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Gluten Intolerance and Schizophrenia

April 22, 2009 Written by JP    [Font too small?]

A fascinating case report was presented in the February 2009 issue of the journal Nutrition and Metabolism. It documents the transformation of a 70 year old woman who had suffered from schizophrenia since the age of 7. The most remarkable aspect of her return to wellness is that it was prompted by a simple shift in her diet. What’s even more important to note is that this miraculous healing is not an isolated event.

Schizophrenia Symptoms

The woman who is featured in the case report presented a variety of common schizophrenic symptoms, such as attempted suicide and bodily harm, auditory and visual hallucinations, confused speech. fatigue, obesity and “poor attention to hygiene”. She was on numerous medications to help address the illness and other unrelated health conditions. But even while taking an extensive list of medications, her condition worsened.

Because of her weight, poor general health and her lack of response to the medication, this lady (known only as “C.D.”) was placed on a gluten-free, low carbohydrate diet. Gluten is a potentially allergenic protein found in wheat and other popular grains. C.D.’s daily diet was comprised of 4 oz of “hard” cheese, eggs, meat, 2 cups of salad and 1 cup of non-starchy vegetables. Her total carbohydrate count was kept under 20 grams per day, often referred to as a “ketogenic diet”.

After just 7 days, C.D. reported feeling “well” and more energetic. By day 8 she was completely free of the auditory and visual hallucinations. She also commented that she felt much calmer at her next evaluation on day 26. Over the course of the next 12 months, C.D. maintained mental stability and also lost some weight.

It’s unclear whether the changes found in C.D. are the result of carbohydrate or gluten restriction. One other study from 1965 found a possible connection between ketogenic (very low carb) diets and schizophrenic improvement. But even if we consider that research and this current case study, we’d have to admit that this is highly preliminary information. It’s regrettable that there isn’t more for us to go on at this time.

The uncertainty about the role of gluten in schizophrenia is more abundant and scattered throughout the medical literature of the past several decades. Several studies suggest that a gluten-elimination diet may be worth considering as a safe and natural therapy for some schizophrenics.

Celiac Disease Is Characterized by Inflammation and Oxidative Stress

Source: Nutrients. 2012 April; 4(4): 243–257. (link)

  • In 1986, twenty four patients in a maximum security psychiatric hospital were placed on a gluten-free diet for 14 weeks. Most of these patients were diagnosed with schizophrenia. A test called the Psychotic In-Patient profile (PIP) was given prior to the induction of the diet and throughout the study. There were positive changes noted in all of the patients during the dietary intervention. Two of the participants had a “relapse” when gluten was introduced back into their diet.
  • From a cultural and historical perspective, it’s important to note that societies that consume little or no glutinous grains have a very low incidence of schizophrenia. Papua New Guinea, Malaita (Solomon Islands) and Yap (Micronesia) documented only 2 cases of chronic schizophrenia out of a population of 65,000 in recent history. In countries that eat a “western diet” (which includes beer, bread and rice), the expected number of schizophrenics in that same population would be about 130. Follow up data also suggests that when grains are introduced into these remote societies, the rate of schizophrenia adjusts to levels consistent with that of western countries.
  • Data that spans all the way back to the World War II also alludes to a possible connection between gluten and schizophrenia. One such study, published in a 1966 issue of the American Journal of Clinical Nutrition is entitled, “Wheat Consumption and Hospital Admissions for Schizophrenia During World War II. A Preliminary Report.” Another study from that same era also supports the link between diet and improved mental stability. The paper, “Relapsed Schizophrenics: More Rapid Improvement on a Milk and Cereal-Free Diet” was presented in the May 1969 issue of the British Journal of Psychiatry.
  • A 2006 scientific review at Johns Hopkins Bloomberg School of Public Health found that, “a drastic reduction, if not full remission, of schizophrenic symptoms after initiation of gluten withdrawal has been noted in a variety of studies. However, this occurs only in a subset of schizophrenic patients.” The reasons why gluten may benefit some schizophrenics and not others may be genetic in nature (1,2). This may also explain the reason why some trials fail to find a statistical connection between diet and schizophrenia.

Schizophrenia is generally considered a chronic condition. In some instances, such as in the case of C.D., it’s virtually a life long affliction. The prescription medications used to treat it are sometimes necessary but, unfortunately, often not ideal because of reported side effects and variable symptom management. Dietary interventions may offer a very real alternative for some individuals struggling with such mental disorders. I believe it’s something worth investigating with the assistance of knowledgeable and open-minded medical professionals.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


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17 Comments & Updates to “Gluten Intolerance and Schizophrenia”

  1. Frann Says:

    More than 20 years ago (can’t pin it down precisely), my partner at the time was a schizophrenic. Because I’m the type of person who always tries to solve problems, I did a lot of research on the subject, and tried him on what we thought was a gluten free diet. We didn’t know a lot about it, and the literature was vague and unhelpful on exactly how to do this, so what we basically ended up doing was to cut out bread, pasta and so on, but we still used many processed foods, which I now realize meant he was not on a strict gluten free diet.

    Having said that, I can report that he had a huge reduction in symptoms, in particular the “voices” and hallucinations were much reduced, and he was much happier and behaved less erratically – he even told jokes and got the timing right, which he wouldn’t have attempted before.

  2. JP Says:

    Wow! Thanks for sharing that, Fran! It’s much appreciated. Very interesting indeed.

    I remember reading, many years ago, about the work of Dr. Abram Hoffer. Perhaps you know of him? If not, he’s a Canadian orthomolecular physician who pioneered the use of diet and high-dosage nutrients in the treatment of schizophrenia and other mental disorders (and beyond).

    I recall that he would sometimes utilize short water-only fasts on treatment resistant patients. Sometimes that would apparently work – presumably by eliminating exposure to allergenic or sensitizing chemicals and foods.

    Be well!


  3. Krista Bernard Says:

    In 2000, when I was 28, my parents called the CAT team (Crisis Action Team) as I was presenting with some signs common to schizophrenia (auditory and visual hallucinations, dillusions etc.). The team spent 15 minutes with me and asked me a few questions. They then decided that, indeed, I was suffering from schizophrenoform psychosis and administered me with a high dose of the anti-psychotic drug, Olanzapine.

    The side effects of the drug were awful. Not only was I rapidly putting on weight, my brain felt shut down and I was rendered completely lethargic. I considered suicide.

    After 2 months, I pleaded with my psychiatrist to allow me to stop taking Olanzapine. My father worked in forensic psychiatry for 25 years – and it was only because of this that the psychiatrist agreed to a slow reduction in the dosage and, under the observation of my father, if this was successful, I could stop.

    4 months had passed and I finally stopped taking the drug. My life felt shattered. The stigma of having suffered from this illness hung over me. It took a long time to get the drug out of my body and to lose the weight. I was petrified that I would have a “relapse” as I was told that my prognosis was not good…

    A year later, I felt the warning signs of a relapse. I had never accepted that I was “schizophrenic”, and under no circumstances did I wish to be medicated in the same way. I tried several alternative methods of healing, such as yoga, kinesiology etc. This seemed to alleviate some of the symptoms.

    In 2005, I suddenly felt like I was losing my mind once again. I tried alternative healing again, but to no avail. After holding the symptoms at bay for 2 months, I finally went to a doctor. His advice to me was short and simple. He said, “You might be suffering from a gluten allergy. I’ll do a blood test and in the meanwhile, exclude all gluten from your diet.”

    I did exactly as he asked and cut out everything that contained gluten. After just 3 days, my mind felt clear again and I no longer felt like I was going to tip over the edge mentally. I went back a week later to pick up the results of the blood test and it showed that I had alot of antigens in my blood, reacting to gluten. The doctor said that my brain had been producing a sort of “morphine” in my brain, in reaction to gluten, and that is what I had been suffering from.

    I haven’t eaten any gluten since then, and have never had any sensations/thoughts/feelings associated with schizophrenia again.

    My diet was undeniably the cause of schizophrenic symptoms and the removal of gluten not just reduced the symptoms, but completely stopped them.

    As I consider my taste for different foods, I’ve realised that ever since I was a child, I have intuitively disliked gluten-based foods, never knowing what gluten was until seeing the doctor in 2005. Interestingly, as I look back on the 3 times when I showed signs of schizophrenia, I was living with my parents or living with my brother, whose diets contain alot of gluten. Naturally, during those times, we were sharing meals and using a kitchen that was not gluten-free.

    This doctor saved my life and without his insight into the link between schizophrenia, I may have been wrongly medicated for this illness for the rest of my life.

    Thanks for putting your article up on the web, it’s unbelievable that this stuff isn’t more widely recognised and acknowledged.


  4. JP Says:

    What an incredible story, Krista! Thank you so much for sharing it with us! Truly fantastic!

    Be well!


  5. rpackmanus Says:

    incredible. how myopic are doctors anyway?

    22 years ago i was diagnosed schizophrenic. just yesterday i am diabetic. today i’ve been researching gluten. why? cause i went off carbs all together and was looking for alternative ‘flour’. then i realized that things i had been suffering for many years are gone!

    i could’nt live without immodium, had constant aches and pains, especially when i woke i could’nt move at first. i’m only 44! my sinuses were always flowing like a tap. gluten causes all sorts of things, maybe even diabetes itself cause it messes with homones responsible for insulin release and absorbtion of minerals. i was vitamin deficient. i’m eating nothing but eggs, meat and vegitables and probably never felt better in my life!

    diabetes was a wake-up call, but maybe a blessing in disguise.

    i will now be very diligent because i have to be, it may save my life. 1 in 7 people are gluten intolerant. 1 in 250 are full blown celiac, but 1 in 20 diabetics are! celiacs are not all skinny. 39% of celiacs are now overweight! a friend was treated for depression and found it was gluten, now he just had a knee operation and found he was rhuematoid. he previously had terrible digestive problems as did i.


  6. Steph L Says:

    Ironically the initials used for this person C.D. – also stand for coeliac disease…

  7. JP Says:

    Ha! Who says God (or the scientists involved) don’t have a sense of humor?! 🙂

    Be well!


  8. joanna Says:

    i have been on a gluten free diet for over 15yrs now, my life literally depends on me sticking to it. i had the most horrendous violent disturbed teenage and twenties years of my life. being arrested and fighting all the time, self harming, suicide attempts, depressions, just wild behaviour…drink drugs and all the awful things that go along with this lost life….i felt so out of control totally mad, but inside, inside my head. as though it was me, i heard voices, had insomnia, anyway one day by chance i read an article about coping with extreme PMT. which i also suffered from, it mentioned naturapathy and food allergy testing. i went for a test and was recommended a gluten free diet. my doctor had tried to suggest a drug fro schizophrenia…..within days of being on the gluten free diet the voices stopped, i felt calm, and i started to sleep. i am so sensitive to gluten now as i have avoided it for so long, the slightest mistake of ingesting some and the symptoms are horrendous, with in 10 minutes i will have diorrehea, be vomitting or screaming and crying bashing my head against a wall, dragging a knife over my wrist, trying to fight my partner, hearing voices etc……this problem has meant i have not really been able to have a relationship…i have meoved myself from society and live alone up a mountain,,,,i am extremely lonely and wish i could have a relationship, i am trying at the moment with a very kind man but he is tested to the limit, and a treat in going out for dinner or a holiday just end in disaster every time how ever carefull i try to be. my brother also was a self harming suicidal extreme person i reccomended the gluten free diet to him and he has found it very important for his mental health also……..

  9. JP Says:

    Thank you for sharing your experience with us, Joanna. I’m so sorry for the hardship that you and your family have gone through.

    I avoid gluten in my daily life. My reaction to it isn’t as severe as yours. However, I find that I think more clearly and feel healthier (digestion- and energy-wise) when I exclude it from my routine.

    Have you considered experimenting with supplemental enzymes on the rare occasions when you go out to eat? I wonder if they may help protect against any cross-contamination issues that could come up. Lots of anecdotal evidence, though little scientific research, suggests such products may assist some people to live more “normal” lives.


    Be well!


  10. JP Says:

    Update 06/05/15:


    Clin Psychopharmacol Neurosci. 2015 Apr 30;13(1):62-7.

    An Open Study of Sulforaphane-rich Broccoli Sprout Extract in Patients with Schizophrenia.

    OBJECTIVE: Schizophrenia is a mental disorder characterized by severe cognitive impairment. Accumulating evidence suggests a role for oxidative stress in the pathophysiology of schizophrenia. Sulforaphane (SFN) extracted from broccoli sprout is an agent with potent anti-oxidant and anti-inflammatory activity. In this study, we attempted to evaluate the effect of SFN on cognitive impairment in medicated patients with schizophrenia.

    METHODS: We recruited a total of 10 outpatients with schizophrenia, all of whom gave informed consent. Participants took 3 tablets of SFN, consisting of 30 mg of SFN-glucosinolate per day, for 8 weeks. Clinical symptoms using the Positive and Negative Syndrome Scale (PANSS) and cognitive function using the Japanese version of CogState battery were evaluated at the beginning of the study and at week 8.

    RESULTS: A total of 7 patients completed the trial. The mean score in the Accuracy component of the One Card Learning Task increased significantly after the trial. However, we detected no other significant changes in participants.

    CONCLUSIONS: This result suggests that SFN has the potential to improve cognitive function in patients with schizophrenia.

    Be well!


  11. JP Says:

    Updated 09/05/15:


    Clin Schizophr Relat Psychoses. 2015 Jul 28.

    Add-on Pregnenolone with L-Theanine to Antipsychotic Therapy Relieves Negative and Anxiety Symptoms of Schizophrenia: An 8-week, randomized, double-blind, placebo-controlled trial.

    AIMS: Pregnenolone (PREG) and L-Theanine (LT) have shown ameliorative effects on various schizophrenia symptoms. This is the first study to evaluate the efficacy and safety of augmentation of antipsychotic treatment among patients with chronic schizophrenia or schizoaffective disorder with PREG – LT.

    METHODS: Double-blind, placebo-controlled trial of PREG – LT or placebo augmentation was conducted for 8 weeks with 40 chronic DSM-IV schizophrenia and schizoaffective disorder patients with suboptimal response to antipsychotics. Oral PREG (50 mg/day) with LT (400 mg/day) or placebo were added to a stable regimen of antipsychotic medication from March 2011 to October 2013. The participants were rated using the Scale for the Assessment of Negative Symptoms (SANS), Hamilton Scale for Anxiety (HAM-A), and Positive and Negative Syndrome Scale (PANSS) scales bi-weekly. The decrease of SANS and HAM-A scores were the co-primary outcomes. Secondary outcomes included assessments of general functioning and side effects.

    RESULTS: Negative symptoms such as blunted affect, alogia, and anhedonia (SANS) were found to be significantly improved, with moderate effect sizes among patients who received PREG-LT, in comparison with the placebo group. Add-on PREG-LT also significantly associated with a reduction of anxiety scores such as anxious mood, tension, and cardiovascular symptoms (HAM-A), and elevation of general functioning (GAF). Positive symptoms, antipsychotic agents, concomitant drugs, and illness duration did not associate significantly with effect of PREG-LT augmentation. PREG-LT was well-tolerated.

    CONCLUSIONS: Pregnenolone with L-Theanine augmentation may offer a new therapeutic strategy for treatment of negative and anxiety symptoms in schizophrenia and schizoaffective disorder. Further studies are warranted.

    Be well!


  12. JP Says:

    Updated 09/23/15:


    Rev Bras Psiquiatr. 2015 Sep 15.

    A 20-week program of resistance or concurrent exercise improves symptoms of schizophrenia: results of a blind, randomized controlled trial.

    OBJECTIVE: To evaluate the effects of 20 weeks of resistance and concurrent training on psychotic and depressive symptoms, quality of life outcomes, and serum IGF-1, IGFBP-3, and brain-derived neurotrophic factor (BDNF) concentrations in patients with schizophrenia.

    METHODS: In this blind, randomized controlled clinical trial, 34 patients with schizophrenia were assigned to one of three groups: control (CTRL, n=13), resistance exercise (RESEX, n=12), or concurrent exercise (CONCEX, n=9). Symptoms, quality of life, strength, and other variables were assessed.

    RESULTS: A significant time-by-group interaction was found for the RESEX and CONCEX groups on the Positive and Negative Syndrome Scale (PANSS) total score for disease symptoms (p = 0.007), positive symptoms (p = 0.003), and on the arm extension one-repetition maximum (1RM) test (p = 0.016). In addition, significant improvements on negative symptoms (p = 0.027), on the role-physical domain of the Short Form-36 Health Survey (p = 0.019), and on the chest press 1RM test (p = 0.040) were observed in the RESEX group. No changes were observed for the other variables investigated.

    CONCLUSIONS: In this sample of patients with schizophrenia, 20 weeks of resistance or concurrent exercise program improved disease symptoms, strength, and quality of life.

    Be well!


  13. JP Says:

    Updated 1/18/16:


    Clin Gastroenterol Hepatol. 2015 Dec 31.

    Efficacy of a Gluten-free Diet in Subjects With Irritable Bowel Syndrome-Diarrhea Unaware of Their HLA-DQ2/8 Genotype.

    BACKGROUND & AIMS: A gluten-containing diet alters bowel barrier function in patients with irritable bowel syndrome-diarrhea (IBS-D), particularly those who are positive for human leukocyte antigen (HLA) allele DQ2/8. We studied the effects of a gluten-free diet (GFD) in patients with IBS-D who have not previously considered the effects of gluten in their diet and were unaware of their HLA-DQ2/8 genotype.

    METHODS: We performed a prospective study of 41 patients with IBS-D (20 HLA-DQ2/8-positive and 21 HLA-DQ2/8-negative) at the Royal Hallamshire Hospital in Sheffield, United Kingdom, from September 2012 through July 2015. All subjects were placed on a 6 week GFD following evaluation by a dietician. Subjects completed validated questionnaires at baseline and week 6 of the GFD. The primary endpoint was mean change in IBS symptom severity score (IBS-SSS); a 50 point reduction was considered to indicate a clinical response. Secondary endpoints were changes in hospital anxiety and depression score, fatigue impact score, and short form 36 results. Clinical responders who chose to continue a GFD after the study period were evaluated on average 18 months later to assess diet durability, symptom scores, and anthropometric and biochemical status.

    RESULTS: A 6 week GFD reduced IBS-SSS by ≥50 points in 29 patients overall (71%). The mean total IBS-SSS decreased from 286 before the diet to 131 points after 6 weeks on the diet (P<.001)-the reduction was similar in each HLA-DQ group. However, HLA-DQ2/8-negative subjects had a greater reduction in abdominal distension (P=.04). Both groups had marked mean improvements in hospital anxiety and depression scores, fatigue impact score, and short form 36 results, although HLA-DQ2/8-positive subjects had a greater reduction in depression score and increase in vitality score than HLA-DQ2/8-negative subjects (P=.02 and P=.03, respectively). Twenty-one of the 29 subjects with a clinical response (72%) planned to continue the GFD long term; 18 months after the study they were still on a GFD, with maintained symptom reductions, and demonstrated similar anthropometric and biochemical features compared to baseline. CONCLUSION: A dietitian-led GFD provided sustained benefit to patients with IBS-D. The symptoms that improved differed in magnitude according to HLA-DQ status. Be well! JP

  14. JP Says:

    Updated 04/13/16:


    Front Hum Neurosci. 2016 Mar 29;10:130.

    Bread and Other Edible Agents of Mental Disease.

    Perhaps because gastroenterology, immunology, toxicology, and the nutrition and agricultural sciences are outside of their competence and responsibility, psychologists and psychiatrists typically fail to appreciate the impact that food can have on their patients’ condition. Here we attempt to help correct this situation by reviewing, in non-technical, plain English, how cereal grains-the world’s most abundant food source-can affect human behavior and mental health. We present the implications for the psychological sciences of the findings that, in all of us, bread (1) makes the gut more permeable and can thus encourage the migration of food particles to sites where they are not expected, prompting the immune system to attack both these particles and brain-relevant substances that resemble them, and (2) releases opioid-like compounds, capable of causing mental derangement if they make it to the brain. A grain-free diet, although difficult to maintain (especially for those that need it the most), could improve the mental health of many and be a complete cure for others.

    Be well!


  15. JP Says:

    Updated 06/14/16:


    Arch Psychiatr Nurs. 2016 Jun;30(3):375-81.

    Research on the Effect of the Foot Bath and Foot Massage on Residual Schizophrenia Patients.

    Researchers performed foot baths and massages for residual schizophrenia patients to gauge the effects on psychiatric symptoms. Subjects were six residual schizophrenia patients hospitalized in a psychiatric hospital. Three times a week for 4weeks, they received an 8-minute effleurage massage to their legs after a 10-minute foot bath. The effect of physiological relaxation was identified by a significant decline in heart rate in all cases. The results of the Positive and Negative Symptom Scale are as follows: a mean score of 29.0 was measured before treatment, which lowered to 21.5 after treatment, indicating that foot care improved their negative symptoms (p<0.05).The results of the Quality of Life Scale before the foot care intervention, were 10.5 and increased to 34.0 after the intervention, indicating improvement in their quality of life (p<0.05). The results of the two measurements indicate that foot baths and massages were effective in improving psychiatric symptoms.

    Be well!


  16. JP Says:

    Updated 08/24/16:


    Acta Neuropsychiatr. 2016 Aug 12:1-13.

    A randomised controlled trial of adjunctive yoga and adjunctive physical exercise training for cognitive dysfunction in schizophrenia.

    BACKGROUND: Yoga and physical exercise have been used as adjunctive intervention for cognitive dysfunction in schizophrenia (SZ), but controlled comparisons are lacking. Aims A single-blind randomised controlled trial was designed to evaluate whether yoga training or physical exercise training enhance cognitive functions in SZ, based on a prior pilot study.

    METHODS: Consenting, clinically stable, adult outpatients with SZ (n=286) completed baseline assessments and were randomised to treatment as usual (TAU), supervised yoga training with TAU (YT) or supervised physical exercise training with TAU (PE). Based on the pilot study, the primary outcome measure was speed index for the cognitive domain of ‘attention’ in the Penn computerised neurocognitive battery. Using mixed models and contrasts, cognitive functions at baseline, 21 days (end of training), 3 and 6 months post-training were evaluated with intention-to-treat paradigm.

    RESULTS: Speed index of attention domain in the YT group showed greater improvement than PE at 6 months follow-up (p<0.036, effect size 0.51). In the PE group, 'accuracy index of attention domain showed greater improvement than TAU alone at 6-month follow-up (p<0.025, effect size 0.61). For several other cognitive domains, significant improvements were observed with YT or PE compared with TAU alone (p<0.05, effect sizes 0.30-1.97).

    CONCLUSIONS: Both YT and PE improved attention and additional cognitive domains well past the training period, supporting our prior reported beneficial effect of YT on speed index of attention domain. As adjuncts, YT or PE can benefit individuals with SZ.

    Be well!


  17. JP Says:

    Updated 12/12/17:


    EBioMedicine. 2017 Dec 2.

    Vitamin D Supplementation in Chronic Schizophrenia Patients Treated with Clozapine: A Randomized, Double-Blind, Placebo-controlled Clinical Trial.

    BACKGROUND: While accumulating evidence suggests that vitamin D deficiency may be involved in the risk to develop schizophrenia and its outcome, there are no studies on vitamin D supplementation in this context. We sought to assess the effect of vitamin D supplementation on psychiatric, cognitive and metabolic parameters in chronic clozapine-treated schizophrenia patients.

    METHODS: This eight-week, randomized, double-blind, placebo-controlled clinical trial, recruited schizophrenia patients who had been maintained on clozapine treatment for at least 18weeks and had low levels of vitamin D (<75nmol/l) and total PANSS scores >70 (to ascertain the presence of residual symptoms). Patients were randomly allocated to either weekly oral drops of vitamin D (14,000IU) or placebo and subsequently assessed at two-week intervals for psychosis severity, mood, cognition and metabolic profile.

    RESULTS: Twenty four patients were randomly assigned to vitamin D (aged 39.4±9.6years, 75% males) and the other 23 patients to the placebo arm (aged 42.5±11.2years, 60.9% males). After eight weeks, the vitamin D group exhibited a significant increase in vitamin D levels (31.4 vs -0.4nmol/l, p<0.0001). There was no significant effect of vitamin D on psychotic, depressive or metabolic parameters. However, in the vitamin D group, there was a trend towards improved cognition (effect size=0.17, significance lost following Bonferroni correction).

    CONCLUSIONS: Vitamin D supplementation was associated with a trend towards improved cognition, but did not affect psychosis, mood or metabolic status. It is possible that the robust decrease in the PANSS scores in both groups may have obscured an effect of vitamin D supplementation.

    Be well!


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