B12 Vitamin Injection

What is a B12 Injection?

A B12 injection is an injectable form of vitamin B12, a micronutrient that is required to maintain good health. Vitamin B12, also known as Cobalamin, is a water-soluble micronutrient or vitamin that the bacteria in the stomach naturally produce. This vitamin is necessary for the body’s ability to form red blood cells, replicate DNA and to grow tissues. It also is required for Myelin to form, a fatty substance that protects nerve cells as well as to lower levels of Homocysteine, which reduces the risk for developing heart attacks and strokes.

Why is it Used?

When people are having difficulty creating or absorbing vitamin B12 naturally, a physician will recommend a B12 injection. Symptoms of vitamin B12 deficiency include: tiredness and fatigue, difficulty breathing, pale skin, poor memory, disorientation, confusion, white spots on the skin, appetite issues, headache, nerve shocks along the body, headaches and random facial pains, random tingles and sores in the mouth corners.

Physicians may also suggest that the patient consume more foods containing Cobalt, the substance that the stomach bacteria rely on in order to create vitamin B12. If improving consumption of cobalt-containing foods is not helping, physicians may recommend B12 supplement injections.

What Conditions Does it Treat?

Vitamin B12 has been successful in treating a variety of medical conditions. The most popular reason a B12 injection is used is for a deficiency, which is condition in which b12 levels in the blood are too low. This vitamin is also used for weight loss, Alzheimer’s disease (memory loss), boosting energy and the immune system, sleep disorders, diabetes, male infertility and to slow the aging process. B12 has been known to help with mental disorders, osteoporosis, AIDS, asthma, allergies, inflammatory bowel disease and some cervical and other cancers as well.



Tammoima Gichana PharmD, MBA, MB(ASCP),RPh.


Our amazing Dr. Tammoima explains anxiety

Anxiety involves feeling uneasy, anxious or nervous, due to stress or trauma, real or imagined. Typically, anxiety is a normal health issue that goes away once a negative situation is completed. Anxiety can even be positive, helping to improve coping or alertness. But when anxiety remains, this mental illness is called an anxiety disorder. Typically lasting for at least six months, these disorders can affect mental health, relationships and quality of life.

Anxiety is actually a group of disorders that all share some level of excessive, persistent, irrational panic and dread. Generalized anxiety disorder (GAD) involves ongoing excessive worry and tension, often with no apparent reason. With obsessive compulsive disorder (OCD), irrational, reoccurring thoughts and uncontrollable compulsions can occur. Post-traumatic stress disorder (PTSD) develops after trauma or terrifying events. PTSD patients may have frightening, long-lasting thoughts and memories. Phobias, excessive, inappropriate fear of an object, situation or activity, are uncontrollable. A phobia can cause extreme stress and anxiety, as people try to avoid their fear. Those with social anxiety disorder worry and feel self-conscious about normal social situations. With separation anxiety disorder (SAD), children have anxiety when separated from loved ones. Panic disorders (anxiety attack, panic attack) are sudden episodes of intense panic or fear, often without reason. A panic attack rarely lasts more than 30 minutes, but can be severe, and you may be worried that another anxiety attack will occur.

Causes and Risk Factors of Anxiety

The exact cause of anxiety and mental illness is not completely understood. Mental health researchers suggest a combination of several factors, including environmental stress, trauma and heredity, may be at fault. Severe or long-lasting stress may actually cause chemical imbalances to the brain and its structures, altering memory and mood. But other underlying health issues shown may also cause anxiety, including: muscle cramps/spasms, thyroid conditions, tingling and burning sensations, tumors, asthma, diabetes and heart disease.

Stress is a major risk factor for anxiety, whether due to illness, big events or smaller life situations. Women are twice as likely to be diagnosed with anxiety. Children who have endured abuse or trauma have greater chances of anxiety, as well. Your risks may be higher if blood relatives, including one or both parents, have an anxiety disorder. While drug and alcohol use causes anxiety, it also masks mental health issues, and should be treated first. If anxiety goes untreated or advances, insomnia, headaches, grinding teeth (bruxism) and digestive or bowel problems can develop. Nearly half of all anxiety patients are diagnosed with depression, as well.

Symptoms, Signs and Testsof Anxiety

Often, anxiety symptoms and signs first indicate physical or mental health illnesses. Anxiety symptoms may include: feeling apprehensive or powerless, increased heart rate, rapid breathing, feeling weak or tired, sweating, dizziness, stomach discomfort, chest pain, startling easily, muscle tension, sleep issues, nightmares and sexual problems. Anxiety disorders may have specific symptoms, such as panic attacks unreal, disconnected feelings and emotional numbness, or recurring, upsetting thoughts and compulsions occurring with obsessive compulsive disorder (OCD). As anxiety may have a medical cause, doctors give physical exams and blood tests. Patients fill out psychological questionnaires, and discuss medications or alcohol/drug use. Mental health professionals diagnose stress, trauma and anxiety with criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM). Anxiety disorders are diagnosed, along with other mental health problems. Depression is diagnosed in about half of anxiety patients.

Treatment, Drugs and Preventionof Anxiety

When anxiety remains, it becomes a mental issue requiring treatment. Typically, anxiety is treated with psychotherapy, medications, or both. Effective drugs enable patients to lead productive, fulfilling lives, although doctors may need to determine optimal treatments. Doctors typically prescribe antidepressants, such as fluoxetine (Prozac) and paroxetine (Paxil, Pexeva). These medications, which influence brain chemicals (neurotransmitters), are thought to play a role in anxiety disorders. Doctors may also prescribe benzodiazepines (sedatives), such as clonazepam (Klonopin) or diazepam (Valium), but they can be habit-forming. Beta-blockers can prevent the physical symptoms of social phobia and other anxiety disorders, as well.

Psychotherapy with mental health professionals is effective, allowing patients to identify stress sources. Its also helpful to discuss mental health issues with trusted friends or loved ones. Anxiety and related mental illnesses can be treated through lifestyle changes. Physical activity is important, and regular exercise incorporating healthy, fun activities reduces stress. Proper sleep and relaxation, along with daily leisure time, eases anxiety and stress. A well-balanced, healthy diet, including vegetables, fruits, whole grains and fish, reduces anxiety, while fried, sugary and processed foods should be avoided. Those with anxiety should limit caffeine, and completely avoid alcohol (and other sedatives), nicotine and drugs. Discuss with your doctor whether any drugs or medications you’re taking may cause anxiety.



Tammoima Gichana PharmD, MBA, MB(ASCP),RPh.


Causes, Risk Factors and Complications of ADHD

ADHD stands for attention deficit hyperactivity disorder and is a condition of mental health that provides the individual with difficulty in holding attention combined with hyperactivity and behavior that is impulsive in nature. Though the condition is most associated with children, it is also common to find the condition in many adults. The condition and symptoms can persist into the adult years, and in some individuals the disorder is not diagnosed until later years.

Causes, Risk Factors and Complications

Often ADHD is passed down from one generation to the next making it a hereditary disorder. The individual suffering with the condition might express signs early on in life that are missed or misdiagnosed as bad behavior or laziness. Some of the things that might put a person at risk for developing the disorder include things such as drug or alcohol abuse during the woman’s pregnancy, exposure to toxins like lead paint or pipes, or if you are born prematurely. You have a greater chance of suffering from ADHD if you have other family members with mental illness or ADHD.

There are many complications involved for those individuals dealing with ADHD in their lives. Performance in school and work can be hindered because of the inability to focus on the topic at hand and follow through to the end. Poor relationships can also become a result of ADHD in adults and children. It is also easy to see how a person with ADHD can be in trouble with the law, suffer from drug or alcohol abuse and go through severe financial stress. In addition, individuals with ADHD are often at greater risk for mental and physical health that is poor in nature.

Signs, Symptoms and Tests

It can be easy to misdiagnose ADHD, particularly in children, as the symptoms appear to be similar to basic childhood actions and laziness. It is important to note that many adults suffer from ADD which is attention-deficit disorder without the hyperactivity. Some of the symptoms include trouble with focus on daily tasks, difficulty completing projects or tasks, disorganization in general, restlessness, mood swings, impulsivity, low frustration tolerance, inability to cope well with stress, quick temper and inability to sustain stable relationships.

A doctor can provide you the individual with a number of tests that will give them feedback to be used in the evaluation of ADHD. This information is broken down into sections of inattention and hyperactivity/impulsivity. The individual should answer yes to six or more signs and symptoms that are designated by the Diagnostic and Statistical Manual of Mental Disorders (DSM) put out by the American Psychiatric Association. If six in each category of the questionnaire ring true to the individual they can be considered ADHD.

Treatment, Drugs and Prevention

There are a series of approaches to take when dealing with treatment of ADHD in children and in adults. These often include a medication such as a stimulant combined with psychological counseling. The medication choices often include Concerta, Metadate, Exedrine, Ritalin and some others newer to the field. These stimulants work to balance the brains neurotransmitters. Some other options for treating the ADHD with medications is the use of atomoxetin, better known as Strattera and Wellbutrin. There are some individuals that can not take the stimulants because of health problems or because of past drug addiction.

Counseling will help the individual learn how to cope with some of the things that can trigger the behavior. In addition, you will learn how to prevent or reduce such things as impulsive behavior and how to be better organized, handle time management better, improve self-esteem and improve relationships with those around you. This is all important for developing a lifestyle free of ADHD symptoms and drama.



Tammoima Gichana PharmD, MBA, MB(ASCP),RPh.


What you need to know about obesity

Obesity is a term used for children and adults who are at an unhealthy weight. It is not the same as being overweight and is a higher level of carrying too much weight compared to your height. It is considered a chronic medical condition with excessive body fat and poses a number of threats to your health. Obesity is often defined more specifically by being over a certain body mass index (BMI). Everyone has a unique BMI that shows where you are on a scale of underweight to morbidly obese.

Being obese is somewhere in the middle of the scale where your BMI is 30 or more. Someone who is overweight is between 25 and 29.9 on the BMI scale while someone morbidly obese is 40 or over. According to MedicineNet.com, over 30% of adults in the United States are currently obese and 20-25% of children are obese. While these statistics are startling, the good news is you have different treatment options. Weight management is done with weight loss programs, weight loss medications, home treatment and even surgery if you require it.

Risk Factors of Obesity

There are many complications associated with being obese and medical conditions you could develop as a result of the added fat. The first thing you should be aware of is that obese increases your risk of dying at a younger age. Around 300,000 deaths each year are related to obesity. If you are obese, you could become resistant to insulin, develop diabetes or heart disease, have any number of cardiovascular problems, get high blood pressure, high cholesterol, have a stroke or heart attack, and increase your risk of getting cancer, osteoarthritis, sleep apnea, gallstones and gout.

Some people are at a higher risk for developing obesity than others. Children who are born to parents who are obese are at a higher risk because it can be genetic. Also, children who are overweight starting at a young age have a higher risk of maintaining the condition through adulthood. Also, if you are African American or Hispanic, you fit a high-risk category as it is more common with these nationalities. Additionally, having an eating disorder, mental health disorder, polycystic ovary syndrome (PCOS), Cushings syndrome or hypothyroidism, you have a risk of becoming obese.

Symptoms, Signs and Tests of Obesity

If you suspect you may be obese, you should consult a doctor right away. The sooner you get help with losing weight; the better off you will be in the long run. Since many complications and adverse health effects are associated with being obese, losing weight and becoming healthy should be your top priority. Your doctor will check your current weight and height to calculate your body mass index, take measurements and ask you a series of questions about medications youre taking, your lifestyle, what you eat on a typical day and your medical history. A series of tests will also be performed to determine if a medical condition may be the source of your obesity, such as lower-than-average metabolism, diabetes, hypothyroidism or PCOS. Your doctor will also want to calculate how much body fat you have compared to your muscle mass.

Body Mass Index

Body mass index (BMI) as mentioned previously is used to determine whether someone is at a healthy weight, overweight, underweight or in the obese category. It actually goes all the way up to morbidly obese and super obese. BMI is calculated using your current weight and your height in inches. This is a screening tool that helps doctors find out how much your weight is affecting your overall health. A BMI of 18.5 or less is underweight, 18.6 to 24.9 is healthy, 25 to 29.9 is overweight, 30 to 39 is obese, 40 to 49 is morbidly obese and 50 or more is super obese.

Signs of Obesity

Another way to determine whether or not you are obese is by looking at other signs you might have. Many people who are obese tend to have joint and muscle pain, dizziness, frequent headaches, gastrointestinal issues, heart palpitations, sleep apnea, fatigue, shortness of breath and the inability to be physically active without becoming exhausted. However take these signs with a grain of salt; they arent enough to diagnose obesity and may occur in people overweight or who are at a healthy weight. The best way to find out if you are obese and the cause of the extra weight is to have a physical exam by a doctor. They will help you with weight control and to start a weight loss program that is right for you.

Treatment, Drugs and Prevention of Obesity

There are many different methods of treatment for obesity, including medical and drug treatment, home treatment, surgery and going to a local weight loss center. Medical treatment is necessary for some obese individuals who are not able to lose weight on their own. Medical treatments include surgery and weight loss drugs.

Weight Loss Surgery

The two most common types of weight loss surgery are gastric bypass surgery and laparoscopic gastric banding, with a third less common option being a sleeve gastrectomy. These surgeries have their pros and cons and you should speak to your doctor about the risks and benefits. Keep in mind if you decide to get weight loss surgery, it is a long process and requires you to stick to a healthy diet and fitness routine after the surgery. It is not a quick-fix and requires a lifelong commitment.

Anti-Obesity Medications Injections

You can also get treated with medications, including anti-obesity medications and appetite suppressant drugs. One medication that helps with weight loss is actually an injection; called the lipotropic B12 injection. This is a fat-burning injection that includes B12 vitamins and amino acids. It will help your body burn fat more quickly and speed up your metabolism. You can also start an HCG diet, which uses pharmaceutical grade Human Chorionic Gonadotropic (HCG) which is a hormone that is naturally produced in women. This diet uses HCG to control your metabolism and lose weight in the process.

Another injection to help with treating obesity is the L-carnitine injection which is a supplement that can help transport fat into cells for producing more energy. It also speeds up your metabolism and helps promote weight loss. Finally, there is an FDA-approved appetite suppressant called Phentermine. This is a pill available in 37.mg pills that will help you improve your mood and control your appetite. Side effects from taking Phentermine include insomnia, high blood pressure, headache, constipation and nervousness.

Weight Loss Program

Perhaps one of the best treatment options is joining a weight loss program offered by a medical center or weight loss center. These programs combine different types of treatments for obesity, including learning about proper nutrition, exercise and fitness programs and treating underlying conditions causing obesity such as mental health disorders or eating disorders.

Home Treatment Methods

Not all obesity treatments are medical, though you should consult your doctor before starting a new diet, weight loss program or exercise program. The basics of home treatment for obesity are changing your lifestyle to become healthier and more conscious of what you eat. Consider your eating habits. Eat small portions of healthy, nutrient-rich food. Work closely with a dietician to decide what foods you should eat; aim for fresh fruits and vegetables, nuts and seeds, lean dairy, lean meats and healthier ways to prepare foods. You shouldnt eat less than 1,200 calories a day regardless of your weight. If you have issues with emotional overeating, find new and healthier ways to handle stressful situations so you can avoid binge eating. Start a fitness routine where you are getting at least 3-5 days of physical exercise. Combine cardio with weight training to help control your obesity and lose weight. Its important not to begin exercise before being examined by a medical professional.



Tammoima Gichana PharmD, MBA, MB(ASCP),RPh.


Dr. Tammoima’s view on Eating Disorders

Eating disorders refers to a group of conditions that involve the preoccupation with weight and food that distracts from everyday life. There are a number of eating disorders; however, the most common are anorexia nervosa, bulimia nervosa, compulsive eating or binge eating disorder and ED-NOS or eating disorder not otherwise specified. Eating disorders cause serious problems that can have both emotional and physical ramifications. At their most severe, these disorders can be life-threatening. They can affect both men and women of all ages.

Causes, Risk Factors and Complications of Eating Disorders

There is no exact cause known for eating disorders. When you look at them as a psychological illness, it makes sense why there might be numerous causes that depend on the individual. Some of the possible causes thought to be responsible for eating disorders include: biology, psychological health, emotional health and societal issues. There also seems to be some hereditary link in eating disorders as people who have first-degree relatives with eating disorders seem more likely to develop one too.

Some of the most common risk factors for eating disorders include: being female, a teenager or young adult, family history of eating disorders, emotional and psychological disorders, obsession with dieting and transitions or big life changes. Certain people such as actors, athletes, models and dancers tend to be more prone to eating disorders because they are expected to meet certain requirements for weight and physical appearance.

Eating disorders actually produce a wide variety of different complications, and some of them can be life threatening. Severe eating disorders and long lasting eating disorders can cause some of the most severe complications. Some complications of eating disorders include: high or low blood pressure, kidney damage, severe tooth decay, digestive issues, bone loss, stunted growth, suicidal thoughts, absence of menstruation, depression, heart problems, organ failure and death. Because these complications are so serious, seeking professional medical help for this type of problem is absolutely essential.

Signs, Symptoms and Testsof Eating Disorders

The symptoms associated with eating disorders are unique to each individual eating disorder. Symptoms of anorexia nervosa, for example, focus on refusal to eat, denying hunger, intensely fearing weight gain, distorted self-image, excessive working out, fear of eating out, thin appearance, difficulty sleeping, menstrual irregularities and dehydration just to name a few. The symptoms associated with bulimia nervosa include: eating to discomfort, binge eating, self-induced vomiting, excessive exercise, laxative use, going to the bathroom immediately after eating, dehydration, damaged gums and teeth and abnormal bowel function. The symptoms of binge-eating disorder involve: eating excessive amounts of food without trying to purge the food afterward through exercise or vomiting. Other symptoms of eating disorders in general can include: frequently eating alone, feeling that the eating is out of control, eating too quickly, eating to the point of pain or discomfort and eating much more than one should during a meal or a snack.

Treatment, Drugs and Prevention of Eating Disorders

Treatment for eating disorders will rely on the type of eating disorder being experienced. A typical eating disorder treatment plan will include nutrition education, psychotherapy and medical treatment. It is important to attain and maintain a healthy weight as well as understand healthy nutrition habits. Psychotherapy and counseling are also important in order to prevent a recurrence of the eating disorder. Some medications can also be used to control urges, but there is no real medical cure for eating disorders.



Tammoima Gichana PharmD, MBA, MB(ASCP),RPh.


What is depression?

Depression is a medical condition, which includes continued feelings of sadness, despair, hopelessness and loss of interest in daily life. It is a serious illness that can affect the body’s functions, behavior, physical health and ones thoughts and feelings. There are three different types of depression major depression, clinical depression and major depressive disorder. This chronic illness requires proper treatment in order to recover fully from its effects on the body and mind. Each year nearly 25 million Americans will suffer from depression. It typically occurs 70% more in women than that of men; mostly likely because women are more willing to seek treatment for the condition.

Causes, Risk Factors and Complications

While it isn’t known exactly why depression occurs, there are many factors into the development of this illness. For some patients, it is caused by changes within the brain or neurotransmitters that researchers suggest are a direct link to depression. Hormones can also trigger depression because of the body’s imbalance. For others, certain life events may trigger depression in their life as well as trauma such as death or abuse.

Some common risk factors for developing depression include:

  1. Being a woman;
  2. Experiencing trauma as a child;
  3. Having family history of depression;
  4. Stress;
  5. Being introverted;
  6. Recently having a child;
  7. Having a chronic or serious illness such as cancer;
  8. Addicted to drugs or alcohol;
  9. Low self-esteem;
  10. Taking certain medications

Untreated depression can lead to dangerous consequences. Some complications include: alcohol or substance abuse, anxiety, conflict, suicide, self-mutilation or premature death. Researchers suggest that nearly one-half of all people who die by suicide were depressed.

Signs, Symptoms and Tests

For outsiders, its hard to detect from the outside as most of the symptoms are fighting internally. This contributes to ones feeling of being alone. Depression symptoms are not the same for every person inflicted, but can include:

  1. Changes in sleep habits (difficulty falling asleep, waking up at weird hours or sleeping longer than normal);
  2. Inability to concentrate;
  3. No energy;
  4. Hopelessness;
  5. Moodiness;
  6. Low self-esteem;
  7. Lack of interest in normal activities;
  8. Weight gain or loss;
  9. Loss of appetite.

Its extremely important to be treated for depression when symptoms are experienced. Not only because it is unhealthy to live in such a state of hopelessness, but also because other medical conditions mimic the same symptoms of depression. Some of these diseases include: anemia, neurological disorders, hypothyroidism and infectious diseases.

During a typical doctors visit concerning depression, a physician may ask questions about ones thoughts and mood. A physical exam will be administered where vital signs such as blood pressure and heart rate are measured. A CBC or complete blood count may also be administered in order to test if the body is functioning properly. A thyroid test may also occur to make sure that the symptoms felt are not because of an under-active thyroid. A psychological evaluation may also occur where behaviors, feelings and thoughts will be explored. This is where any self-harm or suicidal thoughts will be discussed.

Typically, in order to diagnose someone with major depression, a patient must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders. A patient must have five or more symptoms (including loss of interest in life) in a two-week period. A doctor will explore other options that may be causing these symptoms including bipolar disorder, adjustment disorder, dysthymia, post-partum depression and seasonal affective disorder, to name a few.

Treatment, Drugs and Prevention

A patient will be treated in regards to their specific case or type of depression. There are many different types of treatment that can include medication and psychotherapy. For mild cases, a doctor may prescribe an anti-depressant that can lesson symptoms. However, for many counseling allows one to talk about these feelings, work through them and learn how to change them and understand them properly. Experts believe the best treatment is a combination of both. Some antidepressants prescribed include: Selective Serotonin reuptake inhibitors (SSRIs), Serotonin and Norepinephrine reuptake inhibitors (SNRIs), Tricyclic antidepressants, anti-anxiety medications or antipsychotics.

In terms of psychotherapy, cognitive behavioral therapy is typically the most commonly-used therapy for depression patients. This therapy helps patient to understand and identify negative thoughts and behaviors and learn how to replace them.

For extreme cases of depression, electrocution therapy may be used where the neurotransmitters in the brain are affected in order to provide immediate relief to severe depression sufferers. Typically this treatment is used in patients who do not receive any changes from medications or who are at a high risk for committing suicide. Others may be hospitalized and offered psychiatric treatment.



Tammoima Gichana PharmD, MBA, MB(ASCP),RPh.