Guest guest Posted January 15, 2004 Report Share Posted January 15, 2004 THE VITEX ANTHOLOGY: Explorations in Menopausal Balance Barbara Chopin Lucks 2000 INTRODUCTION The Vitex Anthology is a project born of curiosity. Vitex agnus castus, in its herbal form, has been used for many hundreds of years for a variety of conditions, including menstrual difficulties and menopause. The berry is the part traditionally used, and the action of the herb is attributed to a direct effect on the pituitary, resulting in balancing of progesterone levels. An interesting side effect of the herb is reflected in its common names " Chaste Tree " and " Monks Pepper " as its tendency to quell male sexual desire prompted the cooks at medieval monasteries to use it as a seasoning. Records dating back to ancient Greece reference use of the herb to promote chastity. The use of the essential oil of the plant is relatively new. Small experiments have been conducted by the Pacific Institute of Aromatherapy to determine if the oil is a useful tool in managing PMS. The method of use was one drop per day, taken internally. The oil caught my attention when I read Kurt Schnaubelt's " Medical Aromatherapy. " PMS had never been much of an issue for me, but menopause was being a roller-coaster ride. I ordered a small supply of the oil and volunteered to share my experience, for better or for worse. It turned out to be a wonderful oil for me, to the point that I ordered a liter so I would never run out. I would have been perfectly content to stop there, nipping on the Vitex from time to time, minding my own business. Then Kurt asked me to tell my story at his conference. Well, I was delighted to accept, but then I pictured myself telling my own story, just my story, and I pictured the audience saying, " Well, that's real nice, but these oils really can be idiosyncratic. Can't tell much from one person's experience. " I needed to take the investigation beyond myself for the data to have much meaning. I needed to find out if essential oil Vitex agnus castus, in the varied practice of self-care aromatherapy, would be a possible tool for menopausal balancing. Now this posed some instant problems. I live in a little mountain town of 1500 people, ¾ of whom are men. I am not a scientist, though I am a good researcher in the day to day life kind of way. I work full time in the hospitality industry so I can support my passions and still eat. One of my passions is essential oils, which I have been studying and using for five years. I have some 400 hours of formal study, plus countless happy hours of independent study and educated play. I teach grassroots aromatherapy at the community college and at craft fairs and community events in western Colorado. This hardly qualified me to do a clinical study. I was underfunded, underqualified and understaffed. Thank goodness I'm a writer. Writing has few rules, and writers are expected to be working on a shoestring. I decided that since I was underfunded, underqualified and understaffed to do a study, I would simply write an anthology. A collection of the work of others. I just had to find a bunch of ladies who would be willing to experiment with essential oil Vitex and share their stories with me. This process became a writer's dream. A story within a story within a story as some 30+ people, many of whom have never met any of the others, contributed to the completion of 23 case studies. These became 23 pieces of a jigsaw puzzle. Now, 23 pieces of a puzzle make up no more than a small section of the big picture. Yet, even that small section shows a distinct pattern of the action of essential oil Vitex agnus castus on those tormentations hurled at women as they pass through menopause. The dominant pattern is one of delicate and effective balance, with a few isolated splashes of rather surprising-even comical-side effects. We used two Vitex oils in the project. One was distilled in Crete from the ripe fruit of the plant. The other was distilled in Hungary from the aerial parts, the majority of which was leaves. 33 women volunteered to use the oils. 15 women received the 5 ml of the berry oil. 18 received 5 ml of the leaf oil. One woman, myself, used both oils. The ladies were asked to use the oil for three months, and to report their reasons for discontinuing use if they chose to stop sooner. Anyone with medical concerns was referred to their professional health care provider. Suggestions for application, as well as information about the herb and its traditional use, were provided with the oils. The only contraindications I could find in the literature were pregnancy and the use of oral contraceptives; this was noted in the information. Participants, most of whom were experienced with essential oil use, were free to use the oils in the manners in which they were personally comfortable. The only thing that was standardized was the reporting form, which 23 women returned. We gathered some amazing data and some interesting stories. Lest you wonder where the results are, the major quantifiable data is summarized later in this paper. There is a story in the numbers, to be sure. But there is also the story of the numbers and how they came to be. I want to tell you about both. THE PROCESS: The first challenge was to find participants, and I needed to find them fast. I had been participating on two e-mail aromatherapy chat lists with a total enrollment of about 1500 correspondents, most of them women. Now, these aromatherapy chat lists are no academic ivory tower. One is a discussion group made up of a mix of folk using essential oils professionally and personally. It is gently but firmly moderated by the list owner. The other is more like a bar scene where the band is playing in one corner while somebody at the end of the bar is trying to pull a fast one on a companion and another group of folks are throwing punches at each other in a side room. Well maintained, but totally unmoderated. Sometimes chairs fly through the air. Sometimes the bar fight drowns out the band and everybody agrees to settle down-for the time being. The few scientists who frequent the place tend to sit at the bar quietly smoking cigarettes, observing, and throwing out occasional bits of research data when the discussion demands. This is actually a fairly effective way of getting some pretty valuable information, as well as some real garbage. Discernment and the ability to dodge beer bottles are extremely helpful. This is not your typical place that a researcher would look for study participants. The e-mail lists, however, were the perfect place for a writer to find a diverse group of volunteers. I posted a message to both lists detailing my quest, offering 5 ml of oil at my expense, and clearly stating that the whole thing was an experiment. I made full disclosure of my underqualification, underfunding and understaffing. My only requirement for participation was that the woman be in the perimenopausal to postmenopausal transition. Self-diagnosis was fine with me-when a woman has been menstruating for some 30-40 years, I figure she can tell when things are changing. I got 33 takers, plus a wonderful bonus. Janina Sorensen, a Danish distiller and physiologist working in Crete, offered 100 ml of her berry oil to augment the supply of leaf oil I had purchased. Apparently this offer was not well received by her partner, who was horrified that she was sending 100 ml of their most precious oil off to some unknown broad in an American cyber-joint, a reasonable concern on his part. Fortunately, a couple of list mates publicly attested to my character, and Janina and I, plus the 33 participants, set off in a quest for knowledge. This project was the antithesis of a randomized, double-blind, placebo controlled study. If a woman preferred to use one oil over the other, I accommodated. Everybody knew exactly what they were using, and everyone got the high-test stuff. Most of the participants had a positive mind-set toward the use of essential oils, and were already using them in daily life. I needed to get a fair amount of information from each woman, but I didn't want to overwhelm them with paperwork. More than anything, I wanted to solicit information that would give me a picture of each woman and her story, not just her hormonal state. The form asked for general information as well as a brief lifestyle profile. Among other things, I asked about occupation, hobbies, marital status, diet, sleep, exercise, ages of children and the amount of time spent in enjoyable activity. The medical questions were few, and focused on the woman's menstrual and reproductive history, as well as approaches the woman had used for menopausal balancing. Finally, I asked each woman to rate the impact of 9 common menopausal symptoms, both before and after the use of essential oil Vitex. Those of you who are still looking forward to menopause, or who live with someone who has not yet experienced menopause will be thrilled at the following possibilities: 1. Mood swings, depression, personality changes 2. Memory loss, disorientation, difficulty concentrating 3. Hot flashes or night sweats 4. Vaginal thinning, dryness, pain with intercourse 5. Insomnia 6. Loss of hydration and elasticity of skin 7. Heavy or prolonged bleeding 8. Bladder discomfort 9. Changes in libido The ladies reported how often they used the oil, how they used it, and how long they used it. They reported other therapies used concurrently. I asked how they liked the smell. The first interesting data came when I was assembling the packets for the participants. I thought it best to have someone else other than myself bottle the oils-the project was already charged with my energy. I was also interested in the response of men to the oil, so I asked my husband and another male associate to bottle the oils. Aaron, age 26 reported that he actually felt his stomach turn when he opened the bottle of berry oil. Ever a pro, he finished the bottling as his nausea mounted, and then fled the building. I really felt bad, since he lives with us and we had run him out of his home, but he did return after 12 hours to find the house smelling acceptably of neroli. He said it was his first experience with a truly revolting essential oil, which he declared " an evil oil that God never meant to be distilled. " Tom, my husband, declared himself man enough to take on any oil and bottled the leaf oil, only to develop a nasty headache, which he claims is nearly unheard of in Norwegian men. He detests the smell of the oil, and suggested that any woman who wants to ward off men should consider it as a personal perfume. We sent 33 bottles of essential oil and information to widely scattered locations in the U.S. and Canada. And then I waited three months. MY PERSONAL EXPERIENCE While the other ladies were using e.o. Vitex for the first time, I switched from the leaf oil to the berry oil. I might just as well have booked a trip to Mars. I will recount my story in the format used on the standard information sheet, plus an e-mail exchange with Janina Sorensen. I am a Caucasian woman born in 1950. I am 5'3 " tall and weigh 125 pounds. I am married and have two children, ages 23 and 25. I work about 60 hours per week between my day job in condominium property management and my aromatherapy pursuits. I commute one mile to my day job. My free time interests are gardening, the study of Spanish, reading and writing. I am in excellent health, though I have developed restless leg syndrome which interferes with my sleep. It runs in my family, and I do take a minimal dosage of drugs to control it. My diet consists of mainly fresh, home-prepared foods, moderate fat. Almost all of the meat and poultry I eat is wild or organic. I eat soy foods about once a week. I am also on soy-derived hormone replacement therapy. I have a double family history of crippling osteoporosis. I sleep 6-7 hours per night, and I miss the really great, deep sleep of my younger years. I get a lot of exercise, most of it in my daily work, which includes a lot of walking, lifting and landscaping. Other wellness tools I employ are essential oils, calcium/vitamin supplements and occasional massage. Fortunately, I enjoy my property management job as well as my other pursuits. If I did not generally enjoy everything I am doing, I could not do it. I do tend to spread myself too thin, and my great challenge is to let things go. I worry too much. I am blessed with a good marriage, great family, friends and neighbors. I have meaningful work, and I am fortunate to divide my time between a wonderful small mountain town and an enchanted ramshackle village on the edge of a vast desert wilderness. Life is good. I started regular periods at the age of 13, with lots of cramping until I had kids. I had four pregnancies and carried two to term, delivering at the ages of 23 and 26. My typical menstrual cycle was clockwork regular, 5 days in length, with moderate flow and very little cramping or PMS. I always felt pain at ovulation. My normal cycle started to change when I was 37. My periods became very irregular with some flooding, and the marker pain of ovulation stopped. My periods stopped completely at the age of 42. Early natural menopause runs in my family. I read that approximately 15% of women sail through menopause without a hitch, another 15% have symptoms severe enough to negatively impact their quality of life, and 70% are in the middle. I was definitely pushing the 85% panic bar. With the reporting options being " not a problem " , " minor problem " and " major problem " , here's where I stacked up on the nine symptom groups addressed in the anthology. None of these things were actually going to kill me, though I often wished they'd go ahead and finish me off. 1. Mood swing, depression, personality changes-MINOR PROBLEM 2. Memory loss, disorientation, difficulty concentrating-MAJOR PROBLEM 3. Hot flashes or night sweats-NOT A PROBLEM, never had them. 4. Vaginal thinning, dryness, pain with intercourse-MAJOR PROBLEM 5. Insomnia-SUPER MAJOR PROBLEM 6. Loss of hydration and elasticity of skin-MINOR PROBLEM 7. Heavy or prolonged bleeding-MINOR PROBLEM LAST YEAR OF PERIODS 8. Bladder discomfort-MINOR PROBLEM 9. Changes in libido (decrease)-MINOR PROBLEM (for me) MAJOR PROBLEM (for husband) I originally addressed this with standard hormone replacement therapy. It did help with the mood swings, mental disorientation, bladder discomfort, waning libido and thinning vaginal tissues, but it also carried a lot of side effects, including bloating, skin blotching, heavy bleeding and cramping. I could not tolerate the Provera. I simply did not know myself on Provera. Then I learned how the mares are treated to harvest their urine for the Premarin, and I had to stop. I had lived with a nameless fear ever since I went on the HRT, and I have to wonder if the terror of those mares is carried in the drug. I went through a lot of doctors in our small town before I found a doctor who could prescribe soy-derived hormone replacement therapy. It was a godsend. The soy capsules brought me to a reasonable balance, and the nameless fear went away. The skin blotching stopped, and my weight stabilized. I also realized that I had to educate myself, especially after a couple of conversations that I had with medical doctors. I asked four of them how menopausal management was taught in medical school. They each looked at me rather blankly, and all four answers were some form of " well, they taught us that menopause is something that happens to women as they get older. " Standard synthetic HRT was about the only tool they had. After that, I felt truly fortunate to have achieved a comfortable balance with the soy-derived hormones. Still, the information about essential oil Vitex intrigued me, so I tried it. I cut my soy HRT in half and started ingesting one drop e.o.Vitex (leaf) per day. I felt a slight disorientation for a few weeks, but after about a month, I felt the Vitex kick in. One delightful surprise was a significant increase in vaginal lubrication and tone, which was still an issue even with the HRT. I also felt improved emotional stability and mental acuity. Little did I know just how much I would upset the apple cart by switching from the leaf oil to the berry oil. The two months following the switch were an ordeal and an education. A month into the three month trial period, Janina Sorensen posted me to ask if there was any feedback. Along with a few observations from other participants, I posted to Janina: " My own experience has been interesting, as I switched from the leaf oil to the berry oil as soon as I received your oil. I bled for a week (felt like a period, though I have not had those for about 6 years). I broke out in splotches on the left side of my body and face (typical hormonal imbalance " flag " for me). I had some wild internal temperature swings hot to cold, hot to cold, etc, on about 30 minute cycles. Totally exhausting and really weird ( I have not had much experience with hot flashes, thank goodness). I actually took my temperature during these swings, and I was going back and forth between 96 degrees F. and 98 degrees F. (97 is normal for me). I also experienced vaginal thinning and dryness, as well as emotional changes (feeling of disorientation, mild irritability). After a month on the berry oil, I switched back to the leaf oil. Vaginal tone and lubrication improved quickly, as did my emotional state. Skin had already cleared and remains clear. I have not re-experienced the wild temperature swings. It was interesting to note that during the time I was not using the leaf oil (which I take one drop day by licking drop form my palm), I actually craved the leaf oil, and had to use a lot of self control to stick strictly with the berry oil " Janina replied: " I am sorry for the inconveniences you had taking the berry oil-but your post made me jump high…surely a great testimony to the pharmacological activity of the oil!!! As a well stabilized person, 6 years no bleeding-it makes your body react in such a way-this is really very significant pharmacologically....without any sound research from my part here, I would guess that what it did to you was actually try to get you back into productivity, with all the signs of puberty…but since you'd transisted years ago and comfortably, that was not what you wanted of course. But I am really excited about the outcomes for menopausal women-how will it work in transition? " Well, I wasn't the only one, and Janina was very right that a return to menstruation was not what I wanted. Two months after going off the berry oil, I am still dealing with some amount of bleeding, and my soy-based hormones had to be completely recalibrated. I find now that I have a new sensitivity to the leaf oil, and I don't need to use it but two or three times a week. I feel that I have re-balanced. On my own information form, I summed up my experience this way: " After 18 months of use, I find that the e.o. (leaf) works very well with my soy-based HRT. Neither works independently as well as they work together. The Vitex seems to specifically address vaginal lubrication/tone plus mental/emotional stability. The soy-based HRT seems to address mental/emotional stability, skin tone and hydration and the general strength of the pelvic floor. I will continue to use the Vitex in conjunction with the soy-based HRT " . RESULTS FROM THE GROUP As the information forms came back from the participants, similarities and occasional surprises emerged. One woman who was using the diluted leaf oil dermally found it to be a strong sensitizer even in low dilution and discontinued use. Another discontinued use of the leaf oil after experiencing nightmares and nausea with initial use, only to resume use later on with no discomfort. She indicates that the oil which was initially repulsive is now pleasant to her, and she feels it is helpful with hot flashes. One other woman reported increased dreaming, along with increased nightmares. One woman discontinued the berry oil after she started experiencing hot flashes, something she had never experienced until using the berry oil. This aspect of her experience was similar to my own experience with the berry oil. However, the vast majority of women reported that e.o. Vitex (both leaf and berry) had relieved their symptoms to a sufficient degree that they intended to continue using it. The two women who were using the leaf oil in conjunction with either synthetic or soy-derived HRT reported that they needed less hormonal supplementation while using the oil. Methods of use varied widely, ranging from a single method to a combination of applications. Some participants used other essential oils, herbs and hormonal creams in conjunction with the essential oil Vitex. Many women were also using other modalities such as massage, acupuncture, yoga and vitamin supplements. This great variation in use prompted me to evaluate e.o. Vitex agnus castus as a component in a balancing program rather than as an isolated therapy. However, in two cases where e.o. Vitex was the only approach used, the participants reported improvement. In most cases, the use of Vitex was an addition to an established regimen, and the respondents felt confident that any changes were likely due to the addition of the Vitex. Of the women who were still menstruating, 7 reported regulation of their periods and fewer problems with PMS and cramping. One woman reported the recurrence of regular bleeding after 6 years without a period. Several others reported that they resumed regular periods after 3-10 months without a period. Every woman who reported that she had found a comfortable place of balance had arrived there in her own unique way. The true Vitex Anthology is written in 23 three-page surveys. However, the numbers show a degree of anecdotal efficacy that I hope will prompt further study. 23 women reported their experience. 13 women used the leaf oil. 9 women used the berry oil. One woman used both oils. The participants were born in the years between 1944-1958. The following percentages of respondents reported minor to severe problems with the following symptoms prior to the use of essential oil vitex agnus castus: Mood swing, depression, personality changes 57% Memory loss, disorientation, difficulty concentrating 74% Hot flashes or night sweats 65% Vaginal thinning, dryness, pain with intercourse 30% Insomnia 61% Loss of hydration and elasticity of skin 48% Heavy or prolonged bleeding 43% Bladder discomfort 26% Changes in libido 39% Of those reporting the above problems, the following attributed moderate to major improvement as a result of using essential oil Vitex agnus castus. Results are divided by plant part distilled. Percentages representing one or less respondent are noted as such: Leaf Oil Berry Oil Mood swing, depression, personality changes 80% 0% Memory loss, disorientation, difficulty concentrating 27% 0% Hot flashes or night sweats 64% 75% Vaginal thinning, dryness, pain with intercourse 83% 100% (1) Insomnia 56% 60% Loss of hydration and elasticity of skin 0% 0% Heavy or prolonged bleeding 50% 0% Bladder discomfort 0% 0% Changes in libido 43% 0% The only deterioration of symptoms was reported by the two women who experienced hot flashes for the first time when using the berry oil. Resumption of regular periods was regarded as an improvement by some, and an unwelcome event by others. The women reported on their reaction to the odor, and sometimes to the taste of the oil, with some liking taste better than odor, and vice versa. The general response to the odor with 14 women experiencing the leaf oil and 10 women experiencing the berry oil: Leaf Oil Berry Oil Liked it 27% 40% Disliked it 40% 27% Neutral 20% 20% Aversion or attraction to the oil changed 13% 10% With the exception of one women who could not tolerate the oil at all (leaf), the overall effect of the oil was pretty much the same regardless of odor response. They are indeed two very different odors, the berry striking my nose as richer and heavier, and the leaf as greener and spicier. I was neutral to both aromas, and enjoy the taste of the leaf oil but not the taste of the berry oil. I was glad when my self-imposed research month using the berry oil was over. I asked for copies of GC's, not because I can decipher those thing, but because the two oils were so different that I just had to see the numbers. In several cases there was up to a 2.5:1 proportionate difference in the content of particular compounds listed. I ran this information past a chemist associate, who responded as I would have expected. That the differences in any given component would not suggest any differences in the apparent action of the two oils, but that some immeasurable factor of synergy was the more likely mechanism. The numbers, though, do not tell the story as well as the ladies. " When I went off [synthetic hormone replacement therapy] in 1999, due to educating myself…it was a long hard struggle to find the right balance of herbs and exercise. Using the Vitex has helped tremendously " . This woman sniffs the oil out of the bottle as a " hot flash inhaler " . One woman who successfully used the oil to control hot flashes reported the following after not using the oil for two weeks, " I have found that after the 2 week hiatus that the hot flashes are back full force and often. Hopefully they will abate just as quickly again. I have started back using the oil on a regular basis. " An interesting question was raised by a woman using the berry oil " Overall very pleased and I will resume use…especially in the winter…could seasons effect use of? " " Felt improvement in breast engorgement early on, which was great! Length and flow of period stabilized midway through the 3 month period. Libido seems to have improved moderately, especially towards the end of the 3 month period. " This comment came from a woman who has used the plant in crushed berry form earlier, but discontinued when her libido dropped. However, with the use of the essential oil (leaf), she reported that vaginal thinning, dryness and pain with intercourse has improved greatly. Several women experienced this improvement, to their delight. Another woman shared her berry oil with her daughter and had this comment. " My daughter is almost 11. I don't need to tell you she has been going though some real hormonal changes. She gets headaches that are hormonal related. This oil has been very beneficial to her. It has cleared headaches completely. " Several ladies were not happy to have their periods return. One reported her experience with the leaf oil. " The only thing I noticed is that after three months of no period, I had a normal period in May, somewhat heavy, as they have been for a year or two. As I write this seem to have some today-not sure if it is another-YES IT IS!-30 days apart. Seems to me I'm back on schedule perhaps. No other symptoms noticed. " Another who used the berry oil put a " frowny face " next to this comment. " Really the only thing that I've noticed using the Vitex is that my periods that were starting to skip became more regular. " But others welcomed the regularity. From a woman using the berry oil. " I was pleasantly surprised at how my periods became regular again. Maybe menopause hasn't set in yet, but I'm sure the Vitex is why regularity has returned due to the fact that it is the only change I have made. " A lady who was using the berry oil only by inhalation and diffusion reported, " I didn't notice any specific changes at all, except that I did get my period in April and May after not having it for about 10 months. " One of the nicest actions of the oil was mentioned by several women. This lady, who used the leaf oil, said it well. " Alleviated symptoms as described and gave me a balance-a peacefulness and relaxation that was much needed and greatly appreciated. " Another who used the leaf oil. " More balance in mood swings, depression. Sleeping better. Night sweats stopped. " CONCLUSION Clearly this data has to be viewed in light of the small number of participants (23), as well as the totally subjective nature of both use and measurement of success. My own personal conclusion is that e.o. Vitex agnus castus of both berry and leaf extraction are exhibiting the same balancing action that the literature attributes to the dried berries. However, it may be possible that for a substantial number of women, the leaf oil may be both broader and more refined in therapeutic action. If this is indeed the case, the usable parts of the plant may not be confined only to the berries. I would think that this would make cultivation and distillation of the plant more economically feasible and would likely result in an oil that is affordable to the average woman. The versatility of application ( " hot flash inhalers " and the use of the essential oil in creams) is an attractive feature of the oil. My only regret in doing this project is that living at 8500 ft., I did not get the chance to sit down with a Vitex plant. I have never seen one. I was the child who sought out the patches of woods still left in the city. I am a woman who chooses to live in small communities surrounded by wilderness. I love to sit quietly with the plants. A person can learn a lot sitting quietly with a plant. I am looking forward to that experience as my completion of this project. ACKNOWLEDGEMENTS: THE PARTICIPANTS (acknowledged with permission): Lesley Lyons-Newell Sherry Harvey Kate Jerhoff Pamela McCarthy Deborah Redfern Peggy Meehan Cynthia Cyr Corky Lucks-Racek Judy Donovan Paula Harkenrider Charlie Ward Allyn Steffen Jennifer Ruby Ann Harmon Deena Gentle Karobi Sachs Anya McCoy Jane Floyd Barbara Chopin-Lucks Sylla Shephard-Hanger Mindy Kittay Maureen Curran Jacqueline Griffin THE E-MAIL LIST OWNERS: Marge Clark, marge Steven Katz, aromatherapy THE DISTILLERS, DISTRIBUTORS, ASSISTANTS AND OTHERS WHO HELPED: Janina Sorensen Babis Psaroudakis Kurt Schnaubelt Carole Addison Rob Pappas Marcia Elston Tom Lucks Aaron Thomas REFERENCES: Sorensen, Janina Maria. 1997. The Hormonal Activity of Vitex agnus castus and its Importance in Therapy. A Review. Masters Thesis Ojeda, Linda. 1995. Menopause without Medicine. Hunter House, Inc. Alameda, CA. Schnaubelt, Kurt. 1999. Medical Aromatherapy. Frog, Ltd. Berkeley, CA. Stuart, Malcolm (Ed). 1979. The Encyclopedia of Herbs and Herbalism. Crescent Books, NY Harrar, Sari & O'Donnell, Sara Altshul. 1999. The Woman's Book of Healing Herbs. Rodale Press, Inc. Emmaus, PA Kamen, Betty. 1996. Hormone Replacement Therapy, Yes or No? Nutrition Encounter, Novato, CA Quote Link to comment Share on other sites More sharing options...
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