25Aug

Evaluating the man with ED

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Erectile dysfunction can be caused by a diversified variety of factors. Ageing, suffering from certain diseases, smoking, substance abusing, taking certain types of drugs, feeling depressed, stressed out or tired can make your erectile potency dwindle significantly. Viagra online canadian pharmacy can successfully deal with erectile dysfunction brought on by the majority of these factors. However, you should check with your urologist or andrologist if you can safely take sildenafil and have your blood panels taken regularly before and while you do.

A complete evaluation often determines likely etiological factors for ED. The evaluation of ED follows the same pattern as evaluation of any medical disorder, including a pertinent history, physical examination, and laboratory tests. However, this history must include a sexual history. A well-organized brief sexual history can be an effective diagnostic tool. It is better not to accept the patient’s label for a disorder without first questioning and obtaining a clear picture of the complaint. Often, less educated patients misuse medical or technical terminology. For example, because some men con-fuse ED with premature ejaculation, asking if the erection is lost before or after ejaculation can clarify the problem. Learning about the patient’s sexual and relationship histories can also be very revealing.

Questions generally review the phases of male sexual response and focus on problems of desire, arousal/erection, orgasm/ejaculation, and sexual pain. Offering the patient several phrases that describe the same phenomenon in different ways can make communication more clear.

For desire phase disorder, physicians can ask, “Do you still feel in the mood, feel desire, have sexual thoughts or fantasies?” ED preceded by loss of desire can signal hormonal problems, relationship difficulties, adverse effects from medication, and depression. It is difficult for most men to sustain an erection if they feel no desire.

For arousal/erection difficulties, physicians can ask, “Do you have trouble getting or keeping an erection, getting or keeping hard? Or both?” An easy method of distinguish-ing most psychogenic ED disorders from potentially organically induced disorders is to ask if the patient ever has a spontaneous or sexually induced erection at any time? A positive response strongly hints at stress or anxiety as the trigger of the ED rather than a physical cause or medication adverse effect.

For orgasm/ejaculatory phase problems physicians can ask, “Do you feel you ejacu-late, ‘come,’ too quickly (or too slowly or not at all?)?” ED is common in men who, for any reason, became increasingly anxious about quick ejaculations, delayed ejaculation, or perceived absence of ejaculation, as can occur with retrograde emission.

To reveal Peyronie’s disease or pain disorders, a physicians can ask about “a bend to the penis” or pain during or after sexual activity.

Questions about sexuality need to be sensitive to cultural and religious differences. Using terminology that is clear, simple, and respectful of the patient’s feelings can facil-itate communication. Further general questions about sex may reveal deeper misunder-standings or mishaps with sexual activity in the past. These frequently require referral to a sex therapist or viagra australia online shop.

The medical history should include review of risk factors and screening for psycho-logical difficulties. A review of medications, including over-the-counter preparations, may reveal the source of the problem, because medications have been implicated in up to 25% of cases of ED. Medications have adverse effects on all phases of sexual functioning, making clarification of the patient’s complaint a priority before ascribing symptoms to side effects of specific medications. Brief screening for depression, including such questions as “Do you sometimes feel blue, down in the dumps?” may elicit more honest responses than “Are you depressed?” Other psychiatric conditions, such as anxiety, may also be responsible for ED. The social history, which determines stress surrounding a relationship or substance abuse (including alcohol and cigarettes),

04Jul

Good-Enough Male and Couple Sexuality

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Realistic, Age-Appropriate Sexual Expectations Are Essential for Sexual Satisfaction

As you age and your body changes, your sexuality also changes. Sex is different at age 20 than at 40 or 60 or 80, but aging itself does not mean an end to sex. You truly are a sexual person until you die.

The most important positive, realistic expectation is that you are aware of and accepting of your bodily changes rather than fighting against your body. As you age, your vascular and neurological systems become less efficient, so psychological, relational, and psychosexual skill factors become more important in sexual function and satisfaction. Contrary to popular mythology, there is not a dramatic change in testosterone levels with healthy aging. A key to healthy developmental sexuality is to confront the cultural myth that you are past your sexual prime by 22 (this refers to a very narrow definition of sexual ability as able to become aroused quickly after ejaculation). Your penis and orgasm are an integral part of your sexual body, but intimate intercourse is the key to healthy sex after 25. Enjoy being an adult sexual man. Sexual satisfaction at any age is grounded on realistic expectations of your body, emotional well-being, and relationship health.

Good Physical Health and Healthy Behavioral Habits Are Vital for Sexual Health. A Man Needs to Value His Own Body as well as his Partner’s

Taking care of your physical health and body will enhance your sexual function and satisfaction. Anything that is detrimental to your vascular, neurological, or hormonal system is harmful for you sexually. An important example is smoking, which impairs your vascular system. Another crucial factor is drinking. Many young men learn to be sexual in the context of alcohol. Alcohol is a central nervous system depressant that negatively impacts sexual response. However, for young men, their sexual enthusiasm and more efficient vascular and neurological systems can override these effects. Alcohol also “greases social encounters” and can reduce self-consciousness. One or, at the most, two drinks can improve social confidence and put the man (and woman) in a passionate mood— this can be a legitimate use of drinking. The danger is when he needs alcohol as “liquid courage.” A common trap occurs when sex and alcohol are strongly linked. Alcohol abuse is a very frequent cause of male sexual dysfunction, especially erectile dysfunction – canadian pharmacy online.

In contrast, men who don’t smoke and have healthy sleep, exercise, eating, and drinking habits are protecting their sexual bodies and facilitating sexual response. This is of value throughout life, but especially after the mid-30s, because the vascular and neurological systems are less efficient and therefore sexual response is more vulnerable. Remember, healthy sexuality resides in a healthy body.

19Jun

Inhibited Ejaculation (Delayed Ejaculation and Anejaculation)

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Etiology

Inhibited ejaculation (IE) consists of delayed ejaculation (DE) and anejaculation (AE), two conditions along the same clinical spectrum. Inhibited ejaculation refers to persistent or recurrent difficulty, delay in, or the inability to achieve ejaculation despite sufficient sexual stimulation.

Delayed ejaculation and AE may be lifelong or acquired, constant or situational, and patients with DE and AE may or may not experience concurrent orgasm. Viagra sublingual – cheap ed treatment.

Delayed ejaculation and AE can be caused by a number of factors, including medical conditions, surgical procedures, and psychological issues. Any factors affecting the central control of ejaculation, the afferent and/or efferent nerve supply to the vas deferens, bladder neck, penis, and pelvic floor, can potentially lead to DE or AE. Aging is a leading risk factor for IE. Aging-related changes suggested by some authors that lead to IE include: progressive loss of the fast conducting peripheral sensory axons, collagen infiltration of myelin, and atrophy of the dermis, which collectively can lead to an aging-related hypoanesthesia of the penis. Spinal cord injury can also lead to IE. In contrast to erectile function, a man’s ability to ejaculate increases as the level of his spinal cord injury descends, and less than 5% of men with complete upper motor neuron lesions have intact ejaculatory capability. Sometimes, surgical procedures can result in IE. Such procedures include aortic bypass surgery, repair of aortic aneurysms, or other operations involving the periaortic region or pelvis. A particular example of this type of surgery that is familiar to urologists is retroperitoneal lymph node dissection. Retroperitoneal lymph node dissection is often used in treating testicular cancer and may involve the removal of the postganglionic sympathetic nerves emanating from the sympathetic chain and hypogastric plexus. The result of this intervention is ablation of the efferent stimulation for seminal emission and bladder neck closure, essential components of successful ejaculation. Nerve-sparing techniques using modified templates to preserve the essential sympathetic nerves are now commonly employed and result in a high degree of retained ejaculatory function. Even with a nerve-sparing approach, other factors such as large retroperitoneal tumor mass or preoperative chemotherapy increase the risk of postoperative ejaculatory dysfunction. Clomid Australia

Medical conditions can also lead to IE. While much has been written recently about the negative effects of diabetes mellitus (DM) on erectile function, the issues of ejaculatory dysfunction associated with DM are less well studied.

19Jun

The Truth About Sex

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Fact: You Need a Model for Your Sexuality as a Man

So, what is your model for male sexuality? Who is your role model for a sexually healthy man? How can you think positively about the multiple dimensions of your masculinity? How can you create your standard for healthy sexuality? Your model defines what—for you—is sexual health. It includes your assumptions about what is good sex and what causes sexual problems. This framework determines your understanding of the nature and purposes of sex, your attitude toward your body and your partner’s body, your feelings, the value of fantasies, sexual growth and maturity, your expectations about sex, your relationship expectations, what a sexual dysfunction is, your attitudes toward friendships with men and women, your philosophy of life, the relationship between spirituality and sex, and your definition of sexual satisfaction.

Your sexual model will have a valence; sex is either fundamentally positive or negative—sex is good or sex is bad. Your model needs to focus on you as an individual and on your sexual relationship. Focus your model on accurate knowledge, feelings (satisfaction), and behavior (sexual function). You want to avoid being simplistic or one-dimensional. Ensure that your model of sexuality is inclusive, multidimensional, and well integrated with your body and mind. As much as we all wish important things in life could be simple, the fact is that life is complex, and so is sexuality. Canadian health care mall pharmacy

Exercise: Creating Your Model of Male Sexual Health

Consider the following questions about your thoughts, beliefs, and values about male sexuality:

  • Do you think that you can be in poor physical condition and still have a good quality sex life?
  • How do you understand your body to be “programmed”? What is it sexually designed to do?
  • For you, what are the most important purposes for sex?
  • If you feel that you are ugly or have a small penis, can you find sexual satisfaction?
  • What do you think is the relationship between your physical and sexual health?
  • Could you be happy as a celibate man? What are your specific sexual needs?
  • What is the interaction between your sexual thoughts, feelings, and actions?
  • Do you think sex is the one area of your life where you should be free and not need to regulate feelings or behavior?
  • Is your sexuality your own, or is sex meant to be shared with a loving partner?
  • Do you believe that sex is serious or playful?
  • Where does your sex drive come from? Body? Emotions? Relationship? Do you think playfulness during sex is valuable for your relationship? Can you sexually disappoint your partner and still have satisfying sex and feel good about yourself?
  • How important is a good sex life to an intimate, long-term relationship?
  • Do you think sex should rely more on physical desire than emotional closeness?
  • How much do you value intimacy? How much eroticism? Can these be integrated into your relationship? Viagra online Canadian pharmacy

Reflection: There are no simple responses, no correct or incorrect responses to these considerations. Ask yourself:

  • What thoughts stand out as you reflect on these questions?
  • What do you learn about yourself?
  • Your values?
  • Your model of male sexual health?

12May

Pulmonary Hypertension as well as ED and Australian Viagra

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Viagra is a sildenafil citrate medication and was originally studied for use in treating pulmonary hypertension and angina pectoris. Pulmonary hypertension is an increase of blood pressure in the pulmonary artery. Angina pectoris is the clinical term for chest pain or discomfort when the heart muscles do not get the required amount of blood the heart needs to function properly. Initial clinical testing of the drug suggested the drug had very little effect on angina, but the drug could help induce an erection. Most of the men in the group that were part of that that initial testing group all had some level of erectile dysfunction due to hypertension, diabetes and other physical ailments.

After failing to demonstrate positive results for angina, a pharmaceutical company began to study sildenafil citrate for use in treating erecting dysfunction. After it was tested and approved for use in treating erectile dysfunction, it was marketed as Viagra. It is still used to treat hypertension under the name of Revatio.

Hypertension, commonly called high blood pressure, and erectile dysfunction seem to go hand in hand. High blood pressure is a clinical cause of erectile dysfunction and controlling one usually controls the other. There have been considerable studies completed to suggest, and in many cases document, the correlation between high blood pressure and erectile dysfunction.

Sildenafil citrate has the same side effects whether treating high blood pressure or erectile dysfunction and includes headaches and facial flushing, nasal congestion, back pain and indigestion. The side effects are temporary, and in most cases very mild. When used to treat hypertension, sildenafil citrate works to widen the arteries enough to lower blood pressure.

Sildenafil citrate is also effective when treating Mountain Sickness which is pulmonary artery pressure at high altitudes, Reynaud’s Phenomenon which is exposure to the cold that triggers small artery spasms and Heart Disease which includes diastolic dysfunction and congestive heart failure.

Sildenafil, whether used as Viagra Canadian or Revatio, has become a popular and effective method of treating several health challenges without causing other health risks. Taken orally and as directed, the user will find positive effects from the drug.

Before using either drug, always consult a medical professional and confirm the presence of an exact affliction and rule out all other health and physical issues. The medication should always be taken as directed in the time frames prescribed. Taking more of the medication than prescribed will not increase the positive effects.

31May

Etiology and Risk Factors of Erectile Dysfunction: Diabetes Part 2, Metabolic Syndrome

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A large national epidemiologic study was able to review a very large database of the diabetic male population through the use of managed care claims.

The study used this database to determine the prevalence of diabetes in men with and without ED. The prevalence of diabetes in men with ED was found to be much higher than the general population. Twenty percent of men suffering from ED were also found to have been diagnosed with diabetes; this is in comparison to only 7.5% in men without ED – to treat erectile dysfunction try cheap australia viagra online.

Given this finding that men with ED are twice as likely to have diabetes as those without ED, the diagnosis of ED may indeed serve as a useable marker for diabetic screening. A similarly large national study in 2005 evaluating men with ED found four specific comorbidities to be significantly prevalent among men carrying the diagnosis of ED. The authors even suggested that ED may be used as an observable marker for all four: hypertension, hyperlipidemia, depression, and diabetes Although treatment of ED is discussed later in the book, it is prudent to mention here that certain trials in the past decade have been specifically dedicated to the treatment of ED in diabetic males. A retrospective analysis of data from twelve placebo-controlled trials evaluated the efficacy and safety of tadalafil for the treatment of ED in diabetic males. They confirmed that diabetic men have more severe ED than controls at baseline. Interestingly, they also found that baseline erectile function in the diabetic males correlated inversely with baseline HbA(1)c levels. They concluded that although ED was found to be more severe in the diabetic population, response to tadalafil was only slightly lower than controls for the treatment of ED. Metabolic Syndrome An estimated 47 million people in the USA have metabolic syndrome.

Metabolic Syndrome is a combination of medical disorders thatincrease an individual’s risk for CAD and diabetes. Components of the syndrome include abdominal obesity, atherogenic dyslipidemia, hypertension, insulin resistance, prothrombotic states, and proinflammatory states. Correlation between metabolic syndrome and ED has been well established and mirrors the association of CAD or diabetes with the syndrome. Reported prevalence of ED in patients with metabolic syndrome falls between 26.7% and virtually 100%, and this prevalence increases as the number of components of the metabolic syndrome increases.

Of mention, hyperhomocysteinemia is an emerging risk factor for the development of ED in diabetic men. Further studies are needed to evaluate the exact mechanism by which this metabolite exerts its effect.

29May

Etiology and Risk Factors of Erectile Dysfunction: Diabetes

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The pathophysiology of ED in men with diabetes mellitus (DM) is complex and multifactorial. Men with DM, even those without significant comorbidities, suffer from a wide range of sexual dysfunction, including decreased desire and sexual satisfaction.

Prevalence of ED among diabetic men that has been reported in the literature ranges widely. Unfortunately, many studies either have not differentiated between DM Type 1 and Type 2, or were not done in Type 1 diabetics. The prevalence of ED among men with DM in the MMAS was reported at three times the general population, or 28% versus 9.6%. A more recent study evaluated selfreported ED in males with DM Type 1 and found a prevalence of 20% overall and 47.1% in those 43 years of age or older. Along with objective factors, such as decreased libido, men with DM Type 2 demonstrate organic causes with a decreased nocturnal penile tumescence.

Several cellular and molecular derangements have been described in diabetic men that contribute to the increased risk of ED in this population. Vascular injury is an important cause of ED in this population. At gross anatomical level, men with diabetes have an increased prevalence of cavernosal arterial insufficiency, thus impaired arterial response, on ultrasound.

erectile-dysfunction-diabetes1An early study reported impaired endothelial-mediated vasodilation upon exposure to acetylcholine, a parasympathetic agent, in cavernosal tissue of diabetic men with ED.

Since this study, endothelial dysfunction in cavernosal tissue of diabetic men has been characterized by abnormalities including, but not limited to, increased apoptosis, oxidative stress, and overactivity of protein kinase C.

Thus, the effect of DM on penile vasculature is mechanically similar to its effect on other vascular structures throughout the body. Although advanced glycation endproducts have been demonstrated in cavernosal tissue, their significance remains unclear.While a majority of research has focused on diabetic ED as vascular phenomenon, there is at least correlational evidence that autonomic neuropathy plays a role in the development of ED in diabetics. The existence of ED in men with diabetes is also predicted by age and other complications of diabetes, such as retinopathy and depression

18Oct

Xylitol a Diabetic Friendly Sweetener

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Xylitol is an all-natural sweetener that is used as a substitute for sugar. The fibers of various fruits & vegetables contain Xylitol. It is made from fruits like pears, strawberries and plums, as well as cornhusks or birch bark. It tastes more similar to sugar than any of the other substitutes that are available today.

Xylitol was discovered in the latter part of the 19th century. It became popular in Europe as a sweetener that was safe for people suffering from diabetes because it did not affect their insulin levels.

A diabetic individual is generally advised to lower their simple carbohydrates and sugar intake. The majority of the experts agree that a small amount of sugar can be included in a diabetic diet. However, replacing sugar with a sweetener can help a diabetic to manage their glucose levels. This is especially useful for people with a ’sweet’ tooth. Xylitol is a great substitute for sugar. One of the greatest qualities is it can take the place of sugar cup by cup. One teaspoon of xylitol only has 10 calories and a GI of 7. Measuring the same as sugar conversion to this sweetener is extremely easy.

The glycemic index (GI) measures how quickly a food causes blood glucose levels to rise. A food that has a high glycemic index causes glucose levels to rise more rapidly. White sugar has a GI of 68; while xylitol’s GI is only 7. This means that consuming xylitol will not cause an individual’s blood glucose level to spike.

Here is a list of sweeteners and their Glycemic Index measurements:

*High Fructose Corn Syrup-100
*White Sugar-68
*Honey-62
*Blackstrap Molasses-55
*Maple Syrup-54
*Barley Malt Syrup-42
*Agave Nectar-15
*Xylitol-7
*Erythritol-0

Since xylitol is not a carbohydrate its glycemic load (GL) is zero. It is metabolized separately from insulin. The formula GL= (The amount of carbohydrate available x GI)/100 is used to calculate the glycemic load. It measures the quantity and quality of carbohydrates.

Sugar has 40% more calories than xylitol. By using xylitol instead of sugar, a diabetic can reduce their calorie intake to lose weight or control their weight. This is an essential element in managing diabetes. Besides being a sugar substitute for diabetics, it has many other benefits as well.

Benefits of Xylitol

*No horrible aftertaste
*1/3 less calories than white sugar
*Helps reduce the formation of plaque
*Delightfully sweet taste
*Helps increase the flow of saliva aiding in the restoration of damaged enamel on the teeth
*Helps with the reduction of dental cavity development
*Fantastic sugar alternative for people with diabetes

Today, obtaining xylitol products is becoming easier than ever. There are candies, ketchups, honeys and jams. This is just a sampling of the products available. Whether you are diabetic, or just looking to eat healthier without giving up your sweet tooth, xylitol may be just what you need.

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19Aug

How The Insulin Pump Has Changed Life For The Diabetic

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It’s important to recognise that everybody’s requirements are different for insulin infusion. Some may have to administer the hormone more often than others, whilst some people might need other ways than simple injection to administer the substance. By speaking with a doctor or a clinician, a diabetes sufferer will be able to discuss their options and decide which way they want to administer their infusion insulin every day.

Insulin Infusion pumps are widely considered one of the most advanced ways to inject insulin into the body, however, they can carry a heavy price tag with an initial cost of up to $6,000, as well as the extra costs for the other equipment that is necessary. If you are lucky enough to have a great insurance plan to pay for this equipment it makes it easier than ever to use infusion insulin, which can minimise the impact that diabetes has on your life.

For those who suffer with diabetes, injecting insulin into their body can be problematic or difficult – especially when they are first diagnosed with the condition. For many, administering a substance like this can be traumatic. That’s why it’s important for people to realise that they are always able to contact their doctors both about the facts about their condition, and the different ways they can administer the hormone.

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Insulin is incredibly important for the body. Its function allows for the correct amount of glucose to remain flowing through the bloodstream. If the body has too much glucose, or even too little, disastrous effects can be had on the body. Insulin is one of two hormones in the body that regulate the amount of glucose in the bloodstream. Insulin works by telling the liver, fat cells, muscle cells and other cells in the body to absorb some of the excess glucose that currently is flowing through the bloodstream. This means that the amount currently flowing can be regulated, and kept at a level that is safe.

If the body does not have insulin (which is what happens with diabetics whose pancreases are unable to secrete the hormone into the body correctly), then the individual will suffer from hypoglycemia. Hypoglycemia is a condition that causes symptoms like extreme hunger, cold sweats and dizziness. If these symptoms can be found early enough, then kits like infusion insulin pumps can be used inject the correct amount of insulin on a regular basis.

Whether you’re using an infusion insulin pump, or other kits that simply involve needles, a variety of tools are available. Syringe auto-injectors are popular, whilst other commercial injectors are a totally different kind of equipment that allows people who have problems with other equipment to get the dosage of insulin that they require.

For whatever equipment is being used, cleanliness is key. Without clean equipment, infections can occur – causing more problems for the body. Be sure to use the right equipment, and the procedure can be made simple.

18Aug

Herbals for the Management of Diabetes

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Many people with Type 2 diabetes use plants, or plant parts, for the self-management of their medical problems. This is what most people refer to as herbal medicine, botanical medicine, or phytomedicine. In the United States more than one-third of people with diabetes use herbal or traditional and alternative medicine alone, or in combination with their prescribed anti-diabetic medication, according to the Johns Hopkins Point-of-Care Information Technology Center (Johns Hopkins POC-IT Center).

There are many types of herbal preparations used for the treatment of Type 2 diabetes. In fact, in almost every culture there is one herbal medicine intended for the management of increased blood sugar levels. However, there are only a few tested and evaluated systematically and scientifically for this purpose.

Here is a list of the most commonly used herbal and medicinal plants for the management of Type 2 diabetes:

Ginseng: Ginseng is one of the most popular medicinal herbs globally.

There are two major types of this herb:

1. Asian ginseng, the Panax ginseng
2. American ginseng, the Panax quinquefolius.

The active compounds in the ginseng herbs that makes them useful are the ginsenosides. According to one particular study, information from the Johns Hopkins POC-IT Center states ginsenosides can potentially improve insulin resistance. Ginseng can be safely used at a dosage of 1 to 3 grams per day.

However, the adverse effects of using this herbal medicine include:

*hypertension,
*headache,
*insomnia,
*nervousness and palpitations, and
*nausea.

Ginseng is also known to interact with the action of warfarin, an anticoagulant (more commonly referred to as a blood thinner). Ginseng unfortunately causes warfarin to be less effective.

Cinnamon: There is new evidence cinnamon can be helpful in regulating blood sugar. Cinnamon is not just another spice that can be used for cooking and baking. According to Johns Hopkins POC-IT Center, cinnamon can increase the effectiveness of insulin therefore improve your blood sugar level. Human trials indicate that taking between 1/4 and one teaspoon of cinnamon every day helps control blood sugar levels. However, various results from other studies contradict these findings. The safety profile of cinnamon is clean and there are no drug interactions noted with the use of cinnamon.

Bitter melon: Different cultures and traditions used bitter melon (Momordica charantia) for the management of diabetes. Many people believe it can decrease insulin resistance… bitter melon is composed of several compounds with confirmed blood sugar lowering properties. It must be pointed out though, clinical trials regarding this herb show contradicting results.

Although taking as little as 2 ounces of the juice has shown good results in clinical trials, adverse effects with the use of bitter melon include:

*gastrointestinal symptoms, and
*favism, or bursting of red blood cells,

with the ingestion of seeds in certain G6PD deficient diabetics.

Fenugreek: The herb fenugreek is one of the most impressive natural substances helpful for people with diabetes. Fenugreek is a traditional spice often used in curry in Asia and the Mediterranean countries. Fenugreek is believed to contain 4-hydroxyisoleucine, a chemical that can enhance insulin production and secretion by the pancreas. Some clinical studies claim its effectiveness in the treatment of Type 2 diabetes. It lowers blood sugar much the same way that drugs in the class of sulfonylureas (such as glyburide) do.

Adverse reactions related to fenugreek use include:

*dizziness,
*flatulence, and
*diarrhea.

However, no herb to drug interaction has been observed.

Fenugreek helps you lose weight because the seeds of fenugreek are rich in dietary fiber, so it delays stomach emptying and after-eating sugar spikes. As the seeds are bitter, taking supplements may be the better choice. As lowered blood sugar is an expected effect of using fenugreek, if you combine it with medications and do not monitor yourself properly, you could find yourself with very low blood sugar. Make sure you see your doctor regularly to supervise your regimen.

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