Vitamin D is a known vitamin that is fat soluble. It is important because it aids in the calcium absorption of the body and it is vital in the maintenance of healthy bones. A deficiency of it can lead to weaker bones. However, high intake is also not good for one’s health. It can be consumed synthetically or natural via your diet. You can also get it via sun exposure. One can get it via supplements or medications which also have side effects like:

Soreness of the eyes

This is a non serous side effect that is associated with the intake of vitamin D. This will eventually end after the first few weeks. If it bothers you, you must consult your physician.

Diarrhea

This is a typical common side effect especially when you are still starting with this kind of medication. It may occur continually or in severe form. This is a mild condition that eventually ends up by its own.

Fatigue and Lethargy

This occurs when one takes in too much of this drug. Some persons may use this symptom as a reason to end taking in of this drug.

Weight loss

Another common side effect is weight loss. This usually involves a loss of few pounds. When you are dealing with a rapid loss of weight, you must call your physician.

Excessive thirst

Excessive intake will lead to changes in the body fluid. It may lead you to experience increase thirst.

Muscular weakness

This medication can affect your muscular system. Normally, contractions of the muscles are being controlled by the change in the levels of calcium in your muscular fibers.

Hypercalcemia

Experts advised that the allowable limit for adults is around 2000 IU and for children below 12 years old is 1000 IU. High intake of this medication can lead to the medical condition called Hypercalcemia or abnormally high levels of calcium in the blood. This can eventually lead to complications like chest pain, hypertension, stupor, lethargy and coma in the long run.

Vomiting and nausea

This is a common gastrointestinal effect associated with the consumption of this drug. Vomiting and nausea occurs which lead to a loss of appetite and eventually loss of weight.

Excessive urination

Excessive urination may be felt during the changes of fluid in the body. It comes hand in hand with excessive or increase thirsty feeling.

Pain

Pain is also linked to increase intake of this drug. It may become severe and not be able to ease it by resting one’s body. Pain in one’s joints, bones and muscular system may be reported.

Confusion

As the level of calcium in the blood increases, confusion may be felt. It may lead to dementia, memory loss, coma and depression if not treated properly.

Kidney stones

Too much calcium in the body leads to kidney stone formation. This can eventually lead to pain in the extreme level in the back, pelvis or at the sides where anatomically kidneys are located. Pain is felt due to the fact that the stone lodges anywhere in the kidney and leads to the blocking of urine.

Abnormalities in the heart rhythm

Calcium is known to aid in the heart muscle contraction regulation. When a person has increase vitamin D, which goes hand and hand with calcium, it leads to the heart muscles to irregularly contract which results to the person having an abnormal rhythm of the heart.

Liver disease effects

Vitamin D is converted in the liver. When a person has liver disease, it may eventually lead to less activation of this essential vitamin leading to its deficiency which will create health problems like osteoporosis, osteomalacia and hepatic ostodystrophy.

Trimethoprim Uses

Trimethoprim, which is classified as a folic acid inhibitor, is a medication that is classified under antibiotics and it belongs to the chemotherapeutic drugs also known as dihydrofolate reductase inhibitors. It is used in the treatment of specific infections brought about by bacterial invasion. It aids in stopping the bacterial growth. In addition to that, it is a suggested antibiotic for the treatment of urinary tract infections as well as chest infections. Aside from the ones that were mentioned, Trimethoprim can be also used for the treatment of:

• Shigellosis
• Ear infection
• Traveler’s diarrhea
• Acute chronic bronchitis
• Pneumocystis carinii pneumonia
• Acne vulgaris
• Meliodosis
• Whipple’s disease
• Escherichia coli strains

Trimethoprim Advantages

The Trimethoprim has many advantages such as:

• Penetrates into infected tissues and exudates than other antibiotics can do which also means that they can penetrate into one’s eye, blood brain barrier, prostate gland and treat infections in these areas made mentioned.
• Minimal effect on the normal flora which means it has lesser potential for diarrhea induction and less resistant bacteria.
• Considered to be an excellent activity for it is a broad spectrum kind of antibiotic which is a good choice for a general antibiotic wherein the identity of the infecting microorganism is unknown.
• Prevents bacterial folic acid synthesis which is necessary for its growth

Trimethoprim Side Effects

The following are the side effects that are associated when one uses Trimethoprim:

Blood dyscrasias

One of the Trimethoprim side effects includes blood dyscrasias. These are actually abnormal proportion of the person’s blood cells which leads to the tendency to bleed, dysfunction in the immune system and other problems that deals with blood cells. This kind of side effect is part of the inflammation of the joint syndrome which will then be discussed as we go along.

Hepatitis

Hepatitis is one of the Trimethoprim side effects. Persons who are sensitive can be at high risk for the failure of his or her liver which may be manifested with jaundice, nausea and the like. Persons who are taking in Trimethoprim are at high risk to have such side effect that the only treatment is to halt taking of it, as much as possible.

Hemolytic anemia

This deals with the destruction of one’s red blood cells that are mediated by the immune system and initiated via the reaction of medication. Hence, persons who have a medical history of hemolytic anemia, one of the Trimethoprim side effects, are suggested to not take Trimethoprim to avoid further condition.

Bladder stones

This kind of side effect occurs rarely. Some who takes in routinely the Trimethoprim medication may have a high risk of having stones in his or her bladder.

Inflammation syndrome

Sensitive persons to Trimethoprim have been reported to encounter inflammatory syndrome, one of the Trimethoprim side effects, which affects the person’s joint. The inflammation includes soreness of the muscles, inflamed kidney or eye, fever, and even arthritis. This side effect is usually felt or seen in between eight to twenty days after the start of the pharmacological therapy.

Rashes in the skin

This is a normal side effect which results to the response of the body towards Trimethoprim especially during the initial treatment therapy. However, it may become worst when not given the proper attention. Cessation of Trimethoprim can provide the solution.

Dry eye syndrome

Dry eye, which is part of the Trimethoprim side effects, can occur when there is an inability of the production of the adequate tears. Trimethoprim actually can disrupt the tear function and occurs either one dose of the medication or during the span of therapy, usually during long term therapy.

Danger in pregnancy

The Trimethoprim should not be taken by the pregnant woman because it crosses the placenta and affects the development of the unborn child. In addition to that, because Trimethoprim is a folic acid inhibitor it may lead to the baby to be at risk for the development of the neural tube defect.

Allergic reaction

This will happen to persons who are known to be allergic, one of the Trimethoprim side effects, to the drug or its composition. The symptoms associated with this reaction will manifest fever, chills, anaphylaxis, photosensitivity, pruritus or itching sensation, rashes, tightening of the chest, difficulty breathing, swelling of the neck, tongue or face and the like.

Electrolyte imbalance

Trimethoprim side effects include electrolyte imbalance. Another important side effect that one should know is that the Trimethoprim causes the decrease of sodium levels and the increase in potassium level which are both not a good indication and can alter the health of the individual taking in Trimethoprim.

Vitamin B Complex Uses

Vitamin b complex comprises of vitamin B1 or thiamine, vitamin B2 or riboflavin, vitamin B3 or niacin, vitamin B5 or pantothenic acid, vitamin B6 or pyridoxine, vitamin B9 or folic acid, vitamin B7 or biotin and vitamin B12 or cobalamins. It is actually a vitamin group which one can take as a supplement source for a variety of purpose. It can either be culled from fish, red meat, poultry, dairy products, green leafy vegetables and eggs or via tablet or capsule pills itself. There are actually a lot of benefits of vitamin B complex. We will define further the common uses of vitamin B complex which are as follows:

• Alcoholism
• Anemia
• Poor absorption of vitamin
• Beriberi

Vitamin B Complex Advantages

There are a lot of advantages when one take vitamin B complex; the following are the advantages of vitamin B complex:

• Management of Cholesterol
• Hair, Skin and Nails
• Treatment and Prevention of Disease
• Production and Growth of Cells
• Production of Energy

Vitamin B Complex Side Effects

There are side effects associated with the intake of vitamin b complex which are as follows:

Allergic reaction

Some persons may be allergic to vitamin B complex which occurs rarely. When this happens, they manifest the signs of allergic reaction such as itching, redness, pain, and rashes or worse comes to worse having trouble in breathing or dizziness in the severe form.

Gout

It is a medical condition which results to having a higher than the standard amount of uric acid present in one’s body. When one takes larger dosages of vitamin B complex it can result into the buildup of the vitamin B complex which in turn leads to a possibility of having gout.

Diarrhea

During the first few days of taking in vitamin B complex, your body will adjust to it which will then result to the person experiencing stomach cramps which will then proceed to diarrhea as a side effect. However, this should not alarm anyone for this is just a normal response of the body and may get relief without interventions after two days the most.

Nausea

This maybe brought about by the irritation of the stomach to the new substance in your body which is the vitamin B complex ingestion. This is quite common to be reported in the first few days of taking in such medication. Like diarrhea, it will also vanish as the person will be accustomed to vitamin B complex.

Constipation

There is an inability for movement of stools when one experiences constipation which is a common side effect of vitamin B complex ingestion. However, such side effects may vanish after being used to it.

Other side effects are:

• Bright yellow urine brought about too much riboflavin
• Itching and headaches brought about too much niacin
• Numbness brought about too much vitamin B6

One must note that some of the side effects mentioned, will only appear when one takes in too much of the acceptable range or level of vitamin B complex.

What is Degenerative Joint Disease?

Degenerative joint disease or most commonly known as osteoarthritis is a mechanical condition involving the degeneration of the joints, which causes problems on joint movement. Osteoarthritis affects about 25 million people in the USA and is responsible for about 50% of all prescriptions for non-steroidal anti-inflammatory drugs. Osteoarthritis commonly affects people aged 65 years old and above.

Osteoarthritis was taken from the terms “osteo” (bones),” arthro” (joints) and “itis” (inflammation), which means inflammation of the bone joints. However, degenerative joint disease does not really involve the inflammation of the joints. What happens in osteoarthritis is that there is a degradation of the cartilage and synovium between the joints, which leads to the contact and friction between the two bones of the joint. Because of the absence of inflammation, degenerative joint disease is also known as osteoarthrosis. Osteoarthritis also results in atrophy of the muscles and ligaments because of decreased joint movement.
Degenerative joint disease may be primary or secondary. Primary osteoarthritis does not result from other underlying causes, while secondary osteoarthritis results from an underlying medical condition.

Osteoarthritis commonly affects the joints of the hands, spine, feet and weight bearing joints such as the knees and hips. Other joints may also be affected.

Picture 1 – Degenerative Joint Disease (osteoarthritis) of knee

Symptoms of Degenerative Joint Disease

The symptoms of osteoarthritis results from the degeneration of the cartilage in between the joints, leading to:

• Sharp pain on the joint, aggravated by cold and humid environment, usually bilateral
• Burning sensation
• Loss of joint movement
• Stiffness
• Crepitus or presence of crackling sound when the joint is moved
• Muscle spasms around the affected joint
• Joint appears larger due to collection of excess fluid on the knee joint or “water on the knees”
• Presence of Bouchard’s nodes in the proximal interphalangeal joints
• Presence of Heberden’s nodes in the distal interphalangeal joints
• Nodes may be painful and may limit the movement of the joint
• Bunions on the toes (swollen and reddish protrusion on the joint of the big toe)

Causes of Degenerative Joint Disease

The presence of osteoarthritis may be associated with certain causes and risk factors. Previous beliefs say that degenerative joint disease is caused by mechanical injury such as exercise, however, more recent studies has not found any association between osteoarthritis and exercise in normal individuals. Cracking of the knuckles and toes also do not have any association with the occurrence of osteoarthritis. Causes of degenerative joint disease include the following depending on the type of osteoarthritis:

Primary Osteoarthritis

The causes of primary osteoarthritis include:

Aging. Aging causes the fluid in the cartilage to diminish because of a reduction in proteoglycan. Proteoglycan is responsible for protecting the joint and a reduction of it can lead to joint degeneration.

Heredity. Primary osteoarthritis may also be inherited. In fact, identical twins have a high risk for developing the disease when the other twin or sibling already develops it because of certain genetic factors.

Secondary Osteoarthritis

Secondary osteoarthritis develops following certain medical conditions that destroy the joints and cartilages. These include:

Obesity. Being obese or overweight gives undue tension on the weight-bearing joint. As a result, the cartilage and synovium undergoes degeneration from the increased force between the bones. This eventually leads to wearing of the cartilage and contact of the bones with each other.

Other causes include

• Congenital joint disorders
• Injury to the joint
• Diabetes
• Other forms of arthritis that increases joint degeneration
• Instability of the ligaments
• Septic arthritis
• Marfan syndrome
• Wilson’s disease
• Hemochromatosis

Pathophysiology  of Degenerative Joint Disease

Osteoarthritis involves the degeneration of the joint specifically the subchondral bones and the cartilage. The cartilage is the tough and elastic tissue found in between the bones that is responsible for joint movement. The cartilages often do not have a blood supply and it gets nutrients and oxygen through diffusion from surrounding blood vessels. The movement of the joint also is guided by the synovial fluid between the joint. Without this fluid, it becomes very difficult for the joint to perform its range of motion. The synovial fluid serves as a grease to allow smooth joint movement.

Because of aging and certain medical conditions, the cartilage and synovial fluid degenerate and disappear. As a result, the surface at the end of the bone comes in contact with the surface of the other bone, creating excessive tension and friction between the bones. This condition results in the hardening of the bones involving the joint, which causes stiffness. The constant pressure and friction between the bones also result in pain. When byproducts of joint degeneration collect in the synovial space, the body responds by initiating an inflammatory response to repair the joint injury. The synovium also compensates by producing more fluid to increase the lubrication in the joint leading to swelling of the joint. The constant friction between the bones also leads to new bone growth known as osteophytes. The lack of cartilage and the bone outgrowth further leads to pain that is usually bilateral.

Picture 2 – Degenerative Joint Disease Pathophysiology

Diagnosis

The main diagnostic test for osteoarthritis involves imaging studies to visualize the joint. These include:

X-rays are the basic diagnostic procedure for the disease. In x-rays, the common finding is a narrowing of the joint space, increased bone formation, osteophyte growth as well as cyst growth due to increase in the synovial fluid. X-rays also differentiate osteoarthritis from other joint diseases such as rheumatoid arthritis and gouty arthritis. Radiographic studies also rule out the presence of fracture in a joint, which is similar to the symptoms of degenerative joint disease

Treatment

Treatment for degenerative bone disease involves reducing the causative factor as well as managing the signs and symptoms of osteoarthritis which include:

1. Reduction of causative factor

• Adequate exercise. An acceptable level of exercise is required for people with moderate osteoarthritis to enhance the joint mobility and reduce pain. The pain associated with osteoarthritis usually is relieved by a moderate activity. Exercises include active range of motion exercises and graded exercises. Weight lifting and weight bearing exercises involving the affected joint should be avoided to prevent further injury to the joint.
• Weight reduction. For overweight and obese patients, reducing the weight is an important management to prevent added weight on the affected joint. The reduction in the weight also reduces the need for pain medications.

2. Medications

• Analgesics. Analgesics are the primary medications for reducing pain in osteoarthritis. The most commonly used analgesic is acetaminophen. This medication may be used in mild pain associated with osteoarthritis.
• Anti-inflammatory Drugs. Moderate to severe pain in osteoarthritis may require the use of NSAIDs or non-steroidal anti-inflammatory drugs. Ibuprofen is the most prescribed medication; however it may lead to gastrointestinal irritation and bleeding with prolonged use. Because of this, COX-2 inhibitors, a newer form of NSAIDs, in the form of celecoxib may be given to reduce gastrointestinal side-effects. NSAIDs may also be administered through topical applications, but may have lesser analgesic effects.
• Opioid Analgesics. Pain that is not responsive with analgesics and NSAIDs may be managed using more potent analgesics such as morphine and fentanyl; however, their use should be monitored because these may result in adverse effects such as respiratory depression.
• Steroids. Injectable steroids may also be used as a treatment for more severe case of osteoarthritis to reduce the inflammation, pain and swelling.
• Glucosamine and Chondroitin Sulfate. These substances are available as dietary supplements. These are natural components of the joint, which is thought to increase the cartilage formation and production of synovial fluid in the joint.
• Newer Medications. New types of medications such as monoclonal antibody medications have been studied to reduce the symptoms of osteoarthritis. Tanezumab is a monoclonal antibody medication that is found to reduce pain and enhance joint function.

3. Surgery

Advanced cases of degenerative joint disease may be managed through joint replacement surgery. The most common site for joint replacement surgery involves the hips and knees because a severe degeneration of these joints leads to major difficulties in mobility.

4. Conservative Treatments

Manual therapy may also be essential in reducing pain associated with osteoarthritis. Splinting the joints such as of the hands may also hasten healing and prevent further injury.

5. Alternative Therapies

Other conservative treatments for osteoarthritis include the use of ginger, omega-3 fatty acids, Vitamins A, C and E. These substances are believed to produce anti-inflammatory effects thereby reducing pain and swelling. Acupuncture is also used for the reduction of pain and improvement of the joint function. Finally, mud pack therapy may also help in reducing the inflammation by the use of minerals found in mud pack.

Complications

Complications of degenerative joint disease include:

• Permanent loss of function
• Severe pain
• Tissue necrosis of the surrounding tissues
• Infection of the joint as a result of open wound or injury
• Joint deformities

In order to avoid osteoarthritis and prevent the occurrence of complications that may be debilitating, preventive measures should be instituted. These include weight reduction to prevent undue tension in between the bones of the joint. Maintaining an active lifestyle also helps in promoting the range of motion of joints. Other underlying conditions should also be managed to prevent degeneration of the joint as a complication.