Gluten – Functional Medicine Back to Basics

Gluten – Functional Medicine Back to Basics

In this episode of Functional Medicine Back to Basics Dr. Rutherford discusses gluten and why in his opinion anyone suffering from an autoimmune issue should cut it out of their diet completely.

Note: The following is the output of a transcription from the video above. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.

If you are interested in scheduling a consultation with Dr. Rutherford please visit http://PowerHealthConsult.com

Alright gluten is kind of a subset of what we’re, doing relative to talking about functional medicine, basics of functional medicine and kind of a subset to diet, and yet it’s kind of its own, unique subset.

It’s, kind of a subset or in the same, in the same environment as as supplements which we’re gonna be talking about in the near future. Maybe the next thing, maybe the next segment and so gluten. When I first got into practice functional medicine practice well, actually I had I had.

I had a really really interesting case years and years and years ago and like in the early 1980s, were where I had a person who had a car accident was treating her from musculoskeletal problems. As I was treating her for this car accident, which was neck pain migraines, it was low back pain.

She kept getting worse and worse and worse, she kept coming back. I’m, not quite sure. Why, and, and and – and you know at some point, it was like we’re, not helping you and I’m, not sure why you’re getting worse, because I do this with other people and and and the manipulation And the therapies, the types of things that you would treat a person for for a car accident rehab those types of things, and they said that so I mean we’re missing something I have no idea what it is.

She disappeared as she should have and and then showed up five months later and and first of all, looked marvelous lost. Like 50 pounds, the tenderness was gone from her neck. The tenderness was gone from her back.

She was showing up for an adjustment I and as though, as you watch me know, that that I’m a chiropractor also, I’m practice, chiropractic for quite some time, but at that time that was my full practice and she came In for an adjustment and said wow, you know I just need to adjust me a tweak in my neck and I’m.

I’m standing there like who are you like? I didn’t even recognize her. She’s, like 50 pounds less and she’s. Asking me for adjustment, same adjustments that used to make her worse. She went to a local alternative doctor here in Reno and this was 1983 and he he told her to get off of wheat.

Okay was wheat back then she said I got off a wheat and this is what happened. I did not believe her and I know the doctor actually knew him very well and and subsequently had a communication with them, and he explained to me, wheat and it’s in its sensitivities and and the dramatic effects it could have on physiology.

And I just kind of liked that he was like I thought. Okay, I don’t know what it was, but it wasn’t weak, okay. Well, it was it was. It turned out that that young lady in retrospect had a severe gluten sensitivity in a lot of various aspects to gluten, and I’m not going to like.

Do the whole look online and get every single aspect of the gluten protein and discuss and make it a whole book, but the bottom line is is gluten, is a is a huge it’s, not just it’s, not just a Protein that creates abnormal physiology in our immune system.

It also happens to be an excruciatingly ly, trashy carb, so I’m, going to talk for just a few minutes about gluten in a functional medicine practice. I’m gonna talk about gluten in chronic conditions and chronic diseases, which is which is it’s just my practice.

My practice is the great mystery disease practice of like I got pain everywhere. It moves here moves there, but all I’ve been the 26 doctors, but all of my all of my all my tests are normal. You know so some of my colleagues call it the mystery disease practice.

So gluten is a big part of that. Lewton is potentially a big part of that. I want to clear up a few things on gluten: okay, so gluten without getting into it too heavily glutens and pro team that’s, found in wheats naturally-occurring.

There’s. A lot of different theories as to why it’s becoming a big problem and, and you can find them online – I’ll – just hit a few of them. One of the theories is that we’re modifying we’re, genetically modifying it, so that we can make more wheat and feed the world okay, and that’s.

A nice thing to do, and it’s. Very odd twisting the way that we can feed the world is because now we can use more of the toxins that we put on there to kill the bugs. And then we’re, able to make more more crops, larger crops and and thus make more week.

Okay problem is, is the genetically modified wheat gluten is what’s called a very sticky protein? Okay, we’re gonna talk about that a little bit more in a few minutes, but the sticky protein is why it’s used in everything it’s.

Why it’s used in soy sauces. It’s. Why it’s using cake mixes. It’s. Why it’s used in pizzas, and every day it sticks things together, okay, and also because of that stickiness. It also has a significant propensity to damage the inside of our intestines and, as the many of you understand that the inside of our intestines is where 70 % of our immune system, it has a significant profound effect on our immune system.

A lot of the time gluten also is so it’s a so. It’s, a sticky protein, and I know it’s so and also the chemicals. So it’s also theorized and I think properly. So that the chemicals I’m hearing on, I’m hearing on the radio now, so this is April.

19Th. 1920. 19. I’m hearing on the radio right now. Some of these lawyers who do these national. These lawsuits, where everybody is involved and everybody kind of jumps on board, but it’s now being advertised that Monsanto is known, that that roundup was a problem since 1981 and and so, if you’ve had cancer.

If you’ve had these types of things, then them no and you can get in lawsuit and they can win it and you can get four bucks out of it and they ‘ Ll probably get a lot more, but it’s. Just now that that’s starting to come out and it’s been known for quite a while that the toxins very probably are contributing to the gluten issue.

So and there’s other things, but those are those are kind of the two main things so gluten is found in so glutens found in in wheat. It’s found in barley, rye, and it is also found in oats. It is not naturally occurring in oats, but still to this day, it seems like oats are being processed in the same in the same facilities and on the same equipment that is processing the wheat and the barley and the Rye.

And so it seems like oats are pretty consistently across the board a problem don’t eat. If you’re, if you’re gonna listen to me and not eat gluten. Okay, then don’t eat oats. Unless it absolutely says these are gluten-free oats on them, and I understand that now some people are coming out with those products so gluten gluten in the in the in the clinical perspective.

Okay, so it’s, a sticky protein and it has chemicals on it. We eat it. Okay, we’re talking about our mouth and if you’re like most people, you chew your food three times and then it goes so it doesn’t really get.

You know broken down it’s, a it’s, it’s. A lot of the testing on gluten is based on the protein in the gluten being broken down, so that there’s, less mass. For things to cling to and for them to have less effect, it’s.

So, if you, you know so chewing would be a nice thing, but most of us don’t and then it gets down to our stomach and that makes it harder on our on our stomachs to digest it. So if we, if, if we didn’t haven’t chewed it enough or if we don’t have enough hydrochloric acid, because we’re because we’re stressed or because we have a Thyroid problem, or or we have back to your bad bacteria in there, these proteins, don’t get broken down, and this is a third ass effect of gluten that a lot of people aren’t, very aware of which is when the Gluten protein doesn’t break down.

It becomes much more available for even more toxins to cling to it and create significant cross sensitivities, other food sensitivities that can really really be confusing to the person so gluten in this sauce.

Oh, so those are the those kind of mechanisms of the gluten messing you up the when I first gotten started doing functional medicine, which – and I was I & – # 39 ve said it many times. I was definitely in the very first first first group of functional medicine practitioners years ago, and we thought it were really hot when we would like people come into us at fibromyalgia, and we’d, go okay! You’re gonna get off a gluten, and people would argue with us and they’d.

Go it’s in everything and it’s gluten, and this is stupid and it ‘ S like it looks like why it’s stupid it’s like how could that be, causing my fibromyalgia and and on and on and on I don’t. I rarely rarely really get that anywhere, but but I got a lot back then, and then you know certain people would not do it.

I thought I’m. Not gonna do your program because I’m, not get off good. Okay. Well then, don’t, do it you know, but but the ones who did we had a number who you know a percentage, maybe 10 15 percent, maybe 20.

That actually saw a huge difference, just getting off a gluten. That was our diet. It was like get off a gluten and then people get off of gluten. They’d, feel so much better. We do forget us, we really know we’re.

Doing we’re, like you know, we’re, like the smart guys in the world, and that was it. But then we had a lot of people got off of gluten and they didn’t get any better and they didn’t have any changes, and in the beginning it was confusing.

But now that we’re starting to understand the mechanisms that occur, we now understand that some people, even though they might have a sensitivity to gluten or they might have a condition in which they should not be eating gluten.

And I’m, not sure. Yet, if I want, if I’m on the bandwagon of, nobody should be eating gluten, but I think I’m inching it more and more towards that these there’s. Other things that will, let us know if you should be off the glue, so in other words we had people who got off of gluten.

There was no change and then they want to get back on it, because obviously there was all their favorite fruits in the whole world and and then we found out later on that them getting back on gluten, was sabotaging a lot of what we’Re doing because of this abnormal breakdown of proteins gluten was was even though it wasn’t, making a huge effect in their physiology per se.

It was helping them to develop other food sensitivities, other cross sensitivities, cross sensitivities to other grains. This is where you look online to go. Ok, get off all the grains, and that may be okay, but you may not have to do that if you figure out which aspects of the which grains are okay for you, which not but but gluten can cause Cross sensitivity, the other grains.

So we started to realize that if you got off a gluten and you didn’t have any change, there was that you either had cross sensitivities to other grains or you had cross sensitivity to other to other other non grained foods.

Because gluten has a big factor in leaky gut like he got his stress hormones. Leaky gut is poor, hydrochloric acid and your stomach like he got his MS, is all those things causing poor bacterial dysfunction.

Like you got his port. Okay, Lisa go thou, but leaky gut is heavily heavily heavily, contributed to and or caused by gluten in a substantial portion of cases when people come into our office. I just say just know: you’re gonna be off of gluten.

I I I think I attend you know two or three seminars a year from people who are my colleagues. People are my mentors people. I respect people. I know who are in the forefront of this have been for years.

They’re, doing the research they’re, doing the research at Harvard they’re in practice. They’re, taking care of the most difficult patients and they start off. They start off their seminars by saying just want you to know.

I know you just paid seven hours to come here and you’re sitting in this hotel that you’re, just paying some ridiculous amount of money for per night to come and hear me talk and you’re Eitan Or expensive restaurants – and I’m just gonna tell you right now, don’t eat any gluten.

I’m gonna tell you. This gluten is the devil and that’s, how they started off and they’re like if you’re, not going to take all of your patients that come off up in your office off of gluten. Then a lot of what I’m, going to tell you this weekend, isn’t going to work that’s proven to be the case.

Okay, I so gloomy is so gluten. Is it is the most obnoxious? Is the most severe food sensitivity that we know? Corn is now starting to be called the new gluten? I am seeing evidence of that, but this is about gluten and and right now I think gluten is still out front in in being the most like, the most challenging food, the most aggressive protein that we put in our body – and it also happens to be a Trashy carb, so if you’re eating, so if you’re on two or three, if you’ve got diabetes type 2 and you’re, taking two or three blood sugar medications.

But you’re eating like pizza and you’re eating and you’re drinking beer and you’re. You know you’re, probably not drinking beer for diabetes type 2. But if you’re, if, if you’re, even if you’re, even if you think you’re doing well with your carbs, but you’re still eating gluten.

That gluten is gonna. This is going to keep your it’s, going to keep your blood sugar up, be more so than a lot of things that you might be more likely to think is going to keep your blood sugar gluten.

The the III brought one – and I brought one thing here so that I mean I’m, not having as much trouble with this today. But I did bring one thing and just to say I have. I have an article in front of me.

As of April, the 10th 2019 and this art – and this is the internet – okay like the internet – is – is like still it’s, the wild wild west. Okay, anybody can say anything on there. It’s. Anybody anybody can make things sound.

Like they’re, really great, there’s still people on the Internet to make their position that you should be eating gluten that it’s, ridiculous that those of us who tell you not to eat it work some sort Of whack jobs, or something like that and and then you’ll, find that they have their magic potion to to have you be able to eat gluten.

I know years ago, Whittaker, dr. Whittaker, who was he & # 39? S got his stuff out there, and I know years ago when the gluten thing became big. I got the big flyer in the mail, and the flyer said you don’t have to listen to these people to tell you to get off a gluten, because, even though you’re bad, when you, when you get you get bad After you eat gluten, we have the magic pill that’ll help you to eat gluten.

Now we have that magic pill too. In fact, my mentor was the guy who developed the first one and it ‘ S got an enzyme in it that did disengages that that and that breaks down the gluten protein in your gut.

So in theory, you’re, not going to get you’re, not gonna get an effect from gluten. If you, if you eat these now, I have celiac, okay and and even that the hardest of hard rock heads in the medical world go okay, I’ve celiac.

You should be off of gluten. I take that pill. I think that pill I’m, taking that pill now before I eat, while I eat and after I eat, because it’s just hard to not get gluten into your system, and I’m very, very sensitive to it.

But for those of you who don’t have that type of definitive like I have celiac, so I’m, never going to eat gluten again it’s, more easy for you to be to be kind of like swayed By something that says, no, you can eat pizza and pasta and beer, and all that kind of stuff and and and and and no problem, don’t.

Do it? Okay, don’t. Do it. These things are meant for accidental exposures. Dr. Witter put this thing out. Yeah I’m sure he made like a good chunk of money. You aren’t sending it all over the country.

Certain people found out it. Didn’t work, never bought it again, maybe other people. It did work for him because they didn’t have much of a problem. Maybe they didn’t need it. Who knows, but I would beware of these products.

I would I have a gmail in front of me from of all people, my wife who thought this was an interesting who thought this was interesting for me to read mainly because hit this this article sites very, very prominent people such as Deepak Chopra and the, and It cites a a debate between Deepak Chopra and dr.

Perlmutter. If you’re, not familiar dr. Perlmutter, he’s written brain grain. He’s, written Wheat Belly brain maker, all about gluten all about gluten. He sees he’s shown up on PBS. He’s, a very well known, neurologist, mainly because he was brave enough to step outside of his medical model of God.

Now these people are right. This glutton is screwing up. I’m a neurologist, and this is why a lot of people are coming into me. It’s, causing them it’s, causing them brain fog. It’s, causing them it’s.

It’s, contributing to their migraines and and their memory loss, and so on and so forth. So, ok, so so so anyway, so these people argue gluten is is fine. It’s. Not that way it’s, not gluten. It’s, not the weak, and they say if you really want to get to the bottom of the problem.

The key is hog berry that’s. What the key is, the key is hog, mare and and and then you know in the next page, it’s. This special offer. I want to send you a special report on how you can gain better natural health.

I mentioned this because this is popular in the gluten in the gluten world, because everybody wants see, you know gluten because it there’s, an aspect of the gluten protein that goes into your system.

It actually stimulates the same receptor sites in your brain as cocaine, which is why you want to eat it. Ok, it’s like you’re addicted to it, so, okay, so that’s gluten in general gluten in application to your problems.

This is a I basically, this is a. This is probably I’m. Getting nothing for this and I’ve exit out the patient’s, name! Okay! This is probably the best test in the world for finding out. If you need, if you need to cut gluten now, most of the gluten tests, the blood tests are terrible.

They are not accurate. They all there’s. There is there’s 25 aspects of the gluten protein that need to be evaluated to determine if you’re allergic to gluten. If you have it’s called cyrex labs. Ok, I get no fiduciary.

I have no fiduciary like connection to cyrex labs, but this is the best test and I think it’s. It’s. It’s like it’s like 80 or 90 percent accurate, which among testing for food sensitivities, is very, very good, except it’s, not a hundred percent accurate and that’s.

What I need, but the point I wasn’t say is: is there’s 25 different aspects of the protein that needs to be tested and then they and they test it and if, like this person, has just like four of them? This person should never eat gluten again.

Okay, the blood test test, one of those one of them, so the chances of you getting a blood test and being told that you are okay to eat gluten. When you’re, not okay, to eat gluten is substantial that you would be told you can eat it when you can also this.

This test brings me to the next point. There are a couple of things at the bottom of this test that tests for transglutaminase is now. I only run this test for two reasons. I will run this test if the person is gonna be a rock head and they’re gonna go no well, I’ll get off the gluten.

Why are you treating me, but then I’m gonna go back on it. So this will. This won’t, give the person some hardcore data going not doing more, so the test will also tell us potentially what it is that the person is what the gluten is affecting.

So there are, there are Michael transglutaminase, and these are enzymes throughout the body and they they basically fold in different ways and and they help you to process proteins properly and they can affect your immune system.

If there’s, the proteins aren’t folded properly and and so, but basically there are microbial transglutaminase and if and if, if the gluten comes in and it is attacking one of those, it is causing one of those enzymes to develop Antibodies to those to those particular microbial transglutaminase is that will cause autoimmunity.

Okay, so gluten can actually cause autoimmunity there’s. A there is a very known well known. Now there’s. A very well known thing called a molecular mimicry between the gluten protein between the between the proteins on on your thyroid.

They’re, actually metabolites on your thyroid and metabolites on something called your cerebellum cerebellum. You just got to know just no dizziness vertigo balance, stiff neck blurred, vision and and and and overreacted stress responses that’s, cerebellum, okay, so basically the the you can eat we it can affect these.

These. These transglutaminase is in these microbial transglutaminase is a big, and then they all created an immune response, and because you have metabolites on this gluten protein that look exactly like metabolites in your thyroid that look exactly like metabolites on your cerebellum.

All three things can be can be attacked at once. This is very, very well known in common and expanding understanding of autoimmunity, okay, and so you so you eat gluten and all sudden yeah I’ve got. You may be all sudden yeah.

I’ve got problems all of a sudden. You have all the thyroid symptoms. All the sudden. You have all the cerebellar issues. You got a doctor with 26 different with 26 different symptoms and they go yeah right.

You got all these symptoms while you’re testing is normal and so on and so forth. These were the people that we would take gluten away from years and years ago, and all sudden everything got better and and they thought it was a miracle and the doctor thought that the person was a hypochondriac.

So there are these transglutaminase, there are tissue. Transglutaminase –, is they number them there’s, one called tissue transglutaminase two. If, if you find that this one, it comes up on you on one of these tests, you have celiac.

This is the even in the medical model. This is the test that they use to confirm if you have celiac, if you have tissue transglutaminase three, that is very possible. They, you’re eating gluten and it may be affecting your skin.

Your hair follicles, it may be flaring up. Your eczema may be flaring up your psoriasis. It may be causing your your atopic dermatitis, your eczema and and and those types of things, and then there’s.

A tissue transglutaminase for this is one I run it for most just for me, because we do functional neurology as well as functional medicine, and we do it. We see a lot of neurological problems. In fact, I have a case right now.

I was working on this morning before I did this, and and and I’m gonna run this test on her and and and she has cerebellar neurological issues symptoms. She has symptoms and of like I’m, not gonna go into the case too much because she may end up watching this, but but she has neurological findings.

Okay, this will tell us if those findings are hitting your brain. If it’s hitting your nerves, that was hitting your peripheral nerves and and and and it’ll tell us if this is a component of what’s actually causing that neurological play.

I did have a dramatic case of this year, a couple years ago, a couple sisters and they both had an immune attack on their thyroid in their cerebellum, and we confirmed that by testing they had been to multiple research hospitals.

They had been to some of the most famous hospitals in the country we took gluten away from them. They weren’t able to walk, they would walk one day. Their legs would go weak. This is called cerebellar ataxia.

They’re, their legs would go weak and and and then the next day they would and then they would and then they wouldn’t. They had what was called gluten sensitive a taxi. The gluten was actually attacking their cerebellum.

Are these things rare? You know not in our practice they’re, not rare. There’s varying degrees of how much the gluten can affect you. So you could have significant gluten sensitivity and just have mild, dizziness and and stuff like that, or you could have severe gluten sensitivity to the cerebellum and not be able to walk on days when you eat too much gluten.

So gluten is mostly known as as affecting the God’s. So when we talked about gluten, everybody goes no. I don’t have a gluten problem on my that’s; fine, so if glutens affecting your gut, then you probably have celiac there.

There’s, a little bit more nuances to that too, between older patients and younger patients. But but in general, if it’s, if it’s affecting your gut at the very least, you know you’re, you’re. You’re.

Having this microbial transglutaminase thing that we talked about 40 75 percent of your immune systems in your gut, so I can affect autoimmunity or it can directly cause a beat, causing a problem in your gut, so you so but 70 percent of the time.

The gluten response is not in the gut seventy-five percent of time. The glutens response is in the brain on the skin in the peripheral nerves, so you can get burning in your feet now, most of the time people come in here get burning of the feet.

It’s, usually gonna be a component of a small fiber neuropathy and frequently it’s. Gon na be blood sugar, but guess what it can be autumn, unity it can be gluten and it’s actually called gluten gluten sense.

It’s, a peripheral, neuropathy small fiber neuropathy. So you can get an attack in your brain. You can get it, it can be severe to your cerebellum or it can be brain fog. I can’t. I just can’t think I just my memory is going.

I can’t, find my words and stuff like that. It can flare up autoimmunity, so maybe you have autoimmunity, maybe you have chronic asthma or something like that and or or the skin issues that we talked about you’re, not connecting it one day your skin issues flare up and you go like well.

I’m, not stressed because most people will have psoriasis or eczema or something connect it to stress. But I wasn’t stressed how come how come it blew up? It could be an exposure to gluten, because this transglutaminase shows us that it that it can affect your your, your skin, your hair, those types of things so so glutens pretty complex.

I mean I don’t have like out. I do have hours and hours to go over, but I’m, not going to go over for hours and hours, because once you have the framework of this, then you can kind of go online and maybe you can be a little bit more well-armed In my world person comes in here they’re, not getting off a gluten.

We’re, not treating them. Person comes in here and they tell me they’re, not getting off a gluten. No, I’ll. Get off the gluten, but they’re gonna go back to it because they’re, not convinced they’re.

Getting this test. Okay, if they have some really mystery neurological diseases, they’re. Getting this test. The test is called cyrex or a3. I forget how much it costs. I think it’s like 220 bucks, or something like that.

So for the amount of data that you get out of it, it’s. It’s. It’s, actually pretty reasonably reasonably price test, but the reality is: is the vast majority of my patients? It’s, pretty much. I got off a gluten and I felt better and that’s.

What I’m getting tonight and now – and people tonight are coming in here – they’re already on the Paleo diet. They’re already on the ketogenic diet. They’re already on the I’m awful white and sugar diet.

They’re already on some diet. The vast majority of them have tried to get off of gluten and a lot of them, just guy got off gluten felt better. That’s. All I need to know I don’t even run an expensive test once they tell me and that they’ve had a positive response to it.

So I think that kind of summarizes everything that I really wanted to say to gluten. This is really more the clinical aspect of it. This is really more. The legit I’m. Not here to argue whether gluten is is, is bad or not.

I gave you a little bit of an example of people out. There will be happy to sell you a product, because, because we think that this gluten thing is a bunch of crap, let me tell you: it is not a bunch of crap.

I’ve been doing this for a long time. It is a key component when people come in here and they say why can’t, I you know, I can’t do your program because I can’t. Do it. I’m. I’m leaving or I can’t afford it right on time or whatever it is.

Okay, they’ll. Ask me: is there anything I can you tell me to do and the answer is usually no because, because there’s, not much, I can tell person to do without examining him and doing the history. If you’ve been watching this series, you would you would know why.

I say that, but the one thing I can tell them is: they can say, listen, get off gluten and see what happens. So when we’re gonna get off of gluten and nothing’s, gonna happen, others are gonna get off of gluten.

You’re gonna feel little bit better and others are gonna get off on gluten and they’re gonna be that 15 percent that thinks it’s a miracle. You have chronic problems, their chronic conditions if they’re in the realm of anything.

I just got done saying: get off the gluten, get don’t, get off the gluten for three days, get off the gluten for three months and and and and see what happens and eat and and that’s and that’s, the wanted piece of advice I can give people who who just asked for what is that one thing you could tell everybody there this for all the of those that want to know if we’re keeping something back from you know there’s.

One thing I can tell everybody which is which is get off the gluten: it’s, not gonna hurt you. It could only help, and I’m. Like I said, I’m kind of moving towards gluten, like probably isn’t a good thing for anybody, but right now for my patient population it definitely is a non-negotiable dietary change.

So so that’s gluten, and I hope I hope that this is helpful to you. We will be continuing with this series on some more specific and detailed aspects of what functional medicine should look like when you walk into somebody’s office, and I will be looking forward to talking to you about whatever our next subject is.

I think it might be supplements the next time that I talk to you so dr. Martin Redford check us out at power health talk.com, and if you want any more information on us, then you can find the information there.

So I will talk to you next week. You

Source : Youtube

Play

2 Comments

  1. Mona Elisabeth Hedberg

    Dr. Rutherford !

    Thankyou so much !

  2. I want to thank you for increasing public knowledge about what people can do about their thyroid problems. Change happens slowly. The work you are doing is exemplary.
    Just some anecdotal information. In recent months I tried the Whole 30 diet. That eradication of sugar, grains, dairy, quinoa, has changed my life. Effortlessly lost weight, changed my low mood, no brain fog,increased energy, got rid of my eczema and lessened my vertigo. I have been on Synthroid for about 17 years. Healing leaky gut with bone broth too. All good. Once again. Thank you.

Leave a Comment

Your email address will not be published. Required fields are marked *

*