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DESCRIPTION
Bulimia nervosa is an psychological eating disorder characterized by abnormal perception of body image, constant craving for extremely large amounts of high-calorie foods, episodes of uncontrolled binge eating of these foods, followed by self-induced vomiting, and/or the use of laxatives, enemas and/or diuretics often with excessive, obsessive exercising to "purge" the body of the foods eaten during the binge. The binge eating and purging are carried out in secret. The binge/purge episodes vary in frequency, from a few times a week to several times daily. The length of bingeing can range from several minutes to an hour or two.
This is a serious medical and psychological problem with potentially dangerous complications that affects primarily adolescents or young adults, usually female and those with appearance stressed professions, such as models, actors and dancers.
Unlike people with anorexia , whose self-starvation eventually becomes obvious, those with bulimia can hide the disorder for long periods, even years, because their weight is usually in the normal range (some are even overweight) and the binging and purging are done in secret, hidden from family, friends, and associates. This is an indication of a serious medical and psychological problem with potentially dangerous complications.
Usually the person doing the bingeing feels out of control - a sense of not being able to stop eating until he or she is completely full - then is so immediately overwhelmed and shamed by the sense of fullness that he or she feels the need to get rid of the food just consumed.
People with bulimia often feel extremely guilty about their behavior, which is why they may successfully hide the disorder for years, even from their spouses and children. Trips to the bathroom after meals, the sudden disappearance of large quantities of food, frequent dental visits, and mood changes may be hints that something is wrong.
FREQUENT SIGNS AND SYMPTOMS
Recurrent episodes of binge eating (rapid consumption of a large amount of food in a short time, usually less than 2 hours), plus at least 3 of the following:
- Preference for high-calorie, convenience foods during a binge.
- Secretive eating during a binge. Patients are aware that the eating pattern is abnormal, and they fear being unable to stop eating.
- Termination of an eating binge with purging measures, such as laxative use or self-induced vomiting.
- Depression and guilt following an eating binge.
- Repeated attempts to lose weight with severely restrictive diets, self-induced vomiting and use of laxatives or diuretics.
- Frequent weight fluctuations greater than 10 pounds from alternately fasting and gorging.
- People who regularly disappear into the bathroom after meals, experience mood swings, make frequent visits to the dentist and are present when large quantities of food suddenly disappear could be suffering from bulimia. Abrasions on hands and knuckles, and mood changes may be hints that something is wrong.
- No underlying physical disorder.
Physical signs of bulimia may include:
- Bad dreams.
- Hair loss.
- Yellowish or grayish skin.
- Dry skin.
- Premature wrinkles.
- Bad breath.
- Constantly cold hands and feet.
- Excess facial and body hair.
- Extreme weakness.
- Muscle fatigue.
- Dizziness.
- Fainting.
- Mental fuzziness.
The physical signs of bulimia contributed to induced vomiting may be:
- Broken blood vessels in the face and eyes.
- Swollen glands in the face and neck.
- Erosion of the enamel on the back of the teeth.
- Swollen salivary glands, resulting in a "chipmunk" appearance.
- Constant sore throat.
- Inflammation of esophagus.
- Hiatal hernia.
- Sometimes emboweled spoons or sticks used to induce vomiting have to be surgically removed.
If laxative abuse is a part of the picture:
- Damage to the bowel.
- Rectal bleeding.
- Perpetual diarrhea may result.
- Laxative use also washes potassium and sodium from the body, which can lead to electrolyte imbalances that may lead to dehydration, muscle spasms, and eventually cardiac arrest.
CAUSES
There is no known cause for bulimia, but experts think it is the result of a combination of psychological, biological and societal factors.
The causes of bulimia are most often psychological in nature, and episodes of binging are often stress related. Binging may be a means by which an individual with bulimia attempts to manage emotions; they allow the person to focus attention away from unpleasant or uncomfortable emotional problems. People with bulimia may also be obsessed with exercise as a means of controlling weight.
According to the National Association of Anorexia Nervosa and Associated Disorders, there are 8 million men and women with eating disorders in the United States, and this number is on the rise. Bulimia affects many more women than men (although the number of men with disorder is increasing), especially those in professions that stress appearance, such as modeling, acting, or dance. Bulimia does not discriminate on the basis of age, sex, or social status. Obsession with weight can also result from social factors. In today's society, we are constantly bombarded with the message that "thin is in" - and the thinner you are, the better you look. As many as 1 in 8 girls between the ages of 13 and 19, including college students, may have this disorder. Our role models are mostly actors/actresses, music artists, and models who set standards of beauty that are difficult or impossible for most people to attain.
Although people may develop an eating disorder because they want to look and feel better about themselves, the opposite is usually the result. People with bulimia can become consumed with their weight, have a distorted image of their figures, and feel disgusted with themselves for not having what they thing of as the "perfect body".
Other typical psychological implications can include extreme anger at anyone they believe is trying to interfere, anxiety, depression, fear of being found out, isolation, loneliness, and obsessive-compulsive behavior. People with bulimia may also exhibit other extreme behavior, such as alcohol or drug abuse, credit card abuse, or shoplifting. They usually spend exorbitant amount of money on food, sometimes using money meant for paying bills or other necessities to buy certain foods, and they may also bypass social or work-related obligations for an opportunity to binge.
Some studies of families and twins suggest that heredity may also play a role. Psychologically, food has offered us pleasure, comfort, solace, and security from the moment we are born. Episodes of bingeing are commonly stress related, and they may be an attempt to manage their emotions by focusing attention away from unpleasant or uncomfortable emotional feelings and situations.
Many individuals who suffer from this disorder come from families in which they were subjected to mental, physical or sexual abuse. In some families, substance abuse is also a factor. Many women started their first binge because of real or imagined male rejection. Others are perfectionists and overachievers with high standards but low self-esteem. In particular, if a woman's basic emotional needs were not met in childhood, she may come to believe that her problems would be resolved if only she were attractive (that is thin) enough, and this obsession leads to bulimia.
There are indications of possible physiological elements in this disorder as well. For example, people with eating disorders tend to have a type of chemical imbalance similar to one found in persons with clinical depression. Both have high levels of adrenocorticotropic hormone (ACTH), a hormone produced by the pituitary gland that inhibits T cell function and thereby depresses immunity. People who suffer from bulimia may also have low levels of the neurotransmitter serotonin, which can lead to cravings for simple carbohydrates - common binge foods. Some researchers have found bulimia to be associated with right temporal disturbances in the brain.
According to research, lack of a hormone that controls appetite may be the reason bulimics fail to feel full. In such persons, eating a meal apparently does not stimulate adequate production of the hormone cholecystokinin-pancreozymin (CCK), which is found in the small intestine and the brain. They have to keep eating and binging, in order to feel satisfied. However, more research is needed to determine whether this is the cause behind the majority of cases of binge eating.
A study conducted at the University of Iowa College of Medicine and the University of Wisconsin found that reducing weight as part of athletic training may lead to bulimia. A survey of 700 high school wrestlers found that 2 percent were involved with binge eating followed by vomiting, fasting, excessive exercise, or the use of laxatives to avoid weight gain.
RISK INCREASES WITH
Strict, compulsive, perfectionist family environment.
Anorexia nervosa.
Depression.
Stress, including lifestyle changes, such as moving or starting a new school or job.
Neurotic preoccupation with being physically attractive.
PREVENTIVE MEASURES
Raise children in a wholesome family environment with emphasis on caring and good communication rather than on external appearances.
Encourage rational attitude about weight.
Avoid stress.
EXPECTED OUTCOME
Outcome is variable; patients can learn to control the behavior with counseling, psychotherapy, biofeedback training and individual or group psychotherapy.
POSSIBLE COMPLICATIONS
Some of the many serious medical problems bulimia can lead to include:
Anemia.
Fluid balance depletion and electrolyte imbalances from vomiting.
Malnutrition and many other disorders.
Mental fuzziness.
Dental problems including erosion of the gums and/or enamel of back teeth and cavities.
Ulcers.
Internal bleeding; stomach or esophagus rupture.
Stones in the salivary glands.
Inflammation of the throat.
Dehydration.
Pancreatitis.
Hypoglycemia.
Erratic heartbeat, low pulse rate and low blood pressure.
Cessation of menstrual cycles.
Infertility.
Loss of bone mass. If the fat content in a woman's body drops to too low a level, the body will not produce enough estrogen, which can result in destruction of bone tissue and an increased risk of osteoporosis.
Loss of muscle mass. Due to extreme weight loss, extreme exercise, starvation, and/or lack of needed vitamins and minerals, the body can turn to using muscle mass as an energy source - a very serious side effect that few with eating disorders are aware of.
Weakened immune system.
Eventually, life-threatening problems can result. These serious medical problems that without treatment the complications can be fatal. If not treated, bulimia can lead to various cancers (such as cancers of the breast, bowel, esophagus, or reproductive organs), kidney and/or liver damage and finally, cardiac arrest.
Relapse may occur after treatment.
TREATMENT
GENERAL MEASURES
Psychiatric consultation is frequently necessary to overcome bulimia, as the cause is most often psychological. Long-term treatment may be needed to improve self-esteem. Therapy will consist of assessing nutritional status, establishing target goals, identifying triggers, improving relationships, overall well-being, techniques to avoid stress, etc.
Treatment in an eating disorder facility may be recommended.
Hospitalization in severe cases.
Psychotherapy or counseling that may include hypnosis or biofeedback training.
Additional information available from: American Anorexia/Bulimia Association, Inc. (AABA)
C/O Regent Hospital
293 Central Park West, Suite 1R
New York, NY 10024
Phone: (212) 575-6200
Website: www.aabainc.org
American Anorexia/Bulimia Association (AABA): New Jersey Chapter
10 Station Place
Metuchen, NJ 09940
Phone: (732) 549-6886
Toll Free: (800) 522-2230 (NJ Only)
Fax: (609) 688-1588
Website: www.njaaba.org
National Eating Disorders Association (NEDA)
(Formerly National Eating Disorders Organization [NEDO])
(Formerly Eating Disorders & Prevention, Inc. [EDAP])
603 Stewart Street, Suite 803
Seattle, WA 98101
(206) 382-3587 Ext 10
(206) 829-8501 Fax
Information & Referral Helpline: 1-800-931-2237
Website: www.nationaleatingdisorders.org
Center for the Study of Anorexia and Bulimia (CSAB)
1841 Broadway, 4th Floor
New York, NY 10023
Phone: (212) 333-3444
Website: www.icpnyc.org
Anorexia Nervosa & Related Eating Disorders (ANRED)
P.O. Box 5102
Eugene, OR 97405
(503) 344-1144
Website: www.anred.com
National Association of Anorexia Nervosa and Associated Disorders (ANAD)
Box 7
Highland Park, IL 60035
Phone: (847) 432-8000 EXT 5728
Fax: (847) 433-4632
Website: www.anad.org
Multi-Service Eating Disorder Association (MEDA)
(Formerly Massachusetts Eating Disorder Association) 92 Pearl Street
Newton, MA 02158
Phone: (617) 558-1881
Fax: (617) 558-1771
Website: www.medainc.org
MEDICATION
Antidepressants may be prescribed. They are sometimes helpful for some patients.
ACTIVITY
No restrictions.
Possible lifestyle changes include eating a well-balanced diet filled with high-fiber foods and complex carbohydrates. Consume no sugar, junk foods, heavy starches or white flour products. Eat smaller, more frequent meals to avoid feeling hungry or overly full. Chew food well and stop eating before uncomfortably full. Keep a journal to track food choices and emotions associated with eating. Work against cravings by having healthy snacks on-hand, drinking plenty of water and focusing on activities that take the mind off of food, like going for a walk or working on a project. Use stress management techniques, like exercise, meditation and yoga, instead of food to soothe stressful situations.
DIET, SUPPLEMENTS & NUTRIENTS
If hospitalization is necessary, intravenous fluids may be prescribed. During recovery, vitamin and mineral supplements will be necessary until signs of deficiency disappear and normal eating patterns are established.
For outpatient therapy, supervision and regulation of eating habits, a food diary may be maintained, feared foods will be reintroduced.
Try keeping a eating journal with a price list of the foods you eat in it. This can sometimes help to break the bulimic chain. While seeing on paper what you have actually consumed will, no doubt, be overwhelming, it may make you realize exactly what you are doing and how much it is costing you financially. It can also help to note your surrounding circumstances (if you are alone, with someone, what you are doing, and after you eat and/or purge. This will help you see how it happened, and how it made you feel. It can also help you identify things that may trigger the pattern, such as certain foods, situations, or even people. Once these "trigger" elements have been identified, avoid them as much as possible.
While healthier eating behaviors are being established, a well-balanced, high-fiber diet is essential. Eat as many vegetable proteins and complex carbohydrates as possible.
Consume no sugar in any form. Avoid junk foods and white flour products. Be aware that you may experience withdrawal symptoms such as anxiety, depression, fatigue, headache, insomnia, and/or irritability for a time after you eliminate sugar from the diet.
Instead of standard 3 meals a day, eat smaller, more frequent portions. It may help to control both feelings of fullness and hunger pains. Above all, do not go hungry. This only adds to your craving for food. Breakfast is especially important.
Keep a variety of healthy snacks around you, both at work (or school) and at home, and make them readily available for when you feel a hunger pang.
Chew your food slowly and eat well. Stop eating as soon as you feel uncomfortable or as if you might have to purge.
Taking 5-Hydroxy L-Tryptophan (5-HTP) improves serotonin levels and can be helpful if low serotonin levels are associated with bulimia. Several studies have also shown it can reduce caloric intake and curb hunger. Blood testing for eosinophil levels every 3 months is suggested if taking high doses of 5-HTP (greater than 300 mg per day). HTP-Calm form Natural Balance and L-5-HTP from Solaray are good sources of 5-HTP (see more options available from Herbal Remedies below under Supplements).
Herbal Remedies: Natural Mood Stabilizer, 5-HTP Optimum Mood Support, 50 mg, 60 Caps
Herbal Remedies: 5-HTP (Hydroxy Tryptophan), Vegetarian, NOW Foods, 100 mg, 120 VCaps
Herbal Remedies: 5-HTP Supplement / Hydroxy Tryptophan, Natural Serotonin With Vitamin B-6 & C, Nature's Way, 50 mg, 60 Tabs
Cravings can often trigger a binge. The first thing to remember is that cravings do not last long - from several seconds to 10 or 20 minutes. When a craving hits you, you can do one of three things: grab a small, light snack (such as a carrot or grapefruit), distract yourself, or meet and defeat the craving head-on. To distract yourself, drink a full glass of water and then remove yourself from the area by taking a walk, going out somewhere, working on a hobby, or attacking a task that needs to be accomplished. After the task, reward yourself with a healthy snack.
Practice control with other things you do in excess, whether it is alcohol consumption, exercising, shopping, or anything else. The key to a higher self-esteem is for you to be in control of your life, not for something else to be in control of you.
Develop and maintain relationships with positive people who make you feel good about yourself and whom you admire. Anyone bad for your mental health is a waste of your time and feelings.
Practicing stress management can greatly assist anyone fighting bulimia. Regular, moderate exercise, deep breathing, meditation, visualization, and yoga are all excellent ways to relieve stress. They are also good for easing depression.
MoonDragon's ObGyn Information: Stress
Note: Nutritional supplements are available from HerbalRemedies.com and bulk herbs are available from Mountain Rose Herbs. Links to both of these websites are given below. They offer great natural-organic products with great prices.
BENEFICIAL DIETARY SUPPLEMENTS
Multi-vitamin and Mineral Complex combats nutrient deficiencies.
Zinc with Copper aids the sense of taste and eases depression and anxiety.
Acidophilus stabilizes intestinal bacteria and protects the liver.
Calcium and Magnesium calms the body and relaxes muscles.
Coenzyme A aids metabolism, eases depression, fights fatigue and increases energy.
Coenzyme Q-10 protects the heart and aids circulation.
SAM-e relieves stress, eases depression and produces antioxidant effects.
Vitamin B Complex is essential for all cellular function.
Milk Thistle and Red Clover cleanses the bloodstream and protects the liver.
St. John's Wort is an antidepressant and reduces cravings.
Ginger Dry Extract aids digestion.
NUTRITIONAL SUPPLEMENTS
Unless otherwise specified, the following recommended doses are for those over the age of 18. For a child between 12 and 17 years old, reduce the dose to 3/4 the recommended amount.
BULIMIA SUPPLEMENTAL PRODUCTS
Supplements and information for help with bulimia, an eating disorder characterized by episodes of binge eating and purging.
Acidophilus Powder, Non Dairy - 4 oz. Bulk
Acidophilus Powder taken as a dietary supplement may help to detoxify and to rebuild a balanced intestinal flora.Alive! Whole Food Energizer Multi Vitamin with Mineral, Nature's Way 18mg of Iron added - 90 Tabs
Alive Whole Food Energizer Multi Vitamin with Mineral with Iron by Nature's Way is absorbed into your blood stream 5 times faster than other leading brands.B-Stress Vitamin Complex w/ Siberian Eleuthero (Formerly Siberian Ginseng Root), Nature's Way - 100 Caps
If you are looking for herbal stress relief, you have come to the right place. B vitamins are essential precursors of coenzymes involved in the conversion of cellular energy, manufacture of hormones and proteins, and repair and maintenance of nerve structures.CoQ10, Vegetarian Coenzyme, NOW Foods 30mg - 60 VCaps
A coenzyme for several key steps in the production of energy within each cell, and an antioxidant important in its clinical effects. It is these two properties make CoQ10 one of the best supplements available today.5-HTP The Natural Serotonin Solution By Richard Passwater, Ph.D. & J. South, M.A
Explains how 5-HTP (Hydroxytryptophan) helps raise serotonin levels to alleviate depression, insomnia, anxiety and eating disorders.Mood Aid Formula with St. John's Wort & 5-HTP Nature's Way - 60 Caps
Mood Aid uses St. John's Wort, to promote a positive mood. 5-HTP, the precursor of seratonin - a mood regulating neurotransmitter.Once Daily Multi Vitamin & Mineral, All Natural, Lactose Free, w/ Iron - 100 Tabs
Nature's Way Daily Multi Vitamin & Mineral provides many of the essential nutrients that modern diets may lack. They are useful for protection, growth and maintenance of body systems as they age.Red Clover Blossom & Herb, 500mg - 100 Caps
In Europe Red Clover is widely cultivated and used as a tonic and a salad herb. Herbalists have long prized Red Clover for it's traditional use as a blood purifier and it's isoflavones that offer great medicinal potential.St. Johns Wort Standardized Extract, 300mg - 90 Caps
St. John's Wort promotes a positive mood and extracts have been proven in many clinical studies in Europe, to have antidepressant effects, and is widely used for this reason.Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm - 16 fl. oz.
WaterOz Ionic Zinc is a pure liquid Zinc supplement. Zinc moves through all the fluids in the body, it creates a defense against infection-causing bacteria and viruses trying to enter the body and stops bacterial and viral replication.
Herbal Remedies: Bulimia Information
Herbal Remedies: Bulimia Supplements & Products
Herbal Remedies: Anorexia Nervosa Information
Herbal Remedies: Malnutrition / Malabsorption Supplements & Products
HERBS
Burdock root, Milk Thistle, and Red Clover are good for cleansing the bloodstream and protecting the liver.
Herbal Remedies: Burdock Root Powder (Arctium Lappa), 4 oz. Bulk
Herbal Remedies: Burdock Root, Nature's Way, 540 mg, 100 Caps
Herbal Remedies: Burdock Supplement Tincture, 2 fl. oz.
Herbal Remedies: Burdock Root Supplements & Products
Herbal Remedies: Milk Thistle Root Powder (Silybum Marianum), 4 oz. Bulk
Herbal Remedies: Thisilyn Milk Thistle Extract, Vegetarian, Nature's Way, 175 mg, 100 VCaps
Herbal Remedies: Milk Thistle Extract, Standardized, Nature's Way, 175 mg, 60 VCaps
Herbal Remedies: Milk Thistle Seed Tincture, 100% Organic, 2 fl. oz.
Herbal Remedies: Milk Thistle Supplements & Products
Herbal Remedies: Red Clover Herb, Nature's Way, 500 mg, 100 Caps
Herbal Remedies: Red Clover Herb Powder (Trifolium Pratense), 4 oz. Bulk
Herbal Remedies: Red Clover Tincture, 100% Organic, 2 fl. oz.
Herbal Remedies: Red Clover Tea, Caffeine Free, Alvita, 30 Bags
Herbal Remedies: Red Clover Supplements & Products
Ginger helps digestion.
Herbal Remedies: Ginger Tea, Organic Digestive Aid, Yogi Tea, 16 Tea Bags
Herbal Remedies: Ginger Tea, 20 Tea Bags
Herbal Remedies: Ginger Root Powder (Zingiber Officinale), 4 oz. Bulk
Herbal Remedies: Crystallized Ginger slices, NOW Foods, 12 oz.
Herbal Remedies: Ginger Root, Nature's Way, 550 mg, 180 Caps
Herbal Remedies: Ginger Root Tincture, 100% Organic, 2 fl. oz.
Herbal Remedies: Ginger Supplements & Products
Licorice is good for glandular function. Do not use this herb on a daily basis for more than 7 to 10 days in a row. Avoid it completely if you have high blood pressure.
Herbal Remedies: Licorice Root Powder (Glycyrrhiza Glabra), 4 oz. Bulk
Herbal Remedies: Egyptian Licorice Tea, Certified Organic, Yogi Tea, 16 Tea Bags
Herbal Remedies: Licorice Extract Tincture, Herbal Remedies USA, 2 fl. oz.
Herbal Remedies: DGL (De-Glycyrrhizinated Licorice) Extract, NOW Foods, 400 mg, 100 Lozenges
Herbal Remedies: Licorice Root Supplements & Products
A combination of high-potency Royal Jelly and Angelica tea taken once daily, has shown good results.
Herbal Remedies: Royal Jelly, NOW Foods, 300 mg, 100 Softgels
Herbal Remedies: Royal Jelly, NOW Foods, 1,000 mg, 60 Softgels
Herbal Remedies: Angelica Root Tincture, 2 fl. oz.
Mountain Rose Herbs: Angelica, Bulk Herb
St. John's Wort is a good antidepressant and helps to reduce cravings.
Herbal Remedies: Kira St. John's Wort, Kwai, 45 Tabs
Herbal Remedies: St. John's Wort Herbal Tea, 20 Tea Bags
Herbal Remedies: St. John's Wort Tea, Caffeine Free, Yogi Tea, 16 Bags
Herbal Remedies: St. John's Wort, Perika, 300 mg, 60 Tabs
Herbal Remedies: St. John's Wort Tincture, Alcohol Free, 1 fl. oz.
Herbal Remedies: St. John's Wort Supplement Tincture, 2 fl. oz.
Herbal Remedies: St. John's Wort Supplement, 350 mg, 180 Caps
Herbal Remedies: St. John's Wort Powder (Hypericum Perforatum), 4 oz. Bulk
Herbal Remedies: Mood Aid Formula, 5-HTP & St. John's Wort Supplement, Nature's Way, 60 Caps
CONSIDERATIONS
It is wrong to categorize bulimia as "just a food addiction," as its roots are tied to many other factors that vary from case to case, including low self-esteem, psychological, biological, and societal factors.
The most successful treatment plan for bulimia include a psychologist (who can help assess the psychological implications of the person's disorder) and a health care provider (to evaluate and monitor his or her physical state). Long-term treatment may be needed to improve self-esteem and ensure that the person is mentally and physically able to recover.
According to researchers at the National Institute of Mental Health (NIMH) and Duke University, lack of a hormone that controls appetite may be the reason those with bulimia fail to feel full. For these people, eating a meal apparently does not stimulate adequate production of the hormone cholecystokinin-pancreozymin (CCK), which is found in the small intestine and the brain. They have to keep eating, and bingeing, in order to feel satisfied. However, more research is needed to determine whether this is the cause behind the majority of cases of binge eating.
According to an article published in the October 1997 issue of The Harvard Mental Health Letter, women with diabetes who are bulimic often lose weight after a binge by reducing their doses of insulin. This can damage eye tissue and raise the risk of diabetic retinopathy, which can lead to blindness.
A study conducted at the University of Iowa College of Medicine and the University of Wisconsin found that reducing weight as part of athletic training may lead to bulimia. A survey of 700 high school wrestlers found that 2 percent were involved with binge eating, followed by vomiting, fasting, excessive exercises, or the use of laxatives to avoid weight gain.
NOTIFY YOUR HEALTH CARE PROVIDER IF...
You have symptoms of bulimia or you suspect your child has bulimia.
The following occur during treatment:
- Rapid, irregular heartbeat or chest pain.
- Loss of consciousness.
- Cessation of menstrual periods.
- Repeated vomiting or diarrhea.
- Continued weight loss, despite treatment.
More information about a closely related, often seen eating disorder associated with bulimia. Has more dietary information to assist in recovery.
For a full list of available products from Mountain Rose Herbs, click on banner below:
HELPFUL PRODUCTS & FURTHER EDUCATION
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 2nd Edition
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 4th Edition
Prescription for Herbal Healing: The A-To-Z Reference To Common Disorders
-- by Phyllis A. Balch
The Complete Guide to Natural Healing
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