Question & Answer #1
Do fractured bones heal slower due to osteoporosis? and is age a factor – 81 years old?
-Lorraine A.
Dear Lorraine,
Excellent question! As I write in the Osteoporosis Reversal Program, bones are living and active tissue that can regenerate and rebuild itself. Here's an interesting paradox: osteoporosis does not slow down fracture healing. But the most commonly prescribed osteoporosis drugs, bisphosphonates, can slow down fracture healing.
Quoting from an article titled “Bisphosphonate-Associated Osteonecrosis of the Jaw: Pathophysiology and Epidemiology” published by the Institute of Dental and Craniofacial Institute:
“The resorptive power of osteoclasts is essential in bone remodeling. Although bisphosphonates inhibit bone loss, they can also inhibit normal physiological bone remodeling and turnover.”
Age can be a factor, but the bottom line is that regardless of age, bones can heal if their normal metabolism is not tampered with.
To your bone health!
Question & Answer #2
My doctor seems to think I would benefit by taking Fosamax I have osteopenia in my spine. I have read about this drug but I am not happy about the side effects. I am nearly 60 years old I have never had any pain in my back they think it was caused by taking prednisolone for my asthma and last year I had problems in my lung had a ct scan. The contrast they used shut my kidneys down so I had renal failure. So you can see my worry any information you can give me would be helpful thank you. Genny.
-Genny
Dear Genny,
Your doctor – and he is not the only one, unfortunately – is trying to kill an ant with an elephant. Osteopenia is an invented precursor to osteoporosis, a condition that can be reversed without taking dangerous drugs, as I clearly explain in the Osteoporosis Reversal Program.
You are right about not liking the side effects of Fosamax. Bisphosphonate drugs such as Fosamax (alendronate) have a long list of undesirable side-effects. And in your particular case, since you've had kidney issues in the past, the drug could actually harm your kidneys. There have been reports of severe kidney damage – even kidney failure – with intravenous bisphosphonates (zoledronic acid). One could argue that the IV dose is much larger than the pill dosage, but it makes sense to at least be very suspicious of microdamage to the delicate kidney tissue potentially caused by smaller doses of the drug.
Follow your instincts and question everything.
Question & Answer #3
I have been interested in bio-identical hormones and found someone to work with me. However- I am on Coumadin and my gynecologist says I risk getting blood clots- mixing hormones and Coumadin. Since I have to be careful of vitamin K- I thought hormones would be helpful for bone health. Do you think I am in trouble or is it minuscule?
-Sharon
Dear Sharon,
My question to you is “Why take a chance?”, especially if there is an alternate solution to your bone health. After all, your health is one of the most precious gifts you should safeguard. You are taking Coumadin for a reason, most likely because of a tendency to get blood clots. And your doctor knows this.
You don't need any type of supplemental hormones to tackle osteoporosis.There is a reason why the body slows down its production of hormones, and it is not a good idea to alter that balance. So I'll end with yet another question: “Why not try the Osteoporosis Reversal Program without taking ANY risks?”
Wishing you all the best,
Question & Answer #4
My Dr. tested my D levels since I refused to take any drugs for osteo (diagnosed by density scan). He said my test showed my D levels are on the low side. He advised one D per month of 50,000 units for three months & then to retest. It’s about time for the retest, but what do you think of this idea, please? He said D2, I take D3!!
I have an excellent diet for osteoporosis which I have studied throughout the nutrition community, plus supplements.
I’m 76 yrs. & in great health, other than osteoporosis.
Thank you for your good work & answers,
-Liz
Dear Liz,
You are right in taking D3. The Vitamin D2 your doctor has prescribed – also known as ergocalciferol – is of plant origin. Thus, it is very poorly absorbed, typically at 50% of intake. Cholecalciferol (D3) is the best form of vitamin D (at least for humans!). This has been vastly documented, and I am amazed at how often Save Our Bones community members mention that their doctor has prescribed D2 instead of recommending common sense sun exposure (weather permitting, of course), and D3.
In an article published in the American Journal of Clinical Nutrition (Vol. 84, No. 4, 694-697, October 2006) authors Houghton and Vieth clearly confirm this:
“The case that vitamin D2 should no longer be considered equivalent to vitamin D3 is based on differences in their efficacy at raising serum 25-hydroxyvitamin D, diminished binding of vitamin D2 metabolites to vitamin D binding protein in plasma, and a nonphysiologic metabolism and shorter shelf life of vitamin D2. Vitamin D2, or ergocalciferol, should not be regarded as a nutrient suitable for supplementation or fortification.”
Stay healthy and inquisitive!
Question & Answer #5
Can having osteopenia cause thigh muscles to hurt? I have low vit D and take 50,000 units of vit D once a week. I just can’t seem to remedy these aching thighs. I have started to use a Tens unit on my muscles. I’ll see if that helps.
Thanks.
-Dorothy
Dear Dorothy,
Osteopenia does not hurt. In fact, it's just a made-up condition that indicates a “risk” to develop osteoporosis. And in reference to taking 50.000 units of vitamin D, please see my previous answer to Liz.
In good health,
Question & Answer #6
Since you advocate wearing ankle and wrist weights to build bone, what about a weighted vest to wear while doing your normal daily activities. If so, do you recommend a specific brand and what about how many pounds it should hold? Also do the vibrating plates that you can do exercises on build bone as well? I have read extensive research on their benefits to bone health. Thanks for your input!
-Lacey
Dear Lacey,
The weighted vest is one more way to trigger a positive reaction on bones as postulated (and proven true) in Wolff's Law of bone formation. I explain its important principles in great detail in the Osteoporosis Reversal Program. Should you wish to wear the vest, you can adjust the weight to your own comfort.
The vibrating plates are still quite controversial, possibly because people with spinal injuries, such as slipped discs or pinched nerves may increase damage by using the machine. So check with your doctor before you invest in one.
Warm regards,
Question & Answer #7
I am a 58 year old male and had been an avid runner for the past 30 years. After breaking a leg (accident) and having knee surgery, I can no longer run. I was diagnosed with osteopenia 2 1/2 years ago and the Dr. told me to take calcium supplements and vit. D supplements. Two questions: Does working out on the elliptical machine at the gym count as weight bearing excercise? I recently saw the resuts of a study that linked vitamin D with increased risk of pancreatic cancer. Can you confirm and advise? Thanks!
-Steve
Dear Steve,
The term “weight-bearing” means your bones are working against gravity to support your body weight. So using an elliptical machine is considered a weight-bearing exercise.
About vitamin D and an increased risk in pancreatic cancer, you are pointing to a large study conducted in Finland. Here's the catch: all study participants were smokers, and indeed, men who had the highest concentrations of vitamin D in their bloodstreams had a greater risk of developing the cancer.
But an even larger Nurses Health Study and Health Professionals Follow-Up Study in the USA found that those with the highest consumption of vitamin D, 600 IU a day or more, had a 41% lower risk of pancreatic cancer.
Stay healthy and injury free!
Question & Answer #8
I have epilepsy as well as osteoporosis. The latter was a direct result from taking certain epilepsy drugs sine a baby. I am in the process of recovery from a hip fracture that went misdiagnosed for the first month as being soft tissue damage.
I was wondering if there was anything else I could do or take that would speed recovery whilst I am on crutches, as I am more vulnerable to another fall, seeing as I have poorly controlled epilepsy. I don’t want to hinder my process so far with the exercises and diet I am doing for bone strength. Thank you Vivian.
-Julie
Dear Julie,
I hope that you are feeling better. Your best bet is to continue on the Osteoporosis Reversal Program so your bones remodel as nature intended, all the while you nourish them with the Foundation Foods and Supplements.
Wishing you a speedy recovery.
Question & Answer #9
I have been trying to keep to your program for quite a while now and I take a magnesium supplement. For the last month or so I have been using a magnesium oil spray because I feel that sometimes the by mouth supplements can upset the gut. My dilemma is “how do I know that the magnesium is getting into my system”? Has there been any independent research on this?
Regards
-Heather
Dear Heather,
Magnesium oil spray is absorbed through the skin (transdermal absorption). The skin is the largest organ in the body, and it acts like a giant sponge. Dr. C. Norman Shealy, has done extensive research on transdermal magnesium oil and postulates that it is especially valuable for those who can't tolerate oral magnesium supplementation.
Warm regards,
Question & Answer #10
I know you suggest algae calcium but which one do you think is the best? If a person cannot seem to tolerate that kind of calcium, what calcium supplement would you suggest? I am having a terrible time trying to find the best supplement. Thank you.
-Kathleen J.
Dear Kathleen,
Many supplement companies incorporate plant-based calcium in their formulas nowadays, and they are all quite similar in composition. Among them are New Chapter, Garden of Life, and Algaecal. If you have a difficult time tolerating these supplements, your next best option is amino-acid chelated calcium.
As I explain in the Osteoporosis Reversal Program, it is important to take the Foundation Supplements in the right balance, because they all are synergistic with each other. So to get maximum results, don't forget to balance the calcium properly with bone healthy minerals and trace elements.
To your health!
You May Also Like These Related Articles:
Vivian Answers Day #28: Calcitonin Nasal Spray Still Prescribed By Doctors, Persistent Back Pain Between Shoulder Blades, Natural Ways To Reduce Or Eliminate Wrinkles, And More!- Vivian Answers Day #27: Hip Fracture And Forteo Injections, Drinking Cow’s Milk, Filtered Water, Vegetarian Protein Sources, And More!
- Vivian Answers Day # 26: Caffeine and Calcium, Cartilage Integrity, Strontium Conundrum, Osteopenia Diagnosis, Alkalizing Drink, And More!
Comments on this article are closed.
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hi i take levothyroxine 100mg a day i have just had a irm scan on back and told i needed to take protelos 2g and calcium vitamin d3 500mg powder twice a day because of my bones i am 49 if i space the medication at 4 hour interviles will this be ok not to interfere with the meds for thyroid thankyou ,,, also will any of these meds make me gain weight i try so very hard to keep of i swim regularly to stay slim thanks again
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I am a two-time breast cancer survivor and am blessed to say that I have been cancer-free for the past 7 years.
I am interested in your reaction and opinion regarding a problem that I developed a few years ago. My oncologist referred me to an endocrinologist 5 years ago because my blood calcium level was elevated and he suspected a parathyroid problem. My bone density test also revealed that I had osteopenia. The endocrinologist said that it was “most likely” a parathyroid issue and continued to “watch” the problem for the past 5 years. I became concerned because although I was trying to do all the right things for my bone health, I had this condition working against me. A few months ago I decided to take matters into my own hands and seek a second opinion. I got an appointment with the most highly respected and skilled endocrine surgeon in Pittsburgh who told me that my problem was totally solvable through a minimally invasive procedure. The surgery was performed in October and my PTH and blood calcium levels returned to normal levels immediately. Do you believe this was the best course of action? I am in excellent health in all other respects – blood pressure, cholesterol, triglycerides, etc.
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Calcium supplements made from calcium carbonate and other inorganic calcium are now thought to increase the risk for heart disease. You often recommend almond milk instead of regular milk. However, all of the almond milk brands that I have seen are fortified with calcium carbonate. Does the calcium carbonate in almond milk increase the risk of heart disease?
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I have been taking 2000 units of Vit D3 every day. I have read yes and again no. I am 76 years old and have been told that I have osteopenia and I refuse to take any drugs of any kind. Please comment on the Vit3. thank you
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nice point!!!
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The British Medical Journal debunked calcium supplements in a July 2010 article. Can this be true?
The operator on observing my last Dexa scan said I had “quite a bit of calcium” in my system. How could she tell?
My diemma is: am I taking too much calcium? not absorbing it?
Should I stop taking supplements?
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Hi , I enjoy very much your articles. I have a question to ask : what do you think of Ostera for bones? I would like to know if its a drug or natural supplement.
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tHANK YOU vIVIAN FOR ALL THE INFORMATION AND GUIDANCE YOU HAVE GIVEN US.VERY MUCH APPRECIATED. GEORGINA
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Fosomax made me sick for days. Dr. decided to then give me reclasp infusion. It has settled in my joints, caused great acid reflux, made it difficult to swallow at times and caused extreme fatigue. When the year is up will all of these side effects ever be reversed? Never had joint problems before this.
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People with unexplained upper back pain and muscle aches should look at the anti-candida diet. Candida also relates to bone loss. It doesn’t contradict anything I have read on these pages, just adds another dimension. It came to a head for me when I was diagnosed with osteopena and started to eat lots of dairy food. Now I am a different person and it took 2-3 months. All the best!
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Hi Vivian,
I take calcium and minerals. I have started taking natural hormones and was considering taking natural strontium. And I am adding foods that help increase bone density.In a response to one person’s question about taking coumadin and HRT and another person about taking a prescription drug with strontium, you indicated they shouldn’t. I understand that taking natural hormones is not the same and doesn’t have the side effect. Are you saying not to take these also?
Thank you,
Dorothy -
VIVIAN;
THANK YOU FOR YOUR E-MAILS. I ENJOY YOUR ANSWERS & OTHER BONE PROBLEMS WE ALL SEEM TO
GET. I DO AGREE THAT YOUR BOOK IS A BIBLEKEEP UP THE GOOD WORK–IT MUST TAKE SO MUCH
OF YOUR TIME.MB
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Thanks Vivian for this invaluable work, when you answer a question from someone at the same time responding to many people as I would have asked the same question.
It is fortunate to have the gift of yours knowledges, experience and generosity. Cordially yours.
Sergio
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I thought supplemental calcium was now a bad idea due to a recent study linking it to heart disease.
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am on evista. I have osteopenia for few yrs. Bone density fair. Recently primary Dr wants to put me on octonel but my OB said it was not so abnormal and gave me all the numbers N stastestics and advised me to keep on calcium and more exercise. Thinking OB seemed to know and primary didnt give explaination except lower density test per office staff call.I dont trust rx with severe side effects. thank you
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I have never had ANY health problems til I had a complete hysterectomy at 30. I have been soo sorry I ever went to any drs. Now I have soo many health concerns. I have hypothyroid,osteopenia&hormone problems. Will your program help me as I do NOT trust drs. anymore?
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Thank you for the recent day 2 information, I stopped all medication almost 2 years ago and feeling much better also not any of that lethargy that I was experiencing on the drugs. I eat the things advised by you Vivian.
The G.P prescribed ADCAL-D3 recently is this a safe drug please. -
Thanks for your words. I recently went off Actonel and realize what I’ve been doing all along; exercise and healthy eating habits and some weight bearing – is all I need and will certainly advise my doctor of you and your work.
Thanks for helping women everywhere.
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thankyou for all your information i look forward to reading your advice and follow it to help my situation.keep it coming i have passed on your website to friends in similiar situations Thankyou again
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Thank you, Vivian, for your comments. I always anticipate your emails and appreciate your positive attitude!
Andrea Moore -
Again, with a calcium supp question. What do you know about MCHC in Cal Apatite Forte Capsules? Lots of letters and words. Is it just hype??? Also my Endocronogolist said an eliptical trainer does NOT help with bone building. I just read in your replies that is does. Soooo confusing. HELP
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Jackie,
Endocrine people are working in standard medical world, analyzing and prescribing chemicals. They believe they have all the answers! Whilst they do good work in many areas, there are some things that don’t have priority in their training.
I suggest you read through as many forums on this site as you can, to grasp what Vivian and others are talking about. You can also download Vivian’s free publication, and perhaps also get her saveourbones program.
They old saying ‘Move it or Lose it’ applies and any exercise is going to strengthen us in some way.
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I took calcitonin for 6 months thinking it was the drug with the least amount of side effects according to the peoples pharmacy.I have osteopenia and the doctors scared the hell out of me. Anyway the calcitonin upset my stomach ,caused me to be very fatigued and lowered my thyroid to the point they wanted to put me on sythroid. I stopped taking it and my thyroid returned to normal ,my energy level returned and I only take a muti vitamin with 1000 units of vitamin D and eat plenty of calcium loaded foods. I’m 59 and plan on staying away from drugs as long as it’s not life threatening.
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Thank you, Vivian, for the Q&A “program” you continue with. Though I’ve read your book, there’s always something new I find in your answers, and when it’s not new – it’s still refreshing.
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I’m a diabetic taking Actos with dinner and keeping sugars and white foods out of my diet.I’m also Lactose intolerent but Lactase pills when I have dairy products i.e. cheeses.
With diabetes my cholestrol has to be controlled by, Niaspan { I’m allergic to all the other drugs that control cholestrol, other than Ezetimibe & Niaspan. Recently I broke my right ankle and leg and had 9 screws and 2 plates implanted. My Dr. sent me for a Bone scan and I have osteopina. He has had me on Fosomax for 3 months and I am now getting alot of mucle pain and bone pain throughout my body and when I see him on Friday I am not going to take that drug again so I’ll have to do this Hollistically . I’m doing osteo exercises and am taking 2,000 mg of Vitamin D3 and also 700mg of Calcium Citrate and 200mg of Magnesium citrate. Also Plavix so I can’t take the K vitamin. Is there anything else I can do to strengthen my bones. I’m 67 years old.-
Please add me to your e-mail list. Thank you
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Hi Vivian,
Thanks for everyones bits of info.It all helps, but not sure if it is good for all of us.Thank you, for all the work, you to, for all of us. It is much appreciated.
Catherine Smith -
I would like to know if Ezorb calcium is really worth the price that places get for it and if it is better absorbed than calcium caltrate or calcium carbonate?
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I took E-zorb for quite a while. My Dr. said that my osteoporosis was not improving and so I went to Calcium Complex Bone Formula. Haven’t had a test since, but don’t feel that I am making progress. I am 81 yrs old.
Try to get greens every day.
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I have been on Amberen to relieve hotflashes and other menopausal changes for 1 month. I have’nt noticed any difference in my hot flashes so I’m doubling the dosage as suggested by the company. Do you know anything about this all natural product which stimulates your own bodies production of needed ingredients for relief of hotflashes, libedo, and vaginal thinning? I work in obgyn at the medical school and asked a Dr. in my department about it and she read the incregients and said she doesn’t see anything in it that would be bad for me.
Ellen -
Vivian, I have learned so much since reading your book and your comments. I have osteopenia in my neck and spine. I have a lot of pain in my back but your note just read that osteoporosis doesn’t hurt. I had a compression fracture of the spine over a year ago from picking up something too heavy and also scolosis. Even the doctor doesn’t know which is causing the pain. Thanks for all you do for all of us who are in the same boat.
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I can’t thank you enough for caring enough to give us all this excellent advice! Nancy
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Thank you so much for sharing the questions and answers!!!!
Many blessings to you!
Veronica -
I still need some specifics on exercises for treatment for osteopena. Thank you!!!!
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i have osteopina also i go on the treadmill and use 5 to 8lbs weights,dance class,yoga, water excercises in the pool.
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Thank you for all of your positive comments.Wondering how yo
u feel about vitaminK-2
Thanks
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I am a member of the Osteoporosis Reversal Program and somehow missed getting the exercise program. Is there anyway I can get a copy of them? I’m 66yrs. and don’t really know how much I should lift on the weight bench. I know I should start low maybe 5lbs. and work up, and the number of times should I lift? Really would appreciate some help. Thank you
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DEar Vivian, your answers to the questions you tackled this time have helped me either to make good decisions or gain new information in this vast field of “Bone Health”. Thank you for your work.
Regards, Elisabeth
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very interesting reading everyone’s comments. I have recently been put on protelos 2g how safe do you think this is
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I have been on prednisone for 8 mos. for polymyalgia. I have osteoporosis in the spine and osteopenia in the hips. I will have a bone density test on Nov.1. If I have more loss of density, my dr wants to put me on Reclast. I am balking at that. I have your book and am trying to follow it. I have tried all those drugs and they all made me ill. Help!!
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I was happy to read your answer to hormones in question #3: “There is a reason why the body slows down it’s production of hormones and it is not a good idea to alter that”. I have always believed this and have never taken any kind of hormone. The body knows what to do at each time in your life regarding hormones.
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INFORMATIVE. THANKS
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Having been on Fosamax for 12 years, prior to
the knowledge of it’s bad side effects, I am
very interested in the well-researched and relatable info that you are sharing with us
Vivian … please keep it coming. Thanks! -
Could you tell me what is “amino-acid chelated calcium” and who makes a good product?? Also, I am allergic to stevia, which is in some products.
Thank you!!
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My hips and lower back hurt especially if I sit very long or lay very long. Could this be due to my osteoporosis? I am 49 and already have osteoporosis.
Thanks, Margaret -
Could you please tell me something about EZorb calcium?
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Yes —I would like to also know more about E-zorb Calcium —Thats what I am taking
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There are so many calcium suppliments out there, how would we ever know how to choose.
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“Bone Strenghth take care” is a whole-food complex with Vit.D3, K2 and Magnesium with AlgaeCal. It states that evidence suggests that calcium from whole-food sources may produce more favorable effects in bone health than isolated calcium supplements.
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I am also taking E-ZORB calcium. I have been taking it for approx. 3 weeks now. Anybody else that is using this product tell us about your success or failure with this product.
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Dear Vivian,
Thank you for the update to the questions. It has been great to read the answers and learn more information.
I find I refer back often and always learn something more.
You are doing a fantastic job of educating the community on better bone health. Thank you so very much!
Celestina Marie -
Thank You Vivian for all your research and help. I too am finding that I can’t tolerate algae based calcium. I will look into the alternatives you have suggested. Thanks again for all your info. I also have your book and refer to it a lot.
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VERY GOOD!!!!THANKS A LOT.
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I am keen to improve my bone density as I have recently been “diagnosed” as having osteoporosis with a spine T score of -3.8 and want to achieve this the natural way. My only concern is that I had hemicolectomy 9 years ago and my understanding is it is this operation that has probably reduced my ability to absorb vitamins and minerals etc. and so is probably the cause for my condition. This doesn’t stop my desire to improve my bone density but I could very well be wasting my time.
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I was diagnosed with ostopenia several years ago. Two years later, I had another bone scan and it had gotten a little worse. I started taking Viactiv soft-chew vitamins 3X a day (morning, noon & night) and exercising 3X a week. My last bone scan showed that I had reversed my bone loss. I am 73 yrs. old so this is really great news for me.
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No comments yet.
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Hi Vivian:
So grateful for your feedback. Love to read all the questions and answers. Keep up the good work
we all need you.
Joyce -
I was just diagnosed with osteopenia in my feet. I have already been diagnosed with osterporosis and I am terrified. I do not like what I am reading about the drugs available. I am purchasing your book and am going to read everything I can about this disease.
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Vivian, I purchased your Save Our Bones book recently and haven’t finished reading it yet. Can you tell me if breakfast cereals containing bran can interfere with calcium absorption ?
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I recently had a bone density test done and the results were in the 3.0 range. The doctor said I need to be in the 2.0 range. It this a hype of should I be concerned?
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Thank you, Vivian, for answering pertinent questions and posting them for all of us to read. This is a welcomed addition to the Osteoporosis Reversal Program. I have your book and refer to it often. It is kind of my ‘bone bible.’ Keep up the wonderful work that you do. Veronica
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Great stuff. It appalls me how little most doctors know about the important “balance” required to remain healthy and treat problems with better behavior. Then it shouldn’t because our system is driven selling something to get paid! My husband is 77 and has been doing the same thing for 50 years with astounding results. He eats a large bowl of fresh cut (refuses to let somebody he doesn’t know wash or cut) fruit daily. He exercises 5 minutes a day and takes almost no pills or drugs unless he gets sick and needs an antibiotic. He is a fanatic against prescriptions. He looks 55-60 is as strong as a horse and keeps his weight within 5 pounds from were it was at Princeton when he was an undergraduate. They have been trying to put him on blood statins for over a year and although he has tried using them when pressures are high – refuses to take them daily. 120/75 I think is quite remarkable most of the time.
Barbara -
Vivian,
I don’t know how you do it but you will be blessed for all our us you are helping.Le gach dea ghui,
Joe
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I have been diagnosed with osteo arthritis in my left hip which now seems to be affecting both my knees. I don’t take any suppliments but I do have a plant called a feverfew which is good for arthritis I put the leaves in a sandwhich every day. I am not a pill popper never have been never will be I am always worried about side effects. Can you recommend anything else I could be doing to help with the pain sometimes it’s OK then another day it is quite bad. I am a Vegan and I eat lots of green veg and other as well and fruit are any of these better than others for osteo arthritis? Thanks Sonja
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HI Vivien
I know this is probably not the day to ask questions but I was in the pharmacy the other day trying to get the right Calcium supplement and there are so many to choose from! I prefer to have Ca citrate in it rather than Ca carbonate since it is better absorbed but found one labelled Bone Calcium which has calcium hydroxyapatite as the Ca consitutent but it was from bovine bones is this a good/safe one to get or has there not been enough research on it yet? Another paper suggested it was contaminated with heavy metals.
Thanks for your help
Lulu
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I am 60 yrs old and have been taking the lowest dose of Fosamax for several years due to a full hysterectomy. I have been hearing a lot about Amebren and how it helps with hot flashes and weight loss, but I am not sure if the two meds would work together or against each. Can you please help me with this question. Thank you.