Rhabdomyolysis Is Not A Crossfit Issue, It Is A Metabolic Issue!

Rhabdomyolisis, is not a Crossfit issue, it is a Metabolic issue!

What man does not understand, he fears; and what he fears,

he tends to destroy (unknown).

 

 

rhabdoclown.baeef534The condition of Rhabdomyolysis (Rhabdo) is not isolated to the practice of Crossfit.  Has Crossfit created more awareness around the condition of Rhabdo?  Absolutely, however I think understanding why this might be true is very important. As a former Exercise Rehabilitation Coach, I will admit my own skepticism around Crossfit. Now, as a current “Crossfitter” I would have to agree there are individuals who may not be as prepared to meet the physical demands present in the typical Crossfit WOD (workout of the day).  This does not mean I think they can’t and/or shouldn’t, however it can be a dangerous game for many when not properly supported. The goal of this article is to provide awareness and insight into how you can enjoy and benefit from the workout of your choice no matter what the intensity.

EastWest Healing and Performance educates people across the world in how to support the healing and restoration of metabolic function using nutrition.  The breakdown in metabolic function is the common denominator in all degenerative diseases as well as the cause and influence over the condition of Rhabdomyolysis.

Normal Muscle Breakdown

Muscles go through a constant process of breakdown (catabolism) and rebuilding (anabolism). Under the influence of intense exercise muscle fibers undergo trauma in which there is a disruption to muscle cell organelles. This disruption activates skeletal muscle satellite cells or mononucleated myogenic cells. These cells act as a reserve population of cells able to proliferate in response to injury and give rise to regenerated muscle. The muscle cells myofibrils increase in thickness and number serving as a source of new nuclei to supplement the growing muscle fiber.

Hormone like compounds, known as growth factors, are key regulators of satellite cells. While each play a role in the stimulation and migration of these nuclei others support the formation of new blood capillaries during muscle regeneration.  Insulin -like growth factor-I and –II (IGF’s) have been a primary focus of research in the area of muscle regeneration. IGF’s play a primary role in regulating muscle regeneration promoting changes occurring in the DNA for protein synthesis and promoting muscle cell repair. Insulin itself stimulates regeneration by enhancing protein synthesis and facilitating the entry of glucose into the cells. Satellite cells use glucose as a fuel thus enabling their cell growth activities. Glucose is also used for intramuscular energy needs.

What is Rhabdomyolysis?

rhabdomyolysis-sourceRhabdomyolysis (Rhabdo) is the identified as a rapid breakdown of skeletal muscle tissue resulting in the leakage of myoglobin into the urine (myoglobinuria) and elevated levels of creatine kinase (CK). The severity of symptoms can range from asymptomatic elevations in serum muscle enzymes to life-threatening disease associated with extreme enzyme elevations, electrolyte imbalances and acute kidney injury.

Symptoms are not limited to muscle swelling, pain and weakness and can also include:

·      Nausea

·      Vomiting

·      Confusion

·      Coma

·      Abnormal heart rate

·      Dark “tea colored” urine (presence of myoglobin)

What causes Rhabdomyolysis?

Any form of muscle damage of sufficient severity can cause Rhabdo, such as extreme exercise exertion (crossfit, triathletes, etc), metabolic syndromes (hypoglycemic state, hyperosmolar state, hyponatremia (loss of sodium and water retention) and hypokalemia (loss of potassium), low body temperature, and drugs such as statins (cholesterol lowering drugs) and SSRI’s for depression.

The link between Rhabdo and Hypothyroidism

imagesRhabdo is a result of muscle cell death, which can be triggered by a number of initiating events. As described by Mark Miller, MD, the final common pathway for injury is an increase in intracellular mitochondrial calcium. This may be caused by depletion of ATP, the cellular source of energy, and/or by direct injury and rupture of the plasma membrane. The latter pathway of injury also results in ATP depletion.

The increased intracellular calcium leads to activation of proteases, increased skeletal muscle cell contractility, mitochondrial dysfunction, and the production of reactive oxygen species, resulting in skeletal muscle cell death. ATP depletion leads to myocyte injury and the release of intracellular muscle constituents, including creatine kinase and other muscle enzymes, myoglobin, and various electrolytes.

Under normal conditions our cells use sugar to produce energy: ATP, CO2 and water. Under excitation our cells begin to take up water, estrogen and calcium, which alkalizes the cell, increasing the cells affinity for water, thus increasing glycolytic conversion to lactic acid. This slows metabolic rate, decreases body temperature, leading to a hypometabolic state, hypoglycemic state and calcification of the mitochondria. Entering into any exercise program without the proper nutritional and lifestyle support for your metabolic needs will stimulate the process of Rhabdo.

“When hypothyroidism is severe, it can cause myopathy, in which the pain swollen condition involves leakage of muscle proteins (especially myoglobin) into the blood stream. The combination of hypothyroidism with fatigue and stress can lead to the breakdown and death of cells, rhabdomyolysis.” – Ray Peat PhD

imagesCarbon dioxide (CO2) is the driving force behind energy production and sodium in the body. The constant formation of CO2 drives salt excretion, inhibiting the formation of CO2 prevents the excretion of sodium. Since cellular respiration is driven by thyroid hormone and CO2’s main source of production is thyroid hormone, we can conclude that any thyroid deficiency will impair our ability to regulate water and sodium.

According to Ray Peat PhD, hypothyroid is associated with increased prolactin, which perpetuates sodium retention and leads to hyponatremia, low levels of sodium in the blood. Hypothyroid people also fatigue easily taking up more water than normal during exertion. According to western medicine, a symptom of Rhabdo is swelling of damage muscle tissue and hyponatremia.

Additionally, Broda Barnes, MD identified high cholesterol as a marker for hypothyroidism. Our cells use cholesterol to make all our steroidal hormones to fight inflammation, regulate blood pressure and blood sugar. Cholesterol is one of the largest anti-oxidants in the body and will increase under any form of stress.  This happens so our cells can use cholesterol for the purpose of adaptation to what we are doing. If the body’s cells are not equipped with the proper levels of thyroid hormone for CO2 production and we are under constant stress, cholesterol will continued to be produced but prevented from being converted. It is common-place these days for MD’s to prescribe statins to lower cholesterol. Blood lipid lowering drugs impair mitochondrial respiration and increase the incidence of rhabdomyolysis (Barker et all 2003)”

If you are looking to begin any exercise program here are some great ways to properly support your metabolism for the added demand exercise places on the body.

1. Don’t eat Paleo! I know, I know…this can be a bit threatening to many Paleo fanatics out there. But please know this is not only about Paleo. EastWest Healing and Performance does not promote any one diet but believes the proper diet for anyone person is based solely off the metabolic state. Sorry guys, but this is one reason why so many crossfitters get Rhabdo. Remember our cells need sugar to not only produce energy but to produce thyroid hormone. You can’t regulate blood sugar with 60g of carbs per day. Doing this forces the body into adapted alternative energy production, which over time weighs heavily on metabolic health. Lack of glycogen intake and storage forces the body into survival mode and leads to the release of excess amounts of adrenaline, cortisol and…the breakdown of muscle tissue.

2. Avoid polyunsaturated fats (PUFA) at all cost. This includes all nut, seed and vegetables oils as well as all the fish oils! PUFA’s have a high affinity for water. When cells are in an excited state, they take up water. This hyperosmolar condition will increase the cells uptake of unsaturated fats due to their high affinity for water. This will increase calcium uptake (calcification of mitochondria), alter energy production and increase lactic acid production.

3. Hypoglycemia is a metabolic condition that can lead to Rhabdo. Regulating blood sugar with the right foods, right frequencies and ratios can assist in regulating blood sugar. According to Tom Brewer MD, malnourishment is a stress and will increase cortisol production, estrogen production and decreased its detoxification, decrease albumin levels, thus leading to hyponatremic conditions.

 

imagesStarvation, which for some bodies can equate to allowing to poor meal frequency, causes glycogen stores to decrease while adrenaline secretion is increased to liberate more glucose (as long as glycogen is available) and free fatty acids (FA). When our nutrition contains more PUFA, our fat stores will contain more PUFA. Fat cells prefer to oxidize saturated fats for their own energy but the greater water solubility of PUFA cause them to be preferentially released into the blood during stress. This causes the stimulation of stress hormones, which increases lipolysis (FA oxidation and decreased glucose oxidation) producing more FFA decreasing oxidative energy production, thyroid production and body temperature. FFA slow the heart rate, increase heat loss, decrease heat production and shift your cells energy production away from glucose and towards fat use during stress.


4. Vitamin K and Cascara Segrada (active ingredient is emodin) will assist in regulating blood flow and hyperosmolarity of the blood.

5. Be smart! Scale down and take rest when needed. Do what you feel is right for you. Crossfit is about challenging yourself! Don’t worry what everyone else is doing, be safe and have fun! One of the best things about Crossfit is the community and support you receive no matter what level you are at. KNOW YOUR LIMITS!

Jeanne Rubin

References:

Brewer, Tom MD. What Every Pregnant Women Should Know. Penguin Books. 1985

Ivy, John, PhD & Portman, Robert, PhD. Nutrient Timing. Basic Health Publications.  2004

Peat, Ray PhD. Heat and Hormones. Ray Peat Newsletter. May 2013

Peat, Ray PhD. Cascara, Energy, Cancer and the FDAs Laxitive Abuse. 2012

Peat, Ray PhD. Salt, Energy, Metabolic Rate and Longevity. 2007

Peat, Ray PhD. Water: Swelling, tension, pain, fatiuge, aging. 2009

Young sub Kwon, M.S., Len Kravitz, Ph.D. How do muscles grow? Retrieved from http://www.unm.edu/~lkravitz/Article%20folder/musclesgrowLK.html

Research:

Thyroid hormone replacement therapy improves thyroid and renal functions and reverses rhabdomyolysis.

This observation suggests that rhabdomyolysis in hypothyroidism may be due to a reversible defect in glycogenolysis and that hypothyroidism should be excluded in patients with rhabdomyolysis and/or myoglobinuria.

The present case represents rhabdomyolysis secondary to undiagnosed hypothyroidism in a developed stage which manifests itself with rhabdomyolysis.

Hypothyroidism may cause rhabdomyolysis.

After thyroxine replacement, musculoskeletal symptoms disappeared and creatine kinase concentrations decreased.

Conclusion: Hypothyroidism, although rare, should be considered as a potential cause in patients presenting with elevated muscle enzymes and acute renal failure.

The exact cause of rhabdomyolysis in hypothyroidism is unclear, but both impaired glycogenolysis and impaired mitochondrial oxidative metabolism may be responsible. Hypothyroidism should be consideredas one of the causes of rhabdomyolysis.Rhabdomyolysis manifests with muscular symptoms and severely elevated serum levels of muscle enzymes.Thyroid hormone replacement therapyimproves thyroid and renal functions and reverses rhabdomyolysis.

Other YouTubes:

 Are you healthy! 

Cellular respiration: part 1, part 2 and part 3

Sucrose, fructose and glucose: part 1 and part 2

Visit HERE to download your FREE e-book: The Stress Reduction Manifesto!

Jeanne Rubin, CN, CST

Subscribe for updates from East West Healing
+ Restoration Thyroid: 5 Proven Ways to Heal Your Adrenals and Boost Your Metabolism with Food Audio Series

Share Your Thoughts





  1. […] Rhabdomyolysis Is Not A Crossfit Issue, It Is A Metabolic Issue! [2014] […]

    February 20, 2015 • 5:34 pm •
  2. Hi!

    My name is Adele and I’m a sports writer at Excelle Sports. I’m currently working on a piece about rhabdo outside of CrossFit (I’m a CrossFitter, but know that athletes outside of my sport have gotten it…I want to write something that doesn’t focus on CrossFit so I appreciate this!) I also got rhabdo once, but I have recovered well.

    I was wondering: Are people with sickle cell trait more likely to get rhabdo?

    Adele

    February 24, 2017 • 11:26 am •
  3. EastWest Healing

    Thanks and glad you enjoyed it. To be honest, any human that is hypo-metabolic is more likely to get rhabdo. I think that being hypothyroid or functionally hypothyroid would put one more at risk than anything.

    February 24, 2017 • 5:04 pm •
  4. Marcosswide

    tadalafil daily use: http://tadalafilonline20.com/ tadalafil 40

    March 4, 2021 • 1:38 am •
  5. Jasonked

    india pharmacy drugs drugs without doctor script

    March 8, 2021 • 12:14 am •
  6. Jasonked

    generic drugs without doctor’s prescription: https://genericwdp.com/ buy prescription drugs online without

    March 8, 2021 • 8:54 am •
  7. Jasonnaica

    cost of viagra viagra discount
    price of viagra

    March 11, 2021 • 11:39 am •
  8. Jasonnaica

    buy real viagra online viagra from india
    viagra without a doctor prescription usa

    March 11, 2021 • 10:12 pm •
  9. Jasonnaica

    how much is viagra viagra over the counter
    mexican viagra

    March 12, 2021 • 8:30 am •
  10. Jasonnaica

    cheap viagra online buy viagra online canada
    viagra without a doctor prescription

    March 12, 2021 • 7:25 pm •
  11. Jasonnaica

    viagra online usa buy viagra online usa
    viagra cost per pill

    March 13, 2021 • 5:48 am •
  12. Jasonnaica

    buying viagra online generic viagra walmart
    viagra from india

    March 14, 2021 • 7:00 pm •
  13. MichaelRup

    http://zithazi.com/ – zithromax for sale us
    non prescription ed drugs

    March 16, 2021 • 4:46 am •
  14. MichaelRup

    http://diflucanfavdr.com/ – diflucan prescription cost
    best drug for ed

    March 17, 2021 • 12:22 pm •
  15. Kevinedifs

    buy viagra online usa https://viagrapills100.com/ viagra over the counter

    March 18, 2021 • 5:51 am •
  16. Kevinedifs

    viagra cost https://viagrapills100.com/ mexican viagra

    March 18, 2021 • 5:04 pm •
  17. http://ponlinecialisk.com/ – buying cialis online

    March 19, 2021 • 6:50 am •
  18. Richardkeeve

    viagra price best over the counter viagra
    best place to buy viagra online

    March 21, 2021 • 12:04 am •
  19. Terrygep

    cheap ed pills from india cheap ed pills in mexico
    buy ed pills

    March 22, 2021 • 4:07 am •
  20. Terrygep

    cheap ed pills in mexico order ed pills
    canadian drugstore online

    March 22, 2021 • 4:50 pm •
  21. Terrygep

    buy ed drugs cheap ed pills from india
    cheap ed pills from canada

    March 22, 2021 • 9:20 pm •
  22. Terrygep

    cheap ed pills from india ed pills online
    cheap ed pills from canada

    March 23, 2021 • 5:27 am •
  23. Terrygep

    buy ed drugs ed pills without a doctor prescription
    cheap ed pills usa

    March 23, 2021 • 1:35 pm •
  24. Peterhem

    https://hydroxychloroquinest.com/# hydroxychloroquine 300

    March 25, 2021 • 11:27 am •
  25. Peterhem

    http://hydroxychloroquinest.com/# buy plaquenil in india

    March 25, 2021 • 11:37 pm •
  26. Peterhem
    March 26, 2021 • 1:04 pm •
  27. Peterhem

    https://prednisonest.com/# prednisone medication

    March 27, 2021 • 2:02 am •
  28. Peterhem

    http://prednisonest.com/# buy prednisone online india

    March 27, 2021 • 2:41 pm •
  29. Peterhem

    https://zithromaxst.com/# zithromax cost australia

    March 28, 2021 • 4:14 am •
  30. RafaelJam

    http://zithromaxproff.com/# buy zithromax online fast shipping
    purchase zithromax online

    March 29, 2021 • 9:06 pm •
  31. BillyTot

    keftab generic: order bactrim online
    trimox for sale

    April 1, 2021 • 10:19 pm •
  32. MichaelSmuch

    all generic meds from india: united pharmacy india india pharmacies shipping to usa

    April 4, 2021 • 1:54 pm •
  33. MichaelSmuch

    buy prescriptions from india pharmacy: online medications from india trusted india online pharmacies

    April 5, 2021 • 11:53 am •
  34. MichaelSmuch

    reputable online pharmacies in india: generic pills india prescriptions from india

    April 6, 2021 • 10:23 am •
  35. Robertingex

    ed pills for sale: https://edpillsonline24.com/# buy erectile dysfunction pills online

    April 7, 2021 • 3:31 am •
  36. Robertingex

    ed pills: https://edpillsonline24.com/# cialis pills

    April 8, 2021 • 2:09 am •
  37. whօah thiѕ webⅼog is excеllent i loᴠe reɑding your posts.
    Stay up the great work! You understand, a lot of individuals
    are hunting around for this info, yyou can aid them greatly.

    My ԝebƅ page free local singles

    April 8, 2021 • 3:28 pm •
  38. Robertingex

    over the counter ed medication: https://edpillsonline24.com/# male erectile pills

    April 8, 2021 • 11:46 pm •
  39. free chat and dating online
    dating websites new

    April 9, 2021 • 1:11 am •
  40. Michaelovant

    viagra cheap: buy viagra online without prescription no prescription viagra

    April 10, 2021 • 1:27 am •
  41. wonderful publish, very informative. I’m wondering why the opposite experts of this sector don’t notice this.

    You must continue your writing. I am confident, you’ve a huge readers’ base already!
    asmr 0mniartist

    April 10, 2021 • 5:36 am •
  42. Michaelovant

    viagra: viagra online without prescription viagra online no prescription

    April 10, 2021 • 10:45 pm •
  43. Türk takipçi Satın Al işlemi ne kadar önemlidir?

    Instagram takipçi satın almak önemlidir tabiki de bu durumda aktif olmaları ayrıca TÜRK takipçi
    olmasını isteriz.
    Yılların verdiği tecrübeye dayanarak size
    en iyi önerebileceğimiz site türk takipçi satın al konusunda uzman kadrosu ile takip 2018′ dir
    Türk takipçi paketlerini incelemek için siteyi ziyaret
    etmekten çekinmeyiniz.

    April 11, 2021 • 1:58 am •
  44. meet singles online
    the dating list online free

    April 11, 2021 • 9:00 am •
  45. You can definitely see your enthusiasm in the work you
    write. The sector hopes for more passionate writers such as
    you who aren’t afraid to say how they believe.
    All the time follow your heart. 0mniartist asmr

    April 11, 2021 • 8:59 pm •
  46. free single chat
    sexy dating sites

    April 11, 2021 • 9:54 pm •
  47. Claudcrype

    purchase clomiphene: clomid for sale – buy cheap clomid

    April 13, 2021 • 10:53 am •
  48. April 14, 2021 • 6:54 am •
  49. Takipçi satın alabilmek itimat edilir sitelerden hesabınıza zarar vermez.
    Sizi en üst düzey yönetici gibi dahi gösterebilir 🙂
    Takipçi sitelerinin hepsine güvenmeyiniz. instagram takipçi satın al vasıtası ile güvenilir bir siteden alış veriş yapmak size sonsuz bir güvenilirlik sağlayacaktır.

    Bu siteyi size sunmamızın sebebi tamamen güvenilir olması ve
    2018 yılından bu yana güvenilir oldugundan emin olmamızdır.

    .

    April 14, 2021 • 10:27 am •
  50. Claudcrype

    doxycycline tetracycline: doxycycline antibiotic – doxycycline without prescription

    April 14, 2021 • 10:49 am •
  51. Hi there! I know this is somewhat off topic but I
    was wondering if you knew where I could locate a captcha plugin for my
    comment form? I’m using the same blog platform as yours and I’m having trouble finding one?
    Thanks a lot! 0mniartist asmr

    April 14, 2021 • 12:37 pm •
  52. Claudcrype

    clomid coupon: clomid – clomid capsules 50mg

    April 15, 2021 • 10:37 am •
  53. April 15, 2021 • 4:30 pm •
  54. I think this is among the most significant info for me.
    And i am satisfied reading your article. But
    wanna remark on some general things, The website style is great,
    the articles is in point of fact excellent : D. Just right
    activity, cheers asmr 0mniartist

    April 15, 2021 • 7:20 pm •
  55. April 16, 2021 • 12:17 am •
  56. April 16, 2021 • 10:39 am •
  57. Claudcrype

    online diflucan: diflucan generic – diflucan

    April 16, 2021 • 12:32 pm •
  58. Pierreemimi

    http://paxilst.com/# paxil breast cancer

    April 17, 2021 • 3:04 pm •
  59. JamesInata

    propecia pills: generic propecia – finasteride online bonus
    finasteride

    April 21, 2021 • 6:52 pm •
  60. JamesInata

    cheap tadalafil: buy tadalafil – tadalafil 20mg for sale
    finasteride buy online

    April 22, 2021 • 12:25 pm •
  61. JamesInata

    tadalafil pills: tadalafil generic cost – tadalafil generic cost
    propecia buy

    April 23, 2021 • 5:58 am •
  62. April 23, 2021 • 7:52 pm •
  63. JamesInata

    buy ventolin canada: buy asthma inhalers without an rx – buy ventolin canada
    generic propecia cheap

    April 23, 2021 • 11:41 pm •
  64. April 24, 2021 • 12:04 am •
  65. JamesInata

    propecia 1mg: cheap propecia – generic propecia no prescription
    propecia 1mg tablets

    April 24, 2021 • 4:54 pm •
  66. JamesInata

    ventolin inhalers: buy ventolin – ventolin buy
    buy propecia cheap

    April 25, 2021 • 9:59 am •
  67. GeorgeDials

    natural ed medications: ed pills – ed pills otc
    ed medications

    April 26, 2021 • 10:34 am •
  68. April 26, 2021 • 1:17 pm •
  69. GeorgeDials

    erectile dysfunction pills: non prescription ed drugs – the best ed pill
    best ed pills at gnc

    April 27, 2021 • 4:12 am •
  70. I love what you guys are up too. This kind of clever work and reporting!

    Keep up the amazing works guys I’ve incorporated you guys to
    blogroll.

    April 27, 2021 • 5:01 pm •
  71. Can you tell us more about this? I’d like to find out more details.

    April 28, 2021 • 5:30 pm •
  72. This is really interesting, You’re a very skilled blogger.
    I’ve joined your rss feed and look forward to seeking
    more of your magnificent post. Also, I have shared your web site in my social networks!

    April 28, 2021 • 7:48 pm •
  73. These are truly fantastic ideas in concerning blogging.

    You have touched some good things here. Any way keep up wrinting.

    April 29, 2021 • 2:16 am •
  74. RaymondElemi

    canadianpharmacyworld com ed drugs – my canadian pharmacy review
    online pharmacy china

    April 29, 2021 • 11:33 am •
  75. RaymondElemi

    online pharmacy weight loss erectile dysfunction pills – canadian drug stores
    online otc pharmacy

    April 30, 2021 • 5:05 am •
  76. May 1, 2021 • 6:38 pm •
  77. tinder login, what is tinder
    tinder sign up

    May 2, 2021 • 1:36 am •
  78. WilliamCreli

    ordering cialis online australia: buy cialis online at lowest price – generic cialis daily pricing

    May 3, 2021 • 12:47 pm •
  79. Incredible points. Outstanding arguments. Keep up the good work.

    May 3, 2021 • 5:47 pm •
  80. For most up-to-date news you have to pay a quick visit world wide web and
    on the web I found this web site as a most excellent site for hottest updates.

    May 4, 2021 • 3:01 am •
  81. May 4, 2021 • 5:57 am •
  82. WilliamCreli

    cialis 20mg low price: erectile dysfunction pills – buy cialis online europe

    May 4, 2021 • 6:06 am •
  83. Hi, I think your website might be having browser compatibility issues.
    When I look at your blog site in Ie, it looks fine
    but when opening in Internet Explorer, it has some overlapping.
    I just wanted to give you a quick heads up! Other then that, awesome blog!

    May 4, 2021 • 2:07 pm •
  84. Whats up very cool blog!! Man .. Beautiful ..

    Wonderful .. I will bookmark your blog and take the feeds also?
    I am happy to find numerous useful info here in the put up,
    we want develop extra techniques on this regard,
    thanks for sharing. . . . . .

    May 5, 2021 • 10:03 pm •
  85. This is a topic which is near to my heart… Take care! Exactly where are your contact details
    though?

    May 7, 2021 • 12:56 am •
  86. Pretty element of content. I just stumbled upon your web site and in accession capital to assert that I acquire in fact loved account
    your blog posts. Anyway I will be subscribing in your
    augment or even I fulfillment you get right of entry to consistently quickly.

    May 7, 2021 • 12:59 am •
  87. What’s Going down i’m new to this, I stumbled upon this I’ve discovered It absolutely helpful
    and it has aided me out loads. I’m hoping to give a contribution & help other customers like its aided me.

    Great job.

    May 7, 2021 • 1:15 am •
  88. I just like the helpful info you provide in your
    articles. I will bookmark your weblog and take a look at once more
    here frequently. I’m somewhat sure I’ll learn a lot of new stuff proper here!
    Best of luck for the next!

    May 7, 2021 • 4:49 am •
  89. May 7, 2021 • 5:47 pm •
  90. First off I want to say excellent blog! I had a quick question that I’d like to ask if
    you don’t mind. I was interested to find out how you center yourself and
    clear your head prior to writing. I have had a tough time
    clearing my thoughts in getting my thoughts out.
    I do enjoy writing but it just seems like the first 10 to 15 minutes are usually lost just trying to figure
    out how to begin. Any ideas or hints? Thank you!

    May 8, 2021 • 1:21 am •
  91. May 8, 2021 • 9:46 am •
  92. I am sure this article has touched all the internet people,
    its really really fastidious article on building up new weblog.

    May 8, 2021 • 7:09 pm •
  93. May 9, 2021 • 11:51 am •
  94. May 9, 2021 • 9:05 pm •
  95. WilliamCreli

    viagra for women: viagra coupons – buy viagra generic
    buy generic viagra online

    May 10, 2021 • 12:21 am •
  96. WilliamCreli

    buy viagra professional: viagra professional – viagra generic
    natural viagra

    May 10, 2021 • 5:40 pm •
  97. May 11, 2021 • 8:56 am •
  98. May 11, 2021 • 5:26 pm •
  99. overceBok
    May 13, 2021 • 5:13 am •
  100. CharlesVog

    buy cialis very cheap prices fast delivery: buy cialis online best price safe buy cialis
    buy cialis tadalafil tablets

    May 13, 2021 • 12:46 pm •
  101. May 13, 2021 • 7:06 pm •
  102. CharlesVog

    ordering cialis online australia: buy cialis in miami buy cialis now
    buy cialis online europe

    May 14, 2021 • 7:53 am •
  103. scoliosis
    hello!,I like your writing very much! proportion we keep up a correspondence more
    approximately your post on AOL? I need an expert in this house to resolve my problem.

    May be that is you! Having a look forward to peer you. scoliosis

    May 15, 2021 • 5:44 am •
  104. scoliosis
    I want to to thank you for this fantastic
    read!! I certainly enjoyed every bit of it. I’ve got you saved as
    a favorite to look at new stuff you post… scoliosis

    May 16, 2021 • 12:48 pm •
  105. Elbertnek

    buy zestril online: buy lisinopril – lisinopril 20mg daily

    May 17, 2021 • 10:20 pm •
  106. Elbertnek

    lisinopril 40 mg tablets: lisinopril generic – lisinopril 50 mg tablet

    May 18, 2021 • 5:41 pm •
  107. Elbertnek

    ed pills online: cheap erectile dysfunction pill – best ed medications

    May 19, 2021 • 12:15 pm •
  108. free dating sites
    Helpful information. Fortunate me I discovered your web
    site by accident, and I am stunned why this coincidence didn’t
    took place in advance! I bookmarked it. free dating sites

    May 20, 2021 • 5:28 am •
  109. GeorgeHaulp

    buy cialis online viagra: cost of cialis without insurance canadian pharmacy cialis 20mg
    generic cialis 20 mg tadalafil

    May 20, 2021 • 2:44 pm •
  110. Hi there, I desire to subscribe for this weblog to get newest updates, thus where can i do it please help out.

    May 21, 2021 • 6:34 am •
  111. GeorgeHaulp

    how to get ciails without a doctor: buy cialis cheaper online find cheap cialis online
    cialis online without prescription

    May 21, 2021 • 6:53 am •
  112. Felixwhoky

    viagra online viagra – generic viagra

    May 24, 2021 • 1:21 pm •
  113. Felixwhoky

    buy cialis philippines – cialis without presciption in usa can i buy cialis in toronto

    May 25, 2021 • 7:18 am •
  114. Felixwhoky

    buy cheap cialis uk – buy cialis cheaper online cialis original for sale

    May 26, 2021 • 1:01 am •
  115. Have you ever thought about adding a little
    bit more than just your articles? I mean, what you say is important and all.
    Nevertheless imagine if you added some great photos or video clips
    to give your posts more, “pop”! Your content is excellent but with images and videos, this site could certainly
    be one of the very best in its field. Awesome blog!

    May 26, 2021 • 2:44 am •
  116. Hmm is anyone else encountering problems with the pictures on this blog loading?

    I’m trying to figure out if its a problem on my end or if it’s the
    blog. Any feedback would be greatly appreciated.

    May 26, 2021 • 6:45 am •
  117. Felixwhoky

    cialis 20mg for sale – buy cialis doctor buy cialis now

    May 26, 2021 • 6:25 pm •
  118. HowardAdold

    can i buy cialis in toronto cialis for daily use buy cialis ebay

    May 27, 2021 • 11:24 pm •
  119. HowardAdold

    cialis 20mg for sale generic cialis canadian much does cialis cost without insurance

    May 28, 2021 • 4:48 pm •
  120. For newest information you have to pay a visit web and
    on web I found this web page as a most excellent web page for latest updates.

    May 29, 2021 • 8:48 am •
  121. HowardAdold

    how to buy cialis online uk cialis for daily use buy cialis without perscription

    May 29, 2021 • 11:37 am •
  122. zithromax capsules https://zithromaxes.com/ zitromax 500 mg

    May 29, 2021 • 3:39 pm •
  123. HowardAdold

    buy cialis ebay buy cialis in miami buy cialis with paypal

    May 30, 2021 • 6:26 am •
  124. Thanks for sharing your thoughts on for. Regards

    May 30, 2021 • 11:42 am •
  125. is erectile dysfunction a va disability https://plaquenilx.com/ erectile rehabilitation

    May 30, 2021 • 5:32 pm •
  126. With havin so much written content do you ever run into any issues of plagorism
    or copyright infringement? My website has a lot of exclusive content I’ve either
    authored myself or outsourced but it seems a lot of it is popping it
    up all over the internet without my authorization. Do you
    know any techniques to help protect against
    content from being ripped off? I’d truly appreciate it.

    May 30, 2021 • 8:10 pm •
  127. HowardAdold

    buy cialis online cheap buy cialis online best price ordering cialis online australia

    May 31, 2021 • 1:20 am •
  128. Hi there, just became alert to your blog through Google,
    and found that it’s really informative. I’m going to watch out for brussels.
    I’ll be grateful if you continue this in future.
    Many people will be benefited from your writing.
    Cheers!

    May 31, 2021 • 12:04 pm •
  129. Thank you for any other informative website. Where else may I am getting that kind of information written in such an ideal means?
    I’ve a challenge that I’m just now operating on,
    and I have been on the glance out for such info.

    May 31, 2021 • 4:15 pm •
  130. HowardAdold

    buy cialis tadalafil0 with pay pal safe buy cialis generic cialis canadian

    May 31, 2021 • 8:12 pm •
  131. I am sure this piece of writing has touched all the internet viewers, its really really nice article on building up new webpage.

    June 1, 2021 • 4:38 am •
  132. June 1, 2021 • 9:45 am •
  133. AltonLiaig

    best ed treatment buy prescription drugs without doctor – cure for ed

    June 1, 2021 • 3:23 pm •
  134. I’m really enjoying the theme/design of your blog.

    Do you ever run into any web browser compatibility problems?

    A number of my blog audience have complained about my site
    not operating correctly in Explorer but looks
    great in Chrome. Do you have any suggestions to help fix this issue?

    June 1, 2021 • 4:12 pm •
  135. AltonLiaig

    can you order valtrex online generic valtrex – valtrex discount

    June 2, 2021 • 8:32 am •
  136. AltonLiaig

    price of wellbutrin xl wellbutrin – wellbutrin prescription coupon

    June 3, 2021 • 2:46 am •
  137. AltonLiaig

    amoxicillin over counter generic amoxil – amoxicillin capsules 250mg

    June 3, 2021 • 9:09 pm •
  138. AltonLiaig

    wellbutrin prescription coupon cheap wellbutrin – wellbutrin without a prescription

    June 4, 2021 • 3:32 pm •
  139. AltonLiaig

    cheap valtrex generic cheap valtrex canada – valtrex 500 mg buy online

    June 5, 2021 • 9:42 am •
  140. ShaneBeake

    15 mg zyrtec order periactin pills online – allegra 24 coupon price

    June 7, 2021 • 3:25 pm •
  141. tadalafil research best research tadalafil tadalafil cost walmart

    June 8, 2021 • 7:41 am •
  142. ShaneBeake

    men’s ed pills erection pills online – gnc ed pills

    June 8, 2021 • 8:57 am •
  143. overceBok
    June 8, 2021 • 11:58 pm •
  144. ShaneBeake

    ed pill cheap erectile dysfunction pill – ed pills for sale

    June 9, 2021 • 3:01 am •
  145. ShaneBeake

    zyrtec 10 mg tablet order periactin pills online – zyrtec 10mg

    June 9, 2021 • 9:00 pm •
  146. tadalafil herbal substitute buy cialis pills tadalafil cost walmart

    June 10, 2021 • 12:02 am •
  147. ShaneBeake

    discount pharmacy mexico legitimate canadian pharmacy online – cross border pharmacy canada

    June 10, 2021 • 3:19 pm •
  148. DelmerZopit

    erectile dysfunction natural remedies cheap erectile dysfunction pills online – ed medication

    June 11, 2021 • 4:14 pm •
  149. overceBok
    June 12, 2021 • 4:51 am •
  150. DelmerZopit

    male dysfunction treatment buy ed drugs online – cheap erectile dysfunction pill

    June 12, 2021 • 10:03 am •
  151. overceBok
    June 13, 2021 • 10:42 am •
  152. overceBok
    June 13, 2021 • 3:49 pm •
  153. Danielmut

    buy viagra online usa – how much is viagra best place to buy generic viagra online

    June 14, 2021 • 11:12 am •
  154. overceBok
    June 14, 2021 • 2:17 pm •
  155. overceBok
    June 14, 2021 • 7:10 pm •
  156. Danielmut

    viagra from india – viagra discount when will viagra be generic

    June 15, 2021 • 4:46 am •