public peddling of dubious ideas about health and science, and 2012 was no exception. In its annual list of the year's worst abuses against science, the Sense About Science (SAS) campaign also named former U.S. presidential candidate Mitt Romney for spreading misinformation about windows on planes, and Olympic swimmer Michael Phelps for false justifications for peeing in the pool. To help set the record straight, SAS, a charity dedicated to helping people make sense of science and evidence, invited qualified scientists to respond to some of the wilder pseudo-scientific claims put about by the rich and famous. It suggested Romney, who wondered aloud in September why aircraft crews don't just open the windows when there's a fire on board, should listen to aeronautical engineer Jakob Whitfield: "Unfortunately, Mitt, opening a window at height wouldn't do much good," the scientist said. "In fact, if you could open a window whilst in flight, the air would rush out...because air moves from the high pressure cabin to the lower pressure outside, probably causing further injury and damage." January Jones's dried placenta pills, which the actress admitted in March she consumed after giving birth, win no favor with Catherine Collins, principal dietician at St George's Hospital in London. "Nutritionally, there's nothing to be gained from eating your placenta - raw, cooked, or dried," Collins said. "Apart from iron, which can be easily found in other dietary choices or supplements, your placenta will provide toxins and other unsavory substances it had successfully prevented from reaching your baby in utero." Gary Moss, a pharmaceutical scientist, patiently points out to Palmer that while caffeine may have an effect on cellulite, rubbing coffee granules into the skin is unlikely to work, since the caffeine can't escape the granules to penetrate the skin. Phelps's claim that it's fine to pee in the pool because "chlorine kills it" is put straight by biochemist Stuart Jones, who reminds him that "urine is essentially sterile so there isn't actually anything to kill in the first place." And for Cowell, Kay Mitchell, a scientist at the Center for Altitude Space and Extreme Environment Medicine, warns that very high levels of oxygen can in fact be toxic - particularly in the lungs, where oxygen levels are highest. "Celebrity comments travel far and fast, so it's important that they talk sense," said Sense About Science's managing director Tracey Brown. "The implausible and frankly dangerous claims about how to avoid cancer, improve skin or lose weight are becoming ever more ridiculous. And unfortunately they have a much higher profile than the research and evidence." To encourage more vigilance among celebrity pseudo-scientists in the future, SAS provided a checklist of "misleading science claims" it suggests should be avoided: * "Immune boosting" - you can't and you don't need to * "Detox" - your liver does this * "Superfood" - there is no such thing, just foods that are high in some nutrients * "Oxygenating" - your lungs do this * "Cleansing" - you shouldn't be trying to cleanse anything other than your skin or hair.

Korean threads V-lift

Korean threadlift is a new non-surgical procedure that gives a lift to the face by insertion of dissolvable threads under the skin. The threads are made from PDO (polydioxanone), the same thread material in use for cardiac & other major organ surgery. The threads are approved by the Korean Food & Drug Administration (KFDA). Advantages of this procedure: - Quick 30 minute procedure - Can be done with just local anaesthetic cream - Immediate results seen - Long lasting effect 1-1.5 yrs - Additional effects such as improved skin tone & skin elasticity can also be seen - Threads are resorbable i.e. no permanent foreign material left under the skin Pretty much any body part can be treated - face, neck, buttlift, abdomen, bra bulge lift, front & back armpit lifting Introductory price 50% discount - from RM500.

Starving Yourself May Not Help You Live Longer

Foodies may be delighted by the conclusions of this article. Looks like the human lifespan (at least for primates, anyway) is pre-set. As with all things in life, moderation is key. By Sharon Begley NEW YORK (Reuters) Aug 29 - The longevity diet's premise is seductively simple: cutting your calorie intake well below your usual diet will add years to your life. New research published on Wednesday, however, shows the extreme, emaciating diet doesn't increase lifespan in rhesus monkeys, the closest human relatives to try it in a rigorous, long-running study. While caveats remain, outside experts regarded the findings as definitive, particularly when combined with those from a similar study. "If there's a way to manipulate the human diet to let us live longer, we haven't figured it out yet and it may not exist," said biologist Steven Austad of the University of Texas Health Science Center's Barshop Institute for Longevity and Aging Studies, who wrote an analysis of the study in Nature this week. Since 1934, research has shown that lab rats, mice, yeast, fruit flies and round worms fed 10% to 40% fewer calories than their free-eating peers lived some 30% longer. In some studies, they lived twice as long. Such findings have spawned a growing community of believers who seek better health and longer life in calorie-restricted (CR) diets, as promised in the 2005 book "The Longevity Diet," including 5,000 members of the CR Society International. The research has also prompted companies like Procter & Gamble and Nu Skin Enterprises to develop drugs to mimic the effects of calorie restriction. The new study, from the National Institute on Aging, suggests a surprising disconnect between health and lifespan. It found that most of the 57 calorie-restricted monkeys had healthier hearts and immune systems and lower rates of diabetes, cancer or other ills than the 64 control monkeys. But there was no longevity pay-off. "You can argue that the calorie-restricted animals are healthier," said Austad. "They have better cholesterol profiles, less muscle loss, less disease. But it didn't translate into greater longevity. What we learn from this is you can un-link health and longevity." The NIA study, launched in 1987, is one of two investigating whether eating just 70% of the calories in a standard lab diet extends life in a long-lived primate. The Wisconsin National Primate Research Center's study, begun in 1989, also uses rhesus monkeys, whose physiology, genetics and median lifespan (27 years) are closer to humans than are the rodents in earlier calorie-restriction research. Initial results were promising. In 2006 the NIA group reported that calorie-restricted monkeys had younger-seeming immune systems. Wisconsin reported that after 20 years of eating like birds, the monkeys were less likely to get heart disease, diabetes, cancer and other diseases of aging. They also lived longer: By 2009, 80% of the free-eating Wisconsin monkeys had died of age-related illness, but only 50% of calorie-restricted monkeys had. Those findings, the scientists reported at the time, showed "that CR slows aging in a primate species." Experts on aging have since waited for the NIA to weigh in, and the verdict was a shock: "The calorie-restricted monkeys lived no longer than the other monkeys," NIA's Julie Mattison, who helped lead the study, told Reuters. The oldest animals in each group had the same incidence of tumors, heart disease and general deterioration. While the abstemious monkeys had some improved health markers such as cholesterol and triglyceride levels, Mattison said, "that didn't translate into better survival." The NIA study showed that even monkeys starting calorie restriction early in life, from 1 to 14 years of age, had no lifespan edge over their gourmand peers. With 19 of the 40 monkeys whose eating was restricted starting in youth still alive, the NIA scientists calculated, the chance that they will outlive free-eating monkeys is less than one-tenth of 1%. Perhaps more surprising, health markers were often worse in monkeys that began calorie restriction as young adults than older ones, the opposite of what scientists expected. And more of the animals that started calorie restriction when young died of causes unrelated to aging than did their free-eating peers. "There may be something about calorie restriction that makes animals more susceptible to death from other causes," said Austad. Scientists offered several explanations for why the NIA's findings differ from more encouraging results in the Wisconsin study. The Wisconsin monkeys' diet had seven times the table sugar (28% of calories, like Americans' diets) as the NIA's (4%). The Wisconsin control monkeys also ate however much they wished; the NIA control monkeys ate a fixed amount and, as a result, weighed less. That suggests the longevity diet didn't really extend lifespan in the Wisconsin monkeys: It only seemed to because the control monkeys ate themselves into an early grave. "Comparing calorie restriction to what you think is a normal diet but is in fact an unhealthy diet with too much food and too much sucrose can trip you up," said Austad. "If you keep your control animals to a healthy weight, as the NIA did, a diet that produces extreme emaciation has no further effect on longevity." Most problematic, many of the Wisconsin study's calorie-restricted monkeys died of causes unrelated to aging, such as anesthesia used in some experiments and gastrointestinal bloat. Only by not counting those deaths did the Wisconsin scientists find a statistically significant longevity effect, said Wisconsin's Ricki Colman, a leader of that study. It is too soon to know how the NIA study will affect the development of drugs aimed at replicating calorie restriction's benefits without the hunger pangs. They include mannoheptulose, a compound derived from unripe avocados that "tricks cells into thinking they ate less," said George Roth, CEO of privately held GeroScience. Roth helped launch the NIA study and is a co-author of the new paper. He believes there is still good evidence in favor of calorie restriction, including the Wisconsin study's findings. GeroScience is working with Procter & Gamble to use mannoheptulose as a lifespan-increasing supplement for dogs and hopes to raise money for a clinical trial in people. LifeGen Technologies, co-founded by a leader of the Wisconsin study, is testing a nutraceutical that mimicked some genetic changes seen with calorie restriction in rodents. The company was bought by Nu Skin Enterprises in 2011. The NIA and Wisconsin teams are continuing to collect data to see if calorie restriction suddenly proves more beneficial. "But what I take away from these studies is that extreme emaciation may not be the correct paradigm," said University of Texas biologist Austad. "If I were them (companies or scientists banking on this), I'd be worried."

Liposuction Might Have 'Boomerang' Effect

But exercise kept post-surgical increase in fat around organs at bay, study found June 14, 2012 By Alan Mozes HealthDay Reporter THURSDAY, June 14 (HealthDay News) -- Women who have the popular plastic surgery procedure known as liposuction may be trading one form of fat for another, as a new study reveals that the sudden removal of abdominal fat seems to trigger a buildup of fat around the internal organs. At issue, the Brazilian researchers said, is an apparent trade-off between two kinds of fat, with the removal of "subcutaneous fat" spurring the growth of "visceral fat." Subcutaneous fat, located directly under the skin, is the primary target of liposuction. Visceral fat wraps itself around internal organs, and its accumulation has been strongly linked to a higher risk for diabetes and heart disease. Here's the good news: The same research team found that liposuction patients who adopted an exercise program shortly after surgery both enjoyed the benefits of abdominal fat removal while largely preventing the post-surgical growth of visceral fat. "Importantly, a four-month, supervised exercise program prevented this compensatory visceral fat increase, increased fat-free mass and improved physical capacity and insulin sensitivity," the team, led by Fabiana Benatti from the University of Sao Paulo, reported. Benatti and her colleagues detail the findings in the July issue of the Journal of Clinical Endocrinology and Metabolism. The authors focused on the experience of 36 healthy Brazilian women between the ages of 20 and 35, all of whom underwent abdominal liposuction between 2010 and 2011 in Sao Paulo. None of the women had a body-mass index (BMI) over 30 prior to the procedure, meaning that while they were overweight none was obese. All of the surgeries were also described as being "small-volume" in nature. Two months post-surgery, the women were divided into two groups: the first embarked on a four-month (three times per week) exercise regimen, while the second essentially maintained a sedentary lifestyle. Both groups were deemed to have experienced similar drops in body weight and overall fat mass as a result of their surgery, and both followed comparable diets post-procedure. Those in the exercise group engaged in aerobic and anaerobic (weight training) training through the four-month period. The result: Six months after their operation, neither group had regained fat in the abdominal region that was the target area of the liposuction surgery, leading the team to describe the procedure as "cosmetically efficient." However, patients in the sedentary group experienced a roughly 10 percent increase in visceral fat, equating to what the authors described as a "significant regain of total fat mass." In contrast, those in the exercise group did not. Benatti's team said that it is not yet clear exactly how liposuction raises the risk for visceral fat growth. What is clear, however, is that exercise seems to mitigate that risk. Lona Sandon, an assistant professor of clinical nutrition at the University of Texas Southwestern at Dallas, expressed little surprise with the findings. "You oftentime have this snapback of the fats," she said. "Sure, you can get rid of some of it with surgery. But if you don't change your lifestyle, it doesn't stay away forever. And certainly if you've spent all this money and incurred the risk of undergoing liposuction -- and it's not a risk-free option, by any means -- why wouldn't you want to do what you can to preserve the gain?" "So, no, I don't think it's surprising that exercise helps after surgery," Sandon added. "And in that respect, cardiovascular exercise, in particular, is one of the best ways to go. That means jogging, swimming, biking, roller blading, getting your heart rate up for an extended period of time and burning calories. Even walking helps to decrease visceral fat, even in people who have not had liposuction. And so I would expect it would work the same for people who have had liposuction." Connie Diekman, director of nutrition at Washington University in St. Louis, seconded the notion. "This is a small study," she cautioned. "And it raises the question of how this might play out among women who were significantly more overweight than those included in this study." "But I think there is a very important message here," Diekman added, "in that this study is an example of how you can make a positive change with exercise. It may not ultimately prevent the return of body fat, but clearly it can change its distribution or delay its return. And that is very good news."

Not All Calories Are the Same, New Research Finds

From Heartwire Lisa Nainggolan June 26, 2012 (Boston, Massachusetts) — A small mechanistic study comparing three different eating patterns--a low-fat diet, a low-glycemic-index diet, and a low-carbohydrate diet--has found that participants used up the most energy with the last, but there were metabolic disadvantages to this approach [1]. The findings reinforce the message that a low-glycemic-index diet is best for weight loss and cardiovascular disease prevention and illustrate a novel concept--that not all calories are alike from a metabolic perspective, say Dr Cara B Ebbeling (New Balance Foundation, Obesity Prevention Center, Children's Hospital, Boston, MA) and colleagues in their paper published in the June 27, 2012 issue of the Journal of the Medical Association. Extreme restriction of fat or carbs can have bad effects. Senior author Dr David S Ludwig (New Balance Foundation, Obesity Prevention Center) told heartwire : "Extreme restriction of fat or carbs can have bad effects. The best long-term approach will be to avoid restriction of any major nutrient--either fat or carbohydrate--and instead focus on the quality of nutrients. This is not to say that the number of calories isn't important, but it's now saying we should also pay attention to the quality of those calories. So the argument that the food industry likes to make--that all foods can be part of a healthful diet as long as you watch calories--is really misleading at best. "Relatively unprocessed, low-glycemic-index foods are best, things that our grandmother would recognize. Choose relatively unprocessed foods whenever you can and cut back on white bread, white rice, potato products, prepared breakfast cereals, and, of course, concentrated sugars." The argument that the food industry likes to make--that all foods can be part of a healthful diet as long as you watch calories--is really misleading at best. Dr Arne Astrup (Department of Human Nutrition, University of Copenhagen), who was not involved with the study, said it adds to previous research and demonstrates that "a slight reduction in carbs (and increase in protein) with a focus on low [glycemic-index]/whole-grain carbs and 20% to 30% of calories from protein from shellfish, fish, poultry, dairy, nuts, lentils, and beans is the optimal diet today for weight control and reduction of cardiovascular risks." To this end, Ludwig believes it's time to change recommendations. "Most of the professional nutritional associations continue to feature, expressively or implicitly, targets on fat reduction. Our work--and really many other studies--now suggest that there is absolutely no benefit by selectively targeting fat for reduction." Low-Fat and Low-Carb Diets Both Have Important Downsides The researchers conducted a three-way crossover design feeding study between June 2006 and June 2010 involving 21 overweight and obese young adults in Boston who were recruited by newspaper advertisements and postings. After losing 10% to 15% of body weight during a run-in phase, participants were allocated to a low-fat diet (20% fat, 60% carbohydrate, 20% protein), a low-glycemic-index diet, and a very low-carbohydrate diet (10% carbohydrate, 60% fat, 30% protein) in random order, each for four weeks. The primary outcome was resting energy expenditure with secondary outcomes of total energy expenditure, hormone levels, and metabolic syndrome components. Ludwig notes these type of studies are "difficult to perform," because for each participant there were seven months of feeding, "and that's about the limit you can put a human subject through, so we could only examine each diet for a month at a time." The reduction in resting energy expenditure was greatest with the low-fat diet, intermediate with the low-glycemic-index one, and least with the low-carb diet. The decrease in TEE showed a similar pattern. Those on the low-carb diet burned 350 calories per day more than those on the low-fat one, even though they consumed the same amount of calories on all these diets. "Those on the low-carb diet burned 350 calories per day more than those on the low-fat one, even though they consumed the same amount of calories on all these diets. That's equivalent to one hour of moderate-intensity physical exercise," Ludwig said. And those on the low-glycemic-index diet lost about 150 calories per day more than those on the low-fat one, "equal to about an hour of light physical activity," he added. (Neither total physical activity nor time spent in moderate- to vigorous-intensity physical activity differed among the diets.) But he explained that, as well as energy expenditure, "we also looked at heart disease risk factors, and the two restrictive diets both had important downsides." Strongest Support for Concept That Not All Calories Are the Same With the low-carb diet, the researchers observed increases in CRP, a measure of chronic inflammation, and 24-hour cortisol, the key stress hormone, "suggesting that any initial advantages were eroded over time by these biological stressors," Ludwig notes. And the low-fat diet--as well as resulting in the least energy expenditure--"exacerbated many of the components of the metabolic syndrome, so insulin resistance, triglycerides, and HDL cholesterol were all worse on this diet," he explained. Hence the study, despite its limitations, "provides the strongest support for a novel concept, that all calories are not alike from a metabolic perspective. This has been postulated before, but never shown in this context," Ludwig says. "We are emphasizing mechanisms that underlie how diets affect body weight and saying that this knowledge should be used to design more effective and least-restrictive approaches to weight loss and heart disease prevention. We want to line up biology and behavior. Losing weight is hard enough for anybody. We need every advantage we can get. We've wasted a lot of energy pursuing ineffective approaches like a low-fat diet."

Eating placenta, an age-old practice in China

From www.straitstimes.com SHANGHAI (AFP) - After Ms Wang Lan delivered, she brought home a baby girl and her placenta, which she plans to eat in a soup - adopting an age-old practice in Chinese traditional medicine. The health-giving qualities of placenta are currently creating a buzz in Western countries, where some believe it can help ward off postnatal depression, improve breast milk supply and boost energy levels. But placentophagy - the practice of eating one's placenta after birth - is relatively common in China, where it is thought to have anti-ageing properties, and dates back more than 2,000 years. 'It is in the refrigerator now and I am waiting for my mother to come and cook it to eat. After cleaning, it can be stewed for soup, without that fishy smell,' Ms Wang said, adding she believed it would help her recover from delivery. My comment: Oral placenta pills are now freely available & registered with the Ministry of Health in Malaysia so the prices are quite reasonable (depending on concentration of the active ingredient, prices vary between RM300-600 per month's supply.) & you don't have to put up with the fishy gooey original raw product.

Can we educate physicians to be more human?

By Brooke Holmes, Special to CNN Editor’s note: Brooke Holmes teaches the history of medicine and Greek literature at Princeton University. She writes with The Op-Ed Project . http://schoolsofthought.blogs.cnn.com/2012/05/14/my-view-can-we-educate-future-physicians-to-be-more-human/?hpt=hp_bn5 "For all the strides we’ve made through technological innovation, medicine is failing at the very human art of treating patients. Doctors are ill-equipped to deal with factors like diet and poverty, which are now responsible for over half the cases of premature disease and death in the United States. Armed with state-of-the art drugs and machines, they don’t always consider whether using these resources will cause more harm than good. In many cases, it no longer makes much sense to call what physicians and patients have a “relationship” at all." "Let’s back up and ask an even more fundamental question: What do we want from our doctors? In a word: communication." "Right now we inhabit a paradox. We tell pre-med students they need to focus on the sciences and then we complain that the doctors they become don’t treat us like people. If we want to improve the quality of health care, we need to be educating future physicians to think qualitatively and quantitatively, humanistically and scientifically."

Yet another overpriced MLM "miracle" product

Just got approached yesterday to buy waaaaay overpriced Cordyceps & ginseng pills (Nuskin's new product) - RM4500 per month's supply. Buy 10, get 2 free to boot - a RM45K investment - I could use this as a down payment for a car or piece of property (OK, outside Klang Valley)! I'm very open-minded & a supporter of traditional Chinese medicine, where it's due, but it's a fact that these MLM companies always overprice their products & the downliners always misrepresent their products. The Taiwanese (the upline of my gullible friend who can ill-afford such products but looking for a business opportunity) used the classic MLM tricks to pull wool over my eyes: 1. 1st thing was misrepresenting the product as being developed by & endorsed by Stanford University. The fine print of their website says "No". They only plan to approach Stanford U to conduct clinical trials on their product. 2. She used a listing of the product in Physician's Desk Reference as a rubber stamp approval by FDA to treat a long list of diseases. Fact #1 - their product is a food supplement & does not require FDA approval to market it Fact #2 - a listing in PDR in no way implies a drug or substance is FDA-approved. It only means it is available for sale in USA. Fact #3 - food supplements are not permitted to make medical claims of treating anything & of course, the Nuskin upline went on & on about miracle cures of impotence, look 15 years younger in 1 month, blah, blah, blah. I think the only thing she didn't cover was cancer & maybe because she knew she was talking to a doctor. 3. Thousands of rich people including movie stars are using the product & giving it "free endorsement" so why should they when they are already so rich? Well, that's why they are so rich - they are top of the heap of the MLM scheme & even M'sian downliners are subservient to S'pore upliners in Nuskin! 4. When she sensed she was losing me, she went on to say she is promoting this product only because she wants to spread the good word about the positive benefits & "Look at me, I'm 50 & look so good" - yeah, with the thickest layer of makeup. I responded & told her to look at me, I'm 44, no makeup on & I don't spend RM4500 every month on health supplements. The meeting ended pretty soon after that. Take home message: If you're already a Nuskin member, think about whether it makes sense to buy overpriced Chinese herbs from an MLM company when you can buy them from your local trustworthy Chinese medicine shop. If you aren't already a Nuskin member, think about whether it makes sense to buy overpriced Chinese herbs so you can make money off your friends for the business opportunity. So many MLM schemes in the past - Bioyoung, Lampberger (their therapeutic "medicinal" fragrance oils from France were eventually found to be sourced from China), Herbalife (Yes, I got sucked in by a relative - the only benefit I got from my experience with this MLM scheme was learning to eat less & more healthily which kickstarted my journey to healthy weight loss)...- have come & gone. They're here to stay, despite what I say (kinda like corruption in Malaysia) but that's my 2 cents worth...

FDA Announces Safety Label Changes to Finasteride

April 12, 2012 — The product labels for finasteride 1 mg (Propecia) and finasteride 5 mg (Proscar) from Merck & Co are being revised to note that some sexual adverse effects may continue after the drugs are discontinued, the US Food and Drug Administration (FDA) announced April 11.

The new label changes include:

* a revision to the Propecia label to include libido disorders, ejaculation disorders, and orgasm disorders that continued after discontinuation of the drug,
* a revision to the Proscar label to include decreased libido that continued after discontinuation of the drug, and
* a revision to both the Propecia and Proscar labels to include a description of reports of male infertility and/or poor semen quality that normalized or improved after drug discontinuation.

In 2011, both Proscar and Propecia's labels were revised to include erectile dysfunction that continued after drug discontinuation.

The FDA approved finasteride 5 mg in 1992 to treat benign prostatic hyperplasia and finasteride 1 mg in 1997 to treat androgenic alopecia in men. Finasteride 1 mg is also used off-label to treat unwanted facial hair in women. It has also been studied for chemoprevention of prostate cancer and is used off-label for this, but this use has not been approved by the FDA.

Adverse Event Reports Prompt Action

The FDA notes that sexual adverse effects were reported by patients during clinical trials of finasteride, a 5-alpha reductase inhibitor, and that this information was included in the drug's labels at the time of approval. In clinical trials, these adverse effects resolved in patients who stopped taking finasteride, as well as in most patients who continued therapy.
Finasteride (Propecia, Proscar)

For finasteride 1 mg, the FDA reviewed 421 postmarketing reports of sexual dysfunction submitted to the agency's Adverse Events Reporting System database between 1998 and 2011. Of these, 59 cases reported sexual dysfunction that lasted for at least 3 months after discontinuation of the drug, and included erectile dysfunction, decreased libido, problems with ejaculation, and orgasm disorders.

For finasteride 5 mg, the FDA reviewed 131 cases of erectile dysfunction and 68 cases of decreased libido associated with the drug that were submitted to the drug sponsor's global safety database between 1992 and 2010. Where information was available, these reported events of erectile dysfunction and decreased libido lasted for at least several weeks after drug discontinuation, the FDA says.

"Despite the fact that clear causal links between finasteride (Propecia and Proscar) and sexual adverse events have NOT been established, the cases suggest a broader range of adverse effects than previously reported in patients taking these drugs," the FDA notes in a statement. "Information about these adverse events may be important to individual patients. Therefore, prescribers and patients need to be aware of them, as part of a discussion of risk and benefits of finasteride when determining the best treatment options," the statement continued.

The agency notes that in controlled clinical trials of finasteride 1 mg, 36 (3.8%) of 945 men reported 1 or more adverse sexual experiences compared with 20 (2.1%) of 934 men who received placebo.

Sexual adverse events associated with finasteride 5 mg surfaced in 2 clinical trials. In 1 trial, these events were reported more frequently during the first year of treatment compared with in men who received placebo. In years 2, 3, and 4 of the trial, there was no significant difference between treatment groups in the incidences of impotence, decreased libido, and ejaculation disorder, the FDA says.

Botulinum to Relax Frown Lines Relieves Major Depression

From Medscape Medical News
Daniel M. Keller, PhD

March 13, 2012 (Prague, Czech Republic) — For patients with chronic major depression that does not sufficiently respond to other treatments, a single injection of botulinum neurotoxin into the glabellar muscle of the forehead to relieve frown lines appears to lead to strong and sustained improvement of the depression.

Tillmann Kruger, MD, Associate Professor in the Department of Psychiatry, Social Psychiatry and Psychotherapy at Hannover Medical School in Hannover, Germany, reported here at the 20th European Congress of Psychiatry that these findings support the concept that facial musculature not only expresses mood states but also affects mood.

He explained that frowning expresses negative emotions such as anger, fear, or sadness. A facial feedback hypothesis says that the frown itself reinforces negative emotions, with the implication that suppressing frowning will help to relieve the negative emotions.

"The theory is pretty old, and it says that many or most of the emotions we have develop somewhere in the brain, and some of them are expressed in your face, for example...and this is again received and sent back to the central nervous system by this proprioceptive feedback," he told Medscape Medical News. He said that in some cases of depression, there are signs of increased glabellar muscle activity.

Facial Feedback Theory

"Not all glabellar frown lines have to disappear to guarantee a good psychological effect," Dr. Kruger said, and full remissions have been observed in patients with residual frown lines.

"We think, regarding possible mechanisms, that the reduced proprioceptive feedback — the facial feedback theory — is the most important one. I think this is something that works 24 hours per day," he added.

There may also be some effect of social feedback in that friends and family may tell patients that they do not look so angry.

Dr. Kruger said that botulinum is able to travel in a retrograde direction via nerve fibers to the central nervous system, but given the small amount of drug used, he thought this mechanism would not explain the effects seen.

However, when asked whether a more appropriate control than placebo injections would be botulinum injections into a cranial muscle that did not affect frowning, he agreed that such a procedure would be a good control for a possible effect of botulinum not related to the relief of frown lines. Therefore, it is still possible that botulinum acted through a mechanism other than relief of frown lines.

Dr. Kruger said the study also showed that botulinum injections had excellent safety and tolerability. "It may be even economic because it's only a single injection [session], and it works for more than 16 weeks, as we have seen," he said, but the study needs to be validated in larger trials.

At present, botulinum is not indicated for treatment of depression. "But Botox has an indication to treat glabellar frown lines...and if someone has frown lines and has a depression and says, 'I want to have them away, these frown lines,' you can, of course, use it," Dr. Kruger noted.

Top lipstick brands carry highest lead levels

From www.theage.com.au

Four hundred of the most popular lipsticks in the US contained trace levels of lead when tested recently, confirming similar results of earlier analyses but on a much wider scale and at higher levels than previously detected.
Five L'Oreal and Maybelline lipsticks, owned by L'Oreal USA, ranked among the top 10 most contaminated brands, according to the analysis by the Food and Drug Administration. Two Cover Girl and two NARS lipsticks also landed in top 10 slots, as did one from Stargazer.
The findings exacerbate an ongoing disagreement between the FDA and the Campaign for Safe Cosmetics, a consumer group that's been pushing the government for years to set limits for lead levels in lipsticks.

The FDA has resisted, insisting that the lead levels detected in two rounds of its own testing, including the most recent one, do not pose safety risks. But the consumer group says the FDA has no scientific basis for its conclusion.
Reports of lead in lipstick date to the 1990s, when test results from a commercial laboratory raised concerns. The Campaign for Safe Cosmetics tested 33 red lipsticks in 2007 and found that two-thirds of them contained lead — and that one-third of those exceeded the FDA's limit for lead in candy.
The FDA followed up with its own tests on 20 lipsticks in 2008 and then on 400 lipsticks in the most recent analysis, and found detectable levels in all the products it tested.

The 10 lipstick brands and shades that contain the most lead, according the FDA study.
1. Maybelline's Color Sensation in Pink Petal. (Lead content: 7.19 ppm)
2. L'Oreal Colour Riche in Volcanic. (Lead content: 7.00 ppm)
3. NARS Semi-Matte in Red Lizard. (Lead content: 4.93 ppm)
4. Cover Girl Queen Collection Vibrant Hues Color in Ruby Remix (Lead content: 4.92 ppm)
5. NARS Semi-Matte in Funny Face. (Lead content: 4.89)
6. L'Oreal Colour Rich in Tickled Pink. (Lead content: 4.45)
7. L'Oreal Intensely Moisturizing Lipcolor in Heroic. (Lead content: 4.41)
8. Cover Girl Continuous Color in Warm Brick. (Lead content: 4.28)
9. Maybelline Color Sensational in Mauve Me. (Lead content: 4.23)
10. Stargazer lipstick in shade ''c.'' (Lead content: 4.12)


Read more: http://www.theage.com.au/lifestyle/beauty/top-lipstick-brands-carry-highest-lead-levels-20120215-1t4t4.html#ixzz1mPpZEO5h

China stops unapproved stem cell treatments

January 10, 2012

BEIJING, Jan 10 — China has ordered a halt to all unapproved stem cell treatments and clinical trials, state media reported today, as Beijing seeks to rein in the largely untested stem cell therapies now on offer across the country.

The Ministry of Health has also stopped accepting new applications for stem cell programmes, a ban that will last until July and comes as China begins a one-year programme to regulate the sector better, Xinhua cited a ministry spokesman as saying.

A growing number of hospitals and specialist clinics in large cities in China have been offering stem cell therapies in recent years for treatment of diseases ranging from cancer and Alzheimer’s to spinal cord injuries, treatments that are backed by little or no scientific evidence and which are considered at best experimental.

Some of these involve large general hospitals where patients pay thousands — or even tens of thousands — of dollars for treatments that are advertised online.

The ministry spokesman said health providers could no longer charge money for experimental stem cell applications.

According to patients, doctors and relatives of patients who spoke to Reuters earlier, patients have come away with little or no improvement and a number have died. Receipts seen by Reuters indicate that one of these hospitals is run by the Chinese army.

Such treatment involving stem cell therapies is not confined to China.

Experts have raised the alarm about patients turning up at clinics and hospitals in Mexico, India, Turkey, Russia and elsewhere for stem cell therapies that have not undergone clinical trials and which are not recognised as standard treatment.

Last week, the United States’ Food and Drug Administration issued a warning about unproven stem cell claims.

China’s Ministry of Health was not immediately reachable for comment after the Xinhua report. — Reuters

Clinic services - updated list

NEEDLE therapy + GROWTH FACTOR therapy
Needle Therapy is a piercing method creating micro-channels on the skin by using arrays of needles to increase the absorption of Growth factor or PRP to produce collagen. (Detailed info @ http://drleng.blogspot.com/2011/10/growth-factor-therapy.html)

PRP Tissue Regeneration (using MyCells kit, For more info: http://www.my-cells.net/FAQ.htm) – for total face rejuvenation, to fill in deep lines & rebuild collagen using your own growth factors derived from your own blood.

UNIXEL FRACTIONAL CO2 LASER RESURFACING (For more info: www.drleng.blogspot.com/2009/09/unixel-fractional-co2-laser.html )
o Scars (acne, burns, surgical, traumatic)
o wrinkles & skin tightening
o melasma
o uneven skin pigmentation
o open pores

RADIOFREQUENCY skin tightening and face lifting

MESOTHERAPY facial – microdermbrasion followed by needle mesotherapy with infusion of multivitamin & hyaluronic acid & Botox cocktail

Anti-aging BIO-IDENTICAL HORMONES (BIH) - more detailed info @ http://drleng.blogspot.com/2010/06/bioidentical-hormone-replacement.html

CYNOSURE ELITE LASER (detailed info @ http://drleng.blogspot.com/2009/11/cynosure-laser-hair-removal-laserfacial.html)
- Hair removal
- LaserFACIAL for wrinkle reduction & skin tightening
- leg & facial Vein removal

BOTOX injections ( more details @ http://drleng.blogspot.com/2009/07/liquid-facelift.html)
- irons out dynamic wrinkles (frown lines, crows’ feet, undereye lines, lines around lips, Marionette lines, etc)
- brow reshaping
- face reshaping - square to slimmer jaw, calf reshaping
- “dermolift”

FILLERS
NEW!! - Teosyal Puresense - local anaesthetic is incorporated into the filler to make it an almost painless procedure
– Teosyal/Varioderm – fills out deep wrinkles & face reshaping e.g. injection to give fuller lips, fill out depressed (e.g. acne, chickenpox) scars
– Subdermal/Ultradeep – nose augmentation, fill out deep wrinkles, augment cheeks
– Mesolift – rejuvenate thin delicate skin around eyes, neck, back of hands


MICRODERMABRASION (diamond ) – resurfaces the skin, removes whiteheads & blackheads

DERMOELECTROPORATION aka needle-free mesotherapy– a non-invasive transdermal delivery system that delivers nutrients to rejuvenate the skin without trauma or needles


ELECTROSURGERY – removal of warts, moles, lumps & bumps

CRYOTHERAPY – removal of viral warts

MEDLITE laser – removal of pigmentation, tattoos and birthmarks

IPL (Intense Pulsed Light) - good for epidermal pigment removal & overall rejuvenation

Permanent HAIR REMOVAL by ELITE laser

ACNE and SCAR treatment – FCO2 laser (see above), needleabrasion, chemical reconstruction of scars, subcision

RADIANTMAX LED Blue phototherapy for acne

RADIANTMAX Red Low Level Laser therapy for skin & & hair rejuvenation (more info @ http://drleng.blogspot.com/2010/06/lasers-useful-for-promoting-hair-growth.html)

KELOID injections

HAIR REGROWTH PROGRAMME
· home use Radiantlife HRx laser (www.radiantlasercomb.com) +/- in-clinic RadiantMax laser
· Needling cum scalp infusion
· Home-use hair care formulas - Regaine, Tricoaid shampoo & solution
· Oral prescription medications
· Oral nutritional supplements – Crowning Glory


WEIGHT MANAGEMENT PROGRAMMES
– oral prescription meds (Aslene, Duromine) & supplements, food replacement
- lipolytic fat injections

VELASMOOTH "3-in-1” radiofrequency, infrared & negative pressure & tissue massage to
- Reduce cellulite
- Smoothen & firm the skin
- Reshape & contour the body
- Relieves muscle aches & pains

SKINCARE brands – various

MINERAL MAKEUP

Growth factor therapy

Growth Factors are natural proteins found in our body especially in young skin - they play a key role in regulating growth of a wide variety of cells and tissues including production of new collagen and elastin. They help slow down the skin aging process, stimulate new collagen, elastin & hyaluronic acid growth, improve wound healing, decrease skin pigmentation & improve moisture content & elasticity.

They can address skin problems like wrinkles, sagginess, age/sun spots, enlarged pores, acne scars & stretch marks.

Growth factors can be delivered into the skin straight after fractional laser resurfacing or after needle therapy.

Please visit this link to look at before & after pictures of what growth factors can do for your skin. It's in Korean so just visit for pics: http://www.enskin.com/shop/m_mall_detail.php?ps_ctid=01000000&ps_goid=232

An alternative to growth factor therapy is PRP (platelet rich plasma aka PRP (For more info: http://www.my-cells.net/FAQ.htm)

Details of current promos @
http://www.facebook.com/pages/Lengs-Clinic-Medical-Cosmetic-Services/286085575374

Treatment updates

Explore new treatments now available for:

1. Hair loss - DIY treatment @ home instead of spending thousands in clinics or salons

2. Acne scars - harnessing stem cell growth factors

3. Hyperpigmentation - paradigm shift in treatment approach - making it manageable for long-term maintenance & certainly more affordable



Check out new product "Reactiver" now available:
http://www.radiant2life.com/reactiver

30-50% discount on various products including:
- Lashbooster
- Skin whitening range
- Hair loss prevention

Dysport - wise words

Wise words about Dysport (botulinum toxin) from Dr Sergio Escobar M.D.,Argentina, International Fellow American Academy of Dermatology.

"Each patient should be evaluated individually in order to customize treatment according to his/her personal characteristics & preferences.

Notwithstanding this, irrational use of this cosmetic tool has generated fear in many individuals, thus making them reluctant to treatment. There are numerous cases in which excessive use of aesthetic procedures has led to terrible outcomes, but it is also true that doing nothing does not seem to be a good alternative either.

Long term use of botulinum toxin has a beneficial effect fro the aesthetic point of view, and it is estimated that if the treatment approach is adequate, with the right dosage, treatment administered twice to three times a year & in combination with other treatments, the passing of time may work in the patient's favor & not against."

IV skin whitener could be deadly

Publish date: May 19, 2011
By: Bill Gillette
Source: Cosmetic Surgery Times

Manila, Philippines — The Food and Drug Administration of the Philippines has issued an advisory that warns of the potentially serious risks of using the popular intravenous skin whitener glutathione (Glutathione IV), GMA News Online reports.

Citing reports received by the agency, Director Suzette Lazo, M.D., is quoted in the advisory as saying, “The alarming increase in the unapproved use of glutathione administered intravenously as a skin-whitening agent at very high doses is unsafe and may result in serious consequences to the health of users.”

According to Dr. Lazo’s statement, adverse reactions include the deadly Stevens-Johnson syndrome and toxic epidermal necrolysis; thyroid function derangement; suspected kidney dysfunction, potentially resulting in kidney failure; and severe abdominal pain in a patient receiving twice-weekly glutathione administered intravenously.

Glutathione is a liver-generated compound that plays a role in antioxidant defense, metabolism and regulation. It may induce a skin-whitening effect by inactivating the enzyme tyrosinase, which is needed in melanin production and converts the pigment to the lighter pheomelanin. Dr. Lazo noted that this claim has been disputed.

“When administered orally, (glutathione) is hydrolyzed by the gastric juices and further undergoes degradation by the liver enzyme, and the resultant bioavailability is low,” she said. “Intravenous administration delivers very high doses directly into the systemic circulation and may overload the renal circulation.”

Confessions of a Grouponaholic

I got this fantastic article from CNN written by LZ Granderson.
It just about says it all - everything from the customer's point of view & the merchant's point of view.
Enjoy the read!

Grand Rapids, Michigan (CNN) -- There's a deliciously seductive power to Groupon, isn't there?
It creates an illusion of urgency by using flashy fonts and touting retailers who limit the number of people able to take advantage of the tantalizing discounts. So instead of stopping to ask, "Do I need this?" there is an overwhelming sensation to grab it before it's too late. It's like Black Friday, except instead of standing outside in a long line at 4 a.m. for a 6-inch waffle maker, I'm getting my shopping thrill online.
My partner and I bought six coupons -- worth a total of $360 -- for $150 at a fancy steakhouse here in town. The problem is we don't really like fancy steakhouses -- never have -- so we've only been once. The remaining $300 worth of discounts will soon expire, but hey, at least we didn't miss our chance to "save."
It's a brilliant concept really and builds on one retailers have been using for years, such as offering rebates knowing a good percentage of the customers won't bother to mail them in. It's easy money -- which explains in part why Google tried to buy Groupon for $6 billion. That may be a bit generous of an offer until you factor in that Groupon charges the merchant a hefty 50% of the sales made through its website. It's a lucrative business and one frugal customers like me love.
What I can't figure out is what does the company offering the discount get?
Besides screwed.
If you take a service that normally costs $100, the company may end up with as little as $25 once everyone else gets his or her share, assuming all the coupons get used. And that's before staff or utility bills are paid.
"There is an initial hit, but over the course of the year, there is a return," said Julie Mossler, a Groupon spokeswoman. "You can blindly spend a lot of money advertising on the radio or something like that, but Groupon does the best job exposing your business to thousands of people who may not be aware you even exist. That's the service we provide -- amazing exposure. And we work with our clients to help them retain those new customers.
"But our clients have to take responsibility, too. We can get the people in, but if the service isn't good or the quality isn't good, you're not going to benefit. ... If you suck, there's nothing Groupon can do."
Ouch.
But she's so right.

Joining Groupon's increasing mainstream popularity will likely bring in a rush of new customers, making it easier for small business owners to overlook the fact that they're getting squeezed between Groupon's fat cut of the take and the huge discount offered to consumers. And while initially Groupon may seem like a smart investment for small, struggling companies looking for a jolt, it shouldn't take long for mom and pop shops to see they may be cannibalizing what little business they have.
That's because the loyal customers who used to sustain the business at full price are now coming in with 50 percent-off coupons. But if it does take them long to figure that out, well, Groupon is probably the least of their worries. They're probably not a very good business to begin with, and they're paying Groupon and opportunistic customers to highlight that fact.
Now as I said, I'm a Grouponaholic so whatever problems I have with the company's practices is not enough to get me off the sauce. I love waking up each morning to see what new deals Groupon, Living Social and the other similar sites have are out there.
But truth be told, if I were starting a small business, I wouldn't do it.
Why?
Because the problem with attracting customers like me is that we're not loyal.
We're cheap. That's why 40 million of us signed up for discounts in the first place.
So even though Groupon works with merchants to help retain new customers, if we're offered a similar service or good from another company at a cheaper price, chances are we're gone.
Groupon's great at getting a customer's attention, but loyalty can only be earned.
It can't be purchased.

There's a boutique men's clothing store I frequent that doesn't do Groupon and only occasionally has sales. But I'm a regular, full-price paying customer because it does an amazing job.
It's like that line from the Oscar Wilde essay, "The Decay of Lying": If one cannot enjoy reading a book over and over again, there is no use in reading it at all.
For a new business owner the goal should be making the few customers believe whatever is being offered is worth the price, as opposed to selling the goods and services short to a lot of customers who may not even come back.
It's one thing for a company to see Groupon as a marketing investment. But if management believes it has to shell out upward of 75 percent of the receipts to get people to dine at their restaurant, then something may either be wrong with what's on the menu or with the people serving. And as Mossler said, if you suck, there's really nothing Groupon can do about it.
Besides something feels odd about a business model in which a restaurant owner stands to make more money if people don't show up to eat. At least not with the coupons sent out to attract people to show up to eat. That fancy steakhouse I mentioned earlier may make a profit off of my unused coupons. But it didn't earn repeat business, which in the end should be the most important thing.
Face it, if you're a businessperson struggling to make ends meet, Groupon's less of a solution and more like a magnifying glass.
The opinions expressed in this commentary are solely those of LZ Granderson.

RM3000 hCG Weight Loss Programs

hCG Weight Loss Programs: What Is the Evidence?

Andrew Kaunitz, MD

Hello, I'm Andrew Kaunitz, Professor and Associate Chair of the Department of Obstetrics and Gynecology at the University of Florida College of Medicine in Jacksonville, Florida. Today I'd like to discuss hCG Weight Loss Programs: What Is the Evidence?

On a regular basis, patients are asking me about human chorionic gonadotropin (hCG) weight loss programs. Not being familiar with this, I looked into hCG as used in weight loss programs.

It turns out that the use of hCG for the treatment of obese and overweight patients has a long and controversial history. In the 1950s, a Dr. A. Simeons introduced the use of hCG injections combined with a strict 500-calorie-a-day, high-protein diet.[1]

By the 1970s, Simeons' method had become popular among those seeking weight loss, with advocates claiming that this approach indeed induced rapid weight loss with minimal hunger. While the program appeared to work, this approach to dieting fell out of favor after clinical trials noted that weight loss occurred because of the strict diet, not because of the hCG injections. A 1995 meta-analysis concluded that "...there is no scientific evidence that hCG is effective in the treatment of obesity..."[2]

Notwithstanding the lack of evidence supporting hCG's efficacy,[3] for profit weight loss programs are once again promoting hCG injections. A Google search turned up a number of programs advertising hCG-based weight loss right here in Jacksonville, as well as more than 7 million hits overall.

In a 2010 press release, the American Society of Bariatric Physicians indicates that it is "...officially not recommending..." hCG injections for weight loss, once again pointing to numerous studies that fail to demonstrate efficacy.[4,5]

This press release goes on to point out that the pillars of an effective approach to weight loss include:

* Diet modification based on safe caloric and nutrient guidelines;
* Exercise programs tailored to the capabilities and limitations of the patient; and
* Behavioral counseling, including development of proper eating habits, how to deal with stress-related eating, and how to address the diet and lifestyle of the whole family.

Seems like sound advice to me. Thank you.


My comment: A lot of my clients have paid no less than RM3000 for a month of hCG jabs to various clinics around Kuala Lumpur. Sure, they've lost weight, one even lost 10 kg in that month. It just goes to show that when you have someone nagging you to eat no more than 500 calories a day, you'll lose enough weight to model in Oprah's show.
Wow, if I implement this programme in my clinic, I could make a name as a weight loss guru & get me that BMW I always wanted. Ka-Ching!!