2.1 Prevention of Pregnancy
As a result, several studies, including one by Anton and Moak , indicated that when GGT is combined with CDT, the sensitivity for detecting heavy alcohol consumption is improved among women, without losing specificity. Other, more intensive approaches, which have received little empirical evaluation but which have intuitive appeal for this population, should be evaluated. Increasingly, support for water fluoridation has come under attack. Open access journal articles are essentially peer-reviewed and available for access through the directory of Open Access journals. Infant Behavior and Development ; Caffeine has been shown to not only reduce the pain of Delayed Onset Muscle Soreness DOMS  , but also reduces the associated weakness   .
Alcohol — Health Benefit or Hazard?
However, it has been found that the nicotine yield of individual products has only a small effect 4. A major metabolite is cotinine. Other primary metabolites include nicotine N' -oxide, nornicotine, nicotine isomethonium ion, 2-hydroxynicotine and nicotine glucuronide. Glucuronidation and oxidative metabolism of nicotine to cotinine are both inhibited by menthol , an additive to mentholated cigarettes , thus increasing the half-life of nicotine in vivo.
Nicotine is a hygroscopic , colorless to yellow-brown, oily liquid, that is readily soluble in alcohol, ether or light petroleum.
As a nitrogenous base , nicotine forms salts with acids that are usually solid and water-soluble. Nicotine is readily volatile vapor pressure 5. Nicotine is optically active , having two enantiomeric forms. On exposure to ultraviolet light or various oxidizing agents, nicotine is converted to nicotine oxide, nicotinic acid vitamin B3 , and methylamine.
Nicotine is a natural product of tobacco, occurring in the leaves in a range of 0. The biosynthetic pathway of nicotine involves a coupling reaction between the two cyclic structures that compose nicotine. This is followed by a condensation with glyceraldehydephosphate and a cyclization catalyzed by quinolinate synthase QS to give quinolinic acid. Quinolinic acid then reacts with phosphoriboxyl pyrophosphate catalyzed by quinolinic acid phosphoribosyl transferase QPT to form niacin mononucleotide NaMN.
The reaction now proceeds via the NAD salvage cycle to produce niacin via the conversion of nicotinamide by the enzyme nicotinamidase. Biosynthesis begins with decarboxylation of ornithine by ornithine decarboxylase ODC to produce putrescine.
Although studies conclude some form of coupling between the two component structures, the definite process and mechanism remains undetermined. The current agreed theory involves the conversion of niacin into 2,5-dihydropyridine through 3,6-dihydronicotinic acid. Nicotine can be quantified in blood, plasma, or urine to confirm a diagnosis of poisoning or to facilitate a forensic autopsy.
Urinary or salivary cotinine concentrations are frequently measured for the purposes of pre-employment and health insurance medical screening programs. Careful interpretation of results is important, since passive exposure to cigarette smoke can result in significant accumulation of nicotine, followed by the appearance of its metabolites in various body fluids.
Nicotine is named after the tobacco plant Nicotiana tabacum , which in turn is named after the French ambassador in Portugal , Jean Nicot de Villemain , who sent tobacco and seeds to Paris in , presented to the French King,  and who promoted their medicinal use.
Smoking was believed to protect against illness, particularly the plague. Tobacco was introduced to Europe in , and by the late 17th century, it was used not only for smoking but also as an insecticide. After World War II , over 2, tons of nicotine insecticide were used worldwide, but by the s the use of nicotine insecticide had declined below tons.
This was due to the availability of other insecticides that are cheaper and less harmful to mammals. Currently, nicotine, even in the form of tobacco dust, is prohibited as a pesticide for organic farming in the United States. In , the EPA received a request, from the registrant, to cancel the registration of the last nicotine pesticide registered in the United States.
Nicotine was first isolated from the tobacco plant in by physician Christian Wilhelm Posselt and chemist Karl Ludwig Reimann of Germany , who considered it a poison. The nicotine content of popular American-brand cigarettes has increased over time, and one study found that there was an average increase of 1.
Because of nicotine's high risk to health, nicotine patches are not recommended for clinical use in depression. Though tobacco smoking is associated with an increased risk of Alzheimer's disease ,  there is evidence that nicotine itself has the potential to prevent and treat Alzheimer's disease.
Research into nicotine's most predominant metabolite, cotinine , suggests that some of nicotine's psychoactive effects are mediated by cotinine. Little research is available in humans but animal research suggests there is potential benefit from nicotine in Parkinson's disease.
From Wikipedia, the free encyclopedia. This article is about the chemical. For other uses, see Nicotine disambiguation. D Evidence of risk. Nicotine withdrawal and Smoking cessation. Tobacco and other drugs. Addict Sci Clin Pract. Withdrawal symptoms upon cessation of nicotine intake: Thus, nicotine-dependent smokers must continue nicotine intake to avoid distressing somatic and affective withdrawal symptoms. Newly abstinent smokers experience symptoms such as depressed mood, anxiety, irritability, difficulty concentrating, craving, bradycardia, insomnia, gastrointestinal discomfort, and weight gain Shiffman and Jarvik, ; Hughes et al.
Experimental animals, such as rats and mice, exhibit a nicotine withdrawal syndrome that, like the human syndrome, includes both somatic signs and a negative affective state Watkins et al.
The somatic signs of nicotine withdrawal include rearing, jumping, shakes, abdominal constrictions, chewing, scratching, and facial tremors.
The negative affective state of nicotine withdrawal is characterized by decreased responsiveness to previously rewarding stimuli, a state called anhedonia. Psychology research and behavior management. Hollinger 19 October Introduction to Pharmacology, Third Edition. International Union of Basic and Clinical Pharmacology. Retrieved 1 September A Foundation for Clinical Neuroscience 2nd ed. Lobeline is a natural alkaloid of Indian tobacco.
Both drugs are agonists are nicotinic cholinergic receptors The New England Journal of Medicine. The chemical components of tobacco and tobacco smoke. In Yamamoto, Izuru; Casida, John. Nicotinoid Insecticides and the Nicotinic Acetylcholine Receptor. Birth Defects Research Part C: Tracing back the generally accepted lethal dose to dubious self-experiments in the nineteenth century". Expert Review of Respiratory Medicine. Retrieved 10 March Surgeon General of the United States.
Bradley; Lam, David C. Safe to recommend to patients? Cleve Clin J Med. Nicotine plays a direct role in carcinogenesis through a variety of mechanisms, including increasing the activity of tumor growth-promoting transcription factors, decreasing apoptosis, and increasing angiogenesis in tumors.
Additionally, specific types of nicotinic acetylcholine receptors— eg, alpha 7 receptors, which are stimulated by nicotine—are found in many malignant tumors and are thought to play a role in tumor progression. However, these findings were from in vitro studies, and the concerns they raised have not been reflected in in vivo studies.
Retrieved 20 August Perspectives thérapeutiques" [From nicotinic receptors to smoking dependence: Alcoologie et addictologie in French. Towards a biobehavioral explanation".
Throughout its American range it is often associated with a cousin from which it needs to be distinguished, pearly everlasting Anaphalis margaritacea L. This plant has pearly white, unscented flowers, and overlaps in range. It tends to grow further to the north and west. It is also the chief predator of the rabbit. It is remarkable that few of these names betray Old World origins, and that the most common British names, cudweed and cottonweed Salmon, , were completely unknown in the New World.
Many settlers apparently saw this plant for the first time on the sandy coastal shores of eastern North America. The striking appearance stimulated their imagination to provide new names.
At the time when the English settlers first arrived in North America the European everlastings were widely appreciated by housewives in Britain for their decorative potential Gerard, , , but they were hardly used in medicine. However, as will be noted below, cudweed is still in use in English folk medicine today. In North America, the use of sweet everlasting as an indoor bouquet or posy was a well established folk custom among early Anglo-American housewives.
I carry on this practice myself: Rabbit tobacco was also used in the home by American Indians, though here it was used, not just for its smell, but for protection against ghosts and witchcraft see Smith and Merring, below. The popularity which rabbit tobacco achieved among the Anglo-American settlers as a medicine was probably due to Indian influence rather than European.
Culpeper testifies that it was little used in England. The bestowal of new names also shows that Europe was probably not the origin of medical knowledge of this plant. By the time Constantine Rafinesque wrote in , rabbit tobacco was well established as an American folk remedy for cuts, colds, asthma, diarrhea, and pain. It was used by lay healers and professional doctors.
However, Gnaphalium never entered deeply into the medical tradition and today would be considered an obscure and seldom used medicinal agent by herbalists following the literary as opposed to the folk tradition. It remains something of a folk remedy in the American South and is sometimes used by Eastern Europeans searching for Gnaphalium uliginosum. During the height of its popularity in the nineteenth century, Gnaphalium obtusifolium was given a homeopathic proving, i. These revolved mostly around muscular and skeletal issues, especially sciatica.
Some of these symptoms were confirmed in practice, but due to its narrow scope Gnaphalium remained a remedy of little consequence in nineteenth century homeopathy and has largely passed into oblivion in contemporary homeopathy. The fact that the traditional folk medical uses of the plant were not brought out in the provings may be significant. A good sense for the plant was not developed in the homeopathic provings or clinical experience. In the twentieth century the use of rabbit tobacco in herbal medicine and homeopathy declined significantly to the point where it must be considered mostly a local Southern folk remedy of sporadic application.
I first learned about its efficacy in congenital asthma from a woman in Virginia. However, sweet everlasting is still available in Western herbal commerce and it is still well known among American Indian people. The Gnaphaliums are native throughout the world. In North America there are about 10 representatives, plus a close cousin, Anaphalis margaritacea pearly everlasting.
In Europe there are also about a dozen Gnaphaliums, as well as a few Antennarias. Then there is a fourth genus, Helichrysum, only found in the Old World. Gnaphalium obtusifolium is the most common representative of the everlasting clan in eastern North America and the most easily recognized, with its distinct, pleasant smell.
Rabbit tobacco is widely used among the Southern Indians. The name is undeniably of American Indian origin. It is usually applied to Gnaphalium obtusifolium, but sometimes to Anaphalis margaritacea.
Garret , 91, , an Eastern Cherokee,uses the name rabbit tobacco for Gnaphalium obtusifolium, Anaphalis margaritacea, and Antennaria plantaginifolia. Garret treats us to a Cherokee folk tale describing the origin of the name. Rabbit was caught in the underbrush one day and while freeing himself he got cut. There was some sweet everlasting growing nearby and he quickly discovered that the plant was curative for cuts.
This story reflects a knowledge of the habitat in which rabbits like to hide and feed thickets and their weaknesses.
Rabbit skin is very thin and delicate. If a rabbit is chased by a dog or predator the skin can tear and bleed. This tale does not explain the association with tobacco so I asked my friend Sondra Boyd, R. In the Rev. The reputation of sweet everlasting as a wound remedy was reported by Peter Kalm , He learned of it from John Bartram, the noted botanist widely traveled in both Indian and colonial America along the eastern seaboard.
Bartram told me another use of this plant: Here we see the idea of the sweet everlasting pillow, which will be further encountered below. James Mooney , , who studied extensively among the Eastern Cherokee, wrote about the use of Gnaphalium decurrens, winged cudweed or winged life everlasting.
This species, now known as G. It is probable that the two were not differentiated by the Cherokees. As the next source notes, it is also diaphoretic. Several books by modern Cherokee authors mention the use of rabbit tobacco. Hamel and Mary U. Decoction for colds; use with carolina vetch [Vicia caroliniana] for rheumatism; sweat bath for various diseases; warm liquid is blow down through through joy-pye-weed stem for clogged throat diphtheria ; ingredient in medicine for local pains, muscular cramps, and twitching; chew for sore mouth or throat; smoke for asthma; cough syrup.
The use of rabbit tobacco for cramps and twitchings reminds us of rabbit, a twitchy critter. We also find Gnaphalium obtusifolium to be a plant of importance among Indian people further west.
Huron Smith , 30 reports its use by the Menomini Indians of central and northern Wisconsin. Smith himself was knowledgable about the use of herbs he often quotes the eclectic materia medica and was a sympathetic interviewer, so his information is unusually good compared with some other ethnobotanists.
When one has fainted this is used to bring him back to consciousness again, the smoke being blown into his nostrils. Then again, when one in the family has died, his spirit or ghost is supposed to come back to trouble the living. Bad luck and nightmares will result to the family from the troublesome ghost.
This smudge discourages and displeases the ghost which, after a fumigation of the premises with this smudge, leaves and never returns. Smith clearly sees the relationship between getting the soul of the conscious person back, and getting rid of the unwanted spirit haunting the house.
The use of Gnaphalium, to correct problems arising at the border between life and death will be further described below. It is helpful when the dead have been cut off from the living and have something they want to share or say, but it has potentially unpleasant side-effects and applications, so it has to be used with caution. The dried flowers are picked in the fall and, because the life still remains in them, Grandpa Red Elk would not allow them to be taken inside the house for another six months.
In American Indian folk lore the owl is often considered a very unwelcome guest around households because it is taken as a sign that someone is going to die. It is sometimes also associated with sorcerors. The owl is also a major predator of the rabbit. This is true of a picked clump or a stand of the plants in a field. Therefore, one has to be careful with both the wild and the picked plants, to make sure they are not carrying something unhealthy with them. Although Paul Red Elk was unwilling to use sweet everlasting as a tobacco, another native American friend of mine had no such compunctions.
As we move West we find that Anaphalis margaritacea or pearly everlasting is more often cited by Indian medicine practitioners, since it is available out onto the Great Plains and into the Rocky Mountains. Huron Smith , found that the Flambeau Ojibwe of northwestern Wisconsin, living outside the range of sweet everlasting, used pearly everlasting flowers on a fire to revive a person paralyzed from a stroke.
The Minnesota Ojibwe likewise used pearly everlasting combined with wild mint in a decoction, sprinkled on hot stones, as a medicine to revive from paralysis. The top is dried and placed upon a pan of live coals because it is supposed to hurt the eyes of the evil spirits and cause them to stay away from the house.
As mentioned above, rabbit tobacco was one of the most important plants in the Cherokee pharmacopoeia. By contrast, the English cudweed was but little used. Thus, it seems likely that the use of Gnaphalium owes more to the American Indian than the European materia medica. Very few people were in a position to compare the two plants, though one person who does so was the English herbalist William Salmon , He attributes to it the same properties as the English cudweed Antennaria dioeca.
This was certainly the impression of the nineteenth century physicians who stood closer to the folk tradition than we ourselves. Nevertheless, the point has to be made that English cudweed was used on almost the exact same indications as rabbit tobacco.
Charles Millspaugh , 89 gives the following synopsis of the medicinal history of Gnaphalium obtusifolium. The herb, as a masticatory, has always been a popular remedy, on account of its astringent properties, in ulceration of the mouth and fauces and for quinsy. A hot decoction proves pectoral and somewhat anodyne, as well as sudorific in early stages of fevers.
A cold infusion has been much used in diarrhea, dysentery, and hemorrhage of the bowels, and is somewhat vermifugal; it is also recommended in leucorrhea.
The fresh juice is considered anti-venereal. Hot fomentations of the herb have been used like Arnica for sprains and bruises, and form a good vulnerary for painful tumors, and unhealthy ulcers. The dried flowers are recommended as a quieting filling for the pillows of consumptives. Rabbit tobacco was also used as a medicine in the Afro-American community, according to Dr. The first detailed report on the folk medical uses of the everlastings comes from Constantine Rafinesque , , professor of botany at Transylvania College, in Kentucky.
He uses the names Gnaphalium margaritacea, cudweed, silver leaf and none so pretty. They are mild astringents and vermifuges, used in dysentery and hemorrhage, in powder or decoction. Externally they are applied to tumors, contusions and sprains as a wash.
They are given in a disease of sheep. In the twentieth century the use of the everlastings in folk medicine largely died out. One of the few herbalists in the literature I have been able to find who regularly used rabbit tobacco in the late twentieth century was Tommie Bass, a folk practitioner located on Shinbone Ridge in northern Georgia Crellin and Philpott, , 2: He used rabbit tobacco quite a bit, especially as an ingredient in his favorite cough syrup, a recipe for which is given below.
He notes that people formerly used to smoke it. He lists the following uses, which are fairly standard in folk medicine: Bass made a cough syrup that included rabbit tobacco that was very popular with his customers. He mentions it five times, giving five different formulations, but the basic compound seemed to be: His formulation for commerce added yellow root, redshank red root and sumach leaf Ibid.
Hale was the nineteenth century homeopath most responsible for the introduction of many widely used American herbal medicines into homeopathy. His writings show him to be well acquainted with the folk medical uses and the literature of botanical medicine. However, Hale does give a history of its use in homeopathy, the major symptoms derived from its proving, and the symptoms confirmed in practice. Woodbury and others of Boston. Its sphere of action appears to include certain nerves of the face and lower extremities, and the mucous membrane of the bowels.
The provings show it to cause an intermittent neuralgia of the superior maxillary nerve of both sides, and an occipital headache, with shooting pains in the eyeballs. Woodbury has lately reported a case cured. By reference to the provings, you will see that the pain is attended by cramps of the calves and feet, and a numbness which takes the place of the pain, at times.
It seems to faintly resemble Colocynth and Veratrum album. McGeorge added some clinical observations and case histories. The leg was cramped and drawn up, worse in cold and damp weather Clarke, , I: The pains were paroxysmal, coming on when walking, occasionally while lying down. In several instances the pan extended down the right cord into the testicle and caused him to draw up the leg, flexing the thigh on the abdomen. A few doses of Gnaphalium 1x cured him completely. The second case was a widow, aged 68, who had severe pains in the outer side of the right thigh for six years, during part of which time she had been confined to bed.
The pains were paroxysmal, cutting, tearing, extending down the course of the sciatic nerve. Attacks were worse at night and more frequent, causing her to roll about the bed and cry out with the pain. After unsuccessful allopathic and homeopathic treatment Gnaphalium 1x was given with gradual improvement. In eight weeks the cure was complete Ibid. Edwin Hale gives a list of symptoms produced in the homeopathic provings. I have selected what I thought were the most promising from the list.
William Boericke , , fifty years later, includes the more proven and characteristic symptoms, but does not add many new ones. Note that asthmatic and respiratory symptoms, so important in traditional literature in both North America and Europe, were not produced by the provings, except for the suggestion of maxillary sinus problems. Dull, heavy expression of countenance; face appears bloated. Fullness about the temples. Neuralgic pain, of a intermittent form, of the superior maxillary of both sides.
Tongue covered with long white fur. Flatus of the stomach, windy eructations, nausea and hiccough. Colic pains in various parts of the abdomen, which is sensitive to pressure confirmed. Vomiting and purging, like cholera morbus confirmed. Borborygmus abdominal bloating , with much emission of flatus. Diarrhea, with irritable temper; pains in the bowels of children confirmed. Constipation for three days after the diarrhea. Fullness and tension in the bladder. Pain in the kidneys.
Irritation of the prostate confirmed. Dysmenorrhea; menses scanty and painful the first day; weight and fullness in the pelvis McGeorge. Debility and rheumatic pains in arms. Chronic backache in lumbar region. Lumbago; pain and numbness. Intense pain along the sciatic nerve confirmed, Shelton.
Frequent cramps of the calves of the legs. Cramps of the feet when in bed. Rheumatic pains in the knee and ankle joints. Pains alternating with numbness confirmed, Clarke. The European Gnaphaliums suffer from as much or more nomenclatural confusion than the American. In addition to being mixed up with the Antennarias, they are also crisscrossed with the Helichrysums.
And like their American cousins, they are not generally used in professional, or even folk medicine. An exception to all this bother is the marsh everlasting, Gnaphalium uliginosum L. It has also been markedly free of nomenclatural confusion. The second member of this family that figures in medicine is Gnaphalium dioecum L.
Thus, it has a long, but not very extensive, history of medicinal use. A third member of the clan sometimes applied as a medicine is Gnaphalium arenarium, also classified as Helichrysum arenarium.
It is native to Germany, Scandinavia, and Russia, as far east as Japan. The fourth member of the family used in medicine is Gnaphalium stoechas L. Frequently they are a mixture of many different substances that are believed in some way to be stimulating. Energy drinks should be used with caution, as the substances they contain may not have been scientifically evaluated, especially in the combinations provided.
Energy drinks often contain carbohydrate, but the specific types of carbohydrate and the concentration used may not be appropriate to athletic events. I've tried a few different energy drinks, and the only one I use now is Red Bull.
Red Bull is only lightly carbonated, is not too sweet for my taste, and while the mixture of glucose and sucrose is not great for sports drink, it's better than many of the alternatives. One study has shown that the added Taurine, B vitamins and other ingredients do not add any benefit over the just taking the caffeine . However, I like the taste, and my expectation of a benefit provides a useful placebo.
Red Bull contains about 80mg of caffeine per 8oz can  , which is slightly less than the equivalent volume of coffee. Energy shots are more convenient than energy drinks due to their small size and portability. However, they concentrated form can easily cause stomach upsets in addition to the problems noted in energy drinks above.
Caffeine tablets have the advantage of low-cost, predictable caffeine content, and portability. I use Natrol tables, which are mg per tablet. I cut them into halves using a Pill Cutter , then it's easy to bite off a smaller amount as needed. I carry these in my Portable Pharmacy.
Theanine is an amino acid found in tea, primarily green tea. Theanine calms the mind without inducing drowsiness, achieving a relaxed but alert mental state . Theanine has a number of benefits:. While rare, the sudden death of a runner does occur and often makes the news. Running is estimated to have a mortality rate of about 1 in 7, runners, or one death per , man-hours .
Sudden death during a marathon is rarer, at less than 1 in 50,  . The heart not only pumps blood but, like any muscle, it requires its own supply of blood as well. If this blood supply, called myocardial blood flow, is interrupted the result is a Myocardial infarction or heart attack.
Coronary artery disease, which reduces the myocardial blood flow, is the most common cause of sudden death worldwide. A moderate amount of caffeine does not change the myocardial blood flow at rest, but during exercise the caffeine significantly reduces the flow  . This decrease in myocardial blood flow is worse at altitude  and in people with Coronary artery disease .
These changes were seen with mg of caffeine, but the studies did not try other amounts to see of the effect varies with dose. The change in myocardial blood flow is not a risk factor for healthy individuals   , but for those with Coronary artery disease the combination of caffeine and exercise may exacerbate their condition. Cardiac arrhythmias irregular heartbeats are a group of conditions where the heart does not beat normally and can be a life threatening emergency. There is a common belief that caffeine is linked to some types of arrhythmias, but this does not seem scientifically supported for   .
In fact, an animal study showed that moderate caffeine reduces the risk of atrial fibrillation . A study giving recent heart attacks mg of caffeine showed no change in the risk of arrythmia . Giving mg of caffeine before a bicycle stress test to patients who have malignant ventricular arrhythmias made no difference . However, there are anecdotal reports of people having arrhythmia triggered by caffeine.
Note that a caffeine overdoes can result in heart problems . Taking caffeine can increase the risk of excessive blood pressure in people with normal blood pressure  , but the risk is greater in people who already have high blood pressure . Some authorities recommendation that individuals with high blood pressure do not take caffeine with exercise .
Because coronary artery disease may not have any initial symptoms  , risk evaluation is tricky. Some runners who died suddenly had high cholesterol, high blood pressure or chest pains . Other risk factors include diabetes, smoking, family history of heart attacks, obesity, long term alcohol use. If you have any risk factors for coronary artery disease, it would be prudent to talk to a healthcare professional. For most people, caffeine is generally taken as tea or coffee, to the bulk of the scientific evidence around the health impact of caffeine is based on these beverages.
Both green and black tea contain similarly high levels of antioxidants . Green tea contains high levels of EGCG , which has been shown to inhibit cancer cell proliferation  . This EGCG may help trigger natural cell death which in turn may help treat both obesity and osteoporosis . Green tea consumption has been linked to a reduction in upper GI cancers and green team may also help with lung, liver, prostate and breast cancers .
Caffeine intake coffee and other forms is linked to lower rates of the most common type of skin cancer  and coffee drinking is associated with a reduced risk of bladder, breast, buccal and pharyngeal, colorectal, endometrial, esophageal, hepatocellular, leukemic, pancreatic, and prostate cancers .
Coffee drinking is associated with a substantially lower risk of type 2 diabetes   , including decaffeinated .