You & Your Health

Gorpils Throat Lozenges
  • Sore throat (medically known as pharyngitis) is inflammation or irritation of the throat (pharynx).
  • Sore throat is caused by –
    1. Environmental agents – cigarette smoking, automobile exhaust fumes, dust, air, pollution, lack of humidity
    2. Micro-organisms (germs) bacteria and viruses
  • The patient with sore throat may complain of:
    1. Soreness of throat,
    2. Hoarseness of voice,
    3. Pain while swallowing,
    4. Irritation of throat (pharynx).
  • For throat irritation due to environmental causes, mentholated lozenges are helpful. For minor throat infection, lozenges containing anti-bacterial are useful. For more serious infections, appropriate antibiotics are useful.
  • An antibacterial is a chemical substance which acts against bacteria (a microscopic germ) and prevents their growth and multiplication or kills them. In lay terms, an antibacterial is also called antiseptic.
  • Gorpils Throat Lozenges are meant to be sucked in mouth and not swallowed.
    Adults & Elderly Children (6-12 years): Dissolve one Gorpils Throat Lozenge slowly in the mouth every two or three hours; upto a maximum of 8 lozenges per day.

Perkhotal Shampoo
  • Dandruff (pityriasis capitis) is a common condition in which the scalp is covered with small flakes of dead skin. The flakes, which come away when the hair is brushed or combed, represent an increase in the normal loss of the outermost skin layer. One type of dandruff accompanied by inflammation of the scalp is called seborrheic dermatitis. If too little sebum is produced, the hair becomes dry and brittle, with the formation of white skin flakes. However, too much sebum gives greasy hair and yellow flakes.

    Dandruff can happen at any age but is most commonly seen after age of 12. Today most skin specialists agree that dandruff is associated with a tiny fungus called Pityrosporum ovale, (P. ovale). This fungus lives on our bodies and scalp all the time, usually without causing a problem. Unfortunately, for some people, it can increase in numbers, causing dandruff.
  • Internal Causes of Dandruff : Hormonal imbalance, poor health, excessive perspiration, poor hygiene,
    allergic hypersensitivity, lack of rest, emotional stress, excessive consumption of sugar,fat, starch, hereditary predisposition.

    External Causes of Dandruff : Excessive use of hairsprays and gels, cold weather and dry indoor heating, tight fitting hats and scarves, stress, anxiety and tension, infrequent shampooing of the hair or inadequate rinsing, improper use of hair-colouring products or excessive use of electric hair curlers.
  • Perkhotal shampoo contains Ketaconazole, a medically proven ingredient, which deals with the cause of dandruff and provides a long-lasting cure without irritating the scalp.

    How to Use Perkhotal Shampoo?
    1. Wet your hair.
    2. Take about one inch diameter of shampoo in your palm.
    3. Apply all over your scalp
    4. Lather properly
    5. In case it does not lather, please rinse your hair thoroughly & repeat instruction No.2 onwards.
    6. Let it remain on your hair for 5 minutes. This is important for Perkhotal to act on the dandruff-causing fungi.
    7. Rinse thoroughly

    Get rid off Dandruff now
    We recommend two phases in the treatment of dandruff
    1. Attack Phase: Shampoo thrice a week for four weeks.
    2. Maintenance Phase: Shampoo once a week regularly.
  • Yes, Perkhotal shampoo is gentle, it doesn't strip your hair, and can be used on tinted or colour headed hair.
  • If you wash your hair more often than say, twice a week, while you are using Perkhotal shampoo, it's fine to use your regular shampoo for the "in-between washes".
  • Yes. Although Perkhotal leaves your hair soft and healthy, you can use your regular conditioner

Perkhotal Ointment
  • Perkhotal ointment has a potent antimycotic activity against dermatophytes such as Trichophyton sp., Epidermophyton floccosum and Microsporum sp. and against yeast.

    Usually Perkhotal ointment acts very rapidly on pruritus which is commonly seen in dermatophyte and yeast infections as well as in skin conditions related with the presence of Pityrosporum sp. This symptomatic improvement is observed before the first signs of healing are observed.
  • Perkhotal ointment should be applied to affected areas once or twice daily (depending on the severity of infection) in patients with tinea corporis, tinea cruris, tinea manus, tinea pedis, cutaneous candidisis and seborrheic dermatitis, and once daily in patients with tinea versicolor.

    Treatment should be continued for a sufficient period, at least until a few days after disappearance of all symptoms.

    The diagnosis should be reconsidered if no clinical improvement is noted after 4 weeks of treatment. General measures in regard to hygiene should be observed to control sources of infection or reinfection.

    The usual duration of treatment is : tinea versicolor 2-3 weeks, yeast infections 2-3 weeks, seborrheic dermatitis 2-4 weeks, tinea cruris 2-4 weeks, tinea corporis 3-4 weeks, tinea pedis 4-6 weeks.
  • Usually Perkhotal Ointment is safe for topical use. Sometimes after topical administration of ketoconazole irritation, dermatitis, or a burning sensation may persist. Perkhotal ointment is contraindicated in individuals who have shown hypersentivity to any of its ingredients.

Gorpils Herbal Cough Lozenges
  • Sore- throat (medically known as pharyngitis) is inflammation or irritation of the throat (pharynx) while cough refers to forceful expulsion of foreign matter (e.g. dust) from the respiratory tract. The two general classifications of cough are:
    1. Productive coughs (producing phlegm or mucous from the lungs)
    2. Non-productive coughs (dry and not producing any mucous or phlegm)
  • Sore throat or Cough may be caused by –
    1. Environmental agents – cigarette smoking, automobile exhaust fumes, dust, air pollution, and lack of humidity. These cause irritation of upper respiratory tract.
    2. Infections caused by various types of germs – Micro organisms (germs) viruses and bacteria.
    3. Allergy e.g. asthma, allergic rhinitis
  • The patient with sore throat may complain of soreness of throat, hoarseness of voice and irritation of throat (pharynx) while Cough is of two types:
    1. Dry cough – when coughing is not accompanied by production of sputum.
    2. Productive (wet) cough – when coughing is accompanied by production of sputum
  • The treatment should begin with an attempt to discover the cause. Once the cause is clear, specific therapy should be initiated for the underlying cause.
    1. For throat irritation due to environmental causes, mentholated lozenges (Gorpils Herbal lozenges) are helpful.
    2. For minor throat infection, lozenges containing antibacterial (Gorpils Throat Lozenges) are useful.
    3. For more serious infections, appropriate antibiotics are useful.
  • Medical plants and herbs contain substances known to modern and ancient civilization for their healing properties. Ayurveda or science of life is the world’s oldest system of medicine in continuous practice and uses herbs to tackle various ailments. The formula of Gorpils Herbal Lozenge is a direct outcome of years of experience and immense knowledge of relevant ingredients incorporated. Gorpils Herbal Lozenge is an effective and safe preparation indicated for cough, particularly for sore throat.
  • The herbs included in Gorpils Herbal Lozenges are known for their medical and healing properties of sore-throat and cough and have demonstrated additional antiseptic, anti-inflammatory effects. Each of the herbs selected carefully and facilitates relief of cough as well as soothes sore throat.

    a. Glycyrrhiza glabra : (Yashtimadhu)
    Glycyrrhiza glabra : (Yashtimadhu) has been incorporated in Gorpils Herbal Lozenge in view of its demulcent property (soothing to the irritant lining of throat). Additionally, Glycerrhiza glabra possesses cough suppressant action similar to widely used codeine, but is devoid of the latter’s side effects such as constipation, drowsiness and addiction potential. Besides, the upper respiratory secretions are loosened by Glycerrhiza glabra so as to facilitate their removal and thereby allay congestion.

    b. Zingiber officinale : (Sunthi)
    Zingiber officinale : (Sunthi) in Gorpils Herbal Lozenge is very useful in coughs of upper respiratory origin in view of its antibacterial properties, and in asthmatic cough on account of its antispasmodic action. The minimum inhibitory concentrations (MIC) for Zingiber officinale ranges from 0.0003-0.7 mcg/ml against common pathogens such as Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae and H influenzae. The minimum bactericidal concentration (MBC) against the same species is 0.135-2.04 mcg/ml for Zingiber officinale (in Gorpils Herbal Lozenge).

    c. Curcuma longa : (Haldi)
    Curcuma longa : (Haldi) in Gorpils Herbal Lozenge has antiseptic as well as anti-inflammatory properties. Hence, it is useful for persistent coughs throat irritation and is also effective for coryza.

    d. Menthol : (Pippermint ka Phul)
    Menthol : (Pippermint ka Phul) in Gorpils Herbal Lozenge has been traditionally incorporated for its ability to soothe the irritated throat as well as to provide cough relief by virtue of its local anesthetic property on the throat lining. Besides, menthol in Gorpils Herbal Lozenge calms the irritated throat lining and provides a cooling sensation by interacting with cold receptors in voice box (larynx).
  • Gorpils Herbal Lozenges are for sucking.
    Adults: 1 to 2 Gorpils Herbal Lozenges to be sucked upto thrice daily or as required up to a maximum of 20 lozenges per day.
    Children (6-12 yrs): 1 Gorpils Herbal Lozenge to be sucked upto thrice daily or as required upto a maximum of 10 lozenges per day. By sucking the Gorpils Herbal Lozenge there will be increase in saliva flow resulting in soothing of the irritated throat.

  • Osteoarthritis (OA) is the most common affection of weight-bearing synovial joints, occurring especially among older people due to wear and tear. Sometimes it is called degenerative joint disease or osteoarthrosis.
  • Synovial joints are all the freely movable joints of the body which have a cavity filled with lubricating synovial fluid. The other vital component of synovial joints is the cartilage that lines the bones and acts as a shock absorber during the joint movements.
  • OA is one of the most frequent causes of physical disability among adults. Some younger people do get OA from a joint injury, but the disease most often afflicts the elderly. In fact, by age 65, more than half of the population has X-ray evidence of OA in at least one joint.
  • OA, the cartilage underlying the bone is diseased. In OA, the surfaces of the cartilages break down and roughen due to aging-related wear and tear. This causes friction whilst moving the joint and this result in pain and swelling along with restriction of joint movements.
  • OA most often occurs at the ends of the fingers, thumbs, neck, lower back, knees, and hips.
  • Hips: OA in the hip can cause pain, stiffness, and severe disability. People may feel the pain in their hips, or in their groin, inner thigh, or knees. Walking aids such as canes or walkers can reduce stress on the hip.

    Spine: Stiffness and pain in the neck or in the lower back can result from OA of the spine. Weakness or numbness of the arms or legs can also result.

    Hands: Small, bony knobs appear on the end joints of the fingers. They are called Heberden’s nodes. Similar knobs (called Bouchard’s nodes) can appear on the middle joints of the fingers. Fingers can become enlarged and gnarled, and may ache or be stiff and numb. The base of the thumb joint is also commonly affected by osteoarthritis.

    Knees: The knees are the body’s primary weight-bearing joints. For this reason, they are among the joints most commonly affected by OA. They may be stiff, swollen, and painful, making it hard to walk, climb, get in and out of chairs, and use bathtubs.
  • The symptoms of OA include :
    1. Steady or intermittent pain in a joint.
    2. Stiffness after getting out of bed
    3. Joint swelling or tenderness in one or more joints
    4. A crunching feeling or sound of bone
  • Yes. The damaged cartilage in OA can today be reliably repaired and protected by the continual use of a group of natural substances termed as chondroprotectives (chondro=cartilage). Glucosamine and chondroitin are two proven chondroprotectives and well accepted world wide for their beneficial effects in OA. Both glucosamine and chondroitin are useful in nourishing the cartilage by aiding synthesis of proteoglycans which are responsible for the sponginess of the cartilage.
  • Glucosamine, a substance otherwise naturally produced in the body, is a chemical mix of sugar and an amine. It is the building block for important joint components such as the cartilage itself and the synovial fluid, the substance that fills the joint space and acts as a lubricant during the movements of the joints. When glucosamine intake is commenced, the synovial fluid production is induced and this facilitates frictionless joint movements. In fact, the initial pain in OA is on account of synovial fluid depletion, and by virtue of glucosamine’s ability to help in its manufacture there will be a relief of pain in OA.
  • Chondroitin is made up of two glucosamine molecules joined with a chemical bond. Many OA sufferers do not produce enough of it from glucosamine and hence chondroitin has to be supplemented additionally. Chondroitin’s main role lies in protecting the cartilage against the destructive effects of body’s enzymes and free radicals. Additionally, the viscosity of the synovial fluid, which determines the freeness of joint movement, is also chondroitin-dependent.
  • An ideal intake of glucosamine-chondroitin is 1500 / 1200 mg daily i.e. a ratio of 5:4. In the latter proportion, glucosamine-chondroitin combinations provide the best possible results in OA. For preventing OA, lower doses of glucosamine-chondroitin can be taken, but the ratio of 5:4 must be maintained for optimal effects.
  • Yes. Vitamin C and silicon are two other chondroprotective agents which facilitate formation of collagen, another vital component of cartilage. Collagen is a vital part of cartilage providing it with elasticity and the ability to absorb shock. It also creates a framework to hold the proteoglycans in place and can be referred to as the "glue" that holds the cartilage matrix together. Hence, any chondroprotective taken must also assure adequate amounts of vitamin C and silicon. Manganese is a mineral, which also should be amply available if glucosamine has to be optimally utilized for cartilage building. Without manganese, the enzymes responsible for proteoglycans synthesis (from glucosamine / chondroitin as raw materials) cannot be activated. Magnesium, an enzyme activator, is vital to assist glucosamine’s activity. Even adequate boron’s presence has been historically documented to protect against arthritis.
  • Free radicals are today implicated in cartilage destruction (- both proteoglycans as well as collagen), and loss of synovial fluid viscosity. To counter the free radicals antioxidants such as vitamins E and C, selenium, zinc and manganese play an essential role.
  • Yes, very much. It is very, very essential to take the correct quantities of any antioxidant, if the free radicals-mediated damage is to be assuredly tackled. Vitamins E & C, as well as minerals such as selenium, zinc and manganese are all necessary in right concentrations for their antioxidant working.

    VITAMIN E: This is required as 400 mg daily for its antioxidant benefit. Being fat-soluble, vitamin E protects the cartilage cells’ outer wall.

    VITAMIN C: For antioxidant action, minimum of 500 mg of vitamin C is obligatory. This water-soluble vitamin is an excellent protector for the synovial fluid.

    SELENIUM / ZINC / MANGANESE: Selenium is a raw material for the body’s natural antioxidant enzyme glutathione peroxidase (GSHPx). Zinc & manganese, on the other hand, assure adequate superoxide dismutase (SOD) – another natural antioxidant of the body, availability. Zinc, additionally, is also vital for the third natural antioxidant enzyme of the body, namely, catalase. A minimum of 7.5 mg of zinc, 2 mg of manganese and 70 mcg of selenium assure adequate functioning of all the 3 natural antioxidant enzymes, and this is necessary for protecting the inside of the cartilage cells, as well as the cartilage as a whole.

    Table: Summary of antioxidants’ action & requirements.

    Vitamin C Protects the cartilage cell’s interiors (cytoplasm). 500 mg
    Vitamin E Protects the walls of cartilage cells, and media in-between cells. 400 IU
    Selenium Protects the cytoplasm of cartilage cells and its mitochondria (especially) by maintaining adequate levels of GSHPx. 0.07mg
    Zinc Protects the cytoplasm, nucleus as well as the small structures within the cartilage cells by assuring adequate availability of SOD and catalases. 7.5 mg
    Manganese Protects especially mitochondria by enhancing SOD concentrations. 2 mg

    Any compromise in amounts of antioxidants taken leads to poor defenses against the free radicals, and hence leading to greater cartilage destruction in OA.
  • Methyl Sulfone Methane, or MSM, as it is popularly known, has exceptional benefits in providing pain relief. MSM relieves pain by :
    1. Inhibiting pain impulses along nerve fibers.
    2. Decreasing inflammation.
    3. Reducing muscle stiffness around the affected joint.
    4. Breaking up the calcium deposits in the ligaments and muscles adjoining the affected OA joint.

    MSM also requires to be taken as 1500 mg for assuring adequate pain relief, at least initially. Thereafter smaller quantities can be continuously taken for maintaining its pain relief effects. Remember, MSM is as safe as water; it can be taken as long as necessary without any undue concern.
  • An ideal joint supplement for smooth and frictionless movement would be that which provides a judicious blend of chondroprotectives and antioxidants, and in right amounts. Restep is a chondroprotective which provides optimal ratio of glucosamine and chondroitin, plus antioxidants & magnesium-boron for the joint cartilage protection & regeneration, as well as MSM to tackle pain – all in a single sachet for once-a-day intake as a pleasantly flavored drink. Inflammation of the synovial lining (synovitis) is another cause of pain in OA, and it is essential to provide MSM for the relief which all sufferers desire.
  • Restep is useful for managing OA. It is also useful to prevent OA in the obese, or those engaged in heavy exercise, sports, and others with a physically active lifestyle. Restep can be of value in protecting the cartilage in rheumatoid arthritis, ankylosing spondylitis, fractures traversing the joint, low backache due to disc degeneration, as well as for otosclerosis – hearing impaired in elderly due to OA of small bones in middle ear

    INTAKE: 1 Restep Sachet once daily or 1 Restep Regular Sachet thrice daily; to be mixed with a glass of chilled water and drunk for a minimum of 3 months. Once relief has been obtained, 1 Restep Regular Sachet can be taken once daily or as required. If the pain is severe or unbearable, analgesics or medicines for pain could be taken additionally initially (Picture)

  • Viruses destroy the liver cells (hepatocytes) to cause hepatitis. The liver damaging viruses include hepatitis virus A, B, C, D, E & G (latest identified), Epstein-Barr virus and cytomegalovirus. Of these only hepatitis B, C & D viruses (HBV, HCV & HDV) can cause persistent long-term for >6 months liver damage known as chronic hepatitis.
  • HBV is a deoxyribonucleic acid (DNA) containing virus which is enveloped. It is associated with a polymerase (P) protein, and the whole complex is surrounded by a core. The core has antigens (HBcAg & HBeAg) which could be detected in the serum of sufferers of HBV infection. Embedded in the surface lipid layer is the surface antigen (HBsAg) which is commonly tested as Australia antigen in blood examination of hepatitis sufferers. The first detectable viral marker is HBsAg followed by HBeAg and HBV DNA. The core antigen (HBcAg) does not appear in blood but antibodies to it (anti-HBc) are detectable as soon as symptoms start. In fact, if both HBsAg and anti-HBc persist for a long time (>6 months) it indicates chronic hepatitis B.
  • When an individual is a carrier of hepatitis B, this means that he or she has been infected with the virus and their immune system has not been able to get rid of the virus from their body. Some carriers of HBV experience no specific health problems and are silent carriers; but they can infect others without ever knowing that they are doing so. There is another group of carriers who over a period of years develop liver disease, chronic hepatitis. They can be mildly to severely ill and can even ultimately die of their disease since they commonly develop cirrhosis.
  • Usually rest, energizing drinks, avoiding the liver – offensive alcohol / medicines and vitamins are advised for any hepatitis. Although this constitutes a good supportive care for the liver, it is not enough. Phospholipid-based products are the best to stimulate liver regeneration and re-start liver functioning at the earliest.
  • The outer covering cell membrane of hepatocytes is composed of phospholipids, The phospholipid molecules are glued by small amounts of cholesterol present in-between their heads. Phospholipids are fluidizing whilst cholesterol is rigidizing. This arrangement of few RIGIDIZING cholesterol molecules in between the FLUIDIZING phospholipid molecules controls membrane fluidity of hepatocytes and is the key to optimal liver functioning. The most important phospholipids are primarily four:
    1. Phosphatidylcholine
    2. Phosphatidylethanolamine
    3. Phosphatidylinositol
    4. Phosphatidylserine

    Of these phosphatidylcholine is of prime importance,since it is mainly responsible for the liver cell membrane’s fluidity. There are 300 million hepatocytes actively involved in phospholipid manufacturing. In the diseased liver, the phospholipid synthesis is diminished leading to lessening of the membranes’ fluidity and consequently disturbed functioning and damage to hepatocytes.
  • Soya is rich source of essential phospholipids that are superior to those synthesized by liver. The phospholipids in soya are superior since these have around 70% of essential fatty acid content. Intake of essential phospholipids will provide multifarious benefits in hepatitis B:
    1. Phosphatidylcholine
    2. Essential phospholipids restore the hepatocyte membrane structure and stabilize the same. This limits further attack by the offending viruses and hastens recovery in acute HBV infection.
    3. Chronic hepatitis B is essentially due to an abnormality in immune system working. Essential phospholipids intake also ensures their availability for the membranes of white blood cells (WBCs). The phospholipid: cholesterol ratio of the WBCs once normalized, these cells curtail their faulty damaging action to the hepatocytes in chronic hepatitis, and there is improvement in liver functioning associated with lessening of its damaged area.
    4. In chronic hepatitis B, essential phospholipids also ward off the development of the deadly cirrhosis – by decreasing the deposition of damaging fibrous tissue.
  • Two other drugs commonly used for hepatitis B are interferon alpha and lamivudine. Although there is 70 to 80% sustained response in hepatitis B, only 30% of the sufferers benefit with these anti-virals. Therapy with these agents is necessary for 1 to 3 years, and such a long treatment course is besieged with the danger of accompanying side effects. For carriers, therapy with interferon for one year is effective, but there is a high possibility of relapse thereafter. Only 60% of carriers respond to lamivudine, and the latter has to be continued indefinitely.
  • Yes. Phyllanthus amarus is a natural liver protective with antioxidant actions. Although used traditionally for many ailments such as gonorrhea and frequent menstruation, it is best rated for hepatitis
  • The Latin synonym for Phyllanthus amarus is Emblica officinalis. This herb in it can grow 30 to 60 cms in height, and blooms with yellow flowers. All parts are medicinally useful – fruits, leaves flowers, bark & roots. Phyllanthus amarus contains lignans, alkaloids, flavonoids, phenols and terpenes. All these active ingredients not only provide anti-HBV action but even afford antioxidant protection to the damaged liver.
  • Phyllanthus amarus locks the replication of HBV.
    1. It blocks the P protein in DNA that is needed to reproduce the virus.
    2. It stalls the mRNA that signals the DNA polymerase to cause virus replication.
    3. Phyllanthus amarus suppresses release of
  • Phyllanthus amarus removes the HBeAg and HBV DNA markers from blood in 45% of hepatitis B patients – similar to interferon alpha.
  • No side effects have been observed with essential phospholipids over years of usage and there are, therefore, no restrictions attached – including usage by pregnant mothers and lactating females. Phyllanthus amarus is also safe; it can be safely combined with any other drug in hepatitis B. Only those known to be allergic to soya or a product containing lecithin, or Phyllanthus species, should avoid products containing these.
  • Availability of an essential phospholipid – Phyllanthus amarus containing product recently as GEP-B is expected to be big boon for all hepatitis B virus patients. Each soft gelatin capsule of GEP-B contains: Lecithin … 500 mg (Equivalent to 250 mg phospholipids: phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, phosphatidylinositol. Linoleic acid content approx. 70%), Phyllanthus amarus ..450mg, Soyabean oil …8 mg
  • ADULTS: 1-2 GEP-B Softgels 2-3 times daily. In chronic liver disease, the intake could be reduced to 1-2 GEP-B Softgels for long term maintenance after initially recovery has occurred.The duration of intake depends on the response time taken in hepatitis B markers. GEP-B may be taken safely for months or even years if necessary.

    Effectively Attacks Hepatitis B

  • The liver is the largest organ of the body, weighing 1.6 kgs; it has multiple functions (>5000) to perform which can be conveniently categorized as three:
    1. Regulation, synthesis & secretion. The liver participates in utilization of glucose, lipids and proteins; it also produces bile for digesting fats.
    2. Storage. Glucose (as glycogen), fat soluble vitamins (A, D, E & K) and minerals are accumulated in liver.
    3. Purification, transformation & clearance. All hormones and drugs – after their actions are over, as well as toxins are destroyed by the liver.
  • The liver can be struck by over 100 types of diseases.

    The liver cells are known as hepatocytes, and most affections result in hepatitis. The commonest cause of hepatitis is virus infection; depending on the type of virus (A, B, C, D, E) infecting, the diseases is labeled as viral hepatitis A, viral hepatitis B, viral hepatitis C, viral hepatitis D or viral hepatitis E. Viral hepatitis A is commonest and is caused by intake of unhygienic food and / or water.Besides viruses, alcohol-mediated damage is another commonest cause of liver disease. If not checked in initial stages, alcoholic hepatitis leads to a chronic and eventually fatal outcome called as cirrhosis of liver.
  • Usually rest, energizing drinks, avoiding the liver – offensive alcohol / medicines and vitamins are advised for any hepatitis. Although this constitutes a good supportive care for the liver, it is not enough. Phospholipid -based products are the best to stimulate liver regeneration and re-start liver functioning at the earliest.
  • The phospholipid story began when it was isolated first from lecithin. The word lecithin is derived from lekithos, the Greek word for egg yolk, by Maurice Gobley when he isolated it from eggs around 1847. But egg lecithin was too expensive and commercial lecithin was first prepared in Germany from soybean in the 1920s. Chemically, the term phospholipid derives from the fact that these molecules contain a blend of lipid and phosphorus. Hundreds of different varieties of phospholipids exist, but currently the phospholipids in various products all come from one class: the glycerophospholipids.
  • The outer covering cell membrane of hepatocytes is composed of lipids – glycerophospholipids. There are 100 billion hepatocytes in the liver, and hence adequate availability of phospholipids is vital for the structure of the membrane, and the functioning of the hepatocyte as a whole. As is evident, the phospholipid molecules has a head and two tails; it is arranged as a double-layer and has protein molecules scattered in-between.
  • In the hepatocyte membrane the charged heads of the phospholipid molecules face outwards whilst the uncharged hydrophobic tails of the two layers face each other in the center interiorly. The phospholipid molecules are glued by small amounts of cholesterol present in-between their heads. Phospholipids are fluidizing whilst cholesterol is rigidizing.

    This arrangement of few RIGIDIZING cholesterol molecules in between the FLUIDIZING phospholipid molecules controls membrane fluidity of hepatocytes and is the key to optimal liver functioning.
  • There are over 200 varieties of phospholipids present in liver. Of these the most important ones are primarily four:
    1. Phosphatidylcholine
    2. Phosphatidylethanolamine
    3. Phosphatidylinositol
    4. Phosphatidylserine

    Phosphatidylcholine constitutes 70-80% of phospholipid content of liver; the second most prevalent being phosphatidylethanolamine
  • There are 300 million hepatocytes actively involved in phospholipid manufacturing. In the diseased liver, this synthesis of PLs is affected since the energy requirements of 5600 calories/Mol for PC synthesis cannot be easily met by the damaged hepatocytes. This leads to liver cell damage in various hepatitis / cirrhosis. In addition, the hepatocytes have a life span of 150 days, and this also adds to its loss.
  • Lessened phospholipid availability upsets the balance between fluidizing phospholipid and the rigidizing cholesterol in favor of the latter.The diminished hepatocyte membrane fluidity opens up calcium ion (Ca++) channels and consequently the Ca++ enter the hepatocyte membrane. Ca++ facilitates the destruction of the phospholipid molecule with consequent liberation of inflammatory and destructive chemical mediators.Phospholipase A2 (PLA2) is the enzyme which ultimately mediates the formation of inflammatory PGE2 and LTB4, the latter being also tissue destructive to cause cirrhosis.
  • Soybean is the best source of lecithin-derived phospholipids. It has been commercially exploited as a source for phospholipids due to various reasons.
    1. Soybean has a high concentration of lecithin – 1.5% vs the next best peanuts as 1.1%; vegetables / dairy products provide <0.01% and cereals / nonveg food items contain 0.5-1%.
    2. Soybean lecithin has all the important phospholipids, the total content being approximately 50%. Nearly half the phospholipid provided is the all important phosphatidylcholine
    3. Soybean lecithin is devoid of preformed arachidonic acid, which could otherwise lead to liberation of damaging PGE2 and LTB4. 4. Soybean is energizing, but does not additionally provide cholesterol unlike egg lecithin.
    4. Soybean lecithin incorporates essential phospholipids. Essential phospholipids are those whose essential polyunsaturated fatty acid (PUFA) content is approximately 70% of the total provided. The PUFAs, being unsaturated, have presence of double bonds which allows the fatty acid chain to bend (kink). The kinking facilitates better transfer of nutrients across the hepatocyte cell membrane.
  • Essential phospholipids provide a various benefits to the ailing liver:
    1. Essential phospholipids restore the hepatocyte membrane structure and stabilize the same. This limits further attack by the offending viruses.
    2. By enhancing fluidity of hepatocyte membrane, essential phospholipids facilitate optimal entry of nutrients into liver cell. This is especially since the essential phospholipids contain essential PUFAs, and not saturated fats, such that the phospholipid molecules are not tightly placed.
    3. Energy manufacturing (as adenosine triphosphate, ATP) is also stimulated since the mitochondrial membrane also gets a fresh supply of essential phospholipids.
    4. Essential phospholipids intake normalize the phospholipid: protein ratio of 50: 1 molecules. This in itself restarts the protein-enzyme functioning.
    5. The chemical mediators (PG and LT) emitting out of essential phospholipids function as signaling aids for hepatocytes, both to send messages as well as to transmit those received to within the hepatocyte.
    6. The long standing liver damage (chronic hepatitis) is essentially due to an abnormality in immune system working. Essential phospholipids intake also ensures their availability for the defense cells’ membranes such that these white blood cells (WBC) once again function normally. The phospholipid: cholesterol ratio of the WBC once normalized; these cells curtail their faulty damaging action to the hepatocytes in chronic hepatitis.
    7. Adequate phospholipid also facilitates thrombin synthesis, as well enhances vitamin K absorption. This normalizes the otherwise defective clotting which may occur in a liver disease.

    In those taking alcohol, essential phospholipids not only prevents their damaging action, but also have an ability to ward off the development of the deadly cirrhosis – the commonest complication of excessive, long-term alcohol intake
  • In any infection or inflammation, the free radicals are generated by the invading WBCs. It has been claimed that many patient even die due to massive free radical invasion caused by infections such as in viral hepatitis! Hence, it is essential to provide additional support to the liver with an antioxidant.
  • Silymarin is the active principle extracted from the fruit of Silybium marianum. The active principles are silybin, isosilybin, silydianin and silycristin. Silymarin exerts a protective effect for the liver through several mechanisms:
    1. Provides antioxidant protection.
    2. Regenerates damaged liver cells.
    3. Stabilizes hepatocyte membrane.
    4. Prevents the cirrhosis development in alcoholics.

    In fact, as far as the latter three actions are concerned, silymarin complements the phospholipids
  • No side effects have been observed with essential phospholipids over years of usage and there are, therefore, no restrictions attached – including usage by pregnant mothers and lactating females. Silymarin is also safe; only those known to be allergic to soya or a product containing lecithin, or silymarin, should avoid products containing these.
  • Availability of an essential phospholipid – silymarin containing product is expected to be highly beneficial for those affected with any liver disease, and additionally help prevent the dangerous consequences of the acute hepatic disorders, reverse the chronic diseases, and prevent complications of the latter such as cirrhosis. For alcoholic and drug-induced liver damages, essential phospholipids are a valuable adjunct.

  • Osteoporosis (OP) is a condition in which bones become less dense. This causes the bones to become excessively fragile and thus liable to fracture easily.
  • The bone has a hard outer covering called cortex. Inside the compact bone is a spongy (also called cancellous) bone which has a dense meshwork of supporting beams (trabeculae). The interconnecting spaces enclosed by the trabeculae constitute the bone marrow.
  • The bone has minerals within it for its strengthening. This mineral content is expressed as bone mineral density (BMD) – quantity of minerals (gm) in the measured surface area (cm2) of the bone (gm/cm2).
  • Bone is mainly made up of calcium and phosphorous crystals embedded in a framework of interlocking protein fibers (collagen). The calcium (67% of bone content) is present as hydroxyapatite; the remaining 33% is collagen.
  • Osteoclast cells facilitate the calcium removal, whilst osteoblast cells of bone help in fresh deposition of calcium. Deposited in the bones by special cells known as osteoblasts. This process is called remodeling, and it commences once the adulthood begins.
  • In adult life, 250 -1000 mg of calcium is released by bones daily and the same quantum is put back by osteoblasts so that net bone loss / gain are nil. In this fashion, between 2-4% of the skeleton is dissolved and rebuilt back fully annually.

    Between 3rd and 4th decades of life, the equilibrium in bone calcium loss / uptake shifts. This is because the removal by osteoclasts is not fully compensated by osteoblasts during remodeling in the elderly. Hence, OP is definite to commence during the 30s or 40s unless appropriate preventive intervention is resorted to.
  • OP is a disease of the elderly (involutional osteoporosis). Involutional OP, further, can be type I when it occurs in postmenopausal women, or type II when it is age-related (men & women beyond 65 years). Rarely, children could suffer from OP (juvenile osteoporosis).
  • The aging process itself (type II OP), and the hormonal (estrogen-progesterone) depletion in menopause (type I OP) are the main cause of OP. However, OP could occur due to many other reasons (secondary OP) such as include malnutrition, hormonal disturbances (parathyroid hormone excess / thyroid hormone deficiency), prolonged corticosteroid intake (as by those suffering from allergic asthma, rheumatism, etc) or bone diseases such as cancer.
  • Most often osteoporosis does not cause any symptoms. Only when it is moderate-to-severely progressed could there be various manifestations.
    1. Cramps in the legs at night.
    2. Neck pain, discomfort in the neck other than from injury.
    3. Persistent pain in the spine or muscles of the lower back
    4. Rib pain.
    5. Tooth loss.
    6. Brittle fingernails.
    7. Broken bones (fractures).
    8. Loss of height as a result of weakened spines in very severe OP. A person may find that his/her clothes are no longer fitting and their pants looking longer.Patients may loose as much as 6 inches in height.
    9. Spinal deformities (in severe OP) become evident like stooped posture, an outward curve at the top of the spine as a result of developing a vertebral collapse on the back.
  • The most exact way to measure bone density is by a DEXA-scan (Dual-energy x-ray Absorptiometry) which is done on the whole body. A DEXA-scan takes about ten minutes and is associated with minimal radiation exposure.

    A DEXA-scan report compares the patient's BMD values with those of young normal patient (T score). A T score value >-1
  • Osteopenia refers to DEXA-scan reported T scores between -1 and -2.5. This is the range reported in borderline OP; if appropriate intervention measures are instituted at this stage itself, OP could be prevented.
  • Calcium supplements decrease the rate of bone loss in the elderly. Concomitant vitamin D is necessary to increase calcium absorption. Bisphosphonates (alendronate, etidronate, residronate, clodronate, tiludronate, pamidronate, ibandronate) are the latest in managing OP. They assist by re-establishing the normal balance between osteoblastic and osteoclastic activities. In postmenopausal OP, women are advised to supplement their waning estrogen levels.
  • The best calcium salt is that which provides highest blood levels so that its availability to bones is best. The most researched salts are calcium carbonate and calcium citrate from the view points of calcium content and calcium absorption in blood.

    Calcium carbonate has an edge over calcium citrate in view of its higher elemental mineral content. Each 1 gm of calcium citrate salt provides 210 mg of elemental calcium; for calcium carbonate 1 gm this is 400 mg! No other calcium salt provides such high 40% elemental calcium content as calcium carbonate till date!

    Besides the highest elemental calcium content calcium carbonate’s absorption has been proven to be as high as 39% by very sensitive analytical methods.1 This means that for every 1 gm of calcium carbonate taken, 400 mg elemental calcium enters the intestines, and nearly 160 mg of this finds it way into the blood!

    Even the now available calcium citrate2 and calcium citrate malate3 are not absorbed to any great extent beyond 40%.
  • Vitamin D is traditionally known for its ability to facilitate calcium absorption. In the liver and kidneys, vitamin D3 (cholecalciferol) is stepwise converted to 25-hydroxycholecalciferol (calcifediol) and 1, 25 -dihydroxycholecalciferol (calcitriol) respectively.

    Calcitriol enters the lining cells (enterocytes) of small intestine and stimulates special proteins (calbindins) which are needed for calcium uptake.
    Calcitriol enhances calcium absorption by as much as 34%, and this beneficial action occurs within 2-6 hours of its intake along with calcium carbonate.
  • Yes. Calcifediol is marketed as synthetic alfacalcidol. This also expedites calcium absorption, but the action of calcitriol is twice better in this regard!5 Another advantage of calcitriol is it will work inspite of disturbances in liver and kidney but alfacalcidol is dependent on kidneys to be converted to active calcitriol. Remember, it is ultimately calcitriol which matters and works.
  • There are other natural adjuvants which could enhance calcium absorption besides calcitriol. One of these is Evening Primrose Oil (EPO) that is derived from the seeds of a biennial plant – Oenothera biennis or Oenothera lamarckiana. EPO contains an essential fatty acid called gamma linolenic acid (GLA) that has critical role to play in enhancing calcium absorption, decreasing calcium excretion by kidneys as well as facilitating calcium uptake by bones.
  • The nature of enterocyte’s covering membrane determines calcium’s absorption. The more fluidic its consistency, the better is the calcium movement from intestine to blood. GLA increases the fluidity of enterocytes’ membrane and this is the prime mechanism of its utility in increasing calcium levels in blood. By taking GLA bone calcium uptake has been demonstrated to be 2.7 times more as compared to those taking plain (sans GLA) calcium supplements!
  • In menopause, women loose 2-4% of their bone mineral each year. In addition there are additional complaints of hot flushes, mood swings, and sexual intercourse-related difficulties related to vaginal dryness. The special prostaglandin (PG) manufactured from GLA, namely PGE1 (instead of the normally available PGE2) helps in allaying all the menopausal complaints accompanying type I OP.
  • Besides, an insignificant stomach- / intestine–related disturbances, this blend of ingredients is not expected to cause any undue disturbances. However regular monitoring of blood calcium levels is recommended for those who take calcium or calcitriol on long term basis. Calcitriol containing products are not to be taken during pregnancy, or by those intending to conceive.
  • In Russia and Uzbekistan the estimated prevalence of OP is 10.3%.7 Besides, 40% of Russian women have osteopenia.8 In such cases Kostrol is ideal to prevent the osteopenia from progressing into OP, besides tackling the OP per se.
  • Kostrol contains calcitriol which has been widely studied and proven for its anti-osteoporotic benefit. Besides, promoting calcium absorption, calcitriol also decreases excessive hormonal-mediated calcium loss (especially in menopause); calcitriol even conserves body’s calcium by diminishing its removal by the kidneys. Calcitriol main action lies in its ability to facilitate new calcium uptake by the osteoporotic bone.
  • Kostrol can be taken as long as necessary to derive benefits from its ingredients.9 Only prolonged intake warrants checking of calcium levels in blood periodically such that they do not exceed the normal range of 9-11 mg/dl.