Toradol. Lifesaver. I was legit considering the benefits of death by semi truck when I decided urgent care was a better option. Young doc straight out of med school prescribed my far 225lb ass 30mg of Toradol, given IM. Unfortunately wouldn't give a script to go. Worked for about 10 hours, then back into the fray. Broke out the Banamine from my veterinary stash thanks to owning horses, and downed about 3ccs with a shot of juice. Not sure which is worse the taste of that shit or hells itch itself but it put a slight dent into it. That and enough ibuprofen, aleve, Bayer, and Tylenol in one sitting to put an elephant in need of a liver doctor and enough weed and booze to knock a horse on its ass, combined with a triple dose of melatonin yummiest finally got me to the point of a bit of sleep.
LESSON LEARNED: Toradol for the win. Now I just need to find a doctor willing to prescribe me a supply of it to keep on hand for emergencies

I am a 46 year old male, who is trying to sort out which items to keep in the medicine cabinet, for whenever I have cold/flu symptoms in the future. Of course, no one wants to go out and buy anything when they are already sick, so I am trying to plan ahead.
I am trying to make a high-quality post to address cold and flu symptoms we all unfortunately experience throughout our lives. Even if you may feel that I am asking "stupid" questions, please consider that I am putting a lot of time and effort in to learn, while helping to share all of this with others. Some people may feel that I am making this all way too complicated. While this may be true, I still feel there is a lot for us to learn here. Thank you in advance to everyone who takes time to read this post, as well as those who also take time to respond.
​
I assume most people just have one or two pain relievers at home. However, is it worth having most or all of these?
After spending many hours of Google searches, here is my new understanding of the pros and cons of the main options.
​
Acetaminophen (Tylenol).
Ease pain and lower fever, but won’t reduce swelling or inflammation. Best for headache/fever, toothache, back pain, colds. Mild to moderate pain.
Least likely to cause an upset stomach. Be careful not to double dose with cold/flu medicine. Take every 4-6 hours.
​
Acetylsalicylic Acid (Aspirin, Bayer).
Reduce fever, pain, and inflammation. Best for headaches, toothaches, colds, fever. Mild to moderate pain.
Can be difficult on the stomach. Take every 4-6 hours.
Slows blood clots, lowers chance of heart attack/stroke.
​
Ibuprofen (Motrin, Advil) - Does it make sense to have both Ibuprofen and Advil?
Reduce fever, pain, and inflammation. Best for headaches, toothaches, back pain, muscle strains, colds. Mild to moderate pain
Can be difficult on the stomach. Take every 4-6 hours.
​
Naproxen (Aleve).
Reduce fever, pain, and inflammation. Best for headaches, toothaches, back pain, colds. Mild to moderate pain.
Can be worse on the stomach. Lasts longer in the body. Take every 8-12 hours.
​
In each of the four above categories, should a person just always go with the cheapest generic, or under which circumstances should a person pay more for a trusted name brand? It seems the active ingredients are the same for all generic vs name brands.
​
My takeaways from this, if my understanding is right is that

1. Aleve, or a generic version, is a must have for when pain is expected to last longer (8-12 hours or more). Also helps with inflammation.
2. Ibuprofen, or a generic version, is also a must have for pain with inflammation. This works faster than Aleve, but also does not last as long (4-8 hours).
3. Tylenol, or a generic version, is a must have for pain without inflammation, or when you need something easier on your stomach.
4. Aspirin/Beyer, or a generic version, is a must have for blood clots, and lowers the chance of a heart attack/stroke. If in good health, when do you know if you should take this daily?

​
Cough Suppressants are also important. When does a person know when to use each of these? I assume a person may not need to own all of these
Dextromethorphan (Delsym).
Dextromethorphan (Robitussin).
Menthol Cough Drops.
Vicks Vapor Rub.
​
Expectorants should also be considered.
Guaifenesin (Mucinex).
​
Decongestants.
Pseudoephedrine.
​
Nasal Decongestants.
Oxymetazoline (Afrin).
​
Antihistamines also help.
I personally prefer Cetirizine (Zyrtec) over Diphenhydramine (Benadryl), Loratadine (Claritin), and Fexofenadine (Allegra).
​
Anti-Inflammatory for sneezing, stuffy, runny, or itchy nose.
Fluticasone propionate (Flonase).
​
Sinus infection, allergies.
Neil-Med bottles and packets for nasal irrigation. I prefer this over Neti-Pot.
​
Sore throat.
Warm salt water gargle is highly suggested.
Which of the following three should also be kept on-hand?
-Herb Pharm Soothing Throat Spray Herbal Formula with Echinacea and Propolis.
-Chloraseptic Sore Throat Spray, Menthol.
-Propolis Throat Spray by Beekeeper's Naturals.
​
Can Dimenhydrinate (Dramamine) help to reduce nausea when sick, or is it really just for motion sickness?
​
Eyes - dry, red, itch, burn -
Genteal Tears Preservative Free Eye Drops.
Warm compress.
​
Many stomach symptoms; nausea, diarrhea, acid reflux.
Bismuth subsalicylate (Pepto Bismol).
​
Severe diarrhea.
Imodium AD.
​
Laxatives for Constipation.
Polyethylene glycol (MiraLax).
​
Is there anything that I am forgetting? Perhaps there is an item under a specific category that I should consider that I did not list? Or maybe I am forgetting about a symptom I should be ready for?Now I know things become even more complicated when considering cold/flu products that have a combination of ingredients. A main concern is that people can double their doses of pain relievers without even realizing it, as they do not read the labels of these products.
Do doctors and pharmacists usually just suggest buying the items above to treat specific symptoms, or are some of the products listed below also highly recommended under the right circumstances...
​
NyQuill.
​
TheraFlu.
​
Tylenol Cold and Flu Severe.
​
tldr; for each cold and flu symptom, which are the best products to own, and when should a person just go with the cheapest generic option rather than a trusted name brand?

Hopefully this post is acceptable, even though I am currently not sick. I am attempting to compile a list of all of the over the counter medications the average person should have for potential illness, allergies, and injuries. Hopefully someone in the medical field can help to answer the questions throughout, and to generally speak to what is and is not needed on this type of list. I am a single 46 year old male, but I hope this post and responses helps many people who should also stock up their medicine cabinet a bit. I also need to spend $300 in OTC money, or I lose it at the end of this month.
I spent hours searching online and piecing this list together. I am really trying to pay attention more to my health. I appreciate everyone who takes time to respond to any of this.
PAIN RELIEF - When do I use each and when do I avoid each?
Acetaminophen (Tylenol).
Acetylsalicylic acid (Aspirin) - Does it matter if Bayer or are they all the same?
Ibuprofen (Motrin, Advil) - Does it make sense to have both Ibuprofen and Advil? If so, when to use and when to avoid each?
Naproxen (Aleve).
GI
Pepto Bismol - It seems best to use when many stomach symptoms like nausea, diarrhea, acid reflux.
Imodium AD - Used strictly for severe diarrhea when necessary. Should it be strictly Imodium AD, or just anything with Loperamide all the same?
Acid Reflux - Omeprazole (Prilosec). Unfortunately Pepcid does nothing for me.
COLD/FLU/SINUS INFECTIONS (in addition to pain relievers)
**I know an easy mistake is that people take a pain reliever in addition to a medicine like NyQuil, Theraflu, Tylenol Cold and Flu Severe, and not realizing they are exceeding their dose of pain relief.
Cough Medicine - Robitussin or does it matter which one? Should a person have a cough syrup or just pills for symptoms?
Cough Drops - Does it matter which ones? Some say Zinc helps, others say that is a myth.
Vapor Rub - I assume Vicks or any are all pretty much the same.
Decongestants (such as pseudoephedrine) - It seems to make sense to buy this separately, and also be aware if it is in other things taken while sick.
Anything else for sore throat in addition to salt water gargle, cough drops? Maybe throat spray?
Neilmed bottles and packets for nasal irrigation. I personally prefer this way over Neti-Pot.
Expectorant - Mucinex (Guaifenesin)
Cough Suppressant - Delsym
Afrin
SHOULD I EVEN BUY THERAFLU, NYQUIL OR TYLENOL COLD AND FLU SEVERE, OR BEST TO AVOID THOSE AND JUST TREAT EACH INDIVIDUAL SYMPTOM?
ALLERGIES
Antihistamines - diphenhydramine (Benadryl), Loratadine (Claritin), cetirizine (Zyrtec), and Fexofenadine (Allegra). I personally prefer Zyrtec for my allergies.
Anti-Itch Cream - Hydrocortisone 1% Cream or Calamine Lotion? When use each?
Anti-Fungal Cream - clotrimazole, miconazole, or butenafine hydrochloride. When use each?
Eye Drops - Genteal Tears Preservative Free - this is what my optometrist suggested to me for dry/red eyes.
Fluticasone propionate (Flonase).
Warm Compress - Optometrist suggested using this for eyes when red. Should this just be a warm washcloth, or should I buy something specific if I might need this regularly due to allergies?
MISC.
Cracks in heels - both Aquaphor Healing Ointment and Eucerin Cream together is suggested online.
Nausea (motion sickness) - Dramamine
Burn Cream - I assume all pretty much the same and some should come in a first aid kit.
Antibiotic or antibacterial ointment - Neosporin or Bacitracin. When use each?
Laxatives - Does it matter which one?
First Aid Kit (includes many things, some that may be already listed)
Rubbing Alcohol - Recently read that 70% is often better than 91% since it does not dry as fast?
Hydrogen Peroxide
Reading Glasses - My age is finally catching up to me.
Sunscreen SPF what is suggested now days?
Aloe Vera Gel
Oral care like toothpaste, toothbrush, floss, mouthwash is surprisingly covered with my plan.
Consider multi-vitamins?
Lotion
Carmex
Insect Repellant
Hand Sanitizer
Epsom Salt
Q-tips
For sore muscles or swelling - Hot Pad and Cold Pad. Any specific ones out there?
Anything else?

It could be a mixture of the vaccine also. There has to be some effects from eating Glyphosate which is allegedly a carcinogen herbicide. Bayer purchased Monsanto in 2018. Bayer is also the company that supplied the Zkylon B chemical for the holocaust. Bayer owns the largest monopoly on biotechnology agriculture. Meaning they bioengineer just about every seed, fertilizer and animal that is sold at a grocery store or restaurant. Their product list is extensive, featuring casual drugs like Aleve. JP Morgan owns Jamieson Vitamins. They control what is good for us now.
The reason why I think the virus could be a hoax is because of the timing of Bayers purchase of Monsanto.. just a year before the pandemic. Monsanto was already accused and violated laws related to highly regulated chemicals, so it's not like they had to change much of the business model. They've been advancing Glyphosate testing since the 60's. As far as poisoning prisoners in California with RoundUp. Bayer just amplified it's monopoly.
Whether it's a two pronged attack with the vaccine and glyphosate isn't conclusive, but it's conclusive that the carcinogens in our foods are more dangerous. But nobody talks about it. If you told people covid was in their food, then they would take exception to it but not the cancer. There is going to be a cancer pandemic like we've never seen. And I guarantee people's limbic system response is to say "fuck cancer", as if nobody is causing it. We are running out of time.

Today we’ll fill the void that is this sub’s amount of posts on herbs. Admittedly, most herbs have underwhelming research and just quite simply aren’t as powerful or intriguing as other noots, but diving into white willow I found what seems to be a potent nootropic, a potent anti-inflammatory, and possibly even a longevity booster. I actually learned about white willow from u/sirsadalot, and after getting thoroughly impressed by its literature I decided I’d write this up. It’s definitely something worthy to be in all of our supplement stashes.

An Introduction

White Willow Bark (Salix alba) extract has been used for thousands of years as an anti-inflammatory, antipyretic (fever-reducer), and analgesic (pain-reliever). In fact something we all take nowadays to do those same things, Aspirin, only exists because of willow bark. In 1899, scientists at Bayer synthesized Aspirin, which is acetylsalicylic acid, from salicin. Salicin is a salicylate found in white willow bark. Salicin, and willow bark's known efficacy as an analgesic, was the reason research for the creation of Aspirin even started. In our bodies acetylsalicylic acid and salicin both are turned into salicylic acid, which gives the anti-inflammatory effects we see from aspirin and part of the effects we see from white willow.
The Problems With Aspirin & Other Pain Relievers
Aspirin, though, despite having many benefits and even being touted as a simple longevity booster, has gastrotoxic and hepatoxic effects, as well as blood thinning properties which has resulted in cases of brain bleeding. Even naming all those problems, aspirin may be the safest pain reliever on the market. For these reasons, a safer anti-inflammatory and pain-reliever is needed.
Skimming through the safety profile of other popular over-the-counter pain-relievers we find that acetaminophen (Tylenol) can damage the liver, ibuprofen (Advil) can damage the stomach and kidneys, and naproxen (Aleve) may cause kidney damage.
Now, I would bet money you didn’t join this sub to learn about pain relievers, but there is undeniable utility for efficacious anti-inflammatories—as one could almost argue nearly all ailments are a result of inflammation in one way or another. Even then, I doubt you came here to learn about anti-inflammatory herbs, but don’t worry, we will get around to the more interesting neurological properties of white willow later!

The Superiority of White Willow Bark Over Aspirin & Other NSAIDs

Aspirin, and white willow bark, are used to reduce pain, reduce inflammation, and prevent oxidative stress. Conveniently, the studies back up the historical uses of the plant. White willow bark has been shown to have strong pain-relieving effects^(1-2), which confirms the anecdotal findings that led to its usage for thousands of years. Interestingly, while talking to a few people who have tried white willow, they actually thought its analgesic effects were even stronger than aspirin. As a result of its pain-relieving effects it has also shown anti-arthritic abilities^(1,3-5). It has also exhibited a stronger antioxidant ability, as assessed by radical scavenging activity, than ascorbic acid (also known as vitamin c)⁽⁶).
These antioxidant effects seem to be from increased antioxidant enzymes, like increased glutathione, due to its dose-dependent significant activation of Nrf2. SKN-1/Nrf2 signaling has been linked to longevity in C. elegans, Drosophila, and mice, and Nrf2 activation has attracted attention as a target molecule for various diseases, including inflammatory diseases. Therefore, white willow bark might have broad applicability in the setting of chronic and aging-related disease (like dementia) in addition to acute stress.⁽⁸)
Now, since salicin was an already-known anti-inflammatory, the researchers evaluated how much of the effect of the extract was from salicin:

To determine the contribution of salicin to the Nrf2-mediated antioxidative activity of White Willow bark extract (WBE), WBE was separated into five fractions (Frs. A–E), and their effects on ARE–luciferase activity were investigated, together with those of salicin, saligenin, and salicylic acid, as metabolites of salicin. HPLC patterns for WBE, Frs. A–E, and salicin are shown in Fig. 7A. The major peak in the salicin standard chromatogram was confirmed at 15.1min. Salicin was also confirmed to be rich in WBE and was especially concentrated in Fr. C, whereas Fr. A contained no salicin. The ARE–luciferase activities of Frs. A–E, salicin, saligenin, and salicylic acid are shown in Fig. 7B. WBE (50 µg/ml) showed similar ARE–luciferase activity compared to Fig. 3C. Fractions A and B showed more intensive activities than Frs. C–E at a concentration of 50 µg/ml, whereas salicin and its metabolites were incapable of stimulating any activity.

This means that other compounds within white willow bark, not the well known salicin, are the sole culprits of its intense antioxidant and anti-inflammatory activity. This further supports the superiority of white willow over aspirin.
Beyond Nrf2 activation, in the same way as Aspirin, white willow bark exhibits it’s anti-inflammatory and pain-relieving effects through TNFB and NFKα downregulation as well as COX2 inhibition^(3,7). Furthermore, its effects not only seem to mimic aspirin, but actually seem to be stronger:

On a mg/kg basis, the extract was at least as effective as acetylsalicylic acid (ASA) in reducing inflammatory exudates and in inhibiting leukocytic infiltration as well as in preventing the rise in cytokines, and was more effective than ASA in suppressing leukotrienes, but equally effective in suppressing prostaglandins. On COX-2, STW 33-I (the standardized extract of white willow bark) was more effective than ASA. The present findings show that STW 33-I significantly raises GSH (reduced glutathione) levels, an effect which helps to limit lipid peroxidation. The extract was more potent than either ASA or celecoxib. Higher doses of the extract also reduced malondialdehyde levels and raised shows definite superiority to either ASA or celecoxib in protecting the body against oxidative stress. It is therefore evident that STW 33-I is at least as active as ASA on all the parameters of inflammatory mediators measured, when both are given on a similar mg/kg dose.⁽⁷)

And now solidifying the finding in the previous study showing that while willow‘s other constituents are more powerful than the salicylates found in it:

Considering, however, that the extract contains only 24% salicin (molecular weight 286.2), while ASA has a molecular weight of 180.3, it follows that on a molar basis of salicin vs salicylate, the extract contains less than a sixth of the amount of salicin as the amount of salicylate in ASA. Thus it appears that STW 33-I with its lower "salicin" content than an equivalent dose of ASA, is at least as active as ASA on the measured parameters, a fact that leads one to speculate that other constituents of the extract contribute to its overall activity.

Other studies and reviews also support these findings that the polyphenols and flavonoids within white willow bark contribute to its effects⁽⁹).
Due to this, multiple studies have outlined white willow bark as a safer alternative to aspirin or any other pain-reliever. Gastrotoxicty and brain bleeding can also be ruled out with white willow bark: “White willow bark does not damage the gastrointestinal mucosa… an extract dose with 240 mg salicin had no major impact on blood clotting.”⁽¹⁰) Also, in a study on back pain where the patients taking white willow were allowed to co-medicate with other NSAIDs and opioids, no negative drug interactions were found.⁽¹)
Due to these potent anti-inflammatory, possibly longevity-boosting, and analgesic effects, white willow bark shows a lot of applicability in the treatment of inflammatory diseases, age-related illnesses, everyday aches and pains, and arthritis. The literature also points to it being very wise to swap out your regular old pain-reliever for white willow. Not only is it devoid of the usual side effects, but it seems to be all-around more potent.

The Intriguing Side of White Willow

Now we get to the good stuff: the possible and proven neurological effects of white willow.
What piqued my interest to actually even look into white willow at all was the anecdotal experiences (n=5) talked about on this subreddit‘s discord. Given, five people’s anecdotal experiences aren’t the most thorough proofs, but they do give us information nonetheless and illuminate paths for future research. Multiple different brands of White willow extract were used too, which in my opinion adds to their legitimacy.
Some common themes found with supplementation were a positive mood increase, analgesic effects, potentiation of stimulant’s effects, and, oddly, euphoria at high doses. u/sirsadalot (the founder of this subreddit and owner of bromantane.co) even named it the strongest herb he’s ever tried!
There is admittedly little research on its effects on the brain; but the research that does exist is very intriguing, and the consistent anecdotal experiences point to some possible effects that hopefully will soon be found in the lab.
Uncovering some potential mechanisms underlying its positive effects on mood, this study showed that rats on 15-60mg/kg (169-677mg or 2.4-9.7mg/kg human equivalent dose) of white willow bark exhibited slower serotonin turnover in the brain. The extract also significantly outperformed the anti-depressant imipramine (a tricyclic which inhibits reuptake of serotonin and norepinephrine) by more than 2-fold (36% vs 16%) in the standard model of rat depression, the forced swimming test. A modified version of the original extract characterized by increased salicin and related salicyl alcohol derivatives outperformed imipramine by slightly less than 3-fold (44% vs 16%)!⁽¹¹)
It is no joke for a substance to beat imipramine by 2 and 3 fold in a measure of depression! The effects on serotonin turnover could be a result of multiple things. For one, higher inflammation has long been observed to result in higher serotonin turnover. This makes sense since in people with Major Depressive Disorder there is a higher serotonin turnover rate, and also in people with depression there seems to be more brain inflammation. Therefore, since we know white willow is a potent anti-inflammatory, it makes sense that it would protect the serotenergic system. The other possibility is that a compound or multiple compounds within the extract directly modulate to some degree serotonin levels. This also seems very plausible due to the impressive magnitude at which white willow reduced immobility in the forced swimming test.
An interesting anecdotal experience that was also named multiple times was white willow’s potentiation of stimulant‘s effects—in other words it ”boosted” the effects of stimulants. Coffee was the main stim that was found to be synergistic with it, but pemoline was too. White willow seemed to enhance the focus and energy increases.
Now this leads to one of the most intriguing studies of the day:

Both aspirin at a high dose (400 mg kg-1) and caffeine (5 mg kg-1) induced hyperactivity in the DA rat... Caffeine-induced hyperactivity was brief (2 h) but that due to aspirin was evident from 1-6 h after dosing. Co-administration of the two drugs caused long-lasting hyperactivity, even with doses of aspirin which had no stimulant effects themselves. Absorptive and metabolic effects did not appear to play a major role in the interaction. The most likely effect is that of salicylate on catecholamine utilization in the central nervous system, which is compounded in the presence of a phosphodiesterase inhibitor (that being caffeine).⁽¹²)

In this study it was found that high-dose aspirin induced longer-lasting hyperactivity than that of caffeine, and that co-administration of caffeine and low-dose aspirin caused long-lasting hyperactivity. This is a direct proof of the anecdotal experiences of the “boosting” of coffee’s effects. In this study it was found that a white willow bark extract with 240mg salicin (a normal dose) raised serum salicylic acid levels equivalent to 87mg of aspirin. Low dose aspirin is quantified as 81mg, meaning normal doses of white willow should directly copy the pathway in which aspirin increased hyperactivity from caffeine.
The researchers concluded that the most likely mechanism is increased catecholamine (dopamine, norepinephrine, and epinephrine) neurotransmission. Aspirin‘s dopaminergic effect has been solidified in other studies—

• Low-dose aspirin upregulates tyrosine hydroxylase and increases dopamine production in dopaminergic neurons

tyrosine hydroxylase is the rate-limiting step for dopamine production; which means more tyrosine hydroxylase = more dopamine. Tyrosine hydroxylase upregulation is one of the most intriguing and effective nootropic and anti-Parkinson’s pathways.

• Aspirin and salicylate protect against MPTP-induced dopamine depletion in mice

Aspirin and other salicylates successfully protected against dopamine depletion in mice in an animal model of Parkinson’s. Interestingly, the protective effects of aspirin are unlikely to be related to cyclooxygenase (COX) inhibition as paracetamol, diclofenac, ibuprofen, and indomethacin were ineffective. Dexamethasone, which, like aspirin and salicylate, has been reported to inhibit the transcription factor NF-kappaB, was also ineffective. The neuroprotective effects of salicylate derivatives could perhaps be related to hydroxyl radical scavenging.

So the literature does back up the synergistic relationship with stimulants like caffeine by illuminating the dopaminergic capabilities of aspirin and salicin, and therefore white willow bark. But we find another interesting thing when we look back at the anecdotal experiences: The most nootropic and synergistic doses that were found range from 300-600mg of a 15% salicin extract or 375mg of a 4:1 extract (hypothetically equivalent to 1500mg). 300mg 15% salicin is a way lower dose than that found to be effective in the literature based on salicin/aspirin equivalents, which points to there being other compounds in white willow that either potentiate salicin’s neurological effects, or add their own.
Another odd effect that supports the idea that the other compounds in white willow have powerful neurological effects is that at higher doses it seems to cause euphoria and a “high” feeling. The doses this was found at was 900(confounded with other stims)-1200mg 15% salicin, and 750mg of a 4:1 extract. Interestingly, co-use of pemoline (which is a Dopamine Reuptake Inhibitor) and white willow seemed to cause euphoric effects at a lower dose (needs to be replicated), which theoretically points to high dopamine being the cause of it. It would also mean that white willow has very strong dopaminergic effects, so further research is definitely needed. Increased motivation was another anecdotal experience, which further points to dopaminergic activity. A serotonergic pathway for euphoria is also theoretically possible, as high serotonin can in fact cause euphoria, and we already know white willow bark does significantly slow serotonin turnover. Also, looking into the literature, it does seem that high-dose aspirin-induced euphoria exists. By the way, euphoria is anti-nootropic by definition; the only reason I dived into it is that its ability to induce euphoria at higher doses suggests that some other compounds in the extract have potent neurological effects.

Conclusion

White willow bark is a very intriguing compound that seems to be an effective nootropic and health-boosting compound. A lot of new research is needed to confirm its neurological effects, but all signs and anecdotal experiences point to it being a safe dopaminergic and anti-depressant compound.
Recommended Dosage—

• The majority of anectdotal experiences recommend 300-900mg standardized to 15% salicin as the best nootropic dose. A 375mg 4:1 extract was also found to be very nootropic
• The literature seems to back up these experiences, and person-to-person the optimal nootropic dose would probably range from 150-1200mg standardized to 10-25% salicin

Summary of Effects—

• White willow has significant antioxidant activity—stronger than that of ascorbic acid. It also, unlike other NSAIDs like aspirin, potently and dose-dependently activates Nrf2 and upregulates glutathione, which makes it an interesting compound to research for use against inflammatory diseases, dementia, age-related illnesses, and stress.^(6-8)
• White willow is a stronger anti-inflammatory mg for mg than aspirin through many different mechanisms, like TNFB and NFKα downregulation and COX2 inhibition.⁽⁷) But seeing as normal doses of white willow are larger than aspirin, these effects have even larger magnitude. It also seems to be side effect free.^(1,10)
• White willow seems to act as a potent anti-depressant through lowering serotonin turnover⁽¹¹)
• There is significant evidence pointing to a strong nootropic synergistic interaction between caffeine and white willow.⁽¹²)
• The salicin in white willow bark upregulates tyrosine hydroxylase⁽¹³), and the other constituents of white willow are also hypothesized to have strong dopaminergic effects.
• The salicin in white willow bark has a unique anti-inflammatory pathway that possesses protective effects against dopamine loss in Parkinson’s disease that no other NSAIDs seem to have.⁽¹⁴)

​
Sources: (some hyperlinked sources are not listed here)

1. https://www.sciencedirect.com/science/article/abs/pii/S0944711313001323
2. https://onlinelibrary.wiley.com/doi/abs/10.1002/ptr.981
3. https://pubmed.ncbi.nlm.nih.gov/25997859/
4. https://onlinelibrary.wiley.com/doi/abs/10.1002/ptr.2747
5. https://pubmed.ncbi.nlm.nih.gov/15517622/
6. https://pubmed.ncbi.nlm.nih.gov/33003576/
7. https://pubmed.ncbi.nlm.nih.gov/16366042/
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3800243/
9. https://pubmed.ncbi.nlm.nih.gov/17704985/
10. https://pubmed.ncbi.nlm.nih.gov/21226125/
11. https://www.sciencedirect.com/science/article/abs/pii/S0944711312001572
12. https://pubmed.ncbi.nlm.nih.gov/41063/
13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6401361/
14. https://pubmed.ncbi.nlm.nih.gov/9751197/

Thuốc Aleve là một loại thuốc chống viêm không steroid hoạt động bằng cách ngăn chặn sự sản xuất của một số chất trong gây viêm trong cơ thể, thuộc công ty Bayer Cross – một trong những thương hiệu nổi tiếng nhất trên thế giới. Thuốc Aleve có tác dụng giảm đau nhức tạm thời. Chỉ cần 2 viên Aleve có thể giảm đau kéo dài cả ngày. Mỗi viên thuốc Aleve có sức mạnh để kéo dài 12 giờ.
Thuốc giảm đau Aleve của Mỹ với thành phần có chứa 220 Natri Naproxen/ viên. Cụ thể thông tin được chi tiết như sau:
Tên biệt dược: Aleve Tên hoạt chất: Naproxen Nhóm thuốc: Thuốc giảm đau Dạng thuốc: Viên nén, viên con nhộng cac loai aleve Aleve có rất nhiều loại Công dụng của thuốc Aleve như thế nào? Liệu sản phẩm thuốc Aleve có hiệu quả? Aleve trị bệnh gì? Mời các bạn hãy cùng Giaonhan247 đọc tiếp để hiểu rõ hơn chi tiết và công dụng.
Vậy thuốc Aleve trị bệnh gì ? Thuốc Aleve được sử dụng với mục đích trị giảm các triệu chứng đau đầu, đau răng, đau cơ, viêm gân, đau bụng trong thời kì kinh nguyệt. Ngoài ra, nó còn có chức năng là thuốc giảm đau hạ sốt của mỹ, thuốc giảm đau đầu của mỹ được sử dụng để làm giảm các triệu chứng đau, sưng và các cứng khớp do viêm khớp, viêm bụng hay đau do các cơ rút gây nên. Bên cạnh đó, thuốc Aleve còn được dùng để hạ sốt tạm thời. Cách sử dụng thuốc Aleve như thế nào cho phù hợp ? Thuốc Aleve được sử dụng để uống nguyên viên bằng đường miệng và hãy uống thuốc với một ly nước đầy. Không nên nhai hay nghiền nát hoặc hoặc cắt đôi viên thuốc (đối với dạng gel lỏng) để dùng vì sẽ làm giảm tác dụng của thuốc. Nếu bạn phát hiện thuốc đã quá hạn sử dụng nên vứt đi và tuyệt đối không sử dụng nữa, vì sẽ có những tác dụng phụ không mong muốn khi sử dụng thuốc quá hạn, đừng tiếc tiền mà ảnh hưởng đến sức khỏe. Thuốc phải uống đúng liều lượng theo sự chỉ dẫn của bác sĩ, không nên uống thuốc quá liều hoặc thiếu liều.
Các dạng thuốc Aleve
Thuốc Aleve có mấy loại, trường hợp nào nên dùng Aleve phù hợp, Aleve có tốt không? Đó là câu hỏi của nhiều người quan tâm.
Loại 1: Aleve dạng viên nén, hình bầu dục
Với mỗi viên nén thuốc Aleve sẽ có hình bầu dục chứa 220mg Natri Naproxen với tác dụng giảm đau hiệu quả trong thời gian khoảng 12 giờ. Viên thuốc Aleve có tác dụng giảm đau nhức nhẹ do viêm khớp, đau lưng, đau cơ hoặc viêm khớp gây ra.
Mỗi hộp thuốc có chứa số lượng viên khác nhau như 6 viên, 24 viên, 50 viên, 100 viên, 150 viên, 200 viên, 270 viên, 320 viên.
Loại 2: Aleve dạng viên nén, hình tròn
Với dạng viên nén hình tròn thì công dụng cùng thành phần hoạt chất của nó sẽ tương tự như viên nang. Ở đây nó chỉ khác nhau về hình dạng mà thôi.
Loại 3: Aleve Back and Muscle Pain
Với thuốc Aleve Back and Muscle Pain thì nó có tác dụng giúp làm giảm đau cơ, đau lưng trong thời gian 12 giờ cho 1 viên. Nó được sản xuất với dạng nén hình tròn và mỗi hộp sẽ có chứa 24 viên, 50 viên hoặc là 100 viên.
Loại 4: Aleve Gelcap
Thuốc Aleve Gelcap được bào chế dưới dạng viên con nhộng, giúp kiểm soát các cơn đau nhẹ xảy ra như đau do viêm khớp, đau lưng, đau đầu lên tới 12 giờ chỉ với 1 viên uống.
>> Cập nhật thêm tin tức sức khỏe y tế khác tại: https://bacsi247.org

For some weird reason, I envisioned Invisalign being this easy, pain-free journey. Boy was I wrong! They may be almost invisible but they are working like traditional braces which involves‏‏‎‏‏‎‏‏‎‏‏‎­moving teeth around. Hellloooo!! Day #1 was ok. The tray felt weird in my mouth but no biggie. Then day 2 rolled around and the pain kicked in. I didn't sleep for 2 nights. By the middle of day 3, I looked up and realized that I was not in agonizing pain anymore. The thoughts of regret started to disappear. I realized that this might actually be worth it after all. So if you're thinking about getting Invisalign, just be prepared for the first few days. I was popping Aleve and Bayer like candy. LOL

I am so frustrated trying to find gluten free pain meds or fever reducers!! I have one kid test positive for covid, another feeling sick last night, so I need some now, but last one I bought said it was gluten free on the online description, but when we got it, it is NOT Gf, and I keep striking out trying to find some!
Because right now, so many places say that X product is gluten free, including sometimes the online-ordering description. But then you get the bottle and it has no GF label (even though the company labels their GF products) or then I go to check the product's website and the company itself is no longer saying that it's GF. it's getting ridiculous how many companies are jumping the GF ship.
Anyone have any pain or fever reducing meds they use that carry a GF label? My kid has reacted before to meds that were 'no gluten' but weren't officially gluten free, so I have to be really careful for them.
And the following all seem to be strikeouts, so far.
Advil, they now don't claim their products are gluten free AND Advil Liqui-Gels and Advil Migraine contain a wheat derivative, and are specifically stated to not be gluten free, so they're out.
Tylenol used to have a gluten free list, but the manufacturer McNeil-PPC retracted it and said: "Although we don't add gluten or gluten containing grains to our products, we cannot confirm that the product or any ingredients in TYLENOL products are gluten free. Your safety is of great concern to us; therefore, we strongly recommend that you first consult your doctor before using any product if you have a form of gluten intolerance or sensitivity."
Aleve says this: "we do not add any gluten to our products. However, we cannot guarantee that they are 100% gluten-free as this product is produced in a facility that manufactures or packages other items which may contain gluten."
Bayer aspirin basically says the same as Aleve.
CVS supposedly has some acetaminophen that is gluten free and says to check the package for a gluten free label., but when we got to the store, not a single package of their acetaminophen had a gluten free label.
walmart used to have some sizes of their generic ibuprofen listed as gluten free, but they don't have that label any longer, even though online it still lists it as GF.
Target's Up brand supposedly had multiple gluten free meds - ibuprofen, acetaminophen, and naproxen sodium - but you had to check to see if the label was GF. Just like Walmart and CVS, I can't find any that carry the GF label in my target.
Walgreens - same as Target and CVS - some things are supposed to be gluten free, some not, check the label. And again - can't find a single gluten free labeled acetaminophen or ibuprofen in our particular store.
​
Anyone ordered something online recently that was actually still labeled GF? really trying to find something ASAP, you know?

2 hours into day 13. No cravings other than to get drunk and make this neuropathy pain go away. Still taking my vitamins. Eating Bayer back and body and aleve like candy. Shit sucks man.
Went to the VA hospital ER to hope for something to hold me until my va doc appointment on Thursday. This is why I hate the va and got so frustrated I never finished the process for my disability rating when I got out in 2010. I suppose if I can make it through this, that process should be a breeze this time around. When I can.
1 more sleepless night and I’ll be at a full 2 weeks for the first time since I probably started drinking 19 or so years ago.
IWNDWYT.

Just had my first video chat with my recovery counselor. Everything went well. Had to do the normal questionnaire to assess where I’m at and how I’m feeling about all this.
Online classes every Monday, Wednesday, and Friday. For the first few I’ll attend all three but going forward I only have to pick one.
Normally she’s put people on color code for drug/alcohol testing as a another layer of accountability but as I’m not driving right now because of neuropathy issues she told me to see what I can work out and if it’s something I want to do next time I meet with her in the 15th.
Unfortunately couldn’t get a doc appointment until the 15th either so looks like I’m gonna have to go to an urgent care to try and get some relief for the next 9 days instead of popping bayer and aleve like candy.
About to start day 8. IWNDWYT.

Author: u/requantify(Karma: 163, Created: Dec-2019).
Bayer AG Write-Up on securityanalysis
I believe Bayer AG has a discounted valuation and has fallen off investors radar due to poor performance in recent years, presenting an oppourtunity to purchase a strong cash-flow generating business at a reasonable price.
Please let me know your thoughts.
Best,
Requantify
https://drive.google.com/file/d/1ljHOhQg4zOSt2x8K4TLA5k66dI8QtuX2/view?usp=sharing
https://requantify.substack.com/p/bayer-ag
Business Overview
Bayer is a life science company that operates through three channels. Pharma, Crop Science and Consumer Health.
Pharma generates 43% of revenues. Bayer’s pharma operations specialize in cardiovascular and cell and gene therapy, and oncology sectors. Pharma’s revenues are majorly derived from Xarelto, Eylea, and Mirena/Kyleena/Jaydess blockbuster drugs contributing 8.1 billion EUR of Pharma’s total sales of 14.1 billion EUR. In addition, Bayer has invested in cell & gene therapy and oncology markets to prepare upcoming products. Bayer’s next blockbusters are expected to be Nubeqa, Finerenone, and Elinzanetant, operating in oncology, cardiovascular, and women’s health markets.
Crop Science contributes 50% of revenues. However, in 2020 crop science was a drag on Bayer because of lower-than-expected sales, losses from currency fluctuations and glyphosate litigation resulting from the acquisition of Monsanto.
Consumer Health (CH) generates 13% of revenues. In 2020 CH grew by 5.2% through effectively leveraging e-commerce. In addition, CH improved incremental EBITDA margins from 21% to 22% through finding product cost efficiencies and digitizing its supply chain.
Stock performance
Through 2020 Bayer’s share price has had significant volatility; however, it has ended down ~5% even with most of the glyphosate litigation behind the firm and robust growth in the core business through the pandemic. Bayer’s dividend yield is 3.7%; this should increase modestly as Bayer’s management has committed to paying 30-40% of operating cashflows out as dividends.
Thesis
There are two types of company’s worthy of an investment.

1. Companies that are undervalued because they compound at a high rate and become increasingly valuable.
2. Companies that are cheap enough where you are almost guaranteed to make a profit. Enjoy the last puff.

Bayer has the potential to become a compounder; it benefits from multiple tailwinds, exhibits economies of scale and scope and has challenging to replicate expertise in developing complex products in two core verticals, Crop Science and Pharmaceuticals. Bayer’s Consumer Health segment is a strong cashflow generator that can grow by expanding in emerging markets; high cashflow generation allow this segment to take additional leverage lowering Bayer’s cost of capital.
Right now, I would recommend an investment in Bayer now because it is cheap. Investor sentiment is at an all-time low providing an opportunity to invest in a leading health science company at rock bottom prices. Please see the assumptions tab in the attached excel file for my revenue growth expectations, and please see the DCF tab, which shows the impact of assumptions on valuation.
Catalysts for Bayer re-rating towards Comps include.

1. Concluding glyphosate litigation
2. Crop Science division's rollout of fourth generation soybean traits.
3. Commercialization of late-stage pipeline drugs Nubeqa, Finerenone, and Elinzanetant - Projection for Finerenone dived into in internal analysis

Company Industries Overview
Bayer operates in three different industries; its largest revenue source is the Global Fertilizers and Agrochemicals (GFA) market, followed by Pharma and Consumer Health.
Crop Science
The GFA market has undergone significant consolidation. Major events include Bayer acquiring Monsanto (the previously largest player in the GFA market) and the merger of Dow and Dupont, creating Corteva. GFA market is a ~$100 billion opportunity broken down into two groups Crop Protection (CP) 60% and Seeds 40%. The GFA market is critical to sustaining and growing global populations. Bayer has a strong position in both markets, with 21% and 25% market share in CP and Seeds, respectively.
The GFA market is driven by global population, available agricultural land, average crop prices, and price of inputs (natural gas and oil). As inputs to this industry are commodities, there is limited power of suppliers.
GFA producers benefit from two secular tailwinds world population rising and agricultural land decreasing. First, the global population is expected to reach 10 billion by 2050. Second, climate change is expected to decrease harvest yields and arable farmland in developing and low-income countries. In contrast, developed countries can convert forests to agricultural land to increase available farmland; however, developed countries cannot continue this practice indefinitely. These two secular tailwinds ensure that the GFA market grows at 2-3% annually.
The GFA market enjoys high margins, with major players enjoying EBITDA margins in the high-tens to mid-twenties. High margins are achieved because customers are highly diversified, and there are no substitutes for CP or Seeds. High R&D needed to compete in the GFA market creates high barriers to entry. This market structure enhances the need for economies of scale to spread R&D and other expenses over a large customer base; an oligopolistic market structure is seen as five leading players in the space acquire and merge to create ever-larger firms.
Pharma
Bayer competes in the global pharmaceuticals & medicine manufacturing market (GPMM.). The GPMM is a $1.3 trillion opportunity. The GPMM is highly fragmented, with players carving out niches in the space. This industry’s key external drivers are an ageing population, per capita healthcare spend of OECD countries, technological change, and global per capita income.
The GPMM benefits from two tailwinds: developing countries increase in wealth, and western populations continue to age. As Western populations age, spending on healthcare by OECD countries will continue to rise to meet population needs and significant increases in global per capita income increase the demand for medical products. Both tailwinds should allow the industry to grow faster than global average inflation.
Because of the extensive R&D needed to develop products, average EBITDA margins are north of 25%. High margins reflect limited supplier and buyer power. As base chemicals are the raw supplies for industry products, there is little supplier power; however, for firms that purchase patents, there is high supplier power as patents are unique and are sold to the highest bidder. In addition, products in their exclusivity period give the patent owner ultimate pricing power as there are no substitutes. However, substitutes become readily available once drugs lose exclusivity as generic versions are available at lower prices.
Bayer and most competitors meet these KSF’s; however, Bayer stands out as it has a robust biologics portfolio, limiting generic competition as generic bio-similar drugs are more difficult to develop.
Consumer Health
The consumer health (CH) segment is very similar to the Pharma segment. CH operates in a highly fragmented market, with an ageing populating and increases in per-capita incomes driving segment demand. Producers either manufacture CH products in-house through purchasing raw materials as commodities, leading to low supplier power or may outsource production leading to a higher power of suppliers. Buyers have significant power in this market as supermarkets and pharmacies usually carry these products and make them available over the counter, making it of paramount importance to have good buyer relationships. The threat of substitutes is also high as most CH products have significant direct and indirect competition, direct from generic’s, indirect from products with a similar outcome. The threat of new entry is low as there are significant R&D barriers to creating new CH drugs which can receive exclusivity and significant financial barriers to entry for generics that require investments in fixed assets to manufacture products.
The coronavirus pandemic has caused consumers to place increased emphasis on their health. As a result, health-related spending has increased by over 5% in 2020 vs 2019. Additionally, with consumers spending more time at home, they increase acceptance of personalized nutrition and increase purchases of healthcare items through e-commerce channels.
Internal Analysis
Crop Science
Bayer is an established leader in crop science, having a dominant position in CP and Seeds, ranking #1 in market position in three segments and 2nd and 3rd in the final three segments. Bayer’s revenues are well diversified, with seeds, herbicides and fungicides comprising 27%, 25% and 14% of sales. Comparing Bayer’s sales mix to the global agricultural input market (27% Bayer vs 15% global ag market), it becomes evident that Bayer is excessively reliant on its seeds segment. Bayer has significant revenues from the Seeds segment because Bayer acquired Monsanto, an industry leader in genetically modified seeds. Another remnant of Monsanto is a strong North American presence. As a result, 44% of Bayer’s crop science revenues come from North America, making up 24% of the global ag input market.
The main competitors in the agricultural technologies space are Corteva, Syngenta and BASF. Bayer has higher sales than all competitors in both CP and Seeds, allowing Bayer to exercise economies of scale, reducing its costs seen by its ~24% EBITDA margin vs comps, which average ~18%. Greater sales and margins allow Bayer to have a sustained competitive advantage through R&D economies of scale, having over 2 billion EUR in R&D spend comprising ~ 10% of sales vs comps which spend anywhere from 400 million to 1.5 billion EUR on R&D.
Bayer’s higher R&D spend created a robust pipeline with key new products being introduced in all three critical areas of CP (herbicides, fungicides, and insecticides), which are expected to grow crop science revenues by north of 4% annually. In addition, new product launches focusing on emerging markets have the potential to reduce Bayer’s reliance on the North American market.
Risks to the crop science division include
· Higher losses from glyphosate litigation
· Consumer’s voting with dollars to reduce GMOs in foods
· Volatility in commodity markets reducing demand and margins on products
· North American “Next-Gen” corn and soybean upgrades receive poor reception
The crop science division faces risks; however, Bayer has adequately prepared for these risks. Bayer has set aside over 13 billion EUR in reserves for litigation which is wrapping up. Well-off consumers in western countries may use dollars to vote against GMO crops; however, less well-off consumers worldwide and especially in developing countries will see significant benefits from using GMO products. Although a flawed rollout of next­-gen seeds would increase demand for current-gen products, over time, I believe that farmers will choose to use next-gen products as they increase harvest potential and profits through lower maintenance and fastemore efficient growth.
Pharma
Bayer’s Pharma segment is a leader in the following therapeutic areas with revenue breakdown
· Cardiovascular – 37%
· Hematology – 5%
· Women’s health – 16%
· Radiology – 9%
· Oncology – 9%
· Ophthalmology – 14%
Most of Bayer’s Pharma division is highly diversified in terms of available products; however, most pharma sales come from five products, comprising 9.6 billion EUR of 14.1 billion EUR in total sales.
Xarelto is the largest revenue driver for Pharma, with 4.5 billion EUR in sales. However, Xarelto’s forthcoming loss of exclusivity without another massive blockbuster coming out has reduced analyst’s expectations of Pharma’s revenues in the future. Xarelto lost exclusivity in China in 2020 and will lose exclusivity in key markets from 2022-2025, with significant revenue geographies losing exclusivity in 2024. Bayer expects to make up for Xarelto’s lost revenues by introducing three new products that it estimates will generate revenues of over 1 billion EUR each. Nubeqa, Finerenone, and Elinzanetant are the anticipated blockbusters. All three operate in different rapidly growing markets. Bayer maintains a strong product pipeline investing in oncology which analysts and the company believe will be a growth platform for the firm in the next three years. Additionally, through completing a series of acquisitions, Bayer has bought capabilities in the cell and gene therapy market expected to generate products post-2025 and signed 25 business development contracts expected to grow Bayer’s pharma pipeline.
Finerenone is particularly promising. Finerenone isn’t a general inhibitor and is better at targeting the MR receptor in kidneys than diabetes treatments such as Metformin, the current industry leader. As a result, Finerenone goes beyond the capabilities of Alpha-Glucosidase inhibitors or Biguanides (Metformin is Biguanide), which manages type two diabetes but does not prevent chronic kidney disease (CKD) Finerenone is the only drug that prevents CKD.
Finerenone is a big deal because, in America alone, 12.5 million are at risk of CKD. The number is anticipated to continue rising, with obesity a pre-cursor for type two diabetes on the rise. Harvard research shows that the USA has a 34% obesity rate, which they expect to reach 50% by 2050. Age is another risk factor, with developed economies experiencing a demographic shift towards older populations provides another tailwind for Finerenone sales.
Current products meant to manage type 2 diabetes must be taken three times a day, with each pill costing from 41-71 cents. Finerenone is anticipated to cost north of one dollar per pill and can be taken twice a day. My analysis concludes to reach one billion in sales, Finerenone only needs to capture 5% of the American market. Without including revenues from the rest of the world, we can comfortably say that Bayer is understating the size of this opportunity.
Consumer Health
Bayer’s Consumer Health (CH) segment provides products, services, and information to improve their health. Bayer is the #3 OTC player globally, with leading positions in seven of the top ten OTC markets. In addition, CH focuses on non-prescription products in the following markets.
· Allergy, Cough & Cold
· Nutritional’s
· Dermatology
· Pain & Cardio
Some marquee products include Aspirin, Claritin and Aleve. These and other OTC products generate ~5 billion EUR in revenues. CH has achieved a growth rate CAGR of ~2% over the past five years; however, CH has grown at 5.2% in the past year and achieved EBITDA margin expansion from 20.1% in 2018 to 22% in 2020. CH plans to continue its focus on preventative care and expand its sales and product lines globally by more effectively leveraging e-commerce and marketing its products. Geographically Bayer is investing in developing a stronger brand presence in the USA, India, China and South-East Asia. By expanding in these geographies, Bayer can tap a lucrative market the is rapidly growing. The CH segment also cuts costs by achieving production cost efficiencies, implementing cost-cutting programs at facilities, and limiting investments into Capex, opting for a more variable cost structure.
Financials
Bayer has a strong balance sheet with ~55% of capital provided by debt. Bayer intends to pay down their debt; however, under my assumptions, this is improbable unless Bayer cuts their dividend. Bayer maintaining more debt on their balance sheet is a positive for equity investors; Bayer’s pre-tax average cost of debt is ~3.45%, and Bayer recently rolled debt at lower rates. Bayer benefits from global reach, allowing access to markets where credit is cheaper – mainly Europe. With Bayer’s cost of debt low, low exit risk, and revenue visibility into the following three years, why would equity investors want to reduce the use of debt?
Over the past five years, excluding the pandemic, Bayer has grown its revenues rapidly, increasing by 5% in 2018 and 19% in 2019. Growth has mainly come from Crop Science as post-acquisition of Monsanto; Bayer received a solid portfolio of seeds and CP products from which it could develop. As a result, Bayer has maintained a 63% groupwide gross profit margin over the past few years, down from 68% it maintained during 2016 & 2017, caused by CH, which was a drag on margins over the past two years.
Since 2018 even with rising sales, Bayer has failed to earn their cost of capital. Bayer’s cost of capital is 6.8%, earning a ROCE of 3.8%, 5.0% and -39.8% in 2018, 2019, and 2020, respectively. Bayer is on track to earn its cost of capital in the future due to significant cost savings measures and finishing up a restructuring program increasing net income.
My model using below consensus revenue growth for all segments shows that Bayer is undervalued. Bayer will benefit from multiple secular tailwinds and is well-positioned to grow in the crop science and consumer health markets. However, I believe that Bayer’s Pharma segment will represent a drag on revenues resulting in a five-year revenue CAGR of 1.36%. In my base case, EBIT margins slightly shrink from 2020-2027; Bayer cuts back on Capex while annual depreciation and amortization hover around 5% of gross property plant and equipment. I have used a 1.5% terminal growth rate when valuing the firm using Gordon growth and a 10x EBITDA exit multiple under the multiples method. I wanted to be very conservative with my financials for two reasons; first, Bayer is out of my comfort zone; second, Bayer has a history of disappointing expectations set at capital markets days. The result of my valuation revealed that Bayer is undervalued by ~17% as of May 10, 2021. I believe that the fair value for Bayer is around 63 euros per share.
Please see the linked spreadsheet.
TickerDatabase entries updated:

Ticker	Price
CTVA	44.54
AG	17.88
COLD	39.22
CP	80.37
DOW	68

I believe Bayer AG has a discounted valuation and has fallen off investors radar due to poor performance in recent years, presenting an oppourtunity to purchase a strong cash-flow generating business at a reasonable price.
Please let me know your thoughts.
Best,
Requantify
https://drive.google.com/file/d/1ljHOhQg4zOSt2x8K4TLA5k66dI8QtuX2/view?usp=sharing
https://requantify.substack.com/p/bayer-ag
Business Overview
Bayer is a life science company that operates through three channels. Pharma, Crop Science and Consumer Health.
Pharma generates 45% of revenues. Bayer’s pharma operations specialize in cardiovascular and cell and gene therapy, and oncology sectors. Pharma’s revenues are majorly derived from Xarelto, Eylea, and Mirena/Kyleena/Jaydess blockbuster drugs contributing 8.1 billion EUR of Pharma’s total sales of 14.1 billion EUR. In addition, Bayer has invested in cell & gene therapy and oncology markets to prepare upcoming products. Bayer’s next blockbusters are expected to be Nubeqa, Finerenone, and Elinzanetant, operating in oncology, cardiovascular, and women’s health markets.
Crop Science contributes 41% of revenues. However, in 2020 crop science was a drag on Bayer because of lower-than-expected sales, losses from currency fluctuations and glyphosate litigation resulting from the acquisition of Monsanto.
Consumer Health (CH) generates 13% of revenues. In 2020 CH grew by 5.2% through effectively leveraging e-commerce. In addition, CH improved incremental EBITDA margins from 21% to 22% through finding product cost efficiencies and digitizing its supply chain.
Stock performance
Through 2020 Bayer’s share price has had significant volatility; however, it has ended down ~5% even with most of the glyphosate litigation behind the firm and robust growth in the core business through the pandemic. Bayer’s dividend yield is 3.7%; this should increase modestly as Bayer’s management has committed to paying 30-40% of operating cashflows out as dividends.
Thesis
There are two types of company’s worthy of an investment.

1. Companies that are undervalued because they compound at a high rate and become increasingly valuable.
2. Companies that are cheap enough where you are almost guaranteed to make a profit. Enjoy the last puff.

Bayer has the potential to become a compounder; it benefits from multiple tailwinds, exhibits economies of scale and scope and has challenging to replicate expertise in developing complex products in two core verticals, Crop Science and Pharmaceuticals. Bayer’s Consumer Health segment is a strong cashflow generator that can grow by expanding in emerging markets; high cashflow generation allow this segment to take additional leverage lowering Bayer’s cost of capital.
Right now, I would recommend an investment in Bayer now because it is cheap. Investor sentiment is at an all-time low providing an opportunity to invest in a leading health science company at rock bottom prices. Please see the assumptions tab in the attached excel file for my revenue growth expectations, and please see the DCF tab, which shows the impact of assumptions on valuation.
Catalysts for Bayer re-rating towards Comps include.

1. Concluding glyphosate litigation
2. Crop Science division's rollout of fourth generation soybean traits.
3. Commercialization of late-stage pipeline drugs Nubeqa, Finerenone, and Elinzanetant - Projection for Finerenone dived into in internal analysis

Company Industries Overview
Bayer operates in three different industries; its largest revenue source is the Global Fertilizers and Agrochemicals (GFA) market, followed by Pharma and Consumer Health.
Crop Science
The GFA market has undergone significant consolidation. Major events include Bayer acquiring Monsanto (the previously largest player in the GFA market) and the merger of Dow and Dupont, creating Corteva. GFA market is a ~$100 billion opportunity broken down into two groups Crop Protection (CP) 60% and Seeds 40%. The GFA market is critical to sustaining and growing global populations. Bayer has a strong position in both markets, with 21% and 25% market share in CP and Seeds, respectively.
The GFA market is driven by global population, available agricultural land, average crop prices, and price of inputs (natural gas and oil). As inputs to this industry are commodities, there is limited power of suppliers.
GFA producers benefit from two secular tailwinds world population rising and agricultural land decreasing. First, the global population is expected to reach 10 billion by 2050. Second, climate change is expected to decrease harvest yields and arable farmland in developing and low-income countries. In contrast, developed countries can convert forests to agricultural land to increase available farmland; however, developed countries cannot continue this practice indefinitely. These two secular tailwinds ensure that the GFA market grows at 2-3% annually.
The GFA market enjoys high margins, with major players enjoying EBITDA margins in the high-tens to mid-twenties. High margins are achieved because customers are highly diversified, and there are no substitutes for CP or Seeds. High R&D needed to compete in the GFA market creates high barriers to entry. This market structure enhances the need for economies of scale to spread R&D and other expenses over a large customer base; an oligopolistic market structure is seen as five leading players in the space acquire and merge to create ever-larger firms.
Pharma
Bayer competes in the global pharmaceuticals & medicine manufacturing market (GPMM.). The GPMM is a $1.3 trillion opportunity. The GPMM is highly fragmented, with players carving out niches in the space. This industry’s key external drivers are an ageing population, per capita healthcare spend of OECD countries, technological change, and global per capita income.
The GPMM benefits from two tailwinds: developing countries increase in wealth, and western populations continue to age. As Western populations age, spending on healthcare by OECD countries will continue to rise to meet population needs and significant increases in global per capita income increase the demand for medical products. Both tailwinds should allow the industry to grow faster than global average inflation.
Because of the extensive R&D needed to develop products, average EBITDA margins are north of 25%. High margins reflect limited supplier and buyer power. As base chemicals are the raw supplies for industry products, there is little supplier power; however, for firms that purchase patents, there is high supplier power as patents are unique and are sold to the highest bidder. In addition, products in their exclusivity period give the patent owner ultimate pricing power as there are no substitutes. However, substitutes become readily available once drugs lose exclusivity as generic versions are available at lower prices.
Bayer and most competitors meet these KSF’s; however, Bayer stands out as it has a robust biologics portfolio, limiting generic competition as generic bio-similar drugs are more difficult to develop.
Consumer Health
The consumer health (CH) segment is very similar to the Pharma segment. CH operates in a highly fragmented market, with an ageing populating and increases in per-capita incomes driving segment demand. Producers either manufacture CH products in-house through purchasing raw materials as commodities, leading to low supplier power or may outsource production leading to a higher power of suppliers. Buyers have significant power in this market as supermarkets and pharmacies usually carry these products and make them available over the counter, making it of paramount importance to have good buyer relationships. The threat of substitutes is also high as most CH products have significant direct and indirect competition, direct from generic’s, indirect from products with a similar outcome. The threat of new entry is low as there are significant R&D barriers to creating new CH drugs which can receive exclusivity and significant financial barriers to entry for generics that require investments in fixed assets to manufacture products.
The coronavirus pandemic has caused consumers to place increased emphasis on their health. As a result, health-related spending has increased by over 5% in 2020 vs 2019. Additionally, with consumers spending more time at home, they increase acceptance of personalized nutrition and increase purchases of healthcare items through e-commerce channels.
Internal Analysis
Crop Science
Bayer is an established leader in crop science, having a dominant position in CP and Seeds, ranking #1 in market position in three segments and 2nd and 3rd in the final three segments. Bayer’s revenues are well diversified, with seeds, herbicides and fungicides comprising 27%, 25% and 14% of sales. Comparing Bayer’s sales mix to the global agricultural input market (27% Bayer vs 15% global ag market), it becomes evident that Bayer is excessively reliant on its seeds segment. Bayer has significant revenues from the Seeds segment because Bayer acquired Monsanto, an industry leader in genetically modified seeds. Another remnant of Monsanto is a strong North American presence. As a result, 44% of Bayer’s crop science revenues come from North America, making up 24% of the global ag input market.
The main competitors in the agricultural technologies space are Corteva, Syngenta and BASF. Bayer has higher sales than all competitors in both CP and Seeds, allowing Bayer to exercise economies of scale, reducing its costs seen by its ~24% EBITDA margin vs comps, which average ~18%. Greater sales and margins allow Bayer to have a sustained competitive advantage through R&D economies of scale, having over 2 billion EUR in R&D spend comprising ~ 10% of sales vs comps which spend anywhere from 400 million to 1.5 billion EUR on R&D.
Bayer’s higher R&D spend created a robust pipeline with key new products being introduced in all three critical areas of CP (herbicides, fungicides, and insecticides), which are expected to grow crop science revenues by north of 4% annually. In addition, new product launches focusing on emerging markets have the potential to reduce Bayer’s reliance on the North American market.
Risks to the crop science division include
· Higher losses from glyphosate litigation
· Consumer’s voting with dollars to reduce GMOs in foods
· Volatility in commodity markets reducing demand and margins on products
· North American “Next-Gen” corn and soybean upgrades receive poor reception
The crop science division faces risks; however, Bayer has adequately prepared for these risks. Bayer has set aside over 13 billion EUR in reserves for litigation which is wrapping up. Well-off consumers in western countries may use dollars to vote against GMO crops; however, less well-off consumers worldwide and especially in developing countries will see significant benefits from using GMO products. Although a flawed rollout of next­-gen seeds would increase demand for current-gen products, over time, I believe that farmers will choose to use next-gen products as they increase harvest potential and profits through lower maintenance and fastemore efficient growth.
Pharma
Bayer’s Pharma segment is a leader in the following therapeutic areas with revenue breakdown
· Cardiovascular – 37%
· Hematology – 5%
· Women’s health – 16%
· Radiology – 9%
· Oncology – 9%
· Ophthalmology – 14%
Most of Bayer’s Pharma division is highly diversified in terms of available products; however, most pharma sales come from five products, comprising 9.6 billion EUR of 14.1 billion EUR in total sales.
Xarelto is the largest revenue driver for Pharma, with 4.5 billion EUR in sales. However, Xarelto’s forthcoming loss of exclusivity without another massive blockbuster coming out has reduced analyst’s expectations of Pharma’s revenues in the future. Xarelto lost exclusivity in China in 2020 and will lose exclusivity in key markets from 2022-2025, with significant revenue geographies losing exclusivity in 2024. Bayer expects to make up for Xarelto’s lost revenues by introducing three new products that it estimates will generate revenues of over 1 billion EUR each. Nubeqa, Finerenone, and Elinzanetant are the anticipated blockbusters. All three operate in different rapidly growing markets. Bayer maintains a strong product pipeline investing in oncology which analysts and the company believe will be a growth platform for the firm in the next three years. Additionally, through completing a series of acquisitions, Bayer has bought capabilities in the cell and gene therapy market expected to generate products post-2025 and signed 25 business development contracts expected to grow Bayer’s pharma pipeline.
Finerenone is particularly promising. Finerenone isn’t a general inhibitor and is better at targeting the MR receptor in kidneys than diabetes treatments such as Metformin, the current industry leader. As a result, Finerenone goes beyond the capabilities of Alpha-Glucosidase inhibitors or Biguanides (Metformin is a Biguanide), which manages type two diabetes but does not prevent chronic kidney disease (CKD) Finerenone is the only drug that prevents CKD.
Finerenone is a big deal because, in America alone, 12.5 million are at risk of CKD. The number is anticipated to continue rising, with obesity a pre-cursor for type two diabetes on the rise. Harvard research shows that the USA has a 34% obesity rate, which they expect to reach 50% by 2050. Age is another risk factor, with developed economies experiencing a demographic shift towards older populations providing another tailwind for Finerenone sales.
Current products meant to manage type 2 diabetes must be taken three times a day, with each pill costing from 41-71 cents. Finerenone is anticipated to cost north of one dollar per pill and can be taken twice a day. My analysis concludes to reach one billion in sales, Finerenone only needs to capture 5% of the American market. Without including revenues from the rest of the world, we can comfortably say that Bayer is understating the size of this opportunity.
Consumer Health
Bayer’s Consumer Health (CH) segment provides products, services, and information to improve their health. Bayer is the #3 OTC player globally, with leading positions in seven of the top ten OTC markets. In addition, CH focuses on non-prescription products in the following markets.
· Allergy, Cough & Cold
· Nutritional’s
· Dermatology
· Pain & Cardio
Some marquee products include Aspirin, Claritin and Aleve. These and other OTC products generate ~5 billion EUR in revenues. CH has achieved a growth rate CAGR of ~2% over the past five years; however, CH has grown at 5.2% in the past year and achieved EBITDA margin expansion from 20.1% in 2018 to 22% in 2020. CH plans to continue its focus on preventative care and expand its sales and product lines globally by more effectively leveraging e-commerce and marketing its products. Geographically Bayer is investing in developing a stronger brand presence in the USA, India, China and South-East Asia. By expanding in these geographies, Bayer can tap a lucrative source of profits. The CH segment is reducing costs through production cost efficiencies, implementing cost-cutting programs at factories and office facilities, and limiting investments into Capex, opting for a more variable cost structure.
Financials
Bayer has a strong balance sheet with ~55% of capital provided by debt. Bayer intends to pay down their debt; however, under my assumptions, this is improbable unless Bayer cuts their dividend. Bayer maintaining more debt on their balance sheet is a positive for equity investors; Bayer’s pre-tax average cost of debt is ~3.45%, and Bayer recently rolled debt at lower rates. Bayer benefits from global reach, allowing access to markets where credit is cheaper – mainly Europe. With Bayer’s cost of debt low, low exit risk, and revenue visibility into the following three years, why would equity investors want to reduce the use of debt?
Over the past five years, excluding the pandemic, Bayer has grown its revenues rapidly, increasing by 5% in 2018 and 19% in 2019. Growth has mainly come from Crop Science as post-acquisition of Monsanto; Bayer received a solid portfolio of seeds and CP products from which it could develop. As a result, Bayer has maintained a 63% groupwide gross profit margin over the past few years, down from 68% it maintained during 2016 & 2017, caused by CH, which was a drag on margins over the past two years.
Since 2018 even with rising sales, Bayer has failed to earn their cost of capital. Bayer’s cost of capital is 6.8%, earning a ROCE of 3.8%, 5.0% and -39.8% in 2018, 2019, and 2020, respectively. Bayer is on track to earn its cost of capital in the future due to significant cost savings measures and finishing up a restructuring program increasing net income.
My model using below consensus revenue growth for all segments shows that Bayer is undervalued. Bayer will benefit from multiple secular tailwinds and is well-positioned to grow in the crop science and consumer health markets. However, I believe that Bayer’s Pharma segment will represent a drag on revenues resulting in a five-year revenue CAGR of 1.36%. In my base case, EBIT margins slightly shrink from 2020-2027; Bayer cuts back on Capex while annual depreciation and amortization hover around 5% of gross property plant and equipment. I have used a 1.5% terminal growth rate when valuing the firm using Gordon growth and a 10x EBITDA exit multiple under the multiples method. I wanted to be very conservative with my financials for two reasons; first, Bayer is out of my comfort zone; second, Bayer has a history of disappointing expectations set at capital markets days. The result of my valuation revealed that Bayer is undervalued by ~17% as of May 10, 2021. I believe that the fair value for Bayer is around 63 euros per share.
Please see the linked spreadsheet.

I’m curious if anyone else preps for jobs the way I do, I have worked in the industry for years and I always pack the following in a solid black backpack (and my truck).

1 - Various medicines including Tylenol, Tylenol Extra Strength, Advil, Advil Extra Strength, Aleve, Aleve Extra Strength, Motrin, Motrin Extra Strength, Bayer Ibuprofen, PeptoBismal LiquiCaps, DayQuil, DayQuil Non Drowsy Extra Strength, Robatussin, Mucinex, Mucinex Cold and Flu, Vick’s Vapo Rub, Vick’s Vapo Pads, Sudafed, Afrin Nasal Spray, Cleratin, Zyrtec, Allegra, Benadryl, Gas-X, Dramamine, Zantac, Prilosec, Tums, Ducolax, and Imodium

2 - a small first aid kit, as well as a large automotive first aid kit in the car, a large water accident first aid kit in the car, and a roadside kit in the car, including an extra jump start battery.

3 - Various additional first aid kit supplies like extra bandaids and various gauze pads.

4 - An Extra Knife Roll with knives I keep sharpened at all times.

5 - A portable Whetstone Kit and an extra honing Steel.

6 - Two extra pairs of padded socks, and two extra pairs of fast drying socks for dishwashing.

7 - An Extra pair of underwear, and two extra cotton dress shirts, one white, one black. One extra lightweight polyester shirt.

8 - An Extra pair of chefs pants, a pair of pressed slacks, a black dress shirt, and a white dress shirt. At minimum one extra chefs jacket. (these all stay in my car)

9 - An assortment of three to four ties for my shirts. An extra chefs hat, and a few baseball caps.

10 - Extra contact lenses, have to switch these out occasionally, as well as a pair of prescription sunglasses, and an extra pair of prescription glasses Incase I’m in a hurry and forget my contacts. I also now after pandemic days keep glass anti-fog Spray in my backpack.

11 - I keep a bus pass for my city, in my backpack, never know when it’s the only thing that will remotely get you home.

12 - I keep an old flip phone fully charged, it can still dial 911 even with no service. (though I spend the $10 a month to keep it connected)

13 - I keep four boxes of extra large food safe nitrile/vinyl gloves in my car, and a fifth box in my backpack.

14 - I keep an extra cutting glove in my backpack.

15 - I keep a cold weather vest, windbreaker, and heavy jacket in the car, as well as a sweater, and both sweatpants and shorts in the truck.

16 - I keep a pair of nice cowboy boots, a pair of tennis shoes, an extra pair of berkenstock clogs, and a pair of black dress shoes and a pair of brown dress shoes in the truck. I also keep a pair of sandals and some simple black crocs in the truck.

17 - I keep at minimum a pack of mints, and a pack of juicy fruit, and peppermint or spearmint gum in my backpack.

18 - I keep a toothbrush, comb, electric shaver, and manual shaver, as well as comb, nose hair trimmer, toenail clippers, fingernail clippers, and a nail file in the truck.

19 - I keep toothpaste, mouthwash, toothpicks, and floss in the truck.

20 - I keep several protein bars and snack bars in both my backpack and the truck.

21 - I keep a 3’ cord, 6’ cord, 9’ cord, and 12’ cord in both lightning and microUSB versions. I also keep a car charger in my truck and one in my backpack.

22 - I keep both unmedicated Body Powder and Medicated Body Powder, deodorant (antiperspirant), Body Spray, and cologne in my backpack.

23 - I keep a portable Bluetooth speaker, and two portable battery’s to keep things charged.

24 - I keep a large radio/speaker in the truck.

25 - I keep a binder in the truck with a copy (I have originals in a binder at home) with all paperwork ever provided to me from my employer.

26 - I keep all Clock in/out stubs on a spike that sits in my center console.

27 - I keep various tapes, scissors, highlighters, Dry board markers, permanent markers, pencils, mechanical pencils, and assorted pens in both my backpack and a box in my truck.

28 - I keep a few different fast food gift cards and cash, along with an emergency credit card that I keep with a zero balance at all times in my truck.

29 - I keep a few different pocket knives, a survival kit, and a case of bottled water in my truck.

30 - I keep three different length ropes in the truck, along with a tiedown kit, and various bungie straps.

31 - I keep a journal for recording all the shitty stuff that happens so I can write it down while it’s fresh on my mind.

32 - I keep an updated resume, generic cover letter, references, and a list of my certifications, trainings, licenses, degree, etc... at least ten copies in a folder for when my boss finally crosses the line. I also keep a generic resignation letter written to be filled in with the same days date for when it’s just gone too far.

I’ve never encountered issues I couldn’t face. My “work kit” has grown over the years with experience, but it’s served me, and several coworkers well over the years.

My Theory: Syntex was a pharmaceutical company that went out of business in 2008. They were located at Stanford Research park which is in you area. They made naproxen which helped treat pain but is also had propionic acid in it and it was taken orally. Naproxen, sold under the brand name Aleve among others, is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain, menstrual cramps, inflammatory diseases such as rheumatoid arthritis, and fever. It is taken orally. So maybe Syphus is the last person who is in the company who is trying to get something back. This is because the undercover person said that he was the last one. That is my theory so far. I didn't piece it together all of the way though.

I see all sorts of different OTC pain meds. Aleve, Tylenol, Advil, Bayer, etc. And then you have back & body, arthritis, migraine, sinus pain. How many differences can there be?