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In (C) Highly depressed protein anabolic activity in normal accessory sex gland tissues generic 15g brand temovate with mastercard, such as the skeletal muscle, bone, and kidney prostate, most of the direct androgen effect is due (D) Elevated serum levels of testosterone with sub- to dihydrotestosterone rather than testosterone. In the Leydig cell the rate-limiting step in testosterone is considered the biosynthetic rate- testosterone synthesis is the enzymatic cleavage of limiting step? Skeletal muscle cells use the androgen receptor (B) Cholesterol to bind testosterone that promotes the anabolic ef- (C) Androstenediol fect of this hormone. Finasteride is a 5 -reductase inhibitor, which es- (E) Progesterone sentially makes dihydrotestosterone unavailable to 4. Normal skeletal muscle cells the prostate but does not reduce serum testosterone (A) Typically lack androgen receptors and thus levels. The decreased prostatic levels of dihy- are not affected by high concentrations of testos- drotestosterone frequently result in a size regres- terone sion of the prostate, while the relatively normal (B) Respond more readily to dihydrotestosterone testosterone levels minimize a depressed libido. Upon examination, a 68-year-old married man was self-reported aggressive behaviors in hypogonadal found to have a greatly enlarged prostate. The male sex accessory tis- duction dramatically rises from prepuberal levels sues: structure, androgen action, and physiology. Effects of testosterone replacement in testosterone, from the second to the fifth decade of hypogonadal men. He compounds typically use 100 to 200 times the nor- is a good athlete who would like to get a college mal dose and will cycle or stack multiple anabolic scholarship and thinks that if he can increase his compounds together in an effort to enhance the bi- muscle strength, he will get better and win a schol- ological effect. He knows of some other athletes who are Common endocrine side effects of these com- using anabolic steroids and requests your help. Surveys in- hepatotoxicity, suppression of high-density lipopro- dicate that in the United States 6% of high school tein cholesterol, increased cardiovascular risk, in- athletes, 20% of college athletes, and more than sulin resistance, and decreased thyroid hormone 50% of professional athletes in certain sports use or production.

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A deeper and more extensive skin reaction order brand temovate 15g with visa, involving more • animal fur and dander extensive fluid collection, is called angioedema. Ana- • body parts from house mites (microscopic creatures phylaxis, another reaction, is marked by difficulty found in all houses) breathing, blood pressure drop, widespread tissue GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2 55 swelling, heart rhythm abnormalities, lightheadedness, • Khellin (Ammi visnaga) has bronchodilator activity. Diagnosis • Traditional Chinese medicine treats allergic rhinitis Allergies can often be diagnosed by a careful med- with various species. Patent combination medicines ical history, matching the onset of symptoms to the ex- are: Bu Zhong Yi Qi Wan (Tonify the Middle and Aug- posure to possible allergens. Allergy tests can be used to ment the Qi) and Yu Ping Feng San (Jade Windscreen) identify potential allergens. These tests usually begin are used for preventing allergies, and Bi Yan Pian with prick tests or patch tests, which expose the skin to (Rhinitis Infusion) is often prescribed for syptoms af- small amounts of allergen to observe the response. RAST testing is • The homeopathic remedies Rhus toxicodendron, Apis a blood test that measures the level of reactive antibodies mellifica, and Nux vomica have decongestant activities. Food allergen • Vitamins A and E are antioxidants and help to pro- provocation tests require abstinence from the suspect al- mote normal functioning of the immune system. Allergic rhinitis • Acupuncture has been shown to be as effective as anti- histamine drugs in treating allergic rhinitis. It is also The following can help to relieve the symptoms of used to help prevent allergic reactions by strengthening airborne allergies: the immune system. A variety of herbal remedies, either applied topical- • Grape (Vitis vinifera) seed extract has antihistamine ly or taken internally, can assist in the treatment of con- and anti-inflammatory properties. A cream or wash containing calendula (Calendula anti-inflammatory activity and is proven effective in treat- officinalis), a natural antiseptic and anti-inflammatory ing allergies. Ephedra should not be used for prolonged have been effective in treating atopic dermatitis. The fol- periods of time, as it can raise blood pressure, cause rapid lowing are homeopathic remedies to be taken internally: heartbeat, and interfere with adrenal gland function.

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The American Pharmaceutical Association leukotrienes purchase brand temovate 15g with visa, also bring white blood cells into the area. New York: William Many patients with asthma are prone to react to substances Morrow and Company, 1999. Many people with asthma do not realize that aller- ORGANIZATIONS gens are triggering their attacks. While the symp- 136 GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2 toms may be similar, certain important aspects of asthma are different in children and adults. When asthma begins INHALED ALLERGENS in childhood, it often does so in a child who is likely, for MOST OFTEN TRIGGERING ASTHMA ATTACKS genetic reasons, to become sensitized to common aller- gens in the environment. In 2004, scientists in Helsinki, Finland, Animal dander identified two new genes that cause atopic asthma. The discovery might lead to earlier prediction of asthma in Cockroach allergens children and adults. When these children are exposed to Dust mites dust, animal proteins, fungi, or other potential allergens, Indoor fungi (molds) they produce a type of antibody that is intended to engulf and destroy the foreign materials. This has the effect of Occupational allergens such as chemicals, fumes, particles of industrial materials making the airway cells sensitive to particular materials. This condition of atopy is present in at least one third and as many as one half of the general population. When an infant or young child wheezes during viral in- • cockroach allergens fections, the presence of allergy (in the child or a close • pollen relative) is a clue that asthma may well continue throughout childhood. Many adults who are • air pollutants not allergic have such conditions as sinusitis or nasal In addition, there are three important factors that polyps, or they may be sensitive to aspirin and related regularly produce attacks in certain asthmatic patients, drugs. Another major source of adult asthma is exposure and they may sometimes be the sole cause of symptoms. Besides wheezing and minimizing) exposure is the most effective way of treat- being short of breath, the patient may cough or report a ing asthma, it is vital to identify which allergen or irri- feeling of tightness in the chest.

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