Hepatitis C Community
High Uric Acid Levels
About This Community:

This forum is for questions about medical issues and research aspects of Hepatitis C such as, questions about being newly diagnosed, questions about current treatments, information and participation in discussions about research studies and clinical trials related to Hepatitis. If you would like to communicate with other people who have been touched by Hepatitis, please visit our new Hepatitis Social/Living with Hepatitis forum

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

High Uric Acid Levels

I've had High uric acid Levels before Tx and while Txing...  I'm having problems with my back it might be Kidney stones.. I'm going to get an Ultrasound to make sure... Is the high uric acid level the cause of my back pain??
How can i lower these levels?? The pain is in the right side kidney area... If it is kidney stones what do i do?? The study nurse might tell me to stop Tx... and i dont want this to happen.. Please help!! thank you!!

TippyClubb funny you mention high uric acid levels!!!
Related Discussions
34 Comments Post a Comment
Blank
Avatar_f_tn
I mentioned it because my uric acid is high 8.5 and it started out in normal range.  Trial nurse is not worried because she said it can get into the 30's before they are concerned. I've been having some lower back pain ( kidney area ) also and they did a check for infection but it came out ok.  The pain comes and goes so not sure if this is normal for kidney stones.  

I stated to drink lots of Cranberry juice and that seemed to help, but not really sure.  I know one thing the Cran juice wont hurt you.

I'm going to keep an eye on the uric acid levels and if the pain persist get a ultra sound like you.  Keep us posted on what you find out.

I
Blank
Avatar_f_tn
I forgot to tell you few weeks ago I did a quick google search of lowering uric acid.   They said increase Vitamin C, which you would get in the cranberry juice.  Plus there are foods to eat, and foods to avoid.  Google it and try it and see if it helps any.  Only thing I am doing is the cranberry juice everyday. They also said to decrease sugar intake but the juice is loaded with sugar.  What to do ?  I'm just going to keep drinking it and see if my levels are lower next week.
Blank
Avatar_f_tn
You can buy cranberry juice with nothing else added. It's bitter and then some, but I somehow got used to it. Prepare to pucker those lips.
Blank
Avatar_f_tn
Ty --I have been looking for it
Blank
646318_tn?1261185094
I do drink alot of Grape Juice it has alot of vitamin C also.. I will try the cranberry juice.. I need to do something.. I will keep u posted..
Blank
Avatar_f_tn
Just a reminder that any fruit JUICE has a high natural sugar content and can spike your glucose level.
Blank
646318_tn?1261185094
your right thank you
Blank
446474_tn?1404424777
BB81

I have had at least 12 uric acid kidney stones and 2 operations for stones that were too large to pass so here is what I have learned.

There are many types of kidney stones. Most kidney stones are not uric acid stones.
If you have a kidney stone you need to make it pass. To do that the best thing to do is drink plenty of water. So much that you are not even thirsty and your sick of water. Keep a water bottle with you all the time a sip it from time to time. The other thing to do is to stay active. Walk around keep moving. That will get the stone to move.

Do you have a history in your family of kidney stones? It is common to have a history in the family.

When you say you have a problem with your back. What does it feel like? Does it come on in waves of pain? The pain can appear to come from different areas. Many people think they have back pain at first. The pain can also appear to be in the crotch area or the tip of your penis. Fun right? On a scale of 1 to 10 what is the level of pain? The classic answer is 15! The worst pain I have ever felt.

Remember many stones are difficult to find. Even with a KUB (Kidney, Ureter, Bladder x-ray) or ultra sound. The urologist will probably take a urine sample. Even though you can't see it, there may be blood in your urine, which is an indication of a  stone. The stones tend to cut the ureters when trying to come out. Uric acid stones look like crystals with very sharp edges that cut into the ureter when it tightens around it to push it along.

In summary, if you do have a uric acid stone(s) you need to increase the amount of water you drink and stay away from red meats (purine) and salt. There are some othre foods too. As these cause the uric acid stones to form. Also your doctor can give you Flomax which will help you to pass large stones if needed. The med expands your ureters thus making them wider so a stone can more easily pass through. In December I had a 6mm stone that I passed using Flomax. It was painful for 3-4 weeks as the stone worked its way out but it beats a $30k operation and having tubes and other fun plumbing devices put inside you. Ouch!

Don't worry you can be on HCV treatment and have kidney stones. They are totally separate and do not interact in any way except they both can be painful in different ways.

I hope you find out that you don't have kidney stones, but if you do some of this info may be helpful.

Most of all good luck with your HCV treatment!!!

Cheers.
Hectorsf

Blank
568322_tn?1370169040
"I've had High uric acid Levels before Tx and while Txing...  I'm having problems with my back it might be Kidney stones.. I'm going to get an Ultrasound to make sure... "
----------------------

I told you that you needed to get checked for insulin resistance.  High uric acid is associated with having insulin resistance and hyperinsulinemia.  


"In the present study, URIC ACID had an independent, significant association with metabolic syndrome in different logistic analyses, SHOWING A CONSISTENT RELATION TO INSULIN RESISTANCE. Uric acid actually correlated significantly with the fasting and two-hour insulin levels (r = 0.34). These findings are in agreement with the previous studies, in which uric acid has been connected with insulin resistance as measured with the euglycemic clamp technique or the insulin suppression test (Modan et al. 1987, Facchini et al. 1991, Vuorinen-Markkola & Yki-Järvinen 1994). This relationship persisted when the differences in age, sex, overall obesity and abdominal obesity were taken into account. Facchini et al. found (1991) that URINARY URIC ACID CLEARANCE DECREASES IN PROPORTION TO INCREASES IN INSULIN RESISTANCE in normal volunteers, leading to an increase in the serum uric acid concentration. The mechanism explaining the observed association is unclear. On the one hand, there are mechanisms implying DECREASED RENAL EXCRETION OF URIC ACID IN THE PRESENCE OF HYPERINSULINEMIA, including increased levels of ketoacids and increased sodium reabsorption with the elevation of uric acid (Modan et al. 1987). On the other hand, there are mechanisms associated with increased production of uric acid. Uric acid is a purine base that may originate from turnover and degradation of various phosphate nucleosides, such as ATP, or dinucleotides. Increased ATP turnover has, in turn, been shown to explain hyperuricemia induced by ethanol, acetate and fructose."   (Vuorinen-Markkola & Yki-Järvinen 1994).
---------


"Is the high uric acid level the cause of my back pain?? "
---------------------

Since there's decreased excretion of uric acid by the kidneys, that's probably what's causing the pain.  


"How can i lower these levels?? "
---------------------

There is medication that can lower the uric acid.  But you need to also take care of what's CAUSING the high uric acid.  In other words, you need to do something about the insulin resistance.....because having high uric acid levels IS PREDICTIVE OF POOR RESPONSE TO Hep C treatment!!!

Co


(J Med Virol. 2008 Apr;)

"Is serum uric acid a predictive factor of response to IFN-treatment in patients with chronic hepatitis C infection?"

Pellicano R, Puglisi G, Ciancio A, Balzola F, Saracco G, Ciccone G, Baldi I, Abate ML, Smedile A, Rizzetto M.  Department of Gastro-Hepatology, San Giovanni Battista (Molinette) Hospital, Torino, Italy.

Several factors, including metabolic profile, are predictive of response to standard antiviral therapy in patients with chronic hepatitis C. In a retrospective study, it was investigated whether uric acid, involved in metabolic syndrome, could be included. A total of 153 patients (56.2% males; mean age 45.7 +/- 11.3 years) treated with pegylated-interferon and ribavirin were included. Eighty-five were infected with hepatitis C virus (HCV) genotype 1 or 4 and 68 with genotype 2 or 3. Viral load was >1,000,000 IU/ml in 101, < or =1,000,000 IU/ml in 35 and unknown in 17 patients. Ishak fibrosis score was 4 in 15 and unknown in 57 patients. Mean serum uric acid was 5.05 +/- 1.3 mg/dl. Sustained virological response (negative serum HCV-RNA 6 months after treatment cessation) was achieved in 102 patients (67%). In the final logistic model, serum uric acid level > or =5.8 mg/dl (OR = 0.46; 95% CI: 0.30-0.62), viral load (OR = 0.29; 95% CI: 0.09-0.92) and HCV genotype (OR = 0.23; 95% CI: 0.09-0.60) were identified as the most important factors independently influencing clinical outcome. The prognostic role of serum uric acid was confirmed on the sub-sample reporting Ishak fibrosis score (OR = 0.49; 95% CI: 0.28-0.85). SERUM URIC ACID
LEVEL > or =5.8 mg/dl IS PREDICTIVE OF POOR RESPONSE TO HCV TREATMENT. Prospective studies are needed to clarify the issue.

http://www.ncbi.nlm.nih.gov/pubmed/18297716?ordinalpos=118&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Blank
568322_tn?1370169040
"I mentioned it because my uric acid is high 8.5 and it started out in normal range.  Trial nurse is not worried "
------------------------------

She should be.  Because a uric acid higher than 5.8 is predictive of poor response to Hep C treatment.  


"she said it can get into the 30's before they are concerned."
------------------------------

That means she's letting people fail tx.  Make a copy of the study and give it to her (and another to the doctor).


(J Med Virol. 2008 Apr;)

"Is serum uric acid a predictive factor of response to IFN-treatment in patients with chronic hepatitis C infection?"

Pellicano R, Puglisi G, Ciancio A, Balzola F, Saracco G, Ciccone G, Baldi I, Abate ML, Smedile A, Rizzetto M.  Department of Gastro-Hepatology, San Giovanni Battista (Molinette) Hospital, Torino, Italy.

Several factors, including metabolic profile, are predictive of response to standard antiviral therapy in patients with chronic hepatitis C. In a retrospective study, it was investigated whether uric acid, involved in metabolic syndrome, could be included. A total of 153 patients (56.2% males; mean age 45.7 +/- 11.3 years) treated with pegylated-interferon and ribavirin were included. Eighty-five were infected with hepatitis C virus (HCV) genotype 1 or 4 and 68 with genotype 2 or 3. Viral load was >1,000,000 IU/ml in 101, < or =1,000,000 IU/ml in 35 and unknown in 17 patients. Ishak fibrosis score was 4 in 15 and unknown in 57 patients. Mean serum uric acid was 5.05 +/- 1.3 mg/dl. Sustained virological response (negative serum HCV-RNA 6 months after treatment cessation) was achieved in 102 patients (67%). In the final logistic model, serum uric acid level > or =5.8 mg/dl (OR = 0.46; 95% CI: 0.30-0.62), viral load (OR = 0.29; 95% CI: 0.09-0.92) and HCV genotype (OR = 0.23; 95% CI: 0.09-0.60) were identified as the most important factors independently influencing clinical outcome. The prognostic role of serum uric acid was confirmed on the sub-sample reporting Ishak fibrosis score (OR = 0.49; 95% CI: 0.28-0.85). SERUM URIC ACID
LEVEL > or =5.8 mg/dl IS PREDICTIVE OF POOR RESPONSE TO HCV TREATMENT. Prospective studies are needed to clarify the issue.

http://www.ncbi.nlm.nih.gov/pubmed/18297716?ordinalpos=118&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum



"I stated to drink lots of Cranberry juice and that seemed to help, but not really sure.  I know one thing the Cran juice wont hurt you."
------------------------------

Worst thing you can do.   High uric acid is associated with insulin resistance and hyperinsulinemia (see my previous post to BklynBoy).  And juice is loaded with sugar.  So you're making it worse.  

Co
Blank
568322_tn?1370169040

"I do drink alot of Grape Juice it has alot of vitamin C also.."
--------------------

Let me put it this way....

Sugar>>>insulin resistance>>hyperinsulinemia>>>poor response to Hep C treatment.

Co
Blank
568322_tn?1370169040
Great suggestions!


"I have had at least 12 uric acid kidney stones"
-----------------------

Have you been checked to see if you're insulin resistant?

Because uric acid is associated with insulin resistance....and many cirrhotics are insulin resistant.  

(See my previous posts).  

And if you do have IR.....improving insulin sensitivity (with diet, exercise, meds), can slow down the liver damage.


"Don't worry you can be on HCV treatment and have kidney stones. They are totally separate and do not interact in any way"
---------------------

They do if they're uric acid stones.

Co
Blank
646318_tn?1261185094
HectorSF thank you for that info i heard kidney stones can be the worse pain ever and i hope it doesn't happen to me.. with my luck im gonna be in the hospital real soon...
I need to drink more water then i already im.. will do... i dont know if i have a family history of kidney stones.. i really dont think so.. that actually the one thing i never heard anybody in my family having but i will talk to some of them today... the back pain is under the rib cage area definitely the kidney area and im pretty sure its kidney stones..
the pain is like a 3 i think maybe more...

Cowriter i have not check yet if im insulin resistant... im gonna make appointment today with the doctor.. one thing im responding pretty well with the HCV treatment.. my 2 week blood test came back UND... I have not checked since than and i did shot 8 yesterday.. when i talk to doctors its like talking to a wall they dont listen u tell them one thing they do the other... i made the appointment for monday nothing sooner...
thank you for the info and the studys...

sorry i dont reply sooner it takes me mad long to type and i feel like im brain dead with the TX lol i cant spell small azz words... other wise i m feeling good still.. i will keep u guys posted... had the ultrasound today results in 1 or 2 days
Blank
626749_tn?1256519302
My uric acid has come back down after EOT

uric acid before tx, was 7.1...
during tx, uric acid jumped around between 8.4- 9.5
IR,  homa1.6_   glucose 67-80 (most blood draws around 78)

8 weeks post eot blood draw, my uric acid is now at an all time Low, 5.8...  
Glucose went up by 10. not-fasting,but nothing to eat/drink5 hours(as usual) 90...
Probably not significant.

apache



Blank
568322_tn?1370169040

5 hours after eating ....that's a random blood sugar.  Normal is below 120.

Co
Blank
446474_tn?1404424777
Thanks for the info! I will have to learn more about this.

I've been trying to reducing my uric acid levels for years now. I have been changing my diet and get a 24 hour urine test a couple of times of year to make sure it is under control.

My cirrhosis is the biggest factor cutting my odds of therapy working plus as of now I don't have enough platelets to due therapy. I go down into the teens at about 12 weeks. So I'm stuck for now.

Appreciate the info and will read up on uric acid and HCV.

Hectorsf
Blank
646318_tn?1261185094
What’s up guys? I got some good news I just saved a ton of money by switching to geico lol j/k but I really did… good news is the ultrasound came back totally normal, no kidney stones, no gallstones no problems with any organ…Not sure why the pain is still there a little bit, maybe its my liver healing.. My LFTs are normal.. I m slightly anemic HGB is 12.. I still have high uric acid levels.. I did a search

Causes
High uric acid levels can be caused by either excess production of uric acid in the body or by decreased excretion of uric acid in the urine. Specifically, factors that may cause high uric acid concentration in your blood include:

Drugs sometimes used to treat high blood pressure, such as low-dose aspirin and diuretics
Excessive alcohol consumption
Excessive caffeine consumption
Family tendency (genetics), Hodgkin's disease , Hypothyroidism (underactive thyroid), Leukemia , Niacin, or vitamin B-3 , Non-Hodgkin's lymphoma , Obesity, Psoriasis , Purine-rich diet — organ meat, game meat, anchovies, herring, gravy, dried beans, dried peas and other foods , Some immune-suppressing drugs, person with liver disease


I used to drink alcohol every weekend and alot of caffeine..
I’m like 25 – 30 IBs over weight and I do have a liver disease…
The cancer thing I guess I should get screened I do have a family history of cancer. How do I go about doing that..

Co Writer
I went to the dr for a fasting glucose blood test today and I will get my results next week.. The doctor said he will not check IR unless fasting glucose is abnormal… He said its an insurance thing..

When I told u guys that my blood sugar was 40 at one time it was because I was in jail and they didn’t feed me enough I lost 35 ibs in a few months in there I was away for a year.. I felt sick and dizzy so I when to medical in there and I got my blood sugar tested everyday for a week in the mornings at 5:30 before I ate breakfast..  Mind you we ate chow at 4:30 in the afternoon so every time I got my sugar check it was a fasting sugar level because I didn’t eat anything for over 12 hours.. So I think it was my liver storing the sugar.. so when I got out of the slammer I knew something was not normal so I did extra testing and found out I had Hep C.. Also when I got out I was so fcukin hungry I gain 30 ibs in 2 months lol the doctor called me a pig… I could not help it.. lol

PS I sure dam learn my lesson after that experience.. I will even never jay walk again…lol..  There might be something I left out but I m too BD to remember BD as in Brain Dead…

I like long walks in the park to feed the birds :) J/K
Blank
Avatar_f_tn
Well, your pretty feisty today  -- good news no stones.  Is your level still high?  

One of the causes you posted above was excessive alcohol assumption.  Very odd --when I was drinking my uric acid was fine, now I'm not drinking and its high. None of the other things apply to me so it has to be the meds.

Anyway you should almost be done with Telaprevir--3 1/2 weeks for me.  Yeah !
Blank
646318_tn?1261185094
I do still have the high uric acid.. I dont know what is causing it... I just need to keep drinking more water... it will lower my uric acid level alittle bit. I never got my uric acid tested until i started tx.. so i dont know if it was ever high.. for u its probably the meds... i cant wait until i stop the tela maybe i can get more sleep.. I need to buy a treadmill like JTRiver.. I need to get off my azz and lose 25 ibs.. 26lbs in a couple months much respect... i need to lose weight and feel great..lol
Blank
479244_tn?1271567259
wait till you wake up with excruciating pain in your toe!  This is caused gout and is caused by high u.a. levels.  And yes, these high levels are not good if you are tx'ing.

I got mine under control by not eating so much cheese, salty foods and sardines!

bandman
Blank
Avatar_f_tn
I have read high uric acid causes gout.  Mine is now at 9--at what level would it be dangerously high in your opinion.  trial nurse said when it gets in the 30's, but I'm not so sure about that.

If we develop gout to to uric acid when we stop tx and the levels go down does the gout go away?

No more salt or cheese for me.  Yuk!
Blank
479244_tn?1271567259
bbboy,

"I went to the dr for a fasting glucose blood test today and I will get my results next week.. The doctor said he will not check IR unless fasting glucose is abnormal… He said its an insurance thing.."

with all due respect... your doctor is about 5 years behind on this.

Listen to cowriter... take him studies... if he refuses , then find another doctor... don't walk , run!
or pay for these tests yourself,  I don't think that they are very expensive... and all you will need is your fasting insulin level... cause you will already have your fasing glucose level.. it is preferable to have them done on the same day... but you can get a rough idea even if they are days apart.

I also noticed that you said you were "hungr

My glucose levels were high, but within the so-called normal level.  After showing my doc studiies, he ordered the insulin test as well.  Turns out I am extremely IR, almost diabetic,  Not obese either.

I also noticed that you said you were "hungry all of the time" at one point,  are you still hungry all of the time??  I was... still am at times... guess what, hungry all of the time is a symptom of IR... so is irratibility.. I had both of these... they are much better now that I am on metformin, and tweaking my dosage on a monthly basis.
I also check my blood sugar every morning... it is coming down!  I was looking at 120s in the morning, now I am looking at 90-100 range.

IR seems to be a relatively new concept and many docs still operate under the assumption that you area either diabetic or not.  Mine appeared to not even be aware of Insulin Resistance.... but was willing to learn.

Tippy - I am unsure what a high uric acid level would be, I can not remember mine but it was very high.... and the night I woke up with extreme toe pain, I  had eaten cheese, crackers and sardines before going to bed..... not a good idea.  Very painful!
I probably already had a high uric acid level due to IR, and then then the above foods pushed me into a very painful night.

all you need to know is
"She should be.  Because a uric acid higher than 5.8 is predictive of poor response to Hep C treatment."  thanks cw!

You guys need to learn everything you can... many docs don't want to mess with this as the patients tend to highly emotional , irratiible, and unreasonbable... it is the virus and meds messing with your mind.  In addition they realize that if they or one of their staff gets infected with HCV then their career is essentialy over, IF they reveal they are infected.   Thats just my opinion.

bandman
Blank
Avatar_f_tn
Ok thank you.  I am going to get to the bottom of this soon.  I will print out Co Writer info in that other thread and take it with me to my private doctor.

Trial people keep telling not to worry, but I have enough sense to know something is bad wrong, or going to lead to serious complications if I don't get this under control.  If it was just the high uric acid  maybe I wouldn't be so worried but I got a call today ( trial ) and I have other blood work issues going on also.  My thyroid is way high AGAIN--seems they can't get it right. Plus everything is too high or too low.  I'm a mess.  Lol!  Its times to get to the bottom of this.

Geez its always something.!  Lol !  I have to laugh--trying to stay upbeat.

To:  BklynBoy

Sorry for taking over your post but I figure we both have the same isssus going on so need to start another post.
Blank
Avatar_f_tn
Amazing about the sardines and uric acid - I just read about it.

And I try hard to eat sardines because they're supposed to be "good" for you.

Just shows how complicated nutrition is. Next time I'll have a couple of sardines instead of the entire tin.
Blank
479244_tn?1271567259
just don't over do it.   sardines are good for you,  just don't combine them w/ cheese, olives, etc.   google "gout" and you cab\n find a list of foods that you need to be careful with,

bandman
Blank
479244_tn?1271567259
what tx meds are you on?

I was on soc and read the insert that came with a big time warning about the possibility of serious thyroid disease....  it also said that my doc was required to make sure i was aware of this.    Did she?   hell no.   I brought it up to her . and she was "oh yeah, thats right... but we are keeping a close watch on your thyroid levels""  ... fortunately they were fine,  I just felt kind of weird that no one gave me the thyroid disease warning.  I don't think it would have detered me from tx, but still... I like to know whats going on and what could possibly occur.
Course I guess if you read all of that , or were told all of it, a lot of people would get cold feet.. lol.

bandman
Blank
Avatar_f_tn
I am in the Vertex   No Placebo  Telaprevir trial. 1000 Riba -180 Peg and 750mg tela 3 x daily  .The thryoid issues  is in the consent forms I signed. I knew that going in though, from people on this forum.  Pretty smart people here.
Blank
Avatar_f_tn
By the way Bklyn Boy is also in the same trial as me.  Co Writer said high uric acid is not that common during SOC tx.  Were kind of thinking high UA could be a sx of the Vertex trial?
Blank
479244_tn?1271567259
It is probably related to  your diet and IR.  
I would definitely find out if I was IR.     Try to do it as a separate thing from tx.... tell them you believe you are IR because of symptoms you are having, such as high uric acid... google IR and see if you have any of the symptoms, be able to list them to your doc.  and tell him that you are aware that metformin is used to treat this condition.
That is IF you have some of the symptoms.
Were either of your parents diabetics?

bandman
Blank
646318_tn?1261185094
can i be IR even if my fasting glucose levels are normal
Blank
479244_tn?1271567259
Of course you can.   My fasting glucose was not over "their" limit... but it was at 100.  I told them "this is high ,even though it is in the so called "normal range"  (which by the way, they are thinking of lowering to 100, duh)...

think of it this way, even if your glucose is normal, but your insulin is high, and you compute the homa score , you wll be IR... if your insulin is high.

If you have any of the sympoms , or a family history of diabetes , or both (as with me) you really need to have your IR checked.

With my level of IR , i fell into the less than 20% chance of clearing catergory.... if you have a normal homa (1) then you fall into the 60% chance of clearing.   If i had knownn going in that I had a 20% chance, I would have never tx'ed.  I could kill my doctor.

Imagine what the results of the trial studies for soc would have been if IR had been addressed.  makes you wonder.

bandman
Blank
568322_tn?1370169040
Is your thyroid okay?  Thyroid problems can causer high uric acid.

Co
Blank
Avatar_f_tn
He doesn't know because I discussed it with him a few days ago.  I would assume if his thyroid levels were off they would tell him.
Blank
412873_tn?1329178055
I'm in the Vertex trial with the placebo arm...and going 48 weeks.  My uric acid is slightly elevated (7.9).

My nurse is not concerned either.  In fact I mentioned it to her first.  I thought it was because I used to drink alchol.  She told me it could be a sx of tx.  When I googled around I found mention that it could be a sx of chemotherapy drugs.  Didn't mention which ones tho, but interferon is used for leukemia and therefore may be considered a "traditional" chemo drug??

I also found mention that aspirin and caffeine can raise levels.  And drinking water will help.

Hope things resolve for both of you.  Wishing you both well-Izzy
Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Hepatitis C Community Resources
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank
Top Hepatitis Answerers
Avatar_f_tn
Blank
dontworry_behappy1
163305_tn?1333672171
Blank
orphanedhawk
Rural Mural, CA
Avatar_f_tn
Blank
nan535
Brooklyn, NY
446474_tn?1404424777
Blank
HectorSF
CA
1815939_tn?1377995399
Blank
pooh55811
96938_tn?1189803458
Blank
FlGuy
South, FL