How to Detox for Balanced Hormones

Its the New Year!  Feels good to finally get back into a schedule!  If you aren't feeling your best, a quick detox may be all that it takes to get your hormones back into balance. 

How do you know if you need to detox?   Are you having any of these symptoms?

Bloating

Heavy periods

Mood swings

Feeling tired

Not sleeping well

Breast tenderness

Retaining fluid

Achy joints

Hair loss

A detox program will help your body eliminate excess hormones, cellular waste products and environmental chemicals, as well as reducing the amount of toxins that you are exposed to. 

FOODS TO INCREASE:

Certain foods help to support your body's natural detox pathways (especially liver health) and help to keep your hormones balanced.  

1.  Vegetables:  Increase your intake of green leafy veggies, and vegetables of a variety of colors to get all the phytonutrients (plant compounds) that keep your cells at optimal function.  Try to choose organic whenever possible.  

2.  Water:  make sure you stay well hydrated.  The enzyme systems involved in cellular metabolism don't function well when you are dehydrated. 

3.  Healthy fats:  Sources of good fats include avocado, coconut oil, raw nuts, extra virgin olive oil and seeds (like chia seeds, hemp seeds, raw pumpkin or sunflower seeds are all good choices).  The healthy fats help to protect your liver and are necessary for balanced hormones. 

4.  Sulfur containing foods:  The sulfur in these foods is important for your liver detox pathways, especially for the production of glutathione - an important antioxidant made in your liver.    Good sources of sulfur include Allium vegetables like onion, garlic, shallots, chives and Cruciferous veggies like broccoli, cauliflower, cabbage, Brussels sprouts and kale. 

5.  Seasonings:  cilantro, rosemary, ginger, turmeric and many of the other seasonings you have in your kitchen right now are natural detox support nutrients.  Use them!  Your food will taste better, and you will feel better.  Its a win-win!

FOODS TO AVOID:

Certain foods promote hormonal imbalances, and interfere with natural detox processes, so they should be avoided.  

1.  Alcohol:  Sorry, but alcohol is very hard on your liver, so avoiding alcohol is important while you are detoxing.

2.  Sugar  Sugar drives inflammation and insulin resistance,  which cause blood sugar problems and weight gain.  

3.  Hormone disrupting foods:  grains, corn, soy, and dairy should be temporarily avoided.  

4.  Inflammatory fats:  vegetable oils like canola and safflower promote inflammation and hormone imbalance.  The worst of all are trans fats - hydrogenated or partially hydrogenated fats.  These promote diabetes, weight gain and other chronic disease.  They are predominantly found in deep fried foods, commercially baked goods, and in shortening and margarine. Choose healthy fats instead, and keep this up as a new habit!

AVOID ENVIRONMENTAL TOXINS WHEN POSSIBLE

Toxins are everywhere and it isn't possible to avoid them all, but here are some simple things that you CAN do. 

1.  Go through your personal care products (lotions, cosmetics, shampoo, etc).  Look for anything that contains parabens or artificial fragrance, and replace them.  Parabens cause hormone imbalances, and are possibly associated with an increased risk of cancer, including breast cancer  

2. When you are shopping for cleaning products, look for "greener" choices, with less chemicals.  Even better, use natural cleaners like vinegar and baking soda!

3.  Don't microwave your food in plastic (especially avoid putting plastic wrap in the microwave).  Plastics contain phthalates which are a group of chemicals that also contribute to hormone disruption.  Heating them leaches out the chemicals and increases the risk.  Heat things in glass containers instead.

4.  Don't char your meat.  When you cook on the grill and the edges of the meat become slightly charred, heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) are produced.  These are cancer causing compounds.  Cook your food at lower temperatures to avoid this. 




TAKE CARE OF YOURSELF

If you are constantly stressed out, your body's detox pathways won't function effectively.  Here are some stress reducing tips.

1.  Do deep breathing exercises.  Take some slow, deep belly breaths and concentrate on the air going in and out.  Do this for 5 minutes twice daily (you can even start out with 1 minute and it still works!)

2.  Learn to meditate.  A great app is called Calm - it is available for free on your phone!

3.  Start doing yoga.  Yoga stretches your muscles and relaxes your brain - so it helps both physically and emotionally - a two-for-one!

4.  Pet your dog.  Or cat.  Or watch your goldfish swimming.  Caring for a pet helps with stress reduction!

SWEAT

Besides your liver, your skin is another important organ of detoxification!




1.  Exercise helps you in many ways!  When you sweat, you are releasing toxins through your skin.  Make sure you shower promptly so they are not reabsorbed.

2.  A sauna is another good way to release toxins through sweat.  Look around - they don't have to be expensive (I managed to find a barely-used sauna on Craigslist and I love it.  Especially when it is cold outside!)





ADD DETOX SUPPORT SUPPLEMENTS

Many "cleanses" at the health food store are mostly laxatives or fiber supplements that cause loose stools (you get more exercise by running to the bathroom all day!).  

A detox program is supporting your liver function, which is different.  However, it IS important to avoid constipation while you are detoxing:  your liver is doing all that work to excrete unwanted substances into your gut and if you are constipated they are more likely to get reabsorbed back into your system, defeating the purpose. 


My favorite detox supplements are included in our 6 Day Detox Kit. It contains everything you need, including a detox shake (OptiCleanse GHI), a probiotic (Probiomax daily), a fiber supplement, a liver/kidney/gallbladder drainage support supplement and a meal plan with full instructions!   

If you are a patient, and want to join the Signature Wellness staff in our annual January detox, you can call the office to get your kit - the price is reduced for the month of January, but the kits are very popular so call now before they run out!   

You can reach us at 704-752-9346 or questions@signaturewellness.org. 

Yours in Health!

Dr Deborah Matthew 

Imagine life without belly fat!

Top 5 hidden causes of weight gain 

Did you enjoy the holidays a little too much?  Is your New Year's resolution to lose some weight?  Here is what you need to know....

For many years you have been told that weight loss is straight forward - eat less and exercise more.  Unfortunately for many people it is just not that easy!

Whether you are a woman with perimenopausal or menopausal hormone problems, or a man with low testosterone, weight gain is typical (in fact the average woman gains about 20 pounds as she goes through menopause!).

Thyroid hormones and stress hormones including cortisol and DHEA closely regulate whether you burn or store calories.  Insulin is a fat storing hormone, so if you are creeping towards pre-diabetes (or if you are already there) your body will tend to store fat even if you are not over-indulging.

Obviously hormonal balance is important for successful weight loss.  But sometimes it is just not enough.

Apart from balanced hormones and good lifestyle habits, did you know that there are often many other underlying factors that are affecting your weight?

Here is a list of the top 5 hidden (fixable!) causes of weight gain.  

1.  Food sensitivities.   It is very common to develop sensitivities to common foods.  A sensitivity causes low grade inflammation which promotes weight gain.  Changing nutrition to avoid the foods you are sensitive to can help with mood, energy, memory, joint pains, digestive symptoms, menstrual problems as well as weight gain.

2.  Toxins.  There are tens of thousands of chemicals that we are exposed to on a regular basis.  Many of these are “hormone disrupters” - meaning that they interfere with metabolic processes and hormonal  balance.  We know that people with higher levels of toxins tend to be more overweight and more likely to have diabetes, as well as many other hormonally related problems.  Avoidance of toxins and learning how to help optimize your natural detoxification pathways can be a very important step in weight loss.

3.  Dysbiosis.  This is a word that means there is an imbalance in your “microbiome” - the trillions of micro-organisms that live in your digestive tract.  If you have too many of the wrong bacteria and not enough of the good health-promoting "probiotic" bacteria, this is associated with weight gain.  In some cases the bacteria literally cause us to extract more calories from the same amount of food.

4. Candida.  Overgrowth of digestive yeast (candida) is another common problem.  Candida causes sugar cravings that can be quite severe, making it much more difficult to avoid the sugary junk.  Candida also causes bloating, brain fog, fatigue, and hormonal imbalances

5.  Inflammation.  If there are too many inflammatory chemicals circulating in your blood stream, these directly cause problems with insulin and cortisol, resulting in weight gain.  Insulin and cortisol can contribute to more inflammation - so a cycle is created where your body wants to store more fat... 

Solutions are available!

As you can see, the "calories in vs calories out" equation is not the whole story.

If you have hormonal issues, these must be addressed.

In addition to balanced hormones, a medical weight loss program that addresses ALL of these underlying issues simultaneously is much more likely to result in successful longterm weight loss.



As the above issues are corrected, you won't just lose weight, but you can expect to FEEL better!  Symptoms that commonly resolve include fatigue, brain fog, bloating, joint aches, mood problems, and quality of sleep.

If you are ready to lose weight now,  please know that there are options and that we can help!  Call today to get started!  704-752-9346

Could you be in perimenopause?

Before you go through menopause, there is a period of time (up to 10 years!) where things start to change. The changes can be subtle or not so subtle. We call this phase of life "perimenopause", and it can be one of the most difficult transitions in a women’s life. Sadly, some women are told to tough it out and that it will pass. And often women are told that they are too young to be in perimenopause.

Addressing the hormonal symptoms of perimenopause can dramatically improve quality of life for many women. Lets talk about what is going on.

While estrogen levels start to decline around the time of menopause (average age of menopause is 52), progesterone levels start to decline much earlier.  In fact a your progesterone production may decline by as much as 80% between age 30 and 40.  This is one of the reasons that women in their forties have a harder time getting pregnant.

Progesterone is produced in two main places in your body. It is produced in the ovaries and in the adrenal glands. The majority of progesterone is produced in the ovaries after ovulation.  It helps to prepare the uterine lining in case of a pregnancy and is very important throughout pregnancy (it is “pro-gestational”).  

When a woman is in the second half of her monthly cycle, she is producing between 20 and 25 mg of progesterone a day. During pregnancy, production of progesterone spikes to between 300 and 400 mg per day.

When progesterone levels start to decline because of age, and symptoms of hormone imbalance become noticeable, we call this “perimenopause”.  

Progesterone deficiency is the most common hormonal problem we see in peri-menopausal women, but younger women can have this problem as well.  Because progesterone levels naturally vary over the menstrual cycle, the symptoms vary as well.  

Typically the week after a period is a “good” week; you are eating your broccoli, exercising regularly, and cleaning out your closets.  Then as you get closer to your period,  symptoms get worse and worse including irritability, anxiousness, and interrupted sleep.   You may feel more negative, critical, impatient, and easily frustrated - and this can affect how you behave towards your family and co-workers!

In fact, this variation in symptoms is a big clue that hormones are the problem.  If your mood symptoms or insomnia are exactly the same on every day in your cycle, it is less likely that hormones are the cause.

Progesterone has mainly been studied for its effects on the uterus but it turns out that progesterone has far more roles to play.  Women have progesterone receptors on cells in all parts of our bodies, and surprisingly the cells with the most progesterone receptors are our brain cells.  Anyone who has experienced PMS symptoms with mood swings and irritability may not be surprised after all!  

Research is showing that progesterone has important neurological effects.   It acts as a natural anti-anxiety compound, helps with sleep and is calming - sort of like nature’s version of valium or a glass of red wine.

Here is a checklist of symptoms that you may experience if you progesterone levels are declining:

Insomnia (especially wakening in the night)

Night sweats

Anxiety

Irritability

Mood swings

Weight gain

Increased PMS

Pre-menstrual headaches

Heavier periods

Shorter cycles (periods coming less than 28 days apart)

If this sounds like you, please know that there is help! You can feel like YOU again.

You can find more information at our website www.signaturewellness.org or contact the office at 704-752-9346

Yours in health

DrM

Is this why you are tired?

Do you have a hard time getting going in the morning?  Do you have an energy crash in the afternoon?  And then, after feeling tired all day, do you get a second wind late in the evening and have a hard time falling asleep?  If so, you certainly aren't alone!

Cortisol is your stress hormone.  If you have a sudden stressful experience, like being late for an important appointment and getting stuck in traffic, your cortisol level goes up to help you cope with the stress.  Then when you get there and everything turns out ok, your cortisol level goes back down to normal.  This is a normal stress response.

The problem is that in our modern world we tend to have lots of little stresses all day long.  In the past, our stresses were things like being chased by a saber-toothed tiger and having to run for our life. The physical activity (running) helped us to clear the extra stress hormones from our system.  Today our stresses typically don't involve running for our life - they are much more likely to involve fuming at the slow traffic while we sit in our car worrying about being late for our appointment.  The end result can be chronically elevated cortisol levels.

When we are thinking about stresses it is important to realize that we don't just include the emotional stressors.  You are typically well aware of those - family issues, work stress, etc.  But physical stressors count as well - things like allergies, chronic back pain, insomnia, nutritional deficiencies and hormonal imbalances.  And you can have stresses on your system without being aware - for example toxins in the environment.  It is very common in our modern world to have high stress burdens.

If cortisol levels remain chronically elevated health problems can follow.  High cortisol may promote fatigue, mood symptoms including depression and anxiety, food cravings, weight gain, insomnia, high blood pressure, bone loss, poor memory, impaired immune system function and increased menopausal symptoms.  In a nutshell, high cortisol is a wear and tear hormone; it ages you at an accelerated rate.    You have probably witnessed this - people who have lived under extremely stressful conditions often look older than their biological age.

Over time, cortisol levels may drop inappropriately.  If you now have insufficient amounts of cortisol to meet your body's daily demands problems can get even worse.  This is when you start to feel really exhausted, have difficulty coping with stress and feel like little things (that shouldn't really be stressful) feel somewhat overwhelming.

Do you think you may have a cortisol problem?  Here is what can be done.

Your cortisol level can be measured in a saliva or urine test.  We prefer to measure your level at multiple times during the day, since the levels change - they should be higher in the morning to help you wake up and lower at night to help you fall asleep.   We commonly find low levels in the morning and high levels at bedtime - when your daily pattern is backwards, no wonder it is hard to wake up and hard to fall asleep!

Reducing your stress is important.  Breathing exercises, meditation, yoga, walking, laughter and heartfelt prayer are good examples of stress management techniques.  Sometimes reducing stress is not easy.  Please talk to us if you need help.

Caffeine, alcohol and sugar may make you feel a little better in the short term, but in the long term they are not helpful and should be minimized.  Supporting cortisol levels can improve your energy so you don't need to rely on caffeine to keep you moving.

There are a number of supplements that are very helpful, and which ones we recommend for you depend on your symptoms and the pattern of your cortisol levels.  Ashwagadha, rhodiola and holy basil are examples of herbs that are typically safe and beneficial regardless of whether your cortisol is too high or too low.

If you have having symptoms that are affecting your quality of life, and would like to be evaluated to see if cortisol may be a problem for you, please contact the office for further information at 704-752-9346 or questions@signaturewellness.org.  You can also find more information at www.signaturewellness.org

Yours in Health,

DrM

Is this why you are tired?

Do you have a hard time getting going in the morning?  Do you have an energy crash in the afternoon?  And then, after feeling tired all day, do you get a second wind late in the evening and have a hard time falling asleep?  If so, you certainly aren't alone!

Cortisol is your stress hormone.  If you have a sudden stressful experience, like being late for an important appointment and getting stuck in traffic, your cortisol level goes up to help you cope with the stress.  Then when you get there and everything turns out ok, your cortisol level goes back down to normal.  This is a normal stress response.

The problem is that in our modern world we tend to have lots of little stresses all day long.  In the past, our stresses were things like being chased by a saber-toothed tiger and having to run for our life. The physical activity (running) helped us to clear the extra stress hormones from our system.  Today our stresses typically don't involve running for our life - they are much more likely to involve fuming at the slow traffic while we sit in our car worrying about being late for our appointment.  The end result can be chronically elevated cortisol levels.

When we are thinking about stresses it is important to realize that we don't just include the emotional stressors.  You are typically well aware of those - family issues, work stress, etc.  But physical stressors count as well - things like allergies, chronic back pain, insomnia, nutritional deficiencies and hormonal imbalances.  And you can have stresses on your system without being aware - for example toxins in the environment.  It is very common in our modern world to have high stress burdens.

If cortisol levels remain chronically elevated health problems can follow.  High cortisol may promote fatigue, mood symptoms including depression and anxiety, food cravings, weight gain, insomnia, high blood pressure, bone loss, poor memory, impaired immune system function and increased menopausal symptoms.  In a nutshell, high cortisol is a wear and tear hormone; it ages you at an accelerated rate.    You have probably witnessed this - people who have lived under extremely stressful conditions often look older than their biological age.

Over time, cortisol levels may drop inappropriately.  If you now have insufficient amounts of cortisol to meet your body's daily demands problems can get even worse.  This is when you start to feel really exhausted, have difficulty coping with stress and feel like little things (that shouldn't really be stressful) feel somewhat overwhelming.

Do you think you may have a cortisol problem?  Here is what can be done.

Your cortisol level can be measured in a saliva or urine test.  We prefer to measure your level at multiple times during the day, since the levels change - they should be higher in the morning to help you wake up and lower at night to help you fall asleep.   We commonly find low levels in the morning and high levels at bedtime - when your daily pattern is backwards, no wonder it is hard to wake up and hard to fall asleep!

Reducing your stress is important.  Breathing exercises, meditation, yoga, walking, laughter and heartfelt prayer are good examples of stress management techniques.  Sometimes reducing stress is not easy.  Please talk to us if you need help.

Caffeine, alcohol and sugar may make you feel a little better in the short term, but in the long term they are not helpful and should be minimized.  Supporting cortisol levels can improve your energy so you don't need to rely on caffeine to keep you moving.

There are a number of supplements that are very helpful, and which ones we recommend for you depend on your symptoms and the pattern of your cortisol levels.  Ashwagadha, rhodiola and holy basil are examples of herbs that are typically safe and beneficial regardless of whether your cortisol is too high or too low.

If you have having symptoms that are affecting your quality of life, and would like to be evaluated to see if cortisol may be a problem for you, please contact the office for further information at 704-752-9346 or questions@signaturewellness.org.  You can also find more information at www.signaturewellness.org

A hidden cause of weight gain that starts in your gut

Did you know that you have something called a microbiome?  You may not have heard about it, but it is a very important part of you.  In our digestive tract, we have trillions of microbes - in fact we have more bacterial DNA in our bodies than human DNA!  These microbes are called your "microbiome" and they play a very important role in your health, and in your weight.

A healthy microbiome has lots of different types of micro-organisms  - lots of diversity.   Overweight people tend to have different bacteria in their guts than lean people.

Things that can affect the types of organisms in a negative way include:

- antibiotic use
- birth control pills
- stress
- pain medications
- steroid pills like prednisone
- pesticide residues in our food

Poor quality foods (fried foods, trans fats, sugar, processed food and artificial sweeteners) tend to feed and promote the less desirable type of microbes in your gut.  These organisms affect the lining of your digestive tract, causing inflammation and promoting weight gain.

Some bacteria affect our digestive tract to increase the number of calories we extract from food. Evolutionarily this may have helped us survive in times of food scarcity, but in our modern times of readily available, high caloric foods it helps to promote weight gain.

The gut microbes can also cause food cravings.  Having excess amounts of yeast, in particular, causes sugar cravings, because yeast thrive on sugar and they literally highjack your brain so you feed it to them.  Weight gain is not just dependent on what you are eating, but what your gut bugs are eating!

We know that certain probiotics (the healthy kind of bacteria) and prebiotics (natural fiber that feeds the probiotics) can reduce inflammation and improve the makeup of the gut microbes.  For example, a bacteria called Akkermansia helps with weight loss and improves metabolic function. Oligofructose (a prebiotic) increases Akkermansia by 100 fold.   Oligofructose is found in foods like onion, artichoke, leek, and garlic.

A nutrition program that helps to balance gut microbes is an important part of a healthy weight loss program (and weight loss maintenance).    Once again we can demonstrate that "calories in and calories out" is only part of the overall equation for weight loss!

If you are looking for help with your weight, please let us know!  Our medical weight loss programs address the microbiome, as well as the other underlying causes of weight gain including hormone imbalance, hidden food sensitivities, inflammation, environmental toxins.  and blood sugar metabolism.

Yours in health,

DrM

Do you want to lose belly fat? 10 reasons you are not losing weight

For many years we have been told that weight loss is straight forward - eat less and exercise more.  Unfortunately it is just not that easy!  For some people, maintaining a healthy lifestyle is hard in our modern world.  Many of our patients are already eating a reasonably healthy diet, exercising somewhat regularly and yet STILL continue to struggle with their weight.  Clearly there are other factors at play.  Here are some factors that can interfere with weight loss success:

HORMONAL FACTORS:

As you may expect, there are quite a few hormones that affect your weight.

1.  Sex hormone imbalances.  Problems with estrogen, progesterone or testosterone may result in weight gain.  

2.  Stress hormones imbalances.  Cortisol and DHEA are made in our adrenal glands (along with adrenaline) and they regulate weight, especially around the waist.  

3.  Low thyroid function  Thyroid hormone regulates our metabolic rate, how many calories we burn and whether or not we are burning fat for fuel.  Low thyroid makes weight loss very unlikely.  An overactive thyroid gland is the only thyroid problem that can result in weight loss, but it also causes anxiety, heart palpitations, jitteriness and other problems.

4.  Insulin problems.  Insulin is the hormone that regulates blood sugar.  If insulin is not working properly it takes more and more insulin to maintain blood sugar in the normal range.  The problem is that insulin is a fat storing hormone.  The more insulin, the more belly fat.  

5.  Leptin problems.  Leptin is a hormone that controls appetite signals.  If Leptin is not working properly, your brain will always think that you are starving and will cause more hunger.  

As you can see, proper hormone balance is critical to losing weight and maintaining a healthy weight.  Lifestyle factors are also very important - quality of sleep, stress levels, physical activity, nutrient intake, healthy social connections.  Hormone imbalances can make it harder to maintain good lifestyle habits due to fatigue, insomnia, mood symptoms, poor stress tolerance, food cravings as well as directly affecting metabolism and whether you are burning or storing fat.

OTHER IMPORTANT UNDERLYING FACTORS:

These factors are often root causes of the hormone problems above.

6.  Food sensitivities.   It is very common to develop sensitivities to common foods.  A sensitivity causes low grade inflammation which promotes weight gain.  Changing nutrition to avoid the foods you are sensitive to can help with mood, energy, memory, joint pains, digestive symptoms, menstrual problems as well as weight gain.

7.  Toxins.  There are tens of thousands of chemicals that we are exposed to on a regular basis.  Many of these are “hormone disrupters” - meaning that they interfere with metabolic processes and hormonal  balance.  We know that people with higher levels of toxins tend to be more overweight and more likely to have diabetes, as well as many other hormonally related problems.  Avoidance of toxins and learning how to help optimize your natural detoxification pathways can be a very important step in weight loss.

8.  Dysbiosis.  This is a word that means there is an imbalance in your “micro biome” - the trillions of micro-organisms that live in your digestive tract.  If you have too many of the wrong bacteria and not enough of the good health-promoting bacteria (the probiotics) this is associated with weight gain.  In some cases the bacteria literally cause us to extract more calories from the same amount of food.

9. Candida.  Overgrowth of digestive yeast (candida) is another common problem that we see that promotes weight gain.  Candida causes sugar cravings that can be quite severe, making it much more difficult to avoid the sugary junk.  Candida also causes bloating, brain fog, fatigue, and hormonal imbalances

10.  Inflammation.  If there are too many inflammatory chemicals circulating in the blood stream, these directly cause problems with insulin and cortisol, resulting in weight gain.  Insulin and cortisol can contribute to more inflammation - so a cycle is created where all things being equal, your body wants to store more fat.  

Solutions are available!

As you can see, the "calories in vs calories out" equation is not the whole story.  A medical weight loss program that addresses ALL of these issues is much more likely to result in successful longterm weight loss.  If you have been struggling with your weight, please know that there are good options and that we can help!  Please click here for more information on our Optimal Wellness Program

Bioidentical progesterone restores sleep

This study looked at insomnia in menopausal women and found that different types of progesterone replacement had different effects.

Twenty-one postmenopausal women were studied. They were randomized to receive estrogen plus synthetic medroxyprogesterone acetate or estrogen plus bioidentical progesterone.

Sleep efficiency was found to be significantly improved in the progesterone group with no such increase observed in the medroxyprogesterone acetate group. Time spent awake after sleep onset was also significantly improved in the progesterone group but not in the medroxyprogesterone acetate group.

CONCLUSION: This study suggests that bioidentical progesterone might better improve the quality of sleep in postmenopausal women taking estrogen.

OUR COMMENT: We regularly see women complaining of poor sleep during perimenopause and menopause. Chronic sleep deprivation may contribute to weight gain, insulin resistance, mood problems, cognitive function and daytime fatigue. Restoring healthy sleep can make a profound difference in a woman's quality of life.

Menopause. 2001 Jan-Feb;8(1):10-6.
Sleep in menopause: differential effects of two forms of hormone replacement therapy.
Montplaisir J, Lorrain J, Denesle R, Petit D.