Vitamin E

Vitamin E is a popular over the counter vitamin supplement that has many uses. But just like any medication and supplement, there are a few things you should be aware of before supplementing.

Discovery of vitamin E

Vitamin E was discovered in 1922 by Bishop and Evans. However, it wasn’t until the 1940s when the use of vitamin E in the role of nutrition in premature infants was investigated. This led to examining intestinal absorption of vitamin E in premature infants to prevent intracranial hemorrhage, pulmonary oxygen toxicity, hemolysis and more. Since that time, the use of vitamin E in premature infants has helped save many lives.

There are eight different natural forms of vitamin E which can be subdivided into two separate groups: the tocopherols and the tocotrienols. Both are plant based and fat soluble and each of these have four separate analogues. Each analogue has a different potency and effect on health.

Tocopherols are the saturated form of vitamin E and contain the analogues alpha, beta, delta, and gamma. This form of vitamin E is the major source in the U.S. diet.

Food sources of tocopherols include oils derived from walnuts, hazelnuts, peanuts, sunflower oil.

Tocotrienols are the unsaturated form of vitamin E and contain same name but different types of analogues- alpha beta, delta and gamma.

Food sources of tocotrienols are palm and rice bran oil, wheat germ, barley, oats, grapefruit seed oil, and annatto oil.

Vitamin E

Synthetic vitamin E

Synthetic forms of vitamin E contain both tocopherol and tocotrienols and include the four analogs of each. However there is evidence to suggest that synthetic E isn’t  absorbed by the body as efficiently as natural forms.

How to tell if your vitamin E supplement is synthetic or natural

Most vitamin E supplements are derived from natural sources. The natural (D-α-tocopherol) contains the prefix “D”, the synthetic form (DL-α-tocopherol acetate) contains the prefix “DL”.

Vitamin E deficiency

Causes

Vitamin E deficiency is rare; however some causes are:

  • Some genetic disorders that can cause malabsorption of dietary fats
  • Cystic fibrosis patients have trouble absorbing the fat-soluble vitamins- ADEK
  • Malnutrition
  • Short-bowel syndrome patients
  • Surgical resection
  • Mesenteric vascular thrombosis
  • Crohn’s disease
  • exocrine pancreatic insufficiency
  • liver disease
  • Cigarette smoking depletes vitamin E

Symptoms vitamin E deficiency

  • Impaired balance and coordination
  • Muscle weakness
  • Retinopathy

Consult with your care provider before supplementing with vitamin E

Vitamin E toxicity

Vitamin E toxicity occurs by supplementation, not diet alone. Symptoms include excessive bleeding, nausea, vomiting and muscle weakness. If toxicity is suspected, discontinuation of vitamin E and administration of vitamin K may be initiated by your care provider.

Drug interactions and cautions when supplementing with Vitamin E

  • Vitamin E inhibits platelet aggregation and can disrupt vitamin K1 clotting. Use with caution when on anticoagulation and antiplatelet medications as there is the potential risk of bleeding when taken together.
  • Niacin: vitamin E supplementation can reduce effects of niacin

Medical conditions that may be contraindicated with vitamin E supplementation

  • History heart attack or stroke
  • Bleeding disorders
  • Diabetes
  • Vitamin K deficiency
  • Retinitis pigmentosa
  • Kidney disease
  • Anemia
  • Liver disease

- Brooke Lounsbury, RN

Medical Content Writer

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Vitamin D

Vitamin D is a steroid hormone, and sometimes called “activated vitamin D” or “calcitriol.” Steroid hormones are derived from cholesterol and are lipid-soluble molecules. Examples of steroid hormones include the sex hormones (androgens, estrogens, and progesterone) produced by male and female gonads and hormones of the adrenal glands (aldosterone, cortisol, and androgens). It is a fat-soluble vitamin that helps the body absorb and retain calcium and phosphorus. Both are necessary for building bone. Vitamin D also plays a role in bolstering the immune system to fight off viruses and bacteria. In addition, research suggests that vitamin D could play a role in downregulating autoimmune disease. In addition a randomized 5 year clinic trial of high vitamin D supplementation reduced the incidence of advanced cancer without a diagnosis of cancer at the beginning of the study. Much interest and research is ongoing in this promising field of study.

Vitamin D is found in two main forms:

Vitamin D2 (ergocalciferol) – The main source is from plants. Mushrooms, when exposed to UV light produce D2. Fortified cereals are usually fortified with vitamin D2

 

Vitamin D3 (cholecalciferol) – The main source is from animals- Sources of D3 are egg yolks, cod liver oil, fatty fish-salmon, sardines, herring, tuna, beef liver. In addition, when skin is exposed to sunlight vitamin D3 is produced. The body only produces enough vitamin D3 from sunlight as it needs then stops producing it.

The liver metabolizes vitamin D2 and vitamin D3 and form the active compound known as calcifediol. A study done by the National Institute of Health on post-menopausal vitamin D deficient women showed that vitamin D3 yielded twice more calcifediol than an equal amount of vitamin D2.

Excess Vitamin D3 is stored in the bodies adipose tissue and liver and is converted by the kidneys to the active form of vitamin. Excess vitamin D is almost exclusively from supplement sources.

According the NIH:

The amount of vitamin D you need each day depends on your age. Average daily recommended amounts are listed below in micrograms (mcg) and International Units (IU):

Life Stage Recommended Amount
Birth to 12 months 10 mcg (400 IU)
Children 1–13 years 15 mcg (600 IU)
Teens 14–18 years 15 mcg (600 IU)
Adults 19–70 years 15 mcg (600 IU)
Adults 71 years and older 20 mcg (800 IU)
Pregnant and breastfeeding teens and women

15 mcg (600 IU)

 

The 25-hydroxy vitamin D test (a blood test) is the most accurate way to measure how much vitamin D is in your body.

Factors affecting vitamin D deficiency

  • Older adults skin doesn’t absorb vitamin D as well as younger population. Dark skin also doesn’t absorb vitamin D very well either
  • Some diseases- celiac, Crohn’s disease, ulcerative colitits, limit absorption of fats and vitamin D
  • Obesity and gastric bypass may need more vitamin D

Signs of vitamin D deficiency- up to 42 percent of the US population is deficient

  • Rickets in children
  • Osteomalacia in adults
  • Not sleeping well.
  • Bone pain or achiness.
  • Depression or feelings of sadness.
  • Hair loss.
  • Muscle weakness.
  • Lowered immunity to infections-viral and bacterial

Signs of vitamin D toxicity

Vitamin D toxicity is not common, except when extremely high doses of vitamin D is taken in supplement form for a long time (months).

  • Hypercalcemia
  • Nausea, vomiting
  • Can progress to bone pain and kidney stones

How to Improve Your Vitamin D Status

In addition to adequate sunlight exposure, vitamin D requires other nutrients and minerals to work properly. It is always best to get your nutrition from food sources, however long winters and low sunlight may require supplementation. If supplementing with vitamin D, it is best to take with fat since it is a fat-soluble vitamin.

Vitamin K2(MK-7)- activates osteocalcin, which integrates calcium into the bone. Activates matrix GLA protein (MGP) to bind excess calcium and promote arterial flow and flexibility. Food sources include fermented foods, natto

Magnesium- helps convert vitamin D to active form. Food sources include leafy greens, beans, legumes, almonds, cashews

Zinc– synergistic effect- vitamin D enhances zinc action and homeostasis and zinc enhances vitamin D absorption. Food sources include oysers, red meat, poultry

Boron– increases vitamin D in the blood. Food sources include coffee, milk, apples, dried and cooked beans, and potatoes

Cold water fish– salmon, herring, sardines, tuna

- Brooke Lounsbury, RN

Medical Content Writer

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The Advantage of Telehealth During Bad Weather

The massive influx of historic, record-breaking weather that has swept the country has left many communities reeling. Power outages, impassable or treacherous road conditions illuminates how fragile our society is when infrastructure breaks down. Hopefully you have your basic over the counter medicines well stocked along with prescription medicines. You had topped off your preps, food, extra water, and a small indoor safe heater with fuel  in case of power failure.

If you haven’t considered or don’t have a generator check out the Jackery portable power station.. It has USB plug ins to keep cellphones recharged and can take care of basic electrical needs, such as keeping a min fridge cold, running small appliances and even your laptop. You can recharge it via AC outlet, solar panel or car outlet. This could prove invaluable during a power outage, by keeping your phone recharged to monitor weather, check in with family members and neighbors, and if needed, to contact your care provider in case of minor emergency or illness.

Medical preparedness

During inclement weather, you may not have access to in person, non-emergent health care. Power lines or trees may be downed and block the road, snow and ice storms can make a trip to the urgent care or clinic outright dangerous or impassable. Even Southern California experienced blizzard conditions and Portland, Oregon set a record for the second most snowfall to date.  In Oklahoma, tornados have left scores of communities homeless, many injured and without vital infrastructure needed to maintain adequate living conditions. During times such as these EMS workers are spread thin due to wrecks and other health emergencies, road crews can’t keep up with the massive amounts of snowfall and other road hazards. Staying home can be the safest and most prudent thing to do until after the storm passes and infrastructure is restored.

By now you should have medicines that you use on a regular basis, a well-stocked first aid kit and a Jase case (which covers a broad variety of infections) specifically for every member of your family.

Telehealth can help bridge the gap

Sometimes it only takes a phone call to the doctor’s office to answer a question or seek guidance for you or your loved one’s illness or injury. Other times a clinic visit would be preferable, however may not be immediately possible. Telehealth is an effective option for scenarios like this. For example, if your child had been exposed to strep throat while at school and has developed a sore throat while at home for snow days, a virtual visit via telehealth can determine if an antibiotic is needed. A virtual visit can keep you and your child safe, warm and not exposed to the elements.

Telehealth isn’t ideal for every injury or illness, however, if you are stuck at home with no availability to pharmacy or medical care, it is a valuable tool that has proven to be highly successful in diagnosing and resolving minor emergencies and illnesses.

Some common telehealth visits include:

  • Coughs
  • Colds and influenza symptoms
  • Earaches
  • Stomach aches
  • Diarrhea or constipation
  • Nausea and vomiting
  • Skin rashes
  • Sore throats
  • Conjunctivitis
  • Sprains or strains
  • Urinary tract symptoms (until you can get to the clinic for an urinalysis)
  • Food poisoning

Non emergent visits can  include chronic illness visits, prescription refills, weight checks, blood pressure checks and review labs.

How to access telehealth

While telehealth can be a valuable tool to access healthcare, nothing replaces the in person visit to your healthcare provider. Telehealth should be viewed as another valuable tool in your preparedness toolkit when healthcare isn’t accessible.

An increasing number of insurances are allowing telehealth visits. Even Medicare pays for telehealth visits. Check with your insurance company for a list of providers that offer telehealth as an option to in person visits.

Most all regions across the United States offer telehealth services as an alternative to in person visits. Check with your local health systems services, your care provider or health department.

- Brooke Lounsbury, RN

Medical Content Writer

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Vitamin K1 and K2, They Are the Same, Right?

There is confusion surrounding vitamin K. We know vitamin K as the clotting vitamin, found in large amounts in leafy green vegetables. When someone is on blood thinners they are usually cautioned about their intake of greens and how it can interfere with the effectiveness of the medication. But did you know there is a vitamin K1 and K2?

There are two forms of vitamin K, K1 and K2

Vitamin K is the generic name for a family of similar compounds that are fat soluble, are found in food and are also found in supplement form. These compounds include phylloquinone (vitamin K1) and a series of menaquinones also known as MKs (vitamin K2). Vitamin K2 can be divided into subtypes: short-chain (i.e., menaquinone-4; MK-4- most bioavailable) and long-chain (MK-7, MK-8, and MK-9)

Vitamin K1 is found in spinach, cabbage, and kale. K1 can also be found in fruits like avocado, kiwi and grapes. Absorption of K1 is increased when eaten with fat, such as butter or oils.

Vitamin k2 is found in fermented food (sauerkraut and vegetables), meat, and dairy. Other sources of K2 are chicken meat, egg yolks, beef and salmon. K2 is synthesized by bacteria, and a small amount is produced by the bacteria in the gut. Absorption is also increased when eaten with fats such as butter or oils.

Vitamin K1 is retained in the liver, where it assists with and works with other compounds to manufacture the body’s clotting factors. In contrast, vitamin K2, particularly long chain derivatives, are redistributed to the circulation and are available for other tissues, such as bone and vascular system.

Health benefits of both vitamin K1 and K2

Both vitamin K1 and K2 are vital to health. They work in drastically different ways and on different parts of the body. About 10-15% of vitamin K1 is absorbed by the body compared to 50% of vitamin K2. The Standard American Diet (SAD) intake of vitamin K1 is higher than K2.

Vitamin k1 health benefits

  • Assists with bleeding and bruising regulation in the body
  • Acts as an anti-inflammatory and protects against oxidative stress
  • Is a cofactor to make prothrombin ( clotting factors)
  • Precursor to K2
  • Bone health

Vitamin K2 health benefits

Factors that prevent absorption of vitamin K absorption

  • Health problems that can prevent your body from absorbing vitamin K, such as gallbladder or biliary disease, cystic fibrosis, celiac disease, and Crohn’s disease
  • Liver disease
  • Taking blood thinners, such as warfarin (Coumadin)
  • Long-term hemodialysis
  • Serious burns
  • Consumption of trans fats (k2 absorption)
  • Broad spectrum antibiotic use (k2 absorption)
  • Dilantin
  • Fat blocking medications such as Orlistat

- Brooke Lounsbury, RN

Medical Content Writer

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Seasonal Allergy Relief

As we emerge from the depths of winter and attention turns to the longer days that spring presents- more time outdoors, sports, gardening, outings to lakes and local parks can fill our leisure time.

Sunny days beckon us to spending more time outside, however many suffer from seasonal allergies. Seasonal allergies can make life perfectly miserable. Stuffy nose, swollen and teary eyes, clogged ears, sinus drainage, sneezing and cough add up to some allergy sufferers avoiding the benefits of being outdoors. In fact, seasonal allergies affect 19,2 million adults and 4.2 million children in the U.S.

What are seasonal allergies. And when ae they the most prevalent?

Seasonal allergies are also known as “hay fever” or seasonal allergic rhinitis. The immune system kicks into overdrive and overreacts to pollen or other substances. Symptoms happen during certain times of the year, when trees, grasses, and flowering plants  release tiny pollen particles into the air to fertilize other plants.

Spring allergies begin in February and last until the early summer. However, seasonal allergies can happen anytime, depending on where you live and what your body overreacts to.

What are common seasonal allergy symptoms?

  • Congestion
  • Sneezing
  • Itchy eyes, nose and throat
  • Runny nose and eyes
  • Puffy, swollen eyes
  • Postnasal drip (drainage in the throat)
  • Excessive sleepiness
  • Coughing
  • Brain fog

Some common seasonal allergens and when do they occur?

  • Tree pollen—May, June, July
  • Grass pollen—Depending on where you live – March through July
  • Ragweed- sage, mugwort, rabbit brush, etc- end of August through October
  • Mold—mostly in the fall, or in moist, warm environments and climates

How to control seasonal allergies

Environmental

Reduce your exposure to allergy triggers

  • Stay indoors on windy days during pollen season.
  • If the air in your home is humid, run a dehumidifier.
  • Remove clothes you’ve worn outside and shower to rinse pollen from your skin and hair. This is especially important after mowing lawn or working in the garden
  • Pollen can stick to sheets and towels, dry clothes inside.
  • Wear a face mask when outside.
  • Every city and area of the country has a pollen forecast. It can usually be found on weather apps on phone. In addition, your local tv or radio station may have pollen forecasts.
  • Keep doors and windows closed when pollen counts are high
  • Avoid outdoor activity in the early morning when pollen counts are highest.
  • Keep indoor air clean- portable Hepa filter devices can clear a room of allergens. These are very useful in the bedroom. Keep the unit on, even when not in the room to help keep air clean.
  • Use air conditioner in home, change filters on a regular basis
  • Damp mop all hard floor surfaces, thoroughly vacuum carpet with a vacuum equipped with a HEPA filter

Nonprescription medications that may help

Check with your care provider before using any over the counter or alternative treatments for allergy relief. Some over the counter medicines shouldn’t be used with high blood pressure patients, and there are interactions with any drug, over the counter or not.

Oral decongestants. Oral decongestants such as pseudoephedrine (Sudafed) can provide temporary relief from nasal stuffiness. Some allergy medications combine an antihistamine with a decongestant. Examples include cetirizine-pseudoephedrine (Zyrtec-D 12 Hour), fexofenadine-pseudoephedrine (Allegra-D 12 Hour Allergy and Congestion) and loratadine-pseudoephedrine (Claritin-D). Talk to your health care provider about whether the use of a decongestant is good for treating your allergy symptoms.

Oral antihistamines

Some oral antihistamines list sleepiness as a side effect (diphenhydramine and Chlorpheniramine for example. Be sure to read labels and precautions.

Antihistamines can help relieve sneezing, itching, a stuffy or runny nose, and watery eyes. Examples of oral antihistamines include loratadine (Claritin, Alavert).cetirizine (Zyrtec Allergy), Diphenhydramine (Benadryl) fexofenadine (Allegra Allergy) Chlorpheniramine (Chlor-Trimeton)

Corticosteroid nasal sprays. These medications improve nasal symptoms. Examples include and triamcinolone (Nasacort Allergy 24 Hour). fluticasone propionate (Flonase Allergy Relief), budesonide (Rhinocort Allergy) and triamcinolone (Nasacort Allergy 24 Hour. These are not recommended for long term use without medical supervision.

Cromolyn sodium nasal spray (Nasachrom). decreases inflammation in the nose and reduces substances in the body that release that cause allergy symptoms.

Try some home relief remedies

Neti pot

Neti pots can rinse sinuses out, clearing allergens in nasal cavity. They have a proven track record to relieve allergy symptoms. Use saline solutions from ready made pouches or if you use water, only use distilled /sterile water.  Do not use tap water, there have been rare cases of infections from bacteria or protozoa in tap water. It may be safe to drink because stomach acid will kill pathogenic bacteria, however sinuses don’t have that protection. Be sure to thoroughly clean and air dry neti pot after use.

Raw honey, royal honey, propolis

Raw honey has been proven to relieve seasonal allergy symptoms. Start honey before allergy season before allergy season starts. Do not use in children under a year old.

Natural antihistamines are found in:

  • Stinging nettle,
  • Butterbur, a marsh plant
  • Quercetin, found in citrus fruits, grapes, apples and onions along with other fruits and vegetables
  • Bromelain, found in pineapples

Probiotics

Probiotics have been studied and have shown to relieve allergy symptoms. L Casei is a probiotic demonstrated to relieve allergy symptoms, It is found in kefir, a cultured milk product and in a lesser extent yogurts(check labels). There are other probiotics that have been researched and have positive results, however there have been mixed results.

When home remedies aren’t enough, Seek help from your healthcare provider.

If you have bad seasonal allergies, speak with your health care provider if your seasonal allergies aren’t relieved by the above methods or your symptoms are bad. They may recommend skin tests or blood tests to find out what allergens trigger your symptoms. This will enable your care provider to target which treatments are likely to work best for you.

- Brooke Lounsbury, RN

Medical Content Writer

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Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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“Normal” Won’t be Returning Anytime Soon

5 Steps to Help You Navigate These Challenging Times

You are not alone. We are all feeling tensions both globally and at home. We are on the precipice of World War 3, out of control energy and food prices, still reeling from the pandemic, layoffs, consumer debt hitting record highs, severe weather extremes, supply chains disrupted leading to drug and medical supply shortages- these are affecting all our lives. No one is immune to this assault.

To overcome and eventually prosper in this ever changing landscape, we must be solution oriented. Difficult times are here, and it doesn’t look like our “normal” will be returning anytime soon. Our families, communities and our very lives depend on how we face the challenges we are experiencing and will be experiencing over the coming months and years.

Below are 5 steps to guide you through these rocky times. 

  1. Focus on solutions
  • “We become what we think about” Earl Nightingale
  • “When you focus on problems, you get more problems. When you focus on possibilities, you have more opportunities.” Zig Ziglar
  • “Good health is true wealth.” – Urijah Faber “

What challenges are you and your family facing right now? Financial? Health related? Whatever the challenge is there is a solution. We need to acknowledge our problems, shortcomings and unexpected turns our lives take. Absorb and realize the impact these have in our daily living. However it isn’t healthy for you or anyone around us to dwell too long in this. Focus on possibilities. This will lead to opportunities.

2. Plan success = Reduce stress

Solutions start with a realistic plan 

Take time out, away from the noise of media, work, and technology each week. Set priorities to work on during the week. Start each day reviewing this list, set aside time for tasks that take precedent over others. Review your plan and goals. Make sure they are realistic and allow enough time to implement them. What can you do NOW that can make your day run smoother and more efficiently? Prioritize your days tasks; work towards accomplishing them. Move undone tasks to the next day. And so on.

Download our Goal Setting PDF to help you make and track your goals!

Finances-a major stressor

The out-of-control gas, energy and food prices have caught many off guard. You are not alone.

Financial Stress Has a Surprising Link to People’s Health, Relationships, Sleep, and More according to a white paper by Thriving Wallet, Discover and Thrive Global. Their survey included 3,000 adults. 90 percent stated that finances played a major part in wellbeing and stress levels. 

U.S. credit card debt jumps 18.5% and hits a record $930.6 billion 

If you are experiencing financial struggles, there are agencies that can help you budget and plan your finances. Consumer Review lists the top 7 financial consolidation companies. They work with you to consolidate and work with companies you owe money to. Some offer financial coaching and budget planning and clasess on financial education.  

Health

If you are having difficulty affording your prescription drugs, paying for insurance and copays, office visits, etc check with your local care provider and county health and welfare offices for any programs you may qualify for. 

Physical health-If you are out of shape, work on an exercise and diet program with your healthcare provider. Many chronic health conditions respond positively to lifestyle and food choices. Reduce or eliminate alcohol. Alcohol has empty calories and is a depressant.  In some cases, lifestyle changes can reduce or eliminate the need for prescription drugs. 

 Check out online exercise classes- You Tube has many classes geared for beginner to advanced levels. These are free, easily accessed and can be done around your schedule. Plan meals. Restaurant food is convenient but expensive and in many cases not as good tasting or nutritious as a home cooked meal. Make a meal plan and grocery list and don’t shop when hungry. 

Emotional health– If you are experiencing anxiety, are depressed, or feeling stressed talk your healthcare provider. Find meaningful work, volunteer, or take up a hobby. Plan a coffee date with a friend. We are wired for connection. Deep breathing exercises along with mediation or prayer can have profound effects on our health. 

Be prepared for minor emergencies

Urgent care visits may or may not be entirely covered by your health insurance. Depending on deductible you may have to pay out of pocket for the visit. As of this writing, the cost of an urgent care visit, without tests or treatments is a minimum of 75 dollars. Having basic knowledge and supplies for minor emergencies can reduce cost, exposure to diseases, travel time and cost(gas). Enroll in a basic first aid and cpr class if you aren’t medically trained. Keep an updated list of medications, medical conditions and allergies for all members of the family readily available. Look into telehealth visits for minor emergencies. Keep your medical supply kit stocked. In addition, a Jase case , contains antibiotics that cover a wide variety of infections, along with a consultation with a doctor if you have questions. This alone can keep you or your loved one out of the doctor’s office and on the road to recovery.

3. Implement plan- the most important step

A well thought out plan will free up time in your day to reach your goals. Taking charge of your finances will reduce stress and free up cash for necessities. Health is wealth, don’t neglect your health! Carve out time each day to put your plan in place. Stick to the plan, revise as necessary. The most important part is consistency.

4. Assess plan-weekly

Set aside time for assessing your plan. Did you reach your goals? If not, why? What barriers did you encounter? What went well? Were you able to free up time in your day for exercise or hobby? Assess your plan at least once a week will help you tweak and improve your plan and reach your goals.

5. Adjust and revise as necessary- or the only thing consistent in life is change

Plans are not meant to be set in stone. What worked well one day or week may not work at all for the following week. Schedules change- planned and unplanned events and life-come and go. If you get off track, jump back in. You will reach your goals!

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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(5 tips to build resilience) Every day that we turn on the news we are hit with something new that could not only destabilize countries across the seas, but can  have serious implications  for our lives in the states. World War 3 is trying to kick off (Some people...

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