Frequently Asked Questions

Minoxidil is one of two FDA-approved treatments for male pattern hair loss (androgenetic alopecia). It was originally designed as an oral pill to treat hypertension. It was quickly abandoned as a primary treatment for hypertension because patients didn’t tolerate the oral (pill) form very well. It is still available in oral form, but it is rarely used. One of the side effects of oral minoxidil was unwanted hair growth. This prompted a study of minoxidil in topical form, which turned out to still have the positive effect of stopping hair loss and in some cases, even regrowing hair that was lost. The topical form is better tolerated and does not have the same effects as when it was taken by mouth.

Rogaine® was the original brand name version of topical minoxidil that was FDA-approved for male pattern hair loss. After several years of Rogaine® being on the market, the FDA approved generic formulations of minoxidil. Rogaine® and generic minoxidil are both available in 2% and 5% strengths as a solution and as a foam. Minoxidil 5% has been found to be more effective in men, while the 2% and 5% are equally effective in women. Both strengths are FDA-approved for use in men and the 2% strength is also FDA-approved for use in women.

The exact mechanism of action of topical minoxidil is not completely understood. It increases the length of the growth phase of hair follicles (a process called ‘anagen’) and increases the size of hair follicles which dictates the thickness/diameter of the hair that comes out of the follicle. Minoxidil relaxes smooth muscle in blood vessel walls causing them to widen, increasing blood flow. This may be one of the ways that minoxidil works to stop or slow hair loss, and, in some cases, regrow hair.

Minoxidil tends to work best on younger men who have been experiencing progressive hair loss for fewer than 5 years. In fact, the earlier the better. However, even if started early, minoxidil is more likely to stop hair loss than to regrow hair. Hair regrowth can occur, but it is more common to stop or slow hair loss than it is to see hair regrowth. Minoxidil was studied and found to be effective at stopping or slowing down hair loss at the crown of the scalp. Interestingly, in the first few months of using minoxidil, loss of fine hairs may occur before they are replaced by thicker, more mature hairs. For some men, it can seem like it is getting a little worse before it improves.

Topical minoxidil is one of only two FDA-approved treatments for hair loss. It was first approved for the treatment of male pattern hair loss in 1988, and there have been many studies showing its safety and effectiveness at preventing further hair loss. In some men, it is effective at regrowing hair as well. For example, a one-year study with minoxidil 5% solution showed that 62% of men had no increased hair loss. In addition, around 16% had significant hair regrowth and approximately 48% had moderate hair regrowth. When used topically, only around 2% of minoxidil is absorbed, and systemic side effects are rare.

Minoxidil is better at stopping or slowing hair loss than regrowing hair; nevertheless, some men (and women) can experience some regrowth. A one-year study with minoxidil 5% solution showed that 62% of men had the same amount of hair at the end of the study as they had at the beginning of the year which means that they did not have any additional hair loss. In addition, around 16% had significant hair regrowth and approximately 48% had moderate hair regrowth. Another study showed that approximately 40% of men using 5% minoxidil, and approximately 22% of men using 2% minoxidil showed moderate or dense regrowth. It’s important to remember that daily use of minoxidil is essential to maintain results.

Wait 4 hours after applying minoxidil to your scalp before washing your hair. It’s a good idea to develop a routine of washing and drying your hair before applying minoxidil. Wash your hands immediately after applying minoxidil to your scalp.

Avoid touching your clothes and other parts of your body after applying minoxidil. Wash your hands thoroughly and immediately after applying minoxidil to your scalp.

Minoxidil can stain clothes, linens, etc. That means the best time to apply it is not just before going to bed or in the morning just before putting on a hat. Instead, apply it 2 to 4 hours before going to bed and, if you apply minoxidil in the morning, let it dry before you put on a hat.

It’s also a good idea to avoid blow-drying your hair right after applying minoxidil as this can make the treatment less effective.

The most common side effects of topical minoxidil are irritation and itching of the scalp where the medication is applied. Unintended hair growth can occur if minoxidil comes in contact with areas other than your scalp. Other potential side effects of topical minoxidil that are more rare include:

• Acne at the application site
• Burning of scalp
• Increased hair loss
• Inflammation or soreness at root of hair
• Reddened skin
• Facial swelling or swelling of the face, hands, feet, or lower legs
• Blurred vision or other changes in vision
• Chest pain
• Dizziness
• Fainting
• Fast or irregular heartbeat
• Headache
• Lightheadedness
• Numbness or tingling of hands, feet, or face
• Weight gain

You should contact your doctor or nurse practitioner immediately if you experience any of these side effects.

When minoxidil is used topically, only about 2% of it is absorbed, which is why it has such a good side effect profile. Topical minoxidil does not interfere with any known drugs that are taken orally under normal circumstances. You should not use topical minoxidil over damaged skin because this will increase the amount that is absorbed systemically. Consult a dermatologist before using topical minoxidil if you are using other topical medications on your scalp.

Minoxidil comes in two strengths, 2% and 5%. 5% minoxidil has been shown to be more effective than 2% in men but not in women. Both strengths are approved for hair loss in men, but only the 2% strength is approved in women.

For minoxidil solution: The dose should not exceed 2 mL per day.

For minoxidil foam: The dose should not exceed one capful per day.

Finasteride, also known as Propecia, is the most commonly prescribed hair loss medication available today. In 2017 it was the 86th most prescribed medication in the US with almost 10 million prescriptions.

It was initially approved for the treatment of male pattern baldness (androgenetic alopecia) in 1992. It’s an oral medication that reduces the amount of DHT your body produces. Since DHT is the hormone that causes hair loss, reducing DHT helps stop or reverse the hair loss process.

Finasteride is effective in men diagnosed with male pattern baldness, which is 95% of male hair loss cases. Finasteride is not effective in the other 5% of cases who have hair loss due to other causes, such as certain medical illnesses, medications, or more rare forms of alopecia.

If you have a receding hairline or thinning hair that has been gradually progressing, you likely have male pattern baldness, and finasteride would be worth a try with the approval of a doctor or nurse practitioner.

Finasteride is usually not recommended for men who are already in advanced stages of hair loss with very little hair left. For those men, better results can be seen with other treatments like dutasteride or a hair transplant.

In general, finasteride should not be used by women, although there is some evidence to show that it can be safe and effective in women over 50. However, more research is needed on this subject.

Finasteride works by blocking the conversion of testosterone into a byproduct called dihydrotestosterone (DHT). In men who are genetically susceptible to hair loss, DHT will start to attack hair follicles and cause your hair to miniaturize with every growth cycle until it’s eventually too small to be seen and the follicle dies.

Since DHT is the primary hormone responsible for hair loss in men, the most effective way to prevent hair loss is to block DHT.

When a DHT blocker like finasteride is taken, your body produces 66% less DHT. Less DHT in your body means your hair will stop falling out, and possibly start regrowing.

Finasteride is one of the most extensively studied medications for male pattern baldness. Clinical studies have found that finasteride stops hair loss for 90% of men, and 65% will also benefit from increased hair growth and thickening of existing miniaturized hairs.

One study from 1998 showed a significant increase in hair count after 2 years of finasteride 1mg daily. At the beginning of the study, the average hair count measured in a 1-inch diameter circular area of balding vertex scalp was 876. At the end of the study, the hair count increased to 1,014. That’s an increase of 15 percent from baseline.

Keep in mind that it’s unlikely for finasteride to regrow hair in completely bald areas, but it can help thicken up hair in areas where you’ve recently started to notice miniaturization. That is why it’s important to start treatment at the earliest signs of hair loss since finasteride is most effective at preventing future hair loss rather than regrowing hair.

Finasteride can begin to show results after 3-6 months. Results may take longer to show in some men, therefore it is important to be patient and not stop the treatment too early on. It’s recommended you stick with treatment for one year before measuring the final result.

After 1 year of treatment, you will notice that your hair loss has stopped progressing, and you might see an overall improvement in the appearance of your hair.

If you see no positive results after 1 year of use, you might be one of the few unlucky non-responders. In that case, it’s unlikely that finasteride will show any effect going forward and it’s recommended to discontinue the treatment.

Keep in mind that positive results don’t necessarily mean regrowing hair. Maintaining the hair that’s already on your head and preventing future hair loss is the primary positive effect of finasteride.

Finasteride works for as long as you take it. If you stop taking it, the hair loss process will resume and the hair that was preserved or regrown while on the medication will start to fall out again.

Finasteride should be taken as a daily dose of 1mg to treat hair loss. You can also choose to quarter finasteride 5mg (Proscar) tablets and take 1.25mg/day. This is just as safe and effective as taking 1mg daily, except much more affordable.

Taking more than the recommended dose will not speed up your results and will only increase your chance of side effects.

Decades of research shows that finasteride is safe and generally well tolerated by patients. A small percentage of men might experience sexual side effects, but these are rare and generally reversible.

In one clinical study, 3.8% of patients taking finasteride experienced side effects versus 2.1% in the placebo group. This leaves a 1.7% difference in patients who experienced side effects likely related to taking finasteride.

More research shows that side effects stop once the drug is discontinued, and the side effect rate actually drops to 0.3% by the fifth year of treatment.

There is also research done in regards to the relation between finasteride and prostate cancer. In short, finasteride has been found to decrease your overall chances of acquiring prostate cancer. However, in the case that you do acquire it, it may increase the risk of forming a more aggressive form of prostate cancer by 0.5%.

Finasteride is the safest and most effective medication you can buy to treat hair loss. There are other treatments you can use along with finasteride such as minoxidil (active ingredient in Rogaine). Minoxidil is a topical solution you apply to your scalp once or twice a day, which has also been clinically proven to regrow hair. Minoxidil can be purchased over the counter without a prescription.

The combined use of oral finasteride and minoxidil is the gold standard when it comes to treating hair loss.

There is another hair loss treatment called dutasteride that works similar to finasteride, but stronger. It’s not officially approved to treat hair loss, but it’s been shown to be even more effective at regrowing hair.

If it’s your first time treating hair loss, we recommend you stick with finasteride and Rogaine for the first year of treatment. If after one year you’re unsatisfied with your progress, you can switch to dutasteride or even consider surgical options like a hair transplant.

Some men choose to take supplements such as biotin. While these generally won’t hurt to take, there is very little evidence to show that biotin can stop male pattern baldness. Biotin usually only helps if your body is already deficient in this vitamin. Since biotin deficiency is very rare in those who are already eating a normal balanced diet, you’re unlikely to see any benefits.

Propecia is the brand name of the medication, while finasteride is the active ingredient in Propecia. After the patent for Propecia expired, finasteride became a generic drug. You will find that generics are about 80% cheaper than buying brand name Propecia. They are both medically the same – the only difference is the price, and the inactive ingredients in the pill.

Essential Clinic prescribes generic medication by default. However, when you buy the medication from the pharmacy, you do have the choice of buying brand name if you prefer.

You can get a finasteride prescription online through Essential Clinic. Just upload photos of your hair, answer a few questions about your health, and one of our clinicians will review your request and determine if finasteride is a safe treatment for you. If your request is approved, we’ll send your prescription to the pharmacy of your choice.

Biotin and Hair Vitamins Capsules is a supplement that is a sugar and soy-free supplement that encourages hair growth and makes your hair stronger.

Biotin and Hair Vitamins Capsules by The Derma Co. are clinically tested and there are no recorded side effects.

The dosage must be taken as prescribed by our dermatologist. Don’t exceed 1 capsule per day.

We recommend that you consult your doctor before combining it with other supplements. Consult your gynecologist before using this product if you are pregnant, nursing, on medication, or have a medical condition.

• take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level
• are allergic to sildenafil, as contained in VIAGRA and REVATIO, or any of the ingredients in VIAGRA

Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or
nausea during sex, seek immediate medical help.

• an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away.
  If it is not treated right away, priapism can permanently damage your penis
• sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called
  non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking VIAGRA and call your healthcare provider right away if you
  have any sudden vision loss
• sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have
  these symptoms, stop taking VIAGRA and contact a doctor right away

• have or have had heart problems such as a heart attack,
  irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
• have had heart surgery within the last 6 months
• have pulmonary hypertension
• have had a stroke
• have low blood pressure, or high blood pressure that
  is not controlled
• have a deformed penis shape
• have had an erection that lasted for more than 4 hours
• have problems with your blood cells such as sickle cell
  anemia, multiple myeloma, or leukemia
• have retinitis pigmentosa, a rare genetic (runs in families) eye disease
• have ever had severe vision loss, including an eye problem called NAION
• have bleeding problems
• have or have had stomach ulcers
• have liver problems
• have kidney problems or are having kidney dialysis
• have any other medical conditions

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins,
and herbal supplements.

VIAGRA may affect the way other medicines work, and other medicines may affect the way VIAGRA works, causing side effects.
Especially tell your healthcare provider if you take any of the following:

• medicines called nitrates
• medicines called guanylate cyclase stimulators such as Adempas (riociguat)
• medicines called alpha-blockers, such as Hytrin (terazosin
  HCl), Flomax (tamsulosin HCl), Cardura (doxazosin
  mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl),
  Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin).
  Alpha-blockers are sometimes prescribed for prostate
  problems or high blood pressure. In some patients, the use
  of VIAGRA with alpha-blockers can lead to a drop in blood pressure or to fainting
• medicines called HIV protease inhibitors, such as ritonavir (Norvir), indinavir sulfate (Crixivan), saquinavir (Fortovase or Invirase), or atazanavir sulfate (Reyataz)
• some types of oral antifungal medicines, such as
  ketoconazole (Nizoral) and itraconazole (Sporanox)
• some types of antibiotics, such as clarithromycin (Biaxin),
  telithromycin (Ketek), or erythromycin
• other medicines that treat high blood pressure
• other medicines or treatments for ED
• VIAGRA contains sildenafil, which is the same medicine found
  in another drug called REVATIO. REVATIO is used to treat a
  rare disease called pulmonary arterial hypertension (PAH).
  VIAGRA should not be used with REVATIO or with other PAH
  treatments containing sildenafil or any other PDE5 inhibitors
  (such as Adcirca [tadalafil])

VIAGRA does not protect against sexually transmitted diseases, including HIV.

headache; flushing; upset stomach; abnormal vision, such as changes in color vision
(such as having a blue color tinge) and blurred vision; stuffy or runny nose; back pain; muscle pain; nausea; dizziness; rash.

INDICATION

VIAGRA is a prescription medicine used to treat erectile dysfunction (ED).

VIAGRA is not for women or children.

VIAGRA is available by prescription only.

Lidocaine is one of the world’s most common, thoroughly tested anesthetics. Overall, it’s safe and well tolerated by the vast majority of people. If you are allergic to lidocaine, you should not use lidocaine sprays to treat ED.

Used at a normal dose, lidocaine spray side effects are minimal, if non-existent. However, it’s possible to experience lidocaine spray side effects if an excessive amount of spray is used. The most common lidocaine spray side effects are:

• Temporary loss of sensitivity, which could lead to difficulty maintaining an erection during foreplay or penetrative sex
• Skin irritation and/or a burning sensation
• Excessive numbness due to overuse of the spray

Most side effects of lidocaine spray can be avoided by using a small dose of the medication at first, before gradually increasing the dose based on your experience and results.

Lidocaine is an FDA category B medication, meaning it hasn’t been proven safe for use during pregnancy. Because of this, it’s best to avoid using lidocaine sprays or other lidocaine products if your partner is pregnant.

Topical lidocaine and Viagra (sildenafil) do not interact with each other and are considered safe to use at the same time. Some studies have looked at the use of Viagra and topical lidocaine in combination as a treatment for PE with no reported negative effects.

Lidocaine spray is not a form of contraception and should not be used to prevent pregnancy. It also doesn’t provide any protection from STDs, meaning you’ll want to use a condom or other form of protection to stay safe.

The effects of lidocaine can last for up to three hours. Most of the time, you’ll notice the numbing effects of lidocaine spray for about one hour after applying it to your penis.

You can apply lidocaine spray while your penis is erect or flaccid. Make sure to apply the spray to the head and shaft of your penis, as these areas are the most sensitive during foreplay and penetrative sex.

As long as your partner doesn’t have a lidocaine allergy, lidocaine spray is safe for oral sex. As well as waiting for 10 to 15 minutes after applying the spray, it’s best to either wipe your penis with a wet towel or take a shower to wash away any excess spray before oral sex.

Lidocaine spray is completely safe to use with a sexual lubricant. Make sure to wait for 10 to 15 minutes before sex to ensure the spray is effective and to wash off any remaining spray before sexual activity.

Provided you wait for 10 to 15 minutes before sex, it’s uncommon for lidocaine sprays to have any effect on your partner’s level of sensitivity during sex. Make sure to wash away any excess spray before sex to reduce the risk of transferring topical lidocaine to your partner.

As a selective serotonin reuptake inhibitor (SSRI), sertraline works by slowing down the rate at which your body reabsorbs serotonin, an important neurotransmitter. This leads to higher levels of active serotonin activity in your brain.

This increase in serotonin levels can help to improve and regulate your mood, resulting in an improvement in the symptoms of depression, obsessive-compulsive disorder and certain types of anxiety.

Most of the time, it takes four to six weeks for the full benefits of sertraline to take effect. This is the amount of time required for sertraline to reach a steady state in your body, meaning it’s fully absorbed and active at a steady dosage every day.

However, some people who use sertraline start to notice improvements within one to two weeks of using the medication. It’s also common to notice some mild side effects from sertraline during the first weeks of treatment, with these effects often subsiding over the first one to two months.

Sertraline is a versatile medication that’s used to treat a variety of conditions. The most common uses for sertraline include treating:

• Major Depressive Disorder (MDD)
• Obsessive-Compulsive Disorder (OCD)
• Posttraumatic Stress Disorder (PTSD)
• Body Dysmorphic Disorder (BDD)
• Social Anxiety Disorder (SAD)
• Premenstrual Dysphoric Disorder (PMDD)

Sertraline is also prescribed off-label to treat other conditions, such as premature ejaculation (PE).

Zoloft is the name for a specific brand of sertraline manufactured and marketed by Pfizer. The active ingredient in Zoloft is sertraline hydrochloride — the exact same ingredient that’s used in unbranded, generic versions of sertraline.

Yes. Sertraline is a safe and effective medication that’s been thoroughly tested in a wide range of clinical trials. It’s safely used by people of all ages, from young children to teenagers, adults and the elderly.

Like all medications, sertraline can cause some side effects. It can also interact with some other medications, supplements and grapefruit. We’ve covered these side effects and interactions in the two questions below.

ike other SSRIs, sertraline can cause a range of side effects.

In a multi-country study published in 2015 on the safety and effectiveness of sertraline for generalized anxiety disorders, researchers found that sertraline was not only more effective than the placebo drug but also that it was generally well tolerated.

Only eight percent of participants of those taking sertraline left the study due to side effects, compared to 10 percent of those taking the placebo drug.

Additionally, most of the reported side effects were mild to moderate in severity.

Yes. Like other medications, sertraline can interact with other drugs, causing a range of potential health issues. Sertraline interactions are definitely something to consider before beginning treatment.

Diarrhea is a common side effect of sertraline. Like many other sertraline side effects, it usually happens during the first few weeks of using the medication. It’s unusual for this diarrhea to last for longer than a few days after you start taking sertraline.

If you have persistent diarrhea from sertraline, make sure you drink plenty of fluids to keep your body hydrated. Contact your doctor if your diarrhea doesn’t improve over the course of a couple weeks.

Like nausea and diarrhea, most side effects from sertraline occur during the first few weeks of using the medication. It’s common for side effects to gradually become less apparent over the course of the first several weeks, as your body adjusts to the consistent dose of sertraline.

If you have persistent side effects from sertraline that do not disappear over time, it’s best to discuss them with your doctor.

If you feel dizzy, sleepy or fatigued after taking sertraline, you should not drive a car or ride a bike after you take the medication. These side effects typically occur in the first few days and weeks after you start using the medication.

After these side effects have passed, most people who use sertraline can safely drive as they would normally.

Sertraline is available as a tablet and as an oral solution. The tablet is the most common version of the medication.

Sertraline also comes in tablet form. Generally, sertraline dosage comes in 25mg, 50mg and 100mg tablets. Sertraline dosage in liquid is sold in a 20mg/mL concentration. Both versions of sertraline are designed for use once per day based on your doctor’s instructions.

Both the tablet and the oral solution versions of sertraline are prescription medications, meaning you’ll need a prescription from your doctor to purchase them. Sertraline is not available over the counter in the United States.

A usual sertraline dosage is 50mg to 100mg per day, which is commonly prescribed to adults as a treatment for depression and some anxiety disorders. The maximum dose of sertraline is 200mg per day, which is usually reached after several weeks or months of treatment at a lower dose.

If you’ve been prescribed sertraline for any condition, follow the dosage instructions exactly as provided by your doctor.

Sertraline is designed for use once per day. It’s safe to take it at any time of day, with or without food. Many people who experience nausea and other side effects from sertraline opt to take it at night in order to limit these side effects.

Since sertraline can interfere with sleep in a small percentage of users, many people also opt to take sertraline in the morning. There’s no “perfect” time of day to take your tablet. Instead, it’s best to take it whenever it’s most convenient for you.

Sertraline does not appear to be significantly affected by food, meaning you can take it after a meal or on an empty stomach, as long as you do not eat grapefruit or drink grapefruit juice. As long as you take sertraline at the same time every day, you should notice the full effects of the medication without any absorption issues.

Sertraline has a half-life of approximately 26 hours, meaning it will usually reach half of its total concentration about one day after you take it. It takes approximately 5.4 days for your body to get 99 percent of a standard sertraline dose out of your system.

Clinical trials of sertraline show that it’s safe to use for the long-term, with many cases of people using sertraline for years at a time. When used as a treatment for depression, doctors typically recommend using sertraline for up to one year after your depression symptoms end.

Many people who use sertraline for the long term (and most other antidepressant medications) are advised to gradually taper their dosage of the medication as they stop using it, instead of stopping abruptly.

Everyone responds differently to medication, meaning you might not get the same results from sertraline as other people. If you don’t feel that sertraline is working for you, the best approach is to talk about it with your doctor.

Your doctor might recommend adjusting your sertraline dosage or switching to another type of antidepressant medication for better results.

Although sertraline isn’t designed specifically to treat premature ejaculation, studies show that it can increase ejaculation latency — the amount of time required for a man to orgasm and ejaculate during sex — in men.

Just like other SSRIs, taking too much sertraline can cause a range of potentially serious side effects. The most common symptoms of sertraline overdose include nausea, dizziness, fever, vomiting, confusion, shakiness and a rapid heartbeat.

Taking too much sertraline can also cause serious symptoms, such as fainting, delirium, heart problems, changes in blood pressure and serotonin syndrome.

Sertraline overdoses can occur if you take too much sertraline at once, or if you combine your dose of sertraline with other drugs or alcohol.

Do not ever exceed your prescribed dose of sertraline. If you forgot to take your sertraline tablet the day before, do not take two tablets at once. If you are concerned about a potential overdose situation, seek emergency medical assistance immediately.

Sertraline has a relatively short half-life, meaning it will leave your body quickly if you decide to stop taking it abruptly. Because of this, some people notice discontinuation symptoms such as insomnia, nausea and anxiety after stopping sertraline.

Most of the time, your doctor will recommend tapering down your dosage of sertraline over the course of several weeks. This allows you to gradually reduce the amount of the medication that is active in your body, helping you avoid discontinuation side effects.

You should not stop taking sertraline against the advice of your doctor. If you have side effects from sertraline or think another medication might be a better option for you, consult with your doctor and follow their advice and recommendations.

Yes. Although sertraline and other SSRIs are linked to weight gain, monitoring your food intake can allow you to lose weight or maintain your current weight while using sertraline.

About 25 percent of people who use SSRIs notice some level of weight gain. While researchers aren’t fully aware of what causes weight gain happens on SSRIs, some professionals claim that SSRI medications may interfere with people’s ability to “switch off” their urge to eat.

Despite this, there’s no evidence that sertraline affects your body’s metabolism and causes you to use fewer calories than normal. This means that you may lose or gain weight as you normally would by adjusting your calorie intake or activity level.

If you notice weight gain after starting sertraline and feel concerned, it’s best to let your doctor know when you next see them. Our guide to sertraline and weight gain also contains several techniques that you can use to avoid unwanted weight gain while using sertraline.

• Ashwagandha is considered an adaptogen, meaning it promotes balance in many different systems of the body.
• It can help the body adapt to stressful conditions.
• It is a nourishing tonic that supports the nervous system and the endocrine system
• Ashwagandha also supports cardiovascular and immune health.

Ashwagandha has been extensively studied over its four millennia of use. This herb offers support similar to the adaptogens Eleuthero (Eleutherococcus senticosus, sometimes called Siberian ginseng) and Ginseng (both Panax ginseng and Panax quinquefolius) for a healthy stress response.* Because of this, it is sometimes known as Indian “Ginseng,” although it is an unrelated species and provides calming and nourishing stress support, while Ginseng supports energy and stamina.

Dr. Mary Bove considers Ashwagandha to be:

• Grounding
• Calming
• Restoring

It supports the sleep cycle, which is why it is included in SleepThru and
Adrenal Health® Nightly Restore.* It is also in Adrenal Health® Daily Support.

Cortisol is a stress hormone released from the adrenals that has evolutionarily helped the body to mobilize a “fight or flight” response to a perceived imminent danger, freeing up resources for a vigorous fight against an intruder or flight from danger. Cortisol naturally follows a daily rhythm, rising in the morning to help mobilize the body’s forces for the daily needs and lowering in the evening to allow the body to sleep and perform restorative processes. Cortisol is helpful as a short-term defense mechanism and as part of a natural daily rhythm.

The stress of modern human culture chronically activates the cortisol stress response, which can impact delicate glucose and lipid balance as well as vascular integrity, gastrointestinal membrane integrity and nervous system function.

Ashwagandha seems to support the structure and function of the nervous system, and it is also considered to be a neurosupportive and nootropic herb.(Nootropic herbs are those that promote healthy cognitive function.)

Ashwagandha supports healthy nervous system function, providing antioxidant support and naturally stimulating the pathways in the brain for GABA, a neurotransmitter that’s responsible for promoting calmness and regulating muscle tone. Ashwagandha supports a calm and stable mood, and it helps to regulate natural cortisol rhythm. Several studies also have shown that Ashwagandha supports healthy sleep.

In the endocrine system, the adrenals play a “starring” role; their functions are necessary for our survival while reproduction is not. As such, the HPA axis and the stress response are naturally connected to sperm production and fertility in men and hormonal balance and fertility in women. The body produces cortisol from the same precursors used to make reproductive hormones, and, under stress, the body will preferably produce cortisol instead of testosterone, estrogen and progesterone.

Maintaining healthy cortisol levels can free up those resources to be used for reproductive hormones. The HPA axis also interacts closely with the body’s production of thyroid hormones, and Ashwagandha seems to also support healthy thyroid function, although this has not been explored clinically.

In untrained healthy men performing resistance training for eight weeks, consuming Ashwagandha root supported healthy muscle strength and recovery. Ashwagandha promotes healthy levels of creatinine kinase, which reduces the natural muscle damage that happens from exercise and promotes muscle recovery. In men, Ashwagandha has also been shown to support a healthy stress response, healthy sperm levels and normal levels of testosterone.

Metabolically, Ashwagandha seems to have an overall anabolic action, supporting weight gain during the natural growth phase. Ashwagandha-fortified milk given to children helps support a healthy weight, as well as healthy total plasma proteins and hemoglobin levels. It has been shown to support normal lean body weight and fat-to-muscle ratios. Ashwagandha may also promote healthy fat oxidation and support healthy blood glucose and blood lipid levels within normal ranges.

Ashwagandha root has been studied for its support of a healthy inflammatory response and joint health. In human studies, it has been shown to naturally mitigate levels of C-reactive protein, which is a systemic marker for the body’s inflammatory response. Ashwagandha has been shown to support occasional joint pain, stiffness, swelling and discomfort in healthy men and women.

Zinc is a very significant element that is obtained from our diet. Around the world, zinc deficiency affects about 2 billion people.

Zinc is recognized to play a fundamental role in the immune system, and people who are zinc-deficient experience increased susceptibility to an array of pathogens. The immunological mechanisms whereby zinc modulates improved susceptibility to infection have been researched for several decades. It is very apparent that zinc affects several aspects of the immune system, which ranges from the skin barrier to the regulation of the genes within lymphocytes. Zinc is vital for the normal development and functioning of cells mediating non-specific immunity such as natural killer cells and neutrophils. Development of acquired immunity is also affected by zinc deficiency also. It does this by preventing both the outgrowth and certain functions of T lymphocytes such as activation, Th1 cytokine production, and also B lymphocyte help. Similarly, B lymphocyte development and antibody production, chiefly IgG, is compromised. The macrophages, which are an essential cell in many immunologic functions, are adversely affected by the deficiency of zinc, which can dysregulate intracellular killing, cytokine production, and also phagocytosis. The effects of zinc on these key immunologic mediators is entrenched in the innumerable roles for zinc in fundamental cellular functions such as DNA replication, RNA transcription, cell division, and also cell activation. Apoptosis is also potentiated by the deficiency of zinc. Zinc also functions as an antioxidant and can stabilize various membranes.

The manifestations of a moderate level deficiency of zinc include rough skin, poor appetite, mental lethargy, delayed wound healing, cell-mediated immune dysfunctions, abnormal neurosensory changes growth retardation and male hypogonadism in adolescents.

In studies that involved experimental human model in whom just a mild zinc deficiency in males was induced by dietary means, decreased natural killer (NK) cell activity, decreased serum testosterone level, oligospermia, decreased thymulin activity, decreased interleukin-2 (IL-2) production, decreased dark adaptation, hypogeusia, hyperammonemia, and decreased lean body mass were observed. It is, thus, clear that even a mild deficiency of zinc in humans affects biochemical, clinical, and immunological functions adversely.

In the developing countries, Nutritional deficiency of zinc is caused by ingestion of high cereal protein intake, rich in phytate, which makes zinc unavailable for absorption. There are many other causes of zinc deficiency that include blood loss due to hookworm infection, mal-absorption syndrome, hyperzincuria as seen in cirrhosis of the liver and sickle cell disease, and excessive sweating in hot tropical climates.

The National Institute for Nutrition (NIN), India has set the RDA (Recommended Dietary Allowance) for an adult man and NPNL (Non-Pregnant, Non-Lactating) woman for zinc at 12 and 10 mg/day respectively.

Most of the time, it takes four to six weeks for the full benefits of sertraline to take effect. This is the amount of time required for sertraline to reach a steady state in your body, meaning it’s fully absorbed and active at a steady dosage every day.

However, some people who use sertraline start to notice improvements within one to two weeks of using the medication. It’s also common to notice some mild side effects from sertraline during the first weeks of treatment, with these effects often subsiding over the first one to two months.

Sertraline is a versatile medication that’s used to treat a variety of conditions. The most common uses for sertraline include treating:

• Major Depressive Disorder (MDD)
• Obsessive-Compulsive Disorder (OCD)
• Posttraumatic Stress Disorder (PTSD)
• Body Dysmorphic Disorder (BDD)
• Social Anxiety Disorder (SAD)
• Premenstrual Dysphoric Disorder (PMDD)

Sertraline is also prescribed off-label to treat other conditions, such as premature ejaculation (PE).

Zoloft is the name for a specific brand of sertraline manufactured and marketed by Pfizer. The active ingredient in Zoloft is sertraline hydrochloride — the exact same ingredient that’s used in unbranded, generic versions of sertraline.

Yes. Sertraline is a safe and effective medication that’s been thoroughly tested in a wide range of clinical trials. It’s safely used by people of all ages, from young children to teenagers, adults and the elderly.

Like all medications, sertraline can cause some side effects. It can also interact with some other medications, supplements and grapefruit. We’ve covered these side effects and interactions in the two questions below.

ike other SSRIs, sertraline can cause a range of side effects.

In a multi-country study published in 2015 on the safety and effectiveness of sertraline for generalized anxiety disorders, researchers found that sertraline was not only more effective than the placebo drug but also that it was generally well tolerated.

Only eight percent of participants of those taking sertraline left the study due to side effects, compared to 10 percent of those taking the placebo drug.

Additionally, most of the reported side effects were mild to moderate in severity.

Yes. Like other medications, sertraline can interact with other drugs, causing a range of potential health issues. Sertraline interactions are definitely something to consider before beginning treatment.

Diarrhea is a common side effect of sertraline. Like many other sertraline side effects, it usually happens during the first few weeks of using the medication. It’s unusual for this diarrhea to last for longer than a few days after you start taking sertraline.

If you have persistent diarrhea from sertraline, make sure you drink plenty of fluids to keep your body hydrated. Contact your doctor if your diarrhea doesn’t improve over the course of a couple weeks.

Like nausea and diarrhea, most side effects from sertraline occur during the first few weeks of using the medication. It’s common for side effects to gradually become less apparent over the course of the first several weeks, as your body adjusts to the consistent dose of sertraline.

If you have persistent side effects from sertraline that do not disappear over time, it’s best to discuss them with your doctor.

If you feel dizzy, sleepy or fatigued after taking sertraline, you should not drive a car or ride a bike after you take the medication. These side effects typically occur in the first few days and weeks after you start using the medication.

After these side effects have passed, most people who use sertraline can safely drive as they would normally.

Sertraline is available as a tablet and as an oral solution. The tablet is the most common version of the medication.

Sertraline also comes in tablet form. Generally, sertraline dosage comes in 25mg, 50mg and 100mg tablets. Sertraline dosage in liquid is sold in a 20mg/mL concentration. Both versions of sertraline are designed for use once per day based on your doctor’s instructions.

Both the tablet and the oral solution versions of sertraline are prescription medications, meaning you’ll need a prescription from your doctor to purchase them. Sertraline is not available over the counter in the United States.

A usual sertraline dosage is 50mg to 100mg per day, which is commonly prescribed to adults as a treatment for depression and some anxiety disorders. The maximum dose of sertraline is 200mg per day, which is usually reached after several weeks or months of treatment at a lower dose.

If you’ve been prescribed sertraline for any condition, follow the dosage instructions exactly as provided by your doctor.

Sertraline is designed for use once per day. It’s safe to take it at any time of day, with or without food. Many people who experience nausea and other side effects from sertraline opt to take it at night in order to limit these side effects.

Since sertraline can interfere with sleep in a small percentage of users, many people also opt to take sertraline in the morning. There’s no “perfect” time of day to take your tablet. Instead, it’s best to take it whenever it’s most convenient for you.

Sertraline does not appear to be significantly affected by food, meaning you can take it after a meal or on an empty stomach, as long as you do not eat grapefruit or drink grapefruit juice. As long as you take sertraline at the same time every day, you should notice the full effects of the medication without any absorption issues.

Sertraline has a half-life of approximately 26 hours, meaning it will usually reach half of its total concentration about one day after you take it. It takes approximately 5.4 days for your body to get 99 percent of a standard sertraline dose out of your system.

Clinical trials of sertraline show that it’s safe to use for the long-term, with many cases of people using sertraline for years at a time. When used as a treatment for depression, doctors typically recommend using sertraline for up to one year after your depression symptoms end.

Many people who use sertraline for the long term (and most other antidepressant medications) are advised to gradually taper their dosage of the medication as they stop using it, instead of stopping abruptly.

Everyone responds differently to medication, meaning you might not get the same results from sertraline as other people. If you don’t feel that sertraline is working for you, the best approach is to talk about it with your doctor.

Your doctor might recommend adjusting your sertraline dosage or switching to another type of antidepressant medication for better results.

Although sertraline isn’t designed specifically to treat premature ejaculation, studies show that it can increase ejaculation latency — the amount of time required for a man to orgasm and ejaculate during sex — in men.

Just like other SSRIs, taking too much sertraline can cause a range of potentially serious side effects. The most common symptoms of sertraline overdose include nausea, dizziness, fever, vomiting, confusion, shakiness and a rapid heartbeat.

Taking too much sertraline can also cause serious symptoms, such as fainting, delirium, heart problems, changes in blood pressure and serotonin syndrome.

Sertraline overdoses can occur if you take too much sertraline at once, or if you combine your dose of sertraline with other drugs or alcohol.

Do not ever exceed your prescribed dose of sertraline. If you forgot to take your sertraline tablet the day before, do not take two tablets at once. If you are concerned about a potential overdose situation, seek emergency medical assistance immediately.

Sertraline has a relatively short half-life, meaning it will leave your body quickly if you decide to stop taking it abruptly. Because of this, some people notice discontinuation symptoms such as insomnia, nausea and anxiety after stopping sertraline.

Most of the time, your doctor will recommend tapering down your dosage of sertraline over the course of several weeks. This allows you to gradually reduce the amount of the medication that is active in your body, helping you avoid discontinuation side effects.

You should not stop taking sertraline against the advice of your doctor. If you have side effects from sertraline or think another medication might be a better option for you, consult with your doctor and follow their advice and recommendations.

Yes. Although sertraline and other SSRIs are linked to weight gain, monitoring your food intake can allow you to lose weight or maintain your current weight while using sertraline.

About 25 percent of people who use SSRIs notice some level of weight gain. While researchers aren’t fully aware of what causes weight gain happens on SSRIs, some professionals claim that SSRI medications may interfere with people’s ability to “switch off” their urge to eat.

Despite this, there’s no evidence that sertraline affects your body’s metabolism and causes you to use fewer calories than normal. This means that you may lose or gain weight as you normally would by adjusting your calorie intake or activity level.

If you notice weight gain after starting sertraline and feel concerned, it’s best to let your doctor know when you next see them. Our guide to sertraline and weight gain also contains several techniques that you can use to avoid unwanted weight gain while using sertraline.