A pharmacist's look at the supermarket and beyond

Month: November 2014

Foods for Sexual Health: C D E

Chiles and other peppers that heat up your mouth and tongue can also fire up your libido. The capsaicin in the hot peppers makes your blood vessels dilate and can make you all hot and sweaty, ready for sex! Ancient Arabian sex therapists advised rubbing a flaccid penis with a mixture containing pepper, lavender, honey, and ginger to bring it “back to life.” For younger guys, rubbing the penis with just about anything will bring it to life. Eating hot peppers causes a release of endorphins leading to a pleasant natural high that can heighten erotic experiences. Some really do like it hot!

Those fun-loving Aztecs called chocolate “nourishment of the gods”. We know that good chocolate affects neurotransmitters in a positive manner and that can’t be bad for sex. Quality chocolate, especially dark chocolate contain flavonoids which have been shown to inhibit arterial plaque formation, reduce platelet activity, and relax blood vessel walls by increasing nitric oxide, the same body chemical affected by Viagra. A nice dark chocolate with a glass of wine shared with your lover in soft candlelight with Barry White singing in the background…

(Please allow the writer time to take a short break)

Let’s continue with coffee, which, for many of us, starts our day. The physiologic effects of coffee (caffeine) include constricting cerebral blood vessels while dilating peripheral blood vessels. So coffee will not only help with that pesky vascular headache it can improve blood flow to those body parts that express an interest in sex by filling with blood. So now, “not tonight, I’ve got a headache,” can be treated with a quick visit to Starbucks: Headache gone, blood flow improved, wide awake! Let’s screw!

Cilantro (coriander to you gringos) has been reputed to improve fertility and various appetites for thousands of years. In the Arabian Nights, a man who was unable to father a child through 40 years of attempts became a dad after drinking some sort of cilantro tea. For the Freudians among you, note that the plant is often described as having an erect stem and is part of the carrot family. I enjoy cilantro and have added literally handfuls of leaves to my taco salad or Mongolian BBQ but could not discern any sexual effects other than satisfying my more mundane hunger.

More C’s: This from botanical online: “With the cilantro, the cardamom (Elettaria cardamomum), the clove (Syzygium aromaticum), the ginger (Zingiber officinale) and the cinnamon (Cinnamomum Zeylanicum) it was carried out a drink, called ” Hipocras ” that was used in the weddings. cinnamon oil This same drink was imported to Europe by the members of the crusades and later on exported to many nations of South America, but it was banned because it stimulated the libido too much.” I experimented with various mixtures using these herbs and found that cilantro did not play well, taste-wise, with the others. I may have to revisit this concoction. Hipocras could be a lucrative addition to the energy drink marketplace. Note that cloves contain eugenol, a natural anesthetic, so unless you want some temporary numbness, keep it away from your genitals. Perhaps it would be a benefit to premature ejaculators. As for cinnamon, it brings the heat! Cinnamon oil is directly applied to genitals as a sex enhancement in many cultures. I’m still working out the Hipocras tea recipe and welcome any ideas.

Cucumbers are kings of the phallus-shaped veggies and have found their way into many rooks and grannies. cuke These are one of the earliest sex toys, mostly used in solo adventures, and occasionally show up in embarrassing ER visits. An entire cucumber is about 45 calories with little nutritive value other than water and fiber. Tasty and refreshing. Many cosmeticians recommend cucumber facials for younger looking skin and reducing wrinkles around the eyes.

Cleopatra is reported to have used dates as an aphrodisiac. Not going on a date, eating medjool dates. Dates are considered the “fruits of paradise’ in Islamic culture. Considering some of the other things offered in that paradise, a little boost for stamina and improved recovery time would be a great benefit. One writer suggests using dates to make Cupid’s omelette, which contains some other sexy foods like cinnamon and eggs. Dates are super sweet, with their fruit sugars well balanced by their high fiber content. For you potassium checkers, one pitted date has about 2 mEq of potassium. Dates have a dab of protein, and, more importantly some good bioflavanoids such as the antioxidants such as lutein and zeaxanthin. Not only are these flavonoids important for eye health, they are help maintain healthy endometrium, breast, colon, and prostate tissue by preventing damage from free radicals.

Donuts are NOT a benefit to your sexual health. They are loaded with bad sugar and fats. If you must play ring toss with a donut and an erect penis, please discard the donut when you are done.

Dragon fruit has a wild pink and green peel that makes you look twice and some find somewhat seductive. The soft interior is speckled with little black seeds and the flesh can be simply spooned out to eat. It tastes like a melon to me, with a touch of green grapiness. These are fat-free and a good balance of sugar to fiber so a healthy choice. I would think the ones with redder insides would be higher in lycopene. They are a bit hard to find in the US and would likely be better eaten fresh from the source, but in any case, I found no direct effect on libido from the one half that I tried.

There is another, even more bizarre looking, fruit called the durian. I have yet to sample this one. It is reported to have a pungent odor when cut open and a taste that takes getting used to. Research in India seems to show a shorter “time to mount” in mice, as well as increases in sperm count and motility. The “time to mount” is not how long the mouse lasted in the saddle but how long it took to climb aboard when presented with an agreeable female mouse. Again, this was done with mice and some sort of durian extract or concentrate. Apparently, chemical pollution has caused widespread diminished sperm counts in Indian men so there is a touch of desperation in this research.

It goes without saying that eggs are sexy. Because of its connections with new life, the egg has been touted as a fertility aid and an aphrodisiac. Peasants in Central Europe rubbed eggs on their plows to improve their crops. You can read that literally and figuratively. 2 eggsBrides in France broke an egg on the doorstep to ensure a large family. Various egg rituals have been reported to predict the sex of an unborn child. Eggs do contain some cholesterol, which among other things, is necessary for sperm production. Eggs whites are almost totally protein which are so important for making neurotransmitters, including dopamine and oxytocin (happiness and love!). There is enough protein in one egg white to provide enough protein for about a half cup of semen. That’s somewhere around 34 ejaculations, on average. The incredible edible egg, indeed.

endive escarole Endive and Escarole are both vitamin K-rich leafy, green vegetables that provide all the nutritious goodness that you would expect from fresh greens. I found no direct sexual results, although there was a time when knowing to say “ehn-deev” rather than “N-dive” might have helped pick up women in the produce section of the campus Safeway.

Photo assistant and hand model for this post is student pharmacist Joseph Ruiz, Midwestern University College of Pharmacy, Glendale, AZ.

Foods for Sexual Health: A+B

Mankind has long been fascinated by the idea of certain foods as aphrodisiacs. That stems, of course, from mankind’s endless fascination with sex. The very word aphrodisiac derives from the goddess of love, Aphrodite. Word on the ancient streets was that Aphrodite considered sparrows to be sacred because of their “amorous nature.” The heathens responded by grinding the poor little birdies into their love potions. We’ve come a long way since then, so please don’t try that at home. Let’s keep our focus on things that we can find at the market.

Prehistoric horny humans began experimenting with foods that resembled genitalia or were seeds or eggs to see if they could be even hornier or make somebody else hot for them. If it looked. smelled, tasted or felt like a sexual organ, it was worth trying as an aphrodisiac. Often foods became known as treatments for loss of libido, impotence or infertility simply because they were nutritious. Undernourishment was quite common in the old days and good nutrition is a primary path to sexual health.

In many cultures there are still strong beliefs that sexual potency can be enhanced by eating the genitals of our animal brethren. 5 snake wineThere is actually a “Five Penis Wine” sold in China, as well as a “Five Snake Wine” both of which contain five of the named item. Five is considered a lucky number in China, but not so lucky for snakes or animals missing a penis. The availability of Viagra is actually helping save endangered species since it works so much better than dried tiger penis or powdered rhino horn. Even today, many “macho vitamins” sold in Mexico purport to contain powdered or extracts of bull testicles. I do not recommend any of these animal products.

Let’s take a look at foods with a reputation that we can find in our local markets. Foods that we are actually likely to eat and even enjoy. I’ll try to stick to the alphabet and will post in groups of reasonable size, for size does matter when it comes to blogs.

Before we get started on the sexy stuff, I should mention that the ancient Greeks warned against dill, lettuce, watercress, rue, lentils and water lilies as anti-aphrodisiacs. Hmmm, maybe I’ll skip that salad. “Hold the pickle, hold the lettuce,” doesn’t seem like an unreasonable request, especially if you hope that somebody will hold your pickle or caress your lettuce later.

Both ancient Greeks and Romans claimed that sucking on Aniseeds was said to increase desire. I found them flavorful but that’s about it. Taste like licorice. I only chewed a few, though, so perhaps I under-dosed myself. Mukhwas, that seedy mixture offered after the meal at many Indian restaurants, features Aniseeds. Although that mixture is purportedly to aid digestion, we’re talking about the folks who brought us the Kama Sutra, so what better way to start the post prandial activities than with fresher breath and a libido kicker. Anise oil has been used as a treatment for lice. Go figure.

Asparagus is thought of as a sensual food, mostly due to its phallic shape, and there may be something suggestive to feeding your lover these green stalks. It makes for potent urine but no discernible pharmacological effect. The pungent odor imparted to urine is due to thiols which may appear in the urine very quickly after eating asparagus. Interestingly, only about 40% of humans have the gene that allows them to detect this odor. If altered urine aroma is a turn-on for you, then by all means, eat your asparagus.

Arugula, frequently found in upscale salads is a pungent green whose seeds are sometimes called “rocket” seeds. You get the image? Arugula was a popular and sexy for ancient Romans. It was said to be a favorite of a god of fertility, Priapus, from whom we get the medical term for one of those erections that last longer than four hours! I find the robust taste very enjoyable and much more likely to make me feel lusty than a plain lettuce salad.

The Aztecs called the avocado tree “Ahuacuatl” which translates as “testicle tree.” They do tend to hang in pairs. During avocado harvest time Aztecs would lock up their virgin daughters as a safeguard. They are delicious with a sensuous texture. Avocados are very nutritious and a very good source of potassium (~7 mEq/fruit) but are high in saturated fats (>10gm/fruit). I recall the Texas Tornado song where the amorous young Texan wanted to “make guacamole all night long” with his lover.

Bananas have a marvelous phallic shape and make excellent training tools when teaching about proper condom use but offer little, other than providing potassium, B vitamins and suggestive oral maneuvers. The non-verbal communication as one sexily eats a banana has been the beginning of many wonderful relationships. As a rule of thumb, there is about one mEq of potassium per inch of banana. You can develop your own Freudian theories for any dreams or fantasies that you might have that involve bananas.

Mass quantities of sweet basil are reported to boost sex drive and fertility. I haven’t tried mass quantities of it, but I’d be willing to try a warm pesto body rub! In other cultures basil is revered for its sensual powers. Mexican brujas will use basil in love potions that are used to keep one’s lover from straying. Basil is sacred to Indian gods such as Krishna and Vishnu and in Italy, where it is also called kiss me Nicholas, basil has been used for many love-related purposes. Young women would often dust themselves with basil, hoping to drive the man of their desire crazy with lust. Basil has been used as a sign of availability, either as a hair ornament or in a small herb pot placed on the windowsill.

I love brussel sprouts! They are the kings of the vegetables when it comes to nutrition, and they are especially good sources for many of the necessities for sexual health. Many fertility specialists recommend brussel sprouts to improve both male and female fertility. As a favorite for increasing sperm count, I swear my “boys” hang a little heavier after a good helping of these tasty green orbs (or maybe I just need to get laid). Loaded with crucial nutrients like zinc and folic acid, these tiny cabbages come highly recommended. Great stuff for baby-making! Improved sperm count, healthy womb, folate and more for a healthy baby.

I should mention butter, if only because there are numerous reports of people using butter for a sexual lubricant, either when coupling or during individual attempts at self pleasuring. As a pharmacist, I would not recommend butter for any activity that results in exposure to sensitive mucus membranes. External use is likely OK as a natural and edible lubricant. Is this where the expression “I want to butter you up,” comes from? There are many versions of sex butters available but these are usually based on coconut and other oils. I wonder if these so-called “finishing butters” are of any value? What, exactly, are we finishing? There is also a challenging sexual position called the butter churner. You can discover that one on your own. I cannot recommend any other kind of Butterfinger than the candy bar! I prefer my butter on popcorn or toast.

It’s fun to revisit this article that I wrote many years ago and have now updated for the blog. Yes, when I say I tried the food in question, I really did, although it may have been quite some time ago. I have many good memories from many of these foods. I’ll be back with more of the alphabet soon.

Duck and Cover!

I had a patient come in searching for Oscillococcinum, a homeopathic remedy for “flu-like” symptoms. This began an interesting discussion of what the heck this product is, what is homeopathy, and does this product have any value.

You can see from the image that Oscillococcinum lists “Anas barbariae hepatis et cordis extractum” diluted to 200C and listed in the Hoemeopathic Pharmacopoeia of the United States. Sounds very impressive until you dissect all that that.

The so-called active ingredient translates (remember your Latin roots!) as extract of wild duck liver and heart! Whoa, you say, this must be some powerful ancient magic indeed! Some might worry that the entrails of these barbaric water fowl might contain some other pathogen even worse than the flu. Don’t fret though, because the “200C” indicates that the original 1/100 extract of duck organs was diluted 200 times by a factor of 100, ensuring that not a single duck molecule is likely to be present in this product. Whew! This is such a joke that there is a story floating around that even a VP of Boiron, when asked if Oscillococcinum was safe because of the duck organs, replied, “Of course it’s safe, there’s nothing in it!” It does have one gram of sugar per dose, however, so you are paying about $12 for one and a half teaspoonfuls of sugar!

Oscillococcinum was first prepared in 1925 when 35 grams of duck liver and 15 grams of its heart were put into a hopefully sterile liter bottle. After 40 days in the bottle, liver and heart turn into a kind of goo, which is then diluted, as homeopathic principles dictate, until only the “spirit” of the duck parts remain.

Homeopathy is based on the belief that these incredible dilutions, vigorously shaken with each step, somehow retains the “vital energy” of the diluted substance, even when diluted to the point of complete absence. The water remembers! This makes me wonder about the water memory of all that other stuff water has been hanging around with through the ages. Does our water remember… oh, man, this might be too gross to even consider! Have a look at this two minute explanation by Richard Dawkins.

This does not stop people from buying this stuff and many other homeopathic products, however. One of my pharmacists volunteered that her husband swears by Oscillococcinum because that’s what his mom gave him. I also have plenty of patients who swear by Hyland’s homeopathic remedies for leg cramps and even restless leg syndrome. So we are back to that always impressive placebo effect. With a strong trust and belief in mom, the guy in the white coat, the lady on TV, Dr. Oz, or even the Wizard of Oz, anything will work for you, from duck essence to ruby slippers. I really have to laugh when the label advises the pregnant or breast-feeding patient to consult a health professional before using this product. Please, oh please, ask me!

I have even seen this bullshit creeping into mainstream pharmacy magazines that should be about science, not magic. We all love magic though, don’t we? Just look at popular TV shows and movies. This modern society is not that far removed from the old belief systems that relied on potions made from eye of newt, hair of cat, and dung of bat, boiled beneath a full moon by a naked virgin. There’s still a part of us that easily slips into caveman thinking, especially when science is failing us.

With billions of dollars in sales and services, the homeopathic industry is growing, thanks to strong marketing. And why not? It’s a free market, right? What better business plan than money for nothing?

Liver and Onions

FDA has approved a single pill version of Gilead‘s Solvadi combined with J&J‘s Olysio, called Harvoni. The treatment of hepatitis C with these two drugs is reported to be 80 to 90% successful in “curing” this viral infection found in over 3 million Americans. There are some interesting economics to this story and we are facing many contentious decisions when we have to decide who gets treated and who pays the cost.

Solvadi has a 12-week regimen that costs about $84,000 while Olysio’s 12-week therapy costs $66,000. The cost of the new combination, Harvoni, has a cost expected to be around $94,500 for 12 weeks of treatment. If the patient already has cirrhosis of the liver as a result of hepatitis C, then 24 weeks of treatment are recommended for the bargain price of $189,000. Note that these are wholesale costs, before any mark-up! The drugs are commonly given with ribavirin. Olysio was often given with interferon and the new combination is reported to not need the interferon added to therapy, avoiding that cost. However, be aware that there are additional treatments that may needed, possibly doubling total cost to treat.

In a 2013 study published in Hepatology, Razavi et al, suggested an annual cost to the US economy near $6 billion, give or take a couple billion. Somewhere between 20% and 25% of hep C patients develop cirrhosis, another number to consider. So let’s do a little math before we ponder the ethics and economics of the situation.

Let’s assume the lower 20% figure for the cirrhosis and use the 3.2 million patient count provided by the CDC. That gives us 640,000 patients with cirrhosis that need treatment and 2,560,000 patients that will need the 12-week regimen. Here is the math:
640,000 x $189,000 = $120,960,000,000 that’s $120.96 BILLION! For the rest of the hep C patients, 3,200,000 x $94,500 = 302,400,000,000 which is a staggering $302.4 BILLION! So we are looking at a cost of well over $400 billion if we are to treat our hepatitis C patient population. A baby could be born and reach retirement age before we recoup the theoretical annual cost of this disease!

Consider this, from the CDC: “Today, most people become infected with the Hepatitis C virus by sharing needles or other equipment to inject drugs.”
Sure, there are other ways to get hep C, including other more legal ways that one may come in contact with another person’s blood, but sharing needles used for illicit drug use remains the most common vector for transmission in this country.

So, we are faced with a therapeutic conundrum. Who the Hell is going to pay for this stuff?!? Private insurers are quaking in fear that they will have to pony up the big bucks. Government plans would quickly bankrupt the country’s health care system. The wealthy will get it, of course, even if they have to pay full retail. Some of these people are willing to pay over $150,000 for a black market liver! Add in the cost of surgery and even 24 weeks of Harvoni is a bargain.

There is a core ethical dilemma here, of course. Are we, as a society, willing to bear the cost of these exorbitantly priced treatments merely because they exist (more are coming!)? Will we somehow ration it out (death panels!)? Will we consider the etiology of the disease and deny payment for so-called “self-inflicted” diseases such as most hep C cases? Who decides? What about other diseases? We already have folks who would lump all fat people into the “do not pay” category, believing that obesity is always self-inflicted, disregarding metabolic, psychological, or even social reasons for their condition. It’s like pulling layers off an onion, answering one question at a time, getting closer and closer to the heart of the issue, only to find that after all the layers are peeled away, there’s nothing there. It’s enough to make one weep.

There are no easy answers. About 1.8 million hep C patients are prisoners. I’ve already seen state prison systems that are preparing next year’s drug budgets and adding millions for these hepatitis drugs. This on top of their already swollen budgets that include millions for HIV treatment and other therapies that are denied to many citizens, especially the working poor. These are your tax dollars. At a recent drug diversion conference, the Office of the Inspector General of the DOJ was already preparing for ways to detect fraudulent claims for these expensive drugs. There are Senate committees taking a close look at these costs. For most of us, our compassion for our fellow man has its limits, especially when it involves our wallets, our personal quality of life, and our sense of fairness. To paraphrase the old cliche, opinions are like livers, everybody has one. How’s yours?