December is Energy and Mitochondria Month!

According to the Centers for Disease Control and Prevention, over 15% of women and 10% of men experience fatigue. Fatigue is characterized by a lack of mental or physical energy, low initiative, and increased feelings of tiredness. Mitochondria, organelles found in the body’s cells, are known as the body’s “powerhouses” since they play an important role in energy production. Supporting your body’s mitochondria and the process of energy production may involve consuming a balanced diet, engaging in regular physical activity, optimizing sleep, managing stress, and taking certain dietary supplements.

To celebrate Energy and Mitochondria Month, I’m offering you a discount of 5% on all of your orders through my Fullscript dispensary, so making your health a priority is easier than ever.

Below is some useful information about top recommended supplements for energy support, including popular products from my dispensary.

Acetyl-l-carnitine
The amino acid carnitine, found in high amounts in cardiac and skeletal muscle tissue, is involved in transporting long-chain fatty acids into mitochondria to be used for energy. One form of carnitine, acetyl-l-carnitine (ALCAR), may be better absorbed and has been found to cross the blood-brain barrier. Research suggests that ALCAR supplementation may delay the deterioration of mitochondria and reduce mental and physical fatigue associated with aging. 

Top acetyl-l-carnitine supplements on Fullscript:
Acetyl L-Carnitine 800mg by Designs for Health 

Acetyl-L-Carnitine by Seeking Health 

Find acetyl-l-carnitine-containing supplements on Fullscript 


Alpha lipoic acid 
Alpha lipoic acid (ALA), obtained through dietary sources and synthesized in the mitochondria, is an antioxidant and cofactor in mitochondrial energy production. ALA helps to regenerate other antioxidants, including vitamins C, E, and glutathione, the body’s master antioxidant. As a dietary supplement, the antioxidant and anti-inflammatory effects of ALA may benefit individuals with diabetic neuropathy and central nervous system disorders, such as multiple sclerosis and Parkinson’s disease. 

Top alpha lipoic acid supplements on Fullscript
Alpha Lipoic Acid 600mg by Pure Encapsulations 

Alpha Lipoic Acid (R+) 300mg by Professional Formulas 

Find alpha lipoic acid-containing supplements on Fullscript 


B vitamins
The eight B vitamins are essential to brain function and energy production. Deficiency in one or several of these vitamins, such as pyridoxine (B6) and cobalamin (B12), may result in neurological symptoms and cognitive decline. Additionally, thiamin (B1), riboflavin (B2), niacin (B3), and folate (B9) have been studied for their potential to improve symptoms of mitochondrial disorders. In individuals with these conditions, supplementation may reduce fatigue, improve exercise tolerance, and improve general well-being.

Top B vitamin supplements on Fullscript
Active B-Complex by Integrative Therapeutics

B-Complex Plus by Pure Encapsulations

Find B vitamin-containing supplements on Fullscript 

Coenzyme Q10
A fat-soluble compound, coenzyme Q10 (CoQ10) is synthesized in the body, found in certain foods, including fish, meat, and whole grains, and commonly used as a supplement. CoQ10 is an antioxidant and a cofactor in the electron transport chain, a critical cycle that occurs in the mitochondria, which supports cellular energy production. Although research findings are mixed, there is some evidence that CoQ10 supplementation may benefit individuals with mitochondrial disorders by increasing muscle strength and improving energy repletion.

Top coenzyme Q10 supplements on Fullscript
UBQH 100mg by Integrative Therapeutics 

CoQnol (Ubiquinol) 100mg by Designs for Health

Find coenzyme Q10-containing supplements on Fullscript 

N-acetyl-cysteine
N-acetyl-cysteine (NAC) is a precursor to the amino acid cysteine and the potent antioxidant glutathione. Preliminary research suggests that NAC supplementation may benefit individuals with chronic fatigue syndrome and protect against degenerative processes, including neurodegenerative diseases and myocardial dysfunction. Further, studies in athletes have shown that NAC may increase athletic performance.

Top n-acetyl-cysteine supplements on Fullscript
NAC by Integrative Therapeutics 

NAC 600mg by Pure Encapsulations 

Find n-acetyl-cysteine-containing supplements on Fullscript

To learn more, see the Fullscript handouts on Fatigue and Mitochondria.

Log in to your Fullscript account now to explore these supplements and receive a 10% discount on your order!

Book an appointment through Charm EHR

I can assist in a variety of health issues like weight loss, eczema, IBS, food allergies, constipation, low immunity, fatigue, fatty liver, insomnia, hormonal issues, optimal health, sports training, detoxification programs, healthy cooking and shopping, etc. There is a lot of misinformation on the net, so professional advice can not only save you money, but at times it can be critical to prevent complications.

With an integrative and holistic approach, I aim to understand you as a whole and your condition at its root.

Areas of Expertise & Interest:
  • SIBO/Candida/Leaky Gut/Digestive Dysfunction
  • Hormone Balancing
  • Supplement Regimen Customization
  • Detoxification
  • Lifestyle & Diet Education
  • Aromatherapy

Televisits are a great option for people who do not require a prescription.

If you need a prescription, an initial in-person appointment is required.

Click here to book an appointment

1. Go to http://www.charmehr.com. Select “TC Living”. Pick an appointment time slot.
2. Once you create an account and your appointment is confirmed, questionnaires will be uploaded via the secure portal.
3. Visits are one hour in length.
4. You can upload any labs or reports you may have prior to or after your visit.
5. I will help you streamline your regimen, and suggest any testing that may be helpful.
6. A follow up appointment is recommended after the initial appointment to review results and progress..

FAQ

What does the process involve if I decide to see Dr. Comeaux?

Please either schedule in the portal or email (www.vitadoc2@gmail.com) to fix an appointment. Ideally, you would need to forward any recent (3-4 months old) blood test results along with you for the consult. Labs are not required, but are recommended and useful, even if they are not up to date. During the consult, the person’s blood test is analyzed using functional chemistry, then based on the client’s medical history, goals, lifestyle limitations, a diet, supplement and lifestyle recommendations are customized for the individual. A follow up may be necessary within a month’s time.

Do I need to get tests done to achieve my goals?

In order to determine core issues, an assessment or blood test can help determine what nutrients are missing and what is in excess (toxins), which can help customize a plan as opposed to a general consultation based purely on medical history. If you have health challenges, a blood test can be used as a comparison tool if you are using nutrition to create improvements, and help reduce medication as determined by a doctor.

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Do I have to buy all the supplements from you?

No. Your care is not compromised if you do not purchase supplements from me.

I do provide access to fullscripts (https://us.fullscript.com/welcome/tcomeaux) and gethealthy.store (https://tamyracomeaux.gethealthy.store/product/) for medical grade supplements for your convenience. If you need essential oils, my preferred brand is Young Living, because many of my recommendations stem from my experience with this line of products. Young Living access

I may receive a commission or some other benefit from the products from these websites.

Items are sometimes available on other websites, but sometimes counterfeit supplements are substituted for real ones.

I do recommend what supplements to buy and where. In case you are using a particular supplement, I can guide you in helping to maximize your results.

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How do I know the program is working?

The client becomes an active partner in the journey towards optimum wellness. The end result will depend upon the amount of commitment you have put into the program and when you start feeling good, you start looking good! But getting another blood test or assessment done can reveal undeniable results.

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My appointments are booked by the hour.  The cost is $400 per hour.  Most clients see me 2-3 times per year.

If you are local to the Houston area, please call Radiance Medical Aesthetics & Wellness to schedule an appointment.

6777 Woodlands Parkway, Suite 300
The Woodlands, Texas 77382
(281) 367-4700

Young Living- Thieves

Thieves essential oil is a blend of clove, cinnamon, rosemary, lemon and eucalyptus. The Thieves blend was created based on the historical account of four thieves in France who protected themselves from the Black Plague with cloves, rosemary and other aromatics while robbing victims of the killer disease. When captured, they were offered a lighter sentence in exchange for their secret recipe. Thieves is a definite must-have in my home.

What we do know, through extensive use and trial with the Thieves essential oil blend from Young Living is that a powerful combination of clove, lemon, cinnamon bark, eucalyptus, and rosemary have been found to be strong enough to reduce bacterial cultures by 99.96%! This blend was created after years of research results indicated that most viruses, fungi, and bacteria cannot live in the presence of some essential oils. While I’ve seen the use of Thieves in room sprays (by combining distilled water with 15 drops of the oil) or by rubbing a few drops of the oil on the soles of the feet, there is an entire line of products which highlight the blend. Other way to attain the healing benefit of Thieves is to add the blend to a diffuser, use the lozenges, or even add one drop to a glass of water to drink.

The legend behind the oil is as unique as the healing powers it can provide to your system. While the product is more expensive than what you may expect for a small bottle of oil, the germ-killing power of Thieves is worth every penny and not only during the cold weather months when cold and flu strike. If you use an anti-bacterial soap in your kitchen or bathroom year-round, why not consider making it Thieves Foaming Hand Soap without all the harsh chemicals? Young Living also created Thieves toothpastes and even a household cleaner containing the powerful blend!

You can use essential oils, also commonly referred to as EOs, aromatically, topically, internally or around the home.

I love diffusing essential oils, especially Thieves due to the humidity and risk of mold in humid climates, and during flu season.

I also add a few drops of essential oil into my bath, usually Thieves if I feel I have been exposed to someone ill, or something relaxing, like Jasmine, Palmarosa, Lavender or Rose.

You can also take essential oils internally. If I feel under the weather, I will add a drop of Thieves to an 8 oz glass of water, or if I want something refreshing, I add one drop of lemon, grapefruit, or orange to my water before I drink it. I find it helps me hydrate more.

Certain essential oils make excellent cleaning products for around the house or as part of your personal care routine. Thieves and Lavender are so multi-purpose that entire product ranges have been produced out of them, including household cleaners, soaps, toothpaste and shampoos. Thieves essential oil blend is also effective against black mold.

I also like Thieves, and use it in place of some household cleaning products.

Add 1 capful of Thieves Household Cleaner with 1/2 cup of water in a spray bottle. Spray tile and grout. Let sit for a couple of minutes. Use a small brush to get stains out. You may use less water for stronger concentration as needed.

Toilets: Mix 1⁄4 cup of Baking Soda with 1⁄2 capful of Thieves cleaner. Apply to toilet brush. Clean.

Tub Scrub: Take 1⁄2 cup of Baking Soda, 2 capfuls of Thieves Cleaner, 1 T water, 5 drops of Thieves oil, and 5 drops of Lemons. Mix to a paste. Scrub your bathtub with it. Then wipe clean with water. Apply generic Thieves Cleaner Spray and apply!

Mirror Cleaner/Window Cleaner: Place 1 capful of Thieves cleaner in a spray bottle with 4 cups of water. Spray down windows (or any glass) as you would with your “regular” glass cleaner.

My membership number is 13479146
If you want to sign up or just order single products, please refer to the video below for sign up instructions.

For statistical earning data of Young Living members, click here.

Become a member now by clicking the button below.
Pick the membership option—Independent Distributor or customer—that matches your current situation.

Become a Member

7 Signs you need an Integrative Health Coach

An integrative doctor–whether a primary-care physician, an ob-gyn, or an oncologist–enlists Western approaches when appropriate and then complements them with other treatments.

The health of Americans is steadily declining despite the amount of money spent on health care, high-technology medicine, and educational efforts. Hypertension, Diabetes, auto-immune disease and obesity rates continue to sky-rocket among adults and children.

Unless we wake up and take responsibility for our own health, the pattern will continue. An integrative health coach will listen to you and guide you in making choices that will improve your health.

Here are the top 7 reasons you need an integrative health coach now:

1. Many people don’t follow through with their New Year’s Resolution to lose weight or get healthy.

80% of people who make New Year’s resolutions break them. When you break your 2017 resolution, don’t wait for January 1, 2018 to follow through on what you need to do for your health. Make a resolution every day when you wake up to improve your health. A physician who focuses on prevention will show you how to make small changes that will build up to a lifetime of good health.

2. You don’t understand why you have gained the weight.

Over the years the extra few pounds have stayed on you, but you are eating better. There are many dietary changes that you need, but you don’t know where to start. An integrative health coach will help you identify the easiest changes to make today that will make the biggest impact on your health. An integrative physician can also factor in the impact that insulin, cortisol, and other hormones are having on your health.

3. You have cravings that you don’t know how to handle so you end up eating.

You figure that you don’t have any control over the cravings so you just give in, every time, year after year. An integrative health coach will help you identify the cause of the cravings and enable you to beat your cravings or binge eating using a combination of natural and/or prescription methods.

4. You have cancer, diabetes, or heart disease in your family, and want to a plan to prevent them.

We can use genetic information and family history to develop a plan to reduce, delay, or eliminate your chance of getting a chronic illness. In the long run, it saves you money…. and stress.

5. You want to lose your sugar addiction, cigarette craving, or curb your appetite for alcohol.

What do smoking, eating disorders, and texting all have in common? They often result from stress and anxiety. These behaviors often develop as ways to modify a person’s “fight or flight” response to stress triggers. Stressed by work? Fighting or fleeing may not be options—but calming your nerves with a cigarette or drink is. We explore the triggers and possible herbal and prescription medications that may be of benefit.

6. You are confused about whether meat, protein, carbs, dairy, produce, or GMO foods are healthy.

A new diet book is written every day. How can you tell what is healthy for you?  There are various ways to evaluate your “inflammatory foods”. An integrative health coach will help you determine what foods are healthy for YOU and what will work for YOU.

7. Nothing has worked before so you continue to gain weight or have chronic health issues.

Chances are you have given up because nothing you have tried before worked. If you have gained weight, or if you are suffering from chronic health issues that are blood sugar-related, high cholesterol, blood pressure, inflammation or arthritis, or other health issues, you may be able to improve your health with herbs, vitamins, or nutrition. A health coach can help you wade through the mountains of research to figure out what works for you and your health.

Do something for yourself today and talk to an integrative health coach! Your life and health could improve, and you could feel better!

Age Management Medicine

Age Management Medicine

The field of Age Management Medicine is fairly new to the medical world. Most people just assume it’s “Anti-Aging” Medicine, which has a sort of built-in connotation of vanity or the quest to live forever. There often ends up being an immediate reaction that it’s not “real” medicine, but a luxury reserved for the rich and famous or people who fear death – or simply fear looking old.

Clearing Up the Myths:

To start, I’d like to dispel the myth that Age Management is simply a “vanity” sort of medical field. A good place to begin is simply by defining Age Management Medicine. Age Management Medicine is a proactive, preventative approach to healthcare. It’s not simply  testosterone, estrogen, progesterone, thyroid, etc. It is a scientifically-based approach to aging focused on preservation of optimum human function and quality of life, making every effort to slow the process of degeneration of the body that comes with aging.

So Age Management Medicine is not about living to be 120 or 130 years old. It’s about helping you look, feel, and function as good as possible for a long as possible. It’s about enjoying a very high quality of life as you age, continuing to do what you love without becoming increasingly reliant on the care of others – which most of us fear.

The key difference between Age Management Medicine and most other medical specialties is that its approach is proactive. In most fields of traditional medicine, the medical community’s approach is: wait until you get sick, then prescribe treatment. Age Management’s interventions are intended to preserve for the highest quality of life for you for the longest period of time.

Is Age Management Just Prescribing Hormones?

Another myth is that Age Management just means prescribing hormones. While hormones (thyroid, DHEA, testosterone, estrogen, progesterone, Human Growth Hormone (HGH), melatonin) do play a key role in aging as well as in disease prevention, there are many other factors at play.

If you’re like most people, levels of key hormones begin to decline in your late 20s to early 30s (Note to women: this is way before menopause!). And some hormones, like melatonin, start to fall as early as your late teens. So a key component of Age Management is restoring the hormones that are declining as we age to levels that are associated with the highest quality of life and lowest incidence of bodily decline and degenerative diseases.

So in addition to prescribing hormones, we also do this by focusing on other key areas that affect hormone production or decline:

Nutrition: When you think about it, virtually every cell in your body gets its building blocks from what you eat. There are certain types of foods and patterns of eating that optimize hormone production and utilization.  Evaluating your food allergies and food “sensitivities” is an important part of our evaluation.
Exercise: We make personalized exercise recommendations to optimize hormone production and your body’s use of key hormones to burn fat, preserve lean muscle mass, and prevent degeneration.
Lifestyle: Factors like stress and sleep play a key role in determining where your hormone levels are. Both poor sleep and chronic stress (mental and physical) increase the levels of fat-storing, disease progressing hormones (insulin, cortisol, etc.) and decrease the levels of fat-burning, disease preventing hormones (thyroid, DHEA, testosterone, estrogen, progesterone, Human Growth Hormone (HGH), etc.). We’ll help you optimize these areas of your life as well.

So What About Prescribing Hormones?

Even if you’re eating right, exercising right, and have a low stress lifestyle, you will experience a drop in key hormones as you get older. This is called age-related hormonal decline. Either the cells that produce hormones are dying off, or the enzymes that convert less active forms of hormones to their more active forms, are working less efficiently. This loss is what takes away the look and feel of being young and leaves you more susceptible to chronic degenerative disease. This is when individualized, targeted hormone therapy is used. Optimizing your hormone levels is key in increasing your quality of life and level of functioning as well as decreasing your risk of degeneration, decline, and disease.

The Most Common Benefits of Age Management Medicine

Increased energy and decreased fatigue
Maintaining a healthy body weight
Improved body composition and lower body fat
Improved sleep
Increased sex drive and performance
Maintaining bone density and strength
Maintaining healthy brain function and prevention of dementia
Decreased risk of heart disease, cancer, diabetes and other serious ailments
Increased overall feeling of well-being – you just feel better!

 

How To Get Started

Evaluation/Lifestyle Assessment
An in-depth evaluation reviewing your intake questionnaire, your current health concerns, goals as well as looking at your past medical history, family history, medications, and current lifestyle habits.
Comprehensive Laboratory Testing
Comprehensive baseline laboratory testing determining your current health status, key hormone levels and specific disease risk markers.
Analysis & Implementation
Your personalized, proactive treatment plan consisting of appropriate medications, nutritional recommendations, exercise recommendations, lifestyle management and any other appropriate medical interventions.
Ongoing Support & Monitoring
Periodic lab testing and consultations to maintain gains and adjust treatment plan as needed. We continue to work with you to keep you looking and feeling your best.

 

To schedule an Age Management/Hormonal evaluation, call (281) 367-4700 or e-mail us directly at vitadoc2@gmail.com.

History of Low Dose Naltrexone

Naltrexone was created in 1963 as an opioid receptor blocker. This means naltrexone binds to opiate receptor and neutralizes the action of opiates on the opiate receptor. Naltrexone was approved by FDA in 1984 for the treatment of opioid addiction. The typical daily dosage for opioid addiction is 50 to 100 mg daily. Low Dose Naltrexone or LDN refers to daily dosages of naltrexone that are between 1.5 is 4.5 mg.  More than 20 years ago it was discovered that very small doses of this drug—3 to 4.5 mg—have profound effects on the immune system

Basic science work examining the use of opioid antagonists for treating other diseases did not appear until the late 1980s, and the first published LDN trial in humans was presented in 2007. Since that time, LDN has been studied and has been slowly gaining attention as a possible treatment for some chronic medical conditions. Currently, the best documented scientific use of LDN is in treating autoimmune conditions such as multiple sclerosis, Crohn’s disease, and Hashimoto’s thyroiditis.

What Other Conditions has LDN been used for?

ALS (Lou Gehrig’s disease)
Alzheimer’s disease
Ankylosing spondylitis
Anti-aging
Autism
Celiac disease
Chronic fatigue syndrome
Crohn’s disease
Endometriosis
Fibromyalgia
Inflammatory bowel disease
Lupus
Multiple sclerosis (MS)
Parkinson’s disease
Psoriasis
Rheumatoid arthritis
Sarcoidosis
Scleroderma
Ulcerative colitis

Another documented use of Naltrexone is for treating obesity. Contrave, a new medication approved to treat obesity in 2014, combines Naltrexone and bupropion in a sustained release formula. Both bupropion and Naltrexone individually have shown evidence of weight loss and the combination aims to create a synergistic effect. Contrave is a sustained release formulation of Naltrexone and bupropion. The FDA has placed a boxed warning onto Contrave stating that it may affect mood and it may increase the likelihood of suicide. This potential adverse effect is most probably due to bupropion as such adverse effects have been observed with medications designed to treat mood disorders.  The Naltrexone dose in Contrave is higher than we use in Low Dose Naltrexone

What Does Treatment With LDN Involve?

LDN requires a prescription and is available only from compounding pharmacies. (Regular pharmacies typically carry only 50 mg capsules.) The suggested dose is 3–4.5 mg per day, taken orally at bedtime.

The only contraindication is narcotic drugs. Low-dose naltrexone blocks the effects of narcotics and could cause withdrawal symptoms, so it should be started only after those drugs are completely out of your system.

LDN is safe and well tolerated. You may have vivid dreams at first, but sleep disturbances are rare. To avoid this, start with a dose of 1.5 mg and build up slowly over two months.

 

How did you first learn about LDN?
I was familiar with Naltrexone as a treatment option for patients with cancer issues.  I heard about it while I was completing my Integrative Cancer Therapy fellowship at A4M.  Then it became FDA approved as a weight loss drug, and I took a look at how I could use it in my patients with sugar cravings.  I then learned about its use in fertility issues from Dr. Hilgers’ approach, but he was using the “normal” dose of Naltrexone to fully block the opioid receptors in order to improve fertility for patients. Later, I encountered the NaPro website,  which showed different type of approach: boosting endorphins through a low dose of Naltrexone. In this strategy, you aim for endorphin stimulation rather than blocking. So that was a completely new concept, and it didn’t occur to me at first that this would have a role for fertility. But then I started having good results in my patients who had rheumatoid arthritis and had a dramatic improvement on LDN. I thought, “The next time I see somebody with an autoimmune condition, I’m going to try them on this.”

 

What has been your experience using LDN with your patients?
I then started by prescribing LDN to the very obvious autoimmune patients, such as patients with active rheumatoid arthritis. In addition to improvements in their autoimmune condition, often patients would also report back to me, ‘You know what? I used to have horrible premenstrual syndrome and now that’s gone too.’ Or ‘I used to have low mood, fatigue and anxiety, and that’s no longer an issue.’ Or they had brown bleeding that has now stopped. Gradually I began to realize that these symptoms (PMS, polycystic ovaries, endometriosis, persistent fatigue, low mood, anxiety, sleep disturbance, brown menstrual bleeding, family history of autoimmune disorder) can be associated with clinical endorphin deficiency.

I was able to see over the course of about a year of prescribing LDN to the occasional autoimmune patient that not only did the endorphin deficiency symptoms improve with LDN, but it actually helped with weight as well.

It was deductive reasoning through clinical observation that led me to this conclusion.

I then decided that if we have patients who don’t have an obvious autoimmune diagnosis but have symptoms of possible clinical endorphin deficiency, we could try them on the LDN to see if the symptoms improve. Eight times out of ten symptoms like PMS and fatigue would improve. So now I use the presence of such symptoms as a guide for determining probable clinical endorphin deficiency. While other conditions can potentially cause these same symptoms, having low endorphins is a very common root cause, and therefore it’s worth a trial of LDN to see if the symptoms respond.

 

Given your clinical experience with LDN, what kind of patient do you think is best suited to benefit from it?
It depends on whether they need it in the first place. I try and make a clinical judgment about a patient’s probable endorphin levels. I think, ‘Does this person need LDN?’ If it looks like they probably do, we’ll try it and then we’ll listen to what their body tells us.

I look at a variety of factors that can be indicators of an underlying endorphin deficiency such as the presence of PMS, polycystic ovaries, endometriosis, persistent fatigue, low mood, anxiety, sleep disturbance, and family history of autoimmune disorder.

Do you also treat patients that do not have infertility issues with LDN?

I see a small handful of people with food addiction, smoking addiction, autoimmune conditions, and fibromyalgia; these can respond really well to treatment with LDN. I’m very quick to tell people I’m no expert in any of these kinds of conditions, but I’ve got a lot of good clinical experience with Naltrexone. I’m happy to give it a try for these patients because it’s safe. The worst case scenario is that it doesn’t work. It won’t do you any harm at least, apart from short-term transient side effects for a week or two while you get used to it.

Why do you consider LDN such an appealing treatment option?
If somebody has an autoimmune condition and they go on these super expensive, very strong immunosuppressive drugs to get relief of their symptoms but they’ve taken out their immune system by using them, while you may not see any immediate problems, you’re potentially putting yourself in harm’s way. You’re at risk of developing new additional autoimmune conditions, and you may potentially increase your risk of tuberculosis and different cancers because of the profound immune-suppression that you go through. So it’s not a great solution even if you can observe great clinical relief. LDN is so much more attractive. It’s inexpensive, has few side effects, is available in topical, sublingual and capsule forms, and it’s safe and easy to use compared to the alternatives out there.

Call the Woodlands location to schedule an appointment, or email an inquiry to vitadoc2@gmail.com.