Dr. Joe on Vitamin D

This was recorded a while ago, but Dr. Joe says the same thing about Vitamin D today and more.

HBa1C

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Polycystic Ovaries Syndrome

Treated with Diet and Exercise

This is about the Effect of a Hypocaloric Diet with and without Exercise training on Body Composition, Cardiometabolic Risk Profile, and Reproductive Function in Overweight and Obese Women with Polycystic Ovary Syndrome

When people are overweight from Polycystic Ovary Syndrome (PCOS), it is a standard feature to try to have the addition of exercise to diet be the most important function that can be done in these individuals. This study was out to prove how well such a thing would be successful on weight loss.

It appears that people who entered in this study did everything as they were exactly told in terms of diet, exercise and then had subsequent measurements of all the cardio vascular risk factors.

There was shown to be some improved body composition in that there was increased muscle mass, but there was no additional effect on improvements in cardiometabolic, hormonal, and reproductive outcomes relative to diet and this exercise.

Once again it shows that the power of a genetic or metabolic syndrome is genetically strongly related and is going to thwart all the standard treatments that experts have forced everybody to consider i.e. the presence of diet and exercise to get your weight down. It just doesn’t work very well.
“Dr. Joe”, J. Joseph Prendergast, MD

J Clin Endocrinol Metab. 2008 Jun 26. [Epub ahead of print]

Peripheral Vascular Disease Symptoms

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Try The Vitamin D Newsletter

This is an excellent, very conservative, very well informed, entirely accurate continuous update on vitamin D’s new impact on health. As most of you know I am more aggressive than this but that takes nothing away from the great work that he does. I wouldn’t expect us to be identical in how we use Vitamin D3; we work in different fields. He is in a position to know how patients and how reluctant they can be to try a therapy that wasn’t promoted in kindergarten. After all he is a psychiatrist.

The doctors who don’t understand the new implications of recent research on vitamin D need remedial work on reading medical literature. Perhaps you could send your doctor a gift subscription and give him a hint to make a donation to the Vitamin D Council to allow to allow some catch up.

Send him some money, sign up for all that you can learn from this news letter. It’s your time.

Dr. Joe

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The Vitamin D Newsletter
July, 2008

This is a periodic newsletter from the Vitamin D Council, a non-profit trying to end the epidemic of vitamin D deficiency.

Our website is now getting about 3,000 visitors a day and more than 40 people signing up for this newsletter every day. Our most frequent request is that we post a basic Q&A page on our website. I decided to start that process this month. If you can think of questions that should be on a Q&A website, please hit reply and tell me and I'll add your question and my answer to the new Q&A web page.

Before I start, one of the most frequent questions I get is "How can I help?" Besides making a donation to the Vitamin D Council, another way to help is by going, or getting your friends to go, to a series of talks that Carole Baggerly of Grassroots Health is giving around the country this summer. Grassroots Health recently issued a Vitamin D Scientist's Call to Action Statement signed by some of the best known vitamin D scientists in the world. You can access Carole's itinerary here. If you can't go, call a friend in the city she will be in and have them go in your place. Carole is the one who recently talked the AMA into their first position statement on vitamin D.

CHICAGO, June 17, 2008 ----The American Medical Association (AMA), the nation's largest physician organization, voted today at its Annual Meeting to adopt the following new public health policy: The current Reference Intake Values for Vitamin D were established by the Food and Nutrition Board in 1997. Current research suggests that the Upper Limits for adults is likely overly conservative. Today the AMA called on the FDA to re-examine the current Daily Reference Intake Value for Vitamin D in light of new scientific findings. "The health benefits of Vitamin D are plentiful, such as strong bones and a reduced risk of breast cancer and cardiovascular disease," said AMA Board Member Steven Stack, M.D. "It's time to take a good look at the current daily recommended level of Vitamin D and ensure that Americans know the appropriate levels so they can reap the full health benefits."

The AMA's statement is timely in light of another study published a few days later that showed those with the lowest vitamin D levels are twice as likely to die as those with the highest levels.

Deborah Kotz, US News & World Report. Time in the Sun: How Much is Needed for Vitamin D?

Also, don't miss the Washington Post article that just came out:

Rob Stein, Washington Post; Some Seek Guidelines to Reflect Vitamin D's Benefits.

So, one thing you can do is get a group together and go to one of Carole's talks. Again, here is a link to them. If you can't come, but know someone in that city, get them to go with their friends. If you know someone in the cities that do not have venues, and the person you know may be able to arrange a host for the meeting, email Carole at carole@grassrootshealth.org.

Now the Q&A:

1) How much vitamin D should I take?

I don't know.

2) How often should I have a 25-hydroxy-vitamin D blood test?

I don't know.

3) Why don't you know?

OK, but I really don't know. The reason I don't know is that everyone's situation is either a lot, or at least a little, different. How much vitamin D you need varies with age, body weight, percent of body fat, latitude, skin coloration, season of the year, use of sunblock, individual variation in sun exposure, and - probably - how ill your are. As a general rule, old people need more than young people, big people need more that little people, fat people need more than skinny people, northern people need more than southern people, dark-skinned people need more than fair skinned people, winter people need more than summer people, sunblock lovers need more than sunblock haters, sun-phobes need more than sun worshipers, and ill people may need more than well people.

Regular readers should understand the reasons behind all these statements except for the last one. However, don't feel bad, no one understands it. Vitamin D is used by the body, metabolically cleared, both to maintain wellness and to treat disease. If you get an infection, how much vitamin D does your body use up fighting the infection? Nobody knows. If you have cancer, how much vitamin D does your body use up fighting the cancer? Nobody knows. If you have heart disease, how much vitamin D does your body use up fighting the heart disease? Nobody knows. If you are a child with autism, how much vitamin D does your brain need to turn on the genes that autism has turned off? Nobody knows. If you are an athlete, how much vitamin D does your body use up making you stronger and quicker? Nobody knows, etc.

This is what I'd do. If you live in Florida and sunbathe once a week, year around, do nothing. If you use suntan parlors once a week, do nothing. However, if you have little UVB exposure, my advice is as follows. Well children under the age of two should take 1,000 IU per day, over the age of two, 2,000 IU per day. Well adults and adolescent between 80 pounds and 130 pounds should start with 3,000 IU per day, over 130 pounds but less than 170 pounds, 4,000 IU per day and over 170 pounds, 5,000 IU per day. Two months later have your doctor order your first 25-hydroxy-vitamin D blood test. Yes, start the vitamin D before you have the blood test. Then adjust your dose so your 25(OH)D level is between 50 and 70 ng/ml, summer and winter. These are conservative dosage recommendations. Most people who avoid the sun - and virtually all dark-skinned people - will have to increase their dose once they find their blood level is still low, even after two months of the above dosage, especially in the winter.

One more thing. Everyone has different vitamin D machinery. For example, regular run-of-the-mill rickets does not require much vitamin D to be cured. However, two other forms of rickets, both rare, one caused by a defective vitamin D receptor and the other by a malfunction of the enzyme that activates vitamin D, requires either much more vitamin D or activated vitamin D (calcitriol) itself. It seems likely that there is as much variation in the amount and functionality of the enzyme that activates vitamin D as there is in the vitamin D receptor. Furthermore, there are probably tissue variations as well. That is, one vitamin D deficient child gets rickets, another autism, another asthma, and yet another type-1 diabetes because functionality of the vitamin D machinery is genetically variable both between children and within children's tissues. Therefore, some people, who have genetically determined decreased functionality of the machinery in different tissues, will need more vitamin D. How much more, we do not know. However, should you have a child with autism, they will usually need more than a normal child to overcome their genetic defects. None of what I say in this last paragraph has been proven, it is theoretical.

4) What blood test should I have?

The only blood test that can diagnose vitamin D deficiency is a 25-hydroxy-vitamin D [25(OH)D]. Get your levels above 50 ng/ml, year around. Unfortunately, about 10-20% of the doctors in the USA order the wrong test. They order a 1,25-dihydroxy-vitamin D, thinking that by measuring the most potent steroid in the system, they are getting useful information. They are not. 1,25-dihydroxy-vitamin D is an adaptive hormone; it goes up and down with calcium intake. Furthermore, as 25(OH)D is a weak steroid, when 25(OH)D levels are low, the body compensates by increasing the amount of the potent steroid, 1,25-dihydroxy-vitamin D. Thus, a common cause of high 1,25-dihydroxy-vitamin D is low 25(OH)D or vitamin D deficiency. So these doctors see the 1,25-dihydroxy-vitamin D is normal or high and tell their patients that they are OK when they are vitamin D deficient, advice that may prove fatal. Furthermore, the reference labs in this country know this is occurring but, to date, have not taken steps to educate the doctors ordering the test because the reference labs make more money off a 1,25-dihydroxy-vitamin D than they do from a 25-hydroxy-vitamin D. Although the misdiagnosis of vitamin D deficiency may prove fatal, the doctors, and the reference labs, are ordering and processing the wrong test.

5) Does it matter what reference lab my doctor uses?

Yes, it might make a huge difference. A number of methods exist to measure 25(OH)D in commercial labs. The two most common are mass spectrometry and a chemiluminescence method, LIAISON. The first, mass spectrometry, is highly accurate in the hands of experienced technicians given enough time to do the test properly. However, in the hands of a normally trained technician at a commercial reference lab overwhelmed with 25(OH)D tests, it may give falsely elevated readings, that is, it tells you are OK when in fact you are vitamin D deficient. The second method, chemiluminescence, LIAISON, was recently developed and is the most accurate of the screening, high throughput, methods; LabCorp uses it. Quest Diagnostics reference lab uses mass spec. Again, both Quest and LabCorp are overwhelmed by 25(OH)D requests. The problem is that the faster the technicians do the mass spec test, the more inaccurate it is likely to be. If your 25(OH)D blood test says "Quest Diagnostics" on the top, do not believe you have an adequate level (> 50 ng/ml). You may or may not; the test may be falsely elevated. Let me give you an example. A doctor at my hospital had Quest Diagnostics do a 25(OH)D. It came back as 99 ng/ml of ergocalciferol. He is not taking ergocalciferol (D2), he has never taken ergocalciferol, only cholecalciferol, and he is not taking enough to get a level of 99 ng/ml, 50 ng/ml at the most. His email to Dr. Brett Holmquist at Quest about why Quest identified a substance he was not taking went unanswered other than to say "any friend of Dr. Cannell's is a friend of ours."

Long story short: if your lab report says "LabCorp" on the top, it is probably accurate; if it says Quest Diagnostic, it may be falsely elevated. While LabCorp has also been overwhelmed with 25(OH)D requests, the LIAISON method they use is relatively easy to do and does not rely on technician skill as much as the mass spec methods do. I'm not saying this because I'm a consultant for DiaSorin, who makes LIAISON, I'm saying it because it is true. If you don't believe me, get Quest to make me an offer to be their consultant at 10 times what DiaSorin is supposed to be paying me ($10,000 per year) and see how fast I turn Quest down. If Quest fixes their test, I'd love to consult. The ironic thing: I've made both Quest and LabCorp lots of money via this newsletter, the website, and by repeatedly telling the press that people need to know their 25(OH)D level, which has contributed to the skyrocketing sales of 25(OH)D blood tests.

Demand for vitamin D tests soars as nutrient's potential benefits touted.

Here you can help. Find out which labs in your town use Quest Diagnostics and which use LabCorp. Have a 25(OH)D test at both labs the same day (you will have to pay for them yourself). Then send both results to the Vitamin D Council address below. If Quest Diagnostics does not fix their 25(OH)D test, the Vitamin D Council will fix it for them.

6) Where should I get my vitamin D supplements?

Anywhere. Vitamin D in 1,000 IU tablets by Nature Made are available in most pharmacies in the USA and Canada. On the internet, Bio Tech Pharmacal has prices that are hard to beat and has 1,000 and 5,000 IU capsules. Life Extension Foundation also has 1,000 and 5,000 IU capsules. Capsules are important as it is easy dissolve the powder inside the capsule in juice for children. In Canada, Ddrops are now available, with 1,000 IU per drop. Ddrops will soon be available in the USA from Carlson, with 400, 1,000 or 2,000 IU per drop! Unfortunately, Carlson keeps selling products with toxic amounts of vitamin A. LifeSpan Nutrition has a variety of vitamin D preparations including their new "30 minutes of sunshine," which has magnesium together with 5,000 IU of vitamin D. If you don't eat a lot of vegetables, you are probably magnesium deficient. Both Bio Tech Pharmacal and LifeSpan Nutrition support the Vitamin D Council so consider getting your vitamin D from them. In fact, LifeSpan Nutrition began supporting us five years ago and is responsible, in large part, for our website being what it is.

7) My doctor prescribed Drisdol, 50,000 IU per week. What is it?

Drisdol is a prescription of 50,000 IU tablets of ergocalciferol or D2. Ergocalciferol is not vitamin D but it is similar. It is made by irradiating ergosterol, which is found in many living things, such as yeast. D2 is not normally found in humans and most studies show it does not raise 25(OH)D levels as well as human vitamin D (cholecalciferol or D3) does. However, Drisdol is a lot better than nothing. The best thing to do, if you are vitamin D deficient, and a human, is to take human vitamin D, cholecalciferol, A.K.A. vitamin D3.

8) Why are you against cod liver oil?

Cod liver oil contains toxic amounts of vitamin A. Vitamin A antagonizes the action of vitamin D. Stay tuned to the press. In several months you will see a clear warning by numerous experts not to take vitamin A or cod liver oil.

9) What is the ideal level of 25(OH)D?

We don't know. However, thanks to Bruce Hollis, Robert Heaney, Neil Binkley, and others, we now know the minimal acceptable level. It is 50 ng/ml. In a recent study, Heaney et al enlarged on Bruce Hollis's seminal work by analyzing five studies in which both the parent compound, cholecalciferol, and 25(OH)D levels were measured. It turn out that the body does not reliably begin storing the parent compound (cholecalciferol) in fat and muscle tissue until 25(OH)D levels get above 50 ng/ml. The average person starts to store cholecalciferol at 40 ng/ml, but at 50 ng/ml, virtually everyone begins to store it for future use. That is, at levels below 50 ng/ml, the body is usually using up the vitamin D as fast as you make it or take it, indicating chronic substrate starvation, not a good thing.

Hollis BW, Wagner CL, Drezner MK, Binkley NC. Circulating vitamin D3 and 25-hydroxyvitamin D in humans: An important tool to define adequate nutritional vitamin D status. J Steroid Biochem Mol Biol. 2007 Mar;103(3-5):631-4.

Heaney RP, Armas LA, Shary JR, Bell NH, Binkley N, Hollis BW. 25-Hydroxylation of vitamin D3: relation to circulating vitamin D3 under various input conditions. Am J Clin Nutr. 2008 Jun;87(6):1738-42.

10) I have advanced renal failure and I'm on dialysis, how much vitamin D should I take?

The same as everyone else. Since I have told you about commercial labs ripping you off, let's add some drug companies. Patients with advanced renal failure need activated vitamin D or one of it's analogs, available by prescription. This is very important as their kidneys cannot make enough 1,25-dihydroxy-vitamin D (calcitriol) to maintain serum calcium. However, the rest of their tissues activate vitamin D just fine and when those tissues get enough, and when the kidneys get more vitamin D, the calcitriol spills out into the blood, lowering their need for prescription calcitriol or one of its analogs. The companies that make the analogs don't like that, it means reduced sales. So these companies do nothing, the scientists behind these companies say nothing, and renal failure patients die prematurely from one of the vitamin D deficiency diseases.

Vieth R. Vitamin D toxicity, policy, and science. J Bone Miner Res. 2007 Dec;22 Suppl 2:V64-8.

11) When I asked my doctor for a 25(OH)D blood test, he just laughed and said it was all idiotic. What can I do?

Help me unleash the dogs of war, the plaintiff attorneys. If you read about past nutritional epidemics caused by society, such as beriberi or pellagra, you will realize that education alone will take decades. Physicians successfully fought against the idea that thiamine deficiency caused beriberi for decades. However, things are different now. The agents of change in modern America, as obnoxious as they are, are plaintiff attorneys. Once the first malpractice lawsuits claiming undiagnosed and untreated vitamin D deficiency led to breast cancer, autism, heart disease, etc., get past summary judgment, and they will, and end up in front of a jury, and they will, things will change rapidly. One of the main reason physicians do what they do is fear of lawsuits. In a matter of months, arrogance and ignorance will give way to 25(OH)D tests and vitamin D supplementation.

Goodwin JS, Tangum MR. Battling quackery: attitudes about micronutrient supplements in American academic medicine. Arch Intern Med. 1998 Nov 9;158(20):2187-91.

12) The vitamin D Council takes money from Bio Tech Pharmacal and Lifespan Nutrition and now you are a consultant for Diasorin. With those conflicts, how can I believe what you say?

Believe what you want, most people do anyway. As far as conflicts, I am actively soliciting them. No conflicts means no money and I don't want to work in a maximum security hospital for the criminally insane all the rest of my life. (Whops, I means a liberty impaired haven for the mentally challenged who are criminally defiant.) Furthermore, the Vitamin D Council cannot do what we need to do on $12,000.00 per year (what we get from Bio Tech Pharmacal). So if you know anyone or any business with some money to donate that would create a conflict, send them our way.

13) My blood test came back at 120 ng/ml. Am I toxic?

No, vitamin D toxicity has never been reliably documented with 25(OH)D levels less than 200 ng/ml. Ranges for humans living and working in the sun are between 50 and 100 ng/ml. Did Quest Diagnostics do your 25(OH)D?

John Cannell, MD
The Vitamin D Council

This is a periodic newsletter from the Vitamin D Council, a non-profit trying to end the epidemic of vitamin D deficiency. This newsletter is not copyrighted. Please reproduce it and post it on internet sites. Remember, we are a non-profit and rely on donations to publish our newsletter and maintain our website. Send your tax-deductible contributions to:

The Vitamin D Council
9100 San Gregorio Road
Atascadero, CA 93422

Sucralose Question

Question:
I have a question regarding Sucralose in the Pro argi 9 plus. How much of this substance is present in this product because it seems that some have contradictions regarding sucralose. I would just like to get somewhat of an idea so that we can clear up any questions when recommending your product.

Answer from Synergy Worldwide:
ProArgi-9 Plus contains a very small amount of sucralose, approximately 35 mg per scoop.

Sucralose is a sugar substitute produced from sucrose or table sugar. Sucralose underwent 20 years of safety and toxicity research before it was approved by the United States FDA in 1998. Since then it has been approved by 60 countries including the Joint FAO/WHO Expert Committee on Food Additives, The European Union, and Canada’s Health Protection Branch. Sucralose has been shown to be safe even in high doses in animal and human studies.

Below are some study abstracts regarding the safety of sucralose in human subjects:

Abstract 1:
Baird IM, Shephard NW, Merritt RJ, Hildick-Smith G. Repeated dose study of sucralose tolerance in human subjects. Food Chem Toxicol. 2000;38 Suppl 2:S123-9.

Two tolerance studies were conducted in healthy human adult volunteers. The first study was an ascending dose study conducted in eight subjects, in which sucralose was administered at doses of 1, 2. 5, 5 and 10mg/kg at 48-hour intervals and followed by daily dosing at 2mg/kg for 3 days and 5mg/kg for 4 days. In the second study, subjects consumed either sucralose (n=77) or fructose (50g/day) (n=31) twice daily in single blind fashion. Sucralose dosage levels were 125mg/day for weeks 1-3, 250mg/day during weeks 4-7, and 500mg/day during weeks 8-12. No adverse experiences or clinically detectable effects were attributable to sucralose in either study. Similarly, haematology, serum biochemistry, urinalysis and EKG tracings were unaffected by sucralose administration. In the 13-week study, serial slit lamp ophthalmologic examination performed in a random subset of the study groups revealed no changes. Fasting and 2-hour post-dosing blood sucralose concentrations obtained daily during week 12 of the study revealed no rising trend for blood sucralose. Sucralose was well tolerated by human volunteers in single doses up to 10mg/kg/day and repeated doses increasing to 5mg/kg/day for 13 weeks. Based on these studies and the extensive animal safety database, there is no indication that adverse effects on human health would occur from frequent or long-term exposure to sucralose at the maximum anticipated levels of intake.

Abstract 2:
Grotz VL, Henry RR, McGill JB, Prince MJ, Shamoon H, Trout JR, Pi-Sunyer FX. Lack of effect of sucralose on glucose homeostasis in subjects with type 2 diabetes. J Am Diet Assoc. 2003 Dec;103(12):1607-12.

OBJECTIVE: To investigate the effect of 3-months' daily administration of high doses of sucralose, a non-nutritive sweetener, on glycemic control in subjects with type 2 diabetes. DESIGN: A multicenter, double-blind, placebo-controlled, randomized study, consisting of a 6-week screening phase, a 13-week test phase, and a 4-week follow-up phase. SUBJECTS/SETTING: Subjects with type 2 diabetes (age range 31 to 70 years) entered the test phase of this study; 128 subjects completed the study. The subjects were recruited from 5 medical centers across the United States and were, on average, obese. INTERVENTION: Subjects were randomly assigned to receive either placebo (cellulose) capsules (n=69) or 667 mg encapsulated sucralose (n=67) daily for the 13-week test phase. All subjects blindly received placebo capsules during the last 4 weeks of the screening phase and for the entire 4-week follow-up phase. MAIN OUTCOME MEASURES: Glycated hemoglobin (HbA1c), fasting plasma glucose, and fasting serum C-peptide were measured approximately every 2 weeks to evaluate blood glucose homeostasis. Data were analyzed by analysis of variance using repeated measures. RESULTS: There were no significant differences between the sucralose and placebo groups in HbA1c, fasting plasma glucose, or fasting serum C-peptide changes from baseline. There were no clinically meaningful differences between the groups in any safety measure. CONCLUSIONS: This study demonstrated that, similar to cellulose, sucralose consumption for 3 months at doses of 7.5 mg/kg/day, which is approximately three times the estimated maximum intake, had no effect on glucose homeostasis in individuals with type 2 diabetes. Additionally, this study showed that sucralose was as well-tolerated by the study subjects as was the placebo.

PMID: 14647086 [PubMed - indexed for MEDLINE]

Abstract 3:
Knight I. The development and applications of sucralose, a new high-intensity sweetener. Can J Physiol Pharmacol. 1994 Apr;72(4):435-9.

Sucralose is a new sweetener discovered during a collaborative research program between Tate & Lyle and Queen Elizabeth College of the University of London. It is made by selective substitution of sucrose hydroxyl groups by chlorine, resulting in a highly intense (600x) sugar-like sweetness and exceptional stability at both high temperature and low pH. The research leading to the discovery of sweetness in differently halogenated sucrose is described, as well as the development of sucralose and the process of safety testing and government approval. Finally, sucralose properties and applications in Canada's food and beverage industries are discussed.

PMID: 7922876 [PubMed - indexed for MEDLINE]

According to the International Food Information Counsil:

“Sucralose has an excellent safety profile. More than 100 scientific studies conducted over a 20-year period demonstrate that sucralose is safe for use as a sweetening ingredient. The data from the studies were independently evaluated by international experts in a variety of scientific disciplines, including toxicology, oncology, teratology, neurology, hematology, pediatrics and nutrition. Importantly, comprehensive toxicology studies, designed to meet the highest scientific standards, have clearly demonstrated that sucralose is not carcinogenic.”

And:

“Among the regulatory bodies that have evaluated the safety of sucralose are the U.S. FDA, the Joint FAO/WHO Expert Committee on Food Additives (JECFA); the Health Protection Branch of Health and Welfare Canada; Food Standards Australia/New Zealand, the European Union’s Scientific Committee on Food, and a host of others in South America and Asia. Sucralose is now permitted for use in over 60 countries.”

And:

“Sucralose is an essentially inert molecule. It passes through the body unchanged, is not metabolized, and is eliminated after consumption.”

Reference: IFIC Foundation. Sucralose. 2007. Available at: http://www.ific.org/publications/brochures/sucralosebroch.cfm

Also see: Daniel JW, Renwick AG, Roberts A, Sims J. The metabolic fate of sucralose in rats. Food Chem Tox. 2000;38(S2): S115-S121.

The FDA reviewed data from more than 110 studies in humans and animals to determine the safety of sucralose. Sucralose was not found to have reproductive or neurological effects or to be carcinogenic and FDA's approval is based on the finding that sucralose is safe for human consumption.

Reference: FDA Talk Paper: FDA Approves New High-Intensity Sweetener Sucralose. 1998. Available at: http://vm.cfsan.fda.gov/~lrd/tpsucral.html

According to the Canadian Diabetes Association, one can consume 15 mg/kg/day of Sucralose "on a daily basis over a ... lifetime without any adverse effects" For an average size person, this is equal to about 1000 mg of sucralose per day every day over a lifetime.

Reference: 2003 Clinical Practice Guidelines. Acceptable Daily Intake of Sweeteners. 2003. Available at: http://www.diabetes.ca/cpg2003/chapters.aspx?table1acceptabledailyintakeofsweeteners.htm

I hope this information is helpful

Heart Enlargement

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Intro to the Insane Protocol

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Click here to see the Insane Protocol.

Heart Attack, Stroke and Vit D

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