Feel Like a Natural Woman

References

Tammy Wynette sang it best: “Sometimes it’s hard to be a woman.” And not just when it comes to being in a relationship—that’s a different topic for a different magazine. From their pre-teen years on, women are faced with one major health issue—hormone balance—that requires constant attention, and another—breast cancer—that seemingly develops out of nowhere and can have fatal consequences.

For a woman to maintain a healthy lifestyle in light of these obstacles, there are some nutrients women may need more of than men do, though exclusivity shouldn’t enter into the retailer’s recommendation. “While there may be some gender-specific things you can focus on, the fact of the matter is, for anything gender-specific you say to me, I can think of another reason for the other sex to have it,” said Shari Lieberman, Ph.D., CNS, FACN, nutrition scientist and author of The Real Vitamin & Mineral Book.

Added Jan Roberts, new business development manager for Natural Health International: “Suggesting that gender/physiology alone is a determinant of nutritional needs does not take into account biochemical individuality; it underestimates the effects of individual lifestyles, ignores the fact that all nutrients work together and is, in fact, more closely related to the orthodox medical model.”

Many nutrients (not to mention products) are available to help women negotiate hormone balance and prepare for the worst against breast cancer, but a retailer needs to offer the right combination to each customer. That means more than grunting and pointing to an aisle.

“To make intelligent recommendations, it’s important to understand the features and benefits of the products you are offering,” said Marci Clow, R.D., senior director of product research at Rainbow Light Nutritional Systems. “It’s also a good idea to stay up-to-date with current research and product innovations—not always easy, since research on the benefits of nutritional supplements is continually evolving.”

For a woman, the aforementioned issues start in their early teens and before with menarche, when their bodies begin facing constant fluctuation of sexual hormones that will last throughout their lives. Hormone imbalance is also believed to be a cause of premenstrual syndrome (PMS), the one to two weeks before menstruation begins. Among its 150 or so symptoms are abdominal bloating, acne, anxiety, backache, cramps, water retention and depression. About 80 percent of women experience some features of PMS. About 10 percent of women have PMS symptoms that are severe enough to impact their work, relationships or lifestyle in a significant way.

“Fortunately, healthy lifestyle choices can promote metabolic and hormonal balance, easing these symptoms as women transition through various lifecycle changes,” Clow said.

For example, a case-control study nested within the prospective Nurses’ Health Study II cohort found women with the highest intake of vitamin D had almost half the risk of PMS of those in the lowest quintile; high calcium intake produced a 30-percent risk reduction.¹ Vitamin D and calcium, observed Neil E. Levin CCN, nutrition education manager at NOW Foods, can also “[promote] bone density before menopause. This helps the body maintain bone density after menopause, when bone status becomes less healthy.” Lieberman noted a “sun-phobic” mindset has led to most people being vitamin D deficient. She recommends a minimum of 1,000 IU/d.

Calcium’s key partner, magnesium—found in green, leafy vegetables—may also support menstrual health. A double blind, placebo-controlled study at the University of Reading, England, found 200 mg/d of magnesium plus 50 mg/d of vitamin B6 significantly reduced anxiety-related PMS symptoms, including mood swings and irritability.² “Insufficient supplementation of magnesium can make many hormonally-mediated problems such as menopause and PMS symptomatically worse,” said Andrew L. Rubman, N.D., formulator of FibroVera® Estromin® AHS for Arthur Andrew Medical. “FibroVera contains magnesium used as a coenzyme as well as an active ingredient. This ensures a well-absorbed magnesium source with the added benefit of the physiologic alkalization properties of ammoniate.”

Women in their reproductive years can also face problems with menses, highlighted by severe pain and blood loss, known as dysmenorrhea. Vitamin E may prove to be of assistance. Researchers in Iran conducted a double blind, placebo-controlled trial involving 278 girls (ages 15-17) suffering primary dysmenorrhea.³ After two months and four months, girls taking 400 IU/d of vitamin E had lower blood loss and decreased pain severity. Also, Vitex agnus castus, or chaste tree, has been shown efficacious in treating a range of gynecological disorders, including menstrual irregularities, hormone imbalances and cyclic mastalgia, possibly due to the dopaminergenic compounds that influence prolactin levels in the body.⁴

Tori Hudson, N.D., education and research director at Vitanica, likes chaste tree berry for PMS: “It has some definite clinical indications for fertility and has also been indicated for all kinds of irregular bleeding problems. It’s also an herb that improves lactation when you’re breast feeding.”

A 2004 study in Obstetrical and Gynecological Survey found dysmenorrhea can be caused by “a disturbed balance between anti-inflammatory, vasodilator eicosanoids derived from omega-3 fatty acids (EFAs) and pro-inflammatory, vasoconstrictor eicosanoids derived from omega-6 EFAs.”⁵ Increasing the number of omega-3s can therefore reduce the number of disruptive omega-6s, improving conditions for women with menstruation-related problems.

It should be noted not all omega-6 fatty acids are bad. Levin said women have had success supporting their cycles with gamma linolenic acid (GLA), which can be found in borage oil and evening primrose oil. Rubman added his personal experience using GLA at his health practice worked so well helping relieve PMS-associated symptoms such as breast, joint and muscle tenderness that he incorporated it into FibroVera. “This important anti-inflammatory, omega-6 fatty acid is known to work synergistically with many of the other components found in our formula by adding in another distinct modulator of inflammation, specifically the leukotriene and aracadonic acid cascades,” he said.

The benefits of omega-3s also extend to expectant mothers, said Herb Joiner-Bey, N.D., who is affiliated with Barlean’s, which offers fish oils and flaxseed oils. “No matter which omega-3 source is chosen [flaxseed, fish oil, etc.], omega-3s must be amply supplied in the mother’s diet to nourish the baby’s brain and eye cells, as well as help prevent such problems for mothers as post-partum depression.”

Fertility usually winds down for a woman during her 50s, leading to another hormone imbalance, as declining levels of estrogen and progesterone signal the entry into perimenopause. During this two- to four-year time frame, a woman’s periods become less regular, and she may experience menopausal symptoms such as hot flashes and night sweats.

For decades, hormone replacement therapy (HRT), now known as menopausal hormonal therapy (MHT), was the main conventional treatment for menopausal symptoms. However, MHT lost a lot of its luster in 2002 after a large scale study known as the Women’s Health Initiative found increased risks for serious health problems for participants who had taken a combination of progestin and estrogen for several years.⁶ The study, which was ended early, found increased risks for heart disease, breast cancer and stroke.

The good news is there are plenty of natural alternatives supported by research, including the old stand-by, black cohosh (Actaea racemosa, syn. Cimicifuga racemosa). Researchers at UIC’s NIH Center for Botanical Dietary Supplements Research noted in a 2005 review black cohosh appears to alleviate menopausal symptoms such as hot flashes, profuse sweating, insomnia and anxiety at a dosage of 40 to 80 mg/d.⁷ They also noted the extract does not appear to be estrogenic, making it safe for women with estrogen-related cancer concerns.

A 12-week, multicenter, double blind study in Germany involving 304 patients with climacteric complaints found 40 mg/d of black cohosh extract worked to relieve symptoms, particularly hot flushes.⁸ Similar findings were reported in a Swiss study of 122 menopausal women taking black cohosh for 12 weeks,⁹ and in an Italian study in 64 menopausal women, in which black cohosh (40 mg/d) was as effective as traditional HRT treatment in reducing climacteric symptoms.¹⁰ One of the largest trials involved 2,016 Hungarian women taking black cohosh extract (as Remifemin®, from Enzymatic Therapy); after 12 weeks of intervention, favorable decreases were seen in hot flashes, sweating, insomnia and anxiety.¹¹

“I sometimes will give menopausal [patients] Remifemin and chaste berry,” Lieberman said. “I will sometimes do the same for women with PMS. Both together can be effective for cysts and uterine fibroids, a sign of too much estrogen.”

Recent trials have shown black cohosh to be especially effective when paired with St. John’s wort. A prospective, controlled open-label observational German study of 6,141 women followed from six to 12 months showed the fixed combination of black cohosh and St. John’s wort was superior to black cohosh alone in alleviating climacteric mood symptoms.¹² A clinical trial by the Mayo Clinic found black cohosh on its own was ineffective to relieve hot flashes; subjects on placebo had higher satisfaction scores than treatment group.¹³

Hudson also likes maca, which she calls an “incredible adaptogen for men and women,” adding “it has special hormone effects for women on fertility and PMS.” She said maca has a long history of traditional use, and some research is starting to emerge. Natural Health International offers a combination of phenotypes found in two distinct maca species, which is known commercially as Femenessence. Roberts said Femenessence has been shown to increase oestradiol and progesterone, and reduce follicle stimulating hormone (FSH), in post-menopausal women by affecting their own hormone production.

The role of soy isoflavones has been debated for the impact on menopausal complaints. As a review from Loma Linda University, Calif., noted, the estrogen-like effects of isoflavones combined with the low reported frequency of hot flushes in Asian cultures, where soy consumption is more prevalent, has led to increased research into the plausibility of using isoflavone supplements for relief of climacteric complaints.¹⁵ In their review, the researchers found greater effects of isoflavone supplements in women with more frequent hot flashes.

Soy is a source of phytoestrogens, which Joiner-Bey described as “plant compounds with mild estrogenic effects.” They can be a solution to the challenges of a woman’s lifelong hormone fluctuations, he said. They’re also helpful during PMS, when excessive estrogens are present. “The less potent phytoestrogens can block the adverse effects of human estrogens, thereby reducing PMS symptoms,” he added.

Phytoestrogens are also found in red clover, which was observed to reduce hot flushes in menopausal women in one study (with Novogen’s Promensil®),¹⁶ and decrease the rate of menopausal symptoms in another.¹⁷Lignans in flaxseed are also great sources of phytoestrogens, noted Joiner-Bey. “Colon bacteria convert flaxseed into ‘mammalian lignans’ that are absorbed into the bloodstream and perform the beneficial work,” he said. A study in Korea found that a phytoestrogen derivative, EstroG-100 from JLM Industries, Inc., was found to significantly improve hot flashes and vaginal dryness in postmenopausal women.

According to Chris D. Meletis, N.D, director of science and research for Trace Minerals Research, women can help themselves by supporting their adrenal glands. He counts ginseng and vitamins B4 and C among nutrients as being supportive “during hormonal transition for women, since the adrenal glands serve as a buffer for gonadal down-regulation. It is the DHEA production from the adrenal glands that confer this buffering effect, since DHEA can be converted within the body to either estrogen or testosterone. Thus, women who enter menopause with adrenal stress often experience more menopausal symptoms, with all things being equal.”

The FibroVera formula was also designed to address the hormonal imbalance of estrogen dominance and its relationship to fibroid growth; for this reason, the formula contains fibrinolytic enzymes as well as DHEA. “Estrogen dominance is a prime contributor to the deregulation of normal function experienced by not only women approaching, transitioning and resolving the challenge of menopause,” Rubman said. “This imbalance is initially characterized by a decrease in DHEA due to stress, aging, poor diet, side effects of prescription drugs etc.; a decrease in progesterone due to absolute decrease in synthesis secondary to inadequate cholesterol down-conversion and increasing insensitivity of progesterone receptors; and the activation of a cross-conversion pathway that forces progesterone to act as a source for the synthesis of estrogens, decreasing both its bioavailability as a hormone, and as a substrate for the formation of adrenal cortical hormones.”

A simple multivitamin can also do women a world of good. “Irregular periods during adolescence and before perimenopause could be a result of a variety of nutritional deficiencies,” said Michael Yatcilla, Ph.D., vice president of research and development at Natrol. “If poor dietary intake is suspected, a daily multivitamin, in addition to improved dietary intake, may be helpful in supporting a more regular menstrual cycle.”

Menopause also usually marks the onset of osteoporosis. Estrogen helps protect a woman’s bones during her reproductive years; when estrogen levels fall, bone mineral density (BMD) is often quick to follow. As osteoclasts begin to break down bone faster than osteoblasts can make new bone and repair damage, osteoporosis can set in. According to NIH, 10 million Americans over the age of 50 suffer from the disease, and four out of five people who have osteoporosis are women.

Isoflavones, including soy isoflavones, have also been shown to have a positive effect on women’s bones. A sampling of 24,000 women who took the three-year Shanghai Women’s Health Study found post-menopausal women who ate the most soy had a 37-percent lower risk of bone fracture compared to women who consumed the smallest amount of soy.¹⁸ The isoflavone genistein was examined for its bone metabolism effects on 389 osteopenic postmenopausal women.¹⁹ These women had a BMD of less than 0.795 g/cm2 at the femoral neck and no significant comorbid conditions. After a four-week stabilization period during which participants received a low-soy, reduced-fat diet, participants were randomly assigned to receive placebo or 54 mg of genistein daily for 24 months. At 24 months, BMD had increased in genistein recipients and decreased in placebo recipients at the anteroposterior lumbar spine.

Another double blind, randomized, placebo-controlled trial revealed red clover isoflavones may help protect women from the risk of osteoporosis. Researchers found loss of lumbar spine bone mineral content and BMD was significantly lower in the isoflavone group compared to placebo.²⁰ Bone formation markers were also much higher in the treatment group; 205 women, ages 40 to 65, were involved in the study.

Sleepless nights are also a characteristic of menopause. Luckily, women don’t have to toss and turn.“I recommend Lactium® (from INGREDIA), a milk protein that contains bioactive peptide that help reduce stress and improve sleep quality without causing next-day drowsiness, addiction, or other unpleasant side effects seen with prescription tranquilizers,” said Sherry Torkos, pharmacist spokesperson for Proprietary Nutritionals.

Natrol offers Complete Balance® AM/PM, which contains black cohosh (which can relieve night sweats) combined with soy, B vitamins and melatonin. “Melatonin levels can decline in some menopausal women, which can result in a reduced ability to receive a good night’s rest,” Yatcilla said. “The B vitamins and soy add extra support to help menopausal women through this stage of life change.”

A recent estimate from the National Cancer Institute (NCI) has 12.7 percent of women being diagnosed with breast cancer at some point in their lives, with women ages 60 to 69 facing the greatest chance of receiving such news. Though the numbers have declined, possibly because of improved treatment and earlier detection, the chance of dying from breast cancer is still about 1 in 33.

“There are a number of factors, and it’s almost impossible to sort out,” Hudson said. “Is it because they lived next to a nuclear power plant or because they’re fat, or is it because they used bleached toilet paper? If we try to eat better, would that help our breast health? Well, yes. Should we exercise more, would that help our breast health? Yes.” But even if you do everything right lifestyle-wise, Hudson noted, a woman could still be the victim of genetics.

Part of that healthy diet is cruciferous vegetables, which NOW Foods’ Levin said “prevent oxidation of sex hormones into more harmful forms.” DIM (diindolylmethane), a metabolite of indole-3-carbinole (I3C), is derived from these vegetables and is essential for breast health. Hudson added DIM may be able to favorably alter the body’s estrogen metabolism by breaking down estrogen into less carcinogenic or non-carcinogenic metabolites. Rubman also included DIM in FibroVera to discourage the aromatization of testosterone into estrogens, allowing progesterone to act freely opposing estrogen.

Lieberman likes DIM paired with the flavonoid quercetin. Two recent studies linked increased flavonoid intake with decreased breast cancer risk.^25,26 “When you’re exposed to synthetic estrogens in the environment, [quercetin] will help protect against them bonding to estrogen receptor sites,” Lieberman said. “It works synergistically with DIM to metabolize estrogen to its safer and more effective form.”

As far as dietary consumption, studies have shown higher consumption of calcium and/or dairy products may reduce the risk of developing breast cancer,²⁷ as may a higher dietary intake of folate, particularly among women who consume alcohol.²⁸ Hudson is also a huge fan of soy. She added while findings in the past have been contradictory, research has shown a “higher soy diet prior to breast development is associated with lower risk of breast cancer later in life.”

Cheryl Myers, vice president of scientific affairs at Enzymatic Therapy, cites calcium D-glucarate (CDG), which is found in apples and other fruits and vegetables, as important for breast health, because “it binds estrogen, so it can enter bile and be eliminated through the stool.” The ingredient is found in the company’s Protective Breast Formula.

Higher dietary intake of carotenoids may also reduce breast cancer risk. A nested, case-control study used plasma from 1,938 women enrolled in the Nurses’ Health Study and assessed multivariate risk of breast cancer and carotenoid intake.³¹ While there was no general association among carotenoid intake and breast cancer risk, a higher intake of vitamin A and carotenoids did reduce the risk of breast cancer in female smokers. Supporting evidence for the finding comes from in vitro work in which beta-carotene down regulated a number of MCF-7 breast cancer cells, increasing apoptosis.³²

With natural options aplenty, women have a reason to stand by their natural products stores. But only with a consistent effort at learning about the emerging research of these female-specific problems, and their causes, can a retailer ensure that the ladies never leave their side.

References

1. Bertone-Johnson ER et al. Arch Intern Med. 2005;165(11):1246-52.

2. De Souza MC et al. J Womens Health Gend Based Med. 2000;9(2):131-9.

3. Ziaei S et al. BJOG. 2005;112(4):466-9.

4. Wuttke W et al. Phytomedicine. 2003;10(4):348-57.

5. Saldeen P, Saldeen T. “Women and omega-3 fatty acids.” Obstet Gynecol Surv. 2004;59(10):722-30. www.obgynsurvey.com

6. Rossouw JE et al. “Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial.” JAMA. 2002;288(3):321-33. http://jama.ama-assn.org 

7. Mahady GB. “Black cohosh (Actaea/Cimicifuga racemosa): review of the clinical data for safety and efficacy in menopausal symptoms.” Treat Endocrinol. 2005;4(3):177-84.

8. Osmers R et al. “Efficacy and safety of isopropanolic black cohosh extract for climacteric symptoms.” Obstet Gynecol. 2005;105(5 Pt 1):1074-83. www.greenjournal.org

9. Krei-Kleiner S et al. “Cimicifuga racemosa dried ethanolic extract in menopausal disorders: a double-blind placebo-controlled clinical trial.” Maturitas. 2005;51(4):397-404. www.sciencedirect.com/science/journal/03785122    

10. Nappi RE et al. “Efficacy of Cimicifuga racemosa on climacteric complaints: a randomized study versus low-dose transdermal estradiol.” Gynecol Endocrinol. 2005;20(1):30-5.

11. Vermes G, Banhidy F, Acs N. “The effects of remifemin on subjective symptoms of menopause.” Adv Ther. 2005;22(2):148-54.

12. Briese V et al. “Black cohosh with or without St. John’s wort for symptom-specific climacteric treatment-Results of a large-scale, controlled, observational study.” Maturitas. 2007 Aug 20;57(4):405-14. Epub 2007 Jun 21

13. Pockaj BA et al. “Phase III double-blind, randomized, placebo-controlled crossover trial of black cohosh in the management of hot flashes: NCCTG Trial N01CC1”. J Clin Oncol. 2006 Jun 20;24(18):2836-41

14. Cagnacci A et al. “Kava-kava administration reduces anxiety in perimenopausal women.” Maturitas. 2003;44:103-109

15. Messina M, Hughes C. “Efficacy of soyfoods and soybean isoflavone supplements for alleviating menopausal symptoms is positively related to initial hot flush frequency.” J Med Food. 2003;6(1):1-11. www.liebertpub.com 

16. van de Weijer PH, Barentsen R. “Isoflavones from red clover (Promensil) significantly reduce menopausal hot flush symptoms compared with placebo.” Maturitas. 2002;42(3):187-93. www.sciencedirect.com/science/journal/03785122

17. Hidalgo LA et al. “The effect of red clover isoflavones on menopausal symptoms, lipids and vaginal cytology in menopausal women: a randomized, double-blind, placebo-controlled study.” Gynecol Endocrinol. 2005;21(5):257-64.

18. Zhang X et al. “Prospective cohort study of soy food consumption and risk of bone fracture among postmenopausal women.” Arch Intern Med. 2005;165:1890-95.

19. Marini H et al. “Effects of the phytoestrogen genistein on bone metabolism in osteopenic postmenopausal women: a randomized trial.” Ann Intern Med. 2007 Jun 19;146(12):839-47.

20. Atkinson C et al. “The effects of pytoestrogen isoflavones on bone density in women; a double-blind, randomized, placebo-controlled trial.” Am J Clin Nutr. 2004;79(2):326-33.

21. North American Menopause Society. “Management of osteoporosis in postmenopausal women: 2006 position statement of The North American Menopause Society.” Menopause. 2006;13(3):340-67. www.menopausejournal.com

22. Adams J, Pepping J. “Vitamin K in the treatment and prevention of osteoporosis and arterial calcification.” Am J Health Syst Pharm. 2005;62(15):1574-81. www.ajhp.org

23. Saito N et al. “Bone mineral density, serum albumin and serum magnesium.” J Am Coll Nutr. 2004;23(6):701S-3S. www.jacn.org

24. Ryder KM et al. “Magnesium intake from food and supplements is associated with bone mineral density in healthy older white subjects.” J Am Geriatr Soc. 2005;53(11):1875-80.

25. Bosetti C et al. “Flavonoids and breast cancer risk in Italy.” Cancer Epidemiol Biomarkers Prev. 2005;14(4):805-8. http://cebp.aacrjournals.org

26. Fink BN et al. “Dietary flavonoid intake and breast cancer risk among women on Long Island.” Am J Epidemiol. 2007 Mar 1;165(5):514-23. Epub 2006 Dec

27. Ichikawa T et al. “Steroid and xenobiotic receptor SXR mediates vitamin K2-activated transcription of extracellular matrix-related genes and collagen accumulation in osteoblastic cells.” J Biol Chem. 2006;281(25):16927-34. www.jbc.org

28. Martini LA et al. “Dietary phylloquinone depletion and repletion in postmenopausal women: effects on bone and mineral metabolism.” Osteoporos Int. 2006;17(6):929-35. www.link.springer.de/link/service/journals/00198

29. Whitsett T et al. “Resveratrol, but not EGCG, in the diet suppresses DMBA-induced mammary cancer in rats.” J Carcinog. 2006 May 15;5:15

30. Azios NG, Dharmawardhane SF. “Resveratrol and estradiol exert disparate effects on cell migration, cell surface actin structures, and focal adhesion assembly in MDA-MB-231 human breast cancer cells.” Neoplasia. 2005 Feb;7(2):128-40.

31. Tamimi RM et al. “Plasma carotenoids, retinol, and tocopherols and risk of breast cancer.” Am J Epidemiol. 2005;161(2):153-60. http://aje.oupjournals.org

32. Li Z et al. “[Effect of beta-carotene on gene expression of breast cancer cells.]” Ai Zheng. 2003;22(4):380-4.

33. McCann SE et al. “Dietary lignan intakes and risk of pre- and postmenopausal breast cancer.” Int J Cancer. 2004;111(3):440-3. www3.interscience.wiley.com  

34. Wang W et al. “Sulforaphane, erucin, and iberin up-regulate thioredoxin reductase 1 expression in human MCF-7 cells.” J Agric Food Chem. 2005;53(5):1417-21. http://pubs.acs.org/journals/jafcau

35. Jackson SJ, Singletary KW. “Sulforaphane inhibits human MCF-7 mammary cancer cell mitotic progression and tubulin polymerization.” J Nutr. 2004;134(9):2229-36. http://jn.nutrition.org

36. Hardman WE et al. “(n-3) fatty acids and cancer therapy.” J Nutr. 2004;134(12 Supp):3427S-30S. http://jn.nutrition.org

The Magnesium Miracle

Health care advisories that state women should take 1,000 to 2,000 mg/d of calcium, without emphasizing the dual role of magnesium, are causing a relative deficiency of the mineral and an epidemic of chronic disease.

While arbitrary rules hold that calcium supplement intake should be twice that of magnesium, such rules do not account for the amount of these minerals in the diet. Agricultural soil is higher in calcium than magnesium—so chances are calcium is much higher in the diet than magnesium. If a woman consumes yogurt, leafy greens, nuts, seeds and cheese, she may receive about 600 mg of calcium. But foods rich in magnesium, such as sea vegetables, leafy greens and whole grains, lose most of the mineral when they are cooked. Magnesium supplementation is crucial to good health.

Angina, anxiety, asthma, depression, diabetes, fibromyalgia, heart attacks, high blood pressure, high cholesterol, infertility insomnia, migraines, osteoporosis and constipation are all associated with magnesium deficiency, and at least 70 percent of the U.S. population is deficient. One of magnesium’s many jobs is to regulate the amount of calcium allowed into the body’s cells. If too much calcium floods the cells, they go into spasm. When heart muscles spasm, the result is angina and heart attacks; spasm in the blood vessels causes hypertension; hyperirritable brain neurons cause mood swings, depression, anxiety, anger and aggressiveness. Magnesium also keeps calcium in solution and prevents it from building up in soft tissues, which can cause chronic pain, gallstones, kidney stones and more.

Share this article: Email, Slashdot, Digg, Del.icio.us, Yahoo!MyWeb, Windows Live Favorites, Furl
Add this article feed to: RSS, My Yahoo, Newsgator, Bloglines

Read Comments [0]