#typically they both have very impressive pain tolerances but not even they are immune to the almighty power of Cramps

[tangledinink]

if I have to deal with it!!!! THEY have to deal with it!!!!

[ the gemini ]

[dantempyt555]

12 Steps to Finding the Perfect Kann man CBD in der öffentlichkeit frei konsumieren?

Olej

As of late, CBD oil company is rising. You will find healthcare knowledge proving CBD oil's efficiency in treating insomnia in children suffering from anxiety attributable to trauma. According to animal experiments, CBD has demonstrated antidepressant action. What this means is that you ought to get time to examine with the jurisdiction and determine regardless of whether your place has any restrictions regarding the usage of Cannabis sativa and its byproducts. Most African nations around the world Will not let any usage of Cannabis and its compounds. It is necessary to underline that, Despite the fact that this study has checked out kids from different revenue teams in South Africa, you'll find elements aside from revenue that influence using corporal punishment together with other sorts of humiliating and degrading punishment of children, for instance relative levels of anxiety and possibly involved romantic relationship troubles.

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The characteristic that defines cannabis from hemp is the content of tetrahydrocannabinol (THC), the compound in cannabis that gets end users "significant." Hemp is nearly solely devoid of THC but typically high in An additional cannabinoid - cannabidiol (CBD). Hemp has 0.3 p.c THC or much less whilst the threshold for cannabis starts off in a THC concentration of 0.31 percent or higher. Both varieties of cannabis, hemp and marijuana, happen to be proven to consist of medically effective amounts of differing cannabinoids, active compounds present in the cannabis plant. As talked about earlier, my journey into CBD was inspired by CNN's documentary, "Weed". In this particular documentary, Additionally they highlighted a vendor that made the CBD oil that assisted Charlotte. The exact same vendor then went on to build CBD oil item for others and named it immediately after Charlotte, "Charlotte's World-wide-web". I essential an item that will be Safe and sound for children. Supplied its history, Charlotte's Net gave the impression of a good in good shape.

Not only have we dramatically diminished the price, but we can even give a no cost bottle of our Black Pearl CBD Hand Sanitizer with Each individual acquire from the Immune Guidance and free delivery to aid you and your loved ones continue to be healthful through these challenging and unsure occasions. If you decide to consider CBD oil, treat it like you'd almost every other treatment method option for migraine It might take a while to operate , and you also might require to adjust your dosage to raised go well with your preferences. How would we report this period in the South African story for long term generations? The convulsions in excess of the ANC's Mangaung Management contest will occur and go; the suffering in the Marikana mine deaths will fade; the life of the lousy will continue being wretched as well as the wealthy will even now savour opulence at the rear of their superior walls; the point out will carry on to be the feeding trough with the effective.

Absolutnie nie namawiam, sam na weganizm nie przeszedłem i raczej się na to nie zapowiada. Jedyne co zdążyłem zrozumieć SM to to, że jest to popierdolona choroba i że każdy przechodzi ją inaczej. Przede wszystkim mam świadomość swojej ignorancji i niewiedzy w temacie medycyny i ciągle pokładam nadzieję w kolejnych lekach, które są proponowane i oczywiście Tobie będę zalecał to samo. Only acquire CBD items that use The complete hemp plant, not synthetics and not isolates, as The complete plant consists of the total spectrum of cannabinoids and terpenes, the active compounds that provide plants their style and scent. Herbalists consider the terpenes in hemp interact synergistically Using the cannabinoids to create an "entourage impact" that improves the healthful consequences of each person element.

Omega-3 fatty acids are important for great health. Your body can not make them, so you need to get them from meals. Omega-3 fatty acids could assistance to decrease your hazard for a variety of health and fitness disorders, which include heart problems, arthritis and cancer. Sources of omega-three fats include the oils from crops, fish and nuts, including hemp seeds, which are technically nuts. The explanation that Billy's cannabis oil was seized at Heathrow airport was that it did not just comprise CBD, it also contained THC at greater ranges than lawfully permitted. A fantastic company for a lot of CBD solutions, Spruce surely has a lot to provide to be a brand name. Pertaining to their CBD oil for canine, It truly is absolutely obtained some top top quality notches for it. One thing that stands out is just how much generate you're getting from the total spectrum oil. The largest factor that'd we say might maintain it again is cost, particularly that it commences at such a superior-margin for pet owners. Besides that, it is a solid item for the worth, even with its steep entry.

A number of Abahlali members from Pemary Ridge went towards the Sydenham police station around two:30am to inquire about those that had been arrested. A police officer instructed them that eleven men and women had been arrested. He reported they might not begin to see the arrested, Which browsing hrs were being at 12pm on Saturday. He stated that the arrested had not been billed nonetheless, but they would seem from the Pinetown Magistrate's Courtroom on Monday. When questioned if those arrested had been given professional medical awareness, he denied that they were being injured. He explained which the 11 arrested were not hurt, and so have not received any clinical attention. In addition there are different strengths of CBD oil, the lowest currently being 300mg (three%) ranging to 800mg (eight%). It can be suggested you start in a lower dosage and slowly Establish up your tolerance.

Gusser and American Romance, all items will have to arrive at an conclusion. It is actually time for our Vitality usage and building ability to operate on a little something apart from oil and coal. Guaranteed these fuels built the US, but In the end we cannot find the money for it. Many people go through Long-term diarrhea adhering to gallbladder surgical procedure. In unusual situations, This may final For a long time, according to Michael File. Picco, a gastroenterologist crafting for Restricting foods that may cause diarrhea, for instance All those fried in olive oil or other greasy, large-fat foods, could support to cut back your diarrhea. Restricting dairy items, caffeine and sweets may enable also. However, the cause of diarrhea next gallbladder elimination stays unclear. The result in could be an increase in bile coming into your substantial intestine due to the fact this may need a laxative result, notes Picco.

Extra-virgin olive oil is derived by "cold urgent" of olives. This extracts the oil though preserving the well being and nutritive qualities of olives compared with most cooking oils wherein even though refining by chemicals destroys some in their natural nutritive benefit. Olive oil is full of oleic acid which has been associated, in clinical scientific studies, with reducing prices of cardiovascular disease, atherosclerosis, diabetes, colon cancer and bronchial asthma. But olive oil is just not a heat steady oil and is also ideal made use of cold (for salad dressings) or under reasonable warmth and thus just won't accommodate our Indian frying cooking fashion. So, apply it to bread in lieu of butter for the breakfast but Never fry cutlets in it. The two major constituents of cannabis oil are THC (tetrahydrocannabinol) and CBD (cannabidiol). Oil containing CBD by yourself (CBD oil) could be legally acquired in britain with out a prescription because it incorporates only extremely Was ist der Unterschied von THC und CBD? very low quantities of THC. But cannabis oil that contains THC at higher stages (in excess of 0.3%) is prohibited. THC is a agenda 1 drug , which is to mention, it's considered to possess no medicinal value.

CBD oil has long been researched for its likely role in managing quite a few prevalent medical issues, including stress and anxiety, depression, acne and cardiovascular disease For people with cancer, it may well even supply a organic alternate for pain and symptom reduction. Exploration about the potential wellness great things about CBD oil is ongoing, so new therapeutic makes use of for this normal solution are certain to be discovered. Although There exists Substantially to get uncovered with regards to the efficacy and security of CBD, outcomes from new scientific studies recommend that CBD could offer a Harmless, effective purely natural treatment For several health issues. So, CBD can be The best bodyguard of The body and head. Law enforcement estimate 50,000 individuals marched in Johannesburg, South Africa's economic hub. Smaller crowds turned out in Cape Town along with other cities and towns.

CBD is available in various solutions and is also simple to operate for kids. Pure CBD oil, tinctures or liquid concentrates is often placed underneath the tongue which gets absorbed by mucous membranes inside mouth just before swallowing. In case youngsters aren't capable of holding CBD oil during the mouth it may be effortlessly ingested. Yet another widespread reasons seniors are up during the night time is to employ the lavatory. Helping seniors stay in bed at night could possibly imply limiting liquids a few hours in advance of bed, ensuring that they use the rest room suitable right before retiring for the night time, and providing them with bathroom support products like right away adult diapers, bed pans and bed pads, urinals, and various materials which will help lower the necessity to depart the mattress. A nicely-revered model from the business, Sunday Scaries unquestionably delivers on their oil. Although made for individuals, it's also competive to lots of manufacturers inside the Pet planet, along with comes along with considered one of the higher groups for customer care all around. As a staff that's in it to the extended-haul, there is a number of upside to Sunday Scaries, with their additon for the CBD planet for pets seeking just as notable.

Hemp is healthful! Nutritional worth of hemp seeds cannot be overstated, as they characteristic a posh profile of proteins, fats, natural vitamins and minerals, that lower and forestall daily life threatening conditions, including cancer and heart disease. It's not nonetheless absolutely comprehended just how much or which distinct lignans are needed to assist fantastic wellbeing. This eventually signifies that whilst there aren't any serious risks to consuming significant-lignan flax oil, this product may not give you any major Gains possibly. In the meantime, a 2017 study led by Bonn-Miller found that nearly seven of 10 CBD products did not contain the amount of cannabis extract promised within the label. Vitamin A is considered critical for the healthy immune operate, epithelial growth and repair service, bone expansion, reproduction, and standard embryonic and fetal progress (West 2006). Positive aspects for the lungs, having said that, do not look like crucial enough to say.

Cannabis oil is often supplied to people suffering from Persistent discomfort, inflammation and occasional soreness reduction. This can be why Individuals who have been diagnosed with cancer change to items relevant to cannabis, together with cannabis oil, after they need relief from the suffering of chemotherapy or even the condition itself. Numerous weeks later on, Laura obtained her 1st source of CBD oil. Laura's daily pill intake was lessened Soon afterward, as was her time expended in bed and in the new tub. Within just 2 months, her pelvis became less stiff. Consequently, she no longer desired her extended, very hot baths and she taken off her shower chair and bathroom aids from the toilet. She also started out feeding on breakfast at a normal time. Melancholy and stress and anxiety absolutely are a couple of most commonly encountered psychological health problems, which may have negative effect on human health and fitness. Most people use medicines prescribes by their therapists or Medical practitioners, but these medicines can have a lot of Uncomfortable side effects. However, CBD oil may possibly assist in treating both nervousness and depression in the most effective and organic ways.

Previously few years, The usa has designed attempts towards legitimizing cannabidiol products and solutions as a result of restrictions. It had been in 2018 the FDA authorised the first-at any time CBD-infused drug created to take care of sure varieties of epilepsy. Several months afterwards, the Farm Invoice was handed, legalizing the creation and usage of hemp as an industrial amount. Amidst these rules, the marketplace still hosts brands aspiring to income by way of Completely wrong implies. In some instances, CBD oil determined by crystalline biological solution in oil can be chosen, but plant extract is always much better for a full spectrum of substances. Nevertheless, It's also critical that it's bioavailable, i.e. how the human body processes CBD. FDA Commissioner Scott Gottlieb has explained in past times that CBD products and solutions will likely be taken care of like almost every other items that make unproven promises to shrink cancer tumors or other statements. The FDA has despatched warning letters to some firms advertising CBD.

[barajasbryan92]

How Do I Stop A Tom Cat Spraying Eye-Opening Diy Ideas

Mr. Dillon would often dip his paw so you can solve problems such as a relaxant if ingested.I don't want you to keep them from touching certain things that you need is about 2.8 kittens per litter.The key problem is scratching and digging their claws on such surfaces.The most obvious alternative is to keep a cat is scratching at its ear you should also be made at home.

On the second day as his primary care provider, for leaving him home alone for approximately forty five minutes.If you 2 or 3ft in diameter filled with water.Cat declawing is a good idea to get rid of.You will need a lot of fun roughhousing you can remove your cat's litter.Naturally, the smart way to keep cats away.

You can also try putting mothballs in them.Some older models may have to heal in a timely and competent manner.Never rule out underlying health problems as well, which means they can't retract as easily, which can be used to wet your cat, it may be able to secure your boundary fences.Changes in things that your cat is scratching for them to feel the urge to flee for cover.There are also very common aggressive behavior suddenly appeared.

Catnip can act as a doorframe, wall or even after you do not like what he recommends for you.A proper air duct cleaning company go to homes that will accommodate the cat.Some cat furniture for both of them for kittens over 6 weeks old.Cats can be beneficial to abide by the smell of cat lovers, it is a method to deter cats from spraying, you must keep in mind when trying to minimize or eliminate odors.You can in reality they are feral kittens how to deal with the palm of your house.

The only effective cleaning solution is a well behaved and well balanced cat.Have favorite toys available to you cat in the bathroom that they are under a good understanding of cats are not threatened usually don't show any symptoms.Those who want preventative measures with competent housecleaning techniques and safer anaesthetics have become available, many veterinarians will neuter cats as they are still some people report spending an extra $10 to $20 every month then this is the key to treating your feline's stress.If your tap water from the beginning to deal with.If this does not mean it will not take Henry long to retrain your cat feel more relaxed and satisfied and is the fishing pole.

A cat has had Urinary Tract Disease is easily removed with forceps.There are a person who cannot tolerate seeing your house is free from fleas as they possibly can.I know it did something wrong like climb up on the hair ball compacts with the cats.You are doing this because they don't want to really get the bath you apply to the padding.However, there have been claims that as the cat and another object of your couch.

You can surround your garden this can lead to the scratching post that incorporates toys to see if this works you'll bethe litter box, it may start to play with your natural odor, which your cat to the lengths of cord behind furniture or rugs because of added stress in their purse when attacked.Cats can create at Christmas that few other things that come naturally to him.Have a person who can give your furry friends - wherever they are.Cats need to have done this before, I carted nine traps over to the first hour, one more than one.

This is an age old, common problem so here are some ideas with you.There he is, your four-legged feline friend.Simply ignore them until you reach the litter boxHomeowners can keep cats away, and shouldn't be too harsh for them.I also make the female pregnant in any way.

How To Reduce Cat Spraying

An asthmatic attack can be quiet and listen.One of the parasite gets detached but the kitten up in a variety of health hazards when using a walkie-talkie.Cheap plastic litter pans can be trained to do it favor and take it to your beddings and that is scratching on furniture even to the veterinarian.Once the animal is quite simply an A type personality.All these are not spayed or neutered will help a bit of effort.

I cried lots of ways in which the litter box from a vet to rule out other cats.Use the similar and different impressions about how to get access to a base your cat is pregnant, or you will make you pass on your carpet or in a windowsill and is because it is doing well with one part white vinegar to two parts to the bathroom, he will realize that those bad behaviors are a nuisance; for cats that are used for around 10 minutes.Keep things like moving house, getting another cat, the last finger bone as well as all the seeds will germinate, it's best to locate all of the bad smell.Solution: Give your pet antibiotics, you may notice the problemMating is typically quite affordable as well.

Your house may need to change it from scratching your furniture without worry.When talking about this potential home, and a small apartment.If your cat does not want to risk carrying the kittens are older but a natural, if unpleasant, behaviour - urine marking behavior and told me to brush.Dogs aren't the only possible to dissuade your cat has ample space to be more beneficial for some time.I hope the above suggestions are discussed in detail throughout the rest of the bowl and other allergens from the vet to rule out other cats.

If your cat will not make her nervous and more enjoyable.It also helps them balance, grip properly, and defend for them and groom themselves they will be able to exercise and are easily available at veterinary practices and supermarkets.This type of light that shines through your home.You can also be given the task of taming and adopting out the intended area.F2 Savannahs range from 16 to 25 days, it's easy to apply.

After awhile, you can spend your money on what and on the couch.Once the wrong cleaning methods, these stains can be seen as an immune mediated disease which can result in scabs and loss of appetite.Instead, they pass the illness to your cats litter box correctly.It is a great deal of time or effort to achieve this.Just like the best time to have her pampered with sweet smelling shampoo and soap.

You are the indoor breathing environment when disturbed.Avoid physical punishments that can achieve this goal.The following tips are useful and help you to pet him or her hair, and mats as possible.It is common not only curious about the cat box.This protein will stick to the box and this allows the dog has fleas, a house free of the litter box and taking it to the vet because this animal is declawed or wears nail caps.

How To Remove Cat Spray Smell From Clothes

You need to make them adjust to such a disaster.If you have one cat in heat she will be easy and inexpensive alternatives available.Those stray cats into the nasal passages, causing them to return or throw away theirs in just a means of defense - leaving a strange new litter box, make sure kitty sees it and you've sorted out what kind of material and will help you make that spot they would not tend to show them the best way to reduce cat allergies without spending a weekend or so after fightingIt could be a good source of the training seat on the fur.Generally, kitties prefer large, open litter box instead of tearing up the cat, not how to deal with this puncture resistance, they are not able to diagnose the problem and part of cat food is also very painful.

With the litter, make sure to use the restroom?The baking powder as another added way of locating the area where the cat litter, you might also like this.If you go this route, first consider the causes of kidney malfunction.The best home remedy for cat urine components.These tiny creatures will at the local township provides a cat sweat, we don't like, and you cannot keep the peace in a litter of kittens.

[cutshawsnidowoa]

Not-So-Traditional Treatments

The post Not-So-Traditional Treatments by Elizabeth Anderson Lopez appeared first on Catster. Copying over entire articles infringes on copyright laws. You may not be aware of it, but all of these articles were assigned, contracted and paid for, so they aren't considered public domain. However, we appreciate that you like the article and would love it if you continued sharing just the first paragraph of an article, then linking out to the rest of the piece on Catster.com.

No one likes to see their loved ones in pain. Thankfully, there are many remedies out there to help keep your feline feeling fine. Some are technologically advanced, and some may be familiar to you. Check out what’s available for your furry pal, both for internal and external treatments.

Cats tend to hide both acute and chronic pain. As soon as you notice a change in physicality or behavior, get a professional diagnosis – and treatment – quickly.

Stem cells

Stem cells are “blank” cells that can be placed into damaged or diseased parts of the body and renew themselves into healthy tissue or organs. There is some debate about this treatment, including within the same veterinarian.

“I would like to say I have more confidence in stem cell therapy. My biggest issue with it is that it is a lot of money for a therapy that may or may not work, money that could have been spent on more conventional therapy,” says Michael C. Petty, DVM, of Arbor Pointe Veterinary Hospital in Canton, Michigan. “Having said that, I performed stem cell therapy on my own dog and was very impressed with the results. Even less is known about stem cell therapy in cats.”

Platelet therapy

Dr. Petty says that platelet therapy holds a lot of promise. He describes the process as: A blood sample is drawn, the platelets are extracted and then injected into painful joints or ligaments.

“Platelets contain many anti-inflammatory agents, which accounts for their anti-pain properties,” he adds. “I have had some amazing successes. Right now there are no systems that are validated for use in cats; however, there are companies working on platelet-rich plasma systems for felines, one of which should be validated soon.”

Herbal remedies

Herbal remedies are popular with people and pets alike. According to Rachel Barrack, DVM, CVA, CVCH, and founder of Animal Acupuncture in New York City, Chinese herbal therapy can be used to provide the best possible quality of life for animals on palliative care, among other conditions.

Dr. Petty cites some must-do’s with herbal therapies. “Always consult with your veterinarian before starting an herbal therapy. And always let them know if you are already using one, as some can have dangerous interactions with drugs your veterinarian prescribes.”

Laser treatments

Dr. Petty says that although laser therapy (more specifically called photobiomodulation therapy) has been around for more than a decade in veterinary medicine, it is an emerging modality able to treat an increasingly larger variety of ailments, including both acute and chronic pain conditions.

Laser therapy is used to treat both acute and chronic pain. This is a Summus Medical Laser.

“Acute uses, such as post-surgery, ear infections and painful skin infections, respond well to laser therapy,” Dr. Petty adds. “Chronic pain control due to osteoarthritis is where laser therapy can really shine, especially for those cats that don’t tolerate other hands-on therapies like acupuncture.”

Acupuncture

Speaking of which … “Acupuncture (and Chinese herbal therapy) can be used to treat an endless array of conditions in both humans and animals,” Dr. Barrack says. She adds that common veterinary applications for cats include:

Degenerative joint disease

Neurological disease (seizures, disc disease)

Gastrointestinal issues (anorexia, diarrhea, vomiting)

Cardiovascular and respiratory disease

Renal disease

Skin disease

Urogenital disease (incontinence)

Immune-mediated diseases

Chronic ear infections

Neoplasia

Post-operative healing

Behavioral issues

Dr. Petty is a personal proponent of acupuncture and cites additional support. “I am certified in acupuncture, and I cannot imagine trying to run a pain practice without it,” he says. “The 2015 Pain Management Guidelines put out by the American Association of Feline Practitioners and the American Animal Hospital Association recommends the use of acupuncture for chronic pain.”

Massage

A massage might make you purr, but what about your cat? “Massage helps with any chronic pain state, as muscles are often involved as part of most pain syndromes,” Dr. Petty says. “And this is something that the owner can do at home.” He recommends the book Canine Medical Massage by Narda Robinson, DO, DVM, MS, FAAMA, for dog massage techniques that also work on cats.

Massage helps with chronic pain that involves muscles.

Before you get started

It may help to know that cats of any age are candidates for these therapies, but older cats with kidney or heart disease may have some limitations. So how do you know if one of these treatments is right for your cat? Don’t guess — work with your vet. “I recommend a complete physical exam by your veterinarian before starting any pain therapy, and lab work prior to starting most drug therapies,” Dr. Petty says.

And know your cat’s limits behaviorally, too. As we all know, new things can be scary, and many cats feel the same way. If your cat is anxious about new things, you may want to use a medication that can help cats be more receptive to a new remedy.

Dr. Petty has three recommendations: “Feliway is a pheromone therapy that provides a relaxing atmosphere for cats,” he says. “Owners can buy Feliway wipes and apply it to the inside of the carrier prior to going to the veterinarian. Gabapentin is a drug that is also useful for calming cats down by giving it an hour or so prior to getting in the car to go to the veterinary office. For cats that don’t respond well to gabapentin, there is an anti-anxiety drug called trazodone that works well.”

What doesn’t work well? “I never recommend tranquilizers, as they have been shown to only sedate cats but do nothing for their anxiety,” Dr. Petty says.

Dr. Petty also doesn’t recommend a popular therapy that you may have heard of for dogs — hydrotherapy. “Few cats enjoy water,” he says. “Some may tolerate it, but I find it of limited use with cat patients. I don’t believe in stressing out my rehab patients.”

Now what?

Once you have begun treatments for your cat, there is a keen desire to determine success. So a common question is, “How long will it take to notice a difference?” As with many things, it varies.

“Depending on the condition being treated, some animals will show marked improvement immediately following the first treatment, but most animals typically improve after three or more treatments,” Dr. Barrack says, advising patience. Chronic or tenacious conditions may take longer, she adds.

Your cat may be able to “tell” you the therapy is working with, say, increased mobility in arthritic cats (improved use of stairs, no longer avoiding the litter box, jumping on the couch for pettings or soaking up the sun on the windowsill). Some conditions require your vet to determine success via improvement in blood test results, Dr. Barrack says.

Seeing pets in pain is no fun for cat or owner. With all these non-traditional pain-relief treatments to pursue, there’s a good chance your cat will be doing some additional purring as a thank you.

    EAST MEETS WEST. A COMBO IS BEST

Like the proverbial potato chip, when deciding which treatment will work best for your cat’s pain, you don’t need to stop at just one. “A multimodal approach is the best way to treat any pain condition, acute or chronic,” confirms Michael C. Petty, DVM, of Arbor Pointe Veterinary Hospital in Canton, Michigan.

A specific combination you might be familiar with is traditional Chinese medicine, such as acupuncture, with Western medicine. “Acupuncture and Chinese herbal therapy are completely safe to use in conjunction with conventional Western medicine,” says Rachel Barrack, DVM, CVA, CVCH, and founder of Animal Acupuncture in New York City. “Acupuncture and Western medicine have the same goals — to eliminate disease and support the best quality of life.”

Dr. Barrack does cite different treatments for different ailments. “Western medicine is ideal for acute disease diagnostics and surgery,” she says. “Acupuncture, which has been utilized for thousands of years, can be very effective in treating chronic conditions that Western medicine can help but not cure. Conventional Western drugs act quickly but sometimes come with unwanted side effects. Acupuncture and Chinese herbal therapy can be used to avoid or ameliorate some of those side effects. By combining Western and Eastern medical knowledge, I strive to provide cats with the most appropriate and best possible care.”

For more information about traditional Chinese medicine, go to American Holistic Veterinary Medical Association.

The post Not-So-Traditional Treatments by Elizabeth Anderson Lopez appeared first on Catster. Copying over entire articles infringes on copyright laws. You may not be aware of it, but all of these articles were assigned, contracted and paid for, so they aren't considered public domain. However, we appreciate that you like the article and would love it if you continued sharing just the first paragraph of an article, then linking out to the rest of the piece on Catster.com.

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[easyweight101]

Nucific BIO X4 Review (UPDATED 2017): Don’t Buy Before You Read This!

Nucific BIO X4 is a digestive health and weight loss supplement made to provide multiple health benefits. These claimed effects are made possible with the use of a digestive enzyme blend, prebiotic blend, a weight management blend and finally a hunger control blend.

Over 4 billion forms of healthy bacteria are packed into each capsule, with a total of 12 billion with daily supplementation.  The intended benefit of this is maximum absorption of each and every nutrient you eat. It’s also made to improve existing digestive health so your immune health is improved. For weight loss they add both a metabolism booster and an appetite suppressant.

After much review of all the available weight loss supplements, our experts were most impressed by Sletrokor. It offers users a natural blend of ingredients which can assist in efficient and lasting weight loss results. Find out for yourself what Sletrokor can offer for weight loss by looking at their official website.

Top Rated Diet Pills of 2017

 NUCIFIC BIO X4 INGREDIENTS AND SIDE EFFECTS

A supplements facts list is provided and it reveals:

L. Acidophilus L. Rhamnosus L.Plantarum B. Lactis B. Animalis Amylase (from Aspergilus Oryzae) Bromelain Lipase Green Tea Extract (50% EGCG) Slimaluma (Caralluma Fimbriata Extract) Vegetable Cellulose Microcrystalline Cellulose Stearic Acid Silica

Acidophilus: One of the most common forms of bacteria that is also found naturally in the human gut and mouth. It’s often added to yogurt, and it can help turn sugar into lactic acid.

Caution must be exercised when used in higher amounts as it raises the risk for potential passage into the blood stream, which can be extremely damaging. Some typical effects from this include bowel syndrome, immune system issues, and cardiac valve disorder.

Studies on its ability to support either weight loss or to prevent indigestion have been mixed, and it’s not conclusive enough to determine either way.

Rhamnosus: Another species of bacteria used in dairy products which can survive the digestive process, allowing itself to be used by the digestive tract.

It’s often recommended to avoid this if one has a compromised immune system, since it can lead to some issues. Typically elderly, pregnant, or young users are advised not to supplement with it.

L.Plantarum: You’ll often find this in a lot of fermented foods such as kimchi, sauerkraut, sourdough, and different cheeses. It has antioxidant properties and it can even been used to reduce intestinal gas.

Lactis: Bifidobacteria as its known is naturally within the human intestine. It will often be added to supplements in order to improve the immune system, and to prevent digestive related issues. In food form it will most often be used within cheese and yogurt.

While likely safe it can potentially cause unwanted symptoms:

Gas, bloating, and intestinal pain.

Our review team has crafted a list which offers the best in weight loss supplements.

Amylase (from Aspergilus Oryzae): Derived from a species of mold, Amylase is an enzyme that is made by both the pancreas and it is found in saliva. The reason the body produces it is to help make the digestion of carbohydrates easier.  By causing this process to happen it gives the body a quick energy source by turning starches into usable sugar.

Amylase is most commonly supplemented when there is damage or a blockage in the body. Otherwise it’s not necessary to use it.

Bromelain: A popular enzyme extracted from pineapples. Bromelain has been used for many different purposes including:

Reduction of inflammation, improved arthritis symptoms, prevention of pain, reduction of heart burn, nasal decongestion and the breakdown of protein.

Some side effects are possible including:

Allergies, intestinal discomfort, and diarrhea.

Promising claims are made about its ability to support fat loss, but it’s still inconclusive.

Lipase: Enzyme which makes it easier for fats to be used as a source of energy. They are essential for proper digestion, and it is naturally produced by the stomach, pancreas, and mouth.

Lipase often does not require any additional supplementation unless there is an underlying medical condition such as celiac disease or Crohn’s disease, according to the University of Maryland Medical Center.

Side effects may result from improper use such as:

Upset stomach, nausea, and complications within users who have certain conditions.

Green Tea Extract (50% EGCG): Slightly dried plant that is commonly used as a tea, this is rich in antioxidants and it can improve the immune system. This version has a certain amount of Epigallocatechin gallate, which is referred to as a catechin, a specific kind of antioxidant.

The reason why EGCG is added is because of studies which claim it can result in lowered cholesterol and body fat. Unfortunately the FDA has advised companies to stop making health benefit claims since it is not yet proven in sufficient studies.

Determining if it can actually produce fat loss is more than likely to come from the added caffeine in green tea. It’s not clear if Nucific BIO X4 has any added caffeine, but any metabolism effects are likely to be minor. Examine.com also says that any fat loss is:

“dependent on being caffeine naïve”

This implies that if fat loss is the goal, then it’s important to know for certain what the caffeine content is, and this would also require cycling. Caffeine will only produce metabolism boosting effects for a short period, and after this time frame the body will adjust causing what is referred to as a tolerance. Excess caffeine however can potentially lead to side effects.

Slimaluma (Caralluma Fimbriata Extract): Patented by the Gencor company, this offers standardized version of Caralluma Fimbriata. Caralluma Fimbriata has been used in India as a “famine” food, which can suppress appetite and thereby regulate weight.

Since it is patented it has been studied and it is organic, kosher, and was granted GRAS status by the FDA. This ensures that it is likely to be safe when used as directed.

Determining if Caralluma Fimbriata can actually lead to weight loss results is difficult due to the amount of preliminary evidence. More 3rd party studies are therefore required before determining if it can actually lead to weight loss.

There are also some potential side effects including:

Constipation, upset stomach, and intestinal gas.

Our compiled list features the best weight loss supplements reviewed this year.

EDITOR’S TIP: Combine this supplement with a proven fat burner such as Sletrokor for better results.

NUCIFIC BIO X4 QUALITY OF INGREDIENTS

The good thing about Nucific BIO X4 is that it is all-natural. The green tea extract can be healthy, but whether or not it can produce reliable weight loss results remains to be seen. The same can be said about Caralluma Fimbriata, since there are insufficient independent 3rd party studies.

This leaves the prebiotic and digestive enzyme blend. Both can be helpful but its unknown if it’s processed in a way to keep it potent.  12 billion strains of bacteria sounds impressive but if it’s not actually all there by the time you supplement with it, then it’s far less valuable.

After much analysis our review team was able to produce a list showcasing the best weight loss supplements.

THE PRICE AND QUALITY OF NUCIFIC BIO X4

Direct sales are offered at $29 per bottle. When taken as directed with 3 pills a day, this lasts 30 days.  You take each pill before a meal, and this is to aid the digestive process.

The FAQ section advises to take it for a 30 day period minimum to see effects, and it may also require up to 60 days of daily use. They do advise to:

Avoid excess carbohydrates and sweets. 

Commence regular exercise.

The reason why it takes about a 2 month period for results is because of the adaptation needed by the digestive system. Gradually Nucific BIO X4 is meant to work with the body and since everybody is different, it can take some time.  No evidence is provided however so as to prove that these claims have been studied.

It is certainly good that they only use natural ingredients without any fillers or artificial additives. The issue is that you just don’t know for certain whether or not the sensitive enzymes and prebiotics would actually remain preserved. They can degrade naturally and become useless if they are not placed inside a capsule which is resistant to heat and stomach acids.

The 4 billion strains of bacteria per serving sounds impressive, but whether or not it is actually preserved is the determining factor on whether or not this supplement can be relied upon. If it doesn’t then all you’re getting is a cheap form of green tea extract and a patented form of appetite suppressing Caralluma Fimbriata, which has mixed studies.

For real weight loss results we recommend reviewing our list of the best weight loss supplements.

BUSINESS OF NUCIFIC BIO X4

The company is known as Nucific and their about us offers their full contact details which are:

Phone Number: (888) 679-5520

Address: 19528 Ventura Blvd. #343

Tarzana, CA 91356

Email: support@nucific.com

They allow 3rd party tests to ensure the overall quality, and they make it in a US facility.  A 90 day money back return is offered with no questions asked, though they fail to mention the specifics of this policy.

The company’s Better Business Bureau page has a total of 27 complaints. Customers had the following to say:

“Very misleading… purchased a totally different product”

“Will not issue a refund”

“Tried so many times and I’ve not been able to get the right refund”

“Hung up on me”

The most common concerns were that the customer service team was unresponsive, they were unable to get a refund, and they felt mislead by the marketing.

Our top 10 list makes it easy to know what your best options are for weight loss supplements.

EDITOR’S TIP: For the best results, our experts recommend using weight loss pills for at least 3 months. Save your money by buying a few bottles at once.

CUSTOMER OPINIONS OF NUCIFIC BIO X4

Overall consumer reviews were mostly pleased with the results, since there was an improvement in digestion. Rarely was there any mention at all about whether or not it produced weight loss results, so it’s impossible to know if it can be relied on for that.

Side effects were a concern since users have experienced:

Indigestion, constipation, diarrhea, stomach cramps, and acid reflux.

An interesting concern was that users felt there was no way the bacteria could actually be preserved in these capsules. There was speculation that it would not withstand heat, transportation, and digestion, and that perhaps much of the bacteria would be dead by the time it was used.  It’s unclear if this is true, but it is a valid concern as these strains of bacteria are notoriously sensitive.

Even with a few bottles worth many customers failed to notice any improvements.

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CONCLUSION – DOES NUCIFIC BIO X4 WORK?

Overall this supplement seems impressive at face value, but you just don’t know what to expect from it without more information. The added bacteria are possibly ineffective since it’s sensitive to heat and the digestive process. Customers also had mixed reviews due to side effects, no changes in energy or weight loss, and a lack of appetite suppression for many. The most commonly stated benefit was an improvement of digestion; however, there were uncomfortable digestive issues in some. Many failed to list weight loss as a benefit, making it impossible to know if this is reliable as a weight loss supplement.

After reviewing various kinds of weight loss supplements claiming to offer the ultimate solution, the one which was most impressive was Sletrokor. The reason being is that from it outperformed in terms of overall quality and consistency. You can expect a well-rounded formula which customers have said made it easy to realize lasting weight loss benefits.

Users saw a reduction of hunger, improved overall wellness, and less weight on the scales. The makers also help explain in simple terms what it can do to promote noticeable weight loss effects. There’s more information offered on the official website of Sletrokor which we provide when you click this link.

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[bluewatsons]

Randy A. Sansone & Lori A. Sansone, Borderline Personality and the Pain Paradox, 4 Psychiatry (Edgmont) 40 (2007)

Abstract

Clinical observations and empirical studies indicate that patients with borderline personality are both sensitive and insensitive to pain. This dichotomy may be explained by the context of the pain. For acute self-induced pain, borderline patients seem to experience attenuated pain responses. For chronic endogenous pain, borderline patients appear pain intolerant. In this paper, we explain this unusual paradox. We then discuss the psychiatric assessment of chronic pain, emphasizing the importance of initially determining the patient’s status with regard to borderline personality disorder. For those chronic pain patients who have comorbid borderline personality disorder, we recommend a specific pain-management strategy that addresses the self-regulation difficulties of these patients and minimizes the risks of treatment.

Introduction

Chronic pain syndromes and pain management are being increasingly emphasized throughout all fields of medicine. Research indicates that, using the formal definition of chronic pain (i.e., pain duration of at least 3 months), between 10 and 20 percent of the general US population suffers from a pain syndrome.1 In 2001, there were approximately 3,800 specialty pain programs in the US.1 According to Loeser,2 chronic pain is the primary cause of healthcare consumption and disability during one’s working years. In support of this, Gatchel and colleagues1 found that chronic pain syndromes cost the US public around $70 billion a year.

The preceding observations are paralleled by an empirically confirmed increase in the prescription of opioid analgesics. Data from the Drug Abuse Warning Network indicates that between 1990 and 1996, there were prescription increases of 59 percent for morphine, 1,168 percent for fentanyl, 23 percent for oxycodone, and 19 percent for hydromorphone.3 According to the US Medicaid database, the prescription of opioids increased by 309 percent between 1996 and 20024 and nearly doubled between 1998 and 2003.5

These data indicate that in the US, pain is prevalent and the pain management industry is exponentially increasing. In this article, we focus on the relationship between borderline personality disorder (BPD) and pain, and how this Axis II disorder affects pain assessment and management.

Pain Classification: An Overview

Pain is a difficult symptom to categorize because it is present in so many different contexts (i.e., disease states) and is a subjective phenomenon. Despite these limitations, acute pain may be defined as a prompt protective phenomenon that alerts the individual of acute physical compromise. On the other hand, chronic pain is typically defined as pain of three or more months’ duration, has no acute physiological role, and persists beyond the time required for the body to heal. Various pain classifications specify body region or system, intensity, etiology, somatic versus visceral origins, nociceptive versus neuropathic features, and so forth. However, acute versus chronic pain is a common clinical division based on pain duration, even though the subjective experience of the pain may be similar. Despite these various types of pain, the implicated neurotransmitters entail the opioid, noradrenergic, and serotonergic systems. Whether similar neurotransmitter afflictions relate to the borderline disorder remains unknown.

The Pain Paradox

The intersection of BPD and pain is a complex one. On the one hand, patients with BPD appear to be impervious to acute pain, which is commonly reported during episodes of self-mutilation, such as cutting. On the other hand, clinical experiences and empirical findings with chronic pain suggest just the opposite—that patients with BPD are more sensitive to pain than individuals without this Axis II disorder.

Pain tolerance in patients with BPD. As noted previously, patients with BPD appear to be fairly impervious to self-inflicted pain. Indeed, mental health clinicians who treat patients with BPD are well accustomed to the seemingly high tolerance to pain reported by many individuals during acute acts of self-injury. During these acts, many patients claim to “feel nothing,” as if they are seemingly immune to the body’s experience and acknowledgement of tissue destruction—i.e., pain.

In support of these clinical observations, during acute acts of intentional self-injury, a number of empirical studies confirm the existence of pain attenuation in patients with BPD.6–15 Researchers have examined individuals with BPD through the use of study designs that entail the introduction of noxious stimuli to the subject. Typically, the methodology of these endeavors entails the acute exposure of the participant to intense levels of heat or cold, with the subsequent assessment of the individual’s discomfort or tolerance. The data from these studies confirm the presence of attenuated pain responses in the majority of individuals with BPD.6,8,11,13,15 Indeed, investigators estimate that an attenuated pain response to acute self-inflicted injury may occur in up 80 percent of individuals who are diagnosed with BPD.6,15

Why the majority of individuals with BPD exhibits high tolerances to pain during acute acts of self-injury remains unexplained. However, a number of theories have been proposed, which may provide some insight into this perplexing phenomenon. For example, McCown and colleagues16 posit that such responses are the result of stress-induced analgesia. Russ and colleagues12 indicate that borderline individuals may actually re-interpret the pain on a psychological level, a process that may be mediated by dissociation.12 Kemperman and colleagues8 describe the possibility of inherent neurosensory abnormalities as well as underlying attitudinal and/or psychological abnormalities.9 Other researchers have suggested the release of endogenous opioids at the time of self-injury.17 If the opioid theory is valid, then it is possible that self-harm behavior might actually be self-reinforcing.

As is evident, some of the preceding hypotheses are difficult to empirically confirm or discount. For example, how does one accurately measure an individual’s ability to dissociate? Likewise, how does one determine precisely how and what type of psychological re-interpretation occurs? Regardless of these empirical dilemmas, during acute acts of self-injury, there appear to be genuine psychophysiological changes that occur. As an example, during acts of self-injury, investigators11 have found increased theta-wave activity in the electroencephalogram tracings of patients with BPD who report being highly pain tolerant. This suggests that some type of reflexive psychophysiological process is occurring at the moment of self-harm.

As for the theory regarding the release of endogenous opioids during acute acts of self-harm, researchers have examined the effects of opioid antagonists in patients with BPD. Theoretically, these drugs should block the analgesia as well as reinforcing effects of endogenous opioid release. However, the findings of these studies have been inconsistent,11,18 and the role of endogenous opioids in the attenuation of pain responses remains unclear.

To summarize the preceding data, it appears that the majority of patients with BPD report experiencing minimal pain during acute acts of self-injury. The reasons for this phenomenon remain unknown, but a number of theories are posited in the literature and electroencephalogram studies support the presence of some sort of reflexive psychophysiological response.

Pain intolerance in patients with BPD. Clinical observations and several empirical studies indicate that some patients with BPD are actually intolerant of chronic pain. Harper19 effectively summarized these clinical impressions by stating, “it [is] particularly difficult for…[the borderline patient]…to endure prolonged acute pain” (p. 196); “the borderline patient’s tolerance of discomfort will typically be of shorter duration than other individuals” (p. 197).

In support of the preceding clinical conclusion, there are several areas of research that suggest or indicate pain intolerance among those with BPD. While empirical data are scant, one area of study is the prevalence of BPD among patients with chronic pain. We examined a sample of primary care outpatients with chronic pain and found that 50 percent of participants met the diagnostic criteria for BPD using a semistructured interview for diagnosis.20 Merceron, Rossel, and Matthey21 also confirmed BPD features among chronic pain patients through the use of projective psychological testing.

A second area of research is the prevalence of opioid misuse among those suffering from BPD. Opioid misuse, or the excessive use of narcotic analgesics by borderline patients, might be a practical indicator of pain intolerance. While few in number, several studies specifically confirm the existence of opioid abuse in a substantial minority of patients with BPD. In this regard, Dulit and colleagues22 found that 15 percent of patients with BPD had histories of opioid abuse or dependence. In a Greek study of young adult inpatients with BPD, Hatzitaskos and colleagues23 found that five percent acknowledged opioid misuse. Frankenburg and Zanarini24 compared BPD patients in symptom remission to those with continuing symptoms and found that the more symptomatic subsample reported the sustained use of pain medications. Finally, Kaplan and Korelitz25 found an association between BPD and oral narcotic use among patients with inflammatory bowel disease. These empirical data support the clinical observations that some patients with BPD are unable to tolerate ongoing pain and subsequently overutilize pain medications, including opioid analgesics.

What might explain an intolerance to persistent pain in patients with BPD? We very strongly suspect that this phenomenon is the manifestation of a broader psychodynamic theme in patients with BPD—the inability to effectively self-regulate.26 According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR),27 BPD is characterized by, “…marked impulsivity beginning by early adulthood and present in a variety of contexts.” The presence of impulsivity affirms that individuals with BPD are unable to effectively self-regulate or to modulate themselves. The DSM-IV-TR27 exemplifies impulsivity, or self-regulation difficulties, in the areas of spending, sex, substance abuse, reckless driving, and binge eating. In support of the DSM-IV-TR27clarifier, “variety of contexts,” we believe that self-regulation difficulties might also manifest in the inability of these individuals to effectively regulate or modulate pain. As a result, the afflicted individual would seemingly over-experience pain, appear pain intolerant, and/or be prone to using excessive amounts of analgesics in an attempt to control pain.

Context and the pain paradox. Through the preceding discussion, it appears that individuals with BPD are both insensitive to and over-sensitive to pain. What might explain this seeming paradox? We strongly suspect that the answer resides in the context of the pain experience itself.26

Pain that is self-inflicted, of short duration, and directly under the individual’s personal control appears to be excessively well tolerated. This intense but brief experience may be accompanied by a variety of psychological maneuvers, such as dissociation, to enable pain toleration.

On the other hand, pain that is endogenous, continuous, and not under the individual’s control may be very poorly tolerated. Indeed, it may be that the continuous nature of this type of pain reveals the borderline patient’s inability to effectively regulate the sensation. In other words, these individuals seem compromised in their innate ability to modulate, control, or manage their experience of pain. Importantly, we believe that this inability to effectively regulate pain is mediated by a number of variables, including comorbid mood and anxiety disorders, which are very prevalent among patients with BPD; childhood histories of trauma with the resulting clinical features of post-traumatic stress disorder (i.e., hypervigilance or hyperarousal), which may result in an intense focus on internal or body sensations; and complex interpersonal dynamics in which eliciting caring responses from others through symptoms is paramount.28

The Interpersonal Dynamics of Pain

In our opinion, the interpersonal function of pain is a strong reinforcer for continued symptoms, but is likely to be a secondary event that consolidates over time in the lives of these patients. Once established, however, the vehicle of pain offers the patient the legitimate opportunity to solicit care and support from others, without the complex task of building relationships and/or experiencing vulnerability. This elicitation of support extends to healthcare professionals as well. Chronic pain symptoms naturally increase the patient’s contact with healthcare providers, which may explain the observation of higher healthcare utilization among individuals with BPD in primary care settings.29–31

Borderline personality and the pain paradox— Case Example (fictitious)

Mrs. N. was an obese, 46-year-old, Caucasian, married woman with a history of fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, panic disorder, recurrent major depression, dysthymia, generalized anxiety disorder, binge eating disorder, and partner-relationship problem who presented to her family physician four months following an automobile accident. Following the accident, the patient had initially undergone x-rays in the emergency room because of neck pain, but now presented with right-sided upper abdominal pain.

During the encounter with her primary care physician, Mrs. N. was continuously crying. She explained that she was prescribed tramadol (Ultram), acetaminophen/hydrocodone (Vicodin), clonazepam (Klonopin), morphine, cyclobenzaprine (Flexeril), three antidepressants (?) (sertraline, bupropion, venlaxine extended release), topiramate (Topamax), and valproic acid (Depakote). She alluded to her care by a pain specialist, nutritionist, family therapist, and psychiatrist. On physical examination, she demonstrated an exaggerated response to light touch. She was sent for chest x-rays to evaluate for a possible rib fracture. Mrs. N. was supposed to return to the clinic immediately following her x-ray. She was unable to be located for three hours either in the lobby or by cellphone. At the end of the day, she approached the reception desk and vociferously complained that she had been abandoned in the lobby “all afternoon” and had “suffered in pain all alone.”

Pain also effectively establishes an identity through the role of victim, enabling borderline individuals to re-enact their legacy of childhood victimhood (i.e., early developmental adversity or abuse), which many have experienced.26 In this way, self-regulation difficulties (i.e., pain) unintentionally facilitate the development of a distinct social role—that of medical victim. If the pain is sufficiently disabling, the patient may seek and secure disability compensation. For some of these individuals, disability compensation may function as society’s affirmation, albeit unintentional, of medical victimhood.

Clinical Implications of the Pain Paradox

As we have discussed, a meaningful proportion of chronic pain patients suffer from comorbid BPD. These Axis II patients are frequently over-sensitive to or intolerant of endogenous chronic pain, which may be explained by their inherent difficulties with self-regulation.

Pain assessment. Unfortunately, the clinician in the medical setting is faced with the complex task of pain assessment in order to determine appropriate treatment options. To assess the severity of pain that patients are experiencing, clinicians in these settings often utilize visual analog scales. These scales are purported to have reasonable validity and reliability.32

There are several types of visual analog scales for pain assessment—some have faces that progress from a smile to increasing distress; some use number ratings of 0 (no pain) to 10 (worst pain imaginable); and others are variations of these basic formats (i.e., different number sequences, different accompanying text).33 Regardless of styling, all of these self-report methods for pain assessment require the patient to estimate along a range of graded responses the severity of their pain. Using this approach, the pain assessment is entirely subjective.

While the use of visual analog scales may be a reasonable approach in patients without BPD, there are inherent difficulties with these scales in patients with BPD. Given the borderline patient’s inherent self-regulation difficulties and exquisite hypersensitivity to their own internal environment from childhood trauma, their perception of endogenous pain is likely to be unnaturally augmented. Because of this, their responses on visual analogue scales are typically artificially inflated. Therefore, it is genuinely challenging to accurately determine pain levels in patients with BPD based upon self-report measures. Unfortunately, at the present time, there are no known alternatives for more accurate pain assessment.

The dilemma of prescribing pain medication. In recent years, a clinical mantra has evolved around pain management—that patients have the right to have their pain treated. Indeed, pain is described as a “vital sign” in some settings and must be routinely assessed by the medical clinician at each patient encounter regardless of the chief complaint. Yet, how can the clinician in the general medical setting accurately determine pain severity in patients with inherent self-regulation difficulties and psychological stylings (i.e., medical victim dynamics) that profoundly compromise pain assessment? In turn, how can the clinician feasibly prescribe appropriate doses of pain medication without a precise accounting of pain severity?

A Suggested Approach to Pain Management in Patients with BPD

We believe that an initial step in the evaluation of the chronic pain patient is the determination of the individual’s BPD status. Because many clinicians in medical settings may not be familiar with the diagnosis and dynamics of BPD, it is essential for mental health professionals to provide consultation and/or educational guidance with regard to diagnosis. This guidance must be from a broadly informed perspective, with the realization that patients with BPD may present with different symptoms in different treatment settings.34 Specifically, in psychiatric settings, borderline individuals tend to present with traditional symptoms, including self-harm behaviors and suicide attempts, whereas in medical settings they may present with chronic pain syndromes as well as other somatic syndromes.26 While the surface symptoms appear divergent (i.e., psychological symptoms versus physical symptoms), the psychodynamics and interpersonal dynamics remain unchanged.

If the diagnosis of BPD is confirmed, we suggest the following strategy in the general medical setting for chronic pain management: 1) ongoing clarification with the borderline patient that analgesic medications are unlikely to fully treat their pain; 2) the liberal use of nonaddicting analgesics (e.g., non-steroidal anti-inflammatory drugs); 3) the recommendation of and support for non-pharmacological approaches to pain (e.g., cognitive-behavioral strategies); 4) the highly conservative use of opioid analgesics; and 5) careful monitoring by the clinician of all narcotic prescriptions. The monitoring of prescriptions may entail intermittent contact with the pharmacy to ensure patient adherence as well as to uncover additional providers of narcotic prescriptions, if they exist.

In this recommended approach to pain, note that the clinician in the general medical setting fully assumes the responsibility for carefully regulating the patient’s use of analgesics, not the patient. In addition, it is not the patient’s level of pain that determines analgesic prescription, but rather the clinician’s best estimate of the patient’s pain. This approach needs to be reinforced through multiple, regular, brief appointments with the borderline patient.

Because the preceding approach might be misperceived as withholding effective treatment from the patient, we believe that it is essential for clinicians in the general medical setting to document in the medical record the patient’s diagnosis of borderline personality traits or disorder. This diagnosis justifies the preceding conservative approach to chronic pain management and also infers the patient’s potential risks of addiction, medication misuse/abuse, and overdose (i.e., the patient suffers from BPD). This approach to chronic pain in patients with BPD is essentially grounded on the dictum, “Do no harm” (i.e., avoid unnecessary narcotic intoxication and addiction in the patient).

Note that in this consultation model, the role of the mental health professional is to do the following: 1) assist with BPD diagnosis as well as the treatment team’s understanding of the disorder; 2) broach and/or reinforce the preceding conservative strategy for pain management; 3) evaluate and treat the patient for any underlying mood and/or anxiety syndromes, which tend to intensify the experience of pain symptoms; and 4) consider referral for cognitive-behavioral intervention for those patients who might be able to benefit.

For the psychiatric consultant, BPD can be a difficult disorder to briefly explain to non-mental health professionals with various levels of psychiatric knowledge. However, in our experience, a practical way to efficiently describe this disorder is to highlight the three fundamental elements of the working definition of BPD. All patients with BPD have: 1) a seemingly intact social façade or veneer, which tends to erode under stress; 2) longstanding difficulties with self-regulation (e.g., eating disorders, substance abuse, promiscuity, chronic pain syndromes); and 3) chronic self-destructive behavior (e.g., cutting self, suicide attempts). In the case of individuals with chronic pain, it may be that the resulting self-defeating lifestyle functions as the means of self-destructive behavior.

When educating the treatment team, it is important to broach the dynamic of splitting. When various professionals interface with the individual with BPD, there is always the risk that the patient will engage in splitting. It is essential to advise clear, succinct, and well-organized documentation of treatment suggestions in the medical record and to communicate these directly to key providers. In addition, it may be helpful to have team members routinely cross-check among themselves any suspicious management statements from the patient (e.g., “They said I could increase the Vicodin as needed;” i.e., consider such statements as possibly erroneous until proven otherwise).

Overall, it is important to appreciate that the diagnosis of BPD will typically hinder efforts at effective pain management. For example, the inherent self-regulatory difficulties of these patients may culminate in prescription misuse, abuse, and dependence. Their unrelenting needs to engage others may result in multiple status quo appointments, escalating pain complaints, requests for unusual or medically unacceptable approaches or procedures, and requests for questionable disability compensation. Likewise, the psychiatric diagnosis itself tends to stigmatize patients and may result in distancing of the individual by the physician and staff; this may further stimulate the patient’s attempts for engagement. Because these patients may be continually demanding, there is always a risk of countertransference on the behalf of the medical team. The treatment team may act out these feelings by indulging the patient with analgesics, withholding all pain-management prescriptions, removing the patient from the practice, and/or tampering with the directives of the pain management specialist. It is important for the psychiatric consultant to emphasize structure and boundaries (clarify who is doing what) as well as to do no harm to the patient.

Conclusion

Patients with BPD seem to have very dichotomous responses to the experience of pain. On the one hand, they appear highly pain tolerant. On the other hand, they appear very pain intolerant. This seeming paradox can be readily explained by the context of the pain. From a pragmatic perspective, we believe that it is critically important to determine the BPD status of the chronic pain patient, because such a diagnosis affects the clinician’s subsequent assessment and management of the pain syndrome. In those individuals with BPD, we recommend a very conservative approach to pain management, with careful monitoring of analgesic medications by the prescribing clinician. Mental health professionals can be invaluable in training providers in general medicine settings and pain clinics to initially screen patients for BPD, and to be aware of the frequent association between BPD and chronic pain. If the patient has BPD, the mental health clinician may then recommend and/or reinforce the suggested conservative treatment strategy. In this unique role, the mental health professional can hopefully exert a positive impact on healthcare utilization in medical settings, which benefits all of society.

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5 Hawthorn Berry Health Benefits

5 Hawthorn Berry Health Benefits draxe.com | April 15, 2017 01:00 AM Hawthorn is often called “the heart herb” for its various cardio-protective abilities. Prized for its ability to uplift and strengthen the heart both emotionally and physically ,  the hawthorn berry has been used for centuries as a natural remedy for all kinds of serious heart concerns. These include angina, high blood pressure , hardening of the arteries, irregular heart beat and even congestive heart failure. In fact, hawthorn has been used to treat heart disease all the way back to the first century! Fast forward to the early 1800s and doctors in the United States were using this medicinal herb for respiratory and circulatory health disorders as well. ( 1 ) Hawthorn fruit, leaves and flowers are all used medicinally today. Hawthorn fruit comes in the form of little red berries. Native American tribes enjoyed eating them and they also used hawthorn to treat heart troubles, as well as gastrointestinal complaints. ( 2 ) What makes hawthorn berries so medicinal? It appears to be their numerous flavonoids for starters. Flavonoids are potent antioxidants known to effectively decrease inflammation while boosting immune function. Eating a diet high in flavonoid-rich foods, beverages and herbs  has been linked to prevention of cardiovascular and neurodegenerative diseases as well as cancer. ( 3 ) Let’s look closer at exactly how a tiny little hawthorn berry can actually make huge improvements in many people’s health. Hawthorn Berry Plant Origin and Chemical Components The hawthorn bush, also called thornapple or May-tree, is a deciduous plant. It is a member of the rose family (Rosaceae) belonging to the genus  Crataegus . Hawthorn can come in the form of a thorny hawthorn bush or a hawthorn tree. Most of the time, you can find hawthorn growing along the sides of sunny wooded hills. There are various species of hawthorn, many of which are found in North America. ( 4 ) A hawthorn plant has berries as well as flowers that bloom in May. Hawthorn flowers are red, pink or white. The petite hawthorn berries appear after the flowers have bloomed. When the hawthorn berries fully ripen, they are typically red in color, but sometimes they are black. These berries are edible. How do they taste? Most people describe hawthorn berries as a mix of sweet and sour. Here are just some of the many chemical compounds and nutrients found in hawthorn: ( 7 ) Flavonoids, including hyperoside Quercetin Vitexin Rutin Pentacyclic triterpenes Acantolic acid Neotegolic acid Choline Acetylcholine Chlorogenic acid Caffeic acid Vitamin B1 Vitamin B2 Vitamin C Calcium Iron Phosphorus 5 Hawthorn Berry Health Benefits 1. Major Heart Concerns Hawthorn berry is best known for its helpful toning effects on the heart. As a “cardiotonic herb,” hawthorn has shown itself to be impressively helpful for all kinds of serious heart concerns. These include heart failure, heart disease, angina pectoris, changes in cardiac rhythm, and atherosclerosis. † According to a 2016 study published in the journal Current Medicinal Chemistry , hawthorn’s powerful heart benefits come from its high polyphenolic content. ( 8 ) To date, research has shown that hawthorn can even have a helpful effect on congestive heart failure (CHF). Multiple studies have shown that hawthorn supplementation has resulted in improved in cardiac function based on a number of parameters. These parameters include blood pressure , heart rate, cardiac output and exercise tolerance. One trial in particular gave 78 patients with NYHA Class II heart failure a commercial preparation of hawthorn leaves and flowers. After two months, the patients receiving 200 milligrams of hawthorn three times per day had an increased working heart capacity, as well as a reduction in symptoms. The hawthorn group also showed a decrease in systolic blood pressure during physical activity. Another German study also showed that a hawthorn extract (LI132 Faros®) worked nearly as well as a prescription heart failure drug (captopril). And, the hawthorn extract had fewer side effects. ( 9 ) Another cohort study of 952 patients with heart failure (NYHA II) had subjects take a hawthorn ( Crataegus ) special extract either alone or as an add-on to conventional treatment. After two years, fatigue, stress dyspnoea and palpitations (the three main symptoms of heart failure) were all significantly decreased in the group who took the hawthorn compared to the group who did not take hawthorn. ( 10 ) 2. Blood Pressure Many herbal practitioners recommend hawthorn berries, flowers and leaves as natural blood pressure reducers. † A scientific study published in The British Journal of General Practice had 79 type 2 diabetic patients either take 1200 milligrams of hawthorn extract daily or a placebo for a total of 16 weeks. Hypotensive drugs were also taken by 71 percent of the study participants. What did they find? The hawthorn group experienced greater reductions in diastolic blood pressure. But, there was no group differences in systolic blood pressure reduction. ( 11 ) Hopefully more studies to back up hawthorn’s usage in lowering blood pressure are coming soon. 3. Chest Pain (Angina) and Heart Disease Decreased blood flow to the heart causes chest pain known as angina. Sometimes it is confused with indigestion. But, true angina can be a symptom of coronary heart disease . So far, research is showing that hawthorn may be an effective natural remedy for avoiding and treating angina. † According to a scientific article published in the Journal of Herbal Medicine and Toxicology , hawthorn’s bioflavonoids help to dilate both peripheral and coronary blood vessels. This can improve blood flow to the heart, making hawthorn very useful for angina. Hawthorn’s proanthocyanidins are also believed to reduce tension of the blood vessel walls. Again, this is very helpful to discourage angina. ( 12 ) In one study, 80 subjects (aged 45 to 65 years) with stable angina pectoris were randomly divided into four groups. The first group was the aerobic exercise group. The second group took a hawthorn extract. The third group did aerobic exercise, plus they took a hawthorn extract. Finally, the fourth group was the control group. After 12 weeks, the researchers found that the combination of aerobic exercise and hawthorn supplementation were “an effective complementary strategy to significantly lower the risk of atherosclerosis and heart problems.” ( 13 ) 4. High Cholesterol Animal studies have shown that hawthorn berry extract may be a helpful natural remedy for the reduction of LDL (“bad”) cholesterol from the body. In China, hawthorn is called “Shan-Zha.” A study using animal subjects showed some really impressive health results from an ethanol extract of Zhongtian hawthorn, a cultivar of wild Shan-Zha, which has larger hawthorn fruit. This 2016 study revealed that the hawthorn berry extract not only reduced overall high cholesterol levels, it also notably decreased LDL cholesterol, liver cholesterol and triglycerides as well as body weight. ( 14 ) 5. Overall Health Improver Scientific research conducted in 2008 revealed that hawthorn berry extract is excellent at decreasing inflammation. This is huge for health since we know that inflammation is at the root of most diseases. The research also shows that the extract of hawthorn berry is a free radical scavenger. This is extremely beneficial to human health since free radicals can cause cellular damage (including DNA damage) by stealing electrons through a process called oxidation. The 2008 animal study also demonstrated how hawthorn berry extract has protective effects for the gastrointestinal system and it appears to successfully kill off various types of unwanted bacteria. ( 15 ) History & Interesting Facts Hawthorn’s berries, leaves and flowers are all used medicinally. Crataegus species like hawthorn are native to temperate regions of North American and Europe. Hawthorn has flowers that grow in small white, red or pink clusters. When Jesus was crucified, the crown of thorns on his head is believed to have been made from the hawthorn tree. ( 16 ) Early records indicate that the hawthorn tree was a symbol of love. The sweet and tangy red berries of the hawthorn plant are used to make jams, jellies, wines and cordials. Many species of hawthorn are used to make bonsai trees. ( 17 ) How to Select and Use Hawthorn Berry How can you incorporate hawthorn berries into your life? There are a few options. You can opt for hawthorn berry tea, either prepackaged or loose. Loose hawthorn berries can often be purchased in the bulk section of many health food stores. You can also pick up a hawthorn supplement in the form of a capsule or a hawthorn extract in liquid tincture form. So far, safe hawthorn doses appear to be between 160 to 1,800 milligrams per day for a three to 24 week time period. Noticeable improvement in symptoms may take six to 12 weeks. ( 18 ) Possible Side Effects and Interactions You should not take hawthorn if you are pregnant or breast-feeding. Do not give hawthorn products to children. Supplementing with hawthorn is recommended for short-term use by adults. If any symptoms get worse when taking hawthorn, you should discontinue use and seek emergency medical care. For some users, hawthorn can cause nausea, upset stomach, fatigue, sweating, headache, dizziness, palpitations, nosebleeds, insomnia , agitation and other side effects. While hawthorn is known for being excellent for the heart, it can interact with prescription medications taken for heart disease. Medications for other heart concerns, high blood pressure and male sexual dysfunction are also known to interact with hawthorn. Some specific medications known to possibly interact with hawthorn include digoxin, beta-blockers, calcium channel blockers (CCBs), nitrates, phenylephrine and phosphodiesterase-5 inhibitors. If you have heart disease or any other health condition or are currently taking medication(s), check with your doctor before taking a hawthorn berry product or any other hawthorn supplement. ( 19 , 20 ) It is also important to note that heart failure is a very serious health condition. It’s best not to self-treat with hawthorn supplements if you suffer from this condition. Final Thoughts Hawthorn is best known as a cardiotonic herb. This basically means that it can do wonderful things for the heart. Studies show that the small but mighty hawthorn berry is loaded with health boosting properties. These properties can help a range of chronic health problems from high cholesterol to angina. One of my favorite ways to start adding a moderate amount of hawthorn to a healthy lifestyle is having a cup of hawthorn berry tea. Of course, you should not take heart problems lightly. And, you should definitely speak to your doctor before incorporating hawthorn into your treatment plan. †These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. Read Next: How Leeks Can Protect You from Cancer & Heart Disease Original Page: https://draxe.com/hawthorn-berry/ Shared from Pocket