Total cholesterol 7.2,LDL 5.1 is definitely hypercholesterolemia, the consequence of which is that it tends to lead to atherosclerosis, causing thrombotic events or hemorrhagic events in the heart, brain, kidneys, and large arteries.

Cholesterol is an important substance indispensable to the human body, but high cholesterol with high blood pressure, diabetes, as prone to vascular events, especially low-density lipoprotein cholesterol LDL is the formation of atherosclerotic plaque core lipids, LDL is too high, the core lipids grow too fast to form an unstable soft plaque, once the plaque rupture, the platelets flowing through the rupture opening is activated, exposing the fibrin white Receptors, through the fibrin poop platelet aggregation into thrombus, so the heart attack, cerebral infarction, arterial embolism event occurred.

So it should be brought down. LDL accounts for about 60% of total cholesterol, and we must lower it to different target values according to how many risk factors for atherosclerosis are present in order to stabilize, shrink, and even potentially disappear small plaques. These five risk factors are: hypertension, hyperlipidemia, diabetes mellitus, smoking, and family history. the LDL targets are no risk factors should be below 3.6, 1-2 risk factors should be below 3.3, 3 risk factors or more should be below 3.0, coronary artery disease or diabetes mellitus should be below 2.6, both coronary artery disease and diabetes mellitus should be below 2.2, and combination of heart attack should be below 1.8-2.0, and combination of heart attack should be below 1.8-2.2, and combination of heart attack should be below 1.8-2.0. heart attack should be 1.8-2.0. It is not a matter of lowering LDL as low as possible, but of meeting the standard.

Also I want to emphasize that cholesterol is not the same as triglycerides, which are not as related to �food�, while glycerol fats, except for a few greater than 5-10, tend to be genetically related, and are generally related to overeating, too much oil, too much sweetness, and alcoholism. Cholesterol is more correlated with genetic factors than high triglycerides, so there are really a lot of vegetarians with hypercholesterolemia. The effect of food on cholesterol is less than 30% because there are individual differences in cholesterol synthesizing ability and excess cholesterol will be secreted to the intestines through bile and the intestines have receptors for cholesterol-binding denitriles, so the intestines are responsible for about 50% of the cholesterol reabsorption. Therefore, through diet can only control cholesterol-rich foods such as Dan Huang, offal, etc. to prevent cholesterol from rising, there is no evidence of any kind of food can lower cholesterol, even if the exercise is also ineffective. At present, the most effective cholesterol-lowering drugs recognized worldwide are statins.

Some people are concerned about the side effects of taking statins, and although the incidence is extremely low, those taking statins should be aware of them. What exactly are the side effects? Statin drugs may cause myopathy, especially early after taking the drug found walking or diaphanous practice muscle weakness or myalgia should be timely to the hospital to find a doctor, he went to the state you check muscle enzymes, the use of Lipitor, Shugenol, lipids, but the patient and at the same time taking anti-mycobacterial drugs such as etofurazole, fliconazole, or taking to kill H. pylori Clarithromycin, and blood pressure and antihypertensive drugs in the calcium conjugate antagonists, and even grapefruit juice and grape juice, etc., they are all the liver enzymes CYP450 in the CYP450, the CYP450 is the most common in the liver. They are all go liver enzyme CYP450 in the 3A4 this most congested channel, statins belong to the slow metabolism of drugs, easy to be blocked leading to high blood concentration and pay reaction. Another thing to note is that because at the same time rod out triglyceride is too high and take beate a class of drugs should pay more attention. In addition to myopathy should also be checked after a month of liver function, safety is the premise of treatment, patients and patients must pay attention! Comparatively speaking, the hydroxylated water-soluble pravastatin is not metabolized by hepatic enzymes, and 90% of resuvastatin is excreted through the kidneys, and only 10% is passed through the uncrowded channel of 2C9 in the hepatic enzyme CYP450, which is a little safer at the same time.

A standard dose such as Lipitor 10mg, Schwarzkopf 20mg, Pravastatin 40mg, Lovastatin 40mg, Rasuvastatin 5mg, Pitavastatin 1mg can make the LDL drop 33% to 35% or so, to meet the standard to be used with a large amount of self-calculated, but statin doubling to take, the LDL drop is only 6%, and the dose and the payment of the role of proportionality, and to meet the standard, and dare not double the double, then add an intestinal cholesterol reabsorption inhibitor a Ezetimibe 10mg can make LDL drop 20%, and not through the hepatic enzyme metabolism. But if you want to meet the standard, and do not dare to double and double, then add an intestinal cholesterol reabsorption inhibitor, a ezetimibe, a 10mg tablet can reduce LDL by 20%, and not metabolized by hepatic enzymes. Combined with a standard dose of statin can reduce LDL by 55%.

2017.11.7

Dr. Duan Q&A Online 🌵 Treatment for High Blood Lipids 🌵

Total cholesterol of 7.2 mmol/L and LDL of 5.1 mmol/L, both of which are above the normal range, are considered hyperlipidemic. Because elevated levels of these two indicators are most closely related to atherosclerosis, early and aggressive intervention and treatment is warranted.

Normal values for blood lipids

Lipid tests are total cholesterol TC, low-density lipoprotein (LDL) cholesterol LDL-C, high-density lipoprotein (HDL) cholesterol HDL-C, and triglycerides TG. Some lipid checklists also have Apo A1, Apo B, and Lipoprotein a. Non-HDL cholesterol (non-HDL-C) = has total cholesterol - HDL cholesterol. The specific range of values is shown below:

From the chart above, we can see that total cholesterol of 7.2 mmol/L and LDL cholesterol of 5.1 mmol/L are in the elevated range known as hyperlipidemia, or dyslipidemia.

Treatment options for dyslipidemia:

This is because elevated total cholesterol and LDL cholesterol are the most important risk factors for atherosclerotic cardiovascular disease, especially LDL. If total cholesterol is ≥7.2 and LDL cholesterol is ≥4.9, we refer to this group as high-risk. Lifestyle and lipid-modifying therapy must be initiated simultaneously for high-risk groups.

①Lifestyle treatment: including reasonable diet (eat less or no fat meat, limit the amount of food, not too full, less oil in stir-fry, quit smoking, limit alcohol, eat more fresh green vegetables, moderate amount of fruits, moderate amount of proteins); appropriate exercise; control body weight and waist circumference, and so on.

② Lipid-regulating drug therapy: statins are preferred, which can significantly reduce total cholesterol and LDL cholesterol.

With treatment, lipids need to be gradually brought within the desired range, and LDL cholesterol, which is generally used as an observation of the efficacy of treatment, should be <2.6 mmol/L.

Dr. Duan specifically warned:

(1) Lifestyle modification is the basic treatment for lowering blood lipids, which must be adhered to from the beginning to the end, and cannot rely on drugs only.

(2) For people at high risk of developing atherosclerotic cardiovascular disease, we recommend long-term use of statins.

(3) To prevent and detect statin side effects in a timely manner, creatine kinase, blood glucose, and liver function should be checked before and after administration.

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Dyslipidemia characterized by elevated low-density lipoprotein cholesterol (LDL-C) or total cholesterol (TC) is an important risk factor for atherosclerotic cardiovascular disease (ASCVD), and lowering the levels of these two markers significantly reduces the risk of morbidity and mortality from ASCVD. Normal LDL cholesterol values are in the range of 1.3-3.360 mmol/L and normal total cholesterol values are in the range of 3.0-6.18 mmol/L. It can be seen that both of these values are higher than normal in this patient. Therefore, if not properly controlled, then the patient has a higher risk of coronary heart disease, stroke and other cardiovascular diseases. And how should it be controlled?

1. Diet: Take fruits and vegetables as the mainstay, supplemented by high-quality fish and grains and cereals, and control the intake of carbohydrates, red meat (especially red meat produced by some large-scale farms) and alcohol. In addition, avoid foods containing high cholesterol (e.g. pig liver, chicken liver, duck egg yolk, egg yolk, whole milk, cream, cheese, fatty meat, pig skin, hoof and bladder, etc.).

2, sports: according to their own specific situation to choose a reasonable exercise program, overweight people mainly for abdominal fat loss selection program, to moderate intensity exercise. Exercise 3-5 days a week, before strenuous exercise must be warmed up, to prevent sports injuries. Strive to control the body mass index between 18.5-22.5.

3、Drugs: If the blood lipid is still high after diet and exercise control, it is recommended to take statin drugs to lower the lipid, statin drugs are suitable for patients with hypercholesterolemia, mixed hyperlipidemia and ASCVD. At present, there are lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, resuvastatin and pitavastatin in domestic clinic. Different types and doses of statin cholesterol-lowering amplitude has a big difference, but any kind of statin dose doubling, LDL-C further reduction of only about 6%, the so-called "statin efficacy of 6% effect". Statins should be taken once a day at any time of day, but the reduction in LDL-C may be slightly greater when taken at night. Statin use should be continued for a long period of time after the desired effect is achieved, and discontinuation should be avoided if tolerated. Some studies suggest that discontinuation of statin use may increase cardiovascular events. During the period of taking the drug, attention should be paid to monitoring liver function, blood sugar and other indicators, to prevent possible transaminase elevation, muscle pain, blood sugar abnormalities and other aspects of adverse reactions, if the application of statin after the occurrence of adverse reactions, can be used to switch to another kind of statin, reduce the amount of reduction, alternate days, or switch to a non-statin lipid-regulating drugs method of treatment.

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Dyslipidemia is a problem that many friends have, but the degree of hyperlipidemia is different for each person. The ideal level of total cholesterol is below 5.2mmol/L, 5.2~6.2 belongs to the borderline elevated situation, while higher than 6.2, it belongs to the total cholesterol bias; the ideal value of LDL cholesterol is 3.4mmol/L, higher than 3.4 and not higher than 4.1, belongs to the mild borderline elevated situation, while higher than 4.1, it can be recognized as the LDL is also high. The ideal value of LDL cholesterol is 3.4mmol/L, above 3.4 but not higher than 4.1, it is a mild borderline elevation, and above 4.1, it can be confirmed that the LDL is also high. Therefore, for a total cholesterol of 7.2 and LDL of 5.1, the problem of hypercholesterolemia can already be confirmed. It is not known what the triglyceride level is, and if the triglyceride is higher than 1.8 mmol/L, then it belongs to mixed hyperlipidemia.

Clinically, there is a clear risk assessment classification for hyperlipidemia. 7.2 for total cholesterol and 5.1 for LDL, regardless of whether one of the indexes reaches this value or both indexes reach this value, it can be clearly judged as atherosclerotic cardiovascular disease (ASCVD) high-risk group. what does it mean to be a high-risk group for ASCVD? It means that if the blood lipids have been at this level, even if there is no other cardiovascular disease risk (such as hypertension, smoking, obesity, low HDL, diabetes, chronic kidney disease, family history of cardiovascular disease, etc.), the incidence of cardiovascular disease in the next ten years will be more than 10%, which is a higher risk situation.

Therefore, for this situation, it is generally necessary to take medication to control blood lipids, statins are generally the first choice of drugs, statins are the first choice of drugs to regulate blood lipids, prevention of cardiovascular disease, usually commonly used are the old generation of simvastatin, lovastatin, pravastatin, fluvastatin and so on, there are also newer pitavastatin, atorvastatin and reserpine vasotocine and other medications, a variety of different nature of the drug, lipid lowering effect, side effects also vary. The nature of various drugs is different, the effect of lipid-lowering and the chance of side effects are also different. Normally, taking statins can effectively lower LDL and total cholesterol, but during the period of taking the drugs, we should also pay attention to the possible side effects of elevated aminotransferases, muscle pain, abnormal elevation of blood glucose and so on, and regular monitoring of the indicators of blood lipids, aminotransferases and blood glucose is very important.

For the high blood lipid situation above, the control target of blood lipid should also be noted that it is not within the qualified range, even if it is up to the standard, for patients with high risk of ASCVD, there are two main control targets of blood lipid, one is the LDL cholesterol, which is controlled at 2.6 or below in order to be considered to be up to the standard, while the non-HDL cholesterol (i.e., the difference between the total cholesterol and the HDL cholesterol) should be controlled at 3.4 or less, these two values are reached at the same time to be regarded as the case of meeting the standard, while in the case of patients with pre-existing cardiovascular diseases, LDL cholesterol should be controlled at 1.8 or less, and non-HDL cholesterol should be controlled at 2.6 or less, to be regarded as the case of meeting the standard.

If you have intolerance side effects of taking statins, it is good to reduce the dosage, and if you can't meet the lipid targets because of the dose reduction, you can consider adding drugs such as ezetimibe or probucol.

In addition to taking medication to control blood lipids, life interventions are equally important, low-fat and low-sugar diet, adherence to sports and exercise, smoking and alcohol, maintain a good state of mind, regular work and rest, adequate sleep, these good habits, all contribute to the control and regulation of blood lipids, only to maintain good habits, coupled with appropriate and reasonable use of medication, in order to lower blood lipids and reduce the risk of cardiovascular disease.

The easiest way to raise high-density cholesterol (HDL) and lower low-density cholesterol (LDL) and total cholesterol (TC) to reasonable ranges is to do so in three directions: diet, exercise and sleep.

Diet: 1. To gradually and gradually reduce the daily calorie intake, the ultimate goal should be formulated according to individual circumstances, set at 600 ~ 1200 calories is more reasonable. 2. Dietary structure should be based on high-quality fruits and vegetables, supplemented by high-quality fish (wild freshwater fish, imported seafood) and grains and cereals, to control the intake of refined carbohydrates, red meat (especially some of the red meat produced by large-scale farms) and alcohol. 3. ) and alcohol intake. Specific reference can be made to the Desshu Diet (DASH) or the Mediterranean Diet. 3. You can adopt the "5 + 2 light fasting method" - 5 days a week normal diet, the remaining 2 days (preferably on weekends) combined with sleep to control the daily calorie intake of 400 ~ 700 calories. 700 calories.

Second, exercise: 1. Body mass index target set at 18.5 ~ 22.5 is more reasonable. 2. To choose a reasonable exercise program based on their own situation (preferences and physical condition), overweight people are mainly for abdominal fat loss to choose the project to medium-intensity exercise, low-intensity and high-intensity exercise supplemented. 3. 3 ~ 5 days of exercise per week, medium-intensity exercise time to control the time in 2 ~ 4 hours, high-intensity exercise time to 15 ~ 60 minutes is good. 4. High-intensity exercise must be warmed up before, to prevent sports injuries. 5. Time to 15 ~ 60 minutes is good. 4. High-intensity exercise must be warmed up before, to prevent sports injuries. 5. As far as possible to choose a good environment, air quality, excellent place or time period for exercise. 6.

Third, sleep: 1. Ensure that the daily sleep time of 7 to 8 hours; more sleep on weekends, sleep time extended to 11 to 12 hours. 2. Adhere to the nap, nap time to 30 to 90 minutes appropriate; nap days cancel nap.

Total cholesterol and LDL cholesterol are important items for lipid screening. Elevated levels of these two indicators can cause cardiovascular and cerebrovascular damage, increasing the risk of coronary heart disease, stroke, and other diseases, and therefore require early detection and intervention. What should we do if our total cholesterol reaches 7.2mmol/L and LDL cholesterol reaches 5.1mmol/L? Next, Medical Senlution will give you an explanation.

In terms of diagnostic criteria, total cholesterol of 7.2 mmol/L and LDL cholesterol of 5.1 mmol/L have reached the diagnostic criteria for hyperlipidemia.

All adults should be regularly tested for total cholesterol and LDL cholesterol, especially LDL cholesterol, which can enter the coronary arteries, head and neck arteries under the endothelium in large quantities after significant elevation, causing atherosclerosis or formation of atherosclerosis or arterial plaques, and when arterial stenosis or arterial plaques rupture, it can induce acute myocardial infarction, cerebral infarction and other acute cardio-cerebral vascular events, and in the early stages of arterial lesions, there are usually no significant symptoms. Therefore, adults should be tested for total cholesterol and LDL cholesterol regularly, every five years for people under 40 years old, and once a year for people over 40 years old. The normal value of total cholesterol should be less than 5.2mmol/L, and that of LDL cholesterol should be less than 3.4mmol/L, and exceeding the above values can be diagnosed as hyperlipidaemia. Therefore, total cholesterol of 7.2 mmol/L and LDL cholesterol of 5.1 mmol/L have reached the diagnostic criteria of hyperlipidemia.

In terms of the risk of cardiovascular events, patients with total cholesterol of 7.2 mmol/L and LDL cholesterol of 5.1 mmol/L were at high risk.

The greater the elevation of total cholesterol and LDL cholesterol, the heavier the damage to the cardiovascular and cerebrovascular vessels, and the higher the risk of cardiovascular and cerebrovascular events. When the total cholesterol reaches 7.2 mmol/L or LDL cholesterol reaches 4.9 mmol/L, it belongs to the high-risk group of atherosclerotic cardiovascular and cerebrovascular diseases, and it indicates that the risk of acute cardiovascular events such as myocardial infarction, cerebral infarction, etc. will be ≥10% in the next 10 years. The risk of cardiovascular events such as myocardial infarction, cerebral infarction, etc. is ≥10%. What's more, the existence of metabolic disorders in patients with hyperlipidemia, which are easy to be accompanied by hypertension, diabetes mellitus, or lowered HDL cholesterol at the same time, or the existence of risk factors such as obesity, smoking, and family history of premature atherosclerotic cardiovascular disease, implies a higher risk of cardiovascular events in the future, and so these underlying diseases and risk factors can synergize to Hyperlipidemia damages the cardiovascular system.

From the point of view of prevention of cardiovascular and cerebrovascular events, total cholesterol of 7.2 mmol/L and LDL cholesterol of 5.1 mmol/L need to be given lipid-lowering and antiplatelet aggregation drugs based on lifestyle changes.

The primary treatment for high-risk groups is to lower blood cholesterol to reduce cardiovascular and cerebrovascular damage, cholesterol-lowering non-pharmacological and pharmacological treatments, non-pharmacological treatments, i.e., lifestyle changes, the need for a low-salt, low-sugar, low-fat, low cholesterol diet, increase the intake of fresh fruits and vegetables, appropriate exercise, weight loss, and smoking cessation and restriction of alcohol, etc., but non-drug treatments belong to the basic treatment, the lowering of blood lipids is limited, for the For patients with total cholesterol of 7.2mmol/L and LDL cholesterol of 5.1mmol/L, it is impossible to control the blood lipids to reach the standard, so it is necessary to give medication to lower the lipids, and statins are preferred; at the same time of taking statin, antiplatelet therapy should be initiated at the same time, which is because high-risk patients are prone to gather platelets at the arterial breakage place to form a thrombus to block the blood vessel, and antiplatelet medication can prevent platelets from gathering and thus reduce arterial blood clots. Antiplatelet drugs can prevent platelet aggregation, thus reducing the risk of arterial thrombosis and the occurrence of myocardial infarction and cerebral infarction. Commonly used antiplatelet aggregation drugs include aspirin and clopidogrel.

After the administration of statin lipid-lowering and antiplatelet drugs, the relevant indexes should be reviewed periodically to know whether the blood lipid standard is reached and whether there are any adverse drug reactions.

After the use of statin drugs, should review whether the blood lipid standard, at the same time to understand whether the statin adverse reaction, review is usually carried out in 4-8 weeks after the use of drugs, first of all, should review whether the blood lipid standard, focusing on the observation of the total cholesterol, low-density lipoprotein (LDL) cholesterol, due to LDL cholesterol on the prediction of cardiovascular and cerebral vascular events of a higher value, so the blood lipid standard with reference to the index, high-risk patients to control its Secondly, attention should be paid to review whether there are statin drug adverse reactions, need to test aminotransferase, creatine kinase and blood glucose, when aminotransferase elevated up to 3 times the upper limit of the normal value should be discontinued statin, when the creatine kinase reaches 5 times the upper limit of the normal value or the emergence of intolerable muscle pain, statin should also be discontinued, at the same time need to regularly test the blood glucose and glycated hemoglobin, but the blood glucose is abnormal However, patients with abnormal blood glucose should not discontinue statin use and should have symptomatic glycemic control because the cardiovascular benefits of statin far outweigh the risk of developing diabetes mellitus. Aspirin use should be monitored for bleeding, including bleeding from the skin and mucous membranes, hematuria, and dark stools. If bleeding-related symptoms occur, a specialist should be consulted to assess whether aspirin can be continued.

In summary, total cholesterol of 7.2 mmol/L or LDL cholesterol of 4.9 mmol/L belongs to the high-risk group of developing atherosclerotic cardiovascular and cerebrovascular diseases, which predicts that the risk of acute cardiovascular and cerebrovascular events, such as myocardial infarction, cerebral infarction, etc., will be ≥ 10% in the next 10 years, therefore, patients with total cholesterol of 7.2 mmol/L and LDL cholesterol of 5.1 Therefore, patients with total cholesterol of 7.2 mmol/L and LDL cholesterol of 5.1 mmol/L should, on the basis of lifestyle modification, rationally use pain medications to lower cholesterol and antiplatelet aggregation drugs to prevent thrombosis in order to reduce the risk of acute cardiovascular and cerebral vascular events, and should be tested regularly to see if their blood lipids are up to the standard and whether they have any adverse drug reactions after the use of the drugs.

Thank you all for reading!

Please correct me if I'm wrong! Feel free to ask and share in the comments section!

Note: The content of this article is intended as health science only, and is not intended as medical advice or opinion, and does not qualify as medical guidance.

Thanks for the invite! Outside of dietary modifications, my biggest experience has been to stick to cardio. Such as brisk walking 5km, cycling, swimming. Keep your mouth shut, try to eat less animal offal and high fat food, eat more detoxification fruits such as apples, pears, grapefruit, eat more roughage such as corn, oats, buckwheat, etc., and consume enough high quality protein, such as lean beef, fish and soy products!

I had total cholesterol 7.17, triglycerides 2.2, LDL cholesterol 4.67 in April, then had to pipe down and add exercise, now total 5.21, gly 1.47, low 3.25.

Under normal circumstances, people's total cholesterol content of 2.8mmol/L ~ 5.17mmol/L or less, LDL cholesterol content of 3.12mmol/L or less; when the content of the two higher than the above standard becomes a high-risk factor for atherosclerotic lesions, so early detection of dyslipidaemia and timely intervention is the optimal strategy to reduce the incidence of cardiovascular and cerebrovascular diseases. Therefore, early detection of dyslipidemia and timely intervention is the best strategy to reduce the chance of cardiovascular and cerebrovascular diseases!

For healthy people who do not suffer from cardiovascular and cerebrovascular diseases or diabetes mellitus, occasional elevation of blood lipids over the normal range is inevitable, but as long as the total cholesterol content ≤ 7.2mmol / L and LDL cholesterol content ≤ 4.9mmol / L will not need to take medication, at this time, the first choice of the lipid-lowering program that we recommend is "dietary control + exercise therapy In this case, the preferred lipid-lowering program we recommend is "dietary control + exercise therapy". If the above indexes cannot be lowered to the following ranges (total cholesterol ≤5.17mmol/L, LDL cholesterol ≤3.12mmol/L) after 1 month of this program, then it is necessary to consider taking statin drugs;

For patients with cardiovascular diseases such as hypertension or diabetes mellitus, the control of the above indicators will be more stringent, in addition to the total cholesterol level must be controlled at ≤ 5.17 mmol / L, LDL cholesterol content should also be ≤ 1.8 mmol / L; in order to achieve and maintain this goal, we recommend that the patient take long-term statin drugs;

Finally, for people who do not have the disease but have risk factors such as obesity, smoking, family history of high blood lipids, etc., cholesterol should also be controlled at ≤5.17mmol/L and LDL cholesterol ≤1.8mmol/L, but do not have to take long-term medication, as long as the blood lipids are controlled to within the target value can be discontinued, but the "diet + exercise therapy" must continue to be implemented and pay attention to monitor their own blood lipid levels! However, "diet control + exercise therapy" must be continued, and pay attention to monitor their own blood lipid levels!

The above is for reference only!

This situation still needs to attract enough attention, more and more studies have confirmed: dyslipidemia, especially total cholesterol, LDL elevation in atherosclerosis and plaque formation plays a very large role, especially when accompanied by diabetes mellitus, hypertension, the requirements of the control of blood lipids is more stringent, otherwise it will greatly increase the risk of cardiovascular and cerebrovascular disease occurs.

First, let's learn about the normal values for each of the blood lipids and the criteria for determining abnormality:

It should be noted that, although the elevation of total cholesterol and LDL has some relationship with daily diet and exercise, they only play a 30% influence, and the main reason for their elevation is the abnormality of their own lipid metabolism. Therefore, when these two indicators reach the above elevated level, it is often necessary to control the diet and strengthen the basis of exercise, timely intervention through drugs to help the body regulate lipid metabolism, the most commonly used is to take statin lipid-lowering drugs, in order to reduce blood lipids as soon as possible.

I hope this answer can help you, welcome to click on the attention and leave a message, together to learn and exchange more health knowledge.