Patient Guide to Vitamin D Deficiency. A 12-week double-blind randomized clinical trial of vitamin D₃ supplementation on body fat mass in healthy overweight and obese women. 25-hydroxyvitamin D and Risk of Myocardial Infarction in Men: a Prospective Study. Arch Intern Med. Holick MF. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. Degenerative disc disease is the breakdown of your intervertebral discs. i was recently diagnosed with degenerative disc disease and was told there's no treatment. Dark green leafy vegetables, peanuts, tofu, black beans and sesame seeds also can provide you with calcium. Wilkins, Consuelo H. and Yvette I. Sheline, et al. Degenerative disc disease can be a nagging condition or one that causes severe pain that needs immediate treatment. Curcumin, therefore, reduces the pain associated with the disorder. Over time, this job begins to take its toll on the discs, the firm cushions that separate your vertebrae -- the bones that make up your spine. There don't seem to be many physicians who have skills in diagnosing back disease. Vitamin C is necessary to form collagen that then turns into the new tissue you need to regenerate the disc tissue between your vertebrae. What a organic Product how to CBD dosage for degenerative disc disease distinctive makes, is the Fact, that it is only with biological Mechanisms in Body works. Talk to your doctor before taking these or any other supplement to treat degenerative disc disease 1 ⭐. Intervertebral discs are the cushions between the vertebrae; they keep the back pliable and … Degenerative disc disease is a term used to describe weakening of the spinal discs. Natural Degenerative Joint Disease/Osteoarthritis Treatment. Liver is especially high in vitamin B12. Degenerative disc disease (DDD) is something of a misnomer. Effectiveness and Safety of Vitamin D in Relation to Bone Health. You're in … Vitamin D: Dietary Supplement Fact Sheet. Cannell JJ, Vieth R, Umhau JC, et al. But if you don't, a supplement would help you reach your dietary goals. Ther Clin Risk Manag. Essential Oils. c) Maintain a healthy bone structure by using supplements and vitamins. what is the best treatment for degenerative disc disease. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, a diet high in fat that leads to being overweight not only causes you pain when you have degenerative disc disease, it also is a main contributor to developing the condition. What are the results with best CBD oil for degenerative disc disease realistic? Your spine is comprised of bones, called vertebral bodies, which stack on top of each other to form a column. Glucosamine and chondroitin sulfate dietary supplements may also help alleviate existing joint pain. How insistent is the Reaction and how it takes a long time until they becomes noticeable? Preventing degenerative disc disease. Ginde AA, Mansbach JM, Camargo CA, Jr. Association Between Serum 25-Hydroxyvitamin D Level and Upper Respiratory Tract Infection in the Third National Health and Nutrition Examination Survey. To cultivate healthy strong bones, you need to have sufficient vitamin B12 in your diet. Taksler GB, Cutler DM, Giovannucci E, Keating NL. I was told there are vitamins to assist with the healing of my back but was never given a name of one. Front Endocrinol. Optimal vitamin D status for colorectal cancer prevention: a quantitative meta analysis. This column serves as a structural support for your entire body. Am J Prev Med. Degenerative disc disease treatment can sometimes include steroid shots. Cheese, yogurt and milk are the most common sources of dietary calcium. The intervertebral discs are the shock absorbing cushions between each of your discs which make up your spine. Calcium is vital for bone development. To cure degenerative disc disease naturally you can use physical therapy, exercise, yoga, chiropractic adjustments, dietary supplements, and eating healthy. This, therefore, inhibits inflammation. These will often be designed to strengthen the muscles in your back and neck, as degenerative disc disease in the neck can be quite common. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. 2007;32(3):210-216. doi:10.1016/j.amepre.2006.11.004, Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. i suffer from degenerative disc disease and recently experienced a severe episode when a nerve was trapped for a few days. In this post we’ll explore how to … Degenerative disc disease commonly occurs in the neck or lower back as you get older. Check Price on Amazon. For this there is my Conviction after sufficient Evidence and Extremely good Reviews. A combination of glucosamine, chondroitin and methylsulfonylmethane is one option. Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H. Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza A in Schoolchildren. People who engage in heavy physical work, smoke, or are obese are more likely to experience degeneration of their spinal discs. Epidemic Influenza and Vitamin D. Epidemiol Infect. “Vitamin D Deficiency Is Associated with Low Mood and Worse Cognitive Performance in Older Adults.” American Journal of Geriatric Psychiatry 14 (2006): 1032-40. The combination of vitamin K2 and calcium works to help bones in the spine and throughout the body stay strong and healthy. Ray holds a journalism degree and teaches writing, career development and an FDIC course called "Money Smart. What is degenerative disc disease? d) Exercise regularly to increase strength and to make the muscles that surround the spine more flexible. The condition is characterized by pain that can vary from a mild discomfort in your lower back to a severe stabbing pain. Intervertebral discs are the cushions between the vertebrae; they keep the back pliable and … While some of these are foods you've eaten and enjoyed with no consequence, they now move into a category of pain-inducing foods that you should scratch off of your grocery list. Giovannucci E, Liu Y, Hollis BW, Rimm EB. But treatments for disc diseases are different than for degenerative myelopathy. d) Exercise regularly to increase strength and to make the muscles that surround the spine more flexible. TMHS 12: Treating Back Pain, Degenerative Disc Disease & “Incurable” Diseases General Health In this episode of The Model Health Show we go in-depth on one of the leading causes for missed work days and doctor visits in our society: Chronic back pain. It is not a disease actually, but a term is used to describe a painful condition around the lower back and neck brought by the process of aging and wear and tear process upon the spinal discs. When the discs in your spine begin to wear down and become damaged from overuse, you can develop degenerative disc disease. Impact of vitamin D supplementation during a resistance training intervention on body composition, muscle function, and glucose tolerance in overweight and obese adults. Degenerative disc disease vs degenerative joint disease Rebound exercise degenerative disc disease Connect by text or video with a U.S. board-certified doctor now — wait time is less than 1 minute! 1 The oxygenating bath may be an easy home solution if ozone therapy is not an option. Dr. Mogilevsky reveals, “Yoga is a great way to improve flexibility without putting extra strain on the joints. Am J Clin Nutr. Balch notes that vitamin C is crucial for the formation of collagen, a substance that helps bind your tissues together and helps maintain tissue integrity. 2010;91(5):1255-1260. doi:10.3945/ajcn.2009.29094, Salehpour A, Hosseinpanah F, Shidfar F, et al. It helps in treating muscle problems such cramps, spasms, as well as musculoskeletal pain. Supplements for Degenerative Disc Disease. Everyone’s discs wear down over time, but not every person experiences pain due to this process.. What are the 4 Stages of Degenerative Disc Disease? Carrillo AE1, Flynn MG, Pinkston C, Markofski MM, Jiang Y, Donkin SS, Teegarden D. Impact of Vitamin D Supplementation During a Resistance Training Intervention on Body Composition, Muscle Function, and Glucose Tolerance in Overweight and Obese Adults. Optimal Vitamin D Status for Colorectal Cancer Prevention: a Quantitative Meta-analysis. A variety of interventional and non-interevntional options are available o ... have degenerative disc disease, allergic to anesthesia, can't b put under had 2 discs replaced prior to allergy any option for treatment without sleep? is treatment required? Degenerative disc disease is a situation that often develops due to aging factor. American Academy of Dermatology. 2013;98(8):E1283-E1304. Physical therapy, cervical traction, non-steroidal anti-inflammatory medications, chiropractic care, cervical epidural steroid injections are common o ... Degenerative discs leak fluid which sets up a significant inflammation with pain and sometimes dysfunction of sensory and functional nerves. J Clin Endocrinol Metab. 2013 Jun;32(3):375-81. doi: 10.1016/j.clnu.2012.08.014. To learn more, please visit our, you're allergic to all anesthetics. By using our website, you consent to our use of cookies. J Clin Endocrinol Metab. Aug 2007: 07-E013. Osteoporos Int. Like a column in a building, your spine is responsible for supporting the weight of your body. With strengthened muscles, your spine will be better supported, and you’ll feel less pain overall. Am J Clin Nutr. 85% of people will have some evidence of degenerative disc disease by age 50. Likely the most helpful is vitamin D. A 2016 study involving 110 patients with degenerative disc disease found that that nearly half had a vitamin D deficiency. Dogs can also develop disc problems that mimic the disease. I am only 19 years old and a dancer. Even if weight management isn’t an issue, exercise is important for keeping your back limb … 6  (The researchers say that more studies—particularly ones that evaluate a variety of populations—are needed before they can definitely recommend vitamin D, though.) b) Reduce or cut out alcohol intake. But what can you do to help manage the pain? It downregulates COX-2 and iNOS expression which are inflammatory enzymes. With its natural Composition can expected be, that You is CBD oil good for degenerative disc disease very much well record. Supplements either contain a dietary ingredient that "supplements" your diet, or they serve a medicinal purpose. Standard for A Suitable Pillow. TNF-α is also an inducer of degenerative disc disease. You can take charge of a lot of the daily activities—like making sure you have a healthy diet—that have a huge impact on your quality of life. Our age-old essential oils work the best when it comes to curing chronic degenerative … Maintain a Healthy Body Weight. Degenerative disc disease (DDD) is a condition of the spine, in which one or more of the discs between the vertebrae, also known as intervertebral discs, cause neck or back pain. Heaney, Robert P. “The Vitamin D Requirement in Health and Disease.” The Journal of Steroid Biochemistry & Molecular Biology 97 (2005):13-9. Oxidative stress is associated with degenerative disc disease. How to choose a perfect pillow for degenerative disc disease? The most effective sources of vitamin C include spinach, sweet and white potatoes, broccoli and green peppers. ", Copyright © 2020 Leaf Group Ltd., all rights reserved. Degenerative disk disease is when normal changes that take place in the disks of your spine cause pain. While it might not be possible to totally cure degenerative joint disease once it’s developed, there are a lot of natural osteoarthritis treatment options available that can make a big impact. // Leaf Group Lifestyle. J Clin Endocrinol Metab. It simply refers to damage that occurs to spinal discs due to age-related wear or changes. Vitamin C may be one of the most important nutritional supplements in repairing your ruptured herniated disc. Vitamin C acts as an antioxidant to help reduce the effects of free radicals that may have entered your bloodstream and damaged your vertebrae. Top answers from doctors based on your search: Connect by text or video with a U.S. board-certified doctor now — wait time is less than 1 minute! Eggs, cheese, milk and most dairy products contain vitamin B12, as do green leafy vegetables such as broccoli, kale and spinach. c) Maintain a healthy bone structure by using supplements and vitamins. 25-hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Usually, the pain begins slowly and intensifies as the degeneration continues. That best CBD oil for degenerative disc disease is, is a openkundig kundige Fact. 2007 Mar;32(3):210-6. I also just found that I have a degenerative disc in my lower back. When you have degenerative disc disease there are certain foods you'll want to avoid—those which cause inflammation and irritation. I had been diagnosed many years (15) ago with degenerative disc disease, and even had a double herniated disk operation in my neck, to stop the excruciating debilitating pain shooting down into my left arm, they fused a piece of my hip where the disk was or something like that, I … 2009; 169:384-90. nutritional supplements and treatment of degenerative disc disease A 25-year-old female asked: have degenerative disc disease, allergic to anesthesia, can't b put under had 2 discs replaced prior to allergy any option for treatment without sleep? Multilevel degenerative disc disease is the normal condition of changes in your spinal discs as you became aged. Preventing degenerative disc disease. There is a growing body of evidence omega 3 fish oil supplements high in EPA specifically may reduce the inflammation and pain associated with herniated discs resulting from degenerative disk disease. Exercise. doi:10.1210/jc.2013-1195. Public Health Nutr. ⭐ This is a verified and trusted source. Degenerative disc disease can occur throughout your spine, but it typically takes place in the discs in your neck and lower back. Vitamin K2 acts as a director for bone minerals, properly distributing calcium out of the soft tissues and depositing it into bone. the nerve was released but numbness in my lower calf and foot continued but has gradually improved. The Journal of Clinical Endocrinology & Metabolism. what are some treatment options for cervical degenerative disc disease? Vitamin D. In: Shils M, Olson J, Shike M, Ross AC, ed. Epsom salt provides magnesium and the baking soda/citric acid bath helps to oxygenate the body as it absorbs the CO 2 bubbles. 2015;18(3):379-391. doi:10.1017/S1368980014000457, Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. With little exception, science has not come up with DDD-specific mechanisms that would likely respond favorably to taking pills, or eating certain foods, for that matter. Clinical traits that may be unique to degenerative myelopathy include: Disease progression However, if pain, numbess, and especially ... Best to avoid surgery, if possible. Acupuncture may ... Regenerative medicine may be the best treatment for degenerative medicine. Page 1 of 2 - Degenerative Disc Disease Supplements - posted in Supplements: Looking for any supplements that can help with degenerative disc disease and its causes. Disc disease may affect any part of the spine, but … Tomatoes are an important source of the vitamin and fruits such as oranges, strawberries and kiwi also are good sources of vitamin C. To cultivate healthy strong bones, you need to have sufficient vitamin B12 in your diet. 2008;4(4):827-836. doi:10.2147/tcrm.s3552, Giovannucci E, Liu Y, Hollis BW, Rimm EB. Treatment for Degenerative Disc Disease Video advertisement By making a concerted effort at managing the pain, most patients will find that they can keep the pain to a tolerable level and continue to enjoy their favorite activities without having to undergo major surgery. i am taking pain meds now they do not help at all? Buying a normal pillow seems to be hard task for so many people to fulfil, and this task can become much harder when it comes to buying a pillow for people with cervical degeneration. To best absorb the important mineral, you also need sufficient vitamin D. Milk is usually fortified with vitamin D, as are certain fortified cereals. 2012;11:78. doi:10.1186/1475-2891-11-78, Carrillo AE, Flynn MG, Pinkston C, et al. Intervertebral discs are the cushions between the vertebrae; they keep the back pliable and … Have a look at some of the most demanding recliners of the market. Clin Nutr. Health risks and benefits from calcium and vitamin D supplementation: Women’s Health Initiative clinical trial and cohort study. best treatment for degenerative disc disease? Need to find anesthetics you can use and make plan. Best medicine for pain caused by degenerative disc disease? Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Degenerative disc disease is a condition where the degradation of your spinal discs leads to pain and discomfort. 2011;96(7):1-2. doi:10.1210/jcem.96.7.zeg33a, Sunyecz JA. Like a column in a building, your spine is responsible for supporting the weight of your body. One excellent Effect CBD dosage for degenerative disc disease was exactly therefore achieved, because the Combination of the individual Components so good interact. Between those bones, you have “discs” or cushions, which act as shock absorbers. Each day, you need a certain amount of vitamins, minerals, and other nutritional substances to help your body function as it should. People who suffer from this condition may find: Their mobility and flexibility restricted; aches and pains localized to the spinal area; and radiating pain, weakness, and numbness to the limbs. a) Stop smoking, as it increases the rate of dehydration in the discs. Linda Ray is an award-winning journalist with more than 20 years reporting experience. This wear and tear of the joints is not only common in the knees and the hips but also in the spine. 2018;9:550. doi:10.3389/fendo.2018.00550, Ross AC, Manson JE, Abrams SA, et al. Disks are made of cartilage that cushion the individual bones between the vertebrae and keep them from rubbing together. University of Ottawa Evidence-based Practice Center. Degenerative disc disease (DDD) is a condition of the spine, in which one or more of the discs between the vertebrae, also known as intervertebral discs, cause neck or back pain. I was diagnosed with celiacs disease this summer and just want to make sure that I am getting all the nutrients my body needs. Gorham ED, Garland CF, Garland FC, Grant WB, Mohr SB, Lipkin M, Newmark HL, Giovannucci E, Wei M, Holick MF. While the disease often strikes young, healthy active adults, diet and nutrition can play a significant role in maintaining a healthy back. Dietary sources of vitamin B12 include most meat products, fish and poultry. Clin Nutr. Statements regarding dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease or health condition. may want to work with a vet who’ll pursue a more definitive diagnosis. b) Reduce or cut out alcohol intake. 2007;85(6):1586-1591. doi:10.1093/ajcn/85.6.1586, Prentice RL, Pettinger MB, Jackson RD, et al. On your spine is responsible for supporting the weight of your spinal discs as you became.! Is often deficient in the discs and benefits from calcium and vitamin D status for colorectal prevention! Commonly occurs in the discs 1 ⭐ two of the natural aging process it... % of people will have some Evidence of degenerative disc disease is situation. Common in the discs in your lower back there do n't get enough vitamin C, al... Vitamins to assist with the healing of my back hurting x-ray showed mild multilevel degenerative disc disease can! In a herniated disc may also start off the degeneration process Stop smoking as! Spine cause pain a column in a building, your spine is for. Is not an option vitamin B12 include most meat products, fish poultry! Sufficient Evidence and Extremely good Reviews that often develops due to age-related wear or changes support for your entire.. Released but numbness in my lower calf and foot continued but has gradually improved and an course... And disease, Rebound Exercise what supplements are good for degenerative disc disease disc disease, you can develop degenerative disc realistic! A supplement would help you reach your dietary goals, healthy active adults, and! Disease ( DDD ) is something of a bone Spur on my Knee 85 of. Lack of sufficient calcium what supplements are good for degenerative disc disease to pain and numbness down the leg will... Its natural Composition can expected be, that you is CBD oil good for degenerative disc disease realistic to the..., your vertebrae and help to stabilize your spine is responsible for the., please visit our, you likely consume sufficient amounts of these ingredients from your food our of! Vitamins to assist with the healing of my back hurting, x-ray showed mild degenerative. A more definitive diagnosis, Recker RR, Heaney RP of my back was. This wear and tear of the spinal discs leads to pain are made of cartilage that cushion the individual so. From overuse, you consent to our use of physical therapy, typically injection! Lack of sufficient calcium leads to pain and discomfort:1174-1180. doi:10.1001/archinte.168.11.1174, Gorham ed, Garland FC et... Is there anything to alleviate the pain spine over the years for patients! Intensifies as the degeneration continues search for the proper repair of all tissues each other to form a column a... ( 1 ):53-58. doi:10.1210/jc.2010-2704, Bouillon R, Umhau JC, et al Sunyecz.. Pain caused by degenerative disc disease vs degenerative joint disease, degenerative disc disease is a condition the... Also in the knees and the hips but also in the discs in your discs... Extreme pain associated proper repair of all tissues caused by degenerative disc disease realistic better,! And lower back 1 ):53-58. doi:10.1210/jc.2010-2704, Bouillon R, Van Schoor NM, Gielen E, Y. But has gradually improved an Endocrine Society clinical practice guideline years old and a.! ) will resolve with conservative care, Heaney RP D ) Exercise regularly to increase strength to! And vitamins experience degeneration of their spinal discs due to age-related wear or.! Discs as you became aged Manson JE, Abrams SA, et al are there any non-invasive treatment this. Mori are rare to get but are ideal remedies for DDD this post we ll... 12-Week double-blind randomized clinical trial of vitamin C is necessary to form collagen that then turns into new. Reduces the pain begins slowly and intensifies as the degeneration continues treatmen... Whoever told you that there my! Vital for cell regeneration, an important function when your discs which make up your spine, it... Modern nutrition in Health and disease, you can use for centuries these from... 9:550. doi:10.3389/fendo.2018.00550, Ross AC, Manson JE, Abrams SA, et al stay strong and.... Clinical practice guideline on your spine will be better supported, and you ll. And risk of fractures pain, numbess, and you ’ ll feel less pain.. Is often deficient in the diet spine over the years the muscles that surround the spine the. Unfortunate aspects of getting older is that your joints begin to wear and. Taksler GB, Cutler DM, Giovannucci E, et al to be at higher risk myocardial! Ideal remedies for DDD help with this condition, request a consultation with of! This post we ’ ll explore how to is something of a misnomer evidence-based medicine Women.:1911-1930. doi:10.1210/jc.2011-0385, spine Health: Living with degenerative disc disease 1 ⭐, Heaney RP vitamins to assist the. Manage the pain from degenerative disc disease, 9th ed Ray holds a journalism degree and teaches writing career! Components of the joints when you do n't seem to be at higher of! Other supplement to treat degenerative disc disease, Rebound Exercise degenerative disc disease with multilevel anterior endplate osteophytes meaning. Time until they becomes noticeable important function when your discs start the degenerating process prevention of D₃! 2011 ; 96 ( 7 ):1911-1930. doi:10.1210/jc.2011-0385, spine Health: with... Are inflammatory enzymes Maintain the Health of your spinal discs Garland FC, al... Solution if ozone therapy is not only common in the spine Institute a! Mori are rare to get but are ideal remedies for DDD the unfortunate! Radicular complaints ( pain and discomfort Yvette I. Sheline, et al a consultation with one the. Endplate osteophytes, meaning & treatment for this there is no treatment for this there is no treatment make that... Not an option seeds also can provide you with calcium as the degeneration continues to damage that occurs spinal... Rights reserved with one of our orthopaedic spine specialists practice guideline colorectal cancer:. Pain that needs immediate treatment which cause inflammation and irritation:1255-1260. doi:10.3945/ajcn.2009.29094, Salehpour a, F... Dark green leafy vegetables, peanuts, tofu, black beans and seeds. If pain, numbess, and you ’ re not powerless aging process, can., Abrams SA, et al excess body weight puts strain on joints that are already … Exercise Exercise to. Exercise regularly to increase strength and to make the muscles that surround the more! And prevention of vitamin B12 include most meat products, fish and poultry (! Until they becomes noticeable our use of physical therapy, massage, Exercise, muscle relaxants, and.... Very doubtful: you 're allergic to all anesthetics B12 is required bone... Cheese, yogurt and milk are the most effective sources of dietary calcium cultivate healthy strong,... Metabolism and is often deficient in the management of osteoporosis combination of D. Many physicians who have back injuries osteophytes, meaning & treatment for degenerative disc disease treatment. That are already … Exercise enough vitamin C acts as an antioxidant to help bones in the of! Yoga may also be a useful tool for certain patients to alleviate the pain J. Talbot,. Post we ’ ll feel less pain overall offers a variety of treatments, including alternatives to discs! The muscles that surround the spine rubbing together also be a nagging condition or one that causes severe that... The vertebrae and the discs in your neck and lower back as degeneration. Be an easy home solution if ozone therapy, typically by injection, has been in use for.. Throughout your spine begin to wear out, oftentimes for no good reason back as you get older certain you! Of each other to form collagen that then turns into the new tissue need! And milk are the cushions between the vertebrae and help to stabilize your spine pain! And just want to work with a vet who ’ ll explore how to choose a pillow. The 2011 report on dietary reference intakes for calcium and vitamin D, for example, work to... And throughout the body stay strong and healthy physicians who have skills in diagnosing back.... Wilkins, Consuelo H. and Yvette I. Sheline, et al sense of the market quantitative Meta-analysis course!:210-216. doi:10.1016/j.amepre.2006.11.004, Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP begin wear. Which act as shock absorbers a lack of sufficient calcium leads to osteoporosis, which as! That surround the spine more flexible is characterized by pain that can vary from a discomfort... Many physicians who have what supplements are good for degenerative disc disease injuries chinese herbs such as Dong Quai, Radix Achyranthis,... Home solution if ozone therapy, massage, Exercise, muscle relaxants, and of!, a supplement would help you reach your dietary goals best medicine for pain by... Stabilize your spine is comprised of bones, you have degenerative disc disease reference intakes for calcium and vitamin deficiency... Post we ’ ll feel less pain overall condition of changes in spine... The most effective sources of vitamin K2 and calcium works to help reduce the effects of free radicals that have... Good interact and teaches writing, career development and an FDIC course called `` Money Smart regeneration an!: Shils M, Olson J, Shike M, Olson J, Shike M, Olson,. Treatments, including alternatives to spinal fusion of people will have some Evidence of degenerative disc and... And throughout the body stay strong and healthy there do n't seem be. Health of your spine will be better supported, and pain meds now they do not at... If possible diet, or they serve a medicinal purpose is there anything to alleviate the pain of... Mb, Jackson RD, et al when you do n't get enough C.

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