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Severe acne

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He's 17, has severe acne, very shy about going into public, his back hurts so much from the acne it's hard to sleep sometimes. He just started the lowest dose of accutane. I don't want to scare him without a solution. I've heard bad things about accutane. Is the damage permanent? Are there efficacious alternatives? Evidently, he's tried everything else without success.

 

What are some alternative treatments? Supplements? Would mild sun exposure help? Can he get some mild sun exposure while taking accutane?

 

Thank you,

 

-John

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I've heard a lot about accutane unfortunitly I don't remember much. I just remember some boy in the news paper changing the name of it around to make it sound more like what it is.

 

As far as your questions go, if he was prescribed accutane would they not have told him what he can and cannot do?

 

A lot of people may completely disagree with me here, but tell him to try taking 250-500mg of niacin a day, ot higher dose of B-complex. I've noticed that niacin alone helps with the skin very well, and when I did take it my acne disappeared. No idea if flush or nonflush will have any different of an effect, but I always used flush as well as anyone I suggested this to.

 

 

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My daughter has someone else's liver because of accutane. She also has knee problems from playing competitive golf and carrying the clubs and walking the courses with no fluid in her knees. Yes it works, but the costs are way too high. Get him off the stuff NOW!

 

Lasers do a great job, but they were not in as much use then as now. If only we had known mad.gif

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Pantothenic Acid (B5) I think has a lot of anecdotal support for dealing with AAS/PH related acne, bacne specifically. I've never spent much time investigating the science behind the "brotelligence" but it would appear that there may actually be some

 

Med Hypotheses. 1995 Jun;44(6):490-2.

Pantothenic acid deficiency as the pathogenesis of acne vulgaris.

 

For years, the pathogenesis of acne vulgaris has been known to be strongly influenced by hormonal factors. However, the exact role of and the interrelationship among the various hormones in question have not been well elucidated. Here, I wish to suggest a radically different theory for its pathogenesis and relate its basic pathology to a deficiency in pantothenic acid, a vitamin hitherto not known to cause any deficiency syndrome in humans. Hence, the effect of hormonal factors in this disease entity becomes secondary to that of the availability of pantothenic acid. A complete cure of this condition is effected by a very liberal replacement therapy with the vitamin.

 

 

The odd thing is that Pantothenic Acid gets its name because its found almost everywhere and clinical deficiencies are almost unknown. That being said, its also cheap and essentially non-toxic and tolerable in multi-gram doses so a litle experimentation might be in order.

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Run a search on Accutane and look for the official site. Then look at the prescribing information. It should help to answer some of your questions.

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I developed severe nodular acne when I was about 14 and it was so bad on my scalp, shoulders, and back (my facial acne was never severe) that I often found it difficult to sleep and painful to shower. I saw a dermatologist and he prescribed tetracycline and then minocycline, both of which worked only marginally.

 

I credit accutane for curing my acne problems. I still get pimples (I am 21), but no worse than anyone else my age with high test levels, and they are usually small bumps rather than the large nodules I got when I was pubescent. Accutane began workin in just a few months and for several years following I had no acne to speak of whatsoever.

 

I realize that Accutane fucks you up in a lot of ways but I escaped with no long-term ill effects and to me it was a miracle drug. I shudder to think of how painful and virginal my teenage years would have been if I had not had the isotretinoin treatment. If your friend has serious nodular acne and other methods have not proven effective, he should go on Accutane without reservation. They naysayers have no clue how bad it is to have a disfiguring disease.. I liken it to "Who cares if he's dying and in inexplicable agony? Morphine is bad for you! He might get addicted!"

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A lot of people may completely disagree with me here, but tell him to try taking 250-500mg of niacin a day, ot higher dose of B-complex. I've noticed that niacin alone helps with the skin very well, and when I did take it my acne disappeared. No idea if flush or nonflush will have any different of an effect, but I always used flush as well as anyone I suggested this to.

249466[/snapback]

 

I agree with you on this. When I started taking regular niacin (aka nicotinic acid, and it has no relation to nicotine), I noticed some subtle, positive changes in my skin (upper body, shoulders and above). Another friend of mine who I got to try it said he grew a little more hair back and a few others have noticed as well. Not because of the niacin alone, but we suspect the increased circulation in his scalp may have helped his propecia to work better.

 

I don't think the niacinamide version (the original flush-free version) will give you any of the benefits. There is a second flush-free version that is inositol hexanicotinate (I think that's right), it supposedly does not release the niacin until it gets to your bloodstream. They claim that it is a very slow flush. I like something that TELLS me if it's working. Niacin is one of those vitamins (by the way it used to be called B3, if you didn't already know).

 

Has anyone else ever heard of aromatization (estrogen!) causing acne? Some people have claimed this is true, but no hard evidence. At his age, his test levels are peaking or will peak soon. I wonder if he has sensitive nips, or if there are any classic signs to look for to help determine if an estradiol test is needed.

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Currently I have my gf on no-flush niacin. Her acne is not severe whatsoever, but she still gets frustrated so we're trying it out. smile.gif. After a week of use i've noticed practically no knew acne has surfaced, and her skin is becoming a lot more clear and free of redness/dryness.

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I’ve herd about Pantothenic Acid (B5) people would take up to 2grams first week to load up and then decrease the dosage to about ~1gram this proved productive however they were on a ph cycle while implementing this.

 

Perhaps Benson could dig up literature or anecdotal reports on the dosing of it.

Personally, In your case I would suggest starting out in small doses and increasing overtime while evaluating results.

 

Niacin is also found in Powerade drinks so he can drink that during the day.

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Perhaps Benson could dig up literature or anecdotal reports on the dosing of it.

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The medical literature is scant. The review/tutorial I posted above is about it.

 

As for anecdotal information. There is a thread from a year ago in this very forum...try "acne" in the search engine.

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What are some alternative treatments? Supplements? Would mild sun exposure help? Can he get some mild sun exposure while taking accutane?

249346[/snapback]

 

b5 at doses up to 10g/d does nothing for my hormonal acne.

 

accutane helped. my side effects were just bright red skin from about 30minutes of sun exposure (driving and walking around campus) and thin skin (still have some scars from running into things) - i would not get any extra sun, although it may help if he is not on accutane.

 

i heard that vinegar applied topically helps. i've been trying it for about a week and it hasn't reduced the redness, but the size/pain and pus factor has gone down significantly (but no where near completely). just ancedotal though.

 

 

 

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I tried b5 at 5g/day for my damn bacne. It helped a bit, but was not a miracle by any means. The only thing that gets rid of my acne completely is sunlight.

 

After about 2 weeks of being on mega-dose b5 I was having insanely dry eyes. I thought that b5 was doing it and after I stopped my eyes got better and the back acne came on again hardcore.

 

I think I am going to have to try the 250-500mg of niacin. I am prone to flush with only 100mg of niacin, so I am going to have to work up to 500mg. Acne sux.

 

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B5 was a miracle on my facial acne and it was not used while on androgens. I had acne problems trhoughout my life getting prescribed retina and benzaclin with no results. I asked my demotologist about b5 and he said fighting acne internally with b5 would not work.

 

I tried only about 1.5 grams a day and in 2 weeks I started to see almost no more pimples and white heads which are a bitch to me were almost non -existant. After about a month the redness on my face started to decrease. Since some say it doesn't work, maybe it worked for me because my acne was caused by emmence oil production and sweat. Going out for 3 hours and back in cool weather, I would have so much shine on my face.

 

One thing I noticed that my brother concered is after using B5 for a week, when sweating, the sweat seems cleaner. Usually feeling dirty and disgusting from all the oil, the oil seemed thinner and cleaner.

I’ve herd about Pantothenic Acid (B5) people would take up to 2grams first week to load up and then decrease the dosage to about ~1gram this proved productive however they were on a ph cycle while implementing this.

 

Perhaps Benson could dig up literature or anecdotal reports on the dosing of it.

Personally, In your case I would suggest starting out in small doses and increasing overtime while evaluating results.

 

Niacin is also found in Powerade drinks so he can drink that during the day.

249682[/snapback]

 

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Get him off the accutane IMMEDIATELY.He is 17,his acne will fade,the long term side effects of the accutane may not.He seems to have a more severe case than most go thru,but pretty much everyone goes thru an 'acne phase' while growing up.

I will include some accutane info below.The first part deals also with a few other nasty drugs that should have never been allowed to pass by the fda.There is too much information both anecdotal and scientific referring to its links to liver damage,suicide/depression,vision damage,etc that its just not something one should take,period,imo.

 

As far as other treatments.

There are some that are nonresponders,but some that respond very favorably to high dose b-5 treatment.Work up slowly so as to avoid gastric upset,but work up to a solid 10g per day and stick with that dose for at least a few weeks to gauge its effectiveness.If it works for him,he should be able to decrease to a maintainance dose after a while.Its quite inexpesive so that should be no problem.

People that claim diet has no affect on complexion are idiots.I would advise him to get some food allergy tests done and avoid what he is allergic to as that can cause outbreaks in his skin.

Supplementation to his diet is imperitive.Have him stock up on omega 3 fishoil supplements.At least 5g per day if not double that.Again,relatively cheap,everyone should have these as a staple in there diet anyways imo.Make sure he is taking a solid multivitamin/mineral as a deficiency in any of them can cause skin problems(not to mention a host of other problems)I like the NOW brand multi Vita min 75+ it has a high dose of b vitamins in it otherwise I would advise taking a separate b complex.Perhaps addition of rala/milk thistle would be advisable for a few reasons.One-rala is supposed to be quite good for the skin in and of itself and 2-Both supplements are going to detox his liver which will be beneficial for his skin and overal health once it gets flushed out.

Make sure he drinks LOTS AND LOTS(at least 3/4-1 gallon per day)of water to flush all the nasty shit out of his body vs flushing it out thru his skin via acne.

I would also get his thyroid hormone levels tested,see how thats working.An out of whack thyroid can cause skin problems thats for sure.

I appreciate the tip on the flush form of niacin,ill keep that in mind for future use.

Definately get him to get some good solid sun exposure every day or go to a tanning booth.

Also Coprolith do u have any studies or links for that info relating to guggles for acne?

 

Nov 18, 11:10 PM (ET)

 

By DIEDTRA HENDERSON

 

WASHINGTON (AP) - At least five medications now sold to consumers pose such risks that their sale should be limited or stopped, said a government drug reviewer who raised safety questions earlier about the arthritis drug Vioxx.

 

In testimony Thursday before the Senate Finance Committee, Food and Drug Administration reviewer David Graham cited Meridia, Crestor, Accutane, Bextra and Serevent. Drug makers defended the use and safety of their products.

 

Graham contended the country is "virtually defenseless" against a repeat of the Vioxx debacle. Dr. Steven Galson of the FDA rejected that comment as having "no basis in fact."

 

Accutane's best-known risk remains birth defects so severe that doctors are supposed to ensure women use not one but two forms of birth control while taking it.

 

Depression has been listed as a possible side effect on Accutane's label since 1986, and the FDA in 1998 strengthened the warning to say suicide, too, was possible. The suicide link gained wide attention in October when a Michigan congressman, Democrat Bart Stupak, blamed his 17-year-old son's suicide on Accutane -- and charged that patients and families aren't warned about the risk, which appears in the fine print of drug labels that many consumers never receive.

 

There is no scientific proof that Accutane causes depression or suicide, the FDA cautions. But the agency has received 66 reports of suicides among Accutane users or former users.

 

Many could have been depressed before taking Accutane or despite it, nor does Accutane seem to cause the brain chemical changes necessary to spark depression, Harvard University suicide expert Dr. Douglas Jacobs, a Roche consultant, told Congress. Also, of the estimated 1 million teen-agers who suffer depression, 2,000 commit suicide each year whether they take medication or not, he said.

 

Still, the FDA is concerned that the depression of a few patients eased when they quit Accutane, but came back the next time they took the drug. So it is working with Roche and the National Institutes of Health to study if the link is real or a coincidence.

 

 

 

Merck & Co. (MRK) pulled Vioxx from the market on Sept. 30 after a study indicated the popular painkiller doubled the risk of heart attacks and stroke when taken for longer than 18 months.

 

The committee chairman, Sen. Charles Grassley, suggested an independent board of drug safety may be needed to ensure the safety of medications after FDA approval. An "awful lot of red flags" were raised before Vioxx was withdrawn, said Grassley, R-Iowa., and the agency disdained, rather than listened to, its own reviewers.

 

Graham contended that FDA has an inherent conflict of interest that triggers "denial, rejection and heat" when safety questions emerge about products it has approved.

 

In his view, the five most worrisome drugs that demand speedy action:

 

_Meridia, a weight-loss drug. He said the agency should consider whether its benefits outweigh the risks of higher blood pressure and stroke among people taking it. "I don't think Meridia passes that test," Graham said.

 

_Crestor, an anti-cholesterol drug. He said the government should evaluate the occurrence of renal failure and other serious side effects among people taking Crestor. Two of three other statin competitors prevent heart attack and stroke and do not cause renal failure, he said.

 

 

(AP) Vioxx's maker, Merck & Co. pulled the drug from the market on Sept. 30 after a study indicated the...

Full Image

 

 

_Accutane, an acne drug linked to birth defects. Graham said the drug represents a 20-year "regulatory failure" by the FDA and sales should be restricted immediately.

 

_Bextra, a painkiller. Graham said the drug poses the same heart attack and stroke risk as Vioxx. He recommended designing studies to look at the drug's cardiovascular risks.

 

_Serevent, an asthma treatment. He said the drug was shown, with 90 percent certainty in a long-term trial in England, to cause deaths due to asthma. GlaxoSmithKline, told by the FDA to do a large, clinical trial, begged off. "We've got case reports of people dying, clutching their Serevent inhaler," Graham said. "But Serevent is still on the market."

 

Galson, acting director of the FDA's Center for Drug Evaluation and Research, said the agency already has taken steps to alert consumers to those drugs' safety concerns. That includes heightened warnings for Serevent; a tougher risk-management plan to ensure pregnant women don't use Accutane; and an upcoming advisory committee hearing regarding Bextra.

 

"Each of these do have special safety issues, but they're under evaluation and we're watching them carefully," Galson said.

 

Tim Lindberg, a spokesman for Abbott Laboratories, said "science continues to support the safe use of Meridia to treat obesity."

 

AstraZeneca PLC (AZN), maker of Crestor, has confidence in the drug, spokeswoman Emily Denney said. "To date, the FDA has not given us any indication of a major concern regarding Crestor," she said.

 

Carolyn Glynn, spokeswoman for Roche Holdings AG, a maker of Accutane, acknowledged that the drug carries risk and said it is reserved for serious cases. "This drug is extremely beneficial as long as it's used safely and appropriately," she said.

 

Susan Bro, a Pfizer spokeswoman, said Bextra did not increase the risk of serious cardiovascular events in a recent analysis of nearly 8,000 arthritis patients who took the drug from six weeks to 52 weeks. She said Bextra has been found to be safe and effective when used as indicated.

 

GlaxoSmithKline, maker of Serevent, issued a similar statement about its product.

 

In his testimony, Graham said the FDA's Office of New Drugs unrealistically maintains a drug is safe unless reviewers establish with 95 percent certainty that it is not.

 

That rule does not protect consumers, Graham told the Senate committee. "What it does is it protects the drug," he said.

 

Grassley accused the FDA of attempting to intimidate Graham. Sen. Jeff Bingaman, D-N.M., urged President Bush to name a new leader at the FDA, where Lester Crawford is the acting commissioner.

 

Graham said he fears continued intimidation.

 

"I was frightened before," he told reporters after the hearing. "Senior management at the FDA did everything in their power to intimidate me prior to my testimony," he said.

 

Patients taking Accutane may develop potentially serious problems affecting a number of organs, including the liver, intestines, eyes, ears, and skeletal system. And some patients taking Accutane have developed serious psychiatric problems, including depression. More rarely, patients have developed suicidal behavior and killed themselves even years after taking the drug.

 

 

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Whatever happened to using hexachloraphene ?

 

 

Drinking lots of water is definately a good idea as is lots of sweating, a little sun, and chlorinated pool water.

 

Sometimes it pays to stop consuming your normal foods one at a time to see if one of them is aggrevating the condition.

 

I have noticed that guys tend to be too rough on their skin. Astringents and too much BP can irritate and swell the skin, trapping even more than usual. I once roomed with a guy who used mass products every night till his whole face was red and shiny like new skin over a wound (essentialy it was), but he would not open and drain any of the larger ones (they spread! they spread!) and could not find time to wash his face during the day.

 

Both my brothers had acne, one quite severe. My acne was limited. I have always washed my acne gently with LAVA soap (God I love that stuff!), coincedence???

 

Oh, and I have been on a high protein diet since I was a kid (30 years now).

 

 

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Here are a few options, some of which have already been mentioned:

 

- High-dose vitamin B-5. Have witnessed first-hand many successes.

 

- Gugguls. Not enough evidence to say for sure, but have had some anacdotal reports of success.

 

- Tea Tree Oil (pharmaceutical grade undiluted). Has a strong smell but very effective.

 

- Witch Hazel. Cheap and available at any supermarket near the rubbing alcohol.

 

- Salicylic Acid. Common component in many astringent/face cleanser products.

 

- Zinc Oxide. Found in diaper reash creams. Doesnt absorb in completely colorless, so may need to relegate for home use only.

 

- Frequent bathing.

 

- Estrogen levels may be an issue, but I would be careful about attempting any hormonal manipulations at first.

 

- Water

 

Accutane is very harsh. It burdens the liver and causes severe dryness and soreness in the lips, eyes, etc.

 

Peace.

 

 

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John,

 

Sorry to hear of your son's troubles. I suffered through the same cystic acne back before Accutane was released. I took it when it first came out, already into my 20's, I think. As far as I was concerned, the stuff is a miracle drug.

 

Yes, there can be severe side effects. You have to watch out for them. Media reports notwithstanding, I believe I recently read of study which showed a LOWER incidence of suicide among Accutane users than the general population. The sample was pretty large, too.

 

If I had to treat the cystic acne all over again, I would opt for a a mid-range dose. I believe it's calculated in terms of mg per kg body weight. If you go too low, you may need a second course after a year or two. I did. Depending on his weight, he may need to take two capsules one day, then only one the next, and so on.

 

Hexachlorophene, in the form of PhisoHex (yes, it's still available!) is a great idea. I used it on a recent trip to India because my lover worked in a hospital and I kept picking up nasty staph abcesses from him. On the third trip I used PhisoHex and no more abcesses.

 

Another avenue to explore is intra-nasal Bactroban. The nose harbors staph bugs and this is an antibiotic ointment which kills the buggers on the boogers. I believe the generic name is mupirocin.

 

I'll close by offering a bit of reassurance you can pass on to your son: It's what's on the inside that counts.

 

Let's hope he doesn't reply as my brother did when I reminded him of that fact; "Yeah -- pus!"

 

Jim

 

 

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I noticed a clearing of facial acne and bacne when using Pyritinol (a B-6 derivative) for a month. It happened to be one of only two supps I was taking at the time so I'm pretty sure it was this as I doubt HuperzineA would have such effects. I googled it as I wasn't sure of it's base B form and it mentioned at the first site I check that it helps in ""enhancing the immune system (by improving neutrophil activity, the white blood cells that kill germs)." Perhaps this is the mechanism that enacted my acne cessation (nodule ~once a month, and rampant otherwise, so rather drastic improvement I'd say). Minocycline did nothing for me, fyi.

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If an increase in "white blood cells that kill germs" is a cause for concern about intestinal flora then...

 

Well, I'm not sure. Anyone? (Can blood comp affect intestinal flora comp in this case? or any?)

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He's 17, has severe acne, very shy about going into public, his back hurts so much from the acne it's hard to sleep sometimes. He just started the lowest dose of accutane. I don't want to scare him without a solution. I've heard bad things about accutane. Is the damage permanent? Are there efficacious alternatives? Evidently, he's tried everything else without success.

 

What are some alternative treatments? Supplements? Would mild sun exposure help? Can he get some mild sun exposure while taking accutane?

 

Thank you,

 

-John

249346[/snapback]

 

Sounds like he's got a really bad case of acne. If he's already been on oral antibiotics with no sucess (bactrim and minocycline are the more effective ones), accutane would be his best bet. Just make sure he gets his triglyceride levels and liver values checked periodically. Dermatologist usually run these tests once in 3 mths. If you're really concerned with the side effects, get him to do these tests monthly.

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Why is nom one mentioning the use of certain lasers? These have been shown to be as effective as accutane. I forget if it is V-beam or Smooth Beam types, but a colleague of mine has picture after picture of amazing results... at least as good as accutane for 50% of the price. If you do not have a drug stipend , it will cost in the thousands for a full course.

 

Yes accutane has been linked to my daughter's liver transplant, but we were told this could happen when we signed the consent. We never dreamed she would be the one in a million to have this happen. If there is any other way, no accutane. She will take anti rejections the rest of her life for this.. and the side effects are not good.

 

Lasers work.

 

G

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I've been on high dose accutane (3x 40mg) for 5 months. My only side effect was dry skin. I have to go through a stick of Chapstick a week, I use facial moiturizer/sunscreen. and I get nose bleeds due to dried out mucus membranes (saline solution helped with that). Other than that, it is great. No acne what so ever anywhere. I had it BAD everywhere on my body.

I get blood tests once a month to test liver values. Nothing rose 'til now at all.

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Im surprised nobody has mentioned topical retinoids. That is one of the most effective treatments for acne. Not as easy as popping Accutane but far less hazardous. Also vigorous scrubbing in the shower with a cactus brush and controlled, regular exposure to the sun. Anything that increases skin cell shedding is going to help.

 

Riker

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Vigorous scrubbing is NOT a good idea for ANYONE with acne!

 

Exfoliation of dead skin cells is only one step towards a treatment, and it can only be taken to a certain degree. You need a protective layer on top of your skin to protect the living cells beneath from the harmful effects of the sun, pollutants, etc.

 

However, topical retinoids are indeed a great help. That "acne regimen based on scientific evidence" routine I posted, though not based entirely on solid evidence, provides a great regimen that strikes a good balance in attacking multiple causes of acne without going overboard.

 

For what it's worth, I'm doing well right now with an antibacterial wash morning and night (AloeGuard), followed by a salicylic acid toner (Olay Daily Facials Clarity), and then a moisturizer w/ SPF (Rachel Perry Cucumber Calendula). These are all products recommended at the site I posted. In addition, I find dietary factors to be very important. I don't really have to avoid foods, but adding certain substances does seem to help alot, like yogurt and probiotics, almonds, Boswellin, Salvia, and of course Sesathin.

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