CBD Oil For Hashimoto’s

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CBD oil has shown promise in treating Hashimoto's thyroiditis. Learn how this compound may improve thyroid and immune function. Hashimoto's disease, also known as chronic lymphocytic thyroiditis, is an inflammation of the thyroid that causes the gland to stop producing hormones.

5 reasons to Consider CBD oil for Hashimoto’s: Benefits, Safety & More

Can CBD oil (or CBD in other forms) help treat the autoimmune condition Hashimoto’s thyroiditis?

When you start to see places lik e Harvard (1) talking about the benefits of CBD oil you know there may be something to this compound.

This over the counter therapy may be considered in certain thyroid patients, especially those with Hashimoto’s who haven’t found success with more conventional treatments.

In this article, you are going to learn about CBD, how it may influence Hashimoto’s, and 5 reasons you may want to consider using it.

Can CBD Oil Help Treat Hashimoto’s?

CBD, which stands for cannabidiol, is one of many cannabinoids found inside of marijuana.

What are cannabinoids?

Cannabinoids are the compounds which interact with certain receptors inside of your body.

You’re probably familiar with the high that marijuana can cause and this is caused by one of these cannabinoids (known as THC (2)).

Not all cannabinoids, however, cause a “high” and some even exert action on other tissues in your body. The activation of these tissues may lead to the powerful health benefits of CBD.

While marijuana does contain CBD, it’s important to realize that CBD is not the same thing as marijuana (even though marijuana seems to have some positive benefit on thyroid function (3)).

Some people are afraid that taking CBD is the same thing as marijuana and this is NOT the case.

It’s been shown, in an increasing number of studies (4), that some of these cannabinoids may act on certain cells in your body by influencing specific endocannabinoid receptors.

These receptors control and regulate incredibly important tissues including the following:

  • The limbic system (the system that controls pleasure)
  • The hypothalamus (the portion of your brain that helps regulate thyroid, metabolism, and appetite)
  • The gastrointestinal tract (which influences many systems in your body including appetite, metabolism, and weight)
  • Adipose tissue or fat tissue (your fat cells are a rich source of hormones such as leptin which feedback to your brain and other systems)

Can you see now why so many people are interested in CBD?

CBD, acting on cannabinoid receptors, may interact with these organs and tissues and to influence your hormones, immune system, appetite, and weight.

What’s important here, at least for our discussion, is that CBD is a legal supplement and can be purchased over the counter in almost every State.

This provides you, as the patient, with the power and a potential therapy which can influence these important systems.

And this is why I’m interested in CBD oil, especially as a treatment for thyroid diseases such as Hashimoto’s t hyroiditis.

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Potential Benefits of CBD Oil

We know that CBD is powerful but how does CBD help your thyroid?

The benefits of CBD in this setting probably (we don’t know for sure) stem from its ability to impact your immune system, your thyroid directly, and your hypothalamus.

Let’s break each of these down in more detail:

How does CBD affect your immune system?

This is not well understood but it appears that CBD reduces inflammation by increasing levels of IL-10 while simultaneously decreasing pro-inflammatory cytokines such as IL-2, IL-3, INF-y, and TNF-alpha.

You don’t really need to understand the specifics here but what you do need to know is that there is a tug-of-war occurring in your body between pro-inflammatory cytokines and anti-inflammatory cytokines.

If you have Hashimoto’s thyroiditis (or any other autoimmune disease), your body is losing the war.

CBD oil may help ‘even the odds’ by promoting an increase in the cytokines that you want while decreasing those that cause harm.

This effect is probably why certain people with Hashimoto’s see improvement and why other patients with autoimmune conditions do as well.

In addition, CBD may have a direct effect on the production of thyroid hormone (5) by stimulating your thyroid gland directly.

The impact CBD has on the thyroid gland is somewhat confusing, to say the least.

Studies show that CBD can reduce the amount of T4 and T3 that the thyroid gland produces while also reducing the TSH (6).

In addition, these same studies show that CBD seems to have a protective effect against the production of anti-thyroid antibodies.

To summarize, CBD seems to impact all levels of thyroid function including TSH, free thyroid hormones, and thyroid antibody levels.

But how can something which decreases your free thyroid hormone levels be “good”?

My feeling is that it probably impact cellular sensitivity in some way which makes the amount of thyroid hormone in your body more effective.

This might reduce the amount of free thyroid hormone necessary in your bloodstream which would in turn cause a reduction in TSH.

This is just speculation, however, and I will be keeping an eye on the research as it unfolds.

Lastly, CBD also probably impacts your thyroid gland indirectly by influencing your hypothalamic function.

Your hypothalamus is a major regulator of metabolism and, therefore, T3 levels in the body.

Anything which stimulates or regulates the hypothalamus will necessarily have at least some impact on your thyroid gland.

In our case, this stimulation is a positive thing as it may help promote T3 production directly and conversion of T3 from T4.

It may also have an impact on leptin sensitivity and leptin levels which also indirectly impact T3.

While we don’t have all of the details, we do have enough information to suggest that CBD may be helpful for some thyroid patients presumably from the three areas listed above.

Looking at these areas may be enough to make you consider using CBD but there are still some other important points you should be aware of as well.

With that in mind, take a look at 5 reasons that I believe you should consider using CBD oil if you have Hashimoto’s or hypothyroidism:

#1. Safety Profile

Just because a therapy is considered to be “effective” doesn’t mean that it should be used.

We have plenty of therapies in medicine which have been shown to be effective but which cause negative side effects or consequences.

On the flip side, we have plenty of therapies which can POTENTIALLY help people with Hashimoto’s which are very safe but not very effective.

What we really want is something that is shown to be both VERY effective and yet VERY safe.

How safe a medication or therapy is, is referred to as its safety profile.

And whenever you, as a patient, consider any therapy you should always ask yourself about the safety profile of that thing.

CBD, as a therapy, has a strong safety pr ofile (7).

Meaning, it is considered to be a safe therapy.

The most commonly reported symptoms associated with using CBD include nausea, fatigue, diarrhea, and changes in weight or appetite.

*Note: CBD oil can also impact some prescription medications such as coumadin.

You can get these kinds of side effects from certain healthy foods!

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Does this mean CBD is safe and that all people will tolerate it well?

Not necessarily, but it does mean that your risk of developing some serious issues as a result of using it is very low to non-existent.

While it’s important to understand the safety profile of certain medications and supplements, you should also consider the inherent bias that exists between over the counter supplements and medications.

Certain prescription medications, for instance, are notoriously dangerous but this danger is tolerated simply due to the bias that exists in the system.

Take statins, as an example:

We know that people who take statins have an increased risk of developing muscl e damage (8) (1 in 24) and even diabe tes mellitus (9) (1 in 204) and yet statins are prescribed like candy by most conventional doctors.

You might think the benefits of these medications are enough to outweigh the risks but there is enough information to put e ven that into question (10).

Can you imagine if an over the counter supplement was known to increase the risk of diabetes even if it was at a rate of 1 in 10,000?

It would no doubt be all over the news and it would ripped off the market by the FDA.

Why do I bring this up?

Because as a patient, you need to be aware of this bias so that you don’t get confused by sensational headlines that you might see regarding CBD (or other supplements) in the news cycle.

Stay grounded and take a look at what the studies show before you make a decision regarding what to take (or not).

#2. Additional Benefits Beyond Hashimoto’s

I think another reason to consider using CBD oil would be that it impacts more than just one system in your body.

This is true of MOST over the counter supplements, by the way, but is not necessarily true of prescription medications.

Over the counter supplements and herbal remedies tend to impact multiple systems because they are less specific than prescription medications.

Medications are created to impact very specific enzymes or receptors and may not impact ANY other cellular components.

This makes them potentially efficacious but also very narrow in terms of how they help.

You can think of supplements as being less specific and more broad in how they impact your cells.

The result is that you can take a supplement and experience multiple sets of positive effects.

CBD oil seems to fit into the former category probably because there are receptors on multiple cells.

The result is that CBD oil can potentially help you in many other ways aside from just impacting your immune system.

Additional benefits may include:

    (11) (very important as many thyroid patients also suffer from anxiety) (12) (many thyroid patients suffer from insomnia) (13) (many thyroid patients suffer from chronic pain) (14) (inflammation may reduce T4 to T3 conversion and impact your thyroid)

If you have any of the symptoms listed above then there might be a stronger case for you to at least trial CBD oil.

#3. Another Therapy for Hashimoto’s

As a patient with Hashimoto’s, you are probably all too familiar with the current treatment paradigm (or lack thereof).

The standard treatment for Hashimoto’s is really just a ‘wait and see’ approach in which your doctor typically waits until your body destroys enough of itself that you require some form of therapy (usually thyroid medication).

As a patient, this can be troubling to hear.

The good news is that there are several therapies which are available to Hashimoto’s patients who don’t want to take the ‘wait and see’ approach.

The only problem with some of these therapies is that they are not always effective and the results that each patient may obtain varies.

Changing your diet, reducing yo ur stress, taking supplements, and so on are all helpful therapies, but they do not guarantee that you will be able to treat or reverse your condition.

So whenever I see a therapy which can potentially help treat Hashimoto’s I get a little bit excited.

And, as a patient, you should be aware of all of these therapies, not because you necessarily want to use them all right away, so that you can come back to them at a later date.

Even if you don’t plan on using CBD, for whatever reason, at least put it in the back of your brain as a potential option to come back to later.

#4. Availability over the counter

Another big reason is how easy it is to get!

I constantly hear of the frustrations that patients feel regarding obtaining prescription thyroid medication.

In many cases, patients may know more about thyroid medications than your doctor (you probably fit into this category if you are reading this) and yet they are not able to get the thing that they need.

Because something stands in their way. The prescription pad from the doctor.

It doesn’t matter what you know if your doctor isn’t willing to provide you with a prescription.

You don’t have this problem with certain supplements and it doesn’t exist with CBD.

CBD is currently (and for the foreseeable future) available over the counter and can be purchased easily.

Even though you can get it without a prescription from a doctor I still recommend that you discuss what you are taking with your doctor!

It’s important to have an open dialogue with your doctor to ensure that you are not doing anything which would negatively influence your other therapies.

If your doctor is not willing to work with you on this then you may need to seek a second opinion (use this r esource to help you find one).

#5. Patient Success Stories

Some people tend to rely more on clinical studies to support how they treat themselves while others tend to focus on the results of others.

I really think that there is value in both and I tend to look at both sides of the story before recommending therapies to patients.

Clinical studies, while necessary and very helpful, don’t always tell the full story.

The results can be skewed or interpreted in virtually any way that suites the bias of the author of the study.

In addition, we don’t always get to see the results of studies which were not published.

If a study doesn’t show the results that the author was looking for he/she doesn’t have to publish it.

It’s possible for the same study to be run 3-4x until it finally produces the results that the author is looking for (we see something similar happen with some phal medications (15)).

Lastly, just because a study shows that something is effective doesn’t mean it translates into clinical practice!

I’ve been very excited about several therapies when I read about them in studies only to find out that they simply are not nearly as effective as I thought they would be in the real world.

Patient success stories, on the other hand, tend to come from a different place.

They lack the controls that clinical studies have but they still have value as a “proof of concept”.

Do we see that CBD oil has been used successfully in patients with Hashimoto’s and thyroid disease?

The answer is yes.

We see positive success stories in those who have taken it and they have shared their results.

If you are someone who fits into this category I would encourage you to leave your comments or experiences below as it may help those who are on the fence.

Should you try it?

While CBD shows promise and may be something worth considering, just because it has the potential to be effective doesn’t necessarily mean you should take it.

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One of the downsides to CBD and I see this same thing in many other supplements and therapies, is that while it may work to improve your thyroid function, it’s not necessarily working by reversing the issues which are causing your conditions to begin with.

If you are pounding down refined sugar, eating out on a regular basis, and suffering from serious stress from work or other aspects of your life, then CBD is probably not going to solve those issues.

But, if you’ve tried all of the natural therapies that I’ve listed above and have found some improvement, but not a complete improvement, then CBD may be a good idea in that situation.

It might also be a good idea to use if you have Hashimoto’s triggered by something which is not necessarily treatable or reversible.

If an acutely stressful event triggered your Hashimoto’s then it’s not really possible to go back in time to prevent it from occurring.

If this is the case for you, then CBD may be an option worth considering.

Like other thyroid therapies, there isn’t a one-size-fits-all approach that you can or should take.

Instead, make sure you weigh the potential benefits against the potential side effects and determine if it is right for YOU.

Update: I’ve been experimenting with this CBD product which I have used both personally, on my family, and I have seen the third party verification of THC/CBD ratios.

If you choose to use CBD ensure that you are getting a quality product if you want to see results!

I’m coming to understand that there are MANY cheap products available which do NOT contain what they claim (in a somewhat unregulated supplement industry).

So if you try one of these brands and do not see results do not blame the CBD! Instead, it’s probably more related to the low quality of the product.

For now, with this CBD product that I have had success with and continue to both use and recommend.

Conclusion

CBD oil shows promise as an emerging treatment for those with thyroid disease and especially Hashimoto’s thyroiditis.

It’s not clear exactly how or why CBD oil is effective but it probably has to do with how it impacts your thyroid gland directly and other systems, such as the hypothalamus, indirectly.

The net result may be an improvement in both direct thyroid symptoms and indirect symptoms such as anxiety, pain, and insomnia.

As a thyroid patient, it may be worth exploring this therapy especially given its excellent safety profile and relatively cheap cost.

CBD oil is available over the counter and can be purchased online, making it an ideal complementary therapy to whatever you are currently doing to treat your Hashimoto’s.

CBD Oil for Hashimoto’s Disease – September 2022

Why People Are Turning to CBD for Hashimoto’s Disease

Hashimoto’s disease , also called chronic lymphocytic thyroiditis , is an autoimmune condition where the thyroid gland fails to function correctly (7) . The disorder causes a person’s immune system to attack the thyroid ( autoimmunity ), damaging it to the point where it stops producing hormones.

The disease involves inflammation of the thyroid gland and is the most common cause of hypothyroidism ( underactive thyroid ) in the United States (8) .

In some cases of Hashimoto’s disease , the inflammation can cause the thyroid gland to be enlarged ( goiter ), causing neck discomfort. One way to diagnose the disease is through blood test results that measure thyroid-stimulating hormone ( TSH ) and thyroid hormones (FT4 and T4).

Hashimoto’s disease occurs more often in women. However, it is seen at any age and may develop in men and children (9) .

The most common signs of Hashimoto’s disease include fatigue, constipation, joint pain , pale skin, puffy face, weight gain , dry skin , hair loss , and increased sensitivity to cold.

A person with the condition may not notice its symptoms at first, as the disease typically progresses slowly over the years (10) .

Researchers are unsure of what causes some individuals to develop thyroid problems , like Hashimoto’s disease .

The conventional treatment for Hashimoto’s disease is a dose of levothyroxine ( Synthroid ) (11) . This thyroid medication is a manufactured form of a specific hormone used to treat the deficiency caused by the condition – and is usually prescribed for life.

Taking an excessive amount of the drug can lead to harmful effects, such as irregular heartbeats and osteoporosis. However, you and your doctor will titrate the medicine appropriately. You should not stop taking it or adjust this medicine without talking to your doctor first.

Meanwhile, cannabidiol ( CBD ) may theoretically offer a supplementary solution to treating people with Hashimoto’s disease .

CBD is one of many compounds obtained from cannabis plants that do not cause mind-altering effects upon consumption. Researchers believe that cannabinoids, like CBD , have anti-inflammatory properties.

A 2010 review published by the journal Future Medicinal Chemistry found that daily cannabidiol intake inhibited disease progression in mice (12) .

The authors learned that the CBD -treated subjects showed decreased pro-inflammatory cytokines or molecules that cause inflammatory reactions.

Cytokines have been implicated in the development of thyroid diseases , such as Hashimoto’s thyroiditis .

Authors of a 2011 study learned that cytokines play an essential role in the pathogenesis of autoimmune disorders of the thyroid. They also discovered that modulating cytokine responses may help treat autoimmune diseases (13) .

A study in 2020 mentioned that cannabinoids, like CBD , may suppress immune activation and production of inflammatory cytokines. This action suggests that the cannabis compound may have the potential to reduce excessive inflammation in the body (14) .

Another study revealed that cannabidiol is involved in controlling inflammatory response and expression through various bodily receptors. The authors of the study reported that CBD administration in an animal model could inhibit cytokine response (15) .

CBD has been shown to reduce substances that cause inflammation. It may theoretically be used as a therapeutic agent to alleviate the symptoms of thyroid disorders , like Hashimoto’s disease .

However, studies on cannabidiol and thyroid health conditions are yet non-existent. No clinical trials exist to prove that CBD can effectively treat the symptoms of Hashimoto’s disease and other thyroid issues .

How CBD Oil May Work to Help with Hashimoto’s Disease

A study published in 2017 mentioned that specific receptors in the human body could affect cytokine production (16) . The CB1 and CB2 receptors, which are primarily used by the endocannabinoid system (ECS), are said to modulate signaling that influences cytokines.

The ECS regulates various bodily functions, one of which is inflammation (17) . Researchers learned that CB1 and CB2 cannabinoid receptors are involved in managing inflammation-causing cytokines (18) .

Cannabidiol reportedly binds to these ECS structures, particularly with the CB2 receptor, which may explain its anti-inflammatory properties (19) .

Besides CB1 and CB2 receptor activation, the compound may also have other actions that may reduce inflammation.

Meanwhile, researchers of a 2015 study analyzed the endocannabinoid system ‘s role in thyroid tumors and found that its receptors are associated with tumor malignancy (20) .

They learned that CB1 and CB2 receptors influenced thyroid tumors and hypothesized that both could be targets for future therapies.

Another study also implicated the CB1 receptors of the ECS in the control of thyroid hormone output (21) .

Thyroid hormones help regulate body temperature, among many other important metabolic functions, by increasing the available energy in the body.

Since CBD is said to stimulate both CB1 and CB2 receptors, there is a possibility that the compound may be used to influence thyroid conditions through this action.

However, more clinical data on human subjects is needed to confirm CBD ‘s efficacy for thyroid disorders .

The Pros and Cons of CBD Oil for Hashimoto’s Disease

The Pros
  • Using CBD may theoretically help people with Hashimoto’s disease . Studies revealed that CBD might have anti-inflammatory properties, which the compound expresses through its interaction with receptors in the body.
  • Unlike THC ( tetrahydrocannabinol ), the psychoactive compound of cannabis, CBD does not cause mind-altering effects upon consumption.
  • Individuals can purchase and use CBD in most areas in the United States. In places where CBD is sold legally, users can buy CBD products even if they do not have a prescription from a doctor.
  • The U.S. Food and Drug Administration (FDA) recognizes the potential health benefits of cannabis constituents, such as CBD (22) .
  • The World Health Organization (WHO) claims that CBD is well-tolerated in humans, according to several controlled and open-label trials (23) . Subjects were reported to have not developed substance dependence with the use of CBD .
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The Cons
    • There is a significant lack of human studies on CBD ‘s efficacy for Hashimoto’s disease , making it difficult to determine its effectiveness, if any, in treating the condition.
    • Epidiolex, a drug used to treat two rare forms of epilepsy, is the only CBD product approved by the FDA. The agency has not yet allowed any other CBD marketing application for the treatment of a specific disease or condition (24) .
    • A review in 2017 assessed the safety and possible side effects of CBD use. Although it has a favorable safety profile, CBD can still cause interactions with other prescription medications that can lead to adverse reactions (25) .
    • Many CBD products , particularly items sold online and in some physical dispensaries, are prone to mislabeling (26) . Users who buy CBD from these channels are at risk of consuming more or less of the compound than expected.

    How CBD Oil Compares to Alternative Treatments for Hashimoto’s Disease

    Multi-disciplinary diets may help improve the quality of life and thyroid function of patients with Hashimoto’s thyroiditis (27) .

    According to a study that evaluated the various diets for the condition, consuming vegetables, fruits, and animal foods rich in zinc are recommended by experts (28) .

    Eating vegetables several times a day is advised because they contain phytosterols, which are compounds present in plants that have shown anti-inflammatory activity.

    However, raw cruciferous vegetables, like cabbage, should only be eaten once a week as these can interfere with thyroid hormone production .

    The consumption of fruits at least once a day is also suggested as these are abundant in polyphenols, which have anti-inflammatory and antioxidant properties (29) .

    Eating animal-based foods that are high in zinc, such as meats and eggs, are recommended several times a week. According to a report, zinc deficiency could be linked to hypothyroid (30) .

    Meanwhile, iodine supplements are not advised for patients with Hashimoto’s disease . People with abnormal thyroid glands risk exacerbating their condition if they take too much iodine (31) .

    Cannabidiol is believed to have anti-inflammatory properties that could contribute to alleviating thyroid disorder symptoms. CBD products are often promoted as an alternative to combat inflammation.

    Meanwhile, CBD capsules containing zinc are sold by some brands. These CBD products are often advertised as useful in maintaining a healthy lifestyle.

    How to Choose the Right CBD for Hashimoto’s Disease

    There are currently three types of CBD sold today: full-spectrum, broad-spectrum, and CBD isolates.

    The most popular of the three is the full-spectrum CBD . This variant contains all of the phytocannabinoids present in Cannabis sativa plants.

    CBD oil labeled as full-spectrum has flavonoids, terpenes, THC , and other minerals. The ideal full-spectrum CBD oil has high amounts of cannabidiol while containing small amounts of other compounds.

    Broad-spectrum CBD is the next type of cannabidiol product. This variant has the same compounds as that of full-spectrum except for the THC content.

    Since THC is psychoactive and often associated with medical marijuana , some individuals prefer to buy broad-spectrum CBD because it does not have the psychoactive compound.

    The third variety of CBD is called isolates. CBD isolates are usually sold in crystalline or powdered form.

    People looking to purchase pure CBD often decide to get CBD isolates. CBD products containing only pure cannabidiol do not have a distinct smell or taste.

    Whichever type of CBD a person chooses, it is vital to select the best quality product available to maximize its health benefits.

    Follow these tips to choose only the best CBD oil for Hashimoto’s disease :

    • Get a certificate of analysis (COA) or the laboratory report of the CBD product chosen. This document is essential since it indicates that the product has undergone proper testing and contains exactly the specifications mentioned on the label.
    • Read product and shop reviews if purchasing from an online CBD store. If deciding to buy from a physical dispensary, check if the establishment has the proper authorization to sell cannabidiol products.
    • Buy organic CBD obtained from hemp plants. Industrial hemp is the most dependable source for high-quality cannabidiol .
    • Ensure that the legalities involving CBD are followed in the state where one plans to buy and use it.
    • Talk to a health care expert, preferably someone experienced in using medical cannabis, before buying any CBD product .

    CBD Dosage for Hashimoto’s Disease

    The FDA has not approved a CBD product for treating patients with Hashimoto’s disease . Therefore, no official guidelines are available on the proper dosage of CBD for the condition.

    However, some users believe that a few factors need to be considered in determining the right dose of CBD .

    A person’s body weight and the amount of CBD content in each product are two of the most commonly cited factors.

    How to Take CBD Oil for Hashimoto’s Disease

    Taking CBD oil in the form of edibles or capsules is the most straightforward way of consuming CBD . For beginners, CBD gummies , brownies, and tablets are recommended.

    CBD tinctures that allow users to apply CBD oil under the tongue is suitable for those who want to control the amount of CBD they take.

    Meanwhile, CBD , in the form of topicals, like balms, creams, and salves, may be used in massage therapies for relaxation and well-being .

    Other Types of Thyroid Disorders

    The following are the other common disorders associated with inflammation of the thyroid.

    Hyperthyroidism

    People with hyperthyroidism experience an overactive thyroid wherein the gland produces hormones in excess.

    Grave’s disease is a common cause of this disorder. Excessive thyroid hormone levels can lead to symptoms, such as nervousness, irritability, fast heart rate , muscle weakness , and weight loss .

    Grave’s Disease

    Grave’s disease is another endocrine system disorder that happens when the body’s immune system attacks the thyroid gland by mistake. As a result, a body part produces excess thyroid antibodies .

    Patients with Grave’s disease often have enlarged thyroid glands , high blood pressure , and increased metabolism.

    Conclusion

    CBD has yet to be shown as a potential therapeutic agent in reducing inflammation prevalent in Hashimoto’s disease . There is some evidence, however, related to CBD and general inflammation which may or may not apply to the auto-immune process involved in Hashimoto’s disease.

    Several studies have revealed that cannabidiol might suppress immune activation and the production of pro-inflammatory molecules.

    Researchers believe that CBD activates certain cannabinoid receptors in the body to exert its anti-inflammatory effects. The CB2 receptor of the endocannabinoid system was especially mentioned.

    Although CBD is said to have a favorable safety profile, there is a significant lack of clinical trials on CBD and its efficacy in treating Hashimoto’s thyroiditis .

    Users should consult a doctor, particularly one who is experienced in cannabis products, before purchasing any CBD product for their condition.

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