Aspartame is an artificial sweetener, which is non-saccharide in source. It is used as a sugar substitute in some beverages and foods. Aspartame is specifically a methylester derived from aspartic acid. It was first developed in 1965. It was sold under the brand name NutraSweet and it has been sold since 2009 in the brand AminoSweet.

Uses and Advantages of Aspartame

Aspartame was generally used as an artificial sweetener for foods and beverages. It was used in sweetening foods that are diabetes friendly because of absence of sugar that can affect the blood glucose levels. In addition, aspartame was also regarded as safe by the Food and Drug Authority since 174.

Aspartame Side effects

Aspartame side effects are generally focused on the neurological system. More of these Aspartame side effects are mainly subjective in nature and there are no supports for their occurrence. Aspartame side effects include:

1. Seizures

There are a lot of allegations regarding the aspartame side effects of neurological affectation such as seizures. However, there has been no strong link in the occurrence of such. Nevertheless, there have been subjective complaints on the occurrence of seizures as aspartame side effects.

2. Headaches

Headaches are one of the most common aspartame side effect and complaints of people ingesting aspartame. However, there has been no clear connection in its occurrence. Aspartame also acts as a trigger for migraine along with other foods such as hot dogs, citrus fruits, chocolates, ice cream and fatty foods.

3. Hypoglycemia

Aspartame side-effects also include hypoglycemia or low blood sugar levels. This may result from the interference in the regulation of glucose in the blood leading to low blood sugar levels.

4. Increased hunger

Because of absence of sugar in foods containing artificial sweeteners, patients tend to experience increased hunger because of lack of glucose in the cells. Increased hunger may lead to increased consumption of foods as aspartame side effects.

5. Obesity

Although proponents have indicated the possible role of aspartame in weight loss because of absence of sugar, there has been increase in the reports of obesity in people who consumed aspartame frequently such as the consumption of diet colas and sugar-free foods. The obesity may be linked to increased hunger and increase in the consumption of food as a result of aspartame intake.

6. Mood changes

There were also reports in the presence of mood changes in adults and behavioral changes in children as aspartame side effects. There has been increase in hyperactivity and inattention and children as well as increased stimulation in adults. Although there is absence of sugar content in foods containing aspartame, mood changes was subjectively reported by those who consumed it in frequent intervals.

7. Hallucinations

Despite the absence of scientific evidence to support it, people also reported occurrences of hallucinations associated with the use of aspartame.

8. Panic attacks

Panic attacks in adults may be a result with the changes in the mood that increases anxiety reactions. There may also be presence of depression as aspartame side effect.

Other unorthodox aspartame side effects may include blurring of vision, eye pain, ringing in the ears or tinnitus, hearing impairments, unsteadiness, paresthesia or numbness in the extremities, facial pain, tremors, irritability, aggression, insomnia, phobias, personality changes, abdominal pain, diarrhea, nausea, difficulty swallowing, allergies, menstrual changes, weight loss, weight gain, and other subjective complaints. These symptoms tend to be prejudiced and there have been no scientific studies to support these aspartame side effects.

Vitamin B12 or known as cyanocobalamin or cobalamin is a type of B vitamins, which is water soluble. Vitamin B12 is an important nutrient used in the normal functioning of the nervous system especially the brain as well as the normal formation of the red blood cells. Vitamin B12 is specifically used in the DNA synthesis and regulation used in the metabolism of every cells in the body. Vitamin B12 also plays a role in the synthesis of fatty acid as well as energy production. Vitamin B12 is prepared into tablets, injections and gel.

Uses and Advantages of Vitamin B12

Vitamin B12 is used for the treatment of conditions that affect the above functions of vitamin B12. Indications of vitamin B12 supplementation include:

• Pernicious anemia

Pernicious anemia is caused by a disruption in the intrinsic factor in the stomach; which is responsible for vitamin B12 absorption. Without the intrinsic factor, it leads to vitaminB12 deficiency causing pernicious anemia. Intramuscular injections of vitamin B12 are thereby needed.

• Prevention of Vitamin B12 deficiency
• Megaloblastic anemia because it may perform the role of folic acid
• Hereditary deficiency of transcobalamin II
• Memory loss
• Alzheimer’s disease
• Mood boosting
• Cyanide poisoning
• Improve immunes system in cases of allergic reactions
• Hyperhomocysteinemia
• Age-related macular degeneration
• Sleep disorders

Aside from this accepted use of vitamin B 12, off label use also include treatment various types of diseases such as Lyme disease and many others. The vast uses of vitamin B12 make it a good nutrient since vitamin B12 is responsible for the most basic function in the body, which are DNA syntheses. It is safe for use in pregnant women. One of its advantages is also having a low toxicity level so even intake of large doses may not result in harmful effects in the body.

B12 Side effects

The use of vitamin B12 is rendered safe as long as the right amount of the vitamin is taken in. B12 side effects may be related with its function in the body and B12 side effects tend to be uncommon. B12 side effects may be related to its interaction with other medications and diseases, but the sole use of B12 does not result in serious B12 side effects. B12 side effects are also associated with the non-oral administration of B12. Oral B12 has not been associated with any adverse effects. B12 side effects include:

1. Dermatologic B12 side effects

Itching and Exanthema

This B12 side effect is related to the use of parenteral and intranasal gel of vitamin B12. This is related to the possible allergic-like reactions to vitamin B12.

Folliculitis and Inflammatory acne

These B12 side effects are rare and may only include exacerbation of the above conditions and never a cause for its occurrence. Caution is warranted for people having these conditions. The exact mechanism for its occurrence is unknown, but these B12 side effects have been seen in patients taking high doses of B12 of up to 10 mg per week. This occurs on the face during the first and second B12 injections. These B12 side effects usually disappear after 8 to 10 days of stopping the therapy.

Acne Rosacea

This is the eruption of tiny, reddish lesions on the face associated with the ingestion of 100 mcg of B12 every day.  The dermatologic B12 side-effects have been associated with the presence of iodine and sorbitol in ampoules of parenteral B12.

2. Gastrointestinal B12 side effects

Dyspepsia

Dyspepsia has also been reported with the use of parenteral cyanocobalamin. Dyspepsia is the slowing down of the gastric emptying time resulting in bloating and abdominal pain.

Nausea and Vomiting

These B12 side-effects are also related to the use of parenteral cyanocobalamin.

Transient diarrhea

Transient diarrhea may be associated with parenteral injections of cyanocobalamin.

Glossitis

Glossitis or the inflammation of the tongue was also seen in patients using intranasal gel form of vitamin B12

3. Hematologic and Cardiovascular B12 side effects

Vascular thrombosis

Presence of blood clots in the blood vessels was reported in some patients with risk factors of blood clotting such as use of oral contraceptives and sedentary lifestyle.

Congestive Heart Failure

The use of parenteral cyanocobalamin has also resulted to rare cases of congestive heart failure.

Hypokalemia

Hypokalemia was also reported in patients with megaloblastic anemia so care is warranted when using B12 in this type of anemia.

4. Nervous system B12 side effects

Paresthesia

Although vitamin B is responsible for the improvement in the nerve impulse transmission, some cases of paresthesia were reported with the use of parenteral and intranasal cyanocobalamin.

Anxiety

There was also reported anxiety, but the exact mechanism is unknown as to why some patients taking B12 have experienced such.

Abnormal gait and problems in coordination

Some patients also experienced these cerebellar B12 side effects although the exact cause is unknown.

Hypoesthesia

Hypoesthesia is the presence of reduced sensation to pain. This may be related to the affectation of the pain impulse transmission in the brain.

Headache

Headache is also a common B12 side effect as a result of affectation of the nerve impulse transmission in the brain.

5. Musculoskeletal B12 side effects

Joint and muscle pains

Intake of parenteral vitamin B12 has also resulted in joint and muscle pains. These B12 side effects may be due to the function of B12 in the metabolism and production of energy although the exact mechanism is unknown.

Back ache

Patients also may suffer back ache as a musculoskeletal B12 side effect.

6. Respiratory B12 side effects

Rhinitis

The intranasal administration of cyanocobalamin causes rhinitis in some patients. Rhinitis may be due to a local reaction of the nasal passage to the cyanocobalamin gel.

Dyspnea

Dyspnea may be secondary to rhinitis as a result of inflammation of the nasal airways contributing to difficulty of breathing.

7. Immunologic B12 side effects

Infection

This B12 side effect was seen in painters taking parenteral and intranasal cyanocobalamin.

8. Other B12 side effects

Hypersensitivity reactions

Hypersensitivity reactions were seen in patients receiving parenteral cyanocobalamin that may have impurities. However, reactions tend to be mild and there were no reported deaths as a result of hypersensitivity reactions to cyanocobalamin.

Pain at injection site

Patients receiving intramuscular cyanocobalamin may experience pain and swelling at the injection site. This B12 side effect is usually relived after hours to days.

 The B12 side effects tend to be rare and occur in individuals with idiosyncratic reactions to vitaminB12. Vitamin B12 side effects have never been fatal so vitamin B12 supplements are still essential. People who want to take vitamin B12 may also have this through natural sources in foods such as green leafy vegetables and meat. Vitamin B12 is very essential for the body so people should never worry about B12 side effects when they are taking in what is prescribed by the physician. Other essential nutrients such as protein may also have protein side effects, so taking any supplements normally produce side effects that should not cause worry to people.

What is Pemphigus Vulgaris?

Pemphigus vulgaris is a dermatological problem, specifically an autoimmune blistering disease. It is commonly manifested by the appearance of blisters of different sizes on skin and mucous membranes. It came from the Greek words pemphix meaning bubble and vulgus which means common. This disease is chronic, progressive and often fatal.

Pemphigus Vulgaris Characteristics

1. This dermatologic problem has a high incidence rate in Jews or Mediterranean race.
2. It usually happens in men and women in middle age and old age.
3. It is an autoimmune disorder, which is usually inherited among high risk races.

Pemphigus Vulgaris Symptoms and Signs

Symptoms and signs of this disease are the following:

1. Oral lesions
2. Skin Blisters with oozing discharges
3. Foul odor that comes from the blisters and the oozing serum
4. Sloughing of uninvolved skin when there’s an application of minimal pressure

Most clients with this problem have oral lesions characterized by:

1. Pain in the lesion site
2. The lesions simply bleed
3. Healing time takes a long time
4. Looked like irregularly shaped erosions inside the mouth’s mucosal membrane.

The skin blisters increase in size, burst and leave large, painful eroded regions with crusting and discharges. In the long run, large areas of the body will be involved therefore there’s a high chance for bacterial super infection.

Consequently, patients will be vulnerable to secondary bacterial infection. The bacteria on the skin will have moderately effortless admission to the blisters as they ooze, rupture, and leave denuded areas exposed to the surroundings. It is concluded that the most frequent complications begin as soon as the infection process is extensive.

The result will be fluid and electrolyte imbalances, this is due to the loss of fluid and protein as the blister bursts. When the disease process reaches its extensive stage which includes areas of the body skin surface and mucous membranes hypoalbuminemia or a low albumin level in the blood can happen.

Pemphigus Vulgaris Causes and Risk factors

The incidence of Pemphigus Vulgaris is often associated with these factors:

Autoimmune Disorder

This disease originated from immunological mediated reactions. Therefore, this is an autoimmune skin disease concerning immunoglobulin G (IgG). The pemphigus antibody is directed in opposition to a specific cell-surface antigen in epidermal cells. This autoimmune reaction formed the blisters.

Genetics

Some also associate pemphigus vulgaris with genetics. It is stumbled upon that these are common among patients with pemphigus vulgaris:

MHC Class II molecules
Alleles of leukocyte antigen DR4
leukocyte antigen DRw6

Age

Age is also a factor. Individuals who are 50 years old to 60 years old are mostly affected. The onset of the disease also happens during these years. It can also occur in children or older people. Infants can also have what they called neonatal pemphigus, in which they have maternal auto-antibodies passed to them through placental circulation that attack the epidermal cells.

Medication Use

The condition may be associated with medicines like penicillins and captopril. Severe allergic reactions to these medications can result in abnormal blisters in the skin.

Other Conditions

Patients with other autoimmune diseases like myasthenia gravis and thymoma can also be predisposed to have this skin disease.

Pemphigus Vulgaris Diagnosis

The diagnosis of pemphigus vulgaris depend on the following tests:

Biopsy

To diagnose this disease the patient will need to undergo a histologic examination of a biopsy specimen. This laboratory work is usually done by a dermatopathologist.

Immunofluorescent studies

The patient’s serum from the blister and the surrounding skin will be tested for antibodies with the help of Immunofluorescent studies. This involves the examination of the serum under immunofluorescent light to determine the specific antibodies present.

Pemphigus Vulgaris Pictures

The illustrations below depict pemphigus vulgaris at different sites in the body and different stages of disease.

Pemphigus Vulgaris Treatment

The treatment of pemphigus vulgaris aims to lessen the autoimmune reactions using the following modalities:

Corticosteroids

Due to the reasons that this disease is autoimmune in nature, the disease is treated with high doses of corticosteroids. This is done for the following:

1. Control the disease
2. Make the skin free of blisters

There are some cases wherein corticosteroid treatment has severe toxic effects because the high dosage level is maintained until remission is evident.

Immunosuppressive agents

The following can be given to aid in controlling the ailment and decrease the dose of the corticosteroid.

1. Azathioprine
2. Cyclophosphamide
3. Gold
4. Other immunosuppressive agents

Immunosuppressive drugs are given to reduce the number of circulating abnormal antibodies in the blood. Because of immunosuppression, the patient should be placed in reverse isolation status to prevent other infections.

Plasmaparesis

Furthermore, plasmaparesis momentarily reduces the serum antibody level and has been utilized with unpredictable accomplishment, even though it is normally set aside for critical cases. Plasmaparesis involves the filtering of the blood to remove the antibodies causing the autoimmune reaction.

The treatment goals are to bring the disease under control quickly; this is done for the following reasons:

1. To avoid loss of serum
2. To prevent the progress of secondary infection
3. To encourage renewal of epithelial tissue.

Pemphigus Vulgaris Prognosis

Before the arrival of Corticosteroids, most of the patients with this problem died. The treatment with Corticosteroids has diminished the mortality rate to 5-15%. Pemphigus vulgaris if not treated is often fatal due to the reason that the patients are most often than not are susceptible to infections and fluid and electrolyte imbalances. During the first few years of disease most deaths take place. The prognosis is good if the patient survives 5 years.

During the early stage the disease is easier to control rather than if the disease is already widespread. The probability of a higher mortality rate increases if the therapy is delayed.

The prognosis is worse in older patients and in patients with widespread disease. Morbidity and mortality are directly proportional to the extent of disease, the maximum dose of Corticosteroid required to stimulate remission, and the existence of other illnesses.

The outlook is generally enhanced in childhood than in adulthood. There are also reports that a small number of uncommon cases of pemphigus vulgaris are changing to pemphigus foliaceus. In conclusion, experts say that the seriousness and usual records of pemphigus vulgaris are unpredictable.

Pemphigus Vulgaris Complications

Complications of pemphigus vulgaris include:

1. Super infections. The open blisters may attract other opportunistic microorganisms such as fungi, bacteria and virus.
2. Sepsis. When the infection is not resolved, it may lead to replication of microorganisms in the blood leading to sepsis
3. Scarring. When the lesions are treated, it usually leads to cosmetic alterations in the skin.

Pictures of Pemphigus Vulgaris