Showing posts with label Water. Show all posts
Showing posts with label Water. Show all posts

Sunday, January 18, 2009

Water, Our Need For It And Why

Bottled Water

The human body is composed of approximately 70% water. Water is contained in the cells of the body (intracellular fluid), in the arteries and veins (blood plasma), and in the spaces between the blood vessels and cells (Interstitial fluid). The body's water supply is responsible and involved in nearly every bodily process.

Water is required for the distribution of nutrients, electrolytes, hormones, and other chemical messengers throughout the body, as well as the removal of waste products. Water is involved in cellular energy production and the maintenance of body temperature. It is also an important structural component of skin, cartilage, and other tissues.

When we eat, breathe, and use our muscles, our body creates residue waste products that the body has to get rid of. Good clean water helps us do this. Without enough water we do not get rid of these waste products? The waste products that we do not discard have to be stored somewhere within our body.

Storing this waste seems to contribute to, or even help cause, the following: lower back pain, chronic fatigue syndrome, diabetes, headaches/migraines, asthma, allergies, colitis, rheumatoid arthritis, depression, high blood pressure, high blood cholesterol, neck pain.

Besides ridding the body of toxins, water helps to reduce sodium buildup in the body, relieve constipation, and maintain proper muscle tone. Water helps maintain normal body temperature.

Water acts as a solvent for the vitamins and minerals we need everyday for our cells to do their jobs.

A precarious balance exists between fluid intake and output. You get water from three sources: drink (60 percent), food (30 percent), and cellular metabolism (10 percent). At the same time, you constantly lose water. A sedentary person in a temperate climate loses about two quarts of fluid per day, primarily through urine, sweat, and respiration. That amount can jump to four to six quarts per day in hot and/or humid weather, and one to three quarts per hour during physical activity. It’s easy to see how fragile your body’s water balance is.

Therefore, replacing the water that is continually being lost is very important.. While the body can survive without food for about five weeks, the body cannot survive without water for longer than five days.

75% of Americans are chronically dehydrated. (It is possible that this applies to half world population who are in modern countries with the sort of food and so on that we have.)

In 37% of Americans, the thirst mechanism is so weak that it is often mistaken for hunger.

Even MILD dehydration will slow down one's metabolism as much as 5%.

One glass of water shut down midnight hunger pangs for almost 100% of the dieters studied in a University of Washington study.

Lack of water is the #1 trigger of daytime fatigue. (If you feel tired some morning, try drinking a pint of pure water....)

Preliminary research indicates that 8-10 glasses of water a day could significantly ease back and joint pain for up to 80% of sufferers. (Maybe the so called arthritis is just a water deficiency in some cases!)

A mere 2% drop in body water can trigger fuzzy short-term memory, trouble with basic math, and difficulty focusing on the computer screen or on a printed page.

According to some nutritionists, drinking 5 glasses of water daily decreases the risk of colon cancer by 45%, plus it can slash the risk of breast cancer by 79%, and one is 50% less likely to develop bladder cancer.

During a state of drought your body switches into its “water conservation” mode. One of the primary ways it ensures adequate hydration is by holding onto sodium. The result is sodium retention, followed by a rise in fluid levels — the precise mechanism involved in abnormal blood pressure

With more severe dehydration, your body is forced to get by on reduced fluid volume, so it compensates by temporarily closing down capillaries. While the brain and other vital organs continue to receive enough blood to meet their basic needs, some tissues must go without. As capillaries remain closed, the tissues they supply become starved of nutrients and bogged down with cellular wastes. Among the first areas affected are cartilage and synovial fluid, and the result is discomfort in the joints.

In addition, water-conserving chemicals are released. Chief among these is histamine, which reduces water loss, but at the same time may trigger respiratory problems. Prostaglandins and kinins are released as well, which can lead to a variety of discomforts. As you can see, too little water causes much more than thirst and a dry mouth — it parches your entire body.

If you’re only producing small quantities of dark, concentrated urine, you’re not drinking enough. (To ensure a good night’s sleep, try cutting back on fluids two or three hours before bedtime.)

Why aren’t the health benefits of water discussed more often?

Part of the answer is simply that water is free, so there’s little to be gained by advertising its benefits. Water can't be patented and owned by a company. Even though you can buy bottled water, most people don’t have to buy bottled water to have clean water to drink every day. This is why you often don’t hear very much about the benefits of water. For example, it is not well known that many headaches are caused by slight dehydration and can be alleviated by drinking water; instead, we are told to take aspirin or other (and more expensive) analgesics. If you often get a headache after exertion or after crying, the water you drink to take the pill with may be doing as much to relieve the pain as the medicine is.

NOTE: I have had people tell me they do not like plain water. The effects are markedly cut down if one drinks juice or coffee, etc. Digestion comes to play, and the body works, and the water is mixed in with the digestive juices and the effect is lost. It is recommended that you not drink your large quantities of water with meals. A huge quantity of water in the stomach with the food can dilute the digestive enzymes there and affect how easily the digestion occurs.

How much water?

You should drink at least 8 glasses of water a day. As a rule of thumb, you should drink a half ounce of water for every pound of body weight, unless you're very active, in which case you should increase your water intake to two-thirds an ounce per pound of body weight daily.

Thus, if you weigh 120 lbs., you need to take 60 oz. of water, or a little less than 2 quarts or 8 glasses of water. If you are 210 lbs, you need to take 105 oz of water, or about 7 quarts or 13 glasses of water.

8 oz = 1 regular glass of water
32 oz = one quart (4 glasses of water)
128 oz = one gallon (16 glasses of water)

Getting enough water

But this might not be enough. Do not use the thirst mechanism as a gauge to judge hydration. The thirst mechanism kicks in only after we've lost about 6 percent of water weight -- way too late to prevent dehydration. The problem of getting enough water becomes more common in late adulthood, because our need for water actually increases. Our skin and mucous membranes become thinner and lose more water, and our kidneys function less efficiently, so our need for water increases. While a person under age 50 should drink 8 glasses of water a day, 10 glasses are advised for those in their fifties and 10-12 eight oz glasses for active people 60 and over. Also, older people don't feel thirst the way a younger person does, so if your are older, you have to get in the habit of drinking water even if they're not thirsty.

Remember also that you have to drink more water when taking herbs.

Dieting

Water is closely connected to fat gain and loss. This has nothing to do with water retention. Water doesn't have any calories, but.....

When the body begins to run low of any vital nutrient -- even water -- it will trigger hunger to motivate you to go get some more of whatever it needs. This is true for water because most foods provide some amount of water. It can, however, provide many unneeded calories. The thirst sensation is not a reliable way to decide when to drink water. You may often feel the need for water as hunger instead of as thirst.

When dieting, it is important to consciously drink water to make sure you get enough.

Water is a necessary part of the body’s fat utilization process. Water assists the body in metabolizing stored fat because your liver, which metabolizes fat, becomes overloaded when your kidneys don’t get enough water. Your liver’s fat processing function is compromised when it has to do the kidneys’ job as well. Water also helps suppress appetite and relieve fluid retention problems.

There is a common water strategy used by dieters to drink a glass of water when you get up in the morning and then every two hours - whether you feel like it or not. Just make it part of your routine.

Remember that low-calorie sodas cannot be substituted for water and in some cases can have a negative effect on dieting. See our article on Soda

You also have to remember that the need for water can be aggravated by common substances that suppress thirst such as coffee, tea, alcohol and some drugs.

You also need to drink more water when you are taking herbs.

Situations involving our need for water

Dehydration:

We have to be careful of this in a lot of circumstances. When flying in an airplane, your body can become dehydrated. Make sure you drink a glass of water for each hour you spend in the air. When you have the flu, you need to drink plenty of water to replace the fluids you lose through sweating and vomiting. Constipation is a sign of not drinking enough water. Caffeine can also cause dehydration.

Sports & Exercise:

Several days before an event, competitive athletes should 'hyper-hydrate', Hyper-hydration is the process of drinking plenty of water for two to three days before an athletic event. The body is about 60 percent water and it needs to be fully hydrated to perform optimally. When the outside temperature or humidity is especially high, the body requires even more water because it must work harder to cool itself.

Water retention:

Fluid retention can be caused by excess salt intake. Drink plenty of water to help flush out the salt. You also need potassium to balance out the salt/potassium ratio.

Indigestion:

Water is also valuable as a digestive aid especially when combined with activated charcoal. This type of charcoal is available (see Where to get these supplement?) Added to a glass of water, charcoal provides quick relief from most gastric discomfort. Mixed with enough water to form a paste, its great first aid for sprains and insect bites.

Bad Breath:

Drinking lots of water and peppermint tea with a pinch of anise, caraway or cinnamon.

Gallstones:

Water is needed to flush the liver and dilute the bile. Without enough water the bile secretions can turn into gallstones. For additional information see the article Gall bladder for this sort of problem

Kidney stones:

Water helps decrease the concentration of the stone-forming elements in the urine.

Urinary tract infections:

People who get infections usually don't get enough water. The urine sits in the bladder too long and bacteria can build up. Drinking lots of water will flush out the bacteria. Drinking water won't cure an already established infection, but it can make urinating more comfortable and is a barrier to a recurrence.

Gout:

Drinking lots of water keeps urine dilute and promotes the excretion of uric acid. Gout is caused by the formation of sharp crystals of uric acid forming in the fluid of the joint.

Where we get our water

Obtaining quality water would seem to be an easy matter, however, there are different types of water.

Tap Water:

Many people assume that when they turn on their kitchen tap, they are getting clean, safe, healthy drinking water. Unfortunately, that is often not the case. Regardless of the origin of the tap water, it is vulnerable to a number of different types of impurities. Leaching from pipes may give the water dangerous levels of cooper, iron, zinc and arsenic. Other undesirable substances found in water, include radon, fluoride, and cooper, and other heavy metals. Other contaminants, such as fertilizers, asbestos, cyanides, herbicides, pesticides and industrial chemicals may leach into ground water through the soil, or into any tap water from plumbing pipes. Although the body uses these minerals in trace amounts, it can not be used in this form. Other substances including chlorine, carbon, lime, phosphates, soda ash, and aluminum sulfate, are intentionally added to public water supplies to kill bacteria, adjust pH, and eliminate cloudiness, among other things.

Strange smells or tastes in water that was previously fine could mean chemical contamination, however, many toxic hazards that work their way into the water do not change its taste, smell or appearance.

Flouride, a common addition to our drinking water, is yet another enemy of magnesium., it can change it into an unusable compound that is rejected as a waste product. Ironically, this flouride is supposed to protect our teeth against decay, yet it results in loss of one of the very minerals our teeth need for the hard enamel that keeps them from decay. Much of our tap water is a chemical soup these days, so for more reasons than simply flouride content, drinking pure spring water might be a good idea.

Chlorine used as a disinfectant to rid water of harmful bacteria, combines with naturally occurring organic matter to form trihalomethanes - compounds suspected of contributing to cancer.

Impure Water:

What is your drinking water like? IS it free of toxic metals like lead? Is its mineral content well balanced? Any mineral in excess, sodium for example, can cause illness when ingested over long periods of time. Impure water is an environmental stress of which you are often not even aware. Such stress can deplete your store of vitamin E.

Water with aluminum in it has been thought to be linked to Alzheimer's disease, although this connection is still a controversial subject. This is another reason to drink pure water. Aluminum can be gotten from impure water, although drinking from aluminum cans and aluminum cookware might be a problem. It is felt that aluminum cans are coated with plastic to prevent the acid from the soda or juice from breaking down the aluminum. Sticking with glass or plastic containers is, however, an extra precaution.

Bottled water comes in many forms

To meet the needs of a thirsty population, the variety of water products, from spring water to distilled to sparkling and flavored brands, is on the increase. Bottled water can be classified by use - a basic drinking water or a specialty beverage; by its source - spring, well water, or public water supply; and by the presence of carbonation. Read the labels of any bottled water you buy. You may find that the bottle of "spring water" you bought actually came from a municipal water supply.

The United States FDA truth-in-labeling requirements are clear, nonetheless, some bottlers still make erroneous claims.

Bottled water is required to meet the same quality standards and purity standards as public drinking water. FDA guidelines for imported waters require that the water be obtained from sources free of pollution, bottled under sanitary conditions, free from microorganisms. Bottled water generally, but not always have fewer contaminants than tap water because of different purifying methods employed along with filtration and aeration. Ozone is used in bottled water instead of chlorine as a disinfectant. Unlike chlorine, ozone does not combine with organic material to form triholomethanes, nor does it have an aftertaste or odor that occurs with chlorine.

For health's sake, make sure that the water you drink is as pure as you can get.



Friday, January 16, 2009

Itching

Itching

Definition

Itching is an intense, distracting irritation or tickling sensation that may be felt all over the skin's surface, or confined to just one area. The medical term for itching is pruritus.

Description

Itching instinctively leads most people to scratch the affected area. Different people can tolerate different amounts of itching, and anyone's threshold of tolerance can be changed due to stress, emotions, and other factors. In general, itching is more severe if the skin is warm, and if there are few distractions. This is why people tend to notice itching more at night.

Causes and symptoms

The biology underlying itching is not fully understood. It is believed that itching results from the interactions of several different chemical messengers. Although itching and pain sensations were at one time thought to be sent along the same nerve pathways, researchers reported the discovery in 2003 of itch-specific nerve pathways. Nerve endings that are specifically sensitive to itching have been named pruriceptors.

Research into itching has been helped by the recent invention of a mechanical device called the Matcher, which electrically stimulates the patient's left hand. When the intensity of the stimulation equals the intensity of itching that the patient is experiencing elsewhere in the body, the patient stops the stimulation and the device automatically records the measurement. The Matcher was found to be sensitive to immediate changes in the patient's perception of itching as well as reliable in its measurements.

Stress and emotional upset can make itching worse, no matter what the underlying cause. If emotional problems are the primary reason for the itch, the condition is known as psychogenic itching. Some people become convinced that their itch is caused by a parasite; this conviction is often linked to burning sensations in the tongue, and may be caused by a major psychiatric disorder.

Generalized itching

Itching that occurs all over the body may indicate a medical condition such as diabetes mellitus, liver disease, kidney failure, jaundice, thyroid disorders (and rarely, cancer). Blood disorders such as leukemia, and lymphatic conditions such as Hodgkin's disease may sometimes cause itching as well.

Some people may develop an itch without a rash when they take certain drugs (such as aspirin, codeine, cocaine); others may develop an itchy red "drug rash" or hives because of an allergy to a specific drug. Some medications given to cancer patients may also cause itching.

Itching also may be caused when any of the family of hookworm larvae penetrate the skin. This includes swimmer's itch and creeping eruption caused by cat or dog hookworm, and ground itch caused by the "true" hookworm.

Many skin conditions cause an itchy rash. These include:

  • Atopic dermatitis
  • Chickenpox
  • Contact dermatitis
  • Dermatitis herpetiformis (occasionally)
  • Eczema
  • Fungus infections (such as athlete's foot)
  • Hives (urticaria)
  • Insect bites
  • Lice
  • Lichen planus
  • Neurodermatitis (lichen simplex chronicus)
  • Psoriasis (occasionally)
  • Scabies.

On the other hand, itching all over the body can be caused by something as simple as bathing too often, which removes the skin's natural oils and may make the skin too dry and scaly.

Localized itching

Specific itchy areas may occur if a person comes in contact with soap, detergents, and wool or other rough-textured, scratchy material. Adults who have hemorrhoids, anal fissure, or persistent diarrhea may notice itching around the anus (called "pruritus ani"). In children, itching in this area is most likely due to worms.

Intense itching in the external genitalia in women ("pruritus vulvae") may be due to candidiasis, hormonal changes, or the use of certain spermicides or vaginal suppositories, ointments, or deodorants.

It is also common for older people to suffer from dry, itchy skin (especially on the back) for no obvious reason. Younger people also may notice dry, itchy skin in cold weather. Itching is also a common complaint during pregnancy.

Diagnosis

Itching is a symptom that is quite obvious to its victim. Someone who itches all over should seek medical care. Because itching can be caused by such a wide variety of triggers, a complete physical exam and medical history will help diagnose the underlying problem. A variety of blood and stool tests may help determine the underlying cause.

Treatment

Antihistamines such as diphenhydramine (Benadryl) can help relieve itching caused by hives, but will not affect itching from other causes. Most antihistamines also make people sleepy, which can help patients sleep who would otherwise be awake from the itch.

Specific treatment of itching depends on the underlying condition that causes it. In general, itchy skin should be treated very gently. While scratching may temporarily ease the itch, in the long run scratching just makes it worse. In addition, scratching can lead to an endless cycle of itch-scratch-more itching.

To avoid the urge to scratch, a person can apply a cooling or soothing lotion or cold compress when the urge to scratch occurs. Soaps are often irritating to the skin, and can make an itch worse; they should be avoided, or used only when necessary.

Creams or ointments containing cortisone may help control the itch from insect bites, contact dermatitis or eczema. Cortisone cream should not be applied to the face unless a doctor prescribes it.

Probably the most common cause of itching is dry skin. There are a number of simple things a person can do to ease the annoying itch:

  • Do not wear tight clothes
  • Avoid synthetic fabrics
  • Do not take long baths
  • Wash the area in lukewarm water with a little baking soda
  • For generalized itching, take a lukewarm shower
  • Try a lukewarm oatmeal (or Aveeno) bath for generalized itching
  • Apply bath oil or lotion (without added colors or scents) right after bathing.

Itching may also be treated with whole-body medications. In addition to antihistamines, some of these systemic treatments include:

  • tricyclic antidepressants
  • sedatives or tranquilizers
  • such selective serotonin reputake inhibitors as paroxetine (Paxil) and sertraline (Zoloft)
  • binding agents (such as cholestyramine which relieves itching associated with kidney or liver disease).
  • aspirin
  • cimetidine

People who itch as a result of mental problems or stress should seek help from a mental health expert.

Alternative and complementary therapies

A well-balanced diet that includes carbohydrates, fats, minerals, proteins, vitamins, and liquids will help to maintain skin health. Capsules that contain eicosapentaenoic acid, which is obtained from herring, mackerel, or salmon, may help to reduce itching. Vitamin A plays an important role in skin health. Vitamin E (capsules or ointment) may reduce itching. Patients should check with their treating physician before using supplements.

Homeopathy has been reported to be effective in treating systemic itching associated with hemodialysis.

Baths containing oil with milk or oatmeal are effective at relieving localized itching. Evening primrose oil may soothe itching and may be as effective as corticosteroids. Calendula cream may relieve short-term itching. Other herbal treatments that have been recently reported to relieve itching include sangre de drago, a preparation made with sap from a South American tree; and a mixture of honey, olive oil, and beeswax.

Distraction, music therapy, relaxation techniques, and visualization may be useful in relieving itching. Ultraviolet light therapy may relieve itching associated with conditions of the skin, kidneys, blood, and gallbladder. There are some reports of the use of acupuncture and transcutaneous electrical nerve stimulators (TENS) to relieve itching.

Prognosis

Most cases of itching go away when the underlying cause is treated successfully.

Prevention

There are certain things people can do to avoid itchy skin. Patients who tend toward itchy skin should:

  • Avoid a daily bath
  • Use only lukewarm water when bathing
  • Use only gentle soap
  • Pat dry, not rub dry, after bathing, leaving a bit of water on the skin
  • Apply a moisture-holding ointment or cream after the bath
  • Use a humidifier in the home.

Patients who are allergic to certain substances, medications, and so on can avoid the resulting itch if they avoid contact with the allergen. Avoiding insect bites, bee stings, poison ivy and so on can prevent the resulting itch. Treating sensitive skin carefully, avoiding overdrying of the skin, and protecting against diseases that cause itchy rashes are all good ways to avoid itching.

Key Terms

Atopic dermatitis: An intensely itchy inflammation often found on the face of people prone to allergies. In infants and early childhood, it is called infantile eczema.

Creeping eruption: Itchy irregular, wandering red lines on the foot made by burrowing larvae of the hookworm family and some roundworms.

Dermatitis herpetiformis: A chronic very itchy skin disease with groups of red lesions that leave spots behind when they heal. It is sometimes associated with cancer of an internal organ.

Eczema: A superficial type of inflammation of the skin that may be very itchy and weeping in the early stages; later, the affected skin becomes crusted, scaly, and thick. There is no known cause.

Hodgkin's disease: A type of cancer characterized by a slowly-enlarging lymph tissue; symptoms include generalized itching.

Lichen planus: A noncancerous, chronic itchy skin disease that causes small, flat purple plaques on wrists, forearm, ankles.

Neurodermatitis: An itchy skin disease (also called lichen simplex chronicus) found in nervous, anxious people.

Pruriceptors: Nerve endings specialized to perceive itching sensations.

Pruritus: The medical term for itching.

Psoriasis: A common, chronic skin disorder that causes red patches anywhere on the body. Occasionally, the lesions may itch.

Scabies: A contagious parasitic skin disease characterized by intense itching.

Swimmer's itch: An allergic skin inflammation caused by a sensitivity to flatworms that die under the skin, causing an itchy rash.

Resources

Books
  • Beers, Mark H., MD, and Robert Berkow, MD, editors. "Pruritus." Section 10, Chapter 109. In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.
Periodicals
  • Al-Waili, N. S. "Topical Application of Natural Honey, Beeswax and Olive Oil Mixture for Atopic Dermatitis or Psoriasis: Partially Controlled, Single-Blinded Study." Complementary Therapies in Medicine 11 (December 2003): 226-234.
  • Browning, J., B. Combes, and M. J. Mayo. "Long-Term Efficacy of Sertraline as a Treatment for Cholestatic Pruritus in Patients with Primary Biliary Cirrhosis." American Journal of Gastroenterology 98 (December 2003): 2736-2741.
  • Cavalcanti, A. M., L. M. Rocha, R. Carillo Jr., et al. "Effects of Homeopathic Treatment on Pruritus of Haemodialysis Patients: A Randomised Placebo-Controlled Double-Blind Trial." Homeopathy 92 (October 2003): 177-181.
  • Ikoma, A., R. Rukwied, S. Stander, et al. "Neurophysiology of Pruritus: Interaction of Itch and Pain." Archives of Dermatology 139 (November 2003): 1475-1478.
  • Jones, K. "Review of Sangre de Drago (Croton lechleri)-A South American Tree Sap in the Treatment of Diarrhea, Inflammation, Insect Bites, Viral Infections, and Wounds: Traditional Uses to Clinical Research." Journal of Alternative and Complementary Medicine 9 (December 2003): 877-896.
  • Ochoa, J. G. "Pruritus, a Rare but Troublesome Adverse Reaction of Topiramate." Seizure 12 (October 2003): 516-518.
  • Stener-Victorin, E., T. Lundeberg, J. Kowalski, et al. "Perceptual Matching for Assessment of Itch; Reliability and Responsiveness Analyzed by a Rank-Invariant Statistical Method." Journal of Investigative Dermatology 121 (December 2003): 1301-1305.
  • Zylicz, Z., M. Krajnik, A. A. Sorge, and M. Costantini. "Paroxetine in the Treatment of Severe Non-Dermatological Pruritus: A Randomized, Controlled Trial." Journal of Pain and Symptom Management 26 (December 2003): 1105-1112.

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Source: Gale Encyclopedia of Medicine, Published December, 2002 by the Gale Group. The Essay Author is Carol A. Turkington.



Saturday, January 3, 2009

Water for Weight Loss? Yup!

You may have heard me say before that I consider water the greatest weight loss drink in the world. Why? Let me count the ways. Water is needed for virtually every metabolic process. It helps flush toxins out of the body. It helps give you energy (even 2% dehydration can negatively impact physical and mental performance). And much of what we perceive as hunger- driving us to overeat- is actually thirst.

For almost a decade I've been recommending that for weight loss, the ideal amount of water to drink on a daily basis can be approximated by taking your current weight and dividing by 2. That's the number of ounces you should aim for. For example, if you're 200 pounds, go for 100 ounces a day. (I was happy to see, recently, that this is exactly the same formula recommended by Deepak Chopra.)

But even though all nutritionists I know recommend drinking plenty of water, we didn't really have a lot of research to back up what most of us "knew" intuitively.

Now we have some!

In two separate studies, (both published in recent issues of the Journal of Clinical Endocrinology and Metabolism) researchers found that within 10 minutes of drinking about a pint of water, metabolic rates in both men and women begin to increase as much as 24-30 percent!

They don't completely know why, but it might have something to do with osmotic pressure changes. (If you're wondering, other drinks don't seem to have the same effect, so it's definitely the water that's doing it.)

You know, if you drank this much water every day upon rising you could actually burn an extra 17,400 calories a year- for a loss of five extra pounds. Just from drinking water!

Now granted, that's not an awful lot of weight. But added to all the other benefits of water, the little bit of extra weight loss is a nice bonus!

For best results consume it first thing in the morning on an empty stomach.

And then keep on drinking all day!

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Source: jonnybowden.com