Syncope

bradycardia fainting

Last Updated December 20th, 2021

What is syncope?

Syncope is a medical term used to describe a person fainting. It usually happens when there isn’t enough blood flow to the brain. This occurs when the blood pressure is too low and the brain doesn’t receive enough oxygen. Syncope is usually a symptom of an underlying medical problem.

Syncope is a very common condition. 3.5% women and 3% of men have syncope at some point in their life. It is more prevalent in older adults, with 6% of people over the age of 75 being affected by this condition.

How does syncope occur?

bradycardia faintingTo understand how fainting occurs, it is important to understand how the brain functions.

The brain requires constant blood flow for it to get oxygen and glucose. For a person to be awake, the reticular activating system, an area located in the brain stem, needs to be turned on. Also, at least one of the hemispheres in the brain needs to be active. Fainting occurs when the reticular activating system loses its blood supply or both the hemispheres of the brain are inactive due to them being deprived of oxygen or glucose.

Types of Syncope

There are several types of syncope and it usually depends on the underlying problem. Some of the most common ones are

Vasovagal syncope

This is the most common type of syncope. This happens when the body overreacts to certain triggers, such as shock, the sight of blood or emotional distress. The part of the nervous system that regulates heart rate and blood pressure malfunctions in response to these triggers.

This causes a sudden drop in heart rate and blood pressure, which in turn leads to reduced blood flow in the brain. This results in a person briefly losing consciousness (less than a minute).  Some of the symptoms of vasovagal syncope include

  • Pale skin
  • Lightheadedness
  • Tunnel vision
  • Nausea
  • Feeling warm
  • Cold, clammy sweat
  • Yawning
  • Blurred vision

Vasovagal syncope is generally harmless and does not require any treatment. However, your doctor may recommend you more test to rule out other causes such as heart problems.

Situational syncope

stress, anxiety, depressionThis is a type of vasovagal syncope that occurs only in certain situations like

  • Having blood drawn
  • Straining while urinating or defecating
  • Coughing
  • Dehydration
  • Intense emotional stress
  • Anxiety
  • Fear
  • Pain
  • Hunger
  • Excessive use of alcohol or drugs
  • Hyperventilation (breathing too fast)

When faced with these triggers, the person feels nauseated, sweaty, and weak just before losing consciousness. Situational syncope happens due to something known as the vasovagal reaction, a reflex of the involuntary nervous system. The vasovagal reaction prompts the heart to slow down and the blood vessels in the legs to widen. As a result, less blood is pumped and most of the circulating blood is directed towards the legs. When the brain is deprived of oxygen, fainting occurs.

Postural syncope

Also known as postural hypotension, this type of syncope occurs when there is a drop in blood pressure due to a sudden change in position of the body (for example, when you suddenly get up from a lying position).

Postural syncope is characterized by a decrease in systolic blood pressure of at least 20 mm Hg or diastolic blood pressure of at least 10 mm Hg when a person stands up. Depending on the time taken for the blood pressure to drop, postural hypotension can be divided into three types

  • Vasovagal orthostatic hypotension: This happens almost suddenly
  • Classic orthostatic hypotension: This type happens within three minutes
  • Delayed orthostatic hypotension: This type happens gradually.

Postural syncope occurs due to delayed or absent constriction of the blood vessels of the lower body. Constriction in the lower blood vessels is required to maintain a normal blood pressure when the position of the body is changed to standing. When the constriction is delayed or absent, the blood in the legs takes a longer time to reach the heart and this decreases the blood flow to the brain. Postural syncope can also make you feel dizzy or lightheaded.

Neurologic syncope

This type of syncope happens due to a condition such as

  • Seizure
  • Stroke
  • Transient ischemic attack (TIA)

Other less common conditions that lead to neurologic syncope include

  • Migraines
  • Normal-pressure hydrocephalus

Causes

Syncope is often triggered by the vagus nerve, which connects the digestive system to the brain. Its main function is to regulate the blood flow to the abdominal region. When a person eats food, the vagus nerve directs more blood into the stomach and intestine. However, sometimes the vagus nerves can also trigger syncope by directing too much blood away from the brain. This can happen due to the following reasons.

Panic attack

Panic attacks are a common cause of syncope. During a panic attack, a person starts to hyperventilate (breathing faster and more deeply). When this happens, the body takes in too much oxygen and gets rid of too much carbon dioxide. When the carbon dioxide levels in the body become low, the blood vessels start to constrict and this leads to the reduced blood supply to the brain.

Dehydration

Dehydration is a condition that happens when the amount of fluids lost by the body exceeds the amount that is taken in. This may happen due to vomiting, diarrhea or increased urination due to an infection.  When dehydration occurs, the vagus nerve is stimulated and this leads to syncope.

Pain

Pain can stimulate the vagus nerve and is a common cause of fainting. Syncope generally occurs when the body does not feel it can tolerate pain. This is a defense mechanism that the body uses in case of intolerable pain.  Syncope resulting from pain differs from person to person due to each individual having his/her own level of pain tolerance.

Emotional distress

Syncope also happens when people are under extreme emotional distress. For example, a person may faint if he/she gets some upsetting news like the death of a loved one. It may also happen in the presence of certain triggers like medical students fainting while observing their first autopsy or surgery. The vagus nerve is stimulated by certain hormones which are released when the body is under emotional distress.

Shock

Shock is a serious state that results due to decreased blood flow to the brain and other important organs. Shock may result due to

  • Loss of blood
  • Severe allergy
  • Severe infection
  • Dehydration
  • Poisoning
  • Burns

Shock usually leads to unconsciousness due to the disruption in the blood flow to the brain.

Alcohol abuse

Many people faint after drinking a lot of alcohol. A rapid rise in the alcohol levels in the blood prompts the vagus nerve to induce syncope so not the intake is stopped. Fainting after drinking alcohol is a sign of serious intoxication. Alcohol also makes a person dehydrated (due to too much urination), dilates blood vessels and decreases blood pressure. All these results in syncope.

Anemia

Anemia is a condition that is used to describe a condition in which a person doesn’t have enough healthy red blood cells. There are several types of anemia. These are

  • Iron deficiency anemia.
  • Vitamin deficiency anemia
  • Anemia of chronic disease
  • Aplastic anemia
  • Anemias associated with bone marrow disease.
  • Hemolytic anemias.
  • Sickle cell anemia

When the anemia is severe, fainting occurs as they are not enough red blood cells to deliver oxygen to the brain.

Drugs

Illegal drugs and prescribed drugs can also lead to syncope due to dehydration or drops in blood pressure. Here are a few drugs that may make you faint.

  • Nitrates: These drugs lower blood pressure and this results in you fainting
  • Diuretics: These drugs make you urinate more and that can lead to dehydration, which in turn may lead to fainting.
  • Opiates: These drugs work by lower blood pressure and slowing breathing
  • Heart drugs: These also decrease blood pressure
  • High blood pressure drugs: These also lower blood pressure

Abnormal Heart Beat

The heart plays a vital role in maintaining blood pressure. The heart is the organ that is responsible for forcing blood through the arteries and veins. If the heart beats abnormally, it is unable to maintain the required blood pressure. This results in reduced blood flow to the brain, which in turns results in fainting.

Symptoms

The most common symptom of syncope is dizziness just before fainting. However, it may also have the following symptoms

  • Feeling lightheaded
  • Falling
  • drowsiness or grogginess
  • Weakness after eating or exercising
  • unsteadiness or weakness when standing
  • Changes in vision
  • Headaches

People often experience “premonitory symptoms” before a spell of syncope. These may include

  • Heart palpitations (irregular heartbeats)
  • Lightheaded
  • Nausea

Diagnosis

Although most cases of syncope are harmless, you should see a doctor if you faint without any reason. You may be referred to a syncope specialist for a complete evaluation

If you have syncope, you should see your doctor, who can refer you to a syncope specialist for a complete evaluation. He/she will begin by doing a physical exam after carefully evaluating your medical history. You will then be asked questions about your syncope episode or episodes.

You may need tests, including electrophysiology studies, autonomic nervous system testing, neurological evaluation, and computed tomography (CT) scan. Vestibular function testing may be done to rule out problems in the inner ear. If you need any additional testing, your doctor will explain them and why they are needed.

You may then have to do the following tests

  • Tilt Test: This test is done to determine the amount of blood in your body, and the flow in different positions. During this test, you will be put in a bed that tilts vertically. Your oxygen level, heart rate, electrical impulses in the heart and blood pressure is then recorded as you’re tiltedat different angles.
  • Blood tests: This is done to check for anemia or any other blood abnormalities.
  • Electrocardiogram (EKG or ECG): This test is done to check the electrical activity of the heart. During this test, electrodes are attached to the skin near your heart. These record the electrical activity of the heart.
  • Exercise stress test: This test involves a person walking on a treadmill or riding a static bike while the heart is monitored.
  • Ambulatory monitor: You will wear a monitor that uses electrodes to record information about your heart’s rate and rhythm.
  • Echocardiogram: This test uses sound waves to make a pictorial representation of the heart. During the test, a transducer (a wand-like substance) is kept near your chest. This device produces sound waves that are directed towards your heart. These sound waves bounce off your heart to produce an image that is processed electronically. This test can determine the heart is functioning normally.
  • Blood volume determination: This is a test done to see the amount of blood in your body based on your gender, height, and weight.
  • Hemodynamic testing: This test is done to determine the blood flow and the pressure inside your blood vessels.
  • Autonomic reflex testing: This is a series of tests that are done to monitor blood pressure, blood flow, heart rate, skin temperature and sweating in response to certain stimuli.

Treatment

Treatment will usually depend on treating the underlying disease that caused the syncope. However, you may be asked to follow these measures.

  • Make changes to certain medications that you are currently on
  • Improve blood circulation by wearing garments or compression stockings
  • Change your diet
  • Be careful while changing the position of the body
  • Elevate your head while sleeping
  • Avoid certain triggers that induce a syncope episode
  • Do biofeedback training to slow down the fast heart rate
  • Undergo treatment for heart problems
  • Get a pacemaker implanted to keep your heart rate steady

Presyncope

Presyncope is the term to refer to a state when a person almost loses consciousness, usually due to reduced flow of blood to the brain. Some of the symptoms of presyncope include

  • Dizziness
  • Lightheadedness
  • Vertigo
  • Blurry or narrowed vision
  • Nausea
  • Vomiting
  • Headache
  • Sweating
  • Heart palpitations
  • General abdominal discomfort
  • Confusion or disorientation
  • Slurred speech

Presyncope is not that dangerous as the person doesn’t actually lose consciousness and the likelihood of injury is reduced. However, you should immediately see the doctor as presyncope may also be a sign of an underlying health condition.

How to help a person who has fainted?

You can help a person who has fainted by following these measures

  • If the person has not fainted but is showing the signs of syncope then help him/her lie down
  • Raise his/her legs by putting lifting their ankles to induce the blood flow back to the brain.
  • Try to wake the person up by tapping them or calling their name. You may also sprinkle some water on their face.
  • After he/she wakes up to tell them to lie down for at least 15-20 minutes.

Prevention

Although syncope is something that cannot be prevented, you can take certain measures to prevent it from happening.

  • If your fainting is caused by some triggers (for example, the sight of blood) try to avoid it.
  • If you feel lightheaded while standing up, move slowly while changing the position of your body.

 

Dos and Don'ts

Dos
  • Always loosen the victim’s clothing, especially if it is tight
  • Apply a moist towel to the victim’s face and neck
  • Remove the victim’s glasses (if he/she wears one)
Don'ts
  • Slap or shake someone who’s just fainted
  • Try to give the victim any food or drink
  • Don’t try to lift the victim
  • Allow the victim to get up right away after he/she recovers

 

 

 

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Beta hCG Test A Beta hCG test measures the level of human gonadotropin hormones present in the blood that is primarliy…
cystatin C
Cystatin C Test Cystatin C is a specific single-chain protein that is found in body fluids and is a biomarker for…
sodium blood test
Blood Sodium Test A blood sodium test measures the amount of sodium (an important electrolyte) in your body. It is also…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
low fodmap plan
Troubled with IBS? Here’s a complete roadmap to the low FODMAP diet Leaky & inflammatory gut troubling you? No medicine bringing you relief from the pain? Why not try the…
Cordyceps: How the Caterpillar fungus works as a proven cancer-shield Strange as it may sound, but cordyceps or "caterpillar fungus", a fungus variety native to the Himalayas may…
GM Diet: The fastest way to lose weight or yet another hoax diet? General Motors started this trend of extreme dieting for 7 straight days to ensure its employees were able…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
Experts reveal the safest ways to perform an enema at home The idea of pushing some up your rectal area might make you queasy but an enema could actually…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Low fat diets
A complete list of low-fat diets and how to follow them Low-fat diets help you lose weight in a healthy way, but it works only with regular exercise and…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
Inhale oxygen, exhale worries: The top breathing exercises and how to perform them Performing the breathing exercise is like becoming mindful of how you breathe.  Here is a list of breathing…
LFT-test
Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
leptospira Igm test
Leptospira-IgM Test A Leptospira-IgM test is a blood test which is carried out to detect anti-Leptospira IgM antibody. Leptospirosis is…
helping friend with depression
Support and care tips for helping people with depression Read to find out what is depression, its causes and symptoms. Also check out the steps describing how…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Poop chart: Top things you didn’t you your poop could reveal about you Bristol poop chart was designed during the 1990s in order to help doctors identify various types of poops…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
tonometry
Tonometry Tonometry uses a device called tonometer to measure the pressure inside the eye. This pressure is depends upon…
Glucose-6-Phosphate Dehydrogenase (G6PD) test Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme that is found in every cell of the body and it plays…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
elements 22 test
Element 22 test (Nutrients & Toxicity) The element 22 test is used for measuring and monitoring the levels of heavy metals and some nutrients…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
Medical conditions yoga can help with Yoga practitioners have outlined several health benefits of yoga and a daily yoga regimen can help in treating…
Medical conditions yoga can help with Yoga practitioners have outlined several health benefits of yoga and a daily yoga regimen can help in treating…
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…
dandelion weight loss
Caralluma Fimbriata: How to eat this cactus to lose weight Caralluma fimbriata is a miracle cactus that can be safely consumed by most for losing weight and boosting…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
How can Kegels help you overcome weak pelvic muscles & incontinence? Kegel exercises are pelvic floor strengthening exercises that can help you overcome incontinence issues that rise out of…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Gua sha: Scraping away layers of pain with this ancient healing tool Gua sha is an ancient oriental healing method which focuses on scraping the body with specific tools to…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
AUTOIMMUNE HEPATITIS liver
Hepatitis Profile A hepatitis profile or a hepatitis panel is a blood test that checks for markers of hepatitis infection…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
woman with abdominal pain holding ovulation calendar
Ovulation – facts to know about ovulation Learn how and when ovulation occurs, demystify common misconceptions, identify symptoms, methods of detection and right period for…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
How can berberine supplements help you live longer and healthier? Berberine is a turmeric look-alike herbal extract that is credited with numerous health benefits ranging from diabetes cure…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
CERULOPLASMIN- triple marker
Triple Marker Test A triple marker test is an important prenatal test that is performed to detect the presence of chromosomal…
biopsy procedure
Biopsy Biopsy is a procedure of studying a live tissue sample collected from a specific organ for diagnosing a…
malarial antigen test
Malaria Antigen Test A malaria antigen test is a rapid diagnostic test (RDT) that can detect malarial antigens (proteins) in your…
apolipoprotein a1 test
Apolipoprotein -A1 (APO-A1) Test Apolipoprotein A-I (Apo-A1) constitutes 70% of protein content in high-density lipoprotein (HDL) and helps in lipid metabolism.
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
blood ketone test
Blood Ketone (D3HB) Test The Blood Ketone Test measures and monitors the levels of ketone in the blood which is usually performed…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
Goji berry: A traditional Chinese berry that packs the best of antioxidants Goji berry is an ancient berry that is considered to be power-packed with nutrients and antioxidants. Which means…
10 reasons why you should up your selenium intake Selenium, though a trace mineral, is very much integral to your health. Find out how much selenium intake…
waterchestnut
Water Chestnuts: The tastiest ways to include this healthy tuber in your diet Water chestnut is not a nut after all. It is a tuber (much like the potatoes) growing close…
What is the right way to take a pregnancy test? A pregnancy test is undertaken to determine if you have conceived. A home pregnancy test is the most…
Vagus nerve: 7 health benefits of stimulating the “gut-brain” connection As a matter of fact, there are two vagus nerves namely the left and the right but is…
Urologist: When should you visit one and why? A urologist can treat not only genitourinary problems of both men and women but also can treat various…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
Hysteroscopy_procedure
Hysteroscopy Hysteroscopy is a minimally invasive tool to help specialists view the uterus to diagnose and even treat several…
hemoglobin variant analysis
Hemoglobin Variant Analysis Hemoglobin variant analysis is a blood test that is used to detect the presence of hemoglobin variants which…
valproic acid test
Valproic Acid Test Valproic acid test is performed to generally check for psychiatric and even neurological conditions such as bipolar disease…
fructosamine test
Fructosamine Test A fructosamine test measures blood sugar glucose content. Fructosamine level can indicate blood sugar level in past 2-3…
thyroxine t4 test
T4 (Thyroxine) Hormone Test The T4 or thyroxine blood test is an important diagnostic tool that gives a clear picture of how…
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
Agave nectar: The bitter truth about this sweetener revealed Agave nectar is considered to be sweeter than the normal table sugar and even contains higher amounts of…
Bromelain: 11 reasons why you should start adding pineapple to your pizza! If you didn't love pineapples already, here are some of the top health benefits that bromelain can bring…
Cayenne: The remarkable benefits of these red hot chili peppers These may make you rush for a glass of water, but cayenne pepper is actually a healthy additive…
Exercises or diet? Find out the healthiest way to gain weight Tired of being called skinny all the time? Looking for healthy ways to beef up? Why not try…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
Carb Cycling: Weighing the pros vs the cons of this diet routine Completely discarding carbs from your life will do you more harm than good. Read more about carb cycling,…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
anti-chlamydia antibody tets
Anti-Chlamydia Antibody -IgG Test Anti-Chlamydia Antibody - IgG test is performed by collection of urine or genital fluids as sample for testing…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
lipase test
Lipase Test A lipase test is a blood test performed to quantitatively measure the level of the enzyme lipase in…
Rheumatoid Arthritis xray
Arthritis Profile Arthritis profile is a panel of primarily blood tests used to detect the presence of arthritis or check…
social media adddiction
Your health in the age of Social Media: Why is digital detox a necessity? Did you know that more than 400 million people are dangerously addicted to social media? Are you one…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
acne removal tips
Anatomy of acne: 7 instant steps to kiss those zits goodbye Blackheads, whiteheads, or pimples-call them what you may. Acne is never good news.Did you know some of the…
High Fiber Diet – Fire up your fiber intake for these health benefits! Regular bowels, healthy detox, higher immunity, and guaranteed weight loss - a high fiber diet can bring all…

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