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CBP City of New York Employee and Retirees
Getting More Information
Within the U.S.
877.534.3682 (toll free)
Every day, 24 hours a day
Outside the U.S.
877.534.3682 (ext. 37-8710)
Every day, 24 hours a day
(Express Scripts Specialty Pharmacy)
866.848.9807 (toll free)
Weekdays, 8 a.m. to 9 p.m.
Saturday, 9 a.m. to 1 p.m.
Welcome to Express Scripts
HOW TO GET THE MOST FROM YOUR PRESCRIPTION-DRUG Benefit
Your New Prescription-Drug Benefit
© 2010 Express Scripts, Inc. All Rights Reserved 10-2199
Welcome to Express Scripts, the company chosen by Group Health, Inc. to manage
your prescription drug benefit.
•Your plan’s preferred medications............................................................ 3
•Two ways to fill your prescriptions............................................................ 3
•Your personal health and prescription information....................................8
If you have Internet access, you can take advantage of Express Scripts’ website. Register
today at www.express-scripts.com to:
• Check your combined medical and prescription deductible and out-of-pocket maximums.
Order refills of your Home Delivery prescriptions.
• Track the status of your Home Delivery prescriptions.
• Check prescription pricing and coverage.
• Locate a participating retail pharmacy and print claim forms.
• Request Home Delivery order forms and envelopes.
• Obtain health information and much more.
Important telephone numbers
You can reach Express Scripts at the numbers below. All services listed are available at any
time, day or night, 365 days a year.
Member Services 877.534.3682.
Call Express Scripts to:
• Ask questions about your prescription drug benefit.
• Request Home Delivery order forms or envelopes.
• Find the nearest participating retail pharmacy.
• Request claim forms for prescriptions filled at non-participating pharmacies.
• Speak with a Member Services representative.
• Speak with a registered pharmacist.
To refill prescriptions, call 800.227.8338.
Your doctor may fax your prescriptions to the Group Health Express Scripts Pharmacy fax line
at 800.213.3032. To access TTY service for hearing-impaired members, call 800.899.2114.
Getting Started with Express Scripts
At Express Scripts, the company chosen by Group Health to manage your
prescription-drug benefit, we’re ready to serve you.
You should have already received your member ID card. You’ll need your card
when you have a prescription filled at a participating pharmacy or order your
Your plan’s preferred medications
Your plan includes a list of prescription drugs that are “preferred” because they help to
keep prescription drug costs down. This Preferred Drug List, drugs covered under your plan,
contains a wide selection of generic and brand medications. You can access the Preferred
Drug List at www.express-scripts.com, or by calling Express Scripts at 877.534.3682.
Coverage for Over-the-Counter (OTC) medications
• A list of the most commonly prescribed prescription products with over-the-counter
equivalents can be found at www.express-scripts.com or call Express Scripts at
Brand-name medications for certain disease states will require Step Therapy. Examples
of a few of these disease states are asthma/ allergies, depression and high cholesterol.
Medications for disease states such as these will only be covered in situations where a
lower-cost alternative medication has not been effective. To determine if your medication
requires Step Therapy, or is subject to limitations, please call Express Scripts at
877.534.3682. Before the Plan will pay for the medication, it requires you to try an equally
effective but lower-cost generic prior to filling the brand-name medication.
Your personal health and prescription
To provide you with pharmacy services and administer your prescription benefits,
Express Scripts may require personal health and prescription drug information from
you, your doctor or your retail pharmacy. We use this information to verify your identity
and pricing under the program, to check for adverse drug interactions, to process your
prescription order, and to keep you informed about the proper use of your medications,
available treatment and benefit options.
Under the terms of our contract with GHI, Express Scripts is required to provide to GHI
individual pharmacy claims data for payment processing and record-keeping without
identifying individual members. As part of the contract, Express Scripts is obligated to
report any unusual activity that may constitute fraud or abuse of benefits.
GHI and Express Scripts also may use information and prescription data gathered
from claims submitted for reporting and analysis purposes without identifying
If you have a discontinuance or lapse in therapy greater than 130 days while using the
brand-name medication and need to restart therapy, you will be subject to another review
under the Step Therapy program to determine if the cost of the brand-name medication will
be covered under the Plan.
Two ways to fill your prescriptions
You have two ways to fill your prescriptions: either at a participating retail pharmacy or
through Home Delivery from the Express Scripts Pharmacy.
Note regarding controlled substances: Kentucky and Hawaii state laws require you to provide
your Social Security number to the pharmacy before it can dispense your medications. This
applies to prescriptions filled at retail and through Home Delivery .
1. Short-term medication needs
Filling your prescriptions at a participating retail pharmacy
The retail pharmacy is your most convenient option when filling a prescription that you need
immediately (example: antibiotics for strep throat or pain relievers for an injury). Simply
present your Express Scripts member ID card and written prescription to your pharmacist
and pay the required amount as shown on page 3.
You can locate the nearest participating retail pharmacy at any time online at
www.express-scripts.com or by calling Express Scripts at 877.534.3682.
Submitting a prescription by fax
1. Ask your doctor to write a prescription for up to a 60-day supply of your medication,
plus refills for up to one year, if appropriate.
2. Complete a Home Delivery order form. You can print an order form from the
Express Scripts website at www.express-scripts.com.
3. Have your doctor or a member of your doctor’s staff fax your order form to
Express Scripts at 1.800.636.9494. Faxes must be sent from your doctor’s office.
Faxes from other locations, such as your home or workplace, won’t be accepted.
Your prescription drug will be mailed to your home via standard U.S. Postal Service delivery
within ten to fifteen business days from the day we receive the prescription. If you request
overnight delivery, you’ll be responsible for the cost. Availability of and cost for overnight
delivery vary based on location.
CuraScript®,the Express Scripts Specialty
CuraScript, the Express Scripts Specialty Pharmacy, is a full service specialty pharmacy
that provides personalized care to individuals with chronic, complex health conditions.
CuraScript offers several comprehensive patient care management programs specific
to major medical conditions such as cancer, hemophilia, hepatitis, multiple sclerosis,
psoriasis, pulmonary arterial hypertension, respiratory syncytial virus, rheumatoid arthritis,
and more. Through the patient care management programs you can receive a complete
range of services and specialty medications — many of which are costly and often
unavailable at retail pharmacies.
2. Long-term medication needs
• Patient Counseling — Convenient access to highly trained specialty experts, including
pharmacists, nurses and patient care coordinators who provide the support you need to
manage your condition
• Patient Education — Disease specific educational materials and clinicians available
• Convenient Delivery — Coordinated delivery to your home, your doctor’s office or any
other approved location
• Refill Reminders — Ongoing refill reminders from a patient care coordinator
• Language Assistance — Language translation services are provided for non-English
To learn more, please call 866.848.9870.
Filling your prescriptions through Home Delivery from the Express Scripts Pharmacy Home
Delivery is your best option for buying the prescription drugs you take on a regular basis.
NOTE: CuraScript®, the Express Scripts Specialty Pharmacy, dispenses specialty medications
through the mail. Medications obtained through CuraScript are limited to a 30-day supply.
For more information, please refer to page 10 in this handbook.
Using an out-of-network pharmacy
If you use a non-participating pharmacy, you must pay the full cost of your prescription at
the point of sale and then file a claim form with GHI to request benefits. After you meet the
deductible(s), GHI will reimburse you for covered prescriptions at the amount that GHI would
have paid to a GHI participating pharmacy for the prescription, less the applicable copay or
coinsurance. You are responsible to pay any difference between GHI’s payment and the cost
of your prescription. You may contact Express Scripts Member Services at 1.877.534.3682, to
obtain info on where to submit claims and to obtain a claim form.
Filing a claim
Claims must be submitted within 365 days of the date the prescription was filled. Claim
forms are located online at www.express-scripts.com and can be requested by calling your
Group Health Member Services team at 877.534.3682.
Home Delivery from the Express Scripts
After getting the same prescription filled two times at a retail pharmacy, it’ll be more cost
effective for you to refill that prescription through Home Delivery. However, if you continue to
refill that prescription at your retail pharmacy, you’ll pay 100% of the cost.
Getting started with Home Delivery from the
Express Scripts Pharmacy
If you’re planning to use Home Delivery, ask your doctor for two prescriptions: one for up to a
30-day supply that you can fill immediately at your local pharmacy and another for a 60-day
supply, plus refills for up to one year, if appropriate. A Home Delivery order form is included
in your member ID card packet.
You also can get a Home Delivery order form at any time online at www.express-scripts.com
or by calling Express Scripts at 877.534.3682.
Submitting a prescription by mail
1. If appropriate, ask your doctor to write a prescription for up to a 60-day supply of your
medication, plus refills for up to one year.
Benefits of Home Delivery
• Buy up to a 60-day supply of your medications for less than you’d pay at your
• Prescriptions are delivered directly to your home in a plain, weather-resistant pouch
for privacy and protection; standard shipping is free. You can request to have your
prescriptions sent by overnight delivery. You’ll be responsible for the cost. Availability of
and cost for overnight delivery vary based on location.
NOTE: If overnight delivery is requested, prescriptions are not filled and sent the same day
as received. Please allow 3-5 business days for processing.
• Speak with a pharmacist Monday through Friday between 8 a.m. and 11 p.m. Eastern
time. After hours and on weekends, a pharmacist will be paged and your call will be
returned within one hour.
• Once you begin using Home Delivery, you can order refills by telephone or online at
2. Complete a Home Delivery order form. You can print an order form from the Express
Scripts website at www.express-scripts.com.
3. Insert your completed order form, your written prescription, and payment into an
envelope and mail it to Express Scripts:
Home Delivery Program
P.O. Box 510
Bensalem, PA 19020-0510
Note: To help avoid delays, be sure to include payment with your order.
You can find out the price of the prescriptions by visiting the Express Scripts website at
www.express-scripts.com or by calling Express Scripts at 877.534.3682.

domain: health


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Are you considering using Anavar to enhance your physique? If so, you may be wondering how much muscle you can realistically gain on this steroid. Anavar, also known as Oxandrolone, is a popular choice for those looking to improve their body composition and strength. While it’s not as powerful as some other steroids, it’s known for producing quality gains without the same level of side effects.
So, how much can you gain on Anavar? The answer to this question depends on several factors, including your diet, training regimen, and genetics. According to Inside Bodybuilding, Anavar can help you gain anywhere from 5 to 20 pounds of muscle mass during a cycle. However, it’s important to note that this is a rough estimate and individual results may vary. Additionally, it’s crucial to maintain a proper diet and exercise routine to maximize your gains and minimize any potential side effects.
If you’re looking to gain muscle and lose fat, you may have heard of Anavar, also known as Oxandrolone. Anavar is an anabolic steroid that is often used by bodybuilders and athletes to help increase muscle mass and strength. Anabolic steroids are synthetic versions of the hormone testosterone, which is responsible for the development of male sexual characteristics. Anabolic steroids are used to help build muscle mass and increase strength, but they can also have serious side effects if not used properly.
Anavar is a mild anabolic steroid that is often used by beginners and intermediates. It is known for its ability to help burn fat while preserving muscle mass. Anavar is also used by athletes to help improve their performance, as it can increase strength and endurance.
Anavar is available in both oral and injectable forms, but the oral form is more commonly used. Anavar is generally taken in cycles, with a typical cycle lasting 6-8 weeks. The dosage of Anavar can vary depending on your goals and experience level, but it is generally recommended to start with a low dosage and gradually increase it over time.
It is important to note that Anavar is a controlled substance and is illegal to use without a prescription. Anavar can also have serious side effects if not used properly, including liver damage, high blood pressure, and increased risk of heart attack or stroke. Overall, Anavar can be an effective tool for gaining muscle and losing fat, but it should be used with caution and under the guidance of a healthcare professional.
Anavar for Men vs Women
Anavar is a popular steroid among both men and women due to its mild nature and effectiveness in building muscle and burning fat. However, the dosage and results can differ between the genders.
Anavar Dosage for Men
For men, the recommended Anavar dosage ranges from 50mg to 80mg per day. However, some experienced users may take up to 100mg per day. It is important to note that taking higher doses can increase the risk of side effects.
Anavar Dosage for Women
Women, on the other hand, should take a lower dosage of Anavar due to their lower endogenous testosterone production. The recommended dosage for women is between 5mg to 20mg per day. Higher doses can lead to virilization, which is the development of masculine characteristics such as deepening of the voice and facial hair growth.
Anavar Results for Men
When used in a bulking cycle, men can expect to gain around 7 pounds of muscle while using Anavar. In a cutting cycle, it can help to preserve muscle mass while burning fat. Anavar is also known for its ability to increase strength and endurance.
Anavar Results for Women
Women may gain more muscle than men due to their lower endogenous testosterone production. Anavar can help women to build lean muscle mass without the risk of developing masculine characteristics. It can also aid in fat loss and improve overall body composition.
Anavar Side Effects for Men and Women
While Anavar is considered a mild steroid, it still carries the risk of side effects. Some common side effects for both men and women include acne, hair loss, and mood changes. Men may also experience testicular atrophy and decreased sperm count, while women may experience menstrual irregularities.
In conclusion, Anavar can be an effective steroid for both men and women when used responsibly. However, it is important to follow the recommended dosage and monitor for any potential side effects.
The Potential Gains with Anavar
If you’re considering using Anavar to enhance your physique, you’re probably wondering how much muscle mass and strength you can gain. The truth is, the amount of gains you can expect to see from Anavar will depend on several factors, including your diet, training regimen, and genetics. However, there are some general guidelines that can help you estimate the potential gains you can expect from an Anavar cycle.
First and foremost, it’s important to note that Anavar is not a bulking steroid. While it can help you gain some muscle mass and strength, it’s not going to give you the same kind of results you would see from a bulking steroid like Dianabol or Anadrol. Instead, Anavar is best used for cutting cycles, where the goal is to preserve lean muscle mass while shedding body fat.
With that said, many users report gaining anywhere from 5 to 15 pounds of lean muscle mass during an 8-12 week Anavar cycle. Keep in mind that this is not all pure muscle, as some of the weight gain will be due to water retention. However, Anavar is known for producing high-quality gains, meaning that the muscle you do gain will be lean and dense.
In addition to muscle gain, Anavar can also help improve your strength, power, endurance, and stamina. This is because it increases the production of red blood cells, which in turn improves oxygen delivery to the muscles. This can help you push harder and longer during your workouts, leading to better performance overall.
To maximize your gains with Anavar, it’s important to follow a proper diet and training regimen. Make sure you’re eating enough protein to support muscle growth, and focus on compound exercises like squats, deadlifts, and bench presses to stimulate muscle growth. Additionally, make sure you’re getting plenty of rest and recovery time, as this is when your muscles actually grow and repair.
Overall, while Anavar may not be the best choice for those looking to bulk up quickly, it can be a great choice for those looking to preserve lean muscle mass while shedding body fat. With the right diet and training regimen, you can expect to see significant gains in both muscle mass and strength during an Anavar cycle.
Side Effects and Safety Concerns
When it comes to using Anavar, it is important to understand the potential side effects and safety concerns that come with using this steroid. While Anavar is considered to be one of the safest anabolic steroids on the market, it is still important to be aware of the risks involved.
One of the most significant concerns when it comes to using Anavar is liver toxicity. Anavar is an oral steroid, which means that it must be processed by the liver. This can cause stress to the liver and potentially lead to liver damage. It is important to monitor liver function while using Anavar and to avoid using it for extended periods of time.
Androgenic Side Effects
Anavar is a mild steroid, but it still has the potential to cause androgenic side effects such as acne, hair loss, and virilization in women. These side effects are generally dose-dependent, meaning that the higher the dose, the greater the risk of experiencing these side effects.
Anavar can also cause testosterone suppression, which can lead to a decrease in libido, erectile dysfunction, and other sexual dysfunction. It is important to use Anavar in conjunction with testosterone replacement therapy to avoid these side effects.
Anavar can also have an impact on cholesterol levels, particularly by lowering HDL (good) cholesterol. This can lead to an increased risk of cardiovascular disease, so it is important to monitor cholesterol levels while using Anavar.
Other Side Effects
Other potential side effects of Anavar include gynecomastia (breast tissue growth in men), clitoral enlargement in women, and changes in mood or behavior. It is important to be aware of these potential side effects and to seek medical attention if they occur.
Overall, Anavar is considered to be a relatively safe steroid when used responsibly. However, it is important to be aware of the potential side effects and to monitor your health while using it. If you experience any negative side effects, it is important to seek medical attention immediately.
Anavar Cycles and Dosage
When it comes to Anavar cycles and dosage, it’s important to understand that the right cycle and dosage for you will depend on your individual needs and goals. Anavar is often used during a cutting phase, as it can help to enhance fat burning while adding some muscle mass when eating fewer calories.
If you’re a beginner or intermediate user, an Anavar-only cycle may be a good option for you. This cycle involves taking Anavar by itself for a period of 6-8 weeks. The recommended dosage for men is 20-30mg per day, while women should take 5-10mg per day.
Anavar and Test Cycle
For those who are more advanced, an Anavar and Test cycle may be a good option. This cycle involves taking Anavar and Testosterone together for a period of 8-12 weeks. The recommended dosage for men is 40-50mg of Anavar per day, along with 500mg of Testosterone per week. Women should take 10-20mg of Anavar per day, along with 50-100mg of Testosterone per week.
Anavar can also be stacked with other steroids to enhance its effects. One popular stack is Anavar, Anadrol, and Testosterone. When taking two oral steroids together, it’s important to reduce each dose by half. For example, if your usual Anavar dose was 60mg and your usual Anadrol dose was 100mg, you’d take 30-40mg of the former and 50mg of the latter.
Dosage and PCT
It’s important to note that taking too much Anavar can lead to negative side effects, such as liver damage, high blood pressure, and acne. Always stick to the recommended dosage and cycle length, and be sure to follow a proper post-cycle therapy (PCT) plan to help your body recover.
In summary, Anavar cycles and dosage will vary depending on your individual needs and goals. An Anavar-only cycle may be a good option for beginners and intermediates, while an Anavar and Test cycle or Anavar stack may be better for more advanced users. Always follow the recommended dosage and cycle length, and be sure to follow a proper PCT plan to help your body recover.
Buying Anavar and Legal Alternatives
If you’re considering using Anavar to gain muscle, you may be wondering how and where to buy it. Anavar is a controlled substance in many countries, including the UK, and can only be obtained with a prescription from a licensed physician and pharmacy in the United States.
However, there are legal alternatives to Anavar available on the market, such as Anvarol by Crazy Bulk. Anvarol is a safe and legal alternative to Anavar that can help you achieve similar results without the side effects. It is made from natural ingredients and is available for purchase online without a prescription.
When it comes to buying Anavar online, it is important to be cautious. There are many websites that claim to sell Anavar, but they may be selling counterfeit products or products that are not safe for human consumption. It is important to do your research and only purchase from reputable sources.
If you choose to buy Anavar on the black market, be aware that it is illegal and can be dangerous. The quality of the product is not guaranteed, and it may be contaminated or fake. The price of Anavar can vary depending on where you buy it and whether it is legal or not. Legal alternatives like Anvarol can be more expensive than black market Anavar, but they are safer and more reliable.
In summary, buying Anavar can be difficult and risky. Legal alternatives like Anvarol are a safer and more reliable option for gaining muscle without the harmful side effects. If you do choose to buy Anavar, be sure to do your research and only purchase from reputable sources.


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Cost of Orofacial Myology
How much does Orofacial Myofunctional programs cost? Depends on individual client needs. A full evaluation determines detailed treatment plan that is designed to benefit and restore proper muscle function.
Detailed full evaluation identifies clients orofacial myofunctional disorder starting with initial oral motor experience in childhood infancy. This reveals individual challenges and ties it back to symptoms of clients concern for overall health and wellness.
Orofacial Myofunctional Programs
For clients with advanced or multiple orofacial myofunctional disorders, combinations of advanced orthodontics, airway issues, TMJ/TMD, tongue-tie, speech, sleep apnea, snoring. Includes 12 month unlimited sessions, usually 20-24 sessions.
Payment plan $500 down, 6 payments $367 OR pay in full save $300
For clients with one orofacial myofunctional disorder, (tongue-tie, speech, TMJ/TMD, thumb/finger sucking, sleep apnea or snoring.) Includes 12 sessions, habit elimination, intensive phase, completed by final retention phase.
Payment plan $500 down, 3 payments $367 OR pay in full save $200
For clients who do not have advanced needs. Includes 8 sessions of intensive phase: resting tongue position, nasal breathing, lip seal, chewing, swallowing liquids and solids.
Payment plan $500 down, 2 payments $450 OR pay in full save $100
Children 2-5+ years. Includes 1 year program, 12 sessions (once a month). Instruction based exercises with parent participation is key to actively work with your child. Thumb or finger sucking habit elimination is included if needed.
Payment plan $500 down, 2 payments $200 OR pay in full save $75
Myofunctional Program is performed by a professional with advanced training in this specialty. Based on individual needs, increasing muscle tone of tongue and facial muscles, most importantly focusing on four goals.
Tongue Position at Rest
Ideal swallowing pattern uses facial muscles and tongue which lead to an increase in muscle strength and coordination.
The muscles of the face and mouth are designed to work together in a collaborative effort. By recognizing an Orofacial Myofunctional Disorder early, you can help overcome hurdles and have optimal health!
Schedule a FREE 30 minute Assessment today!
Client Comments on Therapy with Marie
I am a "graduate" of Marie's Myofunctional Therapy program, and what a great experience it was. The exercises assigned to me each week were manageable and in fact I enjoyed the feeling of strength over the course of the therapy in my facial muscles, my tongue and my swallow. I greatly appreciate Marie's expertise, patience, good humor and enthusiasm for my progress during these 11 weeks. She took care explaining all aspects of the treatment and the goals of the course, an I am so glad to have improved my breathing habits.
Linda K, Ph.D.
"Marie coached me through a dozen sessions and is very knowledgeable about myofunctional therapy . She thoroughly demonstrated the exercises and helped me make a lot of progress during our sessions. My sleep has improved, and my old habits of tongue thrusting and mouth breathing are fading away. I would recommend her program to anyone interested in improving their health” Tony K, Minnesota
Marie McElderry BSDH
Marie McElderry BSDH


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Including protein to your weight loss plan is a great way to help build lean muscle. Onions are wonderful for including taste to your meals, whether you desire them uncooked or cooked. Generally, raw foods are lower in fat and calories than cooked alternate options, to allow them to actually make it easier to lose weight.
- Simple Steps to Drop a few pounds
- Seize some protein
- Slices of rye bread, minimize in two
- Repeat your entire routine no fewer than 3 times and not more than five times
- I see my body as an amazing miracle
- Complicating easy points
- Blueberries 12 forty one Raspberries 1/2 cup
- Tbsp unsweetened cocoa powder
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The First & Foremost Whitepaper: Our Innovative Formula
FIRST & FOREMOST WHITEPAPER: OUR INNOVATIVE FORMULA
By: Sarah Pettry, MS, RDN
This whitepaper provides a general overview of the design and product attributes of First & Foremost, an evidence-based, nutrition supplement program that is designed to provide comprehensive nutrition and optimal bioavailability. First & Foremost offers a dayparted multivitamin supplementation program that delivers the right nutrients in the right dosage at the right timing, in a patent-pending formulation.
Table of Contents:
- A Dietitian-Designed Formulation
- Our Approach to Comprehensive Nutrition
- Key Nutrients Missing in the American Diet
- Right Nutrients — The 26 Vitamins & Minerals in First & Foremost
- Right Dosage — Recommended Dietary Allowance (RDA) & Why It Matters
- Right Timing — Our Dayparted Approach
First & Foremost is an evidence-based, nutrition supplement program that reflects a better approach to bioavailability. Our dayparted, patent-pending program provides 26 essential nutrients at the right time (morning, afternoon, evening) to ensure your body fully absorbs the nutrients you need. Designed by dietitians and backed by science, First & Foremost provides a healthy foundation for everyday nutrition. We’re here to explain the methodology of our formulation and how we deliver nutrients with better bioavailability.
2. A Dietitian-Designed Formulation
First & Foremost is designed by a team of Registered Dietitians, who are trained and licensed to administer medical nutrition therapy. In fact, they’re the only health profession qualified and certified to give nutrition guidance and advice to others. Because of our specific expertise, Registered Dietitians know how hard it is to get the vitamins and minerals you need, and how your body processes each of them differently depending on what you recently ate or drank, your activity level, how old you are, and more.
Building on our unique understanding of bioavailability, we were inspired to develop a new kind of supplementation program. First & Foremost was born out of our collective frustration with multivitamins that promise optimal health but under-deliver on essential nutrients and absorption — too often, they sacrifice absorption for convenience or contradict the science-backed principles of absorption. The purpose of a supplement is to supplement your diet — to bridge any gaps in your daily nutrition — and we felt that the current options missed the mark. In addition, we find the supplement space to be confusing, misleading and frustrating for consumers. With First & Foremost, we have a comprehensive supplement that we would wholeheartedly recommend — and take ourselves.
3. Our Approach to Comprehensive Nutrition
The scientific connection between food and health has been documented for decades, with significant evidence supporting that a healthy diet and lifestyle can help optimize good health and reduce the risk of chronic diseases. Even as we strive to obtain all the essential nutrients through foods and beverages on a daily basis, maintaining a healthy dietary pattern every day is difficult. Hence, the key benefit of a dietary supplement.
We heavily researched each of the 30 essential vitamins and minerals to develop a clear understanding of their roles and functions within the body. Our team of dietitians reviewed thousands of research studies, textbooks, and scientific resources like the National Institute of Health (NIH). We analyzed the intakes of all essential nutrients, using the micronutrient usual intakes estimates based on nationally representative data from the National Health and Nutrition Examination Surveys (NHANES). We studied each nutrient's RDAs, forms, inhibitors (from foods and nutrients), deficiencies, and toxicities. Nutrients come in many different forms, some work better than others, and some compete for absorption with one another. Poring over the research helped us determine the ideal form, amount and pairings for each nutrient. You can see some of our high-level research at fandfnutrition.com/nutrients, and more information lives in each nutrient deep-dive here.
4. Key Nutrients Missing in the American Diet
As dietitians, it was important to us to provide the nutrients that are under-consumed or missing from the American diet — that is a key purpose of a supplement. Our research showed that a significant number of Americans do not meet their recommendations for several micronutrients, leading to inadequacy of immune health nutrients. For example, 45% of American adults had inadequate intake of vitamin A from food, 46% for vitamin C, 95% for vitamin D, 84% for vitamin E, and 15% for zinc.
Some nutrients are considered Dietary Components of Public Health Concern for Underconsumption by the USDA, identified due to their typical intake in the U.S. — and especially important because low intakes are associated with health concerns. As of the 2020-2025 Dietary Guidelines for Americans, the micronutrients of concern include:
- Vitamin D
We also placed high importance on developing a comprehensive nutrition combination, ensuring we included nutrients that are either omitted from supplements or included in minimal or inefficient amounts. For example, due to its weight, calcium is often left out of multivitamins or provided in minimal amounts not sufficient enough to meet one’s daily needs. The same goes for magnesium and choline. In the spirit of comprehensiveness, we include all of these nutrients in our formulation.
5. Right Nutrients — The 26 Vitamins & Minerals in First & Foremost
After thorough research, we chose to include 26 of the 30 essential micronutrients to provide a comprehensive approach to supplementation — many of these nutrients are dependent on each other for various functions within the body, so it’s best to provide a complete foundation in one cohesive program. Our research also indicated that while there are a handful of nutrients Americans haven’t been getting enough of, there are 4 essential nutrients that Americans consume too much of. We excluded these 4 from our formulation (see list below chart). Here’s an overview of the nutrients we included:
As mentioned, there are four essential nutrients we excluded because we felt they were unnecessary to supplement. Research indicates that Americans consume enough of them, and we didn’t want to risk overconsumption:
- Sodium - This nutrient is consumed in sufficient amounts each day, primarily from processed foods in the form of sodium chloride (aka table salt).
- Fluoride - Most people in the U.S. consume adequate amounts through foods naturally containing fluoride, fluoridated tap water, and food products made with fluoridated tap water. According to the NIH, “an analysis of NHANES data in 2001–2002 and 2011–2012 found that rates of dental fluorosis (from very mild to severe) increased during this 10-year period, from 29.7% to 61.3%.”
- Chloride - Nearly all dietary chloride consumed in the diet is from sodium chloride (table salt), which the average American meets or exceeds this nutrient need each day. The average adult consumes an estimated 2,000-8,000 mg of chloride each day (Gropper, pg 468).
- Sulfur - As a part of all protein-containing foods (meat, fish, poultry, eggs, milk, legumes, nuts), the measure of deficiency is unknown, and a protein deficiency would occur before a sulfur deficiency (Understanding Nutrition; pg 410).
6. Right Dosage — Recommended Dietary Allowance (RDA) & Why It Matters
With 26 nutrients selected, we then needed to determine the appropriate dosage and form for each nutrient. We chose the Recommended Dietary Allowance (or Adequate Intake) amounts as our baseline to support your diet each day. The NIH defines the Recommended Dietary Allowance (RDA) as “the average daily level of intake sufficient to meet the nutrient requirements of nearly all (97-98%) healthy people. Adequate Intake (AI) is established when there is insufficient evidence to develop an RDA and is set at a level assumed to ensure nutritional adequacy.”
Using these research-backed amounts establishes a foundation for the 26 essential micronutrients that we know will benefit nearly all healthy people (defined as those without underlying health conditions). Relying on our thorough research, we determined our dosage based on the nutrient requirements, safety, bioavailability, and form that best complements the average American diet.
The hundreds of roles vitamins and minerals play within the body have led many people to conclude that “more is better” when taking supplements. However, just as insufficient intake can cause harm, so too can excess intake. For example, excess of one mineral can create an inadequacy of another, and over-supplementing is usually the culprit. This is another benefit to supplementing with your RDA/AI amounts.
Here is how we approached the dosage for our Female 19+ program:
7. Right Timing — Our Dayparted Approach
The final piece of our differentiated formulation is daypart. The timing of a nutrient’s delivery — that is, time of day, with or without food, and its pairing with other nutrients — is the underpinning of our bioavailability value proposition.
Our Female 19+ and Male 19+ formulas provide 26 essential nutrients in 3 separate occasions, omitting the few essential minerals (sodium, chloride, fluoride, sulfur) that most Americans already consume in excess daily or for which deficiency is not known. Because of the factors that influence nutrient absorption, we split our formulation into three dayparts, which we’ll dive into below, with the nutrient form specified:
7a. Why Three Dayparts?
We wanted to create a comprehensive program to meet your RDAs. The one-a-day multivitamin can’t be comprehensive, because it is difficult to include all 26 nutrients in beneficial amounts in just 1 or 2 gummies or capsules per day. Most supplements provide little-to-no calcium or magnesium because these two nutrients are heavy and take up substantial space in the formula. However, we believe you can’t consider a supplement complete and comprehensive without these minerals.
Even splitting a multivitamin into two dayparts is not efficient, because of contraindications. For example, iron is inhibited by many minerals. And at dosages in excess of 250mg, calcium begins competing with magnesium and iron for absorption, so you don’t absorb enough of any of them. Yet calcium is a Nutrient of Public Health Concern in the U.S., and it is an important nutrient to supplement, as dietary intake is decreasing year over year.
By separating the nutrients across three dayparts, we're able to provide both a comprehensive formulation and enhanced absorption. Take calcium, for instance. The percentage of calcium absorbed from supplements (as with calcium from foods) depends not only on the source of calcium but also on the total amount of elemental calcium consumed at one time; as the amount increases, the percentage absorbed decreases. Absorption from supplements is highest with doses of 500 mg or less . For example, the body absorbs about 36% of a 300 mg calcium dose and 28% of a 1,000 mg dose . Therefore, separating out the vitamins and minerals that inhibit each other and formulating a three-a-day program offers the ability to provide the right dosage for all 26 nutrients to provide better bioavailability.
Our Dayparted Program:
- Morning’s featured nutrient is magnesium, joined by calcium, zinc, manganese and vitamin E. These nutrients are known to adversely interact with high doses of calcium and Iron — as iron is in the afternoon, and because we use smaller doses of calcium*, there is no conflict.
- *We put calcium in all three dayparts, always less than 500mg, so there’s not enough calcium in a single occasion to be considered a “high dose.”
- While magnesium is typically taken in the evening to aid in sleep, taking magnesium consistently in the morning helps to balance blood pressure and stress responses throughout the day.
- Afternoon provides the bulk of your minerals, the featured nutrient being iron. Because iron has many potential nutrient and food interactions, we put it in the afternoon occasion, between meals and separated from many antagonistic nutrients in the program that would inhibit absorption.
- Evening includes the bulk of your B vitamins, choline, half of your day’s calcium, and a few other minerals and vitamins. This occasion is centered around overnight recovery, allowing your body to rebuild and recover from the day.
- Reider, C. A., Chung, R. Y., Devarshi, P. P., Grant, R. W., & Hazels Mitmesser, S. (2020). Inadequacy of Immune Health Nutrients: Intakes in US Adults, the 2005-2016 NHANES. Nutrients, 12(6), 1735. (https://doi.org/10.3390/nu12061735)
- U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. (DietaryGuidelines.gov)
- Advanced Nutrition and Human Metabolism; 7th edition; S. Gropper, J. Smith, T. Carr. Page 468
- Understanding Nutrition; 12th edition; E. Whitney, S. Rolfes. pg 311-445.
- NIH Fluoride - https://ods.od.nih.gov/factsheets/Fluoride-Consumer/
- NIH Magnesium - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7761127/
- Harvard University. https://www.health.harvard.edu/heart-health/key-minerals-to-help-control-blood-pressure


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There’s a new king in human growth hormone bodybuilding supplements: HGH X2 Somatropin.
You’ll unleash the power of HGH without all of the harsh side effects and risks associated with injections. Fast, effective and affordable, you’ll propel your results in the gym into overdrive with HGH-X2.
What is Somatropin?
Human growth hormone, or HGH, is released by the body naturally when you’re younger, but then it starts to slow to a halt leaving you trying harder than ever before to build muscle and maintain lean muscle mass.
Somatropin is created naturally by the pituitary gland and consists of 191 amino acids.
This growth hormone is responsible for triggering the liver to release somatomedin which is another hormone that causes growth to occur. This is a growth stimulating hormone that is highly active when a person is young but starts to diminish as a person ages.
And over time, the hormone continues to slow.
What is HGH X2 Somatropin?
HGH X2 is a combination of amino acids that have been specially formulated to also signal the liver and hopefully trick the body into producing more growth hormone. The key behind this supplement is to re-ignite the body’s release of HGH.
This formula works to do a few things:
- Triggers the body to release HGH into the bloodstream
- Enhances lean muscle gains
- Speeds up muscle recovery
- Improves weight loss results
Precisely, this pill will engage your pituitary gland telling your body “hey, it’s time to release HGH.” So, when you’re taking these pills you’re not injecting HGH into the body. Instead, you’re merely signaling the body to do what it does naturally.
So, what is HGH-X2 exactly?
It’s a powerful blend of amino acids.
These vital amino acids signal the body to release HGH (it kind of forgets to do it as we age). You’ll quickly realize your body’s full potential when it starts to:
- Increase muscle mass
- Burn fat faster
- Boost the body’s protein production
Everything will work better allowing you to reach your fitness goals faster and more effectively than ever before. You’ll turn back the clock ensuring that you achieve muscle gains that you haven’t been able to hit since you were in your teens and twenties.
The best part is that these are rapid results.
I’m not saying you’ll be Mr. Olympia overnight, but you will notice a measurable difference in as little as a month.
How and When to Take HGH X2 Somatropin
I’m not a fan of needles. In fact, I cringe at the thought of injecting anything into my own body. There are a lot of risks when using injections, and I will touch on this topic a little more in the latter part of this article,
I chose to take HGH X2 Somatropin for a few reasons:
- It’s a safe and legal alternative
- It enhances quality muscle
- It helps the body burn fat more efficiently
- Muscle to fat ratios increase
- Recovery is faster
- Needles and prescriptions are not required
- Results happen rapidly
The results happen rather quickly, and you’ll start to see a difference in as little as a week or two. You’ll start realizing that you can push a little harder at the gym, and then you’ll have a little less fat on your gut.
It all falls into place after a couple month’s of taking this supplement.
When you go to use HGH X2 Somatropin, I recommend:
- 2 months on and 10 days off as a cycle
- Take two capsules 20 minutes before breakfast with water
You’ll need to hit the gym, too if you really want to see results. This isn’t a diet pill or some magical pill that will work to build muscle while you sleep.
You have to hit the iron and follow a proper nutrition plan if you want to see the results of HGH X2 Somatropin.
Potential Side Effects
I recommend adhering to the company’s cycle recommendations (listed right above) so that you don’t suffer from any potential side effects, nor will you start to adapt to the increase in amino acids.
HGH X2 Somatropin is very powerful, and while I didn’t experience any side effects, some people might experience:
- Stomach aches
Of course, if there’s a freak chance that you’re allergic to a certain ingredient, this may be amplified.
Risks of Buying HGH Injections
Over the counter human growth hormone supplements are highly recommended over HGH injections. I have heard a lot of good things from people that have tried real injections from their doctor.
But a lot of people also lose out on their investment.
The risks of injections include:
- Fake products. A lot of sellers are selling fake products. Who knows what you’re injecting into yourself, and there are a lot of dangers here, too. If you get fake products, this means the potential for other complications as well as the risk of the product not working at all.
- Injection risks. I hope you’re smart enough to not use someone else’s needle to inject HGH. And you also need new needles because old ones can cause infections and a slew of other risks unless properly sterilized.
- Costs. When you buy injections whether illegally or from the doctor, the costs are crazy. You’ll spend a ton of money on the same thing that HGH X2 can do for a fraction of the cost without all of the risks.
I encourage anyone that’s truly thinking about HGH injections to try this HGH pill first.
Click here to try HGH X2 today and forget about scary, risky needles.
What Are Customers Saying?
HGH X2 Somatropin results speak for themselves – this product works.
But what are other customers saying?
HGH X2 Somatropin is one of those products where you read the reviews, and you’re like “yeah, this sounds too good to be true.” I was in the same boat until a good friend recommended this product to me, and I decided to take the dive.
It works well, and the results are fast, too.
I don’t have any complaints, and I don’t think I could achieve the same results I have without HGH X2 by my side. But enough about me, what are others saying about this OTC HGH pill?
- Somatropin works! I used it for a month, and I started seeing results in less than two weeks.
- I feel awesome. I gained 4 pounds of lean muscle and cut fat, too.
- I was tired of using injections and gave HGH-X2 a try. I’m blown away. This pill is light years ahead of the competition and works better than the bunk injections I was using.
- I stack this with Winsol and Trenorol – the results are just crazy.
You’ll find so many reviews on HGH X2 Somatropin that are positive.
But remember that you also need to put in the work if you expect to see real results. There’s no way that you’re going to gain muscle and lose weight if you’re eating fast food ands sitting on the couch every day.
It doesn’t work like that.
All the HGH in the world won’t make you look like Arnold without dedication in the gym and in the kitchen. If you can stay dedicated and work your butt off, HGH X2 will amplify your results pushing your muscle mass to new heights.
Delivery is even free, and if you act quick, the company is offering a buy 2, get 1 free deal which is really nice if you stack their products.
CrazyBulk is the only place I recommend ordering this supplement from, and it’s directly from the manufacturer, so you know it’s always top notch. If you’re thinking of skimping and going to eBay to buy this supplement, save your money and only go with the real deal – it’s cheaper in the long run.
If you’ve heard great things about HGH and want to give the best HGH injection alternative on the planet a try, click here to order your first bottle.


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- KN95 Masks Features Up to 95% Filtration
- Protects Better than Standard Cloth Masks
- Suitable for Both Adults and Children
- Alcohol Free Hand Sanitizer Works Better and Is Better for You than Alcohol Based Hand Sanitizer
- Includes 5 KN95 Masks, 8 oz Bottle of Bayes Hand Sanitizer, & 1 Pair of Nitrile Gloves
Keep your family safe with this health and wellness grab and go kit. This kit features 5 KN95 respirator masks as well as includes an 8 oz bottle of Bayes Alcohol Free Hand Sanitizer and a set of nitrile gloves. Everything you and yours will need to keep yourself safe when going out to the store.


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We had the good fortune of connecting with Jayme Hanna and we’ve shared our conversation below.
Hi Jayme, how does your business help the community?
We are a new concept in the facial world. Not only do we deliver results with our facial techniques, we also help you take a deeper dive into YOU. Your skin is your biggest organ and is often times a mirror image of your health and emotions.
There is a new esthetic movement called Integrative Esthetics or otherwise known as Holistic Esthetics. This approach harnesses the traditional facial treatments, but takes a bigger look at the person as a whole, including emotional well-being, diet and social influences. We take a deep dive into the toxins that might be countering the good. A licensed esthetician practicing Integrative Esthetics not only addresses with science what your skin needs, but also how your lifestyle could be hindering any of the results you should be seeing. This interconnectivity allows for a multi-dimensional anti-aging plan to be established. What really sets Birch Botanical Spa apart from the norm is energy work that is applied during the treatment session. By working on blocked energy, created by negative thoughts or experiences, you are allowing that stress and baggage to leave the body. This facilitates the skin’s unique anti-aging responses to fully shift into high gear. Although, this is something all therapists do when working with clients, whether they are aware of it or not, but with intension applied the results are tremendous.
We didn’t stop there, Birch Botanical Spa has expanded its network of other modalities and practitioners to help each individual achieve the wellness results they are looking for. Nutrition also plays a key part in one’s skin healing journey. We brought in our own Skin Nutrionist to work with individuals on a one-on-one basis dealing with chronic skin issues such as eczema and acne. Skin is powerful and for the most part, can be perfectly capable of healing on its own once you can identify the part of the body that has been weakened.
Whether you are looking for relaxing spa treatments for a self-care day or looking to make a wellness lifestyle change, we are here for you in two locations. We have expanded our St. Charles, MO location and are now in our own nature-inspired building located in the heart of St. Charles. Or, if you are in Tennessee, checkout our Knoxville, TN location. We also have a place to stay in Knoxville if you are planning a visit (please contact us).
What should our readers know about your business?
The spa was created to offer a safe and relaxing environment for individuals to learn self care and self healing techniques. What really sets Birch Botanical Spa apart from the norm is energy work that is applied during the treatment session.
As well as give clients the beautifying results they look for in a spa. Birch Botanical Spa supports a community of wellness practitioners and licensed clinicians that delivers true skin care results because it’s more than skin deep. Our goal is to provide a welcoming destination for our clients whether visiting from out of town or coming in weekly taking advantage of all of our services and treatments.
Our biggest challenge is introducing a new concept to the beauty world. We are in an industry that focuses mainly on the physical beauty results rather than focusing on the emotional response. Beauty comes from within and not only does Birch Botanical Spa deliver results with our facial techniques, we also help take a deeper dive into the client’s wellness needs. Skin is our biggest organ and is often times a mirror image of health and emotions.
Shoutout is all about shouting out others who you feel deserve additional recognition and exposure. Who would you like to shoutout?
Being an entrepreneur isn’t easy, there are many days I want to give up but I keep going! I do what I love and it has brought success.
I owe a big thank you to my clients that leave with a happy and glowing face, reminding me of why I love what I do.
I also thank my employees because they truly love what they do, my professional advisors that steer me in the right direction and my husband that reminds me to live authentically while helping me keep my eye on the end goal.
Instagram: @birchbotanicalspa @birchbotanicalspaknoxville
Facebook: @birchbotanicalspa @birchbotanicalspaknoxville


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Christina is a talented and versatile individual committed to elevating the health and well-being of the community. Her journey into wellness started long ago with a practice of yoga. She is continually diving deeper into mindfulness, movement, and the art of holistic healing. She is a graduate from the prestigious Mind Body Institute in Nashville and has been thrilled to serve her community through her connection-based care.
Christina utilizes massage and bodywork as a vehicle for developing greater body awareness, nervous system regulation, and relief of deep fascial tension. Christina uses a balanced blend of relaxation and therapeutic techniques for an integrative massage experience, unique to you.
Her intention is to create a vessel of safety that allows for a full exhale from life’s daily stressors. She utilizes aromatherapy and short guided meditations to support in nervous system regulation. People often find her work to be deeply nourishing and therapeutic. Christina incorporates techniques like Myofascial Release and Trigger Point Therapy into her session. Christina offers Therapeutic Massage, Prenatal Massage, Cupping Therapy, Shiatsu, Reiki, and Sound Therapy.
Outside of massage therapy, Christina enjoys spending time with loved ones, exploring nature with her pups, dancing, playing music and creating art.
Therapeutic Massage 60 min. $75
Therapeutic Massage 90 min. $105
Therapeutic Massage 120 min. $155
Sports Massage 60 min. $95
Sports Massage 90 min. $135
Sports Massage 120 min. $195
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Massage + Cupping 90 min. $115
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Table Thai Massage 60 min. $85
Table Thai Massage 90 min. $115
Table Thai Massage 120 min. $165
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Prenatal Massage 90 min. $115
Reiki 30 min. $45
Reiki 60 min. $70
ZenLeaf Infusion Add-On $20 Reiki Add-On $20
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