Guest guest Posted April 20, 2004 Report Share Posted April 20, 2004 Hi Peggy, How were diagnosed with Hashimoto's? Do you have any test results to share? Free T3 and Free T4, antibody tests? Has your doctor ever mentioned lupus or tested you for other auto-immune issues? I haven't heard anyone here mention Plaquenil before, but I have heard of that used commonly for lupus patients. Youhave to get your eyes checked frequently on that medication. Did he tell you anything more? How about typing Hashimoto's and Plaquenil into a google search and see if anything comes up. I would ask your doc a few more questions about your treatment. What kind of doctor / specialist is he? Tell us some more of your story. Hopefully someone has heard of using Plaquenil before.... Kate Plaqueinl Hi, My name is Peggy and I am new to the group. I have recently started Synthroid for Hashamotos. I have had hives since September. The Synthroid seems like it is helping but I havent been on it for long. My doctor wants to start me on Plaqueinl now to stop the progression of the disease. Has any one else been on this medication?? How does it affect you. ThanksPeggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2004 Report Share Posted April 20, 2004 Hi Peggy, I would agree with Kate in the request for more info on how the diagnosis was reached. How long have you been on Synthroid? At what dosage? And I'm not being noisy, just wondering if the dosage is correct for your test results and body size (something I'm looking into myself) if you don't feel letting us know this last I understand. I also agree that a search for what Plaquenil is commonly used for is highly recommended. I would go to www.webmd.com to begin with and read everything, all of the various possible subject lines. Then do a google search or a yahoo search and READ...sigh, Hashi's is not the easiest thing to live with but it is do able. Nor is a Hive situation for that matter. If it was me I'd do as much research on this drug and then meet with the Doctor and ask him for his reasons for wanting to use this drug. What are his reasonings for its use in your situation. I would also look into other possible causes of the hives i.e.: a new animal in the family. a new laundry detergent or fabric softener a new antiperspirant a new cologne or aftershave or perfume on anyone in the family any new food items or additives introduced any new furniture any new carpet any new sheets, blankets, comforters, down comforters new pet shampoo being used on family pet new pet food new boyfriend or girlfriend (this could include those associated via your brothers/sisters/mother/father. etc.. new work enviroment new job new car or new used car (I'm allergic to Armor All and break out from this commonly used product) change in diet??????? In otherwords, absolutely ANYTHING new at about the same time that the Hives showed up??? (usually hives start to show up anywheres from instant contact to several weeks exposure) Hope this helps, if only just a little bit. Gossimer Oh, almost forgot: WELCOME to the group!!! > Hi, My name is Peggy and I am new to the group. I have recently > started Synthroid for Hashamotos. I have had hives since September. > The Synthroid seems like it is helping but I havent been on it for > long. My doctor wants to start me on Plaqueinl now to stop the > progression of the disease. Has any one else been on this > medication?? How does it affect you. > > Thanks > Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 20, 2004 Report Share Posted April 20, 2004 Does this med have to do with your cholesterol levels? If it does, the reason why your cholesterols are up is because you are hypothyroid. If your diet is right, this problem should resolve, unless you have some sort of genetic issue. This is notoriously a hypo problem. Why does your doctor not know this? My opinion is that, if we can stay off of cholesterol changing meds, and do it with the thyroid hormone and diet changes, it is safer, as long as the cholesterol isn't ridiculously high and needs to come down immediately. What are your lab results, with normal lab reference ranges? How high are your thyroid antibodies? Do you take vitamin supplements, namely vitamin a, c, e, selenium, and particularly the b vitamins. B5, B6, folic acid, and B12 are some of the most important b's for the thyroid, along with biotin. Tx Plaqueinl > Hi, My name is Peggy and I am new to the group. I have recently > started Synthroid for Hashamotos. I have had hives since September. > The Synthroid seems like it is helping but I havent been on it for > long. My doctor wants to start me on Plaqueinl now to stop the > progression of the disease. Has any one else been on this > medication?? How does it affect you. > > Thanks > Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 Hi , Actually this is an antimalaria medication. I strangely have very few symptoms of hypothyroid. The only ones I can think of is I don’t sweat a lot and have some trouble sleeping. I think the trouble sleeping has to do with the AF. I am so afraid I will get it, because I always get it either at night when I go to sleep or I wake up with it. My cholesterol last time I had it checked was 160. I think this is more of an autoimmune thyroid disease. Where my antibodies are on high alert and are destroying my thyroid. At least that is how Hashimotos is described. The Plaquenil, I think slows down the immune system. I always thought it was good to have a good immune system. I am never sick except for the AF and hives. My last TSH though was 9.8 and my thyroid antibodies which are suppose to be under 5 are 398. I don’t really get the whole thing myself, but I am trying to figure it out. I am just afraid to start any new medication. One of the adverse side effects of Plaquenil is irregular heart beat. Thanks Peggy Does this med have to do with your cholesterol levels? If it does, the reason why your cholesterols are up is because you are hypothyroid. If your diet is right, this problem should resolve, unless you have some sort of genetic issue. This is notoriously a hypo problem. Why does your doctor not know this? My opinion is that, if we can stay off of cholesterol changing meds, and do it with the thyroid hormone and diet changes, it is safer, as long as the cholesterol isn't ridiculously high and needs to come down immediately. What are your lab results, with normal lab reference ranges? How high are your thyroid antibodies? Do you take vitamin supplements, namely vitamin a, c, e, selenium, and particularly the b vitamins. B5, B6, folic acid, and B12 are some of the most important b's for the thyroid, along with biotin. Tx Plaqueinl > Hi, My name is Peggy and I am new to the group. I have recently > started Synthroid for Hashamotos. I have had hives since September. > The Synthroid seems like it is helping but I havent been on it for > long. My doctor wants to start me on Plaqueinl now to stop the > progression of the disease. Has any one else been on this > medication?? How does it affect you. > > Thanks > Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 Peggy, did your doctor say that he thought that you have lupus? I am not aware of an antimalarial being used to treat the antibodies of Hashimoto's. However, I do know that antimalarials are used to treat SLE (Systemic Lupus). Has your doctor made statements to you concerning his/her belief that the "hives" that you have may be the rash of lupus? I will do some digging around again, but in all my readings about Hashimoto's (which I also have), I have never seen where a doctor treated with this protocol. I have read over and over though, that antimalarials are used for lupus sometimes, as a last resort. Who is your doctor? How much discussion have you had with your doctor about what he believes are your different diagnoses? Sorry about the misinfo about it being a cholesterol med. The name seemed to imply that. I am not familiar with the names of antimalarials, only that they exist. Tx RE: Plaqueinl Hi , Actually this is an antimalaria medication. I strangely have very few symptoms of hypothyroid. The only ones I can think of is I don’t sweat a lot and have some trouble sleeping. I think the trouble sleeping has to do with the AF. I am so afraid I will get it, because I always get it either at night when I go to sleep or I wake up with it. My cholesterol last time I had it checked was 160. I think this is more of an autoimmune thyroid disease. Where my antibodies are on high alert and are destroying my thyroid. At least that is how Hashimotos is described. The Plaquenil, I think slows down the immune system. I always thought it was good to have a good immune system. I am never sick except for the AF and hives. My last TSH though was 9.8 and my thyroid antibodies which are suppose to be under 5 are 398. I don’t really get the whole thing myself, but I am trying to figure it out. I am just afraid to start any new medication. One of the adverse side effects of Plaquenil is irregular heart beat. Thanks Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 what kind of DR is putting you on antimalaria meds for Hashi? Plaqueinl> Hi, My name is Peggy and I am new to the group. I have recently> started Synthroid for Hashamotos. I have had hives since September.> The Synthroid seems like it is helping but I havent been on it for> long. My doctor wants to start me on Plaqueinl now to stop the> progression of the disease. Has any one else been on this> medication?? How does it affect you.>> Thanks> Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 Hi , I had several blood tests an all were neg for Lupus, but positive for Hashimotos. I have had a very bad rash for 9 months now on my arms and legs and my skin looks a little purple. I also have a rash on my face. It seems a little better now that I started on thyroid meds. The Doctor said that Hashimotos is Lupus like and that the Plaquenil sometimes helps in stopping it to progress to another auto immune disease. I did do some research last night on the internet and found it is given for this purpose to slow the progression of auto immune disease. I see a rheumatologist for this. I also have atrial fibrillation sometimes. This is a fast irregular heartbeat. I have been hospitalized 3 times for this. I am afraid to take the plaquenil because it lists one of the adverse side effects as an irregular heart beat. Thanks Peggy Peggy, did your doctor say that he thought that you have lupus? I am not aware of an antimalarial being used to treat the antibodies of Hashimoto's. However, I do know that antimalarials are used to treat SLE (Systemic Lupus). Has your doctor made statements to you concerning his/her belief that the " hives " that you have may be the rash of lupus? I will do some digging around again, but in all my readings about Hashimoto's (which I also have), I have never seen where a doctor treated with this protocol. I have read over and over though, that antimalarials are used for lupus sometimes, as a last resort. Who is your doctor? How much discussion have you had with your doctor about what he believes are your different diagnoses? Sorry about the misinfo about it being a cholesterol med. The name seemed to imply that. I am not familiar with the names of antimalarials, only that they exist. Tx RE: Plaqueinl Hi , Actually this is an antimalaria medication. I strangely have very few symptoms of hypothyroid. The only ones I can think of is I don’t sweat a lot and have some trouble sleeping. I think the trouble sleeping has to do with the AF. I am so afraid I will get it, because I always get it either at night when I go to sleep or I wake up with it. My cholesterol last time I had it checked was 160. I think this is more of an autoimmune thyroid disease. Where my antibodies are on high alert and are destroying my thyroid. At least that is how Hashimotos is described. The Plaquenil, I think slows down the immune system. I always thought it was good to have a good immune system. I am never sick except for the AF and hives. My last TSH though was 9.8 and my thyroid antibodies which are suppose to be under 5 are 398. I don’t really get the whole thing myself, but I am trying to figure it out. I am just afraid to start any new medication. One of the adverse side effects of Plaquenil is irregular heart beat. Thanks Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 A Rheumatologist Re: Plaqueinl what kind of DR is putting you on antimalaria meds for Hashi? Plaqueinl > Hi, My name is Peggy and I am new to the group. I have recently > started Synthroid for Hashamotos. I have had hives since September. > The Synthroid seems like it is helping but I havent been on it for > long. My doctor wants to start me on Plaqueinl now to stop the > progression of the disease. Has any one else been on this > medication?? How does it affect you. > > Thanks > Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 do you know why the rapid heartbeat? I had the same thing and it turned about to be very low ferritin and transferrin. RE: Plaqueinl Hi , Actually this is an antimalaria medication. I strangely have very few symptoms of hypothyroid. The only ones I can think of is I don’t sweat a lot and have some trouble sleeping. I think the trouble sleeping has to do with the AF. I am so afraid I will get it, because I always get it either at night when I go to sleep or I wake up with it. My cholesterol last time I had it checked was 160. I think this is more of an autoimmune thyroid disease. Where my antibodies are on high alert and are destroying my thyroid. At least that is how Hashimotos is described. The Plaquenil, I think slows down the immune system. I always thought it was good to have a good immune system. I am never sick except for the AF and hives. My last TSH though was 9.8 and my thyroid antibodies which are suppose to be under 5 are 398. I don’t really get the whole thing myself, but I am trying to figure it out. I am just afraid to start any new medication. One of the adverse side effects of Plaquenil is irregular heart beat. Thanks Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 I have a comment.... Why would you take something to slow the progression of something that is inevitable... when you could take the hormone that is missing... to stop all the negative effects from progressing.. then reverse the process completely and get the body to working normally again? Am I just being really slow today or does this not make sense? Topper () *scratching head and wondering if I'm looking at it wrong* On Wed, 21 Apr 2004 09:49:30 -0400 "Peggy Danley" writes: Hi , I had several blood tests an all were neg for Lupus, but positive for Hashimotos. I have had a very bad rash for 9 months now on my arms and legs and my skin looks a little purple. I also have a rash on my face. It seems a little better now that I started on thyroid meds. The Doctor said that Hashimotos is Lupus like and that the Plaquenil sometimes helps in stopping it to progress to another auto immune disease. I did do some research last night on the internet and found it is given for this purpose to slow the progression of auto immune disease. I see a rheumatologist for this. I also have atrial fibrillation sometimes. This is a fast irregular heartbeat. I have been hospitalized 3 times for this. I am afraid to take the plaquenil because it lists one of the adverse side effects as an irregular heart beat. Thanks Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 Hi, A rapid hear beat is different from atrial fibrillation. Rapid is a tachyacardia. Sometimes to much thyroid medication might give you a rapid heart beat, you should tell your doctor if you have that. What I have is very irregular and is about 120-140 bpm, for sometimes between 2 and 10 hours. Is feritin Iron?? Peggy do you know why the rapid heartbeat? I had the same thing and it turned about to be very low ferritin and transferrin. RE: Plaqueinl Hi , Actually this is an antimalaria medication. I strangely have very few symptoms of hypothyroid. The only ones I can think of is I don’t sweat a lot and have some trouble sleeping. I think the trouble sleeping has to do with the AF. I am so afraid I will get it, because I always get it either at night when I go to sleep or I wake up with it. My cholesterol last time I had it checked was 160. I think this is more of an autoimmune thyroid disease. Where my antibodies are on high alert and are destroying my thyroid. At least that is how Hashimotos is described. The Plaquenil, I think slows down the immune system. I always thought it was good to have a good immune system. I am never sick except for the AF and hives. My last TSH though was 9.8 and my thyroid antibodies which are suppose to be under 5 are 398. I don’t really get the whole thing myself, but I am trying to figure it out. I am just afraid to start any new medication. One of the adverse side effects of Plaquenil is irregular heart beat. Thanks Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 Many DR's knew I had that and ignored it. Ferritin is the storage level of iron in your body. I see the asst professor of a med school as my DR now. Here is his web site. Some of the articles may interest you. www.goodhormonehealth.com RE: Plaqueinl Hi , Actually this is an antimalaria medication. I strangely have very few symptoms of hypothyroid. The only ones I can think of is I don’t sweat a lot and have some trouble sleeping. I think the trouble sleeping has to do with the AF. I am so afraid I will get it, because I always get it either at night when I go to sleep or I wake up with it. My cholesterol last time I had it checked was 160. I think this is more of an autoimmune thyroid disease. Where my antibodies are on high alert and are destroying my thyroid. At least that is how Hashimotos is described. The Plaquenil, I think slows down the immune system. I always thought it was good to have a good immune system. I am never sick except for the AF and hives. My last TSH though was 9.8 and my thyroid antibodies which are suppose to be under 5 are 398. I don’t really get the whole thing myself, but I am trying to figure it out. I am just afraid to start any new medication. One of the adverse side effects of Plaquenil is irregular heart beat. Thanks Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 Yes, and it also has the possibility of eye problems. I went to approximately a dozen different sites today, looking for the answer to this riddle of why he gave this for Hashi's, and every single search turns up for antibodies of Lupus only. I can't find one thing with this type of drug treatment for the antibodies of Hashi's. We're talking about different antibodies here, with a whole different treatment protocol. Also, one thing that you don't need now is anything that has the possibility of affecting your red blood cell function (with Hashi's). May I ask specifically what tests that he did for Lupus? The ANA may be negative in so many cases, but there are two more antibody test which are for Lupus, and one of them is very specific for it. The rash being on your face and arms sounds so suspicious to me. Tx RE: Plaqueinl Hi , I had several blood tests an all were neg for Lupus, but positive for Hashimotos. I have had a very bad rash for 9 months now on my arms and legs and my skin looks a little purple. I also have a rash on my face. It seems a little better now that I started on thyroid meds. The Doctor said that Hashimotos is Lupus like and that the Plaquenil sometimes helps in stopping it to progress to another auto immune disease. I did do some research last night on the internet and found it is given for this purpose to slow the progression of auto immune disease. I see a rheumatologist for this. I also have atrial fibrillation sometimes. This is a fast irregular heartbeat. I have been hospitalized 3 times for this. I am afraid to take the plaquenil because it lists one of the adverse side effects as an irregular heart beat. Thanks Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 I'm gonna say, out-right, that this doctor knows nothing about autoimmune thyroid disease. Tx Re: Plaqueinl I have a comment.... Why would you take something to slow the progression of something that is inevitable... when you could take the hormone that is missing... to stop all the negative effects from progressing.. then reverse the process completely and get the body to working normally again? Am I just being really slow today or does this not make sense? Topper () *scratching head and wondering if I'm looking at it wrong* Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 Ferritin levels show how much iron you have in storage, available. Serum iron does not indicate what you have in storage. Do you have PAT (heart)? Tx RE: Plaqueinl Hi, A rapid hear beat is different from atrial fibrillation. Rapid is a tachyacardia. Sometimes to much thyroid medication might give you a rapid heart beat, you should tell your doctor if you have that. What I have is very irregular and is about 120-140 bpm, for sometimes between 2 and 10 hours. Is feritin Iron?? Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 Sounds like this is right up your alley ... I'm glad that you're here to help! I know squat about Lupus and antibodies.... Topper () On Wed, 21 Apr 2004 11:04:41 -0500 " " writes: I'm gonna say, out-right, that this doctor knows nothing about autoimmune thyroid disease. Tx Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 Oh. I don’t think I have had a Ferritin level, but my hemoglobin and hematacrit are above normal. I am not sure what you mean by PAT (Premature Atrial tachyacardia??). If that is it no I don’t have it. Peggy Re: Plaqueinl Ferritin levels show how much iron you have in storage, available. Serum iron does not indicate what you have in storage. Do you have PAT (heart)? Tx RE: Plaqueinl Hi, A rapid hear beat is different from atrial fibrillation. Rapid is a tachyacardia. Sometimes to much thyroid medication might give you a rapid heart beat, you should tell your doctor if you have that. What I have is very irregular and is about 120-140 bpm, for sometimes between 2 and 10 hours. Is feritin Iron?? Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 21, 2004 Report Share Posted April 21, 2004 Hi , I don’t know what all this means, but here are my test results. I highlighted in red the only tests that were off. I had a few others but they were routine Glucose WBC, RBC and they were all normal. ANA Negative (normal is <1.5) mine was 0.2 TSH 9.32 Antimicromosomal AB (Normal is <5.0) mine was 358.5 T- Uptake T-3 (normal 25-35) mine was 26.9 Free Thyroxine (normal 1.1 to 4.2) mine was 2. Cardiolipin Antibody Negative T4 (normal 4.5 to 12.0) mine was 7.5 Thyroglobulin Antib Thyroglobulin A (normal is <10.0) mine was 46 Free T4- (normal is 0.9 to1.71) mine is 1.1 Total T4 (normal is 4.5 to 12.0) mine is 7.5 My thyroid tests look normal except for my antibodies and TSH. Go figure! Dilute RVTT- Normal Platelet Neutraliza – Normal This says no evidence of Lupus anticoagulant or other coagulation inhibitor Sjogrens Antibodie SSA and SSB –Negative B 12 Normal Circulating Anticoa -No circulating anticoagulant identified I had Serum IgG was Normal range IgA Normal IgM Normal Serum Kappa Normal Serum Lambda Normal MPA Kap/Lam Rat Normal Protein Electrophoresis – no M-protein band identified Immunofixation Electrophoresis – no abnormal bands Interpritation no evidence of Monoclonal gammapothy Serum Protein Elect Total protein - Normal Albumin SPE normal Alpha 1 SPE Normal Alpha 2 SPE Normal Beta Glob SPE Normal Gamma Glob SPE Normal Interpret SPE Normal electroporetic pattern Cryoglobulins Qual. Normal C Reactive protein Negative Rheumatoid Factor Negative ANA Negative (normal is <1.5) mine was 0.2 Antimicromosomal AB Normal is <5.0 mine was 358.5 Cardiolipin Antibody Negative Thyroglobulin Antib Thyroglobulin A normal is <10.0 mine was 46 Peggy Yes, and it also has the possibility of eye problems. I went to approximately a dozen different sites today, looking for the answer to this riddle of why he gave this for Hashi's, and every single search turns up for antibodies of Lupus only. I can't find one thing with this type of drug treatment for the antibodies of Hashi's. We're talking about different antibodies here, with a whole different treatment protocol. Also, one thing that you don't need now is anything that has the possibility of affecting your red blood cell function (with Hashi's). May I ask specifically what tests that he did for Lupus? The ANA may be negative in so many cases, but there are two more antibody test which are for Lupus, and one of them is very specific for it. The rash being on your face and arms sounds so suspicious to me. Tx RE: Plaqueinl Hi , I had several blood tests an all were neg for Lupus, but positive for Hashimotos. I have had a very bad rash for 9 months now on my arms and legs and my skin looks a little purple. I also have a rash on my face. It seems a little better now that I started on thyroid meds. The Doctor said that Hashimotos is Lupus like and that the Plaquenil sometimes helps in stopping it to progress to another auto immune disease. I did do some research last night on the internet and found it is given for this purpose to slow the progression of auto immune disease. I see a rheumatologist for this. I also have atrial fibrillation sometimes. This is a fast irregular heartbeat. I have been hospitalized 3 times for this. I am afraid to take the plaquenil because it lists one of the adverse side effects as an irregular heart beat. Thanks Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 2004 Report Share Posted April 22, 2004 There ya go. I can't immagine this treatment for Hashi's. Like you said, enough thyroid hormone would do the trick a whole lot better. Tx Re: Plaqueinl I called my DR about this. He said some people with arthritis and Lupus can do pretty well on this depending on the type of Lupus. He never heard of this for Hashi and said maybe the undertreated Hashi was making joints painful and that is what the med helped, but so would putting the patient on enough thyroid meds. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 2004 Report Share Posted April 22, 2004 With thyroid disease (or any other), you need to know your Ferritin, serum iron, and your transferritin (transports iron). Has your doctor said that there is anything unusual about your hemoglobin and hematocrit being high? How about the MCV and MCHC? Tx RE: Plaqueinl Oh. I don’t think I have had a Ferritin level, but my hemoglobin and hematacrit are above normal. I am not sure what you mean by PAT (Premature Atrial tachyacardia??). If that is it no I don’t have it. Peggy Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 2004 Report Share Posted April 22, 2004 It is obvious that you have Hashimoto's. As someone else said, the only reason i can think of that he might have given this drug is possibly for joint pain, but this is no treatment protocol for Hashi's and cannot stop the progression of antibody destruction to the thyroid. What you need is the proper treatment with thyroid hormone, in the right amount. Tx RE: Plaqueinl Hi , I don’t know what all this means, but here are my test results. I highlighted in red the only tests that were off. I had a few others but they were routine Glucose WBC, RBC and they were all normal. Quote Link to comment Share on other sites More sharing options...
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