The Dr. Hyman Show - Treating & Preventing Shingles From A Functional Medicine Perspective with Dr. George Papanicolaou

Starting point is 00:00:00 Coming up on this episode of The Doctor's Pharmacy. Bacteria and viruses have their own circadian rhythm, and the immune system can then establish a circadian rhythm that will allow it to fight and suppress infection. Fascinating. Hey everyone, it's Dr. Mark. My main goal with diet is to use food as medicine, but even when we eat super well,

Starting point is 00:00:23 most of us are missing out on certain essential nutrients. Our soils have become depleted and our digestive tracts just aren't working so great. They're compromised by stress and toxins and they just can't absorb nutrients as efficiently as they should. And that's why I always use, and I recommend to my patients, a multivitamin mineral as nutritional insurance. It covers the basics for all our day-to-day body functions, all the things that we need that our food might be missing. But there are so many products out there I wouldn't go near because they contain artificial fillers or inactive ingredients, and you have to be pretty picky.

Starting point is 00:00:59 The one I trust and take myself is Athletic Greens. They use high-quality, highly absorbable forms of vitamins and nutrients from real whole foods. Athletic Greens comes in a powder that tastes great and mixes easily with water or smoothies and specifically supports my gut health, immunity, energy, and recovery. And it's not just vitamins and minerals. It has phytonutrient rich superfoods and adaptogens and pre and probiotics and even digestive enzymes. I love that they add the digestive support in their powder since so much of our immune strength and overall wellness starts in the gut. It's really one supplement that covers so many bases and you'd be hard-pressed to find

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Starting point is 00:02:43 and energized. When we get high quality sleep, that's normal. But if we don't, our day-to-day becomes foggy and exhausting and our health suffers. And that's why I'm always looking for ways to upgrade my sleep routine. And my new favorite find is the bedding from Cozy Earth. For me, one of the biggest factors in sleeping well is temperature. I run hot, so I'm always looking for ways to sleep more comfortably, and research shows that we get into a deeper state at cooler temperatures. Cozy Earth's bamboo bedding sheet naturally regulates temperature

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Starting point is 00:04:05 Cozy earth sheets are so soft, you're always going to be excited to go to bed. Better sleep is the cornerstone of better health, and it's something we all have the power to work on. Now, I know nice bedding can feel like a big investment, so Cozy Earth makes it super easy to try out their products with a 30-day free trial and 10-year warranty. Plus, right now, they're offering my listeners a spring cleaning, a bedroom makeover offer of $100 off their sheet set. You can use the code HYMAN100 at checkout. So head over to CozyEarth.com with the code HYMAN100 to check out their great selection of bamboo bedding and loungewear. All right, let's get back to this week's episode of The Doctor's Pharmacy. Welcome to The Doctor's Pharmacy. I'm Dr. Mark Hyman, and that is

Starting point is 00:04:54 pharmacy with an F, F-A-R-M-A-C-Y, a place for conversation of the matter. And if you've ever suffered from shingles or know anybody who has, you better listen up to this podcast because we're having a special episode of our House Call podcast with none other than our Dr. George Papanikolaou from the Ultra Wellness Center in Lex, Massachusetts, one of our incredible team there. And we are going to talk about what to do if you have shingles from a functional medicine perspective. So welcome, George. Mark, thank you for having me. It's always a pleasure to talk to you about anything. Anything. Okay, here we go. We've had some good talks. So let's just jump in here. You know, what is shingles? Why should we care? And how big of a problem is it anyway?

Starting point is 00:05:42 Shingles is a pretty big problem. And it's something that I think everybody is more aware of than they think of. It's really chickenpox. Everybody, you know, most everybody's had chickenpox. Now we have fewer cases where we have vaccines for it. But chickenpox is caused by varicella zoster. And once you have chickenpox, that varicella zoster is going to actually stay in your body, as many viruses do. And it's going to hide in a nerve root in your spine.

Starting point is 00:06:11 And it's going to stay there for a very long time. Unfortunately, as we get older, it's possible that our immune systems may wane. And this virus can then move back out of its hiding place along a nerve root where it creates enormous amount of inflammation and destruction finally escapes onto the skin and you get this blistering rash and if you've ever seen it it's pretty nasty looking and it happens usually on one side of your body it's usually arms or torso most most commonly. And it can be very uncomfortable. Big problem, about 30% of Americans will develop zoster in their lifetime. That's about 1 million people per year.

Starting point is 00:06:54 And it has enormous amount of morbidity and costs associated with it. Yeah, it's pretty bad. You know, basically what happens is you get chickenpox when you're a kid. Now, when I was a kid, we used to go to chicken pox parties. You know, where your mom would take you to a party with the other kids with chicken pox. So you'd get the chicken pox and get it over with. And I still have the chicken pox scar on my head. And what happens is that viruses tend to live in you forever.

Starting point is 00:07:23 They're hard to get rid of. And basically, the chickenpox goes to sleep for 60 years. And then things happen that trigger the reemergence of the chickenpox, which is actually sleeping in your nerves, which is why it's so painful when you get this rash on your skin. It's really the virus traveling through the nerves that causes this horrible pain and burning and inflammation and the blisters are just the end result of that so what is the driver of the emergence of chicken pox into shingles as we get older because not everybody who has chicken pox when they're younger gets shingles right so i mean you know i know when we talk about getting

Starting point is 00:08:06 older and the the issue is it's your immune system so your immune system begins to be suppressed it doesn't work as well as we know during this time of covid we've talked about the immune system a great deal. I think people are more understanding of epidemiology and immunology than any other time in the history of mankind. And I can't go to a party. I can't talk to a pro. I don't go to parties.

Starting point is 00:08:35 There aren't any parties. But I can't talk to people without having a conversation. So it's really, we say as we age, there are things that happen that will cause our immune system to wane. But what does aging mean? We're getting older, but as we're getting older, I think what's happening is things that we've been doing for years begin to catch up. And I think a podcast of yours I listened to recently, you were actually answering questions on your one podcast. You brought up the concept of long latency deficiency disease. And I think over time, when we're not eating foods that have nutritious value, we're not eating foods that have those nutrients and minerals that support our immune

Starting point is 00:09:25 systems, then our immune systems begin to suffer. And that happens as we age. But it's not an aging problem. It's a food problem. It's a stress problem. It's those things that we understand in functional medicine. I think you're talking about it's so important. It's this whole idea of immuno aging, that our immune systems age. and we should talk about how to rejuvenate our immune systems particularly now in the face of COVID we'll get into it but keep going about shingles, you know, it's hard for me just to say it's aging. I think it's the processes. I think it's our lifestyle or nutrition that accumulates over years that results in disease, and particularly in suppression of our immune system. What really drives conventional medicine to address shingles as aggressively, and I say aggressively because we have vaccines for it. So, you know, millions and millions of dollars go into the research and development of vaccines

Starting point is 00:10:32 because you think a disease is creating such a epidemiologic social and health problem that you need to stamp it out. And so then you have this mass immunity. Why? Well, because although it sounds like a simple problem that goes away as a skin rash in about 14 days, and it's mild for most people, it can have some severe adverse outcomes. It can actually travel to your eye. It can travel to your ear. You can actually get meningitis, concephalitis as a complication of shingles. Now, very rare, but it can happen.

Starting point is 00:11:15 And the cost of treating shingles is enormous. So there's a lot of emphasis put on it in terms of a vaccine to prevent it. And that's how conventional medicine works. You know, prevent it with a vaccine or, you know, treat the symptom once it happens or the disease once it happens. But focusing on what I just mentioned earlier and preventing through lifestyle, nutrition, and other factors that we can alter is what we need to be thinking about. Yeah, and I think we are suffering not just from shingles as we get older, but we're suffering from all of the age-related diseases. They're all related to the decline of our immune system. We call it immunosenescence

Starting point is 00:12:05 but but we can a we can be old at 35 too right yeah if we're eating a crappy diet i mean biologically i've seen people who are 20 who are 20 but their biological age was 45 and i'm 61 my biological age is 39 so i think you know have... I knew you were going to bring that up. I got some new tests. I got to see what they show. I got some immune... There's new tests for immune aging too, which has to do with DNA methylation, but...

Starting point is 00:12:35 Yeah, when I see it on paper, I'll believe it. So... I'll send it to you. So, but going back to the shingles, I don't want to underestimate the effect it can have because when we treat people with shingles, it's extraordinarily uncomfortable and painful. And when you are older and you have a declining immune system, you are much higher risk for those adverse reactions I talked about. Yeah.

Starting point is 00:13:02 And so, and you can can end one of the ones i didn't mention the most important thing is something called post-herpetic neuralgia so as i said as i was talking about it the virus comes out and as it's coming along that nerve root it's creating a lot of damage on that nerve and you may or may not recover. And if you don't recover, that nerve can then emanate pain in a chronic fashion for months to years. And I've treated patients, unfortunately, that have had it for years. And it's extraordinarily uncomfortable. It disrupts sleep. It creates a lot of stress.

Starting point is 00:13:39 And it just leads to a lot of, you know, disability. Right. So basically, even after the rash goes away the nerve endings continue to be inflamed and cause pain well conventional medicine isn't that great with jingles right what do we got to offer from conventional medicine and then we're going to get into what's different about about functional medicine and how we treat with functional yeah so the two things that in in conventional medicine is the first thing is that they're really treating the symptoms. But what I wanted to mention is that there is a vaccine.

Starting point is 00:14:13 There is a vaccine. I think it was called Zostavax. And it came out in early 2000s. And it actually only had a 50 percent efficacy rate. And by the time you're after eight years, it has declined about 35 percent. It's actually taken off the market in 2020. But but it did limit potentially your chance of getting it. And if you did get it, it decreased the severity of the illness. And then a new vaccine came out in 2017 called Shingrix, and it has a 97% efficacy rate in keeping you from getting shingles. So it's a much, much better vaccine. The issue with the vaccine, vaccines, and this particular vaccine, it does have some adverse reactions. And if you need to get that second shot, and the concern is,

Starting point is 00:15:13 is that not enough people are going to get it, and that not enough people are going to get the second shot. So it's not a, it's not a panacea to solve that problem. But it's what conventional medicine does. It doesn't look at how can we make your immune system better, you know, and so you have overall improved health so that your immune system can fight off all types of infections, not just one single infection called varicella zoster. That's all that vaccine is good for. So that's what they offer.

Starting point is 00:15:47 They offer a vaccine. And then if you do get it, they offer antivirals. You have 72 hours to get your antiviral. And then it's going to decrease the length of your illness and the severity, but the length by just about two to three days. Yeah, that's not so impressive, right? So basically, you've got steroids, you've got, you know, Advil, you've got topical creams and anesthetic creams. But none of that stuff really solves the problem that much. So let's talk about our approach with functional medicine.

Starting point is 00:16:23 How do we think differently about it? What can we do with these people who are suffering and how do we actually get these people better over the long term using an approach that looks at root causes and also looks at the other side of the equation because traditional medicine is basically shutting down something, right? Steroids shut down inflammation, NSAIDs or, you know, Advil shut down inflammation, narcotics shut down the pain, but it doesn't do anything to deal with the virus itself. It doesn't do anything to do with the virus itself or actually fixing your immune system or rejuvenating your immune system. We're working on only one side of the scale here. And functional medicine is the science of creating health, which means how do you create a healthy

Starting point is 00:17:01 immune system? One, so you don't get shingles activated. And two, if you do get it, how do you create a healthy immune system one so you don't get shingles activated and two if you do get it how do you build a more resilient immune system so you can minimize the effects of it recover faster and actually get over the problem without being too miserable where would you like to start just go in like go in all and just dive in man yeah because then we could go but you know I I'm going to start where you start you know and it's food is medicine um and I really think that it really begins with what we're eating over the long term and there you know we we we have our food system and you've talked about this you you write about it, it's your baby. But, you know, I'm going to jump in on it.

Starting point is 00:17:50 We have a food system that's supplying, you know, food that is, you know, calorie-rich, nutrient-poor, minerals are gone. And why do I bring that up? Because it's in those key nutrients and minerals that we get what we need to support a healthy immune system. We need zinc. We need vitamin A. We need vitamin C. We need vitamin D. We need selenium. And we're finding that a lot of our foods are just missing these. And a lot of those foods that we need to get aren't readily available in our supermarkets. And if they are, they are grown in such a way that they don't have the concentration of those minerals and nutrients that we need. So in functional medicine, you know, we see, you know, supporting your overall health starts by choosing really good, healthy foods from a wide range of vegetables and fruits and fish and healthy, you know, grass fed, grass finished beef and getting nuts and seeds and berries. Because they're all going to carry the nutrients that we need to support the healthy immune system.

Starting point is 00:19:03 So it starts with really, you know, your nutrition. So really upgrading the quality of your food you're eating and using both anti-inflammatory foods, basically spices, herbs, all the colorful phytochemicals in food, ginger, and all these wonderful things that we can use to upgrade our immune system. And at the same time, getting rid of the foods that drive a disturbed immune system. For example, sugar and starch suppress your immune system. So if you're eating tons of processed food and sugar and starch, which is the bulk of our calories, about 60% of our calories, that's going to drive a suppressed immune system and make it more likely to get into trouble. And then you

Starting point is 00:19:41 also mentioned the nutrients, which are critically important because, you know, they're not just making expensive urine. These are regulating all the functions of your body, particularly your immune system. So you mentioned zinc, you mentioned vitamin A, you mentioned vitamin D, you mentioned vitamin C. These are really important. Even amino acids like lysine can be very helpful in regulating viral infections. So I think these are the things we use in functional medicine and often we can get really tremendous benefit with people helping to reduce the course of the illness, to shorten it, and also to reduce

Starting point is 00:20:12 any long-term side effects. So tell us about this 42-year-old patient you had with shingles who kept coming back and back. She was at hives, used to problems, and was a vegetarian. So what was the story with her and what did you do to her? And what did you do to fix her? How did you identify the issues? Because typically in traditional medicine,

Starting point is 00:20:28 we just use conventional tests. We don't really look under the hood. And someone said that, you know, using traditional medicine is like trying to diagnose what's wrong with your car by listening to the noises it makes instead of looking under the hood. And functional medicine is really about looking under the hood. So how do we that right so so this was a you know this is a um a case of a woman as you said she was a 42 year old female um so you know you're you're immediately starting to as they're giving you your their their symptoms you're starting to think about the systems that are involved. And so when I'm hearing that she's a vegetarian, I'm immediately starting to think about some of the possible deficiencies she may have. So I'm thinking about that. I'm thinking about how that will impact her

Starting point is 00:21:22 overall health. I'm thinking about how it will impact the health of her gut. So I'm starting to think about her gut. And what makes me think more about her gut is the hives and the yeast infections. They start to make me think that, you know, that's an unhealthy gut. There's a good chance that she has a bacterial imbalance that we call dysbiosis, and that it might be being driven um by candida or the dysbiosis is there and the candida then grew and candida can cause highs in ease so i'm thinking now there are guts involved that she has some nutritional deficiencies maybe not enough a not maybe not enough zinc maybe not enough c so i So I did a stool analysis, a complete diagnostic

Starting point is 00:22:08 stool analysis. And indeed, I found that she had significant dysbiosis and candida overgrowth. Additional testing I did included what we call an organic acid test. and I looked at her overall amino acids. And what I found was that she was low in zinc, and she was low in amino acids, which again, you know, I was, I wasn't totally surprised because vegetarians, if they're not really careful, may not be getting enough proteins. And indeed, you know, she wasn't when we looked at her diet and her amino acids were low. So what does that all add up to? It adds up to this. She wasn't getting some of the key nutrients you need to support her immune system. She wasn't getting enough protein to give the amino acids she needs to make those proteins

Starting point is 00:22:56 that are important for the immune system to function. And her shingles, she had the candida in her gut, and that all caused her immune system to tank, and she developed shingles. And this was happening repeatedly. She had recurrent episodes. By the time she came to see me, she had had four episodes. She'd been treated four times, and she was being put on a suppressant. She was taking an antiviral every day. And so she was breaking through on the antiviral. So that's why she came. He said, I don't know what else to do. So having put all

Starting point is 00:23:31 that together, I started her on lysine and vitamin C, and I put her on a mushroom compound called Turkey Tail because of its benefits for boosting the immune system and then i treated her gut we treated her candida with um acrylic acid and i used another compound called biocidin to help with the overall general dysbiosis and we cleared up her gut and i talked to her about her diet. She had leaky gut, by the way, which means that that terminal membrane that's responsible for filtering out the bad guys and letting in the good guys through these gates. We treated that with quercetin and some L-glutamine. And so as these things improved, one thing, she just felt generally overall better uh and so um we she you know her her shingles that case of shingles improved um and the other thing that we needed to address was she was under an enormous amount of stress and so i had her start meditating and what's really

Starting point is 00:24:42 interesting is that uh there, you know, there was a recent study that showed that meditation actually will alter the function of genes that will improve immune function, particularly those genes involved in viral, in fighting viruses. So meditation, we started meditating. And six months later, she hadn't had another outbreak. And she had been on pretty much up to that point in every three to five, six-month cycle. So that's how we treated her. And she did really well. That's really amazing, George, because we really often don't think of how do we strengthen our immune systems, not just in terms of shingles, but in terms of everything and in terms of COVID.

Starting point is 00:25:36 And if you go to your doctor, what do I do to boost my immune system? They're like, I don't know. Come to me when you got a problem and there's inflammation. I can give you drugs to shut it off. But if you say, well, where is the inflammation coming from and why is my immune system not working well and how do i up regulate it how do i rejuvenate my immune system well it's all the things you're talking about it's eating the right foods with amino rejuvenating properties it's taking the right nutrients it's fixing your gut which is a big part of your immune system it's using various herbs and nutrients to, actually, that can be

Starting point is 00:26:06 antiviral or immune regulating, like the adaptogenic mushrooms, reishi, shaga, cordyceps, lion's mane, you know, shiitake, all these maitake mushrooms. These are powerful adaptogenic mushrooms that help with the polysaccharides and using food as medicine to upregulate immunity. So, we have this incredible arsenal of tools at our disposal that are completely ignored by traditional medicine. And that's really what we do with the Ultra Wellness Centers. We help people dig down into, one, finding what the root causes are, and two, actually helping people to rejuvenate their health in a very specific way.

Starting point is 00:26:36 It's very personalized. And that's really what's so gratifying for the work we do, because we literally get to see people's lives changed and transformed by by doing some very simple things and you mentioned protein and i think you know people don't understand like a lot of people may be trying to like eat less meat or not eat protein uh and and you know if if you want to be a vegetarian or vegan it's okay but you have to be on top of the protein oh we don't need as much protein we can get we can get it all from greens it's just nonsense you know your immune system is driven by protein you you need protein to build the immunoglobulins the antibodies

Starting point is 00:27:09 and so i've seen many patients and we test them we don't just guess we test right and so we see at the ultra wellness center really dramatically low levels of amino acids protein insufficiencies and and it's not like they're having protein calorie malnutrition like in third world or developing world they're they're having a dysregulated immunity and overall health i mean one woman she's like her hair was falling out she was tired all the time she she had all these health issues and she had like zero meat she just was a vegan who only ate sugar and vegetables and so you know it wasn't really healthy diet yeah and and so we need we need to do those things that's great uh so what happened um when

Starting point is 00:27:46 when you started to do these things with this patient yeah she got better i mean i you know her you know her um i mean her her shingles went away obviously um but what was most important was that her hives stopped um she didn't have another yeast infection she was getting yeast infections monthly you know and at the. Like vaginal yeast infections. Yes, vaginal yeast infections. And so once we cleared up her candida, that resolved, her hives resolved. And at six months out, she was off of her viral suppressive medication, and she hadn't had an episode. And so what was interesting, I want to mention this,

Starting point is 00:28:28 I did get her to eat more protein. And it wasn't because I convinced a vegetarian not to, I mean, to start eating meat. I just went over with her all the foods and made sure that she was really focusing on getting her tofu, her tempeh, her lentils, her chickpeas, her beans. I had her start using some nutritional yeast. So I just reminded her, if you're going to be vegetarian, because she really wanted to be, these are the foods you need to eat. I reestablished her protein needs and had her really be careful about making sure. I think I calculated her out to needing about 50 grams,

Starting point is 00:29:04 48 to 50 grams. I said, you really need to get that every day. And so I helped her be a better vegetarian. And she was really grateful. And it really worked out well. What was really helpful to her, too, and she told me this, was that she really, like, when I told her about the meditation piece, she was like, what's meditation going to do for my shingles? And I explained to her that, you know, it impacts the immune system. So she bought it.

Starting point is 00:29:37 She did it. And she said, George, of all the things I've done, meditation to the biggest impact on my life. So I just am more relaxed every day. I function better at work. I communicate better with my children. My sex life with my husband is actually better. You know, sleep actually, you know, as I was, you know, just reading about the immune system and prep for this, sleep, we talk about how the sleep is so important for overall health, but sleep in the bigger context of establishing a healthy circadian rhythm.

Starting point is 00:30:19 So there have been recent studies that show that it's the circadian rhythm, establishing a good circadian rhythm actually sets the immune system up because bacteria and viruses have their own circadian rhythm and the immune system can then establish a circadian rhythm that will allow it to fight and suppress infection fascinating so working on making sure that we're getting our circadian rhythm in place. Sleep is a big part of that. And from the moment you wake up in the morning to the time you go back to bed, you're actually preparing yourself for sleep. And one of the best things you can do in the morning is wake up, open a window, open a door, go outside, get some fresh air, and look into the sky. Because that light hits your brain. There's a certain nucleus that sets your circadian rhythm for the day. And it's going to now start preparing for 12 to 14 hours later when you go to sleep

Starting point is 00:31:19 to have you completely ready to sleep in a comfortable and restorative way. That's great. So really, you know, what you're saying, George, is that with functional medicine, whether it's shingles or any other viral issue or preventing infections, you had yeast infections, all those two things that we have a lot we can offer from the perspective of functional medicine to one, identify the imbalances that are driving immune dysregulation, immune aging, and immunosenescence, as well as identify very specific interventions from lifestyle, supplements, herbs, and other therapies that can actually help. And one of the things we didn't talk about, which is interesting, is ozone therapy, which we do at the Ultra Wellness Center and has been studied, is published in the online National Library of Medicine database, looking at, for example, the use of ozone therapy with post-herpetic neurology,

Starting point is 00:32:12 and found that it was more effective than any other treatment. It can also be used topically for shingles. So there's a lot of options that we use in traditional and functional medicine that are not typically available with functional medicine. Absolutely. So, George, thank you for joining us on this podcast on this special episode of House Call and the Doctor's Pharmacy, where we dive deep into health care issues and medical problems that many people suffer from that aren't getting good answers.

Starting point is 00:32:36 And here at Delta Wellness Center in Lenox, Massachusetts, we're now doing virtual consults and we can see people from anywhere. It's pretty wonderful. It's one of the silver linings of COVID for us. We've been able to really increase our reach and help so many more people. So if you've been listening to this podcast and you love what you heard,

Starting point is 00:32:51 please share with your friends and family, subscribe wherever you get podcasts, leave a comment. Maybe you've had shingles. Have you found a way to get through it? We'd love to learn from you. And hopefully we'll see you next week for another episode of The Doctor's Pharmacy.

Starting point is 00:33:13 Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter, and in it, I share my favorite stuff, from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health, and I'd love you to sign up for the weekly newsletter.

Starting point is 00:33:40 I'll only send it to you once a week on Fridays. Nothing else, I promise, and all you have to do is go to drhyman.com forward slash PICS to sign up. That's drhyman.com forward slash PICS, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. and better and live younger, longer. advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and

Starting point is 00:34:29 search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.

The Dr. Hyman Show - Treating & Preventing Shingles From A Functional Medicine Perspective with Dr. George Papanicolaou

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