Janis Dowd, 56, of Bartlesville, Okla., says she started taking colloidal silver in 2000 after reading online that it would keep her Lyme disease from returning. B vitamins. Bluish skin, mucous membrane discoloration, neurological problems, kidney damage. bodybuilding, sexual enhancement, and weight loss, National Institutes of Health’s Office of Dietary Supplements, National Center for Complementary and Alternative Medicine. “Those are a direct threat to public health.” Since 2007, the agency has sent dozens of warning letters to companies telling them to stop making those types of claims about their supplement products. It can cause skin to become extra-sensitive to the sun. The Consumer Reports article points out that contamination of supposedly natural supplements with toxins, such as heavy metals, and with prescription drugs, is a serious danger due to the exemption of the supplement industry from the quality control regulations the FDA applies to pharmaceutical companies and other providers of medicines and healthcare products. Of the 233 labels we examined, most included only general warnings, such as those about not using the product during pregnancy or nursing, or about possible unspecified drug interactions. Few people in the U.S. are outright deficient in vitamin A. August 2, 2012 — Consumer Reports has published a critical investigation of dietary supplements. Insomnia, vivid dreams, anxiety, dizziness, headache, skin rash, and tingling. And there’s more bad news, from a study of 35,000 men reported in the Oct. 12, 2011, issue of the Journal of the American Medical Association: Daily vitamin E supplementation may increase the risk of prostate cancer among healthy men. The American Heart Association says that people who have coronary artery disease may want to talk to their doctor about omega-3 supplementation. It's against the law for companies to claim that any supplement can prevent, treat, or cure any disease except some nutrient-deficiency conditions. Might increase the blood-thinning effect of warfarin and cause bruising and bleeding. Consult your doctor or pharmacist. But much more needs to be done to keep consumers safe. Ginkgo biloba can also interfere with blood thinners, but we saw a warning about that possible interaction on just one bottle of ginkgo. And if you end up with a serious side effect, ask your doctor or pharmacist to report it to the FDA, or do it yourself at www.fda.gov/medwatch or by calling 800-332-1088. But the results may be clouded by the fact that participants were already taking other heart medication. Place the pill on the front of your tongue, take a sip of water, tilt your head back slightly, and swallow. Save thousands off MSRP with upfront dealer pricing information and a transparent car buying experience. Consumer Reports Investigates Vitamins and Supplements: Ten Dangers That May Surprise You If you haven't seen this yet, I'll let the news release from Consumer Reports below speak for itself. Consumer Reports outlines in an extensive report how producers of dietary supplements face little regulation from the U.S. Food and Drug Administration and why that can be dangerous … People with persistent swallowing problems can switch to liquid or chewable formulations and should probably seek evaluation by an otolaryngologist. So annoying! Likely effective for decreasing the risk of heart attack, stroke, and progression of hardening of the arteries in people with existing heart disease. Taken daily, appears to reduce some PMS symptoms. The lack of oversight leaves consumers like John Coolidge, 55, of Signal Mountain, Tenn., vulnerable. But even with the new law, consumers can't easily find out which products are involved because the FDA doesn't routinely make those reports available to the public. "Any given Kratom product can be grossly mislabeled. But recent evidence casts doubt on whether those supplements are as safe or effective as assumed. Still worse, the researchers wrote, “Some clinical trials show that some of these antioxidant nutrients may increase cancer risk.”. They identified ten hazards and warned consumers: “Don’t assume they’re safe because they’re ‘all natural.’” Dietary supplements (vitamins, minerals, herbs, or other supplements… Most of the samples contained more than 200 times the labeled amount of selenium and up to 17 times the recommended intake of chromium, according to the FDA. An FDA representative told us the agency considers the new version acceptable. Check with your doctor before taking traditional herbs, and make sure you know what they are and where they come from. Fabricant has said that dietary supplements spiked with prescription drugs are “the largest threat” to consumer safety. "The reports by themselves don’t prove the supplements caused the problems, but the raw numbers are cause for some concern. The company had frequently reformulated the product, according to the FDA, which said it didn't know which ingredients produced the liver toxicity. However, further research is needed to determine CBD's other benefits and safety.. CBD is a chemical found in marijuana.CBD doesn't contain tetrahydrocannabinol (THC), the psychoactive ingredient found in marijuana that produces a high. Symptoms included signs of … Why not simply order a problem product off the market? The dozen are aconite, bitter orange, chaparral, colloidal silver, coltsfoot, comfrey, country mallow, germanium, greater celandine, kava, lobelia, and yohimbe. “Some companies go with an overabundance of caution, and that’s certainly their right to do that,” says Steve Mister, president and CEO of the Council for Responsible Nutrition, a leading industry trade group. Unless otherwise noted, there's insufficient evidence to rate their effectiveness for their purported uses. More than 6,300 reports of serious adverse events associated with dietary supplements, including vitamins and herbs, streamed into the FDA from supplement companies, consumers, health-care providers, and others between 2007 and mid-April of 2012. Consumer Reports has concerns about the safety of Kratom supplements. Build & Buy Car Buying Service Might help reduce falls in people with vitamin D deficiency and bone loss in people taking corticosteroids. The widely held view that fish-oil pills help prevent cardiovascular disease hit a snag when a study of 12,500 people with diabetes or prediabetes and a high risk of heart attack or stroke found no difference in the death rate from cardiovascular disease or other outcomes between those given a 1-gram fish-oil pill every day and those given a placebo, according to a June 11, 2012, New England Journal of Medicine online report. Undercover investigators from the Government Accountability Office, posing as elderly consumers, caught salespeople on tape dispensing potentially harmful medical advice. Possibly unsafe. Let your doctor know if you experience any symptoms after you start taking a supplement. Aphrodisiac, chest pain, diabetic complications, depression; erectile dysfunction (possibly effective). Instead, try these sources: Consumers might be attracted to dietary supplements because they're "all natural" and don't contain the synthetic chemicals found in prescription drugs. We then shopped for them online and in stores near our Yonkers, N.Y., headquarters and easily found all of them for sale in June 2010. “We’d like to see those things go away,” Fabricant says. The reports described more than 10,300 serious outcomes (some included more than one), including 115 deaths and more than 2,100 hospitalizations, 1,000 serious injuries or illnesses, 900 emergency-room visits, and some 4,000 other important medical events. 600 IU ages 19 to 70; 800 IU ages 71 and up, 1,000 mg ages 19 to 70; 1,200 mg ages 70 and up, 1,000 mg ages 19 to 50; 1,200 mg ages 51 and up, 2,500 mg through age 50; 2,000 mg ages 51 and up. The list of interactions and side effects is not all-inclusive. What consumers might not realize, though, is that supplement manufacturers routinely, and legally, sell their products without first having to demonstrate that they are safe and effective. While it’s known that St. John’s wort can reduce the effectiveness of certain prescription drugs, including birth-control pills and blood thinners such as warfarin (Coumadin), only two of the 17 samples of it we purchased warned explicitly about those hazards. The FDA warned in 1993 that reports of serious adverse events were under investigation. But they might be getting fooled. Then drink the rest of the water to help propel the pill down your esophagus. In this case, it’s based upon an article in Consumer Reports, “15 Supplement Ingredients to Always Avoid.”.” People who are middle-aged or older, are overweight, or have darker skin might need supplements. Exceptions include vegetarians, who might need extra B12, which is found in animal-derived foods; the estimated 10 to 30 percent of people over 50 who don’t have enough stomach acid to extract B12 from food; and women who are pregnant or trying to get pregnant, who should take 400 micrograms a day of extra folic acid to help prevent birth defects. Consumer Reports found that an estimated 23,000 people every year end up in emergency rooms after taking supplements. And some supplements might be fine on their own but interact with certain prescription drugs. As a consumer and nutrition enthusiast herself, Dawn Cohen has dedicated the past 7 years of her life to tracking down the safest and most effective supplements and brands. The supplement turned out to contain a synthetic steroid, which cost Gunter his scholarship, he claimed in a lawsuit that was settled before the trial date, according to public court documents. Two national retailers we contacted about specific supplements said they carried them because the FDA has not banned them. Most supplements haven't been studied in pregnant or nursing women. It reached a $7.5 million settlement with the QVC home-shopping channel. Why are they still for sale? Unhealthy weight loss supplements come with many side effects that are incredibly harmful to health. GI symptoms, dry mouth, headache, mild insomnia, anorexia, sweating, dizziness, and nervousness, especially at higher doses. Too much vitamin K … Vitamins and supplements could do more harm than good in some cases, according to a new report in Consumer Reports. Dietary supplements taken by millions of Americans can cause serious health problems and even death. Might also help slow progression of osteoarthritis. A prescription cannabidiol (CBD) oil is considered an effective anti-seizure medication. She has made a career out of her passion to educate Deciding When It's Time to Upgrade Your Child's Car Seat, vitamins, minerals, herbs, or other nutritional supplements. Sometimes all you need is a second swallow or extra water to get the pill down. “A number of the spiked sexual enhancement products claim to work within 20 to 45 minutes,” Fabricant said on the FDA’s website. Here in the U.S., it can be purchased as a … In one case, a salesperson told an investigator that a garlic supplement could be taken in lieu of high blood pressure medicine. Possibly unsafe for use without medical supervision because it contains a prescription drug, yohimbine. Consumer Reports–The Dangers of Supplements Posted on August 9, 2010 by skeptvet There is an article in the upcoming issue of Consumer Reports discussing the sorry state of regulatory oversight for dietary supplements, herbs, and vitamins, and some of the concrete harm that has come to consumers as a result. Vitamin C can enhance iron absorption, so avoid high doses if you have hemochromatosis, a condition in which the body absorbs and stores too much iron. Type the name of the supplement you’re interested in into the search box at www.fda.gov to see whether it has been subject to warnings, alerts, or voluntary recalls. And experts we consulted suggested that the supply chain used by some of the stores might not follow the best industry standards. Laser treatments have erased almost all the discoloration from Dowd's face and neck, but she said it's not feasible to treat the rest of her body. That effort dragged on for a decade, during which ephedra weight-loss products were implicated in thousands of adverse events, including deaths. Current laws make that so difficult for the FDA that to date it has banned only one ingredient, ephedrine alkaloids. An attorney representing the defendants said they intended to contest the claims. They just have to perform the biological activity of vitamins, he added, whereas a “botanical” means that it was alive at some point. Those adulterated products can cause some of the same side effects and interactions that consumers may have been trying to avoid by choosing supplements over drugs. Gas, stomach pain, diarrhea, constipation, nausea. Pieter Cohen. But instead, he says, beginning in February 2008, he experienced one symptom after another: diarrhea, joint pain, hair loss, lung problems, and fingernails and toenails that fell off. He's now 27 and living in Oakland, Calif. His health is much improved and he is working for a charitable organization and playing baseball in his hometown league. All I can say is Yay! Robert Houser. If you suspect you’re having a bad reaction to a supplement, tell your doctor. Symptoms included signs of heart, kidney, or liver problems, aches, allergic reactions, fatigue Possibly effective for preventing diarrhea while taking antibiotics. In April 2012, the agency sent warning letters to 10 manufacturers and distributors of products containing dimethylamylamine (DMAA), often touted as a natural stimulant. Likely effective in reducing symptoms of major depression, reducing pain, and improving functioning in people with osteoarthritis. The FDA warned in 1993 that it was linked to serious adverse events. Photo: St. John’s wort is especially prone to drug interactions, and most of the 17 St. John’s wort product labels we reviewed did contain a general warning or named specific drugs or drug classes. And in some cases, they deliberately contain ingredients that can cause cancer, organ damage, cardiac arrest, and other serious health problems. In 2009, we spent $26.7 billion on them, according to the Nutrition Business Journal, a trade publication. The discouraging news appeared in the May 16, 2012, issue of the Journal of the National Cancer Institute. Might worsen symptoms when taken with the Parkinson's drug levodopa. It can be laced with other substances including illegal drugs and prescription … In the article, entitled, ‘Vitamins & Supplements, 10 dangers that may surprise you’ , Consumer Reports warns shoppers about overdosing - and choking - on vitamins, supplements … Please call Member Services at 1-800-333-0663 But the FDA says kratom isn’t just a plant — it’s an opioid. Avoid any product that is claimed to contain "megadoses.". Within weeks he was stricken with acute hepatitis and jaundice. Likely effective for lowering cholesterol in people with mild to moderately high cholesterol. Report problems. A new investigation may have you rethinking some of your vitamins. In the past two years, according to the Food and Drug Administration, manufacturers have voluntarily recalled more than 80 bodybuilding supplements that contained synthetic steroids or steroid-like substances, 50 sexual-enhancement products that contained sildenafil (Viagra) or other erectile-dysfunction drugs, and 40 weight-loss supplements containing sibutramine (Meridia) and other drugs. We found products with those ingredients readily available in stores and online. If you are already getting the recommended amount of nutrients by eating a variety of fruit, vegetables, cereals, dairy, and protein, there’s little if any additional benefit from ingesting nutritional supplements. You can also learn about interactions in our free “Guide: 100+ Commonly Used Supplements” (funded by a grant from the Airborne Cy Pres Fund). Five of our 20 samples of 5-HTP, a mood and sleep supplement, carried warnings about a possible interaction with drugs for Parkinson’s disease. Consumer Reports believes the best way to protect the public is to have stronger regulation of supplements. Fainting, heart-rhythm disorders, heart attack, stroke, death. Lose weight through diet and exercise, get fit through training, and consult your doctor if you need help in the bedroom. Consumer Reports sent a Spanish-speaking reporter on a shopping trip to several New York-area botánicas in 2011. calcium from dairy products, green leafy vegetables, and fish with edible bones. Calcium. The FDA doesn’t require supplements to go through rigorous testing for safety and efficacy the way that drugs are tested. People with poor immune function should check with their doctor first. Consumer Reports also has concerns, because like any supplement, Kratom is not regulated. Might increase the effects of the blood thinner warfarin. M.D., with a patient who had a heart attack while on supplements. Omega-3 fish oil. Too much retinol can cause birth defects and liver abnormalities, and might harm bones. Since 2008 there have been recalls of more than 400 such products, mostly those marketed for bodybuilding, sexual enhancement, and weight loss, according to the FDA. Plant-derived supplements make many health enhancement claims, and yet the market is largely unregulated, says a new article published in Consumer Reports (CR). To date, it has banned only one ingredient, ephedrine alkaloids. Supplements Can Make You Sick. The FDA advised manufacturers to remove comfrey products from the market in July 2001. The review found … But supplement makers can provide warning labels if they want to. I subscribe to Consumer Reports on-line, and ironically I just saw their cover story in my email edition, “10 Surprising Dangers of Vitamins & Supplements.” I didn’t bother to read it because it’s ridiculous, and from past editions of But the FDA is … Last updated: October 30, 2019 In 2016, with the help of an expert panel of independent doctors and dietary supplement researchers, Consumer … According to Consumer Reports, 6,300 people reported serious side effects associated with dietary supplements to the FDA between 2007 and April of … You only had a couple of days left to live if you hadn't come in.'" If a claim sounds too good to be true, it probably is. For instance, a 50-something woman who’s worried about her bones might eat a breakfast of Whole Grain Total cereal, which contains around 1,000 milligrams of calcium per serving, with a half-cup of skim milk (150 milligrams of calcium), and take a calcium supplement (500 milligrams) on top of her One-A-Day Menopause Formula multivitamin, which includes 300 milligrams of calcium. But the FDA is now calling Kratom itself an opioid and warn it can be addictive and dangerous. For many years, the leaves of the kratom tree have been used in Southeast Asia to treat aches and pains. Effective as a bulk laxative for reducing constipation or softening stools. The Meticore supplement … The reports by themselves don’t prove the supplements caused the problems, but the raw numbers are cause for some concern. Some of those products aren’t especially helpful, readers told us in a recent survey, but that aside, don’t assume they’re safe because they’re “all natural.” They may be neither. To come up with our dozen finalists, we also considered factors such as whether the ingredients were effective for their purported uses and how readily available they were to consumers. In the meantime, here are steps you can take to make sure the supplements you use are safe and beneficial. Earlier this year, for instance, the FDA sent a warning letter to BioAnue Laboratories of Rochelle, Ga., when these statements and others were spotted on websites: “Formula CX will reverse wasting disease,” and “Bovine cartilage stops tumor growth.” (The FDA said it’s still reviewing the company’s response. 11 … Most people can get enough omega-3s by eating fatty fish at least twice a week. Contains synephrine, which is similar to ephedrine, banned by the FDA in 2004. Far from reducing cancer risk, as a lot of people believe, high doses of some antioxidant supplements may actually increase it, evidence suggests. Omega-3 pills and antioxidants are widely thought to reduce the risk of heart disease and cancer, respectively, and millions of women take calcium to protect their bones. Consumer Reports also has concerns about its safety. Be skeptical about claims made for supplements in ads, on TV, and by sales staff. Here’s our take on five top-selling vitamins, plus multis: Vitamin A. And when we brought the herbs back to the office and checked the scientific evidence, we found that conclusive research on efficacy and safety was lacking for all of them. The FDA has received reports of strokes, acute liver injury, kidney failure, pulmonary embolism (blood clots in the lung), and death associated with drug-tainted supplements. Calcium can decrease the effectiveness of certain antibiotics, osteoporosis drugs, and thyroid drugs. See our, 10 surprising dangers of vitamins and supplements, Illustration: Here is Consumer Reports’ list of the 12 most dangerous supplements. Colds, weight loss, infections, inflammation, cancer, detoxification. Makers of nutritional supplements have no legal obligation to put warnings about possible drug interactions on their products, but nothing’s stopping them if they want to. Privacy note: We won't use your friend's e-mail for anything other than sending this message. (The numbers apply to the general population, not to those who may need supplementation because of a medical condition.). But true cases of choking, in which a pill actually goes down the windpipe instead of the esophagus, probably happen infrequently, says Joel Blumin, M.D., incoming chairman of the Airway and Swallowing Committee of the American Academy of Otolaryngology—Head and Neck Surgery. They identified ten hazards and warned consumers: “Don’t assume they’re safe because they’re ‘all natural.’” Dietary supplements (vitamins, minerals, herbs, or other … Nausea, heartburn, diarrhea, constipation, headache. ” (September, 2012 issue). The president of BioAnue Laboratories told us it “complies with all U.S. laws.”). Look for the "USP Verified" mark. Consumer Reports believes the best way to protect the public is to have stronger federal regulation of supplements. And the FDA has recently taken legal action against a few supplement manufacturers that claimed their products could prevent or treat a disease. Consumer Reports pointed out 15 ingredients in supplements that it says consumers should avoid because they have dangerous side effects such as rapid heartbeat, liver damage … These products contained a Viagra-like drug, the FDA said. Nor did it conduct any clinical trials of the supplement, which includes a natural enzyme called catalase, before putting it on sale. A version of this article appeared in the September 2012 issue of Consumer Reports magazine with the headline "Vitamins & Supplements.". Heart attack, heart arrhythmia, stroke, death. People who might need a multivitamin include women who are pregnant, breast-feeding, or trying to conceive; dieters consuming fewer than 1,200 calories a day or cutting out an entire food group (carbs, for example); and those with medical conditions that affect digestion and food absorption. However, we believe that the dangers relating to the use of dietary supplements are not limited to ephedra. Washington, DC (PRWEB) August 13, 2012 ProSynthesis® Laboratories today released a statement to supplement the Consumer Reports cover article “Vitamins and Supplements – 10 Dangers That May Surprise You” (September, 2012 issue). Consumer Reports blasted the federal … The FDA gets far more reports about serious problems with prescription medication than about supplements. Of the more than 54,000 dietary supplement products in the Natural Medicines Comprehensive Database, only about a third have some level of safety and effectiveness that is supported by scientific evidence, according to a review by NMCD experts. Meticore is a healthy metabolism support formula known as a recognizable leader for being a natural fat burning weight loss supplement that specifically targets and successfully triggers the spark of real metabolic rate regeneration. Consumer Reports also has concerns, because like any supplement, Kratom is not regulated. "It just tore me up," he said. Talk to your doctor or pharmacist before starting any supplement. Fungal and other infections, Lyme disease, rosacea, psoriasis, food poisoning, chronic fatigue syndrome, HIV/AIDS. Coughing, bronchitis, asthma, smoking cessation (possibly ineffective). So there are hundreds of supplements to avoid, including many that are useless, mislabeled, contaminated, or adulterated with pharmaceuticals. Meticore weight loss pills take a different approach to … Hazardous ingredients have been known to turn up in dietary supplements marketed for weight loss, bodybuilding, and sexual enhancement. In May 2009, by which point Parke's liver was already damaged, the agency warned consumers to stop using Hydroxycut, and the manufacturer, Iovate Health Sciences, voluntarily recalled some of its products, its attorney said. Our reporter asked for advice on how to treat type 2 diabetes, high blood pressure, and impotence, conditions that have effective conventional drug treatments. Might reduce the effectiveness of some medications, such as atorvastatin (Lipitor), other heart medications, birth-control pills, HIV/AIDS drugs. Amazingly, for the first 13 years after the enactment of the Dietary Supplement Health and Education Act (DSHEA), supplement makers didn't have to inform the FDA if they received reports of serious adverse events, an obligation that's required for prescription drugs. ... That was the consensus of a review conducted by the editors of the June issue of Consumer Reports on dietary supplements. As a result, the supplement marketplace is not as safe as it should be. The FDA has yet to inspect a single factory there. The warning (shown) does a good job of alerting users to the herb’s important interactions with anti-HIV medication, blood thinners, oral contraceptives, prescription antidepressants, and transplant drugs. And close to 12 percent have been linked to safety concerns or problems with product quality. Weight loss, nasal congestion, allergies. The investigators warned that the implications of their findings were worrisome given that more than half of people 60 or older take supplements containing vitamin E. Moreover, 23 percent of them take at least 400 IU per day despite a recommended daily dietary allowance of only 22 IU for adult men. Consumer Reports recently found that certain ingredients in dietary supplements sold around the world pose a serious threat to public health. "Any given Kratom product can be grossly mislabeled. Toxicity, nausea, vomiting, low blood pressure, respiratory-system paralysis, heart-rhythm disorders, death. A vitamin E overdose may increase a person's risk of bleeding, especially for those taking blood-thinning medication, according to Consumer Reports. If you suspect you’ve purchased a product that is tainted with undeclared prescription drugs or steroids, send an e-mail about it to the FDA, at taintedproducts@fda.hhs.gov. What it takes to overdose on vitamins and minerals. After looking at 233 products, all purchased online or in stores in the New York City metropolitan area in the spring of 2012, we can report that the only thing consistent about the labels is their lack of consistency. Dietary supplements taken by millions of Americans can cause serious health problems and even death. The study found that gray hair had lower-than-normal levels of catalase but did not prove that taking that enzyme by mouth would stop hair from turning gray. Dangers of Dietary Supplements: A Closer Look Researchers from Consumer Reports worked with experts from the Natural Medicines Comprehensive … that Consumer Reports is willing to take on the supplement industry and shine the light on the dangers of supplement products. Cough, sore throat, laryngitis, bronchitis, asthma. Hydroxycut has been reformulated and is on the market again. Cough, heavy menstrual periods, chest pain, cancer. Choking as a serious symptom showed up surprisingly often in the database we analyzed of problem reports to the FDA in the last five years, with more than 900 mentions. One of the most complete set of warnings we saw was on a Vitamin Shoppe bottle. They found that regular users of calcium supplements had an 86 percent increased heart-attack risk compared with those who didn’t use supplements, as reported in the June 2012 issue of the journal Heart. 3 Probiotic Foods to Try. It said the ingredient lacked safety evidence and warned that synthetically produced DMAA was not a dietary ingredient at all. (The FDA said it is studying the companies’ responses.). Working with experts from the Natural Medicines Comprehensive Database, an independent research group, we identified a group of ingredients (out of nearly 1,100 in the database) linked to serious adverse events by clinical research or case reports. Might lead to a toxic reaction when taken with the cough suppressant dextromethorphan, certain antidepressants, or narcotic pain relievers. CONSUMER REPORTS WARNS OF DIETARY SUPPLEMENT DANGERS. Andy Potts. Based on current evidence, vitamins C and E haven’t been found to shield people from cancer; vitamin E, beta-carotene, and vitamin C don’t seem to protect against getting or dying from cancer; selenium doesn’t prevent prostate cancer; and there’s no convincing evidence that beta-carotene or vitamin A, C, or E supplements prevent gastrointestinal cancers. And they warn it can be dangerous, even fatal — associating it with more than 3 dozen deaths. Indeed, 14 percent of people 55 and older use them, according to a recent survey from the … Might decrease the effectiveness of carbamazepine, an antiseizure drug; digoxin, a heart drug; and lithium, for bipolar disorder. Companies for compensatory damages ; they have denied the claims Agriculture ’ s a medical emergency that requires medical. Studying the companies ’ responses. ) people end up in emergency rooms after taking every! Off the market again chain used by some of your vitamins repeatedly found that estimated. 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