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Dr. Gregory Pais, ND
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Home arrow Naturopathic News arrow Issue #122 November 2012
Issue #122 November 2012
  1. INTRODUCTION
  2. HOLIDAY GIFT CERTIFICATES
  3. ARTHRITIS AND VITAMIN D
  4. ACETAMINOPHEN USE LINKED TO INFANT ASTHMA
  5. CADMIUM EXPOSURE LINKED TO LOWER IQ
  6. PESTICIDE USE HARMS CHILDREN'S BRAINS
  7. HOMEOPATHY WORKS FOR HOT FLASHES
  8. HERE COMES THE SUN
  9. WEBSITE SERVICES
  10. FACEBOOK
  11. SUPPLEMENT CHOICES
  12. VITAMIN D TESTING
  13. EMERSON ECOLOGICS
Welcome to this issue of Naturopathic News, issue #122. It's my mission to help you find optimal solutions to health problems. This newsletter is one way to do that. The more educated you are about your health options the better able you will be to take control of your health. If you would like to stop receiving my newsletter please send me an email and let me know. If you have a friend or family member who you think would appreciate the information provided, send me their email address. 


HOLIDAY GIFT CERTIFICATES
In gratitude to you, we are devoting our time this holiday season in special service to your family and friends. As the year winds down, we would like to eliminate some of your holiday gift-giving stress: the opportunity to help create health for friends and family. 

For the first time we are offering gift certificates that you can purchase to share the gift of optimal health with a friend or family member. These gift certificates are valued at $165, which covers the entire cost of initial consultation, first homeopathic medicine, and individualized treatment planning for new patients in our practice.* 

There are probably one or two people you know who would greatly appreciate the opportunity to make this step toward better health. In fact, it could be the most important gift anyone gives them this year. Perhaps you know someone who lives out of the area and has been unable to find a naturopath/homeopath to work with where they live. I work with patients from Germany to California utilizing Skype and phone consultations.

To purchase a gift certificate, you may pay with check, cash, or credit card. Once payment is received a gift certificate will be emailed to you that you can customize and print for the lucky recipient. They will be delighted that you thought of them at this special time of the year and grateful for your offering of this wonderful opportunity.

Wishing you a Healthy and Happy Holiday,
Gregory Pais, ND

P.S. Are you aware of all the conditions we work with? Naturopathic and homeopathic medicine address any condition a conventional doctor would see--Irritable Bowel Syndrome, migraine, anxiety, high cholesterol, menopause, Lyme Disease, gluten intolerance, ADHD, chronic fatigue syndrome, etc. So think about anyone – any age – who could benefit from effective, drug-free natural medicine.

*Conditions of gift certificate: Valid for new patient, initial office visit services only. Cannot be used for existing balances, supplements, supplies, or laboratory test fees. 
All gift certificates must be redeemed by June 30, 2013.


VITAMIN D LEVELS ASSOCIATED WITH KNEE ARTHRITIS PAIN
Findings from the University of Florida suggest a protective effect for increased vitamin D levels against knee osteoarthritis pain, which is greater in African Americans compared to those of European ancestry. African Americans have, on average, lower vitamin D levels compared to Caucasians, which may help explain some of the health disparities observed between these populations.

"Chronic pain is a disease," lead author Toni L. Glover, MSN, ARNP and her associates write. "The triage theory, proposed by Ames, hypothesizes long-term micronutrient deficiencies trigger chronic inflammation. In turn, chronic inflammation leads to chronic health conditions, many of which are characterized by pain as a disabling symptom. Recent research by Lee et al. supports the hypothesis that the etiology of osteoarthritis 
includes a systemic inflammatory component."

Forty-five African American and 49 Caucasians between 45 and 71 years of age with osteoarthritis of the knee completed questionnaires concerning knee symptoms and underwent tests of heat and mechanical pain sensitivity. Blood samples collected at the time of testing were analyzed for serum 25-hydroxyvitamin D.

African American participants reported more pain in comparison with Caucasian subjects. While half of the Caucasian participants had vitamin D levels that were lower than 30 nanograms per milliliter (ng/mL), these insufficient levels occurred in 84% of the African Americans. Average Caucasian vitamin D levels were 28.2 ng/mL, in contrast with 19.9 ng/mL among African Americans. 

"People associate vitamin D with good bone health," stated Glover, who is a research nurse practitioner and doctoral candidate at the University of Florida. "Yet, not everyone is aware of what factors decrease vitamin D and how low levels could contribute to health issues, including chronic pain. Our data demonstrate that differences in experimental pain sensitivity between the two races are mediated at least in part by variations in vitamin D levels. It may be warranted that older black Americans with chronic widespread pain be screened for vitamin D deficiency to reduce disparities in pain."
Arthritis & Rheumatism November 7, 2012
DR. PAIS'S COMMENTS: This study is interesting for what was said, as well as for what wasn't said. Ms. Glover is correct in her statement that not everyone is aware of what factors decrease Vitamin D. So what are some of the most important ones?

First, you have to look at lack of sun exposure. Everyone has been strongly intimidated to stay out of the sun to prevent skin cancer. A major consequence of staying out of the sun is that your body then makes less Vitamin D. Remember, low Vitamin D has been shown to be a risk factor for not only skin cancer but many other cancers as well--breast, colon, prostate, etc.

Second, use of certain prescription drugs interfere with Vitamin D. Here are some of the more common ones. Mineral oil depletes Vitamin D. Steroid drugs like Prednisone. Statin drugs like Lipitor. Calcium channel blockers like Verapamil. Reflux drugs like Tagamet. Blood thinners like Warfarin. Anticonvulsant drugs like Dilantin. 

Third, having digestive problems can disrupt Vitamin D absorption. Especially gall bladder disease or other disorders which lower fat absorption and metabolism. This is due to Vitamin D being a fat soluble vitamin.


ACETAMINOPHEN IN INFANCY TIED TO ASTHMA
Babies given acetaminophen for fevers and aches may have a heightened risk of asthma symptoms in their preschool years, a new study suggests.

The findings, from a study of 411 Danish children, add to a mixed bag of research into whether there's a link between acetaminophen - better known by the brand-name Tylenol - and kids' asthma risk.

Researchers found that the more acetaminophen kids were given as infants, the more likely they were to develop asthma-like symptoms in early childhood. The study included 336 children who were followed from birth to age seven. All had mothers with asthma, which put them at increased risk for the lung disease themselves.

Overall, 19% of the children had asthma-like symptoms by the age of three - meaning recurrent bouts of wheezing, breathlessness or coughing. Researchers found that the risk generally went up the more often a child was given acetaminophen in the first year of life. For each doubling in the number of days a baby received the drug, there was a 28% increase in the risk of asthma symptoms.

A number of past studies have suggested that young children given acetaminophen are at increased of asthma. 
Journal of Allergy and Clinical Immunology, online October 26, 2012.
DR. PAIS'S COMMENTS: This is one of those studies were it seems as if everyone assumes certain things to be true. Here, the truism seems to be acetaminophen is necessary so don't worry because we haven't proven that its use causes asthma.

What if we didn't suppress fevers? What if we allowed the body (within specific parameters) to use fever to help heal itself? Remember, raising the body's temperature kills off bacteria and other organisms. There are so many ways to help heal--homeopathy, herbs, hydrotherapy--without suppressing the body's healing mechanism. Why not use one of these therapies and not even have a chance of causing asthma?


PRENATAL CADMIUM EXPOSURE LINKED TO LOWER IQ SCORES IN KIDS
Prenatal exposures to the metal cadmium -- even at low levels common in most countries -- can have long-lasting effects on children's IQ. A study from Bangladesh found that 5-year-olds who were exposed through their mothers to higher levels had IQs that were 2 to 3 points lower than less-exposed children. The new evidence suggests that even low-level exposures before birth may have continued effects on children's brain function.

Even small drops in IQ may affect a child’s ability to succeed at school and work later in life. Lower IQ's across the population also have large impacts on society. IQ is a measure of intelligence when compared to others in the same age group. Genetics plays a big role in determining IQ, but nutrition before and after birth is also important, including the mother's diet during pregnancy and breastfeeding.

Cadmium is a soft, bluish-white metal found naturally at low levels in the air, water and soil. Manufacturers use it in a number of applications and processes, including to make nickel cadmium batteries and solar panels, to coat and plate metal and to stabilize plastics. Cadmium is released from natural sources. It is also emitted in car exhaust; from burning industrial waste, coal and oil; during battery and paint manufacturing; and from the hauling and disposing of waste. When spread on fields, fertilizers and sewage sludge contaminated with cadmium can increase levels in cropland soils.

Most people are exposed to cadmium through their diet. Cadmium from the soil can accumulate in some foods, such as spinach and other leafy greens, rice and other cereals, and potatoes. It also can be found in seafood and organ meats. Cadmium also can concentrate in tobacco leaves, exposing smokers and those around them to the toxic metal.

Cadmium is known to affect the development of the brain and nervous system. Childhood exposures have been linked to mental retardation, learning difficulties, dyslexia, poor hand-eye coordination, and lower IQ and behavior problems in children.

However, little is known about how pre-birth exposures to cadmium might affect a child's long-term brain development. It is important to understand because the developing fetal brain is extremely sensitive, so even small exposures during pregnancy may have effects.

The researchers measured cadmium levels in urine from 1,305 women living in rural Bangladesh who were approximately eight weeks pregnant. All of the babies were born in 2002 and 2003. The participants were part of a larger study looking at food and micronutrient supplementation during pregnancy.

When the children were 5 years old, the researchers measured cadmium levels in their urine and gave standardized tests that measured verbal, performance and full-scale intelligence quotient or IQ. Child behavior was assessed using a questionnaire. The tests and questionnaire were adapted for use with Bangladeshi children.

Those with higher exposures were compared to those with lower exposures. The researchers took into consideration socioeconomic status and personal information, including the quality of home stimulation, maternal IQ and birth order.

While they found links to exposures before birth and at age 5, the children's IQ was more strongly associated with pre-birth exposures than with childhood exposures. When kids with the top 5 percent of cadmium exposures were compared to the lowest 5 percent, full-scale IQ dropped by 2.7 points when pre-birth levels were compared and 1.7 points when childhood levels were compared.

The effects were slightly stronger in girls than boys and stronger in children from higher-income rather than lower-income families. Children with higher cadmium levels in urine also had poorer behavior compared to less-exposed kids.

Surprisingly, cadmium had a larger effect on child IQ than arsenic, another metal known to affect brain development and commonly found in the well water of the region studied.
On average, a doubling of the cadmium levels in the moms’ urine during pregnancy was associated with lower verbal IQ (a drop of 0.84 points), lower performance IQ (lowered by 0.64 points) and lower full-scale IQ (down by 0.80 points) in their children five years later. Similar but weaker patterns were found for verbal and full-scale measures using the child's cadmium levels at age 5.

The findings suggest that early life exposures to cadmium, at levels present in many countries, may be harmful for brain development. 
Early-Life cadmium exposure and child development in 5-year-old girls and boys: a Cohort study in rural Bangladesh. Environ Health Perspect. 2012 October; 120(10): 1462–1468.
DR. PAIS'S COMMENTS: Most people are aware to at least a small extent of lead and mercury's toxicity. Cadmium is another heavy metal that must be considered when looking at environmental contamination related to children.

If in 2012, with arsenic contamination of rice, the defeat of GMO labeling in California, you need another reason to go organic, here it is. Buying organic may not guarantee that you won't have cadmium in your food but it will give you the best chance.


PESTICIDE SEEMS TO HARM BOYS' BRAINS MORE THAN GIRLS'
A widely used pesticide – banned in homes but still commonly used on farms – appears to harm boys’ developing brains more than girls’, according to a new study of children in New York City.

In boys, exposure to chlorpyrifos in the womb was associated with lower scores on short-term memory tests compared with girls exposed to similar amounts. The study is the first to find gender differences in how the insecticide harms prenatal development. Scientists say the finding adds to evidence that boys’ brains may be more vulnerable to some chemical exposures.

“This suggests that the harmful effects of chlorpyrifos are stronger among boys, which indicates that perhaps boys are more vulnerable to this type of exposure,” said Virginia Rauh, a perinatal epidemiologist at Columbia University and co-author of the study.

Chlorpyrifos is an organophosphate insecticide, a powerful class of pesticide that has toxic effects on nervous systems. It was widely used in homes and yards to kill cockroaches and other insects, but in 2001 the U.S. Environmental Protection Agency banned its residential use because of health risks to children. Since then, levels inside U.S. homes have dropped, but residue remains in many homes. In addition, many developing countries still use the pesticide indoors.

“There’s mounting evidence now from epidemiological studies that prenatal exposure to organophosphate pesticides, and chlorpyrifos in particular, may be associated with detriments with IQ in children,” said Kim Harley, an environmental epidemiologist with the University of California, Berkeley who has studied effects of pesticide exposure on children in California farm towns. She was not involved in the New York City study.

The environmental group Earthjustice has sued the EPA in an effort to ban all remaining uses of chlorpyrifos. “The exposures are to farmworkers and farmworker families, and people who live in those rural areas that are abutting the fields where chlorpyrifos is applied,” said Earthjustice attorney Kristen Boyles. The 2007 lawsuit is still pending, although the EPA announced last month that it will require reductions in application rates and buffers to protect children and other bystanders. An EPA spokesperson said the agency is re-evaluating chlorpyrifos and expects to make a decision in 2014.

The 335 pairs of mothers and children in the new study were not farmworkers, but are part of a large group of Latino and African American children from low-income neighborhoods of Northern Manhattan and the South Bronx. Columbia University researchers have been tracking more than 700 of these kids since they were born, between 1998 and 2006. Children there have a history of health problems, including asthma rates that are among the nation’s highest, and low birth weight. Many were born before the residential ban on chlorpyrifos.

An earlier study of the children found that chlorpyrifos was linked to delayed mental and motor skill development even after controlling for poverty, dilapidated housing and other community factors. The scientists, in a more detailed follow-up, then found that IQs and memories were reduced in 7 year olds with higher prenatal exposure. Those with the highest exposures scored on average 5.3 points lower on a short-term memory test, and 2.7 points lower on an IQ test, than children with the lowest exposures.

In the new study, umbilical cord blood was collected from the newborns, who were born before and slightly after the 2001 chlorpyrifos restrictions. When the kids were 3 years old, the researchers studied how well the mothers nurtured and educationally stimulated them. Then, at age 7, the children’s short-term memory was tested, for example, by having them repeat a sequence of numbers. Memory is an important component of IQ tests. Chlorpyrifos exposure had a larger association with working memory scores in the boys, who averaged three points lower than the girls with similar exposures, the study found.

The new finding is consistent with what is known about how other chemicals affect boys more than girls, said David Carpenter, director of the Institute for Health and the Environment at the University at Albany. Lead, for example, seems to cause a greater IQ deficit in boys than girls, and some evidence suggests that polychlorinated biphenyls, PCBs, may have similar consequences, Carpenter said.

Previous research has shown that low to moderate exposure to chlorpyrifos during pregnancy can lead to irreversible changes in a child’s brain. According to a 2012 study of the New York City children, MRIs of 40 children, from about 6 to 11 years old, found that those with high exposures had more abnormalities in regions of the brain associated with memory. They also were significantly more likely than children exposed to low levels to experience attention problems and delays in cognitive and motor skills.

The new study is the first to measure chlorpyrifos in umbilical cord blood, which unequivocally shows if a mother and her fetus were exposed. Researchers do not know how those kids’ exposures, which occurred between 1998 and 2006, compare with levels in kids today because there are no data for comparison.

Known by the Dow trade name Lorsban, chlorpyrifos is still sprayed on some crops, including fruit trees, vegetables, corn, cotton, citrus and nut trees, alfalfa, and grapes. About 10 million pounds of chlorpyrifos are applied to agricultural fields annually, according to the EPA. It is also used on golf courses and for mosquito control. 

Organophosphate exposure has been shown to have similar effects on children from farmworker families. In California’s Salinas Valley, Latino children whose mothers had the highest exposures to organophosphates, including chlorpyrifos, had a 7-point drop in IQ compared with children of moms with the lowest exposures.
Neurotoxicology and Teratology July 2012
DR. PAIS'S COMMENTS: Organophosphates are some of the most environmentally persistent and harmful pesticides used. How many lives need to be affected before they are banned all together?


EFFICACY OF HOMEOPATHIC TREATMENT ON HOT FLASHES
Homeopathic medicines have a place among the non-hormonal therapies for the treatment of hot flashes during the menopause. The objective of this study was to evaluate the efficacy of the non-hormonal treatment BRN-01 in reducing hot flashes in menopausal women. 

This was a multicenter, randomized, double-blind, placebo-controlled study carried out between June 2010 and July 2011. The study was conducted in 35 active centers in France (gynecologists in private practice). One hundred and eight menopausal women, ?50 years of age, were enrolled in the study. The eligibility criteria included menopause for < 24 months and ? 5 hot flashes per day with a significant negative effect on the women's professional and/or personal life. 

Treatment was either BRN-01 tablets, a registered homeopathic combination medicine containing Actaea racemosa 4C, Arnica montana 4C, Gloninum 4C, Lachesis mutus 5C, and Sanguinaria canadensis 4C, or identical placebo tablets. Oral treatment (2 to 4 tablets per day) was started on day 3 after study enrollment and was continued for 12 weeks. 

The main outcome measure was the hot flash score (HFS) compared before, during, and after treatment. Secondary outcome criteria were the quality of life, severity of symptoms (measured using the Menopause Rating Scale), evolution of the mean dosage, and compliance. All adverse events were recorded. 

One hundred and one women were included in the final analysis--BRN-01,?50 women; placebo, 51 women. The global HFS over the 12 weeks was significantly lower in the BRN-01 group than in the placebo group. BRN-01 was well tolerated; no serious AEs were attributable to BRN-01. 

BRN-01 seemed to have a significant effect on the HFS, compared with placebo. According to the results of this clinical trial, BRN-01 may be considered a therapeutic option with a safe profile for hot flashes in menopausal women who do not want or are not able to take hormone replacement therapy or other recognized treatments for this indication. 
Drugs R D. Aug 1, 2012 
DR. PAIS'S COMMENTS: No, I'm not recommending a homeopathic combination product for hot flashes. Why not? Because I rarely see combination products have lasting effect. The way to interpret these results is that the individual remedy needed by the people who responded happened to be one of the remedies in the formula. More importantly, this is a randomized, double-blind, placebo-controlled study--the epitome of scientific validation. The next time you hear that there is no scientific proof for natural medicine just smile and send the fact denier to this study. Then listen to them sputter and try and come up with some reason why this science isn't really 'scientific'.


HERE COMES THE SUN
My eBook, "Here Comes The Sun: Preventing Chronic Disease With Vitamin D", is now available for purchase.

The best way to order my book is to mail a check (made out to Dr. Pais) for $9.95 to my office address below. Drop me an email saying your "check is in the mail" and I will immediately email you my book.

I would appreciate any comments or feedback once you've finished reading it. Enjoy!


WEBSITE SERVICES
Here are some pages that are of particular interest:

Store: There are 357 products from Emerson listed on this page. If yours isn’t one of them please let me know and I will add it so you can order online. This is particularly convenient after hours or on the weekend. Of course, you can always order by phone from Emerson at 800-654-4432.

Newsletter: Here you will find all 116 issues of my health newsletter, "Naturopathic News”.

Optimal Health Points: This is my blog that I update periodically. Check out my latest post, “No Deaths From Vitamins, Minerals, Amino Acids Or Herbs”.


FACEBOOK
Come join my fan page at www.facebook.com/NaturalDoc 
Help me bring information, news, and stories about natural medicine to the Facebook community. 

For those of you who don’t know, Facebook is a social networking website. Users can add friends and send them messages, and update their personal profiles to notify friends about themselves. Additionally, users can join networks organized by city, workplace, and school or college. 

Facebook pages help you discover new artists, businesses, and communities as well as those you already love. On my fan page www.facebook.com/NaturalDoc I post discussions that you can join in with and relay breaking health news related to disease prevention, clinical nutrition, and ways to make you healthier. 

I’m looking forward to exploring this community with you. See you there!


LET ME HELP YOU MAKE WISE SUPPLEMENT CHOICES
As is often the case, a recent new patient asked if I would review their choice and use of supplements and herbs. Why does this happen so often? For many, taking a vitamin or herb is their introduction to natural medicine. Their desire to be healthier drives them to take supplements and herbs. The death, pain, discomfort, and side effects experienced with over the counter and prescription drugs compel people to look elsewhere. It’s very different with supplements and herbs which, when used correctly, have an incredibly low risk of harm.

Some people take this to an extreme and take every supplement or herb that someone tells them is ‘good for them’. It might be a clerk, an internet ‘expert’ source, or a friend who is marketing the latest or greatest fad. Most of these individuals or companies have no professional training or experience in the medical use of the supplements or herbs that they’re selling. The people they’re selling to come into my office with 5, 10, 15, or more supplements that they’re taking. Sometimes it’s been so long since they started taking them that they don’t remember why they’re doing it. When I ask, they can’t tell me what, if anything, a particular product is doing for them. Yet, they can be quite fearful of stopping any of these items, as if their health would careen off a precipice without them.

Why do I think my approach is any different? Partly, it’s because of my background. I’ve literally been working with nutritional supplements since 1974. That’s 36 years assessing the quality and effectiveness of supplements. Beginning in 1980 I started working with Western and Chinese herbs. The quality of herbs used and how they’re combined together has the greatest effect on the efficacy of the final product. Because I’ve grown, identified, harvested, and produced medicinal herbal products I recognize a good formula when I see one.

Licensed naturopaths like me receive the most extensive academic and clinical training in the use of nutritional supplements and herbal medicines of any professional in the United States. Nothing can substitute for such hands on experience, especially when you see, and are responsible for, the results of your treatments. Very different from the clerk in the store, or coworker who’s part of a MLM scheme. 

What I’m offering to is easy access to this experience and training. Both for you and your family. If you have questions about the supplements or herbs you are taking, or are thinking about taking, now is the time to ask. Send me an email with the brand and name of the product you’re taking. Let me know that you want to bring the bottles in at your next visit, so I can see what you’re taking. Start a discussion on my Facebook fan page. Either way I’ll give you honest feedback about what I think is good, or what isn’t. We’ll fine tune what you’re taking to maximize effect and eliminate waste. 

Let me hear from you and we’ll get started. 


GET YOUR VITAMIN D TEST WITH ZRT LABORATORY
It just happened again the other day. A patient sent me a copy of the Vitamin D test she just had done. With frustrating results. The wrong test was done. After all these years, and all the information available, MDs and laboratories still order the wrong test. What a waste of money and time. 

For a long time I looked for a home Vitamin D test. One that would be simple, easy, and accurate to do on your own. I finally found one. ZRT Laboratory in Beaverton OR. ZRT emphasizes research and technological innovation. 

Until now, venipuncture blood serum has been the standard medium for testing Vitamin D. ZRT has developed and refined Vitamin D testing in blood spots. A few drops of blood from a quick and nearly painless nick of the finger, placed on a filter paper to dry are all that is needed. The total 25 (OH) Vitamin D is then determined by liquid chromatography/tandem mass spectrometry (LC-MS/MS). This method has been shown to be as accurate as the assay standard.

Ordering A Vitamin D Test 
ZRT allows anyone to order a Vitamin D test kit for $95 plus shipping and have it sent to their home. ZRT will let me prepay for kits and send them to my office for $55 each, plus $8 shipping. I am charging $65 per kit for patients to cover the total. 

If you are interested in getting a Vitamin D test done through my office please prepay so I can order you a kit. Then you can either pick it up at my office or have it shipped to your home. Once you’ve taken the sample and sent it back to ZRT it’s only a matter of time before your results are sent back to me. I can even look at them online before the mail arrives.

If your doctor has refused to order a Vitamin D test or worse, ordered the wrong one, this is the fastest, least expensive, most accurate way to do it ourselves. Once we know what your Vitamin D levels are, the next step is making sure that you achieve optimum levels for prevention of disease and maintenance of health.


EMERSON ECOLOGICS
I am often asked what supplements I recommend. Many of you have been surprised to discover that I favor food over pills; lifestyle changes over fads. I have been working with nutrition for over 30 years, herbs for over 20 years. Where and when appropriate I recommend them to my patients. I strive to act from knowledge, experience, and research.

Emerson Ecologics (800-654-4432) carries almost all of the nutritional supplements and botanical extracts that I think are useful. Their customer service is excellent and their delivery is reliable (often only 2-3 days to this region). It’s a great way to get physician quality products at reasonable prices. 

To offset the cost of shipping, reference my name when you establish your account and receive a 10% discount on every order. If you have any questions about these items feel free to email me.

That’s it for this issue of Naturopathic News. If you’ve thought a bit extra or learned something new, then I achieved my goal. As usual, if you have questions or concerns brought up by these subjects, let me know. 

Gregory Pais, ND, DHANP
580 E. 3rd. St.
Williamsport PA 17701
570-320-0747 
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