On this episode, Jon D. Kaiser, MD taught us about the mitochondrial health and chronic disease connection.

Dr. Kaiser is a mitochondrial specialist with over thirty years of clinical and research experience in applying functional medicine approaches to treat complex medical conditions, including HIV/AIDS, chronic fatigue syndrome (CFS), fibromyalgia and long COVID.

Dr. Kaiser began his career as an HIV/AIDS specialist in San Francisco at the height of the HIV epidemic. He found that many of his patients needed nutritional and mitochondrial support, especially after manifesting antiviral medication side effects.

He developed protocols to help patients improve their baseline health with an original nutraceutical formulation that supports mitochondrial health. Dr. Kaiser joined James to discuss how he has applied his protocols to help patients with other chronic illnesses and post-infection syndromes.

Tune in to learn more from Dr. Kaiser about the following topics:

  • Lifestyle factors that support healing beyond other integrative interventions
  • How mitochondria are chemically and electrically connected and communicate with each other throughout the body
  • Parasympathetic activation as a critical component of recovery
  • How the poor mitochondrial function impacts the neuro-endocrine-immune axis and gastrointestinal tract
  • His vision for the next steps in medicine, including the need for a readily available blood test that assays the health of mitochondria in blood cells

This episode continues to explore the theme laid out in the August 2023 Functional Forum, Mitochondrial Mayem, where we learned how mitochondrial dysfunction leads to a wide range of chronic illnesses—from autoimmunity to cardiometabolic disease, neurologic disorders and more.


Mitochondrial Support for Post-Infection Syndromes | Ep. 314


Dr. Jon Kaiser: But then, when the drugs came out, hundreds of thousands of people went on antiviral drugs like AZT and DDI.

Within two or three years, we started to see the emergence of bizarre side effects: hepatitis, pancreatitis, peripheral neuropathy, dementia, fatigue. And it was conclusively proven that the antiviral drugs were poisoning an enzyme in the mitochondria that was causing mitochondrial toxicity. And so, I had hundreds of patients who had developed mitochondrial toxicity that was symptomatic. And so, I began a quest to look at the research, trial and error and find the right micronutrients in the right ratio at the right dosages that would help both prevent and reverse these clinical symptoms of mitochondrial toxicity.

And I ended up going to Bristol-Myers Squibb because they had one of these toxic drugs, and I said, “I think I’ve found a combination that can reverse this toxicity.” And they funded a double-blind placebo controlled trial, and it conclusively showed benefit. So, I was really involved in this very early on, and I’ve been supporting the mitochondria of my patients for 25 years based on what I found works.

James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs and health technology, as well as practical tools to help you transform your practice and the health of your community.

This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective functional and integrated medicine. To find out more and to get started, go to goevomed.com/lmrc. That’s goevomed.com/lmrc.

Hello and welcome to the podcast. I am super excited for this week. We are going to speak to Dr. Jon Kaiser. He has been a functional medicine doctor since the early two thousands. As you’ll hear in the podcast, he was one of the people that was pioneering nutritional strategies during the AIDS pandemic and has been at the cutting edge of really understanding the topic that we’re going to be focused on for a while here at the Evolution of Medicine, which is mitochondria. It’s a hot topic, it’s one of the hottest topics in medicine right now, and so, we thought we’d go back to someone who’s been on the cutting edge for a long time.

In this podcast, you’re going to hear about what he learned from the HIV and AIDS pandemic and what he brought into understanding with COVID. We’re also going to talk a little bit about parasympathetic and how to get patients into parasympathetic state. Really, really interesting conversation. And actually, he’ll be presenting at a conference in Park City, Utah in mid-October alongside Andy Heyman and Ritchie Shoemaker. Cutting edge stuff on really understanding the mitochondria and its role in chronic inflammatory conditions. So, if you can make it, we’ll be there with our cameras. I would love to see you. Enjoy.

So, a warm welcome to the podcast, Dr. John Kaiser. Welcome, Doc.

Dr. Jon Kaiser: Hello, James.

James Maskell: Really grateful to have you here, and I’m excited to talk about a topic that is hot. And ultimately, the topic of mitochondria has become really hot in the last few years. We’ll get into some of the conversation about long COVID and some of that kind of thing. But you’ve been at this a long time, and I’d love to just start with what started you down this journey and some of the early years of your research and your work because I think that this has been something that you’ve been thinking about, talking about, learning about for a lot longer than most of us who have only realized the importance of mitochondria, let’s say, in the last decade.

Dr. Jon Kaiser: Right. Well, I have, I think, a fairly unique history because I opened my functional medicine practice in the early nineties in San Francisco, and it was the explosion of the AIDS epidemic. And at that time, there were no antiviral medications approved by the FDA, and people were flying by the seat of their pants trying to stay stable, keep themselves alive until medications and antivirals became available. And so, I got to see what integrative therapies work to support the immune system and which integrative therapies were over the edge and didn’t do anything. And so, I always had my patients with HIV on a basic antioxidant support program because we knew the immune system was helped by vitamin C, vitamin E, beta carotene, zinc. But then, when the drugs came out, hundreds of thousands of people went on antiviral drugs like AZT and DDI.

Within two or three years, we started to see the emergence of bizarre side effects: hepatitis, pancreatitis, peripheral neuropathy, dementia, fatigue. And it was conclusively proven that the antiviral drugs were poisoning an enzyme in the mitochondria that was causing mitochondrial toxicity. And so, I had hundreds of patients who had developed mitochondrial toxicity that was symptomatic. And so, I began a quest to look at the research, trial and error and find the right micronutrients in the right ratio at the right dosages that would help both prevent and reverse these clinical symptoms of mitochondrial toxicity.

And I ended up going to Bristol-Myers Squibb because they had one of these toxic drugs, and I said, “I think I’ve found a combination that can reverse this toxicity.” And they funded a double-blind placebo controlled trial, and it conclusively showed benefit. So, I was really involved in this very early on, and I’ve been supporting the mitochondria of my patients for 25 years based on what I found works.

James Maskell: Well, that was an incredible natural experiment. Obviously, there’s an extra layer of complexity where it takes three years to happen, so there’s a gradual process. And one of the things that you just shared there is one of the things why I believe that functional medicine should be the operating system for the future of chronic disease care, is that it can take into account the fact that something can happen over time slowly and that there’s a loss of function, which that sort of relationship is hard to quantify when you’re really just looking at short-term effects. Right?

Dr. Jon Kaiser: Absolutely. And the mitochondria reproduce, and they have genes. So, when the environment is damaging the mitochondria, it’s causing mutations in mitochondrial DNA. That’s what’s damaging the mitochondria, and when the mitochondria reproduce, they pass on those damaged genes to their progeny. And so, this unhealthy population of mitochondria seeps into the entire body. And so, that’s why it can take years to reconstitute a healthy population of mitochondria system wide.

James Maskell: You mentioned some of those issues there, but can you give some other examples of acute versus chronic mitochondrial dysfunction and how they show up in common chronic disease states that we’re seeing in society today?

Dr. Jon Kaiser: Well, there’s tons of research that demonstrate mitochondrial dysfunction in neurodegenerative diseases like Alzheimer’s and Parkinson’s and ALS, autoimmune diseases, even diabetes. A lot of these complicated age-related diseases, even though Alzheimer’s is in the nervous system or Parkinson’s is in the nervous system, we’re finding abnormalities in the gut microbiome. There’s chronic neuro inflammation, so the immune system’s involved, and I believe in many of these cases you have adrenal fatigue and adrenal suppression. So, you have an intersection of multiple systems that cause these complex diseases, and the only thing that ties all these multiple systems together is the health of the mitochondria.

James Maskell: Interesting. Okay. You mentioned obviously there the AZT, that’s topical. What are some of the common medications that cause this mitochondrial toxicity?

Dr. Jon Kaiser: So, there are papers which describe all the drugs that can damage the mitochondria. Drugs such as statins, which deplete CoQ10, some antidepressants, anti-psychotics, antibiotics. People who take antibiotics over a long time… It’s doing damage to the mitochondria. So, there are lots of medications, and obviously, in functional medicine, we want that medication list to be as short as possible.

James Maskell: Absolutely. That’s so critical. Now that I’m thinking about it, when you watched the movie Dallas Buyers Club, was that your protocols that were being deployed there?

Dr. Jon Kaiser: So, a lot of it. A lot of my patients went down to Mexico to initially get different things. Things really caught on back then that didn’t have good clinical evidence, and so, people were injecting under their skin mistletoe extract. They were painting photographic chemicals on their skin. I mean, they were doing all sorts of stuff, but the things that stood the test of time and now have good clinical benefit is properly supporting mitochondrial health, properly supporting adrenal health, properly supporting your muscle mass.

Your immune function is tied to your muscle mass. If your muscle mass falls too low, your immune function is going to decline. So, there’s lots of things that came out of those times that have become bedrocks of my practice and my programs. But back to the Dallas Buyers Club, in the movie, Matthew McConaughey kept going to this doctor trying to get prescriptions and assistance, and I was that doctor who had people always come into them.

James Maskell: It’s a really amazing story, and it’s super topical too. So, with that life experience, where was your head at in March 2020 when you have a similar kind of situation in that there’s this viral thing that’s happening, and people are trying to work out what’s going on or what to do? Where was your head at that point?

Dr. Jon Kaiser: Well, it was in a number of places. First off, I was like, “Oh dear, here we go again. I’m living through a second major worldwide pandemic.” I didn’t expect that. I thought my experience over 20 years through the AIDS pandemic was good enough for one lifetime. So, here we go again. But also, viruses behave a certain way and respiratory viruses behave a certain way. And so, I had, I think, a somewhat deep understanding of viral dynamics and how viruses behave and what are some really good natural ways to keep your immune system high and keep you from being so susceptible as well as how to treat it once you contracted it. And now, I’m pretty much seeing mostly people with long COVID and helping them put their health back together.

James Maskell: That’s great. Well, I guess, let’s talk about long COVID then since you just mentioned it because… What is the similarities and differences of people who are dealing with that compared to the AIDS patients that you saw? And then how does AZT and those kind of therapies line up to Remdesivir and the things that have been recommended as a standard of care?

Dr. Jon Kaiser: Right. Great question. So, when it comes specifically to long COVID… I think you have two categories of long COVID patients. One category is almost obvious. It’s people who had a severe coronavirus infection, were in the hospital, maybe they were on a ventilator in the ICU. They eventually recover, and they could be in their sixties, and they get home, and they’re compromised. Their lung function’s compromised. Their energy level’s compromised. But they really went through a severe infection, and they’re older. That’s one group.
The other group, which is even more common in my experience, are young people in their twenties, thirties and forties who didn’t really have an unusual infection. Maybe their symptoms lasted for 10 days, and then when they started ramping back up their activity to normal and going to the gym and exercising and working, they fall off a cliff 30 days later.

Or they got through their first COVID infection, and then they got COVID a second and a third time, and just tried to power through it. And the next thing you know, they’re seriously ill, and they can’t do anything. And they have multiple symptoms. And these are people who considered themselves previously healthy. In my experience, the same genetic strain of the coronavirus can infect 100 people and only 20 of them get long COVID, so the difference isn’t the strain of virus. It’s not the virus. It’s the terrain. It’s what the virus finds when it gets into the person and how it’s treated from that point forward.

So, what I find is most of these patients had subclinical underlying imbalances in their health, either very unhealthy diet and microbiome, or they were under way too much stress, or they weren’t sleeping well, their adrenal glands were suppressed. There are these underlying situations that make them ripe for the coronavirus to exploit, and then everything falls apart, and you got to put the whole puzzle back together.

James Maskell: Yeah. Well, that resonates with me too because I lived in the northeast, and for the first years of my career, I was working with a lot of doctors, functional medicine doctors, who were treating Lyme disease. And you see the same kind of thing there where the amount, like 10 patients, have the same infection, the same bite, the same bacteria, and there’s such a range of dysfunction that’s caused by it. And the pathway back could be a number of different therapies, but ultimately, it’s a rebuilding of function over a period of time in those key areas. And that’s why obviously you and I, as we look through this lens, we see that for these chronic inflammatory conditions, there’s only really one path back, and that is a multimodal functional medicine approach. I guess, what would you say are the commonalities? If you take across your experience with HIV and now with long COVID, what are the sort of common things that you see going wrong? And how have you approached fixing them at the broadest possible level?

Dr. Jon Kaiser: Right. Well, I believe that there are three systems of the body that are usually affected at the same time, and sometimes a fourth. And when you have the dysfunction or depletion in multiple systems, that’s when you’re a setup for a severe viral infection really upsetting your health. And you’ve heard this before, the neuro-endocrine-immune axis, right? So, it’s the nervous system, it’s the adrenal glands and it’s the immune system. Those three systems are almost always affected. People are having symptoms other than fatigue and brain fog, they’re having headaches, they’re having rashes. They’re having hyperexcitable immune responses, like asthma and difficulty breathing.

So, you really have to look at supporting and rebuilding the health of the nervous system. You have to assess the adrenal glands and get their levels of cortisol and DHEA at the right place, and then you have to support their immune system. The fourth system that is plus or minus is the gastrointestinal system and the microbiome. Some people it’s a mess, and some people it’s fine, but you really need to do everything possible to support and rebalance and reintegrate those systems. Like I said before, underlying all of these systems is mitochondrial health because if your nervous system and your adrenal glands are worn down and depleted, then I can guarantee you you’ve done the same thing to your mitochondria.

James Maskell: What are your go-to recommendations for rebuilding those three areas?

Dr. Jon Kaiser: Well, of course it’s individualized to a person’s situation, but you’re always going to start with eating healthy. You do that five times a day, so your dietary habits need to be healthy. I do have a very specific tried and true program of nutrient supplements that has research and clinical evidence behind it that I prescribe. A lot of them people have heard of, but they’re not in the average multivitamin. So, N-acetyl cysteine, acetyl L-carnitine, alpha lipoic acid, CoQ10 all at a very defined ratio. And then patients, really we need to look at adrenal glands because in a patient whose cortisol level is next to nothing, your immune system will always be like a pinball machine because cortisol keeps a lid on the immune system being hyperreactive. So, I have had great success in giving very low supplemental dosages of hydrocortisone in patients whose adrenal glands are not functioning properly with good clinical benefit.

And it’s very similar to a person taking a thyroid supplement after age 50 if their thyroid’s low. If your adrenal glands are low, we should be supplementing cortisol. So, I’ve had good results, but you got to put all these pieces together simultaneously. And that’s why a lot of patients come to me and they say, “Oh, I’ve taken acetyl L-carnitine,” or, “Oh, I’ve been on ginseng,” or whatever. But the pieces of the program need to all come together simultaneously and then the catalyst to getting everything to integrate properly is you need to learn how to turn on your parasympathetic nervous system because the majority of these patients are sympathetic over-driven with too many catecholamines and adrenaline all the time, and their parasympathetic nervous system is atrophied. So, I give them techniques to turn on the parasympathetic nervous system and to spend sustained amounts of time resting with your parasympathetic nervous system turned on, and that has very significant benefits.

James Maskell: That’s really cool. What are some of the favorite lifestyle medicine type things that you recommend for parasympathetic tone and parasympathetic shift?

Dr. Jon Kaiser: Well, a lot of people want to find shortcuts to turning on and activating parasympathetic nervous system. There are very basic natural ways to turn on the parasympathetic nervous system, and the first thing is just educating the patient on what the goal is and what you’re trying to achieve. So, I’ll give you a simple one. After you sit down today and have a relaxing meal, hopefully relaxing lunch or dinner, you need to put your feet up and just relax for about 20, 25 minutes to turn on your parasympathetic nervous system. Eating tries to turn on your parasympathetic nervous system, but too many people, they take the last bite of their meal and then they get up and they start doing things, and that inhibits turning on the parasympathetic nervous system. So, that’s one way to do it, build the siesta into your day.

James Maskell: It’s funny because I was just in Spain recently meeting with a guy there. And he was Norwegian, and he was sort of laughing about the Spanish culture and how everything’s slow and it doesn’t get done. But the next breath, he was like, “But I don’t have to take my heart medication anymore.”

Dr. Jon Kaiser: Right. His blood pressure was down. Right.

James Maskell: Exactly. His blood pressure was down. And even for myself, I lived in New York, I lived in LA and now I live in the countryside, and I feel like the greatest blessing for my parasympathetic health is waking up and hearing the birds and not having jarring sounds. And I have two daughters, one that was born in Brooklyn and one that basically was born here, and just witnessing their differences. Obviously, kids are different anyway, but it’s interesting just to see what does it look like when your early years were spent listening to birds chirping and essentially silence the rest of the time versus living half a mile away from a hospital and hearing the sirens.

Dr. Jon Kaiser: Right. And that’s the second way is to get out into nature. If you get out into nature, you engage your parasympathetic nervous system.

James Maskell: Yeah. That’s really powerful stuff. Well, I heard, I’m excited to-

Dr. Jon Kaiser: If I might interrupt, there’s one other technique that I have my patients do. It’s called healing time. So, based on how serious a patient’s condition is, often I will say, “I want you to follow this technique.” I have a three-page handout on how to do it, and it’s basically I am telling them you need one hour of very deep rest with no sensory input. No reading, no phone, no music. You need to reconnect with your body and your nervous system, and it takes 15-20 minutes to get to where you need to be and then if you spend another half hour in that state, that’s when your nervous system heals the most deeply.

James Maskell: Beautiful, and I think that’s really exciting. And I’m excited to actually meet in person because I know in October, we’re all going to be together. We actually recently had Dr. Heyman and Ritchie Shoemaker on the Functional Forum just talking about some of their research. And I know that they’re going to be presenting there, and you’ll be presenting there and look forward to meeting in person. It’s really a hot topic. Four years ago, we came to the equivalent conference that was in Dallas, and at that time, it was really Bob Naviaux, cell danger response. Really, that the mitochondria is really as it relates to energy production.

But I think what I’m hearing from you and what I see when I look at the science over the last few years and obviously through the pandemic is there’s just so much more of an immune function regulation role that they’re playing. And I guess I’d just love to understand where you think we think we are with understanding mitochondria today and where you think things are going because we’ve learned a lot even in the last four years. That was cutting edge four years ago, cell danger response, where it is, but I feel like it’s moved along so quickly. And where do you think it’s going next?

Dr. Jon Kaiser: Right. I think that’s a great question. So, there has been an explosion of information and appreciation for the role of the mitochondria. It is not only the energy powerhouse of the cell. It actually holds the keys to the kingdom because if the mitochondria decides that the cell has become too toxic, it starts the process of apoptosis and the cell shuts down. So, the mitochondria initiate that. They determine when to hit that button. The mitochondria also have been shown… Mitochondrial DNA is a signaling molecule, and so, it’s released into the local and the systemic circulation to ramp up immune function. There’s a lot of pieces on the table, a lot of information on the table, but this is where I think things are going. The mitochondria talk to each other, and this is all shown in research. The mitochondria communicate within a cell and the mitochondria of one cell can communicate to the mitochondria of other cells.

I believe that all the mitochondria in your body are linked in multiple different ways, electrically and chemically, and that they form their own unique body system, your bioelectrical system. And that system is all working together to achieve specific goals, just like your gastrointestinal system and your nervous system and your endocrine system. And once we elevate mitochondrial health to the level of its own system, then we’re going to start looking for ways to better evaluate it. And you can actually do a blood test and put cells in an analyzer and get a mitochondrial health score, and that’s what we need to start evaluating is the mitochondrial health of our patients. We need a readily available—not a research tool—a readily available blood test that assays the health of the mitochondria in blood cells and platelets so we can extrapolate that to evaluating overall mitochondrial robustness. That’s where I think it’s going.

James Maskell: Right on. I love that. And is that part of your vision and your mitochondrial manifesto?

Dr. Jon Kaiser: Yeah. Well, I’m writing a book right now on my experiences like we’ve been talking about over the past 30 years, and an entire chapter is going to be on the bioelectrical system and making the case for what I just stated.

James Maskell: It reminds me of the mycelial layer below the soil, where there’s things that were connected that you don’t see on top are connected, but they’re actually deeply connected. And until you understand the mechanism and you see that it actually exists, you wouldn’t necessarily put two and two together. But once you understand that there’s a mechanism that you can’t see, then you start to realize that this is not things working in isolation. There’s a coherence and harmony underneath everything that is hard to physically see but is creating a function.

Dr. Jon Kaiser: And it includes communication between all those different underlying nodes, and I think that’s a valid analogy. I really like that.

James Maskell: Awesome. Well, look, I’m excited and I’m grateful for you sharing it. I guess I want to share a couple things. One is anytime I meet for the first time a doctor that’s been in the trenches and taking this whole thing forward, I guess I just want to acknowledge just how subtle and hard to measure the work of doing this type of work with individual patients, and the movement that we see in this direction now is this network of people that identified something that was true about the health of the human body, followed that thread.

And then the knock-on effects are very, again, hard to understand what comes from where, but you do see this groundswell of interest in these types of topics. I just want to acknowledge that and your work in that, and just what an incredible journey and then obviously, just being on the front lines and getting it done. So, thank you for the role that you’ve played because I know it’s helped so many people, and I know other people have come to the party because of your influence. Because you’ve never been on the podcast before, I’d love to just get your answer to this question, which I used to ask as my last question for the first few years of the podcast. When I say the words, “The evolution of medicine,” what does that bring up for you?

Dr. Jon Kaiser: Well, I think the evolution of medicine is going to move in a direction where we can no longer take this specialist sharp shooting approach to every symptom a person has. If you have headaches, you go to the neurologist. If you have belly pain, you go to the gastroenterologist. If your hormones are off, you go to the endocrinologist. Where this needs to go and I think where it will eventually go is functional medicine and the excellent practitioners who are involved in it, they put all the pieces together. They see the whole picture. They work on improving the health of the entire individual.

And yes, we may need to send a patient to a specialist for an evaluation, but the cost of the broken system that we have is spiraling out of control and will be and is unsustainable. So, in Thomas Kuhn’s, The Theory of Scientific Revolutions, you always have to have a crisis as the catalyst for the scientific revolution. And I think the financial situation that medicine is going to find itself in with an aging population with all of these age-related conditions is going to ultimately call on functional medicine to help manage the situation better.

James Maskell: It’s really interesting you say that because we’ve never actually spoken before. This is the first time we spoke, but I was trained as a health economist. And in 2003, I was doing my work and recognized it was the cost of medicine spiraling exponentially that would cause an impact in our lifetime because there wasn’t any plan to reverse the cost of chronic disease or flatten the curve. And in that way, some of the weird medicine that I’d grown up with like chiropractic and homeopathy and nutrition and that kind of stuff, I just had an inkling that that would be the thing that would cause this transformation. And when I got involved in 2005, I didn’t know when it would happen, but I knew that it was coming at some point. And it’s interesting to hear you say that because I completely agree. I’m here for it, I’m involved in it, and I’m trying to put together and bring together all these people. So, I think it’s really cutting edge, and I’m grateful for you to feed that back to me because it gives me more energy to keep going.

Dr. Jon Kaiser: And James, I know in your work, if we can demonstrate, if you take a really complex, long COVID patient, let’s just use that example, and you did a study, and you were able to demonstrate that for less costs, functional medicine could generate better outcomes, they can get people better for less cost than sending them to NYU Medical Center Long COVID Clinic, I see the amount of unnecessary testing because they’re just like doing a shotgun approach is off the scale. So, if we can demonstrate a cost benefit and an outcome benefit, that’s when you start to get their attention.

James Maskell: Absolutely. Yeah. And that’s already happening. I’m excited to share. That’s what I’ve been really focused on and seeing, and we’ve been deploying it in a virtual group model because of the cost side of doing that, but I think that the individual practitioner model, which is the majority of functional medicine today, can facilitate that too. We just need to track outcomes well, and we really need to understand the total cost of care, which is very opaque sometimes and hard to get at. But I totally agree with you. Well, look, I’m excited to connect in October. If you’re interested in coming to the conference, it is mid-October in Park City, Utah. Dr. Heyman, Dr. Shoemaker, Dr. Kaiser and others will be there. We’ll be bringing our cameras along to create an episode of the Functional Forum because I think this is mission critical and very topical. And Doc, thank you so much for taking time to be part of the podcast.

Dr. Jon Kaiser: Thank you, James. It was my pleasure.

James Maskell: Thanks for listening to the Evolution of Medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools, like the Group Visit Toolkit. That’s goevomed.com/lmrc. Thanks so much for listening and we’ll see you next time.

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