STAGEWISE MEDICAL TREATMENT OF MALE PATTERN BALDNESS

In Today’s post, we will help you locate your stage of baldness on the international Norwood’s scale and suggest medical hair loss treatments for every stage for reversing baldness stage-wise backwards!

Will will not go into the science and mechanism of male pattern baldness in this video. We have discussed all these in our previous episodes.

Let’s get started!

Baldness is staged commonly using the International Norwood’s scale, the hair loss stages are described with a number ranging from 1 to 7 depending on the severity of hair loss.

Let’s start with:

Norwood Stage 1: This type describes the least amount of hair loss with an adolescent type of hair line. You can consider this normal unless you have a family history of male pattern baldness.  If you have a family history closely monitor your hairline to determine if your hair loss develops into stage 2.  And No Treatment is necessary at for stage 1.

Norwood Stage 2: This stage means a small amount of hair loss with progression to the adult type of hair line.  Here there is slight recession of hair line around the sides or temples.
Regarding Treatment for this stage. If you have family history, first consult a doctor to verify that your hair loss is caused by male pattern baldness. There is a good chance that, with treatment, you can regain most of your lost hair and prevent progression into stage 3. You can start with simple treatment like 2 percent topical minoxidil application at this stage or start rolling a 0.5mm derma roller once a week with or without minoxidil solution. You can check out my detailed post on derma roller for hair loss.

Norwood Stage 3: This stage describes a mild to moderate amount of hair loss. This is the earliest stage of hair loss considered cosmetically significant enough to be called “baldness” according to Norwood scale. At this stage, most men show a deep bilaterally symmetrical recession of hairline at the temples that is sides, which are either completely void of hair or only sparsely covered with hair.  This resembles letter M, U, or V shape. The vertex figure here shows the additional thinning of the hair at the crown of the head.
This is the most important stage of norwood, because you must start treatment as early as possible to prevent progression into stage 3. Remember, The higher the stage, the more difficult the treatment is.

Well, the treatment options at this stage, you may require a combination therapy like minoxidil 5 percent twice daily plus finasteride 1 mg tablet. This stage is stubborn for most people. If you are able to control or grow back hair at this stage, the baldness progression is generally slowed down in later part of your life.
Also the other treatment options you can consider at this stage are PRP and mesotherapy along with minoxidil. You can watch my detailed post on this PRP mesotherapy.

You can also consider Hair transplantation treatment at any stage from stage 3 onwards.

Norwood Stage 4: This stage describes a moderate amount of hair loss. At this stage there is further deepening and recession at the front of the head as well as the temple areas. Hair loss at the crown is also prominent now and a thick bridge of hair will separate hair loss at the front of the scalp from that at the vertex or the crown of the head.  To differentiate this from stage 3, you can draw an imaginary vertical line tangential to the front margin of the ear. If hair loss crosses behind this line, then is stage 4.
Regarding the treatment options at this stage, there is no guarantee that using all the treatments including finasteride, minoxidil or a combination therapy will bring back all your lost hair. But the good news is if you start early treatment, the miniaturized hair will come back to normal and you can switch back to stage 3. You might have to use minoxidil in a higher concentration like 10 percent plus finasteride 1mg daily indefinitely.  Please check my article on DHT to understand this miniaturization and the mechanism of hair loss.

You can also treat this stage with PRP and mesotherapy plus Stem cell therapy and consider hair transplant option at this stage too.

 

Norwood Stage 5: this stage marks the beginning of severe degree hair loss. In this stage, there remains only a thin separation between the loss of hair at the hairline and the loss of hair at the crown, the band of hair between the two is much thinner and narrower. Hair loss at both the crown and the temporal regions are larger and more distinct.   The treatment options at this stage are same as that in stage 4.

 

 

Norwood Stage 6: In this stage there is a large amount of hair loss. The bridge of hair that once separated the front of the head from the crown is now almost fully lost, only a few sparse strands may remain. The remaining hair now forms a horseshoe shape around the baldness concentrated in the center of the scalp. Hair loss on the sides of the head will also extend further at this stage.
At this level, a hair transplant may be the only option.

 

Norwood Stage 7:  The most advanced stage of hair loss, Here, only a wreath of thin hair remains on the sides and back of the scalp. This stage has the least chance of regaining your hair with any treatment.

 

 

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5 BEST TOPICAL MINOXIDIL COMBINATION HAIR LOSS TREATMENTS

In Today’s article, we will discuss on the best combination treatments for hair loss in both men and women. We will also list out the 5 best topical minoxidil formulations with no side effects. We will also discuss on how to use and which formulation to use depending on your stage of baldness and also briefly discuss on how these medications work to promote hair growth.

Topical Minoxidil solution is the only non-prescription, over-the-counter hair loss treatment, clinically proven and FDA approved medication for female and male pattern hair loss.

Minoxidil belongs to a class of medications known as VASODILATORS, that means those medications dilate the blood vessels.

Minoxidil was actually discovered in the clinical trials for high blood pressure treatment. During the trials, oral use of minoxidil showed unexpected increase in scalp and body hair. These incidental findings led to the development of topical minoxidil for the treatment of androgenetic alopecia.

Now lets quickly discuss on the Mechanism of action by which minoxidil works:

Minoxidil is a potassium channel opener which dilates the blood vessels of the skin around the hair follicles and this allows more entry of oxygen, blood, and nutrients to the hair follicles. This increases follicular size and hair shaft diameter and prolongs hair growth and keeps hair in anagen phase for a longer time. This brings back miniaturized hair follicles back to normal. Miniaturized follicles are those that are weakened by the action of DHT – dihydroxytestosterone.

Minoxidil may cause follicles in the telogen phase to shed – that is why you experience hair loss for intial few days after minoxidil application!  These hair are then replaced by thicker hair in a new anagen phase. You can check out a detailed animated explanation on hair growth cycle to understand the how hair grows from HERE.


For what Type and Stage of Baldness is minoxidil effective?

Minoxidil is more effective in younger people who have experienced hair loss for less than 5 years. Minoxidil is less effective when the area of hair loss is large.

Minoxidil use is more effective for central or vertex hair loss and may not be effective to treat receding hairline.

You can start minoxidil from early stages of baldness like Stage 1 and 2 to prevent progression of baldness. You can watch a detailed video on the stage-wise treatment of male and female pattern baldness from links at the end screen of this video.

It is proven that about 40% of men experience hair regrowth after 3–6 months of minoxidil treatment. Minoxidil must be used indefinitely for continued support of existing hair follicles and the maintenance of any experienced hair regrowth.

Before we move on to the Different formulations and combinations of Minoxidil, we will quickly list out some rare side effects of minoxidil.

Burning sensation or redness at the application site may occur. If these persist or worsen, contact your doctor or try a different formulation like minoxidil foam.

Rarely, this medication can be absorbed through the skin and cause systemic side effects including: unwanted facial/body hair, dizziness, fast/irregular heartbeat, fainting, chest pain, swelling of hands/feet, unusual weight gain, tiredness, difficulty breathing especially when lying down.

A very serious allergic reaction to this drug is very rare.

And lastly, Alcohol and propylene glycol present in some topical preparations may dry the scalp, resulting in dandruff and contact dermatitis.

Now let’s discuss on the different Formulations and Combinations of Minoxidil for Hair loss Treatment:

  1. Minoxidil 2%, 5% and 10% solution or foam. 2% is recommended twice daily for stage 1 and 2, 5% for stage 2 onwards twice daily and 10% stage 3 onwards once daily. Minoxidil foam is recommended for those who have scalp irritation on using regular minoxidil solution.
  2. Minoxidil 5 and 10% + Finasteride 0.1% – This is really effective hair loss treatment for stage 3, 4 and 5 and can revert your stage to previous level within 6 months to 1 year. 5% solution should be used twice daily and 10% once daily one or two hours before bed and hair can be washed with a mild shampoo the next day morning. This is also recommended for those who cannot tolerate oral finasteride of 1 mg daily and report adverse effects like erectile dysfunction and loss of libido.
  3. Minoxidil + Diaminopyridine – This is another effective combination. Here Diaminopyridine prolongs life cycle of a follicle by stimulating the anagen phase.
  4. Minoxidil + Aminexil – Here aminexil increases the circulation of blood to hair follicles which triggers an increase in hair growth and also prevents the hardening of hair shaft and the build-up of collagen around it. It can be used by both men and women dealing with hereditary hair loss or androgenic alopecia. Aminexil has no reported side effects.
  5. 5% minoxidil and 0.01% tretinoin is another proven topical combination where tretinoin increases the percutaneous absorption of minoxidil and hence the efficacy and safety of combined 5% minoxidil and 0.01% tretinoin once-daily therapy appear to be equivalent to those of conventional 5% minoxidil twice-daily therapy for the treatment of Andro-genetic Alopecia.

References:

Minoxidil + Tretonoin: https://www.ncbi.nlm.nih.gov/pubmed/17902730

Minoxidil + Finasteride: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314881/

 

 

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PROPECIA – FINASTERIDE SIDE EFFECTS | Hair loss Treatment in Men

Hello Friends and Patients!

In one of our most important article on the stage-wise treatment of hair loss in men, we discussed about the two FDA approved medications: The tablet Finasteride commonly known as Propecia and minoxidil topical application on the scalp.

We also discussed almost everything on hair loss in our previous episodes, starting from what causes hair loss both in men and women, the stages of hair loss in men and women, the medical treatments of hair loss, important facts and misconceptions on hair loss, some bad habits that can cause hair loss, foods that can reverse hair loss and many more. You can checkout that article category from HERE.

Now, Lets first quickly recap some important points on Finasteride and then we will discuss the side effects and real facts on the long term use of finasteride – like, does it really have those side effects?

Finasteride is a 5-Alpha-Reductase inhibitor which blocks the formation or conversion of testosterone to Di-Hydroxy-Testosterone (in short DHT). DHT is the hormone responsible for male pattern baldness or androgenetic alopecia. It acts on the hair follicles and gradually miniaturises the follicles and completely kills them as discussed in our previous articles.

Please checkout my detailed articles and videos on these topics like DHT and hair loss and stage-wise treatment of male pattern baldness.

Now lets jump to our topic and start listing out some important myths, facts and figures on the medication Finasteride for hair loss.

# 1. Finasteride  is used to treat male pattern baldness. And, its action is only at the crown and in the middle of the scalp. It is not helpful in treating receding hair line, except when started very early when the hair follicles are still in the miniaturized state.

#2. Finasteride must be used by adult men only over the age of 18. I suggest over the age of 20 years. Because this is the hormone responsible for the development of secondary male characters like beard growth, chest hair and so on.  But once these male characteristics are developed, blocking DHT does not alter beard growth or body hair.

#3. Women and children must never use this drug. It is not FDA approved for women because it can cause some serious birth defects if taken by pregnant women.

#4. How to use Finasteride?
1 milligram tablet has to be taken by mouth, And, with or without food does not matter! Preferably early morning is the best time, when testosterone levels are higher and avoid at night to reduce most of its side effects like loss of libido and other similar effects which we will discuss shortly.  You ingest 1 mg daily or 1mg on alternate days depending on your hair loss intensity and balancing the benefits versus the side effects.

#5. How Long to use Finasteride to see the results?  Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time each day like early morning as already discussed.  It may take from 3 to 6 months to notice some beneficial effect.

#6. Can I discontinue the medication once I achieve the desired results?

No, Never! You must continue to take this medication to maintain your hair growth. When you stop taking finasteride, any benefit you achieved in hair growth is generally lost within 12 months.

#7. What are the Side effects of Finasteride?
Well! this topic is controversial. Many studies have been conducted on this.
The incidence of side effects like erectile dysfunction, ejaculation impairment, and decreased libido has been confirmed. But the incidence is very low, like 1 in 1000 patients and even less in most studies. Some studies reveal that most of these side effects men experience are psychological. While some other studies indicate long term use of this drug can cause irreversible side effects like erectile dysfunction, ejaculation impairment, and decreased libido. But this is true for 5 milligram daily dose!, which is used for the treatment of prostate enlargement.
However if you experience these effects, try your best to avoid it psychologically, diverting your mind into daily exercise for atleast 30 minutes in evenings and taking finasteride 1 mg in early mornings. If you still experience these side effects, discuss with your doctor and stop this medication.  You can make a decision whether the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

#8. Other side effects: Other rare side effects like allergic reaction to the drug is extremely unlikely.  You might experience allergic rash or something like that but extremely rare.
Another rare side effect is occurrence of man boobs, medically called gynaecomastia. But its very rare. You might even feel tenderness in the part and sometimes even some pain or tenderness in your testicles.

#9. Risk of Prostate Cancer: Finasteride is not approved for prevention of prostate cancer. There is a lot of controversy on this topic. Some research studies show it prevents the occurence of prostate cancer, while some other studies say it may slightly increase the risk of developing a very serious form of prostate cancer. Talk to your doctor about the benefits and risks.

#10 Do I need to use finasteride tablet  in combination with topical Minoxidil ? Yes! this combination if one of the most effective treatments for hair loss and hair thinning since many many years. Minoxidil acts by increasing the local scalp vascularity and finasteride acts by blocking DHT in male pattern baldness. This deadly combination can even reverse hair loss by bringing miniaturised or thinned out hair follicles back to life!

So, there you have it folks! If you found the video helpful, please hit the like button and share this with your friends. Also comment below with your feedback and queries.
Stay Healthy!!

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Male Pattern Baldness – Early Signs, Stages and Treatments

In Today’s article on hair loss, we will look into some important early warning signs to pick up male pattern baldness and start early treatment to prevent further hair loss or even reverse hair loss as early as possible. We will also help you locate your stage of hair loss on the commonly used international Norwoods scale and discuss on what hair loss treatment to use for that particular stage.

Lets begin!

Picking some early signs can certainly help you combat male pattern baldness either to stop further progression of hair loss or even reversing hair loss. And remember – Prevention is always better than Cure!  First of all, try to assess yourself whether you are prone to male pattern baldness or not by considering these important factors:

  1. Age: Male pattern baldness or androgenetic alopecia can start at any age after puberty around the age of 15. Roughly, your risk to baldness is 20% in your twenties, 30% in your thirties, 40% in your forties ties and so on, that’s rising 10% for every decade of your life. Not only your age, but you have to watch out other factors too to deal with baldness prevention.
  2. Genetics: If you have a strong family history, you have to be double or triple cautious to apply preventive steps. And Hair loss, as discussed in my previous episodes – its polygenetic – meaning multiple genes are involved, from maternal side or paternal side or a combination. You might have to even look at your uncles from both sides to assess your risk.
  3. Other Factors like Stress, Smoking and Nutritional deficiencies are also important in adding that risk for baldness. So, if you want to save your hair, better be cautious of these habits and do not forget to read my previous important article on the bad habits that cause hair lossbad habits that cause hair loss.

 

Now! Lets look into the early warning signs of balding. We all know that balding can be a traumatic process for everyone. The one who is pretending to be cool with his baldness is a big liar. Well, the good news is by spotting the early warning signs of balding, you can start applying some preventative measures to secure your hair. Yes nothing is impossible!

So, how do I know whether I am going bald or will become bald? We use the International scale for staging of baldness in men – that’s called the Hamilton-Norwood Scale for androgenetic alopecia or the male pattern baldness. This scale is regularly used by doctors to assess the severity of baldness and depending on the stage of baldness, you have different treatment options and also it helps to assess whether this particular treatment option will be effective or not.

In this Norwood scale, the hair loss stages are described with a number ranging from 1 to 7 depending on the severity of hair loss.

Norwood Hair loss Stage 1: This type describes the least amount of hair loss with an adolescent type of hair line. You can consider this normal unless you have a family history of male pattern baldness.  If you have a family history closely monitor your hairline to determine if your hair loss develops into stage 2.  And No Treatment is necessary at this stage.

Norwood Hair loss Stage 2: This stage means a small amount of hair loss with progression to the adult type of hair line.  Here there is slight recession of hair line around the sides or temples.

Treatment for this stage: If you have family history, first consult a doctor to verify that your hair loss is caused by male pattern baldness. There is a good chance that, with treatment, you can regain most of your lost hair and prevent progression into stage 3. You can start with simple treatment like 2 percent minoxidil topical application at this stage or start rolling a 0.5mm derma roller once a week with or without minoxidil solution. You can check out my detailed derma roller article here.

Norwood Hair loss Stage 3: This stage describes a mild to moderate amount of hair loss. This is the earliest stage of hair loss considered cosmetically significant enough to be called “baldness” according to norwood scale. At this stage, most men show a deep bilaterally symmetrical recession of hairline at the temples that is sides, which are either completely void of hair or only sparsely covered with hair.  This resembles letter M, U, or V shape. The vertex figure here shows the additional thinning of the hair at the crown of the head.
This is the most important stage of norwood, because you must start treatment as early as possible to prevent progression into stage 3. Remember, The higher the stage, the more difficult the treatment is.

Treatment options at this stage: you may require a combination therapy like minoxidil 5 percent twice daily plus finasteride 1 mg tablet. This stage is stubborn for most people. If you are able to control or grow back hair at this stage, the baldness progression is generally slowed down in later part of your life.
Also the other treatment options you can consider at this stage are PRP and mesotherapy along with minoxidil. You can check out my detailed article and video on this PRP mesotherapy.

You can also consider Hair transplantation treatment at any stage from stage 3 onwards.

Norwood Hair loss Stage 4: This stage describes a moderate amount of hair loss. At this stage there is further deepening and recession at the front of the head as well as the temple areas. Hair loss at the crown is also prominent now and a thick bridge of hair will separate hair loss at the front of the scalp from that at the vertex or the crown of the head.  To differentiate this from stage 3, you can draw an imaginary vertical line tangential to the front margin of the ear. If hairloss crosses behind this line, then is stage 4.
Regarding the treatment options at this stage, there is no guarantee that using all the treatments including finasteride, minoxidil or a combination therapy will bring back all your lost hair. But the good news is if you start early treatment, the miniaturized hair will come back to normal and you can switch back to stage 3. You might have to use minoxidil in a higher concentration like 10 percent plus finasteride 1mg daily.  Please read my article on DHT and hair lossDHT and hair loss to understand this miniaturization and the mechanism of hair loss.

Treatment: You can also treat this stage with PRP and mesotherapy plus Stem cell therapy and consider hair transplant option at this stage too.

 

Norwood Hair loss Stage 5: this stage marks the beginning of severe degree hair loss. In this stage, there remains only a thin separation between the loss of hair at the hairline and the loss of hair at the crown, the band of hair between the two is much thinner and narrower. Hair loss at both the crown and the temporal regions are larger and more distinct.   The treatment options at this stage are same as that in stage 4.

 

Norwood Hair loss Stage 6: In this stage there is a large amount of hair loss. The bridge of hair that once separated the front of the head from the crown is now almost fully lost, only a few sparse strands may remain. The remaining hair now forms a horseshoe shape around the baldness concentrated in the center of the scalp. Hair loss on the sides of the head will also extend further at this stage.
At this level, a hair transplant may be the only option.

Norwood Hair loss Stage 7:  The most advanced stage of hair loss, Here, only a wreath of thin hair remains on the sides and back of the scalp. This stage has the least chance of regaining your hair with any treatment.

Switching back to an earlier stage with Treatment:

Yes this is possible with the treatments at every stage as discussed. Though these treatments will not restore a full head of hair, but these can certainly help one to climb back into a lesser stage of the Norwood scale. For example, with stage 6 hair loss, a reasonable outcome with treatment is a return back to stage 5 or even 4 if proper treatment is started.

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Guaranteed Treatments for Male Pattern Baldness – HAIR LOSS DHT LINK

In This Complete Hairloss Guide – Proven Treatment for Hair loss in men is DHT blocking. Di Hydroxy Testosterone is the hormone responsible for Male Pattern Baldness. How the hormone DHT causes Hairloss in male pattern baldness and does excessive masturbation cause hairloss and finally on the DHT blocking agents and natural foods and cures that can reverse or prevent hairloss.

Whatever your age is, If you have noticed hair thinning or receding hairline, you may be wondering whats going on! Is it stress? A bad diet? Unlucky genes? Or is it a lifestyle factor? And Finally a question – Can this be Fixed!.

The Good news is Yes! IT can be fixed. There earlier your start the faster and better the results are. Please follow this video till the end and you may not require any other video to know about hairloss and its guaranteed treatment.

We will First Quickly Understand the Mechanism by which Male Pattern Baldness happens:

Hair loss in men is primarily caused by dihydrotestosterone (DHT), a male steroid hormone that binds to receptors in your scalp follicles and in genetically susceptible men, DHT can bind to receptors in your hair follicles and cause them to shrink, weaken and eventually die. This process is called ‘miniaturization,’ and it eventually leads to a complete end of hair growth in DHT-affected hair follicles.

SO How is this DHT produced in your body? Its made from the male hormone Testosterone through the 5Alpha-Reductase enzyme — an enzyme that converts a certain percentage of your testosterone into DHT. So Blocking the production of DHT at this level will certain help prevent hair loss.

But the fact of the matter is that DHT is an important hormone for hair growth in other areas of the body like your beard, chest hair, arm pits and pubic hair and so on. Meaning the same hormone that’s responsible for causing male pattern baldness is also responsible for fueling the growth of hair on your chest, back and other areas.

But remember one thing, its all at genetic level and the DHT receptors. If you have male pattern baldness due to this mechanism which is the most common cause of male baldness, HERE ARE 10 tips, agents, medications, natural remedies and habits that can reduce the levels of DHT and slow down or completely prevent or even reverse male pattern baldness.

  1. FINASTERIDE 1MG PER DAY: This is an FDA approved medication you can start with a small dose of 1 mg per day to slow down male pattern baldness. Finasteride blocks the enzyme 5-Alpha reductase and prevent formation of DHT from testosterone. And one more fact about Finasteride is it can also cause miniaturized hair follicles damaged by DHT to start to grow back. That Great news! This is commonly marketed by trade names like propecia, finpecia, etc.
  2. MINOXIDIL SOLUTION: This actually works by increasing the blood supply to the hair follicles. This allows more oxygen, blood, and nutrients to the follicles. Its also thought to prevent DHT action on the hairfollicles but its not well understood. Well you can use 2% to 12% depending on the severity of your hairloss. I recommend 5% solution twice daily applied to your scalp, mind you its on the scalp not on the hair. Or if you want to use it once daily 10% solution at bedtime.

Well, please stay tuned. Its not over yet. Lets Continue with more treatment options and natural remedies for hairloss that really work.

  1. BEST COMBO TREATMENT: finasteride 1mg per day in combination with minoxidil 5 to 10 percent solution on scalp is the most effective treatment available for male pattern baldness. But never stop the treatment suddenly, it can cause rebound hairloss. If you skip one or two days that’s fine, but never completely stop it. There are hardly any side effects of these medications. But if you experience any problems always consult your doctor.
  2. DHT Blocking Shampoos: are out in the market. They do help if used in conjunction with other DHT blocking stuff like finasteride. The components of these are DHT blockers mostly natural like the saw-palmetto. We will discuss this next.
  3. SAW PALMETTO: Studies have shown that this naturally occurring substance block the enzyme and hence DHT. Sawplametto is approved in many countries and you get capsules of this substance along with multi vitamin and zinc magnesium supplements. One brand name I remember is Capsule Harvest.
  4. OHER FOODS LIKE PUMPSKIN SEEDS and Pyegeum Bark block DHT. Pumpkin seeds contains a steroid called delta-7 stearine, which blocks DHT buildup in the hair follicle.
  5. LYCOPENE: Is another substance that blocks DHT. Its found in Tomatoes, watermelon, carrots, mangoes
  6. Amino acid L-Lysine – found in Almonds, walnuts, peanuts also helps to some extent.
  7. ZINC: This is important! But studies have shown that zinc might block DHT only on higher doses which may not be appropriate for human consumption. SO zinc won’t increase your hair growth, but helps to strengthen the hair by nourishing the follicles by reducing inflammation.
  8. MASTURBATION AND HAIRLOSS:  This is still a controversial topic. But I will just tell you some scientific facts and things that happen in your body and you decide yourself. When you masturbate or ejaculate, the Testosteone levels rise and DHT formation also should rise due to the availability of lots of testosterone. But one fact to remember is: this might increase DHT but again, this action may be important for genetically predisposed individuals and not everyone will go bald. I think genetically predisposed people should be careful about this and hold on till enough scientific data on this is available. You must also know that anything in excess is BAD!

 

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