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“I developed an open wound on my right ankle. Everything that I was asked to do by my doctor didn’t work and the wound was actually getting worse. A compounding pharmacist suggested two compounded medicines to be applied daily. In two months, my open wound was closed and the pain was gone. The treatment worked as promised.”

M.L., Patient

“Within five days of using the topical solution, my chronic left knee pain subsided approximately 90%, my mental faculties were not impaired professionally, and I am able to sleep pain free. The topical solution developed by Dr. Lanier of Amex Pharmacy relieves[s] the chronic pain in my left knee. I find the topical solution much more effective than the Ibuprofen prescription.”

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PART IV of IV – NUTRITIONAL SUPPLEMENTS

July 28, 2016
The troche (pronounced “trō′kē”), is a sublingual dosage form for medications and nutrients used in the pharmaceutical industry. Troches are a unique dosage form designed to deliver medications directly to the mucus membranes of the mouth by dissolving slowly when placed between the tongue and gums. A number of medications, including both drugs and supplements, can be delivered this way. When placed in the mouth, these lozenges are not designed to be swallowed, but made to dissolve slowly under a patients tongue; most are also flavored to make taking the medication more pleasant. The term for this form of medication delivery is derived from the Greek word for “wheel,” and troches are traditionally round in shape, (however ours are square here at Amex Pharmacy). The size of the medication can vary, depending on what is being delivered, and is usually used when medications cannot be ingested because the digestive juices will damage or compromise the medication. An alternative might be a medication rubbed on the mucus membranes of the mouth, or a transdermal patch applied to the skin. As the troche breaks down, the drug seeps through the porous mucus membranes in the mouth and rapidly enters the bloodstream. This allows for extremely rapid delivery of medications while avoiding potentially damaging digestive processes. “We use the troche dosage form for sublingual drug delivery in our line of Men’s ED products because we found a better absorption rate and patient response when placing the troche under the tongue.” said Mike Boehmer Head of R & D at Amex Pharmacy. “Many of our prescribers have noted patient complaints that traditional tablets take a long time to work, sometimes over an hour. The amount of food and acidity in the stomach also affect this process, so for many patients, the sublingual route of administration provides a faster and better effect over traditional pills.” Amex Pharmacy and other pharmacies across the country have started to adopt this alternative dosage form in supplements and medications for Men’s ED, Pain Management, Hormone Deficiencies, and more; all of which are made available only by a prescription from a physician. The value of sublingual drug delivery also can apply to nutritional therapy as well. In fact the sales of sublingual supplements through health practitioner offices is a growing market; currently about 20% of supplement sales go through physicians offices. IMS reported that physicians wrote 80 million prescriptions for vitamins/minerals last year, mostly to those on government-funded or supplement-covered insurance plans. As well, 8 in 10 physicians recommend supplements to their patients, and 72% of patients given a recommendation comply. SO WHAT ARE THE DOCS RECOMMENDING? According to the IMS, Physicians were most likely (42%) to recommend vitamin D, 33% calcium/fish oil, one in five B vitamins B and C, and one in 10 iron, antioxidants, fiber, vitamin A/E, probiotics or potassium. Always consult with your doctor before trying any dietary supplement or vitamin. If you have any questions regarding the use of supplements please call our pharmacists, at 800-644- 9431or feel free to text them at 321-872- 0723. Our Pharmacists are available 24/7 for questions on this subject, or other Amex Pharmacy areas of expertise like Men’s ED Treatments, Dermatology Compounds, Topical Pain Relief, and more.

PART III of IV – NUTRITIONAL SUPPLEMENTS

July 26, 2016
The term nutraceutical was coined in the 1990’s by Dr. Stephen DeFelice: ‘A nutraceutical is any substance that is a food or a part of a food and provides medical or health benefits, including the prevention and treatment of disease’. Nutraceutical products may range from isolated nutrients, dietary supplements and specific diets to genetically engineered designer foods, herbal products, and processed foods such as cereals, soups and beverages. This applies to all categories of food and parts of food, ranging from dietary supplements such as folic acid, used for the prevention of spina bifida, to chicken soup, taken to lessen the discomfort of the common cold…to a bio-engineered designer vegetable food, rich in antioxidant ingredients, or a stimulant functional food or pharmafood. Nutraceuticals are products derived from food sources that are purported to provide extra health benefits, in addition to the basic nutritional value found in foods. Products can help to prevent chronic diseases, improve health, delay the aging process, or increase life expectancy. Theoretically, the appeal of nutraceuticals has to do with accomplishing treatment goals without side effects. One area that fascinates our team, PHYTONUTIENTS, has seen a lot of growth in the last year. Also referred to as phytochemicals, phytonutrients are compounds found in plants. They serve various functions in plants, helping to protect the plant’s vitality. For example, some phytonutrients protect the plant from UV radiation while others protect it from insect attack. Not only do phytonutrients award benefit to the plants but they also provide benefits to those who enjoy plant food. That’s because they have health-promoting properties including antioxidant, anti-inflammatory, and liver-health-promoting activities. Fruits and vegetables are concentrated sources of phytonutrients; other plant foods like whole grains, legumes/beans, nuts and seeds, and herbs and spices also contain phytonutrients. Since many phytonutrients also serve as the pigment that gives foods their deep hues, you can identify many phytonutrient-rich foods by looking for colorful foods; for example, look for foods that are blue or purple like blueberries, blackberries and red cabbage (rich in flavonoids); yellow-orange foods like carrots, winter squash, papaya, and melon (rich in beta-carotene); red or pink foods like tomatoes, guava, and watermelon (rich in lycopene); and green foods like kale, spinach, and collard greens (rich in chlorophyll). Yet, since not all phytonutrients give color, it’s important to not overlook some off-white foods as well—for example, garlic, onions, and leeks are rich in powerful sulfur-containing phytonutrients. Look for Phytonutrients Like: Hydroxytyrosol (especially for heart, reducing arterial plaque formation), French maritime pine bark (especially for circulation, anti-inflammatory, preventing oxidative stress); astaxanthan (especially for heart, lowering blood pressure, preventing oxidative stress) and pterostilbene (especially for heart, lowering blood pressure, preventing oxidative stress). Anthocyanins joined polyphenols as the most marketable mass market phytonutrients followed by flavonoids and resveratrol. If you don’t know any of these terms…don’t feel badly. According to the Gallup Study on Nutrition Knowledge & Consumption, only 62% of adults were aware of polyphenols and only 21% were making a strong effort to get more. New

Part II of IV: Personalized Vitamins vs. Multi Vitamins

June 29, 2016
The role of the standard Multivitamin has been called into question lately.  And it very well should be.  Recent studies have questioned their usefulness and perhaps their potential for harm. To those of us in the medical field this is not surprising. Every medicine a doctor recommends has potential side effects, so why should supplements be any different? Many of the supplements on the market today are far exceeding recommended doses of certain nutrients.  Research has shown that these excessive doses can be harmful.  For example, too much Vitamin A may lead to cancer.  Likewise the US Preventative Task Force has not recommended the regular use of some supplements at all, stating insufficient data exists to justify their use. On the flip side, we know from years of seeing patients in practice, that most of us are Vitamin D deficient and many of us lack enough iron. We don’t eat meat the way we used to and we wear sunscreen and avoid the sun (for good, health reasons like skin cancer prevention).  We may note symptoms of nutritional deficiencies like hair loss or fatigue. Or we may feel OK but be unaware of harm to our bodies, such as loss in our bone density, that may one day lead to osteoporosis. What to take is a complicated subject to say the least. However, our experience has taught us that we are not all alike. We each have different genes and different lifestyles that interact to give us unique nutritional needs.  The standard multivitamin does not suffice. It in fact may contain many unnecessary and potentially harmful ingredients (Vitamin A and heavy metals) but not enough of essential vitamins. Even the most conscientious among us finds eating healthfully at every meal can be challenging. Vitamins, minerals and other supplements can help to fill the gaps caused by less-than- optimal meals. “The benefit of careful supplementation for most people is very clear,” said Tieraona Low, M.D. “Taking daily vitamins, minerals and herbs in a strategic way, based on a person’s unique profile, circumstances and lifestyle, is one of the best moves we can make toward optimal health.” Personalized Vitamins were developed to find the individual combination of nutrients that is ideal for each person at a given time in their life. When compounding a personalized vitamin Amex Pharmacy takes into consideration multiple factors including but not limited to: age, sun exposure, stage of life, chronic diseases, diet, exercise, and most importantly our patients concerns and symptoms. We are committed to meeting your needs with not just a personalized multivitamin, but a safe well balanced formulation. If you have any questions regarding the use of supplements feel free to call our pharmacists, at 800-644- 9431 or please text them at 321-872- 0723.

Part I of IV: Defining The Nutritional Supplement Market

June 23, 2016
  Dietary supplements are now the third most used remedy for minor ailments for adults and kids, right behind popping an OTC and “waiting it out.” Half of consumers stock up on immunity boosting supplements prior to cold season, and 54% of working women keep them on-the- job. So our team thought we would focus 4 stories on what is happening within the supplement market.  Defining the Nutritional Supplement Market  Personalized Vitamins vs. Multi Vitamins  What is a Nutraceutical?  Troche’ – A New Format and Delivery Technique for Meds. SPORTS NUTRITION will be the fastest growing health category through 2018. Protein, fish oil, ginseng, combination supplements, probiotics, eye health, minerals/calcium and co-enzyme Q10 are projected to be the fastest growing Supplement Categories. CLEAN LABEL supplements are growing as a Category: One-quarter of users opted for supplements that were labeled natural/naturally-sourced, while 3 in 10 consumers classify their “diet lifestyle” as “whole foods; Not surprisingly, whole food supplements were one of the fastest growing supplement sectors in 2014. CONSUMERS 65+ account for 66% of the projected growth in dietary supplement use. The IRI’s 2015 Aging America report indicated that on most days 46% of seniors take a calcium supplement; 24% a fiber supplement; 36% use an antacid/digestive product. These new age seniors are also projected to drive dollar sales of nutrition bars, energy drinks, sports drinks, and refrigerated tea products. (Boomers are also the #1 user of protein drinks for energy.) With the U.S. lifespan now 81 years for women and 76 for men—and 29 million people now aged 70–87—a large new market focused on concerns of much older Americans is taking shape. Stroke, mobility, joint, muscle mass / strength / sarcopenia, memory/cognition, Alzheimer’s, diverticulitis, regularity, weight maintenance and pain will continue to move into the spotlight. MEN represent 43% of primary supplement shoppers—52% of Dads have young kids at home—and 14 million men are living alone. And research shows men aren’t shy when it comes to paying a premium for their health, beauty and supplement products. Weight, followed by cholesterol, hypertension, joint pain, acid reflux, arthritis, vision and prostate issues are men’s top health concerns. SO…WHAT’S HOT NEXT? With recent data confirming a deficiency among nine in 10 Americans, expect the essential nutrient CHOLINE to grab the spotlight. Choline’s role is well established for cognition, memory, healthy pregnancy, sports performance and liver health. Choline also plays a role in eye health, muscle performance, endurance and unique post-menopausal needs. New research links choline status with increased sperm count, the reduction of pre-eclampsia during pregnancy, and reduced anxiety hormone cortisol in fetus, infants and children. Three herbs have seen steady growth in terms of awareness over the past few years, so expect the markets to grow for TURMERIC, GOJI BERRY & GARCINIA The Horehound Herb HOREHOUND was the best-selling herbal supplement, while we see increased us of both MATCHA (especially for heart health, blood sugar and blood pressure regulation) and MUSHROOM SPECIES including MAITAKE (especially for immunity, modulaton of blood sugar and insulin response), KING TRUMPET (especially for antioxidant L-ergothioneine, cholesterol management, bone health), CORDYCEPS (especially for energy, respiration) and REISHI (especially for immune, heart health) are other up-and- comers. If you have any questions

Do We Live In A Post-Antibiotic Era?

June 14, 2016
With the Zika virus and others running rampant around the globe, our team wanted to find some scientific research/progress on our ability to fight viruses.  This article from the American Council on Science & Health has interesting findings on using baceteria phage, to fight off the most resistant viruses. Typically, when we think about viruses, we generally think of them as human contagions such as the flu, HIV, and the common cold. However, all organisms, not just humans, have viruses that infect them, including bacteria. Bacteriophage (or just ‘phage’) is the special name given to these viruses. These phages interact with bacteria in the same way they do with human cells (or any other cell for that matter): they enter the cell, take control of the host’s cellular machinery, trick the cell into making more copies of the virus, burst the cell open to release these new copies, and then the cycle repeats. The phages are also species specific, and sometimes even strain specific; a phage that attacks MRSA is not a threat to a human cells, nor to an E. coli cell. Pond-ering New Antimicrobials
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