Alzheimer’s, Gut Bacteria and Music

UPDATED 1/17/2016 & 10/22/2016.

 

 

(Source: www.sciencedaily.com)
(Source: www.sciencedaily.com)

 

 

Alzheimer’s is a form of dementia that gradually worsens over time, affecting memory, thinking and behavior – eventually becoming severe enough to interfere with all aspects of daily life. Alzheimer’s involves the progressive loss of brain function, is the most common cause of dementia and the 6th leading cause of death in the US.
In 2013 over 5 million American had the disease. The rates rise yearly and are expected to reach 16 million by 2050.

 

(Source: www.senior-care-resources.com)
(Source: www.senior-care-resources.com)

 

Some information from the Alzheimer’s Association (2014):

alzheimersquickfacts

 

The presence and progression of Alzheimer’s is clearly visible in brain scans:

 

Brain Scans

(Source: blog.otka.hu)
(Source: blog.otka.hu)

 

 

 

 

ALZHEIMER’S IS AN AUTOIMMUNE DISORDER

Although many believe genetic make up is the primary cause of Alzheimer’s, research is discovering that Alzheimer’s is actually an autoimmune disease that has become epidemic in the US. Remember: Although you may have a genetic susceptibility to an autoimmune disease, you do not have to allow your genes to express that predisposition.
In announcing her Autoimmune Summit: Helping you Reverse and Prevent Autoimmune Disease, prominent functional medicine doctor Amy Myers, MD, author of The Autoimmune Solution: Prevent and Reverse the Full Spectrum of Inflammatory Symptoms and Diseases, wrote:

Based on twin studies, we now know that 25% of autoimmunity is genetics, and the other 75% is environment. I believe there are 5 main environmental factors that contribute to autoimmunity: leaky gut, diet, stress, toxins, and infections. Every one of these is a piece of the pie–for some, one piece may be bigger–but all play a role to some degree. (Myers, 2014) (Myers, 2015)

 

 

81p3gdeyEsL

 

Researchers are discovering a causal relationship between an imbalanced gut microbiome (gut dysbiosis) and a growing number of conditions and diseases – for example, acne, allergies, asthma, celiac disease, chronic Lyme disease, Crohn’s disease, diabetes, Graves disease, gum and tooth disease, irritable bowel, lichen planus, lupus, multiple sclerosis, psoriasis, rheumatoid arthritis, UTIs, all the other 80-100 autoimmune diseases, and some cancers. See Autoimmune Disorders for more information.
Serious memory loss, as with Alzheimer’s, has also been found to be related to gut bacterial imbalances.
“Autoimmune diseases can affect almost any part of the body, including the heart, brain, nerves, muscles, skin, eyes, joints, lungs, kidneys, glands, the digestive tract, and blood vessels.” (National Institutes of Health, 2012)
When the micro-organisms living in the gut  become out of balance, inflammation develops – and chronic inflammation is the hallmark of all autoimmune diseases.  Which organ or system in the body becomes targeted likely depends on your genes. But having the predisposition doesn’t mean you will necessarily develop an autoimmune disease in that organ or system.
If you keep your gut microbiome healthy and balanced, you can greatly increase your chances of living a long, productive life into old age. See Is It Necessary to Express an Inherited Trait? for more information.

 

 

(Source: bretcontreras.com)
(Source: bretcontreras.com)

 

Ten years ago D’Andrea, an immunology researcher in the Drug Discovery section of Johnson and Johnson Pharmaceutical, reviewed the causes of Alzheimer’s and published an article entitled Add Alzheimer’s disease to the list of autoimmune diseases in which he concluded “… these observations suggest autoimmunity-induced cell death in AD.” (D’Andrea, 2005)

 

(Source: anguishedrepose.com)
(Source: anguishedrepose.com)

 

 

 

 

A GENETIC PREDISPOSITION FOR ALZHEIMER’S

A few possible genetic predispositions for Alzheimer’s have been identified by researchers. Here’s information about the most recent discovery:
Using new sequencing techniques, a team of researchers working at 44 institutions around the world under the auspices of the Mayo Clinic recently discovered a gene that nearly triples the risk of developing Alzheimer’s. The gene is TREM2. The researchers’ work found a set of rare variants in TREM2 that occurred more often in a group of 1,092 Alzheimer’s patients than in a control group of 1,107 healthy people. The most common of these variants, R47H, was evaluated in follow up studies of a much larger number of Alzheimer’s patients and controls. TREM2 was found to be present in 1.9% of Alzheimer’s patients and only 0.37% of controls.
The researchers concluded that not all people with the R47H variants in their TREM2 gene will develop Alzheimer’s and other genes and environmental factors will also play a role in those who do.
One of the study’s authors, Dr Rosa Rademakers, says, “The variant found in our study identifies a fascinating new Alzheimer’s disease gene,TREM2, which is involved in the immune system. This fits well with other evidence linking the immune system to Alzheimer’s disease….”
Another of the study’s authors, Dr Stephen Younkin, says, “There is a broad consensus that prevention will be the best way to manage Alzheimer’s disease.” (Science Daily, 2012)

 

(Source: www.deepakchopra.com)
(Source: www.deepakchopra.com)
In reading the information above, please remember:
  • 25% of autoimmunity is genetics and the other 75% is environment
  • The immune system is involved in the development of Alzheimer’s disease
  • Like other autoimmune diseases, Alzheimer’s develops after years of chronic inflammation
  • And chronic inflammation can be prevented by keeping the micro-organisms in your gut microbiome healthy and balanced

 

(Source: geneticsawareness.org)
(Source: geneticsawareness.org)

 

 

 

 

 

ALZHEIMER’S AND VITAMIN D DEFICIENCY

 

 

(Source: www.healthbyharvey.com)

 

 

New research has found that older adults who have a severe vitamin D deficiency also have a 125% increased risk of developing Alzheimer’s. Vitamin D provides many benefits to our health. It is a vitamin that acts as a steroid, a neurosteroid hormone in this case, and could be a potential biomarker of Alzheimer’s disease.
The authors of a 2014 article about vitamin D and Alzheimers wrote, “Finally, in addition to the current knowledge that defines AD, we suggest that AD could be the result of a long-term hormonal imbalance in which the critical hormone is vitamin D… ” (Gezen-Ak, 2014)

 

(Source: hl123.blogspot.com)
(Source: hl123.blogspot.com)
The vast majority of Americans are vitamin D deficient. A 2000 study published in the Archives of Internal Medicine reported that 77% of Americans are vitamin D deficient.
(Source: simplygreenandhealthy.com)
(Source: simplygreenandhealthy.com)
Personal note: Since I live in NYC, spend most of my time inside and wear clothing when I’m outside, I’m never going to be able to get enough vitamin D from exposing my skin to the sun. So I take a D3 supplement – 5,000 iu in the summer months and 5,000-10,000 iu in the darker months – and have my vitamin D blood levels tested once or twice a year. The particular supplement I take is D3 5000. It’s made by Metagenics, is high potency and provides fully bio-available D3 (as cholecalciferol).
1/17/2016 UPDATE:
It’s important to have your 25 hydroxy-D blood level checked to make sure your blood level of vitamin D isn’t TOO LOW or TOO HIGH … both are problematic.
Dr Robert Mercola included this chart in a 5/10/2015 article called The Real RDA for Vitamin D Is 10 Times Higher Than Currently Recommended, which I recommend reading.
(Source: Mercola.com)
(Source: Mercola.com)
10/22/2016 UPDATE:
A more recent 25 hydroxy-D blood level check found that my Vitamin D blood level was too high. (Perhaps I’d underestimated the amount of D3 I obtain from my diet.) So I’m now taking 5,000 iu once a day (after breakfast) in the darker months and the same amount every other day in the sunnier months. The next blood test will let me know if that schedule is working well for me.
The high quality D3 supplement I like and take is Metagenics D3 5000 – purchased online from Amazon.

 

In taking nutritional supplements, it’s important to look for ones made by companies that produce high quality products. These often cost a bit more than the brands you’ll find at chain drugstores. Bio-availability is the amount of a drug or supplement that is physiologically absorbed from a given dose – as distinct from its chemical potency.

 

 

 

ALZHEIMER’S AND OMEGA-3 SUPPLEMENTATION

 

Omega-3-Alzheimers

Scientists have observed lower than normal concentrations of an omega-3 fatty acid, docosahexaenoic acid (DHA), in the brains of people with Alzheimer’s disease. DHA is critical to brain health and function throughout our lives – including in utero, when omega-3 and other essential polyunsaturated fatty acids accumulate in the developing fetus’ central nervous system.
Omega-3 fatty acids are essential to a wide variety of bodily functions – including control of blood clotting, building cell membranes in the brain, and reducing inflammation.
A team of Swedish researchers who were looking into the causes of Alzheimer’s, observed that oral supplementation with omega-3 essential fatty acids (EFAs) passes through the blood-brain barrier and has a highly beneficial effect on brain functioning – as well as on reducing inflammation throughout the body. (Scutti, 2013)
(Source: theadplan.com)
(Source: theadplan.com)
The human body doesn’t make omega-3 fats so we must obtain them from our food and high quality nutritional supplements.

 

 

 

 

 

ALZHEIMER’S AND THE GUT MICROBIOME

 

 

(Source: biomeonboardawareness.com)
(Source: biomeonboardawareness.com)

 

Science is gradually coming to understand the important functions the 4+ pounds of non-human micro-organisms living inside our intestinal tracts (the gut microbiome) have on the whole range of our physical and mental health.
The number of microbial cells living in the average healthy human adult’s body outnumbers its human cells 10 to 1. This means we are only 10% human and 90% other. Disruptions in the composition and balance of these microbial communities cause digestive disorders, acne and other skin conditions, tooth and gum disease, multiple sclerosis, allergies, and all the 100 or so autoimmune conditions and diseases – including Alzheimer’s.

 

 

slide_8

For autoimmune conditions and diseases, it’s clear that appreciating the “25% genetic predisposition/ 75% environmental influence” division of causes described above is of great importance to the prevention and probably even the cure for ALL autoimmunity problems, including Alzheimer’s.
The authors of a recent scholarly article on the GI tract’s microbiome and its link to Alzheimer’s disease wrote:

Accumulating clinical- and scientific research-based evidence is driving our increased awareness of the significance of the human microbiome (HM) to the healthy and homeostatic operation of the human central nervous system (CNS)….  The complex symbiotic inter-relationship between the GI-tract microbiome and its host is strongly influenced by diet and nutrition, and when optimized can be highly beneficial to food digestion, nutrient intake, and immune health

This is evidenced by multiple findings in common autoimmune, inflammation-linked systemic, and neurological disorders including ALS, anxiety, diabetes, epilepsy, metabolic disease, obesity, rheumatic fever, schizophrenia, Sydenham’s chorea, PD, AD, and other age-related pathologies….

… Westernized societies have very successfully reduced the incidence of microbial-borne infectious disease, while an environment of autoimmune, cardiovascular, metabolic, and neuroinflammatory diseases continues to flourish. We have only recently begun to truly appreciate the potential for complex and beneficial contributions of the GI-tract HM to host genetics, phenotype, and the development and course of CNS disease. (Hill et al, 2014)

(Source: www.drperlmutter.com)
(Source: www.drperlmutter.com)

 

The authors of a recent article discussing the role of the gut microbiome in health and disease – including Alzheimer’s, published in the journal Environmental Health Perspectives, wrote:

Disturbances to the microbial equilibrium of the gut may mean that some microbes become overrepresented while others are diminished. “It’s like a garden—you’re less likely to have weeds growing if you have lush vegetation, but without this vegetation the weeds can potentially take over,” Mazmanian (one of the authors, a microbiologist at the California Institute of Technology) says. When the gut moves toward a state of microbial imbalance, normally benign gut microbes may begin to induce inflammation and trigger disease throughout the body, even in the nervous system.

Researchers have long postulated that gut bacteria influence brain function. A century ago, Russian embryologist Elie Metchnikoff surmised that a healthy colonic microbial community could help combat senility and that the friendly bacterial strains found in sour milk and yogurt would increase a person’s longevity….

“From my perspective, it’s going to be easier to make and sustain changes to the [microbiota] of individuals than to come up with drugs to alter immune pathways,” says Danska (another of the authors, Senior Scientist in Genetics and Genome Biology at the Hospital for Sick Children at the University of Toronto). “I believe that within a handful of years, in countries with high-quality medical care, we will start to see routine administration of well-defined combinations of bacteria to children to prevent autoimmune-mediated diseases.”

 

(Source: bretcontreras.com)

 

 

 

 

 

 

DIETARY STRATEGIES TO PREVENT ALZHEIMER’S (Mercola, 4/27/2014)

 

 

(Source: articles.mercola.com)
(Source: articles.mercola.com)

 

Dr Robert Mercola points out that what we eat greatly effects our risk of developing Alzheimer’s:
  • A diet high in carbohydrates and low in healthful saturated fats has you heading straight towards Alzheimer’s.
  • Research done at the Mayo Clinic showed that a carbohydrate-rich diet is associated with an 89% increased risk for developing dementia. A diet high in saturated fats was found to be associated with a 44%  reduced risk.
  •  A chronically elevated blood sugar level is directly related to shrinkage of the brain’s memory and the development of dementia, including Alzheimer’s. Many in the field now refer to Alzheimer’s as ‘diabetes of the brain’.
  • Women taking cholesterol-lowering statin medications have a 44% increased risk for type-2 diabetes – and having diabetes is known to double your risk for Alzheimer’s disease
  • Even if you already find you’re having “senior moments,” you can regenerate the cells in your brain’s memory center through a process called neurogenesis. This regenerative process requires improving the health and balance of the micro-organisms living in your gut. Cleaning up your diet and supplementing with probiotics are good places to start. 

 

(Source: drjockers.com)
(Source: drjockers.com)

 

Mercola has stressed the benefits of saturated fat for years:

“Conversely, for well over half a century, the media and a majority of health care officials have warned that saturated fats are bad for your health and lead to a host of negative consequences, including high cholesterol, obesity, and heart disease. There’s little doubt that this wholly inappropriate fat phobia has had a lot to do with our burgeoning Alzheimer’s epidemic.”

Others, such as neurologist Dr David Perlmutter, author of the book Grain Brain, strongly agree:

We’ve been led down the wrong road. [Saturated] fat is your friend. You desperately need fat. You desperately need to have good cholesterol in your body. That war on cholesterol is a perversion of the science that was even used to tell us we should stop eating foods with cholesterol…

“We know quite well that in elderly individuals, for example, those in the highest level of blood cholesterol, have about a 70 percent risk reduction for becoming demented. These are the things that are good for the heart. They’re good for the immune system. Cholesterol is the precursor of vitamin D, progesterone, estrogen, testosterone, and cortisol… This is probably one of the reasons why statin drugs are so damaging. You lower cholesterol, and you set the stage for things that are very, very worrisome.”

 

Mercola says this about which dietary fats are good or bad for us:

“The type of fat you eat naturally makes all the difference in the world. Avoid all trans fats or hydrogenated fats that have been modified in such a way to extend their longevity on the grocery store shelf. This includes margarine, vegetable oils, and various butter-like spreads.”

(Source: www.drperlmutter.com)
(Source: www.drperlmutter.com)

 

 

 

Mercola’s chart of healthy fats to add to your diet:

Avocados Butter made from raw, grass-fed organic milk Raw dairy Organic pastured egg yolks
Coconuts and coconut oil (coconut oil actually shows promise as an effective Alzheimer’s treatment in and of itself) Unheated organic nut oils Raw nuts, such as pecans and macadamia, which are low in protein and high in healthy fats Grass-fed meats

 

“Let me make one other important point. Fat, protein, and carbohydrates are the Big Three in terms of food. That said, we’ve got to understand two things: (1) the human requirement for carbohydrates is zero. We require no carbohydrates in the diet, unlike fat and protein. (2) Well beyond the sources of calories that we take in, food is information. The foods that we choose to consume are instructing our DNA in terms of its expression. This is called epigenetics. How empowering is that?”

 

SOME OTHER THINGS THAT REDUCE ALZHEIMER’S RISK

 

 

AVOID FLU SHUTS:

Flu-Shot-Graphic_NVIC

 

The following tips are from an article by Chris Kresser with the to-the-point title How to prevent spending the last 10 years of your life in a diaper and a wheelchair (Kresser, 2011):

AVOID FOOD TOXINS

Avoid foods that are known to be toxic: Industrial seed oils, excess sugar, high fructose corn syrup, cereal grains, processed soy

FIX YOUR GUT MICROBIOME

“Fix the gut. There’s a saying in functional medicine, “Fire in the gut = fire in the brain”. Inflammation in the gut will cause activation of the microglial cells (immune cells) of the brain.”

(Source: empoweredsustenance.com)
(Source: empoweredsustenance.com)

IMPROVE THE BALANCE OF OMEGA-3 TO OMEGA-6 FATTY ACIDS IN YOUR DIET

The DHA in Omega-3 essential fatty acids (EFAs) has been proven to enhance plasticity in the brain while reducing inflammation and neuro-degenerative conditions.
Omega-6 deficiency will result in serious health problems, but this condition is extremely rare in the US because the typical Western diet provides an over-abundance of Omega-6  from corn, soybean, safflower and sunflower oils. Omega-6 oils are heavily used in the food industry because they are cheap, stable, and prolong the shelf life of processed foods.
Omega-6s increase inflammation. Omega-3s reduce it.

0508_omegas

 

EAT ADEQUATE MICRONUTRIENTS

The micronutrients involved in oxygen deliverability to the brain are especially important for avoiding dementia: Vitamin B12, iron, and folate

STAY MENTALLY ACTIVE

Without constant stimulation, brain neurons will atrophy and die. Elderly people who are active and mentally engaged age considerably better than those who retire to watch TV many hours a day

INCREASE BLOOD FLOW TO THE BRAIN

Walking and other exercise does wonders for keeping a good blood flow to the brain. Acupuncture and stress management are also very helpful.
(Source: www.wacha.org.au)
(Source: www.wacha.org.au)

 

 

GET ENOUGH SLEEP

Insufficient sleep sabotages brain health in every possible way.

 

NUTRIENTS AND BOTANICALS THAT PROTECT AGAINST NEURO-DEGENERATION

There are micronutrients and botanicals that are known to protect against neuro-degeneration. They have been shown to prevent – and even reverse – neuro-inflammation and preserve brain function. Almost all the treatments for dementia being studied and reported in the scientific literature are either micronutrients or botanicals, including:
  • DHA – See section on omega-3 EFAs above
  • Huperzine A –  Increases acetyl-choline activity, activates eNOS and nNOS systems (increasing blood flow to the brain) and suppresses iNOS (which causes tissue damage)
  • Vinpocetine – Increases blood flow to peripheral tissues, including the brain
  • Gingko Biloba – Increases blood flow to the brain and promotes healthy brain function via multiple mechanisms
  • Polyphenols like apigenin, luteolin, baicalin, rutin, catechin and tumeric – Reduces microglial activation and inflammation, which protect brain neurons against degeneration
Chris Kresser says about his list:

Please don’t go out and buy a shopping bag full of these and start taking them all. The key is to identify the underlying mechanism and address that. Is it gut inflammation? Is it micronutrient deficiency? Is it blood sugar dysregulation? You’ll make far more progress correcting those problems than you will taking a bunch of supplements.

That said, the supplements and botanicals can provide additional support and therapeutic effect, especially when the problem is advanced or recalcitrant.

 

 

 

 

 

 

ALIVE INSIDE (DOCUMENTARY FILM)

This fascinating and touchingly done documentary film, Alive Inside: A Story of Music and Memory, demonstrates the effect music has on people with Alzheimer’s. Giving Alzheimer’s patients iPods programmed with a personalized play list had an immediate and profound effect, allowing them to access memories and language that had seemed lost to them.
I highly recommend watching it.

 

 

Alive-Inside-Film-Poster-2014

From the film’s website:

ALIVE INSIDE is a joyous cinematic exploration of music’s capacity to reawaken our souls and uncover the deepest parts of our humanity. Filmmaker Michael Rossato-Bennett chronicles the astonishing experiences of individuals around the country who have been revitalized through the simple experience of listening to music. His camera reveals the uniquely human connection we find in music and how its healing power can triumph where prescription medication falls short.

This stirring documentary follows social worker Dan Cohen, founder of the nonprofit organization Music & Memory, as he fights against a broken healthcare system to demonstrate music’s ability to combat memory loss and restore a deep sense of self to those suffering from it. Rossato-Bennett visits family members who have witnessed the miraculous effects of personalized music on their loved ones, and offers illuminating interviews with experts including renowned neurologist and best-selling author Oliver Sacks (Musicophilia: Tales of Music and the Brain) and musician Bobby McFerrin (“Don’t Worry, Be Happy”).

An uplifting cinematic exploration of music and the mind, ALIVE INSIDE’s inspirational and emotional story left audiences humming, clapping and cheering at the 2014 Sundance Film Festival, where it won the Audience Award.

 

You can watch the Alive Inside trailer here … and the entire film (1 hour 39 minutes) as a rental on iTunes for $4.99.

 

0aliveinsidedoc

 

Please donate money, iPods, your time to promote this project. Here’s the Music and Memory website.
When you donate money to Music and Memory, more people living in nursing homes can reconnect to their favorite music and to the world around them through digital music technology.  Your donation will help provide iPods, create personalized playlists, and train caregivers to help residents regain a sense of identity, ease depression, pain and isolation and create a pathway to long lost memories. Donations are tax deductible.

 

Many thanks to Blake Jessee for telling me about this wonderful documentary film.

 

 

REFERENCES

Alive Inside.  Trailer. 2014. See: https://www.youtube.com/watch?v=IaB5Egej0TQ

Alzheimer’s Association. (2014). What is Alzheimer’s? See: http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp

D’Andrea, M.R. (2005). Add Alzheimer’s disease to the list of autoimmune diseases. See: http://www.ncbi.nlm.nih.gov/pubmed/15617848

Gezen-Ak, D. et al. (2014). Why vitamin D in Alzheimer’s disease? The hypothesis. Journal of Alzheimer’s Disease, 40:2, 257-269. See: http://www.ncbi.nlm.nih.gov/pubmed/24413618

Hardin, J.R. (2013). Autoimmune Disorders. See: http://allergiesandyourgut.com/symbiosis-versus-dysbiosis/autoimmune-conditions-diseases/

Hardin, J.R. (2014). Is It Necessary to Express an Inherited Trait? See: http://allergiesandyourgut.com/necessary-express-inherited-train/

Hill, J.M. et al. (2013). The gastrointestinal tract microbiome and potential link to Alzheimer’s disease. Frontiers in Neurology. See: http://journal.frontiersin.org/Journal/10.3389/fneur.2014.00043/full

Konkel, L. et al. (2013). The Environment Within: Exploring the Role of the Gut Microbiome in Health and Disease. Environmental Health Perspectives, 121:9, 276-281. See:  http://www.medscape.com/viewarticle/812353

Kresser, C. (2011). How to prevent spending the last 10 years of your life in a diaper and a wheelchair. See: http://chriskresser.com/how-to-prevent-spending-the-last-10-years-of-your-life-in-a-diaper-and-a-wheelchair

Mercola, R. (4/27/2014). Key Dietary Strategies to Protect Yourself from Alzheimer’s. See: http://articles.mercola.com/sites/articles/archive/2014/04/27/diet-alzheimers-disease.aspx

Mercola, R. (5/10/2015).  The Real RDA for Vitamin D Is 10 Times Higher Than Currently Recommended. See: http://articles.mercola.com/sites/articles/archive/2015/05/10/vitamin-d-recommended-dietary-allowance.aspx
MusicAndMemory.org. See: http://musicandmemory.org/

Myers, A. (2014). The Autoimmune Summit: The World’s first free online summit dedicated to Helping you Reverse and Prevent Autoimmune Disease, November 10th – 18th 2014. See: http://autoimmunesummit.com/

Myers, A. (2015). The Autoimmune Solution: Prevent and Reverse the Full Spectrum of Inflammatory Symptoms and Diseases. See: http://www.amazon.com/The-Autoimmune-Solution-Spectrum-Inflammatory/dp/0062347470

National Institutes of Health. (2012). Understanding Autoimmune Diseases. See: http://www.niams.nih.gov/Health_Info/Autoimmune/

Rossato-Bennett, M. (2014). Alive Inside website. See: http://www.aliveinside.us/#about

 

Science Daily, 2012. Gene nearly triples risk of Alzheimer’s, international research team finds. See: http://www.sciencedaily.com/releases/2012/11/121114171710.htm

Scutti, S. (2013). Alzheimer’s Cured By Omega-3 Supplements? Fatty Acids Pass Blood-Brain Barrier And Decrease Levels Of Tau Protein. See: http://www.medicaldaily.com/alzheimers-cured-omega-3-supplements-fatty-acids-pass-blood-brain-barrier-and-decrease-levels-tau

 

 

 

© Copyright 2014 Joan Rothchild Hardin. All Rights Reserved.

 

DISCLAIMER:  Nothing on this site or blog is intended to provide medical advice, diagnosis or treatment.

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