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Can anyone comment on the use of niacin to lower LDL and raise HDL?

niacin cholesterol

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#1 RichardAlan

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Posted 02 December 2018 - 10:21 AM


I was watching some videos and it seems like this was a popular suggestion five years ago but not so many people talking about it now.  Does anyone know if it is effective / recommended these days? Is it a good alternative to Statins and does it have any relation to nicotinamide? 



#2 pamojja

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Posted 02 December 2018 - 11:20 AM

I use high dose niacin for improving lipids and along with other supplements and lifestyle interventions for 10 years as outlined in this regimen post. Altogether it improved in average for about 40% in my case and time period (HDL up 52% LDL and Trigs down 33 and 34% respectively).

 

 

Is it a good alternative to Statins

 

Guess everyone finds oneself in a different situation, and therefore has to consider all the available evidence for making an informed decision:

 

 

Statins Given for 5 Years for Heart Disease Prevention (With Known Heart Disease)

83 for mortality

In Summary, for those who took the statin for 5 years:

Benefits in NNT
  • 1 in 83 were helped (life saved)
  • 1 in 39 were helped (preventing non-fatal heart attack)
  • 1 in 125 were helped (preventing stroke)
Harms in NNH
  • 1 in 100 were harmed (develop diabetes*)
  • 1 in 10 were harmed (muscle damage)
*The development of diabetes is one such unanticipated harm found in a recent large study and it seems likely therefore that this applies to the data above, although this is a best guess.



Blood Pressure Medicines for Five Years to Prevent Death, Heart Attacks, and Strokes

125 for mortality

In Summary, for those who took anti-hypertensives:

Benefits in NNT
  • 1 in 125 were helped (prevented death)
  • 1 in 67 were helped (prevented stroke)
  • 1 in 100 were helped (prevented heart attack*)
Harms in NNH
  • 1 in 10 were harmed (medication side effects, stopping the drug)
*fatal and non-fatal myocardial infarction and sudden or rapid cardiac death



Aspirin to Prevent Cardiovascular Disease in Patients with Known Heart Disease or Strokes

333 for mortality

In Summary, for those who took the aspirin:

Benefits in NNT
  • 1 in 50 were helped (cardiovascular problem prevented)
  • 1 in 333 were helped (prevented death)
  • 1 in 77 were helped (prevented non-fatal heart attack)
  • 1 in 200 were helped (prevented non-fatal stroke)
Harms in NNH
  • 1 in 400 were harmed (major bleeding event*)
*Required hospital admission and transfusion



Coronary Stenting for Non-Acute Coronary Disease Compared to Medical Therapy

None for mortality

In Summary, for those who received the stenting:

Benefits in NNT
  • None were helped (life saved, heart attack prevented, symptoms reduced)
Harms in NNH
  • 1 in 50 were harmed (complications such as bleeding, stroke, kidney damage)

 


Edited by pamojja, 02 December 2018 - 11:35 AM.

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#3 tunt01

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Posted 02 December 2018 - 04:55 PM

Niacin reduces PCSK9 levels, which prevents the degradation of LDL receptors in the liver and improve hepatic recycling of LDL.  (Khera 2018).  I would personally make sure your diet/exercise is appropriate before supplementing.  I would get an NMR lipoprofile to understand your lipids (particles, etc.) before being overly concerned with LDL and HDL levels.  If you are a male and your HDL-C is above 40 and your LDL-P is below 1000, you are probably fine.  In the case of supplementation, I would use niacin only once and with a meal, preferably during the day (i.e. lunch), as it probably can interfere with SIRT1 and NAMPT feedback on NAD+ levels.

 

Khera AV, e. (2018). Effects of niacin, statin, and fenofibrate on circulating proprotein convertase subtilisin/kexin type 9 levels in patients with dyslipidemia. - PubMed - NCBI Ncbi.nlm.nih.gov. Retrieved 2 December 2018, from https://www.ncbi.nlm...pubmed/25432415

 


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#4 pamojja

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Posted 02 December 2018 - 05:05 PM

In the case of supplementation, I would use niacin only once and with a meal, preferably during the day (i.e. lunch),

 

Or even every second day, as I started to do.


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#5 Dorian Grey

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Posted 02 December 2018 - 11:03 PM

Avoid time released niacin (and multiple daily doses) as this has been associated with liver damage. 

 

https://www.lifeexte...7/3/atd/Page-01

 

"Niacin’s safety record is equally impressive. However, a brief foray into the use of very-slow-release niacin preparations in the 1980s taught us an important lesson: niacin is very safe, if the liver is exposed to it for only a few hours at a time. Niacin is, after all, just vitamin B3. However, 24-hour, day-after-day exposure to niacin over an extended period can be toxic to the liver. Thus, the very-slow-release niacin preparations that yielded sustained, high blood levels of niacin caused liver toxicity in 10-20% of people who used these preparations in the 1980s. Unfortunately, this learning experience left some physicians fearful of recommending niacin to their patients. For this reason, very-slow-release niacin should be avoided."


Edited by Dorian Grey, 02 December 2018 - 11:04 PM.

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#6 John250

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Posted 03 December 2018 - 04:58 PM

Only supplement that ever raised my HDL is Citrus Bergamot.

#7 MikeDC

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Posted 04 December 2018 - 01:47 PM

Niagen can also lower LDL without the side effects of Niacin.
Niagen also has strong anti aging effects. People over 50 must take Niagen to maintain health and prevent age related diseases.
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#8 RichardAlan

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Posted 05 December 2018 - 09:02 AM

Niagen can also lower LDL without the side effects of Niacin.
Niagen also has strong anti aging effects. People over 50 must take Niagen to maintain health and prevent age related diseases.

 

Hi Mike, Can you explain a bit more about the benefits of taking Niagen and what the difference is between that and Niacin.  Also if already taking NMN and Metformin, then are there likely to be any additional benefits taking Niagen and what dosage is recommended?  Thanks


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#9 RichardAlan

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Posted 05 December 2018 - 09:04 AM

I use high dose niacin for improving lipids and along with other supplements and lifestyle interventions for 10 years as outlined in this regimen post. Altogether it improved in average for about 40% in my case and time period (HDL up 52% LDL and Trigs down 33 and 34% respectively).

 

 

Guess everyone finds oneself in a different situation, and therefore has to consider all the available evidence for making an informed decision:

 

Hello Pamojja,  thanks for your reply to my post.  Just one question.  Do you know what is meant by NNT and NNH?

 

Benefits in NNT

  • None were helped (life saved, heart attack prevented, symptoms reduced)

Harms in NNH



#10 pamojja

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Posted 05 December 2018 - 12:28 PM

NNT is the 'number needed to treat'.

NNH is the 'number needed to harm.'

 

So in patients already having had a heart attack given statin for 5 years, only 1 patient in 83 taking the statin experienced a reduction of 5-year mortality. 1 in a 100 experienced muscle damage. Not much relyable data for taking statins longer than 5 years. And in someone who hasn't had a heart attack yet, this NNT becomes astronomical.

 

It is the absolute percentage of improvement from a drug. While drug studies usually only report the more appealing relative percentage. As in this example the absolute percentage is a bid more than 1%. If for example  in the placebo arm died 3 out of 100 patients, in the drug arm of a placebo controlled trial only 2 out of 100 (simplified here), the absolute percentage is 1% the 'relative' percentage of improvement is 30%!

 

All my cardiologist I got to know started to argue with me about that, and embarrassingly even them don't seem aware of this crucial difference between relative and absolute percentage of improvement in hart end-points reported in drug-studies.

 

And accordingly treated me like an irresponsible idiot for refusing such a wonder drug which according to their myth helps 30% of patients against earlier mortality.


Edited by pamojja, 05 December 2018 - 12:50 PM.

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#11 MikeDC

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Posted 05 December 2018 - 12:47 PM

Hi Mike, Can you explain a bit more about the benefits of taking Niagen and what the difference is between that and Niacin. Also if already taking NMN and Metformin, then are there likely to be any additional benefits taking Niagen and what dosage is recommended? Thanks


NMN is in the same class as Niagen(NR). NR is more efficient than NMN and have many clinical trials in humans. NMN has no clinical trials in humans yet that has been published. Also the cheap NMN on the market are of questionable quality. Any decent NMN will cost over $100 per month.
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#12 pamojja

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Posted 05 December 2018 - 01:54 PM

NR is more efficient than NMN and have many clinical trials in humans.

 

There is no placebo controlled trial yet, that shows NR would be even close to effective as Nicotinic acid is for improving lipids.
 



#13 MikeDC

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Posted 05 December 2018 - 02:43 PM

There is no placebo controlled trial yet, that shows NR would be even close to effective as Nicotinic acid is for improving lipids.


You are correct. But many long time Niacin users get great anti aging benefit after adding Niagen. I have many friends whose LDL dropped after taking Niagen. Niacin has been used for a long time. But you don’t see many users come out saying they are getting younger. Even though Niagen has not been around very long, a large percentage of Niagen users report great rejuvenation benefits. At the moment, science can’t explain why Niagen has strong rejuvenation benefits while Niacin and Nicotinamide don’t.
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#14 tunt01

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Posted 05 December 2018 - 03:31 PM

At the moment, science can’t explain why Niagen has strong rejuvenation benefits while Niacin and Nicotinamide don’t.

 

Isn't the predominant thesis for the difference between the two due to SIRT1 activity?  Niagen activates it while Niacin/Nicotinamide inhibit it?



#15 able

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Posted 05 December 2018 - 05:11 PM

NMN is in the same class as Niagen(NR). NR is more efficient than NMN and have many clinical trials in humans. NMN has no clinical trials in humans yet that has been published. Also the cheap NMN on the market are of questionable quality. Any decent NMN will cost over $100 per month.

 

 

Please post the test results you, or Chromadex have done to back up your slander that any NMN that is priced competitively is bad.

 

Why does the  NMN powder have a 4 1/2 star average on amazon, while even though it cost less, Tru Niagen is at 3 1/2 stars?

 

(Apologies to ABN, as I'm sure you and the other NR stockholders will go hammer them now with bad reviews)


Edited by able, 05 December 2018 - 05:14 PM.

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#16 pamojja

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Posted 05 December 2018 - 06:39 PM

Niacin has been used for a long time. But you don’t see many users come out saying they are getting younger.

 

Well, then take me as the first one. Though I can't subscribe all health-benefits to niacin alone, but along with comprehensive supplementation and lifestyle changes all my lab-markers improved substantially. Inflammation markers, kidney, liver, androgens, CBC, electrolytes, etc. all improved throughout. If I put my numbers into one of those calculators which extrapolate biological age I definitely rejuvenated during the last 10 years. Though with a PAD II and COPD I from close to my last breath, and thereby also reversing a 60% walking-disability. However, with lipids niacin definitely was one of the major agents.
 



#17 mikeinnaples

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Posted 05 December 2018 - 09:31 PM

Niagen can also lower LDL without the side effects of Niacin.
 

 

Well this is pretty much wrong.

 

Seriously, is there a single poster on these boards with more negative feedback?


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#18 MikeDC

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Posted 06 December 2018 - 12:14 AM

Niacin is a good product. But it is yesterday’s hero. Look at the ranking of B3 sales on amazon. People are paying 400% more for Niagen for a reason.

https://www.amazon.c...sr_hpc_1_5_last
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#19 RichardAlan

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Posted 06 December 2018 - 07:40 AM

Niacin is a good product. But it is yesterday’s hero. Look at the ranking of B3 sales on amazon. People are paying 400% more for Niagen for a reason.

https://www.amazon.c...sr_hpc_1_5_last

 

Mike,  Not doubting you at all and I am considering Niagen.  Although it has probably been mentioned many times, could you outline some of the benefits people might expect if moving from Niacin to Niagen.  I thought one benefit of niacin was for the skin (benefit caused by flushing), but seems like Niagen does not produce the flush.

 

Also what about dosage, should I use the same dosage with Niagen? When should it be taken and dose it have any effect on the liver?



#20 pamojja

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Posted 06 December 2018 - 12:58 PM

Also what about dosage, should I use the same dosage with Niagen? When should it be taken and dose it have any effect on the liver?

 

There's been this safety study with niagen:

 

 https://www.ncbi.nlm...pubmed/29992272

 

Conclusion: 12 wk of NR supplementation in doses of 2000 mg/d appears safe, but does not improve insulin sensitivity and whole-body glucose metabolism in obese, insulin-resistant men.

 

Charles Brenner, PhD, with financial ties to NR (just as MikeDC as a stock-holder) and one of the co-authors, interprets the results like this:

 

https://aboutnad.com...iver-in-people/

 

However, though the group that got NR began the trial with 2.8% lower liver fat, they appeared to benefit from NR by virtue of a 2% reduction in fatty liver over the course of the trial. Moreover, of the 13 individuals in the NR arm of the trial with 5% fat content in their livers, 9 appeared to respond to NR in reduction of fatty liver. This trial also showed a tendency for the NR group to lower their low density lipoprotein cholesterol (P = 0.13).

 


Edited by pamojja, 06 December 2018 - 01:00 PM.


#21 pamojja

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Posted 06 December 2018 - 01:06 PM

Niacin is a good product. But it is yesterday’s hero. Look at the ranking of B3 sales on amazon..

 

Lol, I must also be so yesterday. I never even bought anything on amazon, and thought reviews are made for boosting sales? Not something someone self-educated would ever bother with?
 


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#22 MikeDC

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Posted 06 December 2018 - 01:28 PM

Mike, Not doubting you at all and I am considering Niagen. Although it has probably been mentioned many times, could you outline some of the benefits people might expect if moving from Niacin to Niagen. I thought one benefit of niacin was for the skin (benefit caused by flushing), but seems like Niagen does not produce the flush.

Also what about dosage, should I use the same dosage with Niagen? When should it be taken and dose it have any effect on the liver?


NIagen doesn’t cause flush. NIagen makes liver healthy.
250mg or 300mg per day is the recommended dose. Some people double it with another dose in the afternoon.

Most people feel more energy. Many people see improvements in skin, age spots, hair color, blood markers, etc. you can read the reviews on Amazon. They are real.
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#23 pamojja

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Posted 06 December 2018 - 01:59 PM

Most people feel more energy. Many people see improvements in skin, age spots, hair color, blood markers, etc. you can read the reviews on Amazon. They are real.

 

Made 2 experiences with reviews. One is that I would get a discount for writing, second is I would get a discount on rewriting a bad review. The discounts are indeed real.
 



#24 MikeDC

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Posted 06 December 2018 - 02:02 PM

The reviews on Amazon are controlled by amazon. For some reason, my review was deleted by amazon. Amazon somehow thinks I am related to the company.

#25 Daniel Cooper

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Posted 06 December 2018 - 08:05 PM

NNT is the 'number needed to treat'.

NNH is the 'number needed to harm.'

 

So in patients already having had a heart attack given statin for 5 years, only 1 patient in 83 taking the statin experienced a reduction of 5-year mortality. 1 in a 100 experienced muscle damage. Not much relyable data for taking statins longer than 5 years. And in someone who hasn't had a heart attack yet, this NNT becomes astronomical.

 

It is the absolute percentage of improvement from a drug. While drug studies usually only report the more appealing relative percentage. As in this example the absolute percentage is a bid more than 1%. If for example  in the placebo arm died 3 out of 100 patients, in the drug arm of a placebo controlled trial only 2 out of 100 (simplified here), the absolute percentage is 1% the 'relative' percentage of improvement is 30%!

 

All my cardiologist I got to know started to argue with me about that, and embarrassingly even them don't seem aware of this crucial difference between relative and absolute percentage of improvement in hart end-points reported in drug-studies.

 

And accordingly treated me like an irresponsible idiot for refusing such a wonder drug which according to their myth helps 30% of patients against earlier mortality.

 

 

The effectiveness of statins are a myth perpetuated by those that stand to make $11B/year selling them.  Worse, those same entities support the status quo in the drug approval process which ensures they can milk current drugs as long as possible while at the same time acting as a barrier to any disruptive new drug/technology.


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#26 MikeDC

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Posted 06 December 2018 - 08:18 PM

The statin scam is huge. My primary doctor send my lab to the local hospital instead of quest. I think they intentionally raise cholesterol and glucose level to sell drugs to you.
My quest LDL is 185. Their LDL is 225.
My glucose was 89 at home and their result is 106.
Don’t use Virginia Hospital Center for blood tests.

Edited by MikeDC, 06 December 2018 - 08:42 PM.


#27 pamojja

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Posted 07 December 2018 - 12:25 AM

My quest LDL is 185. Their LDL is 225.
My glucose was 89 at home and their result is 106.

 

I regularly test since 10 years, and such differences reflect just normal biological changes at different time points.

 

However, both your LDL results don't particularly display the effectiveness of NR in lowering LDL ;)
 


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#28 MikeDC

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Posted 07 December 2018 - 12:45 AM

I regularly test since 10 years, and such differences reflect just normal biological changes at different time points.

However, both your LDL results don't particularly display the effectiveness of NR in lowering LDL ;)

My LDL has been consistently just over 200 before NR. It has dropped below 200 after taking NR. I did two other tests near the same time and both below 190. 225 was even higher than before NR. I am 100% certain the measurements at the hospital was adultered. Same thing happened to my wife last year and the doctor pushed statin on her.

Edited by MikeDC, 07 December 2018 - 12:48 AM.

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#29 BieraK

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Posted 07 December 2018 - 02:15 AM

I'm starting to use it.
The major side effects or concerns about Niacin are two
1) Insulin resistancce

2) Reduced levels of methyl donors and an increased levels of histamine and serotonin

 

for 1) you can take niacin bound chromium, or change your diet and eat less carbs and doing more exercise. for 2) you can take TMG/Betaine.

 

What I'm doing for now is to take Niacin before bed. It makes me sleep a lot better, don't know why but sometimes I wake up refreshed after just 3 hours of sleep. Niacin before bed has other benefits, it is known that increased insulin levels reduces HGH pulsatile effects, basically low insulin enhances HGH, such thing happens with fasting, If you don't know try to search about it, muscle is preserved while fasting due to HGH increase.

Niacin produces glucose store release the first hours and stops FFA release, but then it produces a rebound effect in FFA, apparently (I have not tested yet) Niacin increase ketone bodies production, so if you take Niacin before bed and if you sleep 8 hours you will have increased ketone bodies because you are not eating food in that sleeping window.

 

So Niacin before bed enhances HGH, increased ketone bodies production and reduces the potential develop in insulin resistance because you are in an empty stomach for 8 hours or more.


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#30 pamojja

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Posted 07 December 2018 - 11:51 AM

My LDL has been consistently just over 200 before NR. It has dropped below 200 after taking NR. I did two other tests near the same time and both below 190. 225 was even higher than before NR. I am 100% certain the measurements at the hospital was adultered. Same thing happened to my wife last year and the doctor pushed statin on her.

 

That's standard of care. The doctor has to 'push' statin above a certain level, otherwise he is risking loosing his license. Even in my case where the monitoring internist is well aware that I already improved my lipids in average by 40% for 10 years with natural means, he still has to write in his report that statin medication would be indicated. Well knowing that I already accomplished what statins could do with other means. And knowing I would never let it be pushed upon me. It's for assuring him not risking loosing his license.

 

All remaining equal, these tests to variate quite a lot. In my experience and Chris Masterjohn's opinion:

 

https://chriskresser...disease-part-2/

 

So here’s the general rule. If you’ve only measured it two times, you should expect to see an increase or a decrease greater than 35 mg/dl before you can be 95% confident that your cholesterol has increased or decreased. You should expect your HDL cholesterol to go up either 9 or 10 mg/dl or down 9 or 10 mg/dl before you can say with 95% that it’s increased or decreased. You can expect your LDL cholesterol to go up either 30 mg/dl or down 30 mg/dl before you can conclude that it’s different. If you’re looking at the ratio you should expect the ratio of LDL:HDL cholesterol or total:HDL cholesterol to go up by 0.8 or down by 0.8 before you can conclude it’s changed. And you should expect your triglycerides to go up by at least 40 mg/dl or down by at least 40 mg/dl before you can conclude that they’ve changed.

 

bolded emphasis by me.


Edited by pamojja, 07 December 2018 - 12:04 PM.






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