When Shakespeare was writing The Merchant of Venice, he was talking about the extent to which people are the same under the skin. But culture is more than skin deep and what one group of people find an everyday treatment, others find extraordinary. As an example, let’s take acupuncture. This is a technique perfected in Traditional Chinese Medicine (TCM). Put most simply, the practitioners treat sickness and disease by sticking needles into their patients. But in China, there are more than two thousand years of experience in administering treatment this way and many medical hospitals in Asia and ASEAN include acupuncture as one of the therapies available to treat patients. The point of interest today is that China is now also adapting its techniques to produce aesthetic acupuncture to treat acne and premature baldness, and to promote weight loss. Westerners are used to using a range of treatments for cosmetic problems such as acne and baldness. Some are available over the counter while others require a prescription. Accutane, being the most powerful treatment for acne, usually requires the approval of a dermatologist before it is prescribed. The treatment for acne in TCM relies on acupuncture, herbal preparations and a change in diet to food with a low fat content, low spiciness and not fried. The aim in the treatment is to improve the condition of the skin by stimulating the flow of blood around the face. This requires needles to be inserted in the upper back, shoulders and neck. There is increasingly sound scientific evidence about the effectiveness of TCM as more Western researchers begin to study these century-old techniques. Results are not simply a placebo effect produced by the strength of the patient’s belief. There are verifiable “cures” when TCM, including acupuncture, is used. For Westerners, the question is of some importance. As it stands, the drug of final resort for the treatment of acne is accutane which has significant problems associated with its use by women of child-bearing age. If the same improvements seen among those who use acupuncture could be replicated in the West, would this not be a better way to treat a serious skin problem rather than having to rely on heavy-duty drugs with sometimes dangerous side effects?

The loss of hair is usually stressful. People groom their self-image for years, knowing exactly how they can get the maximum effect. So the imminent loss of their crowning glory is a threat to their apparent youthfulness, their physical attractiveness and, most importantly, their self-confidence. It’s estimated about 80 million men experience male-pattern baldness. Roughly the same number of women also lose their hair. Every day in the bathroom is a trial as more hair falls during combing or brushing. There’s often a panic reaction. People rush to a clinic or try one of the commercial products.

They start covering their heads to hide their embarrassment, scan websites on hair pieces when no-one is looking, and then the men sigh with relief because they find propecia. Taking this drug is a commitment. It’s slow to take effect and then its effects only last so long as you continue taking it. Stop and the hair loss resumes. But it works and it’s safe. Except that women can’t take propecia. All this emotion caused by hair. Assuming you’re not a cancer patient going through chemo- or radiotherapy, hair falling out is not a sign your life is in danger.

In fact, it’s perfectly normal. Every day, a healthy person loses an average of one hundred hairs. All of which prompts us to ask, “What causes hair loss?” In both men and women, the most usual cause is heredity. Current recent research suggests some people are born without one or two key genes. But there are other possible causes. Breaking off for a moment, men can always take propecia which stops the loss and may even allow some hair to grow back. But this drug cannot be taken by women, so we need to say a few words about the other possible causes for them.

Another possibility is a hormone imbalance. Some women find some brands of oral contraceptive cause hair loss as can the physical stress and hormonal changes during pregnancy and birth. Similarly, hormone replacement therapy can cause hair loss. More generally, you can lose hair because of fungal infections of the scalp or thyroid problems, diabetes or lupus. Ask your local healthcare provider if you are taking medications. Some cause hair loss as a side effect.

Both in the abled Olympics we’ve just watched in Beijing and the Para-Olympics to come in the same place, the basic rules are laid down by the organizing committees and enforced through the WADA. The general rule is that athletes can use inhaled, topical and systemic corticosteroids to deal with a wide range of medical conditions. Probably the most common is the use of inhaled corticosteroids and beta-2 agonists to allow asthma sufferers to compete. For this and the relief of joint pain and other inflammations, cheap Prednisone is the most common medication, but athletes must get a full Therapeutic Use Exemption before using it. There are myths that using steroids enhances performance. So asthma sufferers are able to breathe during the competition. Inflamed joints are able to move more smoothly again, etc. For example, one medic has conducted three double-blind, randomized, placebo-controlled studies of asthma drugs. The results showed no enhanced performance. So why does WADA control their use? Probably because corticosteroids will mask the prohibited performance enhancers.

So you can reach for cheap Prednisone online knowing it’s approved as the standard treatment by elite athletes. To get to the Olympics yourself, all you have to do is to become one of those elite athletes. No problem!

Well, yes, I am going to talk about a new book about coping with sleep disorders. Appropriately enough for a site devoted to Ambien, it is Insomniac by Gayle Greene. Gayle Greene has the distinction of being a non-professional member of the American Academy of Sleep Medicine. She wins this prize even though not a medical researcher because she is the “patient representative” on the board of the Association, which operates within the AASM’s umbrella. This latest tome (quite heavy at 520 pages) adds to her impressive resume of academic publications.

This is a highly personal account by an articulate and intelligent woman who has been afflicted by insomnia for most of her adult life. In one sense, the only person who can really tell you what it is like in a foreign country is one who has been there. For those of us who have always been able to sleep without difficulty, insomnia is like a foreign country, and the idea of having to use a medication like Ambien as the passport to get into sleep is alien.

Conventional wisdom always says that insomnia is somehow related to anxiety or stress levels, perhaps aggravated by drinking too many cups of real coffee. Greene comes up with a simple and practical explanation of what insomnia is. Insomnia means nothing more than you cannot get the number of hours of sleep you need to feel good about yourself and function efficiently. There is no reason for this. It is nothing more than a failure to sleep. There should be no pejorative implication. To use stress as an excuse is to blame the person for being weak or neurotic when there is no reason to blame yourself or anyone else. Instead of looking for some psychological explanation or a less judgemental physical cause, we should just accept that it happens to about 20% of the population at one time or another during their lives.

Greene considers that the National Institutes of Health in the United States spent less than $20m in 2005, whereas Sanofi-Aventis spent more than $120m promoting Ambien in the same year. This is neither to praise nor condemn Ambien. It is all a question of priorities. Why bother to spend Government money on researching the cause of a condition when private capital has already used Ambien as a cure for it? Folk tales may tell us that we went to sleep when dusk fell and waited for the cock to crow before waking. But was that actually the case? Who can say what the real biological norms were before electricity came along and gave everyone the chance to live through the darkness. As it stands, no researcher can actually explain why we have to sleep nor why some people sleep more than others. It is all guesswork. All that we can say with any certainty is that those who are deprived of sleep do not do as well as those who sleep through the night. The sleepless so often end up demotivated, their sense of humour worn thin, their judgement warped. For one who has never had problems sleeping nor had to take Ambien, Insomniac was a riveting insight into the condition and the problems it causes. Required reading for everyone who reads this article.

There’s this overpaid Brit who plays this weird game they call football. This is the game played by women over here in the US. I think our girls won a gold medal at the Olympics a few days ago, but that Beckham is not a girl, of course, although he does wear a sarong (that’s a skirt for men). They also act like sedatives which helps you to sleep. When you are better rested, you have a more balanced view of your condition. But let’s stop pretending that we are very clever. This Beckham guy is hanging out with the stars in LA and now Tom Cruise is boasting that he’s lost 10 pounds in six weeks thanks to Beckham’s advice. So kicking a ball help you lose weight. But Cruise has been under pressure from Katie Holmes who’s fifteen years younger than him. Love handles aren’t that sexy, even in a movie star. You don’t have to be a scientologist to figure that one out. Most other A-listers would have been quietly popping pills like Acomplia - the top European weight loss pills. But Beckham must have a diet book coming out, so Cruise is out there pitching for him. If he has lost weight, perhaps he’s quietly taking Acomplia. The moral of this is: if you can’t hang out with top Brit footballers who dress like girls, you can take Acomplia and lose weight the easy way.

No matter how great is effectiveness of a drug like Tramadol in the short term, you cannot afford to become too dependent on Big Pharma. Ignoring the financial cost which soon becomes the proverbial millstone round your neck , the longer you take any drug, the more your body adjusts to it and the less effect it has. That means the temptation to increase the dose or move on to ever stronger medications. You need hope to motivate yourself. So the next time you see your doctor, you will ask for a repeat prescription for the Ultram online, but you will also ask for real help in coming to terms with the sickness or disorder causing your pain. Yes, it may cost you money to see a therapist but balance that cost against the drug bill you will have for the rest of your life unless you take action now. Combined, this is the slippery slope to economic and physical ruin. To deal with this, you have to go back to the source of the problem - the pain itself. You cannot allow the pain to dominate your life. You have to take back control. The first step is like a New year Resolution. It’s a commitment that you’re going to restore your quality of life.

In an increasing number of rural and urban areas in the US, there is a widening gap between the supply of primary care physicians and the demand for their services. Because pay levels are lower than in hospitals and the debts from medical school are higher, only about a quarter of newly qualified physicians go into general practice. It can now take months to get an appointment as the population ages and more boomers require treatment. The shortage of doctors is also highlighted in states like Massachusetts where new health insurance legislation is restoring cover to many who have gone years without insurance. It is an irony that universal health cover is meaningless without a significant increase in the number of doctors in general practice. This situation will only grow worse as older doctors retire over the next decade. As it applies to insomnia, not only is there is a shortage of physicians but also of therapists.

Achieving a good sleep at night is so easy for the majority but for some people this can become almost impossible problem. It can be simply that you feel excessively tired. You walk around in a daze, feeling as if you had no sleep at all. This can affect your performance at work because you find it more difficult to think about. Mood can also change for the worse with you feeling more irritable and bad tempered. Headaches become more common. One quite understandable reaction is to reach for the ambien bottle which has a proven track record for helping people get to sleep and stay asleep for longer. But, like many conditions, insomnia is not treated by taking medication. The best that ambien can do is to give relief to the immediate symptoms. In the long term, cognitive behavioural therapy provides a treatment in most cases. Well, it is not necessarily.

Against this background, it was interesting to see a new potential solution for the treatment of insomnia. It has long been known that as people fall asleep, the circulation of blood slows and more blood stays longer in the arms and legs. If this technique can be proved effective in a statistically significant number of ordinary people rather than volunteers patient and persevering enough to learn a physical skill, it could be a highly cost-effective solution to a difficult medical problem. As it stands, physicians are forced into the expedient of prescribing ambien to treat insomnia because there are too few therapists. The heart and temperature monitors are relatively cheap. If demand rose, the price would drop further. A simple “how to” guide plus the equipment might be all that many people need to relearn the art of failing asleep. As a result, the hands and feet warm slightly. In the Center for Sleep Medicine in New York, specialists have begun to train insomniacs in the use of biofeedback techniques to replicate this physical response. It usually takes between two and three hours of training spread over a number of weeks for the brain to learn how to control the body’s heart rate, circulation and temperature rise. About 90% of those taking part in the experiment have mastered the necessary skills and have found it easier to get to sleep. Although biofeedback and relaxation skills have been used alongside or as an alternative to ambien for some time, this is one of the first major centers to run a full-scale training exercise.

One of the rather more unfortunate side effects o f surgery to remove a growth in the prostate, is the phenomenon politely called erectile dysfunction. Put simply, when a surgeon is waving a sharp knife around “down there” and that knife has to cut away a growth, it’s very difficult, if not impossible, to avoid cutting through some of the nervous system that makes sex possible. A significant proportion of men find they can no longer get or maintain an erection. Sex becomes a memory. Except that some clever people in Canada have been trying out Levitra in a placebo-controlled, double-blind, randomized trial. The study involved some 423 participants in 87 hospitals in Europe, the U.S., Canada and South Africa over a period of some two-and-a-half years. The present system calls for one of the PDE5 inhibitors to be given every night at a low dose. This tested the response of men taking Levitra at the standard dose whenever they felt like attempting sexual intercourse. The results clearly show a higher success rate than taking the drug every night. So the moral of this news story (published in the exciting journal European Urology) is that even if a guy with a knife cuts chunks off your manhood, Levitra can still bring life back to the old dog (or young dog if you were unlucky enough to have prostate cancer as a younger man).

Warning to all weight watchers. The Japanese have just published a scientific report in Polar Biology - another of those must-read journals. Kenji Konishi, who works out of the Institute of Cetacean Research in Tokyo, said August 27 that killing was the only way to accurately measure factors such as body weight or fat thickness! So if you’re holidaying in the polar regions this Fall and see a Japanese researcher coming towards you with one of those big samurai swords, you may decide that you don’t want to be a part of the research. Except that he’s talking about Antarctic minke whales. OK, so when did you last see a minke whale on your bathroom weighing scales? He’s got a point. It’s hard to get a whale to stay still long enough to get an accurate reading. And then there are those caliper things, the “fat pinchers”. Where would you get pinchers big enough? Seems hard to have to kill them to find out whether their diets are working. How would you like it in a clinical trial? Take these Acomplia tablets for six months and then we’ll kill you to find out how much adipose fat you’ve lost. Can’t they just guess? Actually, when it comes to human clinical trials, they use advanced science like tape measures for waists. Acomplia has done well. Participants lose an average 10% of their body weight and an average 3 inches (8 cm) from their waists. Perhaps the minke whales are buying Acomplia online. Let’s not kill them to find out.

According to reports in several online magazines, Ambien was the thirteenth highest selling brand-name drug in the United States in 2006. So ignoring all the categories of antibiotics, antidepressants and so on (Ambien is the best selling hypnotic sedative used to treat insomnia), only twelve other medications sold more by volume in the US.This is a great advantage of ambien, and of cause other companies would like to get some profits from ambien’s name. But, to do that, the competition has to prove their products are as good (if not better) in direct comparison trials. As Ambien might say, “Bring it on!”

Perhaps even as recently as last year, there was investment money available to develop and bring new medications to the market. Now the credit crunch is starting to bite more fiercely, that money is harder to find. Take as an example, the Neurogen Corp., a biotech company based in Connecticut. It has a medication in development intended to go head-to-head against Ambien. But that is only half the problem. To get past the Food and Drug Administration, it needs clinical data from properly designed trials. This takes time and money. So it all comes down to priorities. Which is more important: current operations or future profits?

Neurogen has just announced it is laying off forty-five of its staff and raising some $30m with private investors to focus on just four prospects. So, the company has decided that one of the four prospects - to treat insomnia, anxiety, restless legs syndrome (RLS) and Parkinson’s disease - must succeed for the company to survive. It does not have the capital to maintain the search for future medications. Even the more general administration of the company can be allowed to degrade. The share value fell one third on the announcement, the company having lost almost $58m last year.

But the potential value of even a flea bite in Ambien’s market share would restore Neurogen to profitability. So it has to bet its shirt on its head-to-head competitor in development. If it can produce clear clinical data that it has a safe and effective product and that product is at least as good as Ambien, it will have saved itself. The results of the trial are due at the end of this year.

What price should any company pay to chase the pot of gold at the end of the commercial rainbow? Market dominance such as that enjoyed by Ambien is not necessarily a good thing. In a capitalist society, we should encourage open competition if it benefits consumers by producing excellent products at a good price. But I worry about the forty-five staff who lost their jobs. Who is to say they would not have developed a special new medication next year? Now all they have to look forward to is next month’s red reminders from the credit card companies.

I am not arguing that companies should not compete with Ambien. Competition keeps the established player on form. But I wonder who really benefits if a biotec company like Neurogen does get a good product out there. A few already rich investors get a spectacular return. There is a new product that has to maintain a high price to recover its development costs.