A literature research and review

Vitamin C, Gastritis, and Gastric Disease: a historical review and update

The discovery of Helicobacter pylori as the cause of gastritis and peptic ulcers ushered in the modern era of research into gastritis and into acid-peptic diseases and rekindled interest in the role of ascorbic acid in the pathophysiology and treatment of gastritis and peptic ulcer disease. Here, we review historic and modern studies on ascorbic acid and gastric diseases with an emphasis on H. pylori gastritis and its sequelae. The relationship of ascorbic acid and gastritis and peptic ulcer and its complications was extensively studied during the 1930’s through the 1950’s. Much of this extensive literature has been effectively “lost”. Ascorbic acid deficiency was associated with all forms of gastritis (e.g., autoimmune, chemical, and infectious) due in varying degrees to insufficient intake, increased metabolic requirements, and destruction within the GI tract. Importantly, gastritis-associated abnormalities in gastric ascorbic acid metabolism are reversed by H. pylori eradication and potentially worsened by proton pump inhibitor (PPI) therapy. Diets rich in naturally occuring ascorbic acid are associated with protection of the gastric corpus from atrophy and a reduction in the incidence of gastric cancer possibly through the ability of ascorbic acid to reduce oxidative damage to the gastric mucosa by scavenging carcinogenic N-nitroso compounds and free radicals and attenuating the H. pylori-induced inflammatory cascade. Ascorbic acid supplementation was possibly associated with a decreased incidence of bleeding from peptic ulcer disease. Pharmacologic doses of ascorbic acid also may improve the effectiveness of H. pylori eradication therapy. Occasionally, looking back can help plot the way forward.

Keywords: Helicobacter pylori, ascorbic acid, vitamin C, peptic ulcer, gastritis, pernicious anemia, gastric cancer, dehydroascorbic acid, ntestinal metaplasia, gastrointestinal bleeding, absorption https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874117/

Hemorrhage associated with vitamin C deficiency in surgical patients.
Diffuse hemorrhage in surgical patients with normal coagulation parameters may be caused by vitamin C deficiency and is rapidly reversed by vitamin C replacement.
Patients treated on a surgical service were entered into a clinical registry over a 12-month period if they experienced diffuse hemorrhage in the face of normal coagulation parameters and a plasma ascorbic acid level < 0.6 mg/dL (normal 0.6-2.0 mg/dL). Oral vitamin C replacement was administered after determination of plasma ascorbic acid level. Response to therapy, including subsequent bleeding events, need for blood transfusions, and demographic data including social and dietary history were retrospectively reviewed from hospital and outpatient clinic records. RESULTS: Twelve patients with bleeding diatheses and low plasma ascorbic acid levels were identified. Plasma ascorbic acid levels were 0.1 to 0.5 mg/dL (mean, 0.3 mg/dL). There were 6 men and 6 women; age ranged from 46 to 90 years (mean, 78 years). Coagulation parameters were normal in all patients. Diffuse postoperative bleeding from nonsurgical causes was evident in 10 of 12 patients. Four patients, 2 of whom had operations, presented with chronic recurrent blood loss from the gastrointestinal tract. Each patient received 250 to 1000 mg of vitamin C replacement daily. Within 24 hours of vitamin C administration, there was no further evidence of clinical bleeding nor need for subsequent blood transfusions in any patient. CONCLUSIONS: Vitamin C deficiency should be included in the differential diagnosis of nonspecific bleeding in surgical patients. Prolonged hospitalization, severe illness, and poor diet create vitamin C deficiency with significant clinical consequences. Oral vitamin C replacement rapidly reverses the effects of this disorder. https://www.ncbi.nlm.nih.gov/pubmed/11935131

Role of vitamins in gastrointestinal diseases

A tremendous amount of data from research was published over the past decades concerning the roles of different vitamins in various gastrointestinal diseases. For instance, most vitamins showed an inverse relationship with the risk of colorectal carcinoma as well as other malignancies like gastric and esophageal cancer in observational trials, however interventional trials failed to prove a clear beneficial preventive role. On the other hand, more solid evidence was obtained from high quality studies for a role of certain vitamins in specific entities. Examples for this include the therapeutic role of vitamin E in patients with non-alcoholic steatohepatitis, the additive role of vitamins B12 and D to the standard therapy of chronic hepatitis C virus, the role of vitamin C in reducing the risk of gallstones, the positive outcome with vitamin B12 in patients with aphthous stomatitis, and the beneficial effect of vitamin D and B1 in patients with inflammatory bowel disease. Other potential uses are yet to be elaborated, like those on celiac disease, pancreatic cancer, pancreatitis, cholestasis and other potential fields. Data from several ongoing interventional trials are expected to add to the current knowledge over the coming few years. Given that vitamin supplementation is psychologically accepted by patients as a natural compound with relative safety and low cost, their use should be encouraged in the fields where positive data are available. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419060/

My son asked me yesterday why I was taking colostrum, like what was it for and how could I get it from other foods? All I could tell him was that it has immunoglobulins that boosted the immune system. He said to me, “You should have an answer about why you believe this, Mom.” Or something similar to that. I thought about the fact that my daughter Jessica had an IgM deficiency on a lab test several months ago. Maybe looking a deficiency could tell me more about the immune system.

I found some interesting nuggets about that particular deficiency and maybe answers some questions about her health and issues now. I found this statement on the rare disease website, “IgM is the first antibody the immune system makes to fight a new infection.[3] Therefore, when a person does not have enough IgM, the body may have difficulty fighting infections. SIgMD can occur in infants, children, or adults.[1] The disorder may occur as a primary disorder (on its own) or more commonly, as a secondary disorder (associated with another underlying disease or condition). SIgMD may occur in association with some cancers, autoimmune diseases, allergic diseases, and gastrointestinal diseases.[2][4] https://rarediseases.info.nih.gov/diseases/12547/selective-igm-deficiency

I found it interesting that selective IgM deficiency is more commonly occurs as a secondary disorder associated with an underlying disease or condition. They say that SIgM may occur in association with some cancers, autoimmune diseases, allergic diseases and gastrointestinal diseases. The reason this is so profound to me is because one of Jessica’s doctors diagnosed her with IBD. Several other doctors are debating that diagnosis with me. While her lab test shows that she no longer is deficient in IgM I have already shared my thoughts on lab tests and even though they may now say there is no issue with whatever it may be, that doesn’t mean there still isn’t a problem like with Jessica’s egg issue. She was IgE to eggs on a lab test and now she’s not but she still reacts badly to eggs. My thought is it might be possible that could be happening with her IgM issue.

An article I found in livestrong.com talks about the immune system and the fact that immunoglobulins play a critical role in immune function and that they actually act like antibodies to prevent illness. They talk about certain nutrients and studies which have shown that they benefit your immunoglobulins. They are vitamin A, zinc, and vitamin E. A study in the March 1994 issues of clinical and diagnostic laboratory immunology suggests that eating foods high in vitamin A may benefit your immunoglobulin levels and that can increase in children as well. Foods for vitamin A include eggs, cream, liver and kidneys. Two of those foods Jess can’t eat right now eggs and cream. We do eat liver though.

Research from February 2010 Journal of the Indian Medical Association says zinc boots immunoglobulin levels in patients with tuberculosis. Some foods high in zinc are of course oysters which many people talk about and we don’t eat but also red meat, seafood, pork and poultry, baked beans, cashews, beans and cheese. We do eat pork seafood and poultry and sometimes cashews but not beans or cheese right now.

February 2008 issue of Anatomia, Histologia, Embryologia noted a correlation between vitamin E intake and immunoglobulin even though the study was carried out on chickens we can still glean some good information from that. Foods with vitamin E are liver, eggs, nuts, dark green leafy greens, sweet potatoes and avocado. I don’t think we really can even eat enough to get all the nutrients because somehow I am still deficient of borderline deficient in vitamin E more recently on my lab tests.
So much to learn as I know these are not the only nutrients beneficial for the immune system. https://www.livestrong.com/article/501949-nutrients-that-raise-levels-of-immunoglobulins/

When my daughter Jessica was around 11 months old the rattle in her nose got worse and then turned to very bad congestion that wouldn’t go away. Then she got a strange rash on her back that continued to get bigger. At the same time she was getting low grade temperature’s up to 99.7.

I did a little research on vitamin C for kids from the book Superimmunity for Kids and found the following:

Dr. Leo Galland author of Superimmunity for Kids: What to Feed Your Children to keep them healthy now and prevent Disease in their future said about vitamin C, “Vitamin C in high doses is also an effective antihistamine. The doses that can produce this effect, 500 to 5000 mg. a day, are quite safe, even for toddlers, and vitamin C come in chewable tablets. The main side effect of an excess of either magnesium or vitamin C is diarrhea, which will stop when the dosage is reduced.” Pg. 132

Dr. Galland recommends about 500 mg. of vitamin C every three hours for a cold or viral infection. I never did give Jessica that much when she was under two years old. When she got a bad rash on that covered half of her back when she was being exposed to high levels of mold, I gave her 500 mg. 3x a day. I have increased that as she has gotten older and only when a cold lingers a long time. The most she has gotten is 2500 mg. of vitamin C in a day. Dr. Galland recommends that if you have recurrent or chronic respiratory infections that 500 mg. of vitamin C a day is good for a 1-3 year old. Jessica has other issues that deplete vitamin C including allergies and a genetic histamine issue.

Dr. Galland says, “In allergies, as in recurrent infections, deficiencies in certain nutrients contribute to a malfunction of the immune system.

Dr. Galland recommends a few things for colds and other viral infections but the vitamin C recommendations are, “give him vitamin C about 500 mg. every three hours. If his bowels become loose, stop giving it that day. the next day, give him 200 milligrams every three hours. If his bowels again become loose, stop vitamin C that day; the next day, give him 100 mg. every 4 hours. Then give him about 500 mg. a day until he’s recovered…although some claim that megadoses of vitamin C are not utilized by the body and are just excreted in the urine, vitamin C in doses of 1,000mg a day or more has been shown to enhance immune function in normal human volunteers.” Pg. 124

One concern about high doses of vitamin C could be oxalates or calcium oxalate stones or kidney stones. The following is a quote from a book entitled, Curing the Incurable; vitamin C, infectious diseases, and toxins by Thomas E. Levy, M.D. JD. “One of the primary reasons why the vitamin C/kidney stone connection continues to generate concern is because vitamin C does increase the urinary concentration of oxalate. Therefore, it just seems logical to assume that more and prolonged vitamin C administration will continue to increase this concentration until calcium oxalate stones begin to form…however, research proves that this is not the case, although vitamin C is one of many risk factors for increased oxalate formation and the subsequent formation of calcium oxalate stones. Schmidt et al. (1981) determined that there was actually a leveling off of oxalate production even though vitamin C dosing was continued. The researchers noted that a significant amount of the vitamin C does not even get metabolized to oxalate and is excreted unchanged in the urine…when very high doses of vitamin C are administered for any significant medical condition, the active, non-oxidized form of vitamin C is much more readily regenerated from the oxidized vitamin C than the metabolic breakdown products. This process further inhibits the irreversible metabolism of vitamin C to the oxalate end product. Takeouchi et al. (1966) noted that about 80% of vitamin C administered to human subjects was eliminated as dehydroascorbic acid, the oxidized form of vitamin C. They concluded that the metabolic breakdown of vitamin C in humans does not necessariliy have to follow the entire sequence down to oxalate. They also noted that as the vitamin C dose is increased, urinary excretion of diketogulonic acid increased. This is a clear indication that further oxidative breakdown of the diketogulonic acid to oxalate does not have to occur for a metabolic breakdown product of vitamin C to be excreted.”

He further states, “Logically, there have to be multiple other ways to metabolize and excrete vitamin C rather than by urinary oxalate. Casciari et al., (2001) showed that 50,000mg daily doses of intravenous vitamin C have already been given to cancer patients for eight-week periods without problem. If urinary oxalate was the only excreted metabolic product of vitamin C, such doses would cause such a supersaturation of oxalate in the urine that crystal deposition and eventual stone formation would have to occur. Yet, this does not occur.” Pg. 381-382

Since it is logical to think that this author is talking about adults and the above doses are extremely even for adults. I wanted to point out that Dr. Levy includes studies showing that vitamin C is even safe for premature infants saying, “In an article reviewing a large number of vitamin C studies, Hanck (1982) also confirmed the remarkable safety of long-term supplementation. Bass et al. (1988), in a double-blind study, found that vitamin C administration was very safe even for premature infants.” Pg. 374

Dr. Levy includes a list of risk factors involved in precipitation of calcium oxalate out of the urine, leading to stone formation. He includes a few that stood out to me in thinking about our situation with my daughter, calcium ascorbate as the type of supplemental vitamin C, vitamin D supplementation, intake of oxalate stone generating or oxalate containing beverages (we drink fermented drinks like fermented coconut water and kombucha, intake of oxalate stone-generating toxins (Jess was exposed to toxic mold, and Crohn’s disease itself (we don’t know what kind of IBD Jess may have.

I looked up the study that Levy quotes about renal stones and IBD and it says in part, “RESULTS: Renal calculi were found in two patients with CD and in none with UC. Hyperoxaluria was present in 36% of patients with CD but was absent in those with UC. Analysis of covariance showed an association between low urinary citrate/creatinine ratio and renal stones (P=0.02), and between a combined urinary citrate and magnesium deficit relative to calcium, as expressed in the CMC index (citratexmagnesium)/calcium), and renal stones (P=0.017). Changes in urinary calcium, oxalate, urate, magnesium or the calcium oxalate index were not associated with the presence of stones. There was no independent relationship between any clinical factor and the presence of stones. CONCLUSION: Lower urinary concentrations of magnesium and citrate (stone inhibitors), relative to calcium (stone promoter; the CMC index) may be more important in lithogenesis in inflammatory bowel disease than is hyperoxaluria. In patients with a functioning colon, a low CMC index may predict likely stone-formers; this requires a prospective evaluation. Avoiding low urinary levels of magnesium and citrate may aid in preventing and treating renal calculi.” https://www.ncbi.nlm.nih.gov/pubmed/12010224

In my research about IBD I have found more information about vitamin deficiencies and the need for supplementation than the other way around. See the following study about that, “A case of scurvy presenting in a patient with Crohn’s disease is reported. A normal response to replacement therapy is seen. Vitamin C (ascorbic acid) deficiency was found in 7 out of 10 patients with clinically quiescent Crohn’s disease, 4 of whom had an adequate oral intake of vitamin C. There was no significant difference in oral intake between patients with Crohn’s disease and matched controls but there was a significant difference (P less than 0.001) in leucocyte ascorbic acid levels. It is recommended that patients with Crohn’s disease be screened for vitamin C deficiency and receive prophylactic vitamin C supplements daily. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2425408/

It seems to me that Jessica should be more carefully monitored for her vitamin status and supplemented as necessary given her restricted diet. The OAT (Organic acid) test from 1 year ago did not show specifically a vitamin C deficiency but it did for multiple B-vitamins including B6, B12, and B1. That test from what I can tell did not look at magnesium which I think we should look at.

Have you had any side effects or experience with Vitamin C, please share, it could help someone else.

Until I recently read the book entitled The Autoimmune Wellness Handbook by Micky Trescott and Angie Alt both health coaches and blog at https://autoimmunewellness.com/our-story/. I didn’t realize that I could have a condition called multiple autoimmune syndrome. The authors of the above book say that, “…this disorder usually includes one skin disorder like psoriasis. 25% of people with 1 autoimmune disease will go on to develop more.”

I was diagnosed with endometriosis when I was very young in my early twenties. Endometriosis is not exactly an autoimmune disease but what they classify as on the autoimmune spectrum. Endometriosis.org http://endometriosis.org/news/research/endometriosis-and-comorbidities/ talks about it more detail on their site on the above page.

A few years later I was diagnosed with psoriasis on the back of my neck under my hairline. Then in 2010 I was diagnosed with eosinophilic esophagitis (EoE) which is Eosinophilic esophagitis, also known as EE or EoE, is an allergic inflammatory disease and typically chronic disorder that affects from one to four of every 10,000 people in the United States. It is a recently recognized disease with increasing diagnoses, resulting in part from growing awareness of the condition. . https://acaai.org/allergies/types/food-allergies/types-food-allergy/eosinophilic-esophagitis

Psoriasis is actually considered an autoimmune disease. Here the national psoriasis foundation has to say, “Researchers agree that psoriatic disease is an autoimmune disease.” https://www.psoriasis.org/research/science-of-psoriasis/immune-system

I think it was somewhat of a fluke that I ever found out about EoE. I had an endoscopy in 2009 which showed I had that condition of my esophagus. I always had issues with bananas and my throat causing it to squeeze too much after I ate a semi unripe banana. Then after my family was exposed to high levels of mold in 2017 my throat started squeezing even harder than it ever had with bananas and it went down into my stomach. It was very painful and drinking water wouldn’t relieve the symptoms. My gastroenterologist said that condition is like asthma of the esophagus. I took a pain pill and that helped and once I was out of the mold it stopped.

It is so interesting how the body works and how environmental exposures to toxins affect it and contribute to its dysfunction. Knowing this about myself sheds light on what is going on with my daughter. It’s interesting to note that my husband also has psoriasis and she got genes from both of us.

In spite of all that’s wrong with our bodies we are blessed to be able to eat very healthy food and take good supplements so that we can override many symptoms that might have overtaken our lives. We are blessed.

What has been your experience with autoimmune disease? Do you have this condition or many autoimmune diseases? I’d love to hear your story.

There a several different reasons someone could get SIBO. Nutritionist from Dr. Amy Myers website says that the following can all be a root cause of SIBO

1. Slow motility due to stress
2. Diabetes causing nerve damage
3. Bowel obstruction – not as common
4. Antibiotics
5. PPI – low stomach acid
6. Aging – slows down the GI tract
7. Lack of digestive enzymes
8. Low thyroid causing slow motility and slow metabolism

Some symptoms of SIBO

1. Malnutrition
2. Fatigue
3. Weight loss
4. Food intolerance
5. Rosacea
6. Acne
7. Eczema

My daughter doesn’t have many of these symptoms. The reasons I think Jess could have SIBO are slightly different but still a concern for me:

1. After eating pumpkin cake (no sugar) Jess complained of stomach pain, laid on her daddy for about 4 hours and vomited three times.
2. 2 lab tests showed different possibilities for SIBO that I wasn’t concerned about until she complained of stomach pain two times once after eating pumpkin and once after
eating sweet potato. She ate or I should say overate both of them. She had 5 small sweet potatoes. They were very small. She had several pieces pumpkin spice cake which
did not contain any sugar because I don’t use sugar to cook or prepare food with. That kind of thing has happened to me before and I had a small amount of SIBO.
3. She is consistently constipated only going to the bathroom BM every other day
4. Unusual vomiting not due to any other reason – after eating pumpkin spice cake (no sugar)

We are retesting the Urine Organic Acid test and will see if the above marker is still there now that she is a year older. I plan on not giving her too many carbs at once so hopefully we won’t have any abdominal pain any time soon. Hopefully she won’t get this diagnosis because it just means more work and more concern about all the supplements my daughter takes.

I have read a few books on different versions of the AIP diet including Dr. Amy Meyers The Autoimmune Solution as well as Terry Wahl’s The Wahl’s Protocol as well as bits and pieces of The Paleo Approach by Sarah Ballyntyne. I must have missed a lot when I was reading the Paleo Approach because she clearly talks about stevia not being good on AIP. I may not have been ready to hear this information about stevia. I have been personally been eating and using stevia for many years on the anti-candida diet, at least nine or ten years now and it has never caused me any problem at all.

I have heard doctors talk about stevia in relation to blood sugar because it is so sweet it sends a message to the brain that a sweet food is coming and it should release insulin that is not needed so the insulin could possibly raise blood sugar but and article entitled Stevia is Not a Good sweetener for an autoimmune diet by Angie King-Nosseir says, “Here’s the problem with stevia concerning blood sugar dysregulation – a s non-nutritive sweetener, stevia does not contain any sugars or calories, but it does impart the sweet tastes to the taste buds. When the brain sense the sweet taste, signaling processes clear the blood stream of sugars in order to make way for more sugars. Now, this would be fine if there were actually more sugars (not too many though) coming down the pike; however, since there are none, this leaves the blood sugar tanked and thus, results in hypoglycemia. Hypoglycemia, in turn, leads to an effort by the body to replenish blood sugar levels by calling upon stored glucose from the liver and muscles, in the form of glycogen. To accomplish this mobilization of glucose from body stores, stress hormones must be released.” http://www.autoimmunemom.com/diet/stevia-sweeteners-hypoglycemia.html

I have suffered with hypoglycemia for years and I have not had any symptoms like that with stevia, nor do I crave more carbs. This author goes on to say that safe sugars are thinks like whole fruits, raw honey, maple syrup a coconut palm sugar. My daughter and I have had issues with all of those above except whole fruits. When I say issues I mean we have gotten pretty sick if we ate just a little too much of those sweeteners.

Author Angie King also says that many people with autoimmunity struggle with hormone imbalances with stress, insulin, thyroid and sex hormones and hormone imbalances are tightly linked to blood sugar control. She says that author Sarah Ballantyne, PhD says that stevia glycocides which are responsible for the sweet taste of stevia actually have a hormone structure.

The reason this all just seems like too much is because first of all I have no problem with stevia and I am still breastfeeding. Another reason is that I give Jessica many supplements including some very bad tasting ones like nystatin, which I mix up myself and I put stevia in it so she can tolerate the taste without throwing up. Until we test Jessica’s blood sugar or sex hormones which I don’t think is going to be any time soon I don’t know that we have a good case to stop the stevia except if this is all happening on an internal microscopic level we can’t see like the blood in her stool.

We have much more to learn and test out for Jessica with her diet, supplements and lifestyle like lowering her stress. I don’t even know how that is possible to lower the stress of a happy, well adjusted two year old.

What has been your experience with stevia on an AIP protocol? I’d love to hear from you.

A few weeks before we did Jessica’s fecal occult blood test she was eating red meat. I think she may have been eating cantaloupe too. The bottom line is that I don’t think I had Jess eat the proper diet before the test. Red meat itself can have micro amounts of blood in it and affect the test in a negative way.

A really great article I read after doing some research on the best fecal occult blood test and trying to figure out what role vitamin C played because I was giving Jessica higher amounts of vitamin C than normally recommend. The article is entitled Diet for Fecal Occult Blood Test Screening: Help or Harm? From http://ecp.acponline.org/julaug01/fletcher.pdf. They say, “Dietary advice might decrease the positivity rates by eliminating some causes of false-positive test results. That’s what we are hoping for is that Jessica’s recent test is a false-positive. We won’t really know until we test again. The really disturbing thing to me is that, “After all, positive results, even one trace positive result in six specimens should be followed with colonoscopy – even if occult bleeding might be attributed to another cause.”

So it’s possible that we may be looking at a colonoscopy even if only one in six tests comes back positive. This is why we really need to make sure that this test was a true positive. We will eventually need to see the gastroenterologist but for now I am making more changes to Jess’s diet before we even consider a colonoscopy.

The article above lists out simple but comprehensive diet that should be followed at least two days prior to and including the test period which includes red-meat free and vitamin C in excess of 250 mg per day for 2 days prior to and during testing.

Have you had any experience with this test? Please share.

We recently took Jess to my medical doctor who practices natural medicine. I wanted him to muscle test a list of things that I was thinking may have been contributing to the increase in Jessica’s inflammation.

One surprising thing that came from that visit and the muscle testing that was done is that beef and spices from the beef and turkey sticks were causing inflammation! I am not sure why I was so surprised but my heart sank because that meant more hard diet changes.

My first list consisted of things like lactoferrin in my breastmilk, soy isolate from hot dogs, micro yeast, lack of probiotics, imbalance SCFA (short chain fatty acids), a virus Jess had in June 2018, SBI protect (maybe it had tapioca starch), stevia, cornstarch in VSL, nuts, eggs in mayonnaise.

Jess was reacting to eggs too but from the muscle test she wasn’t reacting to the things I thought she was. About a week later we tested several other foods none of which showed any muscle test reaction. That list consisted of colostrum supplement (I wanted that tested because that supplement has micro amounts of whey protein but no casein), coconut flour, beef gelatin vital proteins brand, bullet proof collagen, tomato, white potatoes, tera brand pumpkin protein, kombucha, melatonin, chocolate, maca powder, sunflower lecithin, rice cakes, sweet potato, butter.

I wanted all these different foods tested is because there are so many contradictions, like she can’t have beef right now because that is causing inflammation but beef gelatin is ok. She reacts badly to dairy usually but is fine with colostrum with whey protein. This can be so confusing to figure out. It is overwhelming because when a lab test shows blood in your 2 ½ year olds stool it’s very concerning.

We will be retesting in about a month or so.

Muscle testing does not look exactly like the above photo but I thought it was cute!