Exclusion Diets for Eczema

Exclusion Diets for Eczema
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Infants of mothers randomized to cut out eggs, milk, and fish were significantly less likely to have eczema even years later.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The original randomized, double-blind, controlled trial of diet and eczema found that cutting out eggs, chicken, milk, and beef significantly improved eczema in 70% of the kids that completed the study. Subsequent studies found similar results; though in this case, for example, it only seemed to work for a quarter of the kids. But, bottom line, out of 13 studies on avoiding milk, eggs, or both: “Ten [out of 13] studies documented overall clinical improvement.”

The economic burden of eczema caused by just regular cow’s milk formula alone may be hundreds of millions of dollars a year, though eggs appear to be worse “in terms of [predicting] persistence and severity of the disease.” Sensitization to egg white and cow’s milk can occur even in breastfed infants, though. And so, presumably the source of the exposure is the passage of egg and cow proteins through the mother’s milk. But, you don’t know until you put it to the test.

New mothers were randomized to cut out eggs, cow’s milk, and fish from their diet during the first three months of breastfeeding after giving birth, or to continue their regular diet. And indeed, the infants of mothers who cut out the eggs, milk, and fish were significantly less likely to have eczema by age six months—though after that age, the decreased rates of eczema in the no eggs, milk, or fish group was no longer statistically significant.

Follow those same kids out to four years, though, and those whose moms cut out the eggs, milk, and dairy for just three months while breastfeeding had significantly lower eczema rates, even years later. Consuming that hypoallergenic diet during breastfeeding cut childhood eczema rates in half.

Eating more plant foods may also help. “The majority of fruit and vegetable studies [suggest that] higher consumption…by mothers during pregnancy and children in early life result[s] in reductions in…asthma,” another allergic-type disease. Maybe it’s the phenolic phytonutrients in plants that are helping, supported by evidence that “certain vegetarian diets” appear to alleviate “the severity of skin diseases” in adults with eczema—though if you look at that citation, it was a very strange diet.

They found striking benefits in terms of reducing the severity of eczema, and even two months after they went off the diet, they were still doing better than when they started. But, the diet was just vegetable juice, brown rice, kelp, tofu, tahini, and “persimmon leaf tea,” and severely calorie-restricted. And, just straight fasting alone can improve eczema, as can a strictly plant-based diet—which is not so surprising, given the data on children showing how much better they can do cutting out eggs and dairy.

“In spite of these data Dermatologists and Pediatricians have, for many years, denied the role of food…in [eczema],” even though as many as 80% of kids may benefit cutting out milk and/or eggs, regardless of what the various allergy tests showed. You can’t necessarily tell if diet is going to help until you yourself put it to the test in your own body. And, that’s what parents are doing. They’re not waiting for their pediatricians to catch up; 75% of parents with eczema-stricken kids have “tried some form of dietary exclusion”—most commonly cutting out dairy and eggs, though only about 40% of parents who tried it feel that it worked. But hey, why not give it a try?

A typical recommendation you see in the medical literature is like, “Look, if you have a child with some bad eczema, and the drugs aren’t working, then why don’t you try cutting out some foods?” But, that seems to me backwards. If foods are contributing, why not treat the cause and eliminate the offending foods, and then do the drugs if diet isn’t enough?

Now, there are some pretty nutty eczema diets out there, like the so-called “few food” diet, excluding everything except like “lamb, potatoes,…Rice Crispies,…broccoli, [and] pears.” To my surprise, it was actually put to the test—I told you docs were desperate! But it “failed to show [a] benefit.” Basically, if you don’t know where to begin, “the simplest approach [may be to just cut out dairy] and egg[s],” and see what happens. That’s a controversial recommendation, though. Avoiding fish, beef, eggs, and dairy “without medical supervision”? That might “trigger… malnutrition-related pathology.” What? I checked out that citation, and it’s just another article making an unsupported claim.

Now, if you exclude everything, like 99% of your diet is rice milk, well then, obviously, that’s completely insufficient. But for most parents, the #1 thing they add to their child’s diet for eczema is vegetables, and the #1 thing they cut down on is junk food. And I don’t think we have to worry about a junk-food deficiency.

Please consider volunteering to help out on the site.

Icons created by Iconic, Herman Susanto and Harden Dwi Lester from The Noun Project

Image credit: psyberartist. Image has been modified.

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The original randomized, double-blind, controlled trial of diet and eczema found that cutting out eggs, chicken, milk, and beef significantly improved eczema in 70% of the kids that completed the study. Subsequent studies found similar results; though in this case, for example, it only seemed to work for a quarter of the kids. But, bottom line, out of 13 studies on avoiding milk, eggs, or both: “Ten [out of 13] studies documented overall clinical improvement.”

The economic burden of eczema caused by just regular cow’s milk formula alone may be hundreds of millions of dollars a year, though eggs appear to be worse “in terms of [predicting] persistence and severity of the disease.” Sensitization to egg white and cow’s milk can occur even in breastfed infants, though. And so, presumably the source of the exposure is the passage of egg and cow proteins through the mother’s milk. But, you don’t know until you put it to the test.

New mothers were randomized to cut out eggs, cow’s milk, and fish from their diet during the first three months of breastfeeding after giving birth, or to continue their regular diet. And indeed, the infants of mothers who cut out the eggs, milk, and fish were significantly less likely to have eczema by age six months—though after that age, the decreased rates of eczema in the no eggs, milk, or fish group was no longer statistically significant.

Follow those same kids out to four years, though, and those whose moms cut out the eggs, milk, and dairy for just three months while breastfeeding had significantly lower eczema rates, even years later. Consuming that hypoallergenic diet during breastfeeding cut childhood eczema rates in half.

Eating more plant foods may also help. “The majority of fruit and vegetable studies [suggest that] higher consumption…by mothers during pregnancy and children in early life result[s] in reductions in…asthma,” another allergic-type disease. Maybe it’s the phenolic phytonutrients in plants that are helping, supported by evidence that “certain vegetarian diets” appear to alleviate “the severity of skin diseases” in adults with eczema—though if you look at that citation, it was a very strange diet.

They found striking benefits in terms of reducing the severity of eczema, and even two months after they went off the diet, they were still doing better than when they started. But, the diet was just vegetable juice, brown rice, kelp, tofu, tahini, and “persimmon leaf tea,” and severely calorie-restricted. And, just straight fasting alone can improve eczema, as can a strictly plant-based diet—which is not so surprising, given the data on children showing how much better they can do cutting out eggs and dairy.

“In spite of these data Dermatologists and Pediatricians have, for many years, denied the role of food…in [eczema],” even though as many as 80% of kids may benefit cutting out milk and/or eggs, regardless of what the various allergy tests showed. You can’t necessarily tell if diet is going to help until you yourself put it to the test in your own body. And, that’s what parents are doing. They’re not waiting for their pediatricians to catch up; 75% of parents with eczema-stricken kids have “tried some form of dietary exclusion”—most commonly cutting out dairy and eggs, though only about 40% of parents who tried it feel that it worked. But hey, why not give it a try?

A typical recommendation you see in the medical literature is like, “Look, if you have a child with some bad eczema, and the drugs aren’t working, then why don’t you try cutting out some foods?” But, that seems to me backwards. If foods are contributing, why not treat the cause and eliminate the offending foods, and then do the drugs if diet isn’t enough?

Now, there are some pretty nutty eczema diets out there, like the so-called “few food” diet, excluding everything except like “lamb, potatoes,…Rice Crispies,…broccoli, [and] pears.” To my surprise, it was actually put to the test—I told you docs were desperate! But it “failed to show [a] benefit.” Basically, if you don’t know where to begin, “the simplest approach [may be to just cut out dairy] and egg[s],” and see what happens. That’s a controversial recommendation, though. Avoiding fish, beef, eggs, and dairy “without medical supervision”? That might “trigger… malnutrition-related pathology.” What? I checked out that citation, and it’s just another article making an unsupported claim.

Now, if you exclude everything, like 99% of your diet is rice milk, well then, obviously, that’s completely insufficient. But for most parents, the #1 thing they add to their child’s diet for eczema is vegetables, and the #1 thing they cut down on is junk food. And I don’t think we have to worry about a junk-food deficiency.

Please consider volunteering to help out on the site.

Icons created by Iconic, Herman Susanto and Harden Dwi Lester from The Noun Project

Image credit: psyberartist. Image has been modified.

Motion graphics by Avocado Video

Doctor's Note

I talk about the original randomized, double-blind, controlled trial of diet and eczema in my last video: Best Foods to Avoid for Eczema.

Nonsteroidal topical treatments are covered in my videos Eczema Treatment with Coconut Oil, Mineral Oil vs. Vaseline and Eczema Treatment with Evening Primrose Oil, Borage Oil vs. Hempseed Oil.

Some other skin health videos include:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

41 responses to “Exclusion Diets for Eczema

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  1. That is all correct, though it’s the streptococcus bacteria which feeds off the eggs and dairy, that causes eczema.
    That’s why only some people have it, not everyone.




    1
        1. That was indeed a strange rant by Buster. Seventh Day Adventists are even mentioned in the main video about Okinawan diet:

          https://nutritionfacts.org/video/the-okinawa-diet-living-to-100/

          “The plant-based nature of the diet may trump the caloric restriction, though, since the one population that lives even longer than the Okinawa Japanese don’t just eat a 98% meat-free diet, they eat 100% meat-free. The Adventist vegetarians in California, with perhaps the highest life expectancy of any formally described population. Adventist vegetarian men and women live to be about 83 and 86, comparable to Okinawan women, but better than Okinawan men. The best of the best were Adventist vegetarians who had healthy lifestyles too, like being exercising nonsmokers, 87 and nearly 90, on average. That’s like 10 to 14 years longer than the general population. Ten to 14 extra years on this Earth from simple lifestyle choices. And, this is happening now, in modern times, whereas Okinawan longevity is now a thing of the past. Okinawa now hosts more than a dozen KFCs.”




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        2. To me it is funny how two people can look at the very same thing and come to two different conclusions , Susan your point about there being lots of info about 7thDA is also my exact point . There isn’t a video on 7thDA , only partial studies where info looks promising to further a vegan or whole food agenda .In other words , you don’t want to deal with the fact some 7thDA are healthier than SAD people even though most use some dairy .It also might be possible you don’t want to address the health benefits of no tobacco , alcohol ,tea, coffee , chocolate or drugs , It might not be a huge point , however I still feel it is a valid critique .




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          1. buster, I think perhaps you have made some assumptions about me. I am familiar with the Adventist Health Studies first and foremost because of Dr Greger’s frequent mention of them throughout many videos. I was so interested that I keep the website on my favs, and post it often. The AHS 1 and 2 outcomes are a fascinating read, even for lay people like myself. The same for the more recent walnut studies. I am not vegan, but I eat whole foods and only plants. I do not use tobacco, alcohol, coffee, tea, chocolate or drugs (avoiding rx drugs as well).

            I was not always wfpb .. I did eat a healthy vegetarian / rarely fish diet for most of my life. The positive health changes I experienced in switching to wfpb was nothing short of spectacular. I have no doubt that some SDA are healthier than those consuming the SAD. .. I know because I was one of them. I am saying that my health today is what it is due to plants… and exercise… its that simple.

            One of fav speakers is Dr Hans Diehl of Loma Linda Univ fame http://responsibleeatingandliving.com/favorites/dr-hans-diehl-interview/ I am sure you have heard many of his lectures and read his books, but I post it here for others. https://m.youtube.com/watch?v=9OV1TtNoJR0 enjoy!




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            1. * I avoid rx whenever possible and reasonable. I have to take 1/2 baby aspirin per day and 1/4 of one beta blocker pill per day because of my heart surgery years ago. its protocol they say.




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          2. Virtually all SAD people consume dairy so what is your point?

            Certainly, red meat appears to be worse than full fat dairy. And low fat dairy appears to be less unhealthy than full fat dairy. However, even low fat (2%) milk provides 25% of its total calories from saturated fat. That can’t be healthy.
            http://nutritiondata.self.com/facts/dairy-and-egg-products/71/2

            My understanding is 7DA people consume a variety of diets and some may even consume the SAD. I can’t see how saying that some (but not all 7DA) people consume dairy, and 7DA people live longer than average, somehow suggests that dairy is healthful.




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            1. hi TG, I believe you were responding to buster’s comment, but I thought I would just add a bit to my own. I didn’t get into the details of diets because it is my impression that buster is not familiar with the findings of the AHS 1 and advance findings of AHS 2. https://publichealth.llu.edu/adventist-health-studies/findings/findings-ahs-2 His comments seem to alude to the idea of the Adventist diet being consistent throughout the community and consistently ‘good’ when it is not. The very fact that the studies divided the people into groups according to dietary status is for me, what makes it intesting. The closer you get to vegan status, the greater the health rewards – a fact which was revealed in my own experience as well. ( I would have been interested though to see a group , vegan + fish, ie no dairy ) I included the links for Dr Hans Diehl because as founder of the CHIP (coronary health improvement program), and clinical professor at the School of Medicine, Loma Linda University, there is no one more familiar with the outcomes health studies.. and he himself advocates a diet of plants.




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              1. Hi, Susan, I have read your posts with interest. Have you read “The World Peace Diet,” by Tuttle? If not, I think you would find it interesting–especially his chapter on fish. That did it for me….




                1
                1. hi Liisa, I will check the book out, thanks! I don’t eat fish, (or any animal derived food, knowingly) although prior to 2014, I did.. probably once a month on average. I only wondered what eating just vegies, fruit, beans, whole intact grains and small amounts of fish or shellfish might work out healthwise since my own doctors pressured me to consume it. My own cholesterol (still high) didnt fall until all animal products were eliminated.

                  As for fish on my plate? Just can’t do it.. between parasites, contamination with polutants, ecological concerns, and the horrors of the fishing industry, I’ll be content with my beans and greens.




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                  1. I understand. I thought you were thinking about consuming fish. I was at some point in my nutrition growth–until I read Tuttle’s book and that clinched the question for me. Someone could talk about fish till they’re blue in the face now; I won’t touch it!




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  2. Thanks very much for this video. I have had eczema for my entire life. I have eliminated dairy and eggs (and all other meat products) for 5 months now but still have eczema on my hands and face. Can I expect this to eventually go away or is the best I can expect after 5 months?




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    1. Sarah, you may also want to try omitting gluten. The last study showed a 51% improvement in eczema symptoms when gluten was removed from the diet (5:19).




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    2. 5 months compared to your entire life isn’t very long. Sometimes improvements in a bodily condition due to positive changes in ones diet can take years.




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    3. Sarah – I’m not experienced with exczema and am no expert. But it took me about 2 years for my gut to adjust to the inclusion of beans in my diet when going WFPB. I also just saw a paper put out by the American Heart Association and their information stated that it takes 1-2 years for a reduction/elimination of saturated fat in the diet to show a real difference. Dr. Esselstyne’s book (Prevent Reverse Heart Disease) stated that it took 36 months for the arteries of deathly ill patient to clear fully. So I would guess that I wouldn’t be surprised if it takes a while. Good luck to you.




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    4. Sarah, I’m a nurse volunteer moderator for this site and am pleased to see you already received some encouraging words from other commenters. Yes, while it would be great if you saw faster results, please don’t give up on your improved whole food plant based diet. You may try to see if minimizing gluten has any effect, but it may just take more time for your symptoms to resolve. Best of health to you.




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      1. I’ve been plant-based for years and got eczema WHILE plant-based. What happened is this: A cat scratched my hand while jumping down from being held. I got ringworm on the scratch area. A pharmacist recommended some ringworm meds–some cream starting with a C. It didn’t work. I went to my doctor. She said, “Oh, that one’s no good; use Lxxxx.” As a precaution, she also prescribed an antibiotic. Lxxxx cleared up the ringworm, but then I got eczema, which has never left. I think the antibiotic screwed up my skin somehow–or my microbiome? (Not sure if I’m saying this right!) and it never recovered.




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      2. Thanks so much! I agree I should be more patient, but I’ve had such wonderful results in eliminating my arthritis pain since going whole food, plant based that I hoped my eczema would also disappear quickly as well. I have noticed that I’ve been getting small flare ups in my hands when I eat gluten and having been wondering if there might be a link. I’ll try to cut back and see if that makes a difference! Thanks everyone for your advice :-)




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  3. Quick question offtopic! YOGURT

    can yogurt be compared to dairy (milk, cream etc)? because i think it stands out (still not “healthy”) solely because of a paragraph in How Not To die:
    “Overall, the study showed a dose-dependent higher rate of mortality (in both men and women) and fracture (in women), but the opposite was found for other dairy products, such as soured milk and yogurt, which would go along with the galactose theory, because the bacteria in these foods can ferment away some of the lactose”
    &
    Michaëlsson K, Wolk A, Langenskiöld S, et al. Milk intake and risk of mortality and fractures in women and men: cohort studies
    “Indeed, a high intake of fermented milk products has been associated with a decreased risk of cardiovascular diseases”

    Can you help me find a conclusion?
    Yellow or Red light?




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    1. Hi Jacob! While there is not a specific video or post on this topic, I will definitely pass it on so it can be covered in the future! Thanks for your interest!




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  4. I had to laugh at this video. I did not look it up but I don’t (think) there were any studies done in the mid 1950’s on this issue, but may have been. I am 65 yrs old and when I was ages 3-6 I had Eczema on the inside of my legs 1/2 way between my knee/groin. The patches were about 6 inches long by 4 inches wide. Boy I remember scratching real bad. So my mother takes me to our old fashioned family physican. Immediately, after he looks at it he says to my mother eliminate the milk out of his diet. So she did. One week later it was gone. How did he know? Maybe there were journals suggesting it then. So, when I was 12 I started drinking skim milk. Results: no Eczema! Body adapted. Fast forward to age 60 I began drinking Raw Cows Milk. I did so for about three yrs. Results: No Eczema. Fast forward to 64: I met Dr. Greger on line through videos. Dairy gone, eggs gone, all junk food gone, 85% of meat gone, all fish gone-soon to be vegan at 65 yrs. 8 mos. Thank You!




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  5. I keep waiting for Dr. Greger to please post something on blood thinners and atrial fibrilation. Are these really necessary in someone on a WFPB diet?

    Thank you in advance.




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  6. Those who recall past videos on the cellular growth regulator mTOR (1,
    2, 3, 4), which plays a role in aging and cancer, may be as intrigued as I was to discover mTOR is also activated in psoriatic skin (5), and mTOR inhibitors are effective in psoriasis treatment (6, 7, 8, 9, 10). These results suggest that excess growth stimulation plays a role in psoriasis, and reducing excess dietary protein, and other growth stimulators like the microRNAs in dairy, may contribute to the benefits of elimination diets.




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  7. Hi Eliza – I felt that I should comment on your question as well from the perspective of an emergency room doctor who sees and treats atrial fibrillation very often. If you are currently in atrial fibrillation, then you are at increased risk for stroke due to clot formation in the heart which can then embolize to the brain and cause a stroke – that is the reason/indication for blood thinners. Oftentimes, patients can go in and out of a fib. Sometimes, a cardiologist can perform a procedure to put your heart back in a normal rhythm and possibly decrease the need for long term blood thinners. It depends on the reason that you are in a fib and the likelihood that your heart can return to a normal rhythm. Please discuss this with your doctor before you proceed with any changes to your medications. WFPB will certainly help to decrease your risk for other cardiac problems, but the blood thinner will likely be necessary until your heart is back in a normal rhythm.




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    1. Hello Kristi – I am so grateful for your reply. I am aware of the need for blood thinning medications when one is in currently in active A-fib. However practitioners want someone to be on them every day with the consequent risk of bleeding, etc. That is my concern – do people really need to be on them every day and for life? I am just wondering about the options.




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    2. Hello again Kristi, there is also the issue of the effects of the new blood thinners on the immune system. Apparently the immune system needs the blood to clot to work properly. This is being studied now. It is heavy on my mind in making the decision to take these daily regularly or not.




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  8. Why do all studies of eczema seem to be about children? I hadn’t even heard the word until I was diagnosed with it at age 45. It became pretty freaking debilitating for a while (turns out at one point that I reacted badly to clobetasol). After three more different steroid creams from dermatologists offering little relief, I went to a podiatrist, who prescribed a 2-day rota: one day fluocinonide, next day urea cream. This, coupled with “wet wrap” therapy, helped get and hands immensely. Then my new GP recommended coal tar ointment. I now can walk like a “normal” human, and rarely need gloves – my regimen with the coal tar ointment is every other day, applied after shower.

    Oh, and through all this, I’ve been varying degrees of vegetarian to vegan (admittedly, never a pure vegan for long periods). I’ve probably drank a gallon of milk since my 17th birthday (that’s a gallon spread over almost 4 decades). And eggs have never been high on my menu, even back when I was a meat eater. In fact, I’ve eaten eggs more in the last 2 years since we started raising chickens than ever before in my life, practically every Saturday and Sunday).

    I don’t mean to discount diet, I just want to point out that eczema, at least in my case, and from much of what I’ve read, is largely attributable to either genetics, or else other outside factors.

    Oh, one last bit, one study I read pertaining to childhood eczema showed that children whose parents put the pacifier in their own mouth before passing it to the child had substantially less chance of developing eczema than those whose parents provided the pacifier directly to the child. I think it was an Italian study. Anyway, their hypothesis was that the germs on the pacifier from the parents helped the child’s immune system “learn” which germs to react to (since eczema is an auto-immune condition) . Sorry, that is from memory, but I think I am representing it fairly close.




    0
    1. The study you were referring to is:Pacifier Cleaning Practices and Risk of Allergy Development | Articles …
      pediatrics.aappublications.org/content/early/2013/04/30/peds.2012-3345
      Although eczema is more commonly seen in children, as you know all too well it can affect adults and because several factors can contribute to development of eczema identifying cause can be frustrating. However, because we know food is usually a contributing factor keeping to a whole food plant based diet to minimize risk makes sense so I encourage you to continue following this site to get the information and inspiration you need to eat well. To your good health.




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  9. I’ve been following Dr. Gregor’s daily dozen for about 3 weeks now and already my blood pressure has dropped from 138/72 to 126/62. I have a doctor appointment this Friday and I’m actually excited to see what my cholesterol count is and if they will lower my meds. If not this then maybe next time. I also have horrible eczema on my hands and feet and have just finished a 14 days of prednisone. Sure wouldn’t mind never having take that stiff agsin.




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