Guest guest Posted July 13, 2006 Report Share Posted July 13, 2006 I feel for you. I may freak out when I get my testing4health back...but think of it this way: knowledge is power. You have been carrying these genes all your life. They have not killed you. In fact, you got some genes for intelligence and curiosity that allowed you to come on to this list, learn things, and take the initiative to get tested. Life is on your side, in this way. And yes, you've got Rich. As someone on this list emailed me recently, he's been sent from God to the CFS community. It might be true! > > HI Everytone. > > Well I got the shock of my life today when the results of my test > came back. The worst thing is the that their is " no gene present on > either chromosome for GSTM1 " !!!! and a + - on GSTP1. It is called > null allele. Rich can you give me help with this??? Do I understand > this correctly??? > > In effect they are saying their is no gene present on either > chromosome to make glutathione. I think! IS THAT RIGHT??? So I can't > detox! They obviusly suggest raising glutathione! > > I am good with that, except I got that terrible reaction with Whey > protien Isolate and that terrrible yeast infection that cost me at > least a $1,000. to clear and I am still working on that. I waiting > to try again the True Whey by Source Naturals. CAN ANYONE GIVE ME > HELP WITH THIS???? I CANNOT TOLERATE NAC!!! > > That is the worst of it, but I also have problem with CYP1BI and > this detoxs car exhaust, cigurette smoke and charbroiled foods, it > also detoxifies estrogen! I just came back with a Class 2, pap, been > on low dose HRT for one year. I have to go to biodential hormones, > looks like to me. CAN ANYONE GIVE ME HELP HERE???? Am I thinking > corectly on this??? > > I have another problem with CYP2C9! This detoxs alot of drugs! No > wonder anesthia floors me!!! " prevents the normal metabolism of some > drugs " . I have a very long list. CAN ANYONE HELP ME HERE???? Rich is > their a way to get around this???? > > My last problem is another gene CYP2C19 which is also involved with > detoxing more drugs. I have another very long list! " Risk of > phenytoin toxicity " . CAN ANYONE HELP ME HERE??? Is their a way to > get around this??? > > Lastly, it says, " superovide dismutase is the primary anti-oxidant > enzyme with the mitochondria of cells. SOD2 converts reactive oxygen > species into less reactive hydrogen peroxide. Polymorphisms in SOD2 > + and ++ are associated with reduced SOD activity and thus higher > risk of oxidative stress and related conditions. This genotype has > specifically been associated with cardiomyopathy " ! THIS SOUNDS REAL > FAMILIAR FROM THIS LIST!!! DO I NEED TO TAKE SOD??? CAN ANYONE HELP > ME HERE??? Rich is their a way to get around this??? > > I feel like I faced my mortality today. One of things I do have > going is I can supplement glutathione, but it has been a very rough > day!! > > Any help would be so very much appreciated. > > Janet > in San Diego > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 13, 2006 Report Share Posted July 13, 2006 Janet, I agree with Jill, a test is just a test, you are no more ill now than you were yesterday, before reading the test results. You are still alive, so you are already a proven survivor. Anyway, I realize you need to learn how to prop-up your methylation cycle and so forth. But there is another take-away from this - you are highly toxic. If you do not have much glutathione production, and have poor detox of drugs, well then you probably have a high toxin load. So aside from building these detox substances I think it might be prudent to start taking toxin binders and work through a gentle series of mild cleanses. Start getting those toxins out! For example, what are you taking to bind up neurotoxins and metals? Chlorella, bentonite clay, activated charcoal, modifilan or other seaweed products, etc.? And maybe find some natural ways to build glutathione, for example eat foods high in precursors and other antioxidants. For instance, can you tolerate Avacados and Tomatos? I have read they are very high in precursors. And some berries, and probably other foods are available that will assist in detox. Maybe a high-quality Noni juice. And a good but mild herbal cleanse might help. I have very poor glutathione status, sluggish phase II liver, almost no sulfatization, do NOT tolerate NAC and only tiny amounts of whey protein, and I did alright recently on a 30 day herbal cleanse using 'Ultimate Cleanse,' and there are probably many equivalent products that are quite tolerable. I assume that you have not had CFS all your life. So before you became toxic and entered the glutathione depletion merry-go-round, you were able to manage some detox. So maybe if you can get all those toxins to come out safely, some of your remaining detoxification systems will re-start. Remember that this test is only of a small group of known genes. You may have other genes that are involved in detox that still work alright. The body chemistry has a host of back-up systems. --Kurt Test Results back from Genovations. BAD NEWS!! HELP! ! Ricfh//All HI Everytone. Well I got the shock of my life today when the results of my test came back. The worst thing is the that their is " no gene present on either chromosome for GSTM1 " !!!! and a + - on GSTP1. It is called null allele. Rich can you give me help with this??? Do I understand this correctly??? In effect they are saying their is no gene present on either chromosome to make glutathione. I think! IS THAT RIGHT??? So I can't detox! They obviusly suggest raising glutathione! I am good with that, except I got that terrible reaction with Whey protien Isolate and that terrrible yeast infection that cost me at least a $1,000. to clear and I am still working on that. I waiting to try again the True Whey by Source Naturals. CAN ANYONE GIVE ME HELP WITH THIS???? I CANNOT TOLERATE NAC!!! That is the worst of it, but I also have problem with CYP1BI and this detoxs car exhaust, cigurette smoke and charbroiled foods, it also detoxifies estrogen! I just came back with a Class 2, pap, been on low dose HRT for one year. I have to go to biodential hormones, looks like to me. CAN ANYONE GIVE ME HELP HERE???? Am I thinking corectly on this??? I have another problem with CYP2C9! This detoxs alot of drugs! No wonder anesthia floors me!!! " prevents the normal metabolism of some drugs " . I have a very long list. CAN ANYONE HELP ME HERE???? Rich is their a way to get around this???? My last problem is another gene CYP2C19 which is also involved with detoxing more drugs. I have another very long list! " Risk of phenytoin toxicity " . CAN ANYONE HELP ME HERE??? Is their a way to get around this??? Lastly, it says, " superovide dismutase is the primary anti-oxidant enzyme with the mitochondria of cells. SOD2 converts reactive oxygen species into less reactive hydrogen peroxide. Polymorphisms in SOD2 + and ++ are associated with reduced SOD activity and thus higher risk of oxidative stress and related conditions. This genotype has specifically been associated with cardiomyopathy " ! THIS SOUNDS REAL FAMILIAR FROM THIS LIST!!! DO I NEED TO TAKE SOD??? CAN ANYONE HELP ME HERE??? Rich is their a way to get around this??? I feel like I faced my mortality today. One of things I do have going is I can supplement glutathione, but it has been a very rough day!! Any help would be so very much appreciated. Janet in San Diego Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 Kurt, What do you think about cholestryramine as a detoxer. I read that it doesn't get absorbed into the body in " Worst Pills, Best Pills " and that it stays in the intestines and cleans up the toxins from mold and yeasts. The book also says there are no side effects. Dr. Shomaker recommends it very much. Just wondering. Thanks Edy Kurt R <kurt@...> wrote: Janet, I agree with Jill, a test is just a test, you are no more ill now than you were yesterday, before reading the test results. You are still alive, so you are already a proven survivor. Anyway, I realize you need to learn how to prop-up your methylation cycle and so forth. But there is another take-away from this - you are highly toxic. If you do not have much glutathione production, and have poor detox of drugs, well then you probably have a high toxin load. So aside from building these detox substances I think it might be prudent to start taking toxin binders and work through a gentle series of mild cleanses. Start getting those toxins out! For example, what are you taking to bind up neurotoxins and metals? Chlorella, bentonite clay, activated charcoal, modifilan or other seaweed products, etc.? And maybe find some natural ways to build glutathione, for example eat foods high in precursors and other antioxidants. For instance, can you tolerate Avacados and Tomatos? I have read they are very high in precursors. And some berries, and probably other foods are available that will assist in detox. Maybe a high-quality Noni juice. And a good but mild herbal cleanse might help. I have very poor glutathione status, sluggish phase II liver, almost no sulfatization, do NOT tolerate NAC and only tiny amounts of whey protein, and I did alright recently on a 30 day herbal cleanse using 'Ultimate Cleanse,' and there are probably many equivalent products that are quite tolerable. I assume that you have not had CFS all your life. So before you became toxic and entered the glutathione depletion merry-go-round, you were able to manage some detox. So maybe if you can get all those toxins to come out safely, some of your remaining detoxification systems will re-start. Remember that this test is only of a small group of known genes. You may have other genes that are involved in detox that still work alright. The body chemistry has a host of back-up systems. --Kurt Test Results back from Genovations. BAD NEWS!! HELP! ! Ricfh//All HI Everytone. Well I got the shock of my life today when the results of my test came back. The worst thing is the that their is " no gene present on either chromosome for GSTM1 " !!!! and a + - on GSTP1. It is called null allele. Rich can you give me help with this??? Do I understand this correctly??? In effect they are saying their is no gene present on either chromosome to make glutathione. I think! IS THAT RIGHT??? So I can't detox! They obviusly suggest raising glutathione! I am good with that, except I got that terrible reaction with Whey protien Isolate and that terrrible yeast infection that cost me at least a $1,000. to clear and I am still working on that. I waiting to try again the True Whey by Source Naturals. CAN ANYONE GIVE ME HELP WITH THIS???? I CANNOT TOLERATE NAC!!! That is the worst of it, but I also have problem with CYP1BI and this detoxs car exhaust, cigurette smoke and charbroiled foods, it also detoxifies estrogen! I just came back with a Class 2, pap, been on low dose HRT for one year. I have to go to biodential hormones, looks like to me. CAN ANYONE GIVE ME HELP HERE???? Am I thinking corectly on this??? I have another problem with CYP2C9! This detoxs alot of drugs! No wonder anesthia floors me!!! " prevents the normal metabolism of some drugs " . I have a very long list. CAN ANYONE HELP ME HERE???? Rich is their a way to get around this???? My last problem is another gene CYP2C19 which is also involved with detoxing more drugs. I have another very long list! " Risk of phenytoin toxicity " . CAN ANYONE HELP ME HERE??? Is their a way to get around this??? Lastly, it says, " superovide dismutase is the primary anti-oxidant enzyme with the mitochondria of cells. SOD2 converts reactive oxygen species into less reactive hydrogen peroxide. Polymorphisms in SOD2 + and ++ are associated with reduced SOD activity and thus higher risk of oxidative stress and related conditions. This genotype has specifically been associated with cardiomyopathy " ! THIS SOUNDS REAL FAMILIAR FROM THIS LIST!!! DO I NEED TO TAKE SOD??? CAN ANYONE HELP ME HERE??? Rich is their a way to get around this??? I feel like I faced my mortality today. One of things I do have going is I can supplement glutathione, but it has been a very rough day!! Any help would be so very much appreciated. Janet in San Diego Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 Hi, Janet. Thanks for faxing me your Detoxigenomic profile and RBC total glutathione results, as well as posting some of the results on the list. I'm sorry these results were upsetting. It can be chagrining to learn that one's genes have some aspects that one would not have chosen, realizing that one has them for a lifetime. However, there are some good aspects to it. One is that now you know the facts about them, so that you can operate on the basis of hard data rather than speculation. Another is that even though we can't change our genes, there are ways of compensating for some of the less desirable issues that arise because of genetic variations. I can offer some specific comments: First, your red blood cell total glutathione level is below the normal range, 562 compared to 568-1048 micromolar in concentration. This is very common in CFS, and puts you in one of the main subsets. Fortunately there are things that can be done to restore the glutathione level to normal, and when that occurs, you should experience improvement in many of your symptoms. I'll comment on this more below, but I think it would be best to wait until your Yasko panel results come back before deciding on what approach to use to raise your glutathione. I recall that you don't respond well to NAC, and also had considerable difficulty with a whey protein isolate. I suspect that this means that you have some genetic issues in the enzymes affecting your methylation cycle, and it may be necessary to compensate for them in order to raise your glutathione. The Yasko panel will give information that will help decide how to do that. So now let's start at the top of your Detoxigenomic profile results. In Phase I detox, your profile shows SNPs in CYP1B1, CYP2C9, and CYP2C19, three out of the eight that are characterized in this test. Note first that you have normal genes for CYP2D6 and CYP3A4. That's good, because those enzymes detox most pharmaceuticals. So should you need to take some drugs for some reason, most of them will be handled normally in Phase I. Now, what about CYP1B1? As it says on the report, this SNP is an upregulation. That means that the enzyme will work faster than normal when it processes its substrates. As it also says, this enzyme is responsible for detoxing polycyclic aromatic hydrocarbons (PAHs) which are present in all types of smoke (tobacco smoke, engine exhaust, and barbecuing, for example). It is also responsible for one of the reactions with the estrogens, which converts them to 5-hydroxy estrogens. As you may know, the way the detox system typically is supposed to work, Phase I converts substances to intermediates, and then Phase II follows to convert them to forms that are very water soluble and easy to excrete, so that they can be removed from the body. Often the intermediate is more toxic than the original substance. If Phase I is faster than normal, and Phase II is slower than normal, then the intermediates hang around longer and build up to higher concentrations than normal. A person who has this situation has been termed a " pathological detoxifier. " In your case, as I will discuss below, you do have some issues in Phase II that could slow the reactions down there, so I think you would fit into this category. In the case of the estrogen aspect of the CYP1B1 function, the 5-hydroxy estrogens (also called catechol estrogens) have the property that if they aren't processed by Phase II, they can auto-oxidize to form what are called semiquinones and quinones. These can oscillate back and forth from one to the other, and when they do, they generate oxidizing free radicals, which can make demands on the glutathione supply and contribute to oxidative stress. This may be part of the reason for your glutathione depletion. So what can you do about this one? Well, the smoke part is pretty obvious. You can avoid inhaling smoke of all kinds, though air pollution may be hard to avoid. If it's possible to put a good air filter in your living space, I think that would be a good idea. Charcoal filters are very good for removing the substances that you are sensitive to. Of course, they have to be replaced fairly often, which is a nuisance and costs money. My mother-in-law has Orreck electrostatic air fllters in her house, and they include a small charcoal filter. I think they do a pretty good job. What about the estrogen part? I know that you are post menopausal, and that you have been on low-dose hormone replacement therapy to avoid the unfun stuff that you had to endure for quite a while after menopause. You mentioned going to bioidentical hormones. I think that's a good idea for other reasons, but it won't eliminate the production of 5-hydroxy estrogens by your CYP1B1. The fact that you use low doses of the hormones should help. It's a tough choice to make, whether to stay on HRT or not. One thing I should mention is that there is a somewhat greater risk for certain cancers from the CYP1B1 SNP that you have, because of the elevated amounts of 5- hydroxy estrogens produced by it, and the resulting oxidizing free radicals. Getting your glutathione level restored and controlling the oxidative stress should help reduce that risk. O.K., now CYP2C9: This SNP is a down-regulator, and this enzyme detoxes quite a few drugs, a list of which you have received. The fact that it's a downregulator means that you are not a pathological detoxifier with respect to these drugs, but that if you were given a standard dose of one of these drugs, you would get " more bang for your buck " than people without this SNP. The drug would stay in your body longer, and would rise to higher concentrations. Thus, a standard dose of one of these drugs might be toxic to you, while it would not be for others. One solution is to avoid taking any of the drugs on the CYP2C9 list. If you really need to take one of them for some reason, then you should ask your doctor to prescribe a smaller dose than the standard dose for that drug. For CYP2C19, the same advice applies, for the list of drugs that it detoxifies. Don't worry about that comment " Risk of phenytoin toxicity. " That would only apply if you were taking phenytoin (Dilantin), which is a drug for seizures. If you aren't taking it, then you won't experience toxicity from it. Moving on to Phase II, note that all the SNPs you have here are heterozygous, except for the missing GSTM1. In other words, you have one normal copy of each of these affected genes. First, you have a COMT V158M (+/-). Catechol-O-methyl transferase is an enzyme that forms part of the breakdown pathway for the catecholamines: dopamine, norepinephrine, and epinephrine. It also performs Phase II methylation on the 5-hydroxy estrogens, mentioned above. This SNP causes a downregulation of the activity of this enzyme, and that means that you probably have somewhat elevated levels of these substances. Elevated dopamine can cause mood swings, because the dopamine level tends to oscillate as a result of a feedback control loop. COMT uses methyl groups that it obtains from SAMe (S- adenosylmethionine), which is in the methylation cycle. We will have to wait until your Yasko panel results come back to see whether your methylation cycle has issues that would further interfere with the breakdown of these substances. One thing you can do is to avoid taking supplemental phenylalanine or tyrosine, because they are the precursors for the catecholamines, and taking them will tend to raise these substances to even higher concentrations. Next, you have two SNPs in your NAT2 enzymes (NAT2 I144T +/- and NAT2 R197Q +/-), both in the direction of making it operate more slowly. This will slow down the detox of certain toxins, among them the aromatic amines that are rapidly processed by CYP1B1 above. So I think that this would make you even more sensitive to smokes, and the obvious response is, again, to avoid inhaling smoke of all types. Now the glutathione transferase enzymes. Your GSTM1, which would be located at chromosome 1p13.3, is missing on both your chromosomes. This is actually not so unusual. Something like 2/3 of Americans don't have a gene for this enzyme, if what I'm reading from Sciona is correct, based on 2002 U.S. census data. GSTM1, when present, is found in the liver and kidneys, and it's also in the blood serum. It specializes in conjugating organic toxins to glutathione molecules so they can be water-soluble and more easily disposed of. So this suggests that your body's handling of organic toxins, such as solvents and pesticides, for examples, might be slower than normal. You also have a polymorphism in one copy of the other GST that they characterize: GSTP1 I105V (+/-). This enzyme is found in the brain and the skin, as well as in the red blood cells, and it seems to specialize in conjugating heavy metals to glutathione. Having this SNP means that your body's ability to dispose of heavy metals, such as mercury, would be slower than normal. It should be noted that there are other glutathione transferase enzymes that are not characterized in this profile, that there is overlap between what the various ones do, so that they can " stand in " for each other to some degree, and that glutathione is actually able to conjugate to toxins without the help of transferase enzymes, just more slowly. So some smart responses to having these polymorphisms would be to build the glutathione back up and to avoid toxins such as heavy metals, organic solvents, and pesticides. Having clean air in your living space, using a water filter that has a charcoal block in it, and eating organic foods would be good ideas. Try not to breathe fumes of various sorts, such as from painting or highway repair. If you have to be in an environment like that, wear a respirator that has an activated charcoal filter in it. Finally, you have an SOD2 A16V (+/-). Superoxide dismutases are enzymes that convert superoxide, which is an oxidizing free radical, into hydrogen peroxide. SOD2 is the mitochondrial form of SOD, which contains manganese. It deals with the superoxide free radicals that are produced naturally by oxidative metabolism in the mitochondria. This SNP causes the reaction to run slower, so that the superoxide radicals would be able to react with other molecules in the mitochondria, such as the lipid membrane molecules, and produce damage. This constitutes oxidative stress. The hydrogen peroxide is normally dealt with by catalase or by glutathione peroxidase, which makes use of glutathione and selenium. If the peroxide reacts with a lipid before it can be taken out, then the glutathione transferases deal with the lipid peroxide, again using glutathione. As you know you have some polymorphisms in your glutathione transferases, and you are currently depleted in glutathione, so it's likely that your body is not currently able to deal properly with hydrogen peroxide, either, and this may exert a back pressure on the superoxide dismutase reaction, making it run even more slowly, You definitely have a recipe here for oxidative stress, and that corresponds to the fact that your glutathione is depleted, since it is normally the basis for the whole antioxidant system, and it has been overwhelmed. What can you do about the SOD2 SNP? I know that there are some SOD supplements on the market, but I'm not sure they will make it from the digestive system into the mitochondria of the cells. Maybe if they were in a two-layered liposome they would have a chance, but I'm not sure if anything like that is commercially available. You can also take bioflavonoids, such as OPCs (oligomeric proanthocyanidins) as in grape seed extract or marine pine bark (Pycnogenol). Or you could take vitamin C, at doses near bowel tolerance. That might also help to recycle the glutathione that you do have, even though it's low. After your glutathione is back up, once we see what the Yasko panel says and can deal with that, then you could add vitamin E. After mercury is cleared, you could add alpha lipoic acid. Beyond these things, there is the issue of what toxins may have built up in your body, and what to do about them. Since your glutathione is low, and probably has been so for a while, and since you have the SNPS discussed above, I think it's likely that you have some significant body burdens of various toxins. If possible, I think it's a good idea to try to identify what's there. For heavy metals, I would suggest getting the DMSA-provoked 6-hour urine collection test for metals from Doctors Data Lab. However, I would not recommend running that test until you get your glutathione back up. Marcia found out about that the hard way, unfortunately, back in January. For other toxins, I would suggest getting screening tests from http://www.nmslab.com in Pennsylvania. Which tests would depend on what exposures you think you have had. They have screening tests for pesticides and hydrocarbons, in addition to lots of specific tests. When you know what toxins you have stored up, you can get more specific about detoxing them. Kurt described several things that can be used. If you can tolerate sauna, that's a possibility for some. Several substances will bind various types of toxins if they are cycling through the gut. Chelation can be used for heavy metals. Amy Yasko finds that a lot of detoxing happens automatically once the methylation cycle is restored to proper function and bacteria and viruses are dealt with. Well, anyway, please don't despair. Having these genetic data in hand is progress, even though the results aren't everything you might have wished them to be. The point is that you are on a path toward doing something about these toxins, correcting your oxidative stress, and getting your glutathione back up where it should be, with all the benefits that can bring. Hang in there! Rich P.S. If you don't mind commenting on this, I would be interested to know about your menstrual history. For example, did you have heavy periods? Was there anything irregular about your cycles? Did you have endometriosis? The reason I'm asking is because of your CYP1B1 SNP. I'm wondering if that can have such effects. Also, as you probably know, CFS occurs dominantly in women, with a ratio between 2 to 1 and 4 to 1, depending on which study you look at. Nobody has ever explained this. An obvious suspect is something to do with estrogen. If the production of estrogen in higher quantities, as is found in women, somehow places an additional demand on glutathione, that would fit with my glutathione depletion model and tend to push more women than men into glutathione depletion and hence, into CFS. One possibility for this is the CYP1B1 SNP, for the reasons described above. I have Detoxigenomic reports in front of me from four women who have CFS. All four have the CYP1B1 SNP. Hmmmmmmmm. > > HI Everytone. > > Well I got the shock of my life today when the results of my test > came back. The worst thing is the that their is " no gene present on > either chromosome for GSTM1 " !!!! and a + - on GSTP1. It is called > null allele. Rich can you give me help with this??? Do I understand > this correctly??? > > In effect they are saying their is no gene present on either > chromosome to make glutathione. I think! IS THAT RIGHT??? So I can't > detox! They obviusly suggest raising glutathione! > > I am good with that, except I got that terrible reaction with Whey > protien Isolate and that terrrible yeast infection that cost me at > least a $1,000. to clear and I am still working on that. I waiting > to try again the True Whey by Source Naturals. CAN ANYONE GIVE ME > HELP WITH THIS???? I CANNOT TOLERATE NAC!!! > > That is the worst of it, but I also have problem with CYP1BI and > this detoxs car exhaust, cigurette smoke and charbroiled foods, it > also detoxifies estrogen! I just came back with a Class 2, pap, been > on low dose HRT for one year. I have to go to biodential hormones, > looks like to me. CAN ANYONE GIVE ME HELP HERE???? Am I thinking > corectly on this??? > > I have another problem with CYP2C9! This detoxs alot of drugs! No > wonder anesthia floors me!!! " prevents the normal metabolism of some > drugs " . I have a very long list. CAN ANYONE HELP ME HERE???? Rich is > their a way to get around this???? > > My last problem is another gene CYP2C19 which is also involved with > detoxing more drugs. I have another very long list! " Risk of > phenytoin toxicity " . CAN ANYONE HELP ME HERE??? Is their a way to > get around this??? > > Lastly, it says, " superovide dismutase is the primary anti-oxidant > enzyme with the mitochondria of cells. SOD2 converts reactive oxygen > species into less reactive hydrogen peroxide. Polymorphisms in SOD2 > + and ++ are associated with reduced SOD activity and thus higher > risk of oxidative stress and related conditions. This genotype has > specifically been associated with cardiomyopathy " ! THIS SOUNDS REAL > FAMILIAR FROM THIS LIST!!! DO I NEED TO TAKE SOD??? CAN ANYONE HELP > ME HERE??? Rich is their a way to get around this??? > > I feel like I faced my mortality today. One of things I do have > going is I can supplement glutathione, but it has been a very rough > day!! > > Any help would be so very much appreciated. > > Janet > in San Diego > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 Hi, Jill. Wow! I hope that's true! It's a pretty tough thing to try to live up to, though. If I do something good, please give God the credit, but when I screw up, please don't anyone blame Him! Rich And yes, you've got Rich. > As someone on this list emailed me recently, he's been sent from God > to the CFS community. It might be true! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 Holy shit. I don't mean to swear but this is an amazing post. I have printed it out. Unbelievable what you are offering this list. I guess I have to get detoxigenomics test somehow myself. I wonder if I have that polymorphism too, in regards to estrogen, as irregular periods and estrogen dominance run on my mother's side. Interesting. > > > > HI Everytone. > > > > Well I got the shock of my life today when the results of my test > > came back. The worst thing is the that their is " no gene present > on > > either chromosome for GSTM1 " !!!! and a + - on GSTP1. It is called > > null allele. Rich can you give me help with this??? Do I > understand > > this correctly??? > > > > In effect they are saying their is no gene present on either > > chromosome to make glutathione. I think! IS THAT RIGHT??? So I > can't > > detox! They obviusly suggest raising glutathione! > > > > I am good with that, except I got that terrible reaction with Whey > > protien Isolate and that terrrible yeast infection that cost me at > > least a $1,000. to clear and I am still working on that. I waiting > > to try again the True Whey by Source Naturals. CAN ANYONE GIVE ME > > HELP WITH THIS???? I CANNOT TOLERATE NAC!!! > > > > That is the worst of it, but I also have problem with CYP1BI and > > this detoxs car exhaust, cigurette smoke and charbroiled foods, it > > also detoxifies estrogen! I just came back with a Class 2, pap, > been > > on low dose HRT for one year. I have to go to biodential hormones, > > looks like to me. CAN ANYONE GIVE ME HELP HERE???? Am I thinking > > corectly on this??? > > > > I have another problem with CYP2C9! This detoxs alot of drugs! No > > wonder anesthia floors me!!! " prevents the normal metabolism of > some > > drugs " . I have a very long list. CAN ANYONE HELP ME HERE???? Rich > is > > their a way to get around this???? > > > > My last problem is another gene CYP2C19 which is also involved > with > > detoxing more drugs. I have another very long list! " Risk of > > phenytoin toxicity " . CAN ANYONE HELP ME HERE??? Is their a way to > > get around this??? > > > > Lastly, it says, " superovide dismutase is the primary anti-oxidant > > enzyme with the mitochondria of cells. SOD2 converts reactive > oxygen > > species into less reactive hydrogen peroxide. Polymorphisms in > SOD2 > > + and ++ are associated with reduced SOD activity and thus higher > > risk of oxidative stress and related conditions. This genotype has > > specifically been associated with cardiomyopathy " ! THIS SOUNDS > REAL > > FAMILIAR FROM THIS LIST!!! DO I NEED TO TAKE SOD??? CAN ANYONE > HELP > > ME HERE??? Rich is their a way to get around this??? > > > > I feel like I faced my mortality today. One of things I do have > > going is I can supplement glutathione, but it has been a very > rough > > day!! > > > > Any help would be so very much appreciated. > > > > Janet > > in San Diego > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 Where have we been? Where have *you* been. New York State does not ALLOW Genovations testing. I have to travel and probably have an expensive initial consult with a non-New York doctor who will have his or her own ideas about how to treat me, simply in order to get a Genovations test. I have to figure out a better way to do it as money is tight. As for testing4health, I spent the last 2.5 years completing a huge book project that will be published next spring. I put off any major shifts in my approach to my health until it was finished. I think I have mentioned this in the past, not that I expect anyone to really notice. That's where I've been. Also, until Rich really had all this stuff thoroughly absorbed and understood, there was nobody to interpret testing4health results. You have to wait even more than the 2 months for the teset results, to get Dr Yasko to interpret and its very expensive. And she is mainly focussed on the autistic kids. Everybody juggles different stuff in their life, and when windows of opportunity arrive to get these tests, and there is not only the financial ability, but the time to address whatever they show, well, that's when the person does it. I plan to chelate next year, and so I need these tests first. I have been pondering extensively how I can get genovations without dropping a lot of unecessary money on a new practitioner out of state. > > > > > > HI Everytone. > > > > > > Well I got the shock of my life today when the results of my test > > > came back. The worst thing is the that their is " no gene present > > on > > > either chromosome for GSTM1 " !!!! and a + - on GSTP1. It is called > > > null allele. Rich can you give me help with this??? Do I > > understand > > > this correctly??? > > > > > > In effect they are saying their is no gene present on either > > > chromosome to make glutathione. I think! IS THAT RIGHT??? So I > > can't > > > detox! They obviusly suggest raising glutathione! > > > > > > I am good with that, except I got that terrible reaction with Whey > > > protien Isolate and that terrrible yeast infection that cost me at > > > least a $1,000. to clear and I am still working on that. I waiting > > > to try again the True Whey by Source Naturals. CAN ANYONE GIVE ME > > > HELP WITH THIS???? I CANNOT TOLERATE NAC!!! > > > > > > That is the worst of it, but I also have problem with CYP1BI and > > > this detoxs car exhaust, cigurette smoke and charbroiled foods, it > > > also detoxifies estrogen! I just came back with a Class 2, pap, > > been > > > on low dose HRT for one year. I have to go to biodential hormones, > > > looks like to me. CAN ANYONE GIVE ME HELP HERE???? Am I thinking > > > corectly on this??? > > > > > > I have another problem with CYP2C9! This detoxs alot of drugs! No > > > wonder anesthia floors me!!! " prevents the normal metabolism of > > some > > > drugs " . I have a very long list. CAN ANYONE HELP ME HERE???? Rich > > is > > > their a way to get around this???? > > > > > > My last problem is another gene CYP2C19 which is also involved > > with > > > detoxing more drugs. I have another very long list! " Risk of > > > phenytoin toxicity " . CAN ANYONE HELP ME HERE??? Is their a way to > > > get around this??? > > > > > > Lastly, it says, " superovide dismutase is the primary anti-oxidant > > > enzyme with the mitochondria of cells. SOD2 converts reactive > > oxygen > > > species into less reactive hydrogen peroxide. Polymorphisms in > > SOD2 > > > + and ++ are associated with reduced SOD activity and thus higher > > > risk of oxidative stress and related conditions. This genotype has > > > specifically been associated with cardiomyopathy " ! THIS SOUNDS > > REAL > > > FAMILIAR FROM THIS LIST!!! DO I NEED TO TAKE SOD??? CAN ANYONE > > HELP > > > ME HERE??? Rich is their a way to get around this??? > > > > > > I feel like I faced my mortality today. One of things I do have > > > going is I can supplement glutathione, but it has been a very > > rough > > > day!! > > > > > > Any help would be so very much appreciated. > > > > > > Janet > > > in San Diego > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 I wouldn't characterize myself as an angry person, but I definitely am angry at the fact that NY State makes it nigh impossible for me to get certain tests, that's definitely true. It's infuriating, and corrupt on their part. It also makes it more difficult for me to forge my own future path to wellness, if I have to spend so much more $ in order to try and find an out of state doctor so I can get some of the tests that might be truly informative. Maybe the word I should use is frustrated. I am extremely frustrated that 1) it costs $750 and takes TWO MONTHS for me to get results back from testing4health, where most lab tests come back in a week or two and 2) that I can't even GET the genovations test that I need... So that is really frustrating. My doctor would order the test for me if she could, but she can't, its not " standard practice " and Genova won't even allow a NY State doc to order it anyway. The organic acids test from Great Plains--they are not standard practice EITHER in NY so I " m not sure how my doc will feel but they leave it up to the docs, and WILL do the tests if the docs send them in. So two of the main tests I want to get are not " standard " in NY and are difficult or impossible to get. That is SO frustrating. End of rant. (that's a smiley) > > > > > > > > HI Everytone. > > > > > > > > Well I got the shock of my life today when the results of my test > > > > came back. The worst thing is the that their is " no gene present > > > on > > > > either chromosome for GSTM1 " !!!! and a + - on GSTP1. It is called > > > > null allele. Rich can you give me help with this??? Do I > > > understand > > > > this correctly??? > > > > > > > > In effect they are saying their is no gene present on either > > > > chromosome to make glutathione. I think! IS THAT RIGHT??? So I > > > can't > > > > detox! They obviusly suggest raising glutathione! > > > > > > > > I am good with that, except I got that terrible reaction with Whey > > > > protien Isolate and that terrrible yeast infection that cost me at > > > > least a $1,000. to clear and I am still working on that. I waiting > > > > to try again the True Whey by Source Naturals. CAN ANYONE GIVE ME > > > > HELP WITH THIS???? I CANNOT TOLERATE NAC!!! > > > > > > > > That is the worst of it, but I also have problem with CYP1BI and > > > > this detoxs car exhaust, cigurette smoke and charbroiled foods, it > > > > also detoxifies estrogen! I just came back with a Class 2, pap, > > > been > > > > on low dose HRT for one year. I have to go to biodential hormones, > > > > looks like to me. CAN ANYONE GIVE ME HELP HERE???? Am I thinking > > > > corectly on this??? > > > > > > > > I have another problem with CYP2C9! This detoxs alot of drugs! No > > > > wonder anesthia floors me!!! " prevents the normal metabolism of > > > some > > > > drugs " . I have a very long list. CAN ANYONE HELP ME HERE???? Rich > > > is > > > > their a way to get around this???? > > > > > > > > My last problem is another gene CYP2C19 which is also involved > > > with > > > > detoxing more drugs. I have another very long list! " Risk of > > > > phenytoin toxicity " . CAN ANYONE HELP ME HERE??? Is their a way to > > > > get around this??? > > > > > > > > Lastly, it says, " superovide dismutase is the primary anti-oxidant > > > > enzyme with the mitochondria of cells. SOD2 converts reactive > > > oxygen > > > > species into less reactive hydrogen peroxide. Polymorphisms in > > > SOD2 > > > > + and ++ are associated with reduced SOD activity and thus higher > > > > risk of oxidative stress and related conditions. This genotype has > > > > specifically been associated with cardiomyopathy " ! THIS SOUNDS > > > REAL > > > > FAMILIAR FROM THIS LIST!!! DO I NEED TO TAKE SOD??? CAN ANYONE > > > HELP > > > > ME HERE??? Rich is their a way to get around this??? > > > > > > > > I feel like I faced my mortality today. One of things I do have > > > > going is I can supplement glutathione, but it has been a very > > > rough > > > > day!! > > > > > > > > Any help would be so very much appreciated. > > > > > > > > Janet > > > > in San Diego > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 14, 2006 Report Share Posted July 14, 2006 Hi, Janet. > > HI Rich, > > Thank you so much for taking the time and energy to get back to me. I am still learning so clarity I needed. You are a blessing! ***You're welcome! > > About glutathione, I have gone back to the sublingual glutathione about 200-300 mgs every day. I have the liposomal glutathione in my fridge and I am so tempted to try maybe a teaspoon a day and see how that goes. Yeast is being controlled (gone) by Candex and I take some Lactoferrin every day. DO YOU THINK THAT WOULD BE OK.??? ***Go for it! I would just suggest paying attention to how it makes you feel. If good, continue. If crummy, stop. We don't know what your methylation SNPs look like yet. If you should happen to have a CBS SNP, especially if combined with a SUOX SNP, the glutathione might make you feel crummy because of inability to get rid of sulfites fast enough. But I understand your wanting to get on with it. Twenty-five years is enough! > > I do try to stay away from smoke, I will be even more careful now and since I live about 10 miles from the beach, I get good clean arir. I am grateful for that. ***That sounds good. > > My sister has aleady had breast cancer (one breast was showing the problem and the other had calcim deposits in it), so she has had both removed. This happened pretty quicly after she started HRT. She does smoke/drink and I do neither. I have only been on the HRT for one year, I resisted for three years before that, but I just could not take it any longer. This morning I ordered Indol-3-carbinol which is showing promise against this problem. I have not had a mammogram since I started HRT, so I know that is on my " to do list NOW! " ***That sounds good. I did look into the literature to see if there is any evidence that HRT can cause elevated breast cancer risk for a woman who has a CYP1B1 SNP, and found a paper. The abstract is at the end of this post. It does say that there is an increased risk, but it isn't easy to apply it to your case, because they are talking about what's called the CYP1B1*3/*3 genotype. What genovations tests for is two SNPs combined, one of them being the *3 and the other being the *4. The Genovations report doesn't say exactly which combination of alleles you have, and it may not be the *3/*3 combination. So the issue is a litte muddy. If you want to get a copy of the full paper, it's free at PubMed. Just punch in the PMID number in the search box at PubMed, and click on the symbol at the top. > > The only drug that worries me a little is Neurontin I was taking for my neuropathy, but I stopped that when even a dose as low as 200 mg, made me dizzy! I am still trying to address that problem. (Exercise makes that better.) Yesterday in the doc's office he had a " Aware Magazine " > > on FM and it it they are using Lyrica for FM and it also works for neuropathy. He gave me a RX for that in a low dose. ***Neurontin is excreted unchanged in the urine, so the dizziness would not have been related to SNPs in your detox system. Lyrica behaves the same, less than 1% being N-methylated, the rest going out in the urine unchanged, so your detox SNPs should not be involved with it, either. ***I'm hopeful that your neuropathy will be cleared up once your methylation cycle is working well again. That of course will have to wait until you get the Yasko panel back and can figure out what supplements to take to compensate for whatever SNPs show up there. Methylation is important for the nervous system, since it is required for making myelin, which is the electrical insulation on nerve fibers. > > I was at the dentist and had quite a reaction to epinephrine. I know now why! ***Yeah, the COMT SNP probably has something to do with that! > > I do notice that I don't have a problem with mood swings, but my patience level could be better.. I also tend to be more of the loner type. ***Hmmm. Well, I know I keep saying this, but the neurotransmitter levels are affected by other aspects, such as the biopterin cycle, which is linked to the folate metabolism, which is linked to the methylation cycle, so if you have SNPs there, that could hold down the levels of your neurotransmitters. We'll just have to wait and see about that. I don't know about the loner part...maybe you have a loner SNP! (:-) > > I do eat some organic foods, but I will eat more, now that I know. ***O.K. > > SOD does come in a sublingual. WOULD THAT HELP ME??? ***I don't know. Do they have any evidence that the SOD will get into the cells, and then into the mitochondria? What kind of SOD is it? Is it the mitochondrial type, with manganese, or is it the cellular cytosolic type, with copper and zinc? The first one is the one that has the SNP. I do take OPC's.and I will add in the VIT C. ***O.K. In order to get the benefit from the vitamin C in this situation (glutathione depletion), you will need to go up to bowel tolerance (just below where it softens your stools, and you have to find out where this dose is experimentally, so it's best to stay near the " water closet " when you are experimenting!) I have shown high mercury before, so I know that is one of my toxins. ***O.K. That makes sense. > > I was wondering if I could do a liver flush now and be safe???? Biotics have a good program and the doc also mentioned it. WHAT DO YOU THINK??? ***I think it would be O.K., so long as you don't have gallstones that could get stuck in your bile ducts. Also, I don't think that doing them very often is a good idea, because it can deplete your bile salts. Do I have to know what the toxins are?? Or can I go with a general cleanse and get the process going??? I do know in the past I have used sauna's with great success! Even was able to go back on the treadmill, so I think my toxic body needs relief as soon as possible. I would not even attempt to approach the metals with chelation at this point. ***I think a general cleanse would be O.K. I'm glad to hear that you can tolerate saunas. PWCs who have low cardiac output can have a tough time if their body is heated, because the blood is released to flow to the skin in an effort to cool the body, and since there isn't enough total cardiac output to go around, the brain gets less blod flow than it needs, and the person passes out. > > You hit the nail on the head about heavy periods! Started when I was 9 years old, very heavy and painful!! Went the full 7 days. No endometriosis. ***Wow! Nine is pretty early to start that, and heavy to boot! That's kind of interesting, though. You must have had higher tnan normal estrogen levels at that age, perhaps because the estrogen was not being broken down by the detox system as fast as normal. I realize that this gets into a " touchy " area, so you should tell me to buzz off if you want to, but did your body " develop " early, also? I would think that it would have, if the estrogen level was high. Well, I had better get off this subject and back to working on a safer topic, like mitochondrial dysfunction! ***Over the years, though, I've read a lot on the lists from women who have CFS, about PMS, menstrual irregularities, heavy periods, endometriosis, fibrocystic breasts, and other things of that sort, but I'm not able to say whether there is more of this in CFS than for women in general. I'm starting to wonder, though, whether this CYP1B1 thing might be messing up the estrogen levels in women who have CFS, and whther that might be causing some of this stuff. This afternoon I dug up some more Detoxigenomics test results, and so far we are batting 1000 on PWCs having the CYP1B1 SNP. I have test results now from six women and two men with CFS, and all of them have this SNP. I tried to find out what the frequency of this SNP is in the general healthy population, and it's kind of messy to make the comparison, because Genovations combines two of them, and I'm not smart enough yet to figure out how to compare this with what the researchers have done in the literature, but I don't see numbers anywhere close to 100% for the general population, so I think this might be a significant difference. > > For me, I want to detox as quickly and safely as I can. ***I get that, and I agree. I think this is a lot of my problem and get that glutathione up. ***I think so, too. Amy's test is really holding things up for me. I sent my test in on 5/15/06 and I still don't even have my labs back. When I called the office they told me 8 weeks is about right on time. ***Yes, that's an ongoing problem. My biggest worry along with the rest of this is that estrogen problem. I hope I have managed to avoid a breast cancer problem. I don't think I am up for that. ***I don't know anyone who would sign up for that. I had cancer a little lower down eight years ago, and I'm not volunteering to try it again! So far, so good. > > Again thank you so much for your help. I have been sick for 25 years. This list has helped me more than anything. I am very grateful. ***I appreciate your being willing to try these things. We are all learning from you and from the others here who are giving this a shot. > > Janet > in San Diego. ***Rich Carcinogenesis. 2003 Sep;24(9):1533-9. Epub 2003 Jul 4. Related Articles, Links Cytochrome P450 1B1 gene polymorphisms and postmenopausal breast cancer risk. Rylander-Rudqvist T, Wedren S, Granath F, Humphreys K, Ahlberg S, Weiderpass E, son M, Ingelman-Sundberg M, Persson I. Division of Molecular Toxicology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden. tove.rylander@... Cytochrome P450 1B1 (CYP1B1) is active in the metabolism of estrogens to reactive catechols and of different procarcinogens. Several studies have investigated the relationship between genetic polymorphisms of CYP1B1 and breast cancer risk, however, with inconsistent results. We investigated such an association in postmenopausal Swedish women, with special emphasis on long-term menopausal hormone users, in a large population-based case-control study. We genotyped 1521 cases and 1498 controls for the CYP1B1 single nucleotide polymorphisms (SNPs) m2, m3 and m4 and reconstructed haplotypes. The frequencies of CYP1B1*1, CYP1B1*2, CYP1B1*3 and CYP1B1*4 alleles among controls were estimated to be 0.087, 0.293, 0.444 and 0.175, respectively. It thus appeared that very few haplotypes contained combinations of SNPs at two or three loci and that single SNP genotype data effectively represented haplotypes. Odds ratios (OR) and 95% confidence intervals (CI) were calculated from logistic regression models. We found no overall association between any CYP1B1 genotype and breast cancer risk. The data indicated, however, that women who had used menopausal hormones for 4 years or longer, and carried the CYP1B1*3/*3 genotype may be at increased risk of breast cancer, OR 2.0 (95% CI 1.1-3.5), compared with long-term users without this genotype. We explored the effect of CYP1B1 genotype on breast cancer risk in subgroups defined by body mass index, family history, smoking and catechol-O-methyl transferase genotype, but found no convincing evidence for interaction. In summary, our results strongly indicate that the studied CYP1B1 gene polymorphisms do not influence breast cancer risk overall but may modify the risk after long-term menopausal hormone use. PMID: 12844487 [PubMed - indexed for MEDLINE] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 16, 2006 Report Share Posted July 16, 2006 I consider it unethical for Genova to offer this test without pointing out what the population incidence of some these alleles and conditions is. As I recall the double null is 40% incidence. There are many many genes to make and use glutathione, most important genes are present in multiple copies. They are only checking one location here. Another thing I think it is unethical for them to omit from the general discussion they append to the report. Also your reaction to whey probably goes with elevated serum cysteine (another Genova test, one that is inexpensive and actually useful) and if so you will get the same reaction to all high thiol foods and supplements, and will experience dramatic improvement on excluding them. The test is about $35 so it can be worth getting rather than the week or 2 dietary trial. Andy . . . . . > > HI Everytone. > > Well I got the shock of my life today when the results of my test > came back. The worst thing is the that their is " no gene present on > either chromosome for GSTM1 " !!!! and a + - on GSTP1. It is called > null allele. Rich can you give me help with this??? Do I understand > this correctly??? > > In effect they are saying their is no gene present on either > chromosome to make glutathione. I think! IS THAT RIGHT??? So I can't > detox! They obviusly suggest raising glutathione! > > I am good with that, except I got that terrible reaction with Whey > protien Isolate and that terrrible yeast infection that cost me at > least a $1,000. to clear and I am still working on that. I waiting > to try again the True Whey by Source Naturals. CAN ANYONE GIVE ME > HELP WITH THIS???? I CANNOT TOLERATE NAC!!! > > That is the worst of it, but I also have problem with CYP1BI and > this detoxs car exhaust, cigurette smoke and charbroiled foods, it > also detoxifies estrogen! I just came back with a Class 2, pap, been > on low dose HRT for one year. I have to go to biodential hormones, > looks like to me. CAN ANYONE GIVE ME HELP HERE???? Am I thinking > corectly on this??? > > I have another problem with CYP2C9! This detoxs alot of drugs! No > wonder anesthia floors me!!! " prevents the normal metabolism of some > drugs " . I have a very long list. CAN ANYONE HELP ME HERE???? Rich is > their a way to get around this???? > > My last problem is another gene CYP2C19 which is also involved with > detoxing more drugs. I have another very long list! " Risk of > phenytoin toxicity " . CAN ANYONE HELP ME HERE??? Is their a way to > get around this??? > > Lastly, it says, " superovide dismutase is the primary anti-oxidant > enzyme with the mitochondria of cells. SOD2 converts reactive oxygen > species into less reactive hydrogen peroxide. Polymorphisms in SOD2 > + and ++ are associated with reduced SOD activity and thus higher > risk of oxidative stress and related conditions. This genotype has > specifically been associated with cardiomyopathy " ! THIS SOUNDS REAL > FAMILIAR FROM THIS LIST!!! DO I NEED TO TAKE SOD??? CAN ANYONE HELP > ME HERE??? Rich is their a way to get around this??? > > I feel like I faced my mortality today. One of things I do have > going is I can supplement glutathione, but it has been a very rough > day!! > > Any help would be so very much appreciated. > > Janet > in San Diego > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 16, 2006 Report Share Posted July 16, 2006 > > Where have we been? > Where have *you* been. New York State does not ALLOW Genovations > testing. I have to travel and probably have an expensive initial > consult with a non-New York doctor who will have his or her own ideas > about how to treat me, simply in order to get a Genovations test. I > have to figure out a better way to do it as money is tight. Anger is occasionally useful when you can turn it into a cold hard knot in your belly to prod you into getting on with doing what you have to do, but very rarely does it help to vent it on others. Generally anger is maladaptive and cuts off avenues to getting help with getting better. I realize NY is an evil state, but then the people who live there do keep electing evil politicians. If you are one of the unfortunates who doesn't do that and is still stuck with the result you simply have to accept that it is going to cost you more to get care if you continue to live in NY. You can be demanding of doctors and ensure that they understand what you are coming for and will do it before you make your appointment. I would suggest you consider seeing Dr. Larry , DO, in Lansdale PA who is good, on some insurance plans, and a reasonable person. He can be reached at (215) 412-4910. I am sure he would tell you beforehand whether he'd be willing to order a specific test or tests, and what the appointment would cost. Andy Quote Link to comment Share on other sites More sharing options...
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