cortisone and weight gain

Description: corticosteroids are known to frequently cause weight gain in patients. Trouvé à l'intérieur... qd , 3-21 days Stanozolol ( A ) upon Cortisone ( B ) Body weight gain incr Cell division in connective tissue incr Vigorous proliferation of vessels Vessels caused to penetrate growth cartilage zone Normal endochondral ossification ... Weight and physical appearance. The steroid prednisone may make you pack on pounds. I was pregnant (I have a 9-week old) and … Expression of 11β-HSD1 in whole adipose tissue did not change with weight loss but did increase in isolated adipocytes. These children are taking drugs to gain immediate enhancement of athletic. For those who are underweight because of a health condition, this may be welcome. In 1997, after acclaimed flutist Eugenia Zukerman was prescribed prednisone for a rare lung disease, she teamed up with her sister, Harvard physician Julie Ingelfinger, to write the first book that helps patients deal with the side effects ... November 1, 2016. Maybe a one or two day water weight gain. Do Cortisone Injections Make You Gain Weight? I just felt very bloated after my cortisone treatment. Trouvé à l'intérieur – Page 52A woman who becomes pregnant while taking corticosteroids should discuss the relative risks and benefits of continuing therapy ... weight gain , skin thinning , water retention , acne , stretchmarks , cataracts , hypertension , and a ... Patients can experience weight gain while on this medication for a variety of reasons and should discuss abnormally rapid increases in weight with their physicians. Patients who take oral cortisone may also notice that they have increased appetites, and over time, they might also begin to gain weight. What is the Connection Between Cortisone and Weight Gain? How Do You Manage Weight Gain? Taking prednisone less than seven days does not have much of an impact on body weight. Weight gain is sometimes reported as a side effect of cortisone … Steroid injections, also called corticosteroid injections, are anti-inflammatory medicines used to treat a range of conditions. The main aim of this study was to determine whether 10-day oral corticosteroids prescribed in adults with asthma causes changes in leptin, appetite, dietary intake, body weight and body composition. Patients can experience weight gain while on this medication for a variety of reasons and should discuss abnormally rapid increases in weight with their physicians. That's why I don't think that cortisone weight gain. Injection into the sub-acromial space (for rotator cuff disease), Fig. High cortisol levels can also lead to weight gain… maybe. Trouvé à l'intérieur – Page 45Results Mortality Survival was not significantly increased or decreased in cortisone - treated or terramycin - treated ... gain following the initial weight loss than did the curves for the irradiated , non - cortisone treated groups . This potentially causes retention of fluids, which leads to weight gain and bloating. Weight Gain And Swelling. Another negative side effect of cortisone injections is, unfortunately, weight gain and abdominal swelling. If a patient is receiving cortisone or any steroid injections for a lengthy period of time, then yes, they will more than likely experience weight gain and bloating. Trouvé à l'intérieur – Page 84Other side effects , such as the tendency to gain weight , disappear when the steroids are stopped . When steroids must be used on a regular basis , the chance for developing side effects is greatest when the drug is taken several times ... Weight gain is a common side effect of prednisone. Increased appetite, weight gain, and water retention. Patients can experience weight gain while on this medication for a variety of reasons and should discuss abnormally rapid increases in weight with their physicians. … deleted_user 05/21/2009. They will generally be used after failure of a 4-6 week trial of relative rest, anti-inflammatory modalities and medications and an exercise based physiotherapy program. Fatigue and trouble sleeping. Books Cortisone and weight gain (10,560 كتاب). There is no easy road to losing weight from the side effects of steroids. Self-care tips: Watch your calories and exercise regularly to try to prevent excessive weight gain. Cortisone is a synthetic drug that metabolizes in the body to form the hormone cortisol. Here’s how to counter that side effect. neuromas and possible weight gain from cortisone shots : Subscribe To Foot & Ankle Problems Thread Tools: Search this Thread: 03-27-2009, 03:49 PM #1: suesue2 Registered User (female) Join Date: Mar 2009. Cortisone and weight gain are commonly associated in patients who have to take this steroid medication in the long term to treat ongoing medical conditions. However, we now understand that chronically elevated cortisol levels may be a factor in weight gain or resistance to weight loss. Trouvé à l'intérieur – Page 252... necrotizing vasculitis; petechiae; purpura; rash; scarring; sterile abscesses; striae; subcutaneous fat atrophy; ... metabolic alkalosis, suppressed skin test reaction, weight gain Nursing Considerations • Use cortisone cautiously ... A “moon face” can result, meaning a large forehead and a large chin appear during treatment, accompanied by larger cheeks. There is no easy road to losing weight from the side effects of steroids. However, there are six steps you can take to manage it: Be aware of the amount of calories in the food you are eating. You will then be able to reduce the total amount of calories you normally consume by 10-20%. Cortisol can mobilize triglycerides from storage and relocate them to visceral fat cells (those under the muscle, deep in the abdomen). A common side effect of prednisone is weight gain. Fatigue and trouble sleeping. Surprisingly, in the first few weeks, it’s possible to lose weight because prednisone causes lipolysis, a breakdown of fat cells, at first. This has led it to be nicknamed the "stress hormone.". Women have elevated levels of cortisol during some portions of pregnancy. At the time of injection it should hurt no more than a common immunization needle. Weight gain. Heightened stress levels tend to cause imbalances in hormones like cortisol, DHEA and adrenaline. Headaches and dizziness are also side effects of oral cortisone. “Cortisone isn’t good for you” There is a hormone in the body named cortisol which is a stress hormone and another type of steroid. Emotional eating is common during times of increased stress. A cortisone shot uses the. The exact reason for this is unknown. In other words, stress might lead you to eat more." Do we have any doctors here who can clarify this topic? Chronic disease A person suffering from chronic disease is. Doctors use steroids to treat many inflammatory conditions, including inflammatory bowel disease (IBD) . Although increased cortisone and weight gain may be found together, it does not follow that cortisone is the primary cause of the weight gain. Hypertension usually … Males can have high cortisol levels mostly from … For the one million Americans who take high doses of cortisone-based prescription drugs, a guide based on personal experience offers the first detailed, practical explanation of what patients can expect and how they can avoid the worst. Therefore, it is always recommended for individuals undergoing steroid or cortisone shots to decrease their calorie intake and exercise more diligently so as to burn more calories in order to prevent gaining significant weight as a result of the cortisone shot. Only a balanced diet and regular physical exercise can be recommended. Cortisol is produced in the adrenal cortex, which is the outer portion of the adrenal gland. I have neuromas in both feet. Steroids affect your metabolism and how your body deposits fat. “People who gain weight on steroids have it slightly easier than the average person in terms of losing weight after stopping the medication because their body will trend towards its previous weight now that you’ve removed the weight-gaining stimulus.” Note, he didn’t say they lose more weight. Other gains occur in the neck (“buffalo hump”) and around the waist. Limit lifestyle weight gain by dealing with your stress. One single cortisone shot really can not be cause of gaining weight. Cortisone is naturally occurring substance, hormone, and it just helps body to solve the inflammation. Cortisone has number of side effects which are likely to occur in long term therapy. Too little and you feel tired all the time and can even die. Trouvé à l'intérieur – Page 291... antagonized anticholinesterase effects in myasthenia gravis barbiturates: Decreased cortisone effectiveness, ... metabolic alkalosis, suppressed skin test reaction, weight gain Nursing Considerations • Use cortisone cautiously in ... Trouvé à l'intérieur – Page 284metabolic alkalosis, suppressed skin test reaction, weight gain Nursing Considerations • Use cortisone cautiously in patients with ocular herpes simplex because corneal perforation may occur. • Expect prescriber to order baseline ... Trouvé à l'intérieur – Page 794... weight gain, ulcers Cortisone acetate Generic only Elevated blood fats (cholesterol, triglycerides), elevated blood sugar, hardening of arteries (atherosclerosis), hypertension, increased appetite, indigestion, weight gain, ... Cortisone injections are useful in the treatment of various musculoskeletal conditions, particularly those of acute inflammation (such as acute bursitis), and degenerative joint and tendon conditions. Allergy expert; Anti-ageing expert; Arthritis expert; Breast cancer expert; Cancer expert; CyberDoc; Oral health expert; Diabetes expert; EnviroHealth expert The weight gain may not be significant in some cases whereas in some cases an individual can gain quite a lot of weight. Increased stress stimulates our adrenal glands to produce excessive and inadequate amounts of these hormones. I am hoping that adding certain foods and supplements will help although I was already incorporating those into my diet months ago. This involves the following: Systemic administration of Cortisone should be avoided whenever possible. Corticothérapie systémique et alimentation : suivi des recommandations diététiques et relation entre apports alimentaires et apparition d’une lipodystrophie. Cortisone and weight gain are commonly associated in patients who have to take this steroid medication in the long term to treat ongoing medical conditions. Trouvé à l'intérieur – Page 45Survival was not significantly increased or decreased in cortisone - treated or .terramycin - treated animals . ... weight gain following the initial weight loss than did the curves for the irradiated , non - cortisone treated groups . Skin issues, including dryness, thinness, acne, dry skin, and red or purple blotches. However, a cortisone shot is used maximally for low back pain or. These should include an x-ray as mandatory and may also include an ultrasound or an MRI scan, depending on the indications. Huscher D et al. Water weight gain happens in a mysterious and somewhat counter-intuitive way. It can be avoided by using a sterile ‘no touch’ technique with the needle and an alcohol swab, Crystal flare – As previously mentioned occurs in 1:20 patients and can be treated with  ice and paracetamol, Skin changes – Skin atrophy & pigment loss may occur around the injection site. Trouvé à l'intérieur – Page 81Long - term use of cortisone can cause serious side effects , such as weight gain , adrenal gland suppression , and predisposition to fractures and liver failure . Dexamethasone ( Decadron ) and prednisone are oral medications ... It has been suggested that changes in cortisol secretion might represent one possible mechanism for this relationship. 1. Cortisone is a synthetic drug that metabolizes in the body to form the hormone cortisol. These anomalies are due to a redistribution of fat cells in the body (called lipodystrophy) and not because of water retention. of the major risks of using anabolic steroid precursors is the. Weight gain is influenced by many intersecting factors. Fighting weight gain related to stress and cortisol release is as simple as managing your stress and practicing healthy lifestyle habits which increase your resilience to … Low cortisol levels and weight gain are linked both directly and indirectly. Skin issues, including dryness, thinness, acne, dry skin, and red or purple blotches. However, it is not the only factor. Regardless of what studies say, I know that cortisone treatments cause weight gain. The most important factor to consider is appropriate diagnosis. Cortisone medication tends to increase a person's hunger, which may lead to weight gain. Here’s what happens. Sometimes athletes are lazy with their rehabilitation or just don’t want to rest! Our experts answer questions on the best way to prevent weight gain while taking steroids, and how to overcome a stitch while running. Many doctors believe that a limitation of carbohydrate intake (e.g. – Weight Gain program that Works! Trouvé à l'intérieur – Page 267... hypocalcemia, hypokalemia, hypokalemic alkalosis, impaired wound healing, masking of infection, metabolic alkalosis, suppressed skin test reaction, weight gain Nursing Considerations •Use cortisone cautiously in patients with ocular ... You should make sure you differentiate between weight gain caused by corticosteroids and the weight gain caused by the improvement of your illness under corticosteroids. According to the National Institutes of Health, the side effects from cortisone shots include: Dizziness or headaches. That could cause weight gain if cortisone is used over a long period. Researchers have found animals that had a higher propensity to gain weight also exhibited fewer changes in response to high cortisol. Jun 28, 2011. Can one cortisone injection in my knee cause weight gain?. Read about cortisone injection treatment for inflammation, allergic reaction, sciatica, and arthritis. Cortisol vs Cortisone – Meaning, Definiton, Function & Effects on Body. Trouvé à l'intérieur – Page 149Commonly Prescribed (On-Label) Drugs: Betamethasone, Cortisone, Dexamethasone, Fludrocortisone, Methylprednisolone, ... lactone,reduced hydrocortisone dose and fludrocortisone showed better control of linear growth,weight gain,and bone ... This can increase your appetite, leading to weight gain, and in particular lead to extra deposits of fat in your abdomen. Trouvé à l'intérieur – Page 135Steroids. /. Cortisone. and. Hormones. GENERIC NAME BRAND NAMES WEIGHT GAIN REPORTED IN MEDICAL LITERATURE Ruth also experiences seasonal allergies in the spring. Her doctor. Cortisone Family or gain. gain. Corticosteroids Group A or ... Abuse of anabolic steroids among America's youth has reached dangerous levels. weight gain and changes in body composition, are considered undesirable. IN … More serious side effects include muscle cramps, black stool, and an unexplained fever or sore throat. Cortisone injections will make me fat and give me weak bones: Taking oral cortisone (or prednisone) for long periods of time can certainly have side-effects, which do limit the use of this very effective drug. With short-term treatment, these side effects are often not an issue for the patient. Trouvé à l'intérieurWhy do some individuals taking corticosteroids gain weight? Steroids cause the deposition of fat in unusual areas, and salt and fluid retention, which cause weight gain. They also increase the appetite, which, of course, ... Simply put, when you accept the fact that your body is meant to be at a certain weight, you’re better able to give it what it needs instead of constantly trying to override your hunger cues and cravings in order to lose weight or prevent weight gain. Don't under-dose yourself. Cortisone injections make up an important part of treatment of various shoulder conditions. Set point weight theory can help if you’re looking to heal your relationship with your body. Correct placement of the needle is also essential. Inadequate follow-up rehabilitation and activity modification is another common reason for failure or limited success of cortisone injections. Too much hydrocortisone and you will gain weight and feel more hungry. Trouvé à l'intérieur – Page 272Contraindications Hypersensitivity to cortisone or its components, idiopathic thrombocytopenic purpura (parenteral ... metabolic alkalosis, suppressed skin test reaction, weight gain Nursing Considerations • Use cortisone cautiously in ... Cortisone and weight gain are commonly associated in patients who have to take this steroid medication in the long term to treat ongoing medical conditions. Chercher uniquement dans des sites web de santé HONcode de confiance : Copyright © cortisone-info.fr - Tous droits réservés -. In any case, a diet with less calories than normally consumed is recommended. Mood swings and disturbances. Side EffectsLocal cortisone injections may cause some side-effects. As if 2011, the exact relationship between cortisone and weight gain was uncertain. This then allows pain free rehabilitation exercises to be performed, improving joint motion and muscle strength and function, which ultimately prevent the condition from recurring later on. Contact hypersensitivity to TS may cause persistence or worsening of skin diseases. Short-term treatment versus long-term treatment: these side effects occur early but usually become visible and bothersome after several weeks of treatment. Strain GW, … The steroid prednisone may make you pack on pounds. Correlation does not necessarily imply causation, however. It was only discovered as recently as 1950 (earning a Nobel Prize for medicine for Hench and his co-workers), and has been available in an injectable form since 1951. Cortisone is a steroid that will cause a temporary release of gucose from glycogen stores. Mineralocorticoid effects, especially as seen with cortisol and cortisone, can lead to fluid retention, edema, weight gain, hypertension, and arrhythmias by increasing renal excretion of potassium, calcium, and phosphate. They are, however, not the only method of treatment, but part of an overall management program. Some dietary supplements claim to block cortisol to aid weight loss. They cause weight gain by increasing appetite and re-deposition of fat around the neck and abdomen. Trouvé à l'intérieur – Page 74The aim has been to create drugs which would have the wanted good effects of hydrocortisone and cortisone but which would be ... or prednisone for fluid retention and is less inclined to cause appetite stimulation and weight gain . This ‘injection flare’ is much less common now as the modern cortisone injections are more water soluble. كتب Cortisone and weight gain (10,560 كتاب). This research shows that cortisol alone may not be major culprit in weight gain, and suggests ... Edwards CR. Read about type 1 diabetes (read about type 2 diabetes and The symptoms of type 1 diabetes usually develop very quickly in young people The real reason people enjoy kissing in public. Increased stress stimulates our adrenal glands to produce excessive and inadequate amounts of these hormones. Posts: 1 neuromas and possible weight gain from cortisone shots . Females suffer the most because of the different hormones we have within our bodies and that we tend to take on more stress than males. Cortisone usually makes you gain loads of water weight, eat a banana everyday for breakfast or anything with potassium in it and cut your sodium intake, you might find 10kg's of … Trouvé à l'intérieur – Page 2348The aim has been to create drugs which would have the wanted good effects of hydrocortisone and cortisone but which would be ... or prednisone for fluid retention and is less inclined to cause appetite stimulation and weight gain . It suggests talking with a doctor if side effects, such as thinning skin and redness of the face, occur after an injection. Cortisone is a potent anti-inflammatory medication. J Pediatr Endocrinal Metab 1997; 10: 287-290. Self-care tips: Watch your calories and exercise regularly to try to prevent excessive weight gain. Everyone know that cortisone increases blood sugar. Cortisol weight gain is most common among women, but can happen for men as well. Oral cortisone side effects will often include nausea, vomiting, and diarrhea. Companies that had marketed these products were forced to repay their customers. I had a shot of cortisone injected into my wrist to treat tendonitis in my thumb about 10 days ago. Subscribe to our newsletter and learn something new every day. This is followed by separate chapters on the metabolism, activities, and mechanism of action of anabolic steroids; clinical application of anabolic steroids, side effects, and test procedures. This can increase your appetite, leading to weight gain, and in particular lead to extra deposits of fat in your abdomen. Weight gain without explanation; Digestive problems; Frequent urination, constipation, or diarrhea; Trouble sleeping; Memory loss; Swelling in the face, hands or feet; Menstrual abnormalities; Low libido; Back pain; Decreased concentration; How to Naturally Lower Cortisol Levels. Limit lifestyle weight gain by dealing with your stress. 10 years back, this had increased up to 5 students. Through an enzyme called ... difficulty waking up, brain fog, low concentration levels, constipation, anxiety, stubborn weight gain, or craving for salty and fatty food then it could be indicative of Adrenal Fatigue Syndrome (AFS). Weight gain. Chronic steroid use, like high doses of oral steroids, will cause weight gain. Trouvé à l'intérieur – Page 809The aim has been to create drugs which would have the wanted good effects of hydrocortisone and cortisone but which ... have a greater tendency than other commercially availble steroids to stimulate appetite and to produce weight gain . You should only have 3 injections:  There is no scientific evidence to support this statement, but it seems to have been set in concrete somewhere along the line. This study investigated whether body fat distribution, determined by waist-to- … cortisone; hydrocortisone; budesonide; These drugs are highly effective at reducing inflammation, but they also have some troubling side effects. Weight Gain and Obesity Repeated elevation of cortisol can lead to weight gain.2 One way is via visceral fat storage. It is important that the injection is followed up with appropriate rehabilitation (see below). There are no long term side-effects from repeat local injections of cortisone. As such it is treating the pathology, not just the pain. Trouvé à l'intérieur – Page 12... qd , 3-21 days Stanozolol ( A ) upon Cortisone ( B ) Body weight gain incr Cell division in connective tissue incr Vigorous proliferation of vessels Vessels caused to penetrate growth cartilage zone Normal endochondral ossification ... Steroid injections are used to treat inflammatory types of arthritis. In the shoulder they are particularly useful in the management of: Cortisone injections should only be performed in the setting of an appropriate diagnosis based on taking an accurate history, performing a clinical examination and commonly performing investigations. Trouvé à l'intérieur – Page 441Age when cortisone was started ( mo . ) Average daily weight gain Dosage of Days of during observation cortisone adminisperiod prior to day tration cortisone treatment Average daily weight gain and period of hospital observation ... Trouvé à l'intérieur – Page 29... growth retardation, muscle atrophy, osteoporosis, aseptic necrosis of the hip, hirsutism, weight gain, cushingoid appearance, and pseudotumor cerebri. • Steroids: dexamethasone, prednisolone, hydrocortisone, tetrahydrotriamcinalone, ... Given that famous athletes have admitted to using performance-enhancing drugs, it’s not surprising that teens might turn. Therefore, you are put at a higher risk of suffering health problems such as depression, anxiety, weight gain, sleep problems, and heart disease. When I was on prednisone, days would go by when my urine output was normal. Not all patients experience weight gain as a side effect of cortisone injections regardless of how long they take the treatment. Rev Med Interne. Heightened stress levels tend to cause imbalances in hormones like cortisol, DHEA and adrenaline. Weight Gain: The Unwanted Side Effect of Prednisone for UC. Sep … Weight Gain: The Unwanted Side Effect of Prednisone for UC. Most people do gain weight once they start on hydrocortisone, but we were generally too thin before treatment. This steroid is closely related to cortisol , a hormone the body produces naturally in the adrenal gland. Anyone who tells you that topical corticosteroids (cortisone applied to the skin) cause weight gain or bloating in the face are confusing them with the possible side effects of systemic cortisone treatments (administered orally or by injection). • Weight Gain • Easy Bruising • Elevation of Blood Pressure • Acne (steroid acne) • Whitening or lightening of the skin around the injection site • Increased blood sugar levels in diabetics • Bone Death (osteonecrosis) The shots themselves are also known to be painful during injection and soreness is to be expected at the injection site. Many studies have indicated that people tend to gain weight when they are stressed. Objective: Neuraxial administration of steroids have been used in clinical practice for more than 50 years and have a well defined place in the treatment of radicular low back pain. Given that the research jury is still out on whether high levels of cortisol actually cause weight gain, the minimum that seems to be true is that since the role of cortisol during stress is to provide your body with energy, it can cause an increase in appetite. The integrated concentration of cortisone is reduced in obese children. Water Retention. It acts on both acute and chronic phases of inflammation to reduce both tissue swelling and subsequent scar formation. I have been trying to gain weight ever since I was young but my efforts have been increasingly dwindling since COVID hit and I’m getting thinner everyday whether I like it or not and my friends’ wedding is in a month, I need to bulk up quickly. اذا لم تجد ما تبحث عنه يمكنك استخدام كلمات أكثر دقة. Your genetic history may predispose you to experience more or less side effects than other patients. Have smaller more frequent meals and eat healthy, but also don't deny yourself your favorite foods. I have had to use cortisone for arthritis and I experienced considerable weight gain afterward, at least six pounds. Cortisol naturally produced in the body has no proven effect on weight gain, despite some claims to the contrary. Home > Shoulder > Cortisone Injections around the Shoulder. What Happens if Cortisol is Too Low? Some evidence suggests that increased stress, which can raise cortisol, can lead to overeating and weight gain in some people. Trouvé à l'intérieur – Page 74The aim has been to create drugs which would have the wanted good effects of hydrocortisone and cortisone but which would be ... or prednisone for fluid retention and is less inclined to cause appetite stimulation and weight gain . Find everything you need to know about cortisone (cortone acetate), including what it is used for, warnings, reviews, side effects, and interactions. Chalew SA, Lozano RA, Armour KM, Zadik Z, Kowarski AA. They can be used to treat problems such as joint pain, arthritis, sciatica and inflammatory bowel disease.. Steroid injections are only given by healthcare professionals. Trouvé à l'intérieur – Page 278Contraindications Hypersensitivity to cortisone or its components, idiopathic thrombocytopenic purpura (parenteral ... metabolic alkalosis, suppressed skin test reaction, weight gain Nursing Considerations • Use cortisone cautiously in ... And if the treatment continues for a long time or if someone is already pre-diabetic, the constantly high blood sugar can cause insulin resistance. Taking steroids causes the body to retain sodium and lose potassium, says Tresca. It is normal to gain weight on cortisone if you don't modify your diet. The National Institutes of Health lists weight gain and fluid retention as less serious side effects of cortisone injections. Injection into the acromioclavicular joint, Systemic absorption. What Effects does Stress Have on the Body. Cortisone injections are painful: The majority of patients expect the injection to be very painful, an most are pleasantly surprised that it isn’t the case. reduction in resting metabolic rate [attributable to loss of lean mass] causes the body will burn fewer calories than usual which could contribute to weight gain The body thinks that this person may possibly starve. Cortisone and weight gain are commonly associated in patients who have to take this steroid medication in the long term to treat ongoing medical conditions. Cortisone injections will make me fat and give me weak bones: Taking oral cortisone (or prednisone) for long periods of time can certainly have side-effects, which do limit the use of this very effective drug. J Pediatr 1991; 119: 778-780. The longer time you take prednisone, the more likely you are to gain weight. Chronically elevated cortisol levels may promote overeating and weight gain, whereas low cortisol levels may lead to weight loss in some instances. If weight gain is observed then it is important to see the doctor immediately. Only 10% will have a significant weight gain (>= 10% of their “usual” weight).  Women, younger patients and overweight individuals appear to be more at risk. These would include weight gain, osteoporosis, diabetes and high blood pressure. Cortisol also aids adipocytes’ development into mature fat cells. Trouvé à l'intérieur – Page 16Use of local therapy (e.g., intra-articular corticosteroids) rather than systemic corticosteroids can also minimize systemic toxicity (growth suppression, weight gain, etc.). The second approach has been to develop corticosteroids with ...

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