Inicio IVB Blog
Back

Blog IVB

Latest entries

Recuperación en el postparto sin lactancia materna: equilibrio hormonal y físico

Recuperación en el postparto sin lactancia materna: equilibrio hormonal y físico

Es lógico pensar que tras el parto, al no dar lactancia el cuerpo no sufrirá tanto desgaste físico y la recuperación es más rápida. Sin embargo, la realidad es muy distinta. La recuperación durante el postparto afecta a la energía, el estado de ánimo y el bienestar, provocando agotamiento, cambios en el pelo y en la piel, independientemente de si se da lactancia materna o no. Una gran transformación hormonal altera tu metabolismo. Es por esto que tu cuerpo necesita tiempo para volver a su equilibrio y adaptarse a esta nueva etapa. Pero ¿cuánto tarda el cuerpo en recuperarse después del parto sin lactancia? En esta guía te explicamos qué ocurre en tu organismo, cuáles son las molestias más habituales y cómo la alimentación, el descanso y un aporte adecuado de nutrientes pueden ayudarte a cuidar tu recuperación.   ¿Qué le ocurre a tu cuerpo tras dar a luz? Durante el embarazo, la placenta produce estrógenos y progesterona, que son las encargadas de sostener el embarazo y mantener la melena densa y la piel luminosa (Barreto et al., 2025). Tras el parto, se produce una caída brusca de estrógenos y progesterona. Esta transformación hormonal, junto con la falta de descanso y las nuevas exigencias físicas y emocionales, puede contribuir a la aparición de altibajos emocionales y dificultades de concentración durante los primeros días. El descenso de los estrógenos también puede influir en la hidratación de las mucosas y en determinados cambios de los tejidos. Asimismo, las variaciones de progesterona y sus metabolitos participan en la adaptación del sistema nervioso, aunque el descanso, el estrés y otros factores también influyen en el bienestar emocional durante esta etapa.   ¿Cuándo vuelve la menstruación después del parto sin lactancia?  Durante el postparto sin lactancia, los niveles de prolactina, la hormona encargada de la producción de leche, descienden de forma natural o con ayuda farmacológica, permitiendo que las gonadotropinas vuelvan a producirse con mayor rapidez (Barreto et al., 2025). Por este motivo, la primera regla en mujeres no lactantes suele reaparecer entre las 6 y 8 semanas después del parto. Durante los primeros ciclos es habitual que puedan producirse reglas irregulares, sangrado más abundante y síndrome premenstrual, ya que el equilibrio entre estrógenos y progesterona todavía se está reajustando.   Caída del cabello en el postparto: causas y recuperación  Notar cómo el cepillo, la almohada o la ducha se llenan de pelo supone un gran impacto emocional para la madre. Por ello, es vital entender la causa de esta caída para saber qué entra dentro de la normalidad sin alarmarse. Caída hormonal Embarazo. La elevación de estrógenos mantiene el cabello en fase de crecimiento (anágena), donde el cabello no experimenta caída, y la densidad aumenta visiblemente. Puerperio. Tras el parto, la caída brusca de hormonas provoca que muchos folículos pasen a fase de reposo (telógena). Efluvio telógeno. De 2 a 4 meses después de dar a luz, el cabello cae de manera difusa. Lo que se experimenta es una caída abundante de cabellos que, tras el parto, han entrado en fase de reposo (Arranz, 2018).   Otras causas de caída capilar Ahora bien, si la caída se acompaña de un afinamiento del cabello en la zona superior de la cabeza, piel grasa o acné, podría existir una mayor sensibilidad a los andrógenos u otros factores implicados en la caída capilar. En estos casos, conviene realizar una valoración dermatológica para identificar la causa y establecer el abordaje más adecuado. El parto implica una pérdida de sangre considerable. A esto se le suma el sangrado postparto, que puede prolongarse de 4 a 6 semanas. Esto puede contribuir a una disminución de las reservas de hierro, especialmente si ya eran bajas durante el embarazo.  Por ello, no hace falta tener anemia en la analítica para sufrir los síntomas de la falta de hierro. Unos niveles bajos de ferritina, que reflejan una disminución de las reservas de hierro, pueden contribuir a la caída capilar, el cansancio y la fatiga, incluso cuando todavía no existe anemia. Aunque valores inferiores a 30 µg/L pueden orientar hacia un déficit de hierro, es importante interpretar los resultados junto con el resto de la analítica y la situación clínica de cada mujer. Si tus analíticas muestran reservas bajas, notas fatiga, palidez o sangrados abundantes, un complemento como FerroPlus puede ser un gran aliado. Está formulado con hierro bisglicinato, vitamina C y otros micronutrientes que influyen en su metabolismo (Layrisse et al., 2000). Combina la patente Ferrochel® de máxima absorción y tolerancia gástrica junto a cofactores en su forma activa como el cobre, folato activo Quatrefolic® y metil-B12, que acompañan todo el recorrido metabólico del hierro en tu organismo. Otras molestias físicas durante el postparto y cómo abordarlas  En el siguiente resumen hemos querido reflejar las molestias más habituales en esta etapa, junto a sus causas y posibles soluciones. Síntomas Causa Abordaje Diástasis abdominal Distensión del abdomen por el crecimiento del útero Fisioterapia y ejercicios de fortalecimiento abdominal adaptados tras valoración especializada  Incontinencia urinaria Debilidad muscular y sobrecarga del suelo pélvico Reeducación perineal tras valoración especializada Molestia en cicatriz Adherencias en los tejidos e inflamación de los nervios Masaje de cicatriz y alivio y control del dolor Dolor lumbar y articular Mayor flexibilidad de los ligamentos y cambios en la postura. Fortalecimiento de manera progresiva y aporte de proteínas   Muchas madres conviven con molestias musculares, dolor lumbar y sensación de fatiga física durante el postparto, como consecuencia de los cambios corporales del embarazo, el esfuerzo del parto y las nuevas exigencias del día a día. En esta etapa, el magnesio desempeña un papel importante, ya que contribuye al funcionamiento normal de los músculos y del sistema nervioso, además de ayudar a reducir el cansancio y la fatiga. Por ello, Magnesio Total puede ser un buen complemento nutricional para ayudar a cubrir las necesidades de este mineral durante la recuperación posparto.   ¿Cuándo conviene consultar con tu médico? Aunque el agotamiento y los cambios físicos forman parte de la adaptación en esta etapa, hay manifestaciones que no deben normalizarse. Sangrado vaginal excesivo. Empapar más de una compresa maternal en una hora o expulsar coágulos de gran tamaño. Fiebre o febrícula persistente. Temperatura corporal igual o superior a 38°C, ya que podría indicar infección. Flujo con mal olor. Alteración en el olor de las pérdidas postparto acompañada de dolor en el bajo vientre. Dolor en pantorrillas o piernas. Hinchazón asimétrica, enrojecimiento, calor o dolor en una sola pierna. Dolor de cabeza intenso o alteraciones visuales. Cefalea que no ceda con analgésicos, visión borrosa o destellos. Tristeza profunda o desconexión emocional. Sentimientos persistentes de incapacidad o indicios de depresión postparto.  ¿Qué hábitos pueden ayudar a la recuperación? Asegurar una correcta ingesta de proteínas Fuentes de alto valor biológico como los huevos, pescados, carnes magras y legumbres te ayudan a reparar los músculos, cicatrizar las heridas y producir colágeno. Durante el postparto, el cuerpo necesita un aporte adecuado de proteínas para favorecer la recuperación muscular, la reparación de los tejidos y los procesos de cicatrización. Por ello, si la alimentación no permite cubrir las necesidades diarias, incorporar un cazo de Proteína Láctea o Proteína Vegana IVB puede ser una opción práctica para completar el aporte de proteínas y aminoácidos esenciales. Hidratación y balance mineral Beber entre 2 y 2,5 litros de agua al día ayuda al riñón a depurar el exceso de líquidos retenidos durante el embarazo, favoreciendo el drenaje de edemas. Asegurar el descanso Aunque es complicado mantener un horario de sueño regular por las necesidades del bebé, intenta aprovechar los pequeños momentos de descanso a lo largo del día. Esto puede ayudarte a reducir el estrés y el cortisol. Además, durante el postparto es especialmente importante asegurar un aporte adecuado de magnesio. Este mineral contribuye al funcionamiento normal de los músculos y del sistema nervioso, además de ayudar a reducir el cansancio y la fatiga  (Baaij et al., 2015).  En este sentido, Magnesio Total puede ayudarte a completar el aporte de este mineral cuando la alimentación no cubre tus necesidades, acompañando así tu recuperación. Movimiento consciente Hacer paseos diarios de manera progresiva en terreno llano puede favorecer la circulación y ayudar a reducir la hinchazón de las piernas. Para favorecer el bienestar circulatorio, CircuDren puede ser un gran apoyo. Combina extractos de Castaño de Indias, Semilla de Uva y Diente de León (Pittler & Ernst., 2012). Una fórmula multidiana con patentes estandarizadas (como Venocin®, VinOseed™ y Lymphaselect®) que abordan simultáneamente el tono venoso, la permeabilidad capilar y el drenaje linfático. Balance hormonal Durante el postparto sin lactancia, pueden aparecer cambios en la piel, tensión mamaria o hinchazón asociados a la adaptación hormonal. En este contexto, FemmeBalance combina Vitex agnus-castus, Saw palmetto, NAC y cúrcuma, en una fórmula de apoyo nutricional orientada al bienestar femenino durante esta etapa. Preguntas frecuentes sobre el postparto sin lactancia ¿Puedo tomar hierro si mis análisis no muestran anemia? Sí, es posible presentar reservas bajas de hierro incluso cuando los niveles de hemoglobina son normales. Esta situación, conocida como déficit de hierro sin anemia, puede asociarse a cansancio, fatiga y caída capilar, especialmente tras las pérdidas de sangre del parto. Si tus analíticas muestran niveles bajos de ferritina y se confirma una necesidad de suplementación, nuestro FerroPlus puede ser una buena opción para complementar el aporte de hierro.  ¿Cuándo puedo volver al ejercicio físico de impacto? La vuelta al ejercicio físico después del parto debe ser progresiva, adaptando la intensidad y la duración a la recuperación de cada mujer. Durante las primeras 6–8 semanas después del parto, el cuerpo suele entrar en recuperación de los tejidos y del suelo pélvico (Calzada Flores, 2014). Para retomar ejercicios de alto impacto, como correr o saltar, te recomendamos realizar previamente una valoración con un fisioterapeuta especializado en suelo pélvico para comprobar el estado de la musculatura, la recuperación de los tejidos y la presencia de molestias, ya que la recuperación puede necesitar más tiempo. ¿Es normal retener tantos líquidos en las piernas tras el parto? Sí. Los cambios hormonales y circulatorios que se producen después del parto pueden favorecer la retención temporal de líquidos, especialmente en las piernas. Beber suficiente agua, mantener las piernas elevadas y apoyarte en complementos que favorezcan la circulación facilitará el drenaje natural. ¿Cómo diferenciar el cansancio habitual con un desajuste de la tiroides? El cansancio común cede o se alivia con descanso. En cambio, un desajuste tiroideo, como la tiroiditis postparto, puede causar fatiga profunda y constante, frío, estreñimiento, piel seca o caída masiva de cabello. Ante estos síntomas, te recomendamos pedir a tu médico una analítica para salir de dudas. Da el paso hacia tu recuperación El postparto sin lactancia es un proceso de grandes cambios que no se debe invisibilizar por la creencia de que la recuperación tiene que ser más rápida. Volver a sentirte bien y con energía lleva tiempo. Tu cuerpo acaba de pasar por un cambio enorme. Trátate con calma, descansa todo lo que puedas y dale los cuidados y la nutrición que necesita para recuperarse poco a poco.  En IVB queremos acompañarte durante esta etapa. Por eso, contamos con FemmeBalance, una fórmula que combina ingredientes seleccionados específicamente para el bienestar femenino y el equilibrio hormonal. Si estás pensando en incorporarlo tras el parto, te recomendamos comprobar con tu especialista que sea adecuado para ti. Recuerda que tu recuperación también importa. Escucha a tu cuerpo, respeta sus tiempos y, si necesitas orientación sobre cómo cuidarte durante el postparto, estamos aquí para ayudarte   Referencias científicas Barreto, K., Bello, L., Chiluisa, P., Sandó, C., Márquez, D., & Noguera, Z. (2025). Endocrinología del embarazo, parto y puerperio. Revisión narrativa. Revista de Obstetricia y Ginecología de Venezuela, 85(1), 75-87.   Arranz, J. F. (2018). Suplementación con micronutrientes y efluvio telógeno pós-parto. Matronas prof, 18(4), 135-136. Layrisse, M., García-Casal, M. N., Solano, L., Baron, M. A., Arguello, F., Llovera, D., Ramírez, J., Leets, I., & Tropper, E. (2000). Iron bioavailability in humans from breakfasts enriched with iron bis-glycine chelate, phytates and polyphenols. The Journal of Nutrition, 130(9), 2195-2199. Calzada Flores, A. B., (2014). Guía de ejercicios para el fortalecimiento del compartimento abdomino–pélvico en mujeres postparto.  Baaij, J. H. F., Hoenderop, J. G. J., & Bindels, R. J. M. (2015). Magnesium in man: implications for health and disease. Physiological Reviews, 95(1), 1-46. Pittler, M. H., & Ernst, E. (2012). Horse chestnut seed extract for chronic venous insufficiency. Cochrane Database of Systematic Reviews, 11, CD003230.

Síndrome metabólico: qué es, cómo se diagnostica y cómo mejorarlo

Metabolic syndrome: what it is, how it is diagnosed, and how to improve it

Glucose, triglycerides, blood pressure, weight… we often focus on these parameters separately, but metabolic health does not depend on a single value. What is often important is how they relate to each other and what happens when several alterations appear at the same time. Metabolic syndrome is precisely the combination of different metabolic and cardiovascular risk factors. It does not always produce obvious symptoms and can appear even in people who are not obese. In this article, we will look at what metabolic syndrome is, what its criteria are, why it can appear, and what strategies can help improve its different components. We will also look at what role supplementation can play and how far the evidence really goes. What is metabolic syndrome? Metabolic syndrome is not a single disease, but the joint appearance of several metabolic and cardiovascular risk factors. To establish its presence, five components are assessed: waist circumference, triglycerides, HDL cholesterol, blood pressure, and fasting glucose. The diagnosis is established when there are at least three of these five criteria. Therefore, talking about metabolic syndrome does not simply mean being overweight, having high blood sugar, or having hypertension. What matters is the combination of different alterations. What are the symptoms of metabolic syndrome? One of the peculiarities of metabolic syndrome is that it may not produce obvious symptoms. An elevated abdominal waist can be seen externally, but high blood pressure, elevated triglycerides, or low HDL can go completely unnoticed. When glucose is sufficiently elevated, symptoms such as increased thirst, increased urination, fatigue, or blurred vision can appear. Therefore, feeling well does not necessarily mean that metabolic health is in good condition. The assessment must be carried out taking into account different measurements and analytical parameters, not just how we feel. How is it diagnosed? The 5 criteria of metabolic syndrome The diagnosis is based on the presence of at least three of the five established criteria. The values commonly used are: Elevated waist circumference: the cut-off points depend on the population and the criteria used. Triglycerides: ≥150 mg/dL (1.7 mmol/L) or specific treatment. HDL: Blood pressure: ≥130/85 mmHg or antihypertensive treatment. Fasting glucose: ≥100 mg/dL (5.6 mmol/L) or treatment. In the case of waist circumference, there is a peculiarity: the cut-off points can vary according to the population and region. For people of European origin, for example, the International Diabetes Federation proposes ≥94 cm in men and ≥80 cm in women, although other criteria use different values. Therefore, these data serve to understand how the diagnosis is established, but the assessment must be individualized based on each person's context. What causes metabolic syndrome? There is no single cause capable of explaining metabolic syndrome. The abdominal adiposity and insulin resistance are closely related to its appearance, although the pathophysiology is more complex. Insulin resistance has been studied for decades as one of the possible common elements. When cells respond worse to the action of insulin, the body needs to produce more to manage to keep glucose within adequate levels. Over time, this alteration can be related to other metabolic changes, such as lipid alterations, increased abdominal fat, or changes in glucose control. Therefore, when we talk about metabolic health, we should not focus only on blood sugar. Glucose, lipids, blood pressure, and body composition are part of the same metabolic context. Can you have metabolic syndrome without obesity? Yes. Elevated waist circumference is one of the five criteria, but it is not essential to establish the diagnosis. A person may not have obesity and still meet three of the other criteria: for example, having elevated glucose, high triglycerides, and high blood pressure. Similarly, a person with excess weight does not necessarily have to present all these alterations. Therefore, body weight alone does not allow us to determine how metabolic health is. It is necessary to assess the set of parameters and the individual context. How can metabolic syndrome be improved? Lifestyle changes constitute a fundamental part of the approach, especially when combining nutrition and physical activity. A recent review that brought together 98 clinical trials and more than 12,800 participants with metabolic syndrome observed that interventions that combined nutritional components and physical activity had advantages over exercise alone for improving metabolic syndrome. This does not mean that there is a single diet or a single type of exercise that works for everyone. Each of the alterations present may also require a specific approach. Therefore, improving metabolic health is not about looking for a quick fix, but about working on the different factors that are altered. What role does fiber have in metabolic health? Within nutrition, soluble fiber can be especially interesting. A review of 181 clinical trials with more than 14,500 participants observed overall reductions in total cholesterol, LDL, and triglycerides with soluble fiber supplementation. However, the effect varied depending on the type of fiber, the dose used, and the characteristics of the people studied. This is important because we cannot assume that all fibers produce exactly the same effect or that a certain dose will have the same result in all people. One of the fibers that has specific research is partially hydrolyzed guar gum or PHGG. In a trial conducted on people with type 2 diabetes and metabolic syndrome, the administration of 10 g daily of PHGG for six weeks was associated with a reduction in waist circumference and HbA1c compared to the start of the study. However, no changes were observed in other parameters such as fasting glucose, triglycerides, HDL, LDL, or blood pressure. This allows us to better understand where fiber can be of interest: as part of a global strategy, not as an intervention capable of correcting metabolic syndrome on its own. Can fiber supplementation be useful? When it is difficult to achieve a sufficient intake of fiber through diet, a supplement can help complete the intake. FiberTotal provides 6 g of soluble fiber per serving, of which 3 g comes from PHGG Sunfiber®. This fiber stands out for its digestive tolerance and for being certified as low FODMAP. However, it is important to maintain the context: the amount of PHGG in FiberTotal does not reproduce the dose used in the clinical trial mentioned above. Therefore, we should not automatically transfer the results of a study conducted with a specific dose to any product that contains the same ingredient. Supplementation should be understood as a tool to complement nutrition when it makes sense, not as a substitute for an adequate diet. Can supplements help with metabolic syndrome? Supplements do not replace nutrition, physical activity, or medical treatment when it is necessary. That said, some ingredients have been studied for their possible influence on parameters related to glucose and lipid metabolism. Here it is important to differentiate between the evidence available on a specific ingredient and the evidence of a complete formula. Just because an ingredient has demonstrated certain effects in a study does not automatically mean that a combination that contains it will produce exactly the same result. Berberine and metabolic syndrome The berberine is one of the ingredients that has the most clinical research within this context. A recent review of randomized, placebo-controlled trials found favorable effects on different parameters: triglycerides, LDL, total cholesterol, fasting glucose, two-hour glucose, body mass index, and waist circumference. In contrast, it did not find a significant overall effect on HDL or blood pressure. These results are interesting, but they must be interpreted correctly. The available evidence does not allow us to state that berberine alone reverses metabolic syndrome. In addition, the review evaluated high-purity berberine administered without other ingredients. Therefore, its results cannot be directly transferred to any formulation that contains berberine. Why does the formulation of berberine matter? One of the aspects that have been studied in relation to berberine is its limited oral absorption. For this reason, different formulations have been developed aimed at improving its bioavailability. Metabolic-Max uses Berbevis®, a formulation of berberine associated with a matrix with phospholipids and other components. In a pharmacokinetic study conducted on 12 healthy volunteers, the formulation of berberine associated with phospholipids produced a plasma exposure superior to that of non-formulated berberine. The total exposure was approximately 9.76 times higher after taking into account the different effective amount of berberine administered. But there is an important difference between bioavailability and clinical effect. Just because a formulation produces greater exposure to berberine does not mean that it has a clinical effect nine or ten times greater. What do we know about silymarin? The silymarin, from milk thistle, has also been studied in different contexts related to metabolic health. A meta-analysis of 33 trials and 1,943 participants found reductions in fasting glucose, insulin, HbA1c, total cholesterol, triglycerides, and LDL. However, the included studies presented important differences in terms of population, dose, and duration. In addition, the majority presented low methodological quality or a high risk of bias. Therefore, it is more appropriate to consider silymarin as a supporting ingredient within a global strategy, and not turn it alone into the protagonist of the metabolic approach. What do we know about Gymnema sylvestre? With Gymnema sylvestre we must be somewhat more cautious. The available clinical research is more limited and there are important differences between the extracts used, the doses, the duration of the studies, and their standardization. In a small double-blind, placebo-controlled trial conducted on people with glucose intolerance, 600 mg daily were administered for 12 weeks. Within the supplemented group, changes were observed in some parameters, including two-hour glucose, HbA1c, LDL, weight, body mass index, and insulin sensitivity. However, at the end of the intervention, there were no significant differences between groups in the continuous variables analyzed. A subsequent review also highlights the heterogeneity of the evidence and the need to conduct larger and longer-duration clinical studies. Therefore, it can be considered a complementary ingredient of interest, but we still need more evidence to precisely define its clinical effect. Where does Metabolic-Max fit in? After reviewing each of these ingredients, we can better understand the logic of a formula oriented towards metabolic health. Metabolic-Max should not be understood as a product intended to «accelerate» the metabolism. Its approach is to bring together different ingredients related to some of the processes we have explained. The daily dose of two capsules provides: 550 mg of Berbevis®, which provide 170.5 mg of berberine. 300 mg of Gymnema sylvestre, which provide 225 mg of gymnemic acids. 132 mg of milk thistle, which provide 105 mg of silymarin. 4.75 mg of piperine. 100 µg of chromium. In addition to berberine, gymnema, and silymarin, the chromium contributes to normal macronutrient metabolism and the maintenance of normal blood glucose levels. The formula, therefore, should be understood as a complementary tool within a broader metabolic care strategy, which starts with nutrition and physical activity and which must be adapted to the needs of each person. Frequently asked questions about metabolic syndrome Is metabolic syndrome the same as insulin resistance? No. Insulin resistance frequently appears associated with metabolic syndrome, but it does not constitute the diagnosis on its own. To talk about metabolic syndrome, at least three of the five established criteria must be met: waist circumference, triglycerides, HDL, blood pressure, and fasting glucose. Can metabolic syndrome be reversed? Its different components can improve to the point that a person stops meeting the diagnostic criteria. However, there is no single intervention valid for all cases. The strategy will depend on which parameters are altered and may include changes in nutrition, physical activity, and, when necessary, specific treatment. Do supplements accelerate the metabolism? It is not an appropriate way to describe the function of the supplements we have reviewed. Their possible interest is mainly related to parameters such as glucose, insulin, lipids, or body composition, not with demonstrating a general increase in energy expenditure. Therefore, talking about «accelerating the metabolism» oversimplifies its possible function. Is Metabolic-Max for losing weight? It should not be considered as a product specifically intended for weight loss. The available clinical evidence refers mainly to individual ingredients or specific combinations, not to Metabolic-Max as a complete formula. Weight control must be addressed from a global strategy that takes into account nutrition, physical activity, rest, and the individual characteristics of each person. Metabolic health is better understood when we stop looking at each piece of data separately Metabolic syndrome reminds us of something important: metabolic health does not depend on a single parameter. Glucose, lipids, blood pressure, and body composition are related to each other and must be interpreted within the context of each person. Therefore, improving metabolic health is not about looking for a supplement that «accelerates» the metabolism or focusing only on losing weight. The basis remains adequate nutrition, physical activity, and an individualized approach to the alterations that may exist. Fiber and certain ingredients can have a complementary role when they are justified, but supplementation should accompany the strategy, not replace it. Understanding what is happening in each case allows for better decisions and using each tool at the right time. Know more to fear less and choose better.  

HMB: qué es, para qué sirve y cuándo puede ayudar a conservar la masa muscular

HMB: What It Is, What It's Used For, and When It Can Help Preserve Muscle Mass

What is HMB, what is it used for, and what science says about muscle mass, weight loss, training, dosage, and how to take it. When we talk about preserving muscle mass, two factors are fundamental: strength training and proper nutrition. Both provide the muscle with the necessary stimuli and nutrients to maintain its structure and function. However, it is not always possible to maintain these pillars in the same way. An injury, a recovery period, a reduction in physical activity, or a weight loss process can make it difficult to maintain muscle mass. In these situations, different nutritional strategies that can help limit its loss have been studied. Among them is the HMB or beta-hydroxy-beta-methylbutyrate, a leucine metabolite that takes part in muscle protein metabolism. But what do we really know about HMB? Can it help preserve muscle mass? Does it make sense when strength training is already in place? To answer these questions, it is necessary to go beyond its mechanism of action and analyze what human studies show. Losing muscle is not just a matter of age Muscle mass is in constant renewal. New muscle proteins are continuously synthesized while others break down and are replaced. When this balance is maintained, muscle mass can be preserved. However, when breakdown sustainedly exceeds synthesis, a loss can occur progressive muscle loss. Aging is one of the factors that can contribute to this process, but it is not the only one. Reduced physical activity, periods of immobilization, or lower food intake during certain stages of illness or recovery can also contribute to muscle loss. Something similar can happen during a weight loss process. When we reduce dietary energy, our main goal is to decrease fat mass, but part of the lost weight can also come from fat-free mass if attention is not paid to training, physical activity, and nutrition. That's why, when we talk about weight loss, it's not just about how much weight you lose, but how much of it is fat and how much is muscle mass.   What is HMB and how is it related to leucine? HMB is a metabolite of leucine, one of the essential amino acids that form part of proteins. Our body naturally produces HMB during leucine metabolism, although only a small portion of it ends up being converted into HMB. In supplementation, HMB can be found in different forms. One of the most widely used in research is Ca-HMB or calcium beta-hydroxy-beta-methylbutyrate, which corresponds to the calcium salt of HMB. This difference is important because some studies express the dosage in amount of Ca-HMB and others in amount of HMB. Therefore, both figures should not automatically be considered equivalent. The interest in HMB in the field of muscle health is related to its possible influence on the muscle protein replacement, a continuous process in which new proteins are synthesized and those that are no longer necessary or are damaged are degraded. In a small metabolic study conducted in humans, an acute dose of HMB increased muscle protein synthesis and simultaneously reduced its breakdown. These results provide a physiological basis for studying HMB in situations where there is a risk of muscle loss. However, a distinction must be made between modifying protein metabolism over a few hours and demonstrating an ability to preserve more muscle mass over weeks or months. Therefore, to evaluate its real usefulness, we must look especially at studies conducted over longer periods and at the characteristics of the people who participated in them.   What does science say about HMB and muscle mass? The available evidence does not offer a single answer. Results seem to depend on factors such as age, physical activity level, diet, baseline status, and whether or not a training stimulus is present. Seniors and low muscle mass Older adults are one of the groups in which HMB has been studied the most. A review pooling nine studies with 448 participants found a favorable signal regarding fat-free mass. However, when analyzing the studies based on whether they included exercise, the improvement was mainly observed in those that did not include an exercise intervention. When HMB was added to a training program, no clear additional change in fat-free mass was observed. These results should be interpreted with caution. The included studies were not entirely homogeneous: some used HMB in isolation while others combined it with compounds such as arginine, glutamine, or lysine. In addition, several presented methodological limitations. Another one-year study conducted in older adults with insufficient vitamin D levels combined HMB and vitamin D3. In individuals who did not exercise, some improvements were observed in certain indicators of strength and function, whereas adding supplementation to exercise did not produce a clear additional advantage. In this case, furthermore, HMB was administered together with vitamin D3, so the results cannot be attributed exclusively to HMB. Overall, the evidence does not indicate that all older adults need HMB. What it suggests is that the context in which it is used can be decisive.   When activity is reduced or it is not possible to train normally Immobilization is one of the situations in which the potential role of HMB has been studied, as the absence of mechanical stimulus can accelerate the loss of muscle mass. One of the most cited trials studied older adults subjected to ten days of complete bed rest and compared 3 g daily of Ca-HMB with a placebo. During that period, the control group lost lean mass, whereas the average loss was lower in those who received HMB. However, it was a small study, with only 19 evaluable participants after the washout period. Therefore, HMB has been studied as a potential strategy to limit muscle loss during periods of disuse, but the available evidence in immobilization situations remains limited and needs to be confirmed by larger studies.   HMB during weight loss When we lose weight, it's not just about how much weight disappears, but also de what fabrics procede. A recent 2026 trial evaluated a nutritional strategy in 102 adults with obesity who followed an energy-restricted diet for 12 weeks. The intervention group received a formula providing 3 g daily of Ca-HMB and 24 g of protein, while the control group received an energy-equivalent product based on maltodextrin. At the end of the study, the group that received the enriched formula preserved their muscle mass better. However, these results do not allow the effect to be attributed exclusively to HMB, as the intervention also provided protein, fiber, and other nutrients that were not present in the control group. What this study does reinforce is an important idea: during a weight loss process, preserving muscle mass should be part of the goal. Does HMB make sense if you already strength train? When there is regular strength training, the scenario changes. A review analyzing ten trials in older adults found that adding HMB to exercise produced, overall, a null or small effect on body composition, strength, and physical performance compared to exercise alone. Another subsequent trial reached a similar conclusion: major improvements in strength and function came from training, while HMB did not significantly enhance these effects. This does not mean that HMB ceases to have an effect on muscle metabolism when a person trains. It means that, when it already exists a powerful and regular training stimulus, the margin for making an additional profit may be lower. Therefore, understanding HMB solely as a supplement to gain more muscle oversimplifies its potential usefulness. Their interest may lie precisely in those moments when maintaining muscle mass becomes more difficult.   So, when might HMB make sense? The available evidence makes it possible to consider HMB as a complementary tool, but not as the central element of muscle care. It may make more sense when there is concern about muscle mass loss and, at the same time, it is not possible to optimally maintain training, physical activity, or diet. This can occur during certain stages of recovery or reduced mobility, in some older adults, during menopause, or during weight loss processes. It can also happen when appetite and food intake decrease significantly, for example, in people treated with GLP-1 or GLP-1/GIP receptor agonists used for the treatment of obesity and weight management. Likewise, certain medical and oncological treatments may be accompanied by inflammation, reduced appetite, fatigue, decreased activity, and loss of muscle mass. In these cases, any supplementation strategy must be approached in a individualized and coordinated with the healthcare team. That's why the question shouldn't just be "does HMB work?", but «in what situation are we using HMB?".   Muscle Guard: a formula focused on muscle mass care Muscle Guard is a formula designed to complement muscle mass care during times when maintaining it can be more difficult. Its goal is not to replace strength training or proper nutrition, but rather to serve as an additional tool within a comprehensive muscle care strategy. Its main ingredient is myHMB®. Each stick provides 3.896 g of calcium beta-hydroxy-beta-methylbutyrate monohydrate, of which 3 g correspond to HMB. This raw material has been used in part of the clinical research on HMB and has independent quality and manufacturing certifications. The formula also incorporates 1 g of L-Taurine AjiPure®. Taurine is found in high concentrations in skeletal muscle and participates in various processes related to its physiology, such as the regulation of cellular volume and the management of calcium involved in muscle contraction. It has also been linked to mitochondrial function and the response to oxidative stress. Taurine is not a stimulant like caffeine, even though it is a common ingredient in some energy drinks. In addition, Muscle Guard provides 1,000 IU of vegan-sourced vitamin D3V® and 45 µg of vitamin K2 MenaQ7 PharmaPure®. Vitamin D contributes to the maintenance of normal muscle function and to the normal absorption and utilization of calcium and phosphorus. Both vitamin D and vitamin K also contribute to the maintenance of normal bones. Thus, the formula expands its focus from muscle mass care to musculoskeletal healthcare. How and when to take Muscle Guard? The 3 g daily dosage frequently appears in studies on HMB, although, as we have seen, the literature does not always use the terms HMB and Ca-HMB in the same way. In the case of Muscle Guard, the recommended guideline is one stick a day, dissolved in a minimum of 150 ml of water, with or without food. Regarding the timing of intake, there is not enough solid evidence to support that a specific time of day is generally superior. Therefore, when used daily, it can be taken whenever it is easiest to incorporate into your routine and promotes adherence. Precautions and things to consider In available clinical trials, HMB has generally shown good tolerability. However, much of the research has been conducted in selected populations and has excluded individuals with certain medical conditions. Therefore, these results should not be automatically generalized to any clinical situation. Muscle Guard also contains vitamins D3 and K2, so it is advisable to take into account the total intake of these vitamins when using other supplements simultaneously. In particular, people treated with vitamin K antagonists, such as warfarin, should consult their healthcare professional before using supplements containing vitamin K, as they may interfere with the effect of the anticoagulant treatment. Additionally, according to the product instructions, it is contraindicated during pregnancy. In situations such as breastfeeding, kidney disease, cancer treatments, polymedication, or other complex clinical circumstances, it is more prudent to evaluate its use individually with your healthcare team. Finally, when there is immobilization, medical recovery, or pharmacological treatment for weight loss, supplementation should not replace an individualized strategy that considers diet, physical activity, and clinical status.   HMB FAQ Which is better, HMB or creatine? They do not pursue exactly the same goal. The creatine it features a specially consolidated role to improve the ability to perform high-intensity efforts and promote training adaptations. HMB, for its part, has been studied from another perspective: the maintenance of muscle mass in situations where there is a higher risk of loss. Therefore, the choice depends more on the goal and context than on viewing one as a substitute for the other. Can you take HMB and creatine together? Yes, they have been used together in studies. However, the results on whether the combination provides additional benefits are mixed. Some studies have observed advantages in certain performance indicators or body composition, while others have not. Can HMB replace protein? No. The protein provides the amino acids that the body needs to maintain and renew muscle proteins. HMB, for its part, is a metabolite of leucine and should be considered, when used, as a complementary strategy and not as a substitute for a adequate protein intake. Why does Muscle Guard come in a stick pack and not in capsules? To provide 3 g of HMB per day using capsules, it would be necessary to take several units, which can be less convenient and make adherence more difficult. The stick format allows concentrating the daily dose into a single serving, which dissolves in water and makes it easy to add to your routine. Does it make sense to take HMB during weight loss? This may be a context where HMB is of particular interest, since paying attention to preserving muscle mass is also important during weight loss. The priority should remain maintaining proper nutrition and encouraging whatever exercise is possible. HMB can be considered as a complementary tool when the context justifies it. Caring for the muscle also means knowing when to protect it Muscle mass does not depend solely on how much we train or how much protein we consume. There are times when maintaining it can be more difficult: during an injury, a period of immobilization, recovery, a weight loss process, or certain stages of life. In these situations, HMB can be a useful tool, but does not replace the fundamentals of muscle care. Strength training, proper nutrition, and adequate protein intake remain the foundation. Supplementation can complement that strategy when circumstances make it necessary. Because taking care of muscle isn't just about trying to gain more. It also means preserving what we already have when circumstances may make it difficult. Know more to fear less and choose better.

Menopausia y perimenopausia: cómo cuidar tu salud en seis pilares

Menopause and perimenopause: how to take care of your health in six pillars

The menopause and perimenopause can change many things at once. Are you sleeping worse, noticing more abdominal fat, or worried about your bones and mood? You are not alone: these are common changes and they have an explanation. The good news is that there are concrete habits that help look after your well-being, without needing to do everything or take every supplement. In this article, we review six pillars: nutrition, strength, bone health, metabolic health, rest, and emotional health. Later, we will explain how to evaluate supplementation tailored to your needs. ☝️ This article is for informational purposes only and is not a substitute for professional medical advice. Perimenopause and menopause: what changes and why it matters The perimenopause is the transition stage in which hormones fluctuate and menstrual changes, hot flashes, or sleep difficulties may appear. The menopause is confirmed after 12 consecutive months without menstruation, provided there is no other cause to explain it. Not all women experience the same symptoms or with the same intensity. These hormonal changes can coincide with transformations in body composition, muscle mass, and metabolism. That is why, rather than looking for a single solution, it is best to work on several habits that complement one another. If hot flashes are your main concern, there are specific formulas for this stage, such as MenoMaster for Menopause. Before making a decision, review your habits and discuss with your healthcare professional what works best for your situation. 1. Nutrition: covering what your body needs There is no one-size-fits-all “menopause diet”. What helps the most is a diet sufficient, varied, and sustainable, with vegetables, fruit, legumes, whole grains, olive oil, and quality protein. These guidelines serve as a basis: Include protein in your main meals: it contributes to the maintenance of muscle mass. Eat calcium-rich foods, along with an adequate intake of vitamin D, due to their importance for bone health. Adds fiber, useful for digestive and metabolic health. General restrictions are usually not necessary, although alcohol, excess caffeine, or ultra-processed foods can worsen hot flashes or sleep for some women. Before taking supplements, review what your diet already provides and consult a professional if necessary. 2. Strength training: protecting muscle and independence With age and the menopausal transition, preserving muscle is especially important. Progressive strength training, tailored to your fitness level, helps maintain strength and physical function. You can combine it with walking, climbing stairs, and other activities you enjoy. There's no need to start with heavy loads, consistency and progression matter more than the intensity of a single session. Two or three weekly sessions are a good starting point. If you have injuries or limitations, a professional can help you adapt the exercise. In this context, the creatine is one of the most studied supplements. Women have 70 to 80% less endogenous creatine than men, and a review on women's health considers it effective for strength in premenopausal women [3]. If you use it, combine it with strength training and an adequate protein intake. 3. Bone health: taking care of it before noticing problems The decline in estrogen is associated with a accelerated bone loss at this stage. That is why it is advisable to start taking care of your bones early, before symptoms appear. Prevention is based on several habits: Strength and weight training. An adequate intake of calcium. Avoid tobacco. Vitamin D and Magnesium If you have previous fractures, a family history, or other risk factors, consult a doctor to see if you need a specific bone evaluation. No supplement replaces the diagnosis or treatment of osteoporosis. 4. Metabolic health: looking beyond the scale It is common to worry about the belly fat, but body changes do not depend solely on estrogen: age, sleep, physical activity, and habits also play a role. Rather than pursuing restrictive diets, we recommend prioritizing strength, daily movement, fiber, and a balanced diet. Based on your history, it may be helpful to check with your healthcare professional: Blood pressure. Glucose. Lipid profile. The goal is to take care of cardiometabolic health, not just a number on the scale. 5. Rest: addressing hot flashes and insomnia The hot flashes and sweating nighttime can disrupt sleep; stress and other causes of insomnia can also have an effect. A few simple measures can help: Maintain relatively consistent schedules. Get natural light in the morning. Prepare a cool bedroom. If insomnia is persistent or hot flashes significantly affect your daily life, it is advisable to seek an evaluation. Clinical evidence-based treatments exist, including hormonal and non-hormonal options, which should be evaluated on a case-by-case basis; the NICE guideline on menopause outlines how to consider them [1]. 6. Emotional health: it deserves a space too Irritability, the feeling of “brain fog,” or mood swings can coincide with the hormonal transition, but not everything should be attributed to menopause. Making room for rest, physical activity, social connection, and stress management strategies can help you feel better. When anxiety, sadness, or a lack of focus interfere with your day-to-day life, it is important request professional support. Menopause-specific cognitive behavioral therapy is one of the options considered by clinical guidelines for certain symptoms [1]. How to connect these six pillars with a supplementation protocol The starting point is always the same: First habits and needs assessment; then, if appropriate, supplementation. At IVB, we can organize options by goals, but We do not recommend an identical protocol for all women. Objective What to value first Complementary support that can be considered Hot Flashes and Transition Symptom severity, history, and medication MenoMaster: check composition and individual suitability; does not replace effective treatments. Muscle and Strength Training and protein intake Creatine Essential, along with strength and sufficient nutrition, when appropriate. Bone health Dietary calcium, risk factors, and vitamin D if appropriate Vitamin D3+K2, only if indicated; exercise caution with vitamin K and anticoagulants. Rest and muscle function Sleep Routine and Magnesium Intake Total Magnesium if the diet does not meet needs; do not present it as a treatment for insomnia. Metabolic health Movement, Fiber, and Cardiovascular Risk Vegan Omega 3+ if omega-3 intake is low; does not replace the management of risk factors. Important: this table is a selection guidance, not dosing instructions or a prescription. The selection and dosage should take into account lab tests, diet, medical history, current medications, potential pregnancy, and tolerance. In case of a history of hormone-dependent cancer or concomitant treatments, consult a doctor before using preparations containing phytoestrogens. If hot flashes are one of your main concerns, you can check the composition of MenoMaster and discuss with your healthcare professional whether it is right for your situation. The best menopause protocol is the one that adapts to you Taking care of yourself during the perimenopause and menopause does not mean doing everything at once. Starting with sufficient nutrition, strength training, paying attention to your bones and metabolism, sleeping better, and taking care of your emotional well-being is a solid foundation. Supplementation can be considered later, only when it responds to a specific need. To explore support options, visit our menopause product selection. If you have any questions, let us know which change concerns you most: we will be happy to guide you on what information is worth reviewing.   References National Institute for Health and Care Excellence (NICE). Menopause: identification and management. Guideline NG23. nice.org.uk/guidance/ng23 Taku K, Melby MK, Kronenberg F, Kurzer MS, Messina M. Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: a systematic review and meta-analysis of randomized controlled trials. Menopause. 2012. doi:10.1097/gme.0b013e3182410159 Smith-Ryan AE, Cabre HE, Eckerson JM, Candow DG. Creatine Supplementation in Women's Health: A Lifespan Perspective. Nutrients. 2021;13(3):877. doi:10.3390/nu13030877 Santo André HC, Esteves GP, Barreto GHC, et al. The Influence of n-3PUFA Supplementation on Muscle Strength, Mass, and Function: A Systematic Review and Meta-Analysis. Adv Nutr. 2023;14(1):115-127

Caída del cabello: causas, síntomas y cómo mejorarla de forma natural

Hair Loss: Causes, Symptoms, and How to Improve It Naturally

Caída del cabello: causas, síntomas y cómo mejorarla de forma natural The hair loss It is concerning when more hair than usual appears in the shower, on the brush, or on the pillow. Even so, losing between 80 and 100 hairs a day is normal: it's part of the hair's natural cycle. The caída del cabello it becomes a problem when it increases, hair loses density, or new hair grows thinner and thinner. Hormones, stress, diet, iron levels, weight changes, or thyroid imbalances can alter the hair growth cycle and cause hair loss caída del cabello. In this guide, you will see the hair loss causes, how to tell the difference between telogen effluvium and androgenetic alopecia, and which habits and supplements can help you care for your hair. Why does hair loss occur? Each hair goes through phases of growth, transition, and decline. Under normal conditions, while some hairs fall out, others begin to grow, and that is why a certain hair loss daily is physiological. However, certain situations cause many follicles to enter the telogen phase, the resting phase prior to hair loss. This can occur after a period of significant stress, during the postpartum period, following rapid weight loss, or due to a nutritional deficiency, and in all these cases, the hair loss increases. Not all falls are created equal hair loss it is the first step in deciding what to do. Main Causes of Hair Loss Hormonal changes and androgenetic alopecia In the androgenetic alopecia dihydrotestosterone (DHT), which is formed when the 5-alpha-reductase enzyme converts testosterone. It is one of the most common hormonal causes of hair loss miniaturization: a progressive process in which hair grows increasingly fine, short, and weak. In women, this hormonal hair loss can appear alongside acne, excess sebum, increased hair growth, or menstrual cycle irregularities. These signs indicate a possible hyperandrogenism (excessive action of male hormones), common in polycystic ovary syndrome. In these cases, FemmeBalance, con Saw Palmetto and Vitex, can accompany a global approach. Stress, Postpartum, and Telogen Effluvium Another common cause of hair loss is the telogen effluvium, una pérdida generalmente difusa que aparece semanas o meses después de un desencadenante. Puede ocurrir tras: One period of intense stress El posparto. One disease. One rapid weight loss or a very restrictive diet. A period of high physical or emotional demand. postpartum postpartum hair loss is striking, but it does not mean that the follicle has been lost. Iron, Zinc, and Diet The hair follicle needs energy, protein, and micronutrients to maintain its activity. Iron is one of the key nutrients to check during a hair loss, You don't need to have anemia so that your reservations deserve attention. That is why a healthcare professional can evaluate the ferritin (the protein that stores iron) and other markers of iron metabolism. If the lab work shows low reserves, an iron supplement such as FerroPlus El zinc plays a role in keratin formation, cell division, and tissue repair. In addition, its absorption varies depending on the chemical form in which it is taken, as shown by a comparative study of zinc picolinate, citrate, and gluconate (Barrie et al., 1987). Its role in various female reproductive system disorders has also been described (Nasiadek et al., 2020). The idea is not to take iron or zinc “just in case,” but to first check with a blood test if there is a real need. Rapid weight loss When you significantly reduce your energy or protein intake, the body prioritizes vital functions. Hair growth is not one of them, so highly restrictive diets can cause hair loss due to telogen effluvium.  It can also occur with treatments that significantly reduce appetite, such as GLP-1 receptor agonists (medications such as semaglutide). A pilot study with semaglutide in people with type 2 diabetes observed changes in intestinal iron absorption (Melis et al., 2025). For this reason, in these cases it is best not to attribute the hair loss directly to the medication. It is more useful to ensure that you are meeting your needs for protein, iron, zinc, and other nutrients. How to know what type of hair loss you have? The way your hair changes provides clues about the origin of the hair loss. Esta tabla resume las diferencias entre las dos causas más frecuentes:  It is also worth distinguishing the fall from the root cause of hair breakage. Frequent direct heat, bleaching, and certain chemical treatments weaken the fiber without there being an issue in the follicle. Efluvio telógeno Androgenetic alopecia Drop pattern Diffused and uniform across the entire head Wider center part and lower density in the top area   Trigger Stress, postpartum, illness, weight loss, nutritional deficiencies Hormonal sensitivity of the follicle and genetic predisposition Evolution It usually reverses once the cause is resolved Progressive if left unaddressed Cuándo consultar If it lasts more than a few months or increases When you notice that new hairs are becoming increasingly fine ¿Cuándo conviene consultar por la caída del cabello? Not all hair loss should be a cause for concern, but in certain cases, it is recommended to see a professional. Seek an evaluation if completely unpopulated areas, dolor, picor intenso, inflamación o descamación del cuero cabelludo. Also if the caída del cabello es muy brusca, continues to increase for months, or is accompanied by menstrual irregularities, signs of hyperandrogenism, or changes consistent with a thyroid disorder. try to solve it with supplements alone How to Care for Hair Health Through Your Habits Ensures sufficient protein intake Hair is mainly composed of keratin Eggs, fish, meat, dairy, legumes, tofu and other protein sources help you meet your daily needs. You don't need to calculate every meal in grams. It is enough that protein does not take a back seat, especially if you are following a weight loss diet. For example, Include a protein source in every main meal: huevos en el desayuno, legumbres o pescado en la comida y tofu o lácteos en la cena. Avoid losing weight too fast If you want to reduce body fat, doing so in a progressive form allows you to better maintain your nutrient intake. A caída del cabello several months after a period of intense restriction usually indicates that the deficit was too aggressive. If you're already in that situation, restore a sufficient and varied diet is the first step. Afterwards, your hair needs weeks or months to normalize its cycle. Manage stress and take care of your scalp Sleeping poorly for a few days does not cause hair loss. However, a intense and prolonged stress can indeed play a role in telogen effluvium, so rest, physical activity, and stress management tools matter as well. Washing your hair does not cause it to fall out more. The hair you see in the shower was already ready to shed, and not washing it as often as your scalp needs can be counterproductive. You can wash it daily if needed, using the right products for your skin type. What role can supplementation play? Supplementation is helpful when a specific need exists, but it is no substitute for identifying the root cause of hair loss. Hormonal component. If there is acne, excess sebum, or cycle irregularities, FemmeBalance can complement a comprehensive approach. Its formula includes Saw Palmetto, Vitex, NAC, turmeric, and vitamin B5. Zinc. If your intake is insufficient or your needs are increased, Zinc Plus complements the intake of this mineral, which is important for the formation of keratin and other cellular processes of the skin, hair, and nails. Iron. If your lab tests show low reserves, especially with heavy periods, FerroPlus provides bisglycinate iron along with vitamin C and other micronutrients involved in its metabolism. Antioxidant protection. Anti-OX Global Serves as support against oxidative stress as part of a comprehensive strategy. It is not a specific hair loss treatment. More supplements don't mean better results. What matters is using only what makes sense for your situation. Preguntas frecuentes sobre la caída del cabello Does creatine cause hair loss? Based on current evidence, we cannot claim that creatine causes hair loss. The concern stems from a 2009 study by van der Merwe et al., published in the Clinical Journal of Sport Medicine. En él aumentaron los niveles de DHT, pero no se evaluó la caída del cabello. Later, a 2025 randomized clinical trial by Lak et al., published in the Journal of the International Society of Sports Nutrition, directly studied hair density and thickness over 12 weeks. No significant differences were found between creatine and placebo. You can learn more about this topic in our article on creatine and hair loss. ¿Necesito tomar biotina? Not necessarily. Biotin deficiencies are rare, y tomar dosis elevadas sin indicación no hace que el cabello crezca más. In addition, the high doses may interfere with certain laboratory tests, including some thyroid and hormone function tests. If you are going to have a blood test, always let them know that you are taking biotin. You can find more information in our article on biotin for hair. How long does it take for hair loss to improve? The hair cycle needs time. The hair that falls out today began entering the telogen phase weeks or even months ago, so changes in hair loss are not evaluated in a few days. After correcting the cause, it is usually wait several months to feel it less hair loss and denser hair. If the loss continues after that time, consult a professional. What to do if your hair is falling out When hair falls out more than usual, it's tempting to look for a quick fix. But you don't always need another shampoo, biotin, or five supplements at once.  If you notice that your hair loss identify what has changed in recent months: diet, stress, hormones, weight, or iron reserves. A blood test and a professional assessment will help you decide if you need nutritional support. If this sounds like your situation, discover FerroPlus     Scientific References Lak M, Forbes SC, Ashtary-Larky D, et al. Does creatine cause hair loss? A 12-week randomized controlled trial. J Int Soc Sports Nutr. 2025;22(S1):295229. van der Merwe J, Brooks NE, Myburgh KH. Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players. Clin J Sport Med. 2009;19(5):399-404. Barrie SA, Wright JV, Pizzorno JE, Kutter E, Barron PC. Comparative absorption of zinc picolinate, zinc citrate and zinc gluconate in humans. Agent Actions. 1987;21(1-2):223-228. Nasiadek M, Stragierowicz J, Klimczak M, Kilanowicz A. The Role of Zinc in Selected Female Reproductive System Disorders. Nutrients. 2020;12(8):2464. Melis P, Lucijanic M, Kranjcec B, Cigrovski Berkovic M, Marusic S. The effect of semaglutide on intestinal iron absorption in patients with type 2 diabetes mellitus: a pilot study. Diabetes Obes Metab. 2025;27(6):3542-3545.

Vuelta a la rutina: cómo recuperar tus hábitos saludables tras el verano

Back to the Routine: How to Get Back to Healthy Habits After Summer

Returning from vacation doesn't mean you have to start from scratch. During the summer, it's common for schedules to change, for us to eat out more often, to train differently, or to go to bed later. And that's okay. In fact, learning to adapt our habits to different moments and circumstances is also part of a healthy lifestyle. The problem usually arises when September arrives accompanied by the feeling that we have to “compensate” for everything we did during the holidays: going back to the gym five days a week all at once, starting a much more restrictive diet, eliminating certain foods, or trying to get back to all our old schedules in 24 hours. And you probably don't need to do any of that. Getting back into a routine can simply be that: returning, little by little, to those habits that we know help us feel good. Nutrition, rest, movement, and organization are some of the pillars that can facilitate this transition. In this article, we review how to recover a healthy routine after the summer in a progressive, realistic, and, above all, sustainable way. Returning to your eating routine after the summer After several weeks with different schedules, travel, eating out, and more improvisation, one of the first habits that can help regain a certain sense of routine is to reorganize your nutrition. Not because you ate “badly” during the holidays and now you have to do it “well,” but because having a certain structure makes day-to-day life much easier. Going back to grocery shopping, getting back to certain schedules, preparing some meals in advance, or simply having basic foods at home again can make a huge difference. How to plan your week without relying on improvisation Planning doesn't mean knowing exactly what you're going to eat every day of the week. Flexible planning can be enough. For example, before going grocery shopping, it can be useful to think about: 2-3 protein sources: eggs, fish, chicken, tofu, legumes... Different vegetables and greens. Seasonal fruit. Carbohydrate sources like potatoes, sweet potatoes, rice, quinoa, bread, or whole grains. Healthy fats like extra virgin olive oil, nuts, seeds, or avocado. Some quick resources for days with less time: cooked legumes, canned fish, frozen vegetables, hard-boiled eggs, gazpacho, or vegetable creams. From there, those foods can be combined in different ways throughout the week without needing to follow a rigid menu. It can also be useful to cook extra portions. Preparing more vegetables, rice, potatoes, or a protein source allows you to have part of your next meal already sorted. Teresa's Tip: One of the things that helps me the most when I return from vacation is doing a fairly basic grocery shop and filling the fridge again with foods that make things easy for me. You don't need to do a three-hour meal prep: often, just having good staples available completely changes the week. Regaining regular meal times During the holidays, our schedules also tend to change. We have breakfast later, eat at different times, or have dinner whenever it comes up. When returning to a routine, regaining some regularity can help reorganize the day and our meals. That doesn't mean everyone should have breakfast at 8:00, lunch at 14:00, and dinner at 21:00. There is no universal perfect schedule. The important thing is to find a structure that fits each person's needs, work, training, rest, and hunger and satiety cues. Why is it so hard to get back into a routine? After several weeks with different schedules, more social life, travel, and changes in diet, rest, or exercise, it is normal to need a few days to re-adapt. This temporary difficulty in re-adjusting to usual schedules and obligations is popularly known as “post-vacation syndrome” and can be accompanied by tiredness, apathy, irritability, difficulty concentrating, or changes in sleep. The good news is that it usually improves as we regain some regularity. And it's not about going back to being who you were before the summer, but about recovering a routine that is compatible with your current life. The mistake of wanting to recover everything in a single day September is like starting a new year. Suddenly, the desire to get organized, eat better, train more, sleep eight hours, prepare all the tupperware for the week, and recover any habit that was relaxed during the holidays in just a few days appears. However, trying to modify too many things at once usually makes it harder to maintain the changes. A more realistic strategy consists of identifying which two or three habits have the greatest impact on your day-to-day life and starting with them. It could be going to bed a little earlier, preparing lunch to take to work, or getting back to three training sessions a week. When those habits are part of your routine again, you can start incorporating others. Teresa's Tip: I would try not to turn September into a punishment for having enjoyed August. You don't need to compensate for your vacation or prove anything during the first week. Just go back little by little to the things you know make you feel good. Recover your sleep schedules little by little Sleep is usually another one of the big changes in the summer. The days are longer, we make more plans at night, we have dinner later, and often the time we wake up also changes. Therefore, trying to suddenly go to bed two hours earlier and sleep perfectly from the first night may not be very realistic. How to move your bedtime earlier without suffering from insomnia The body regulates the sleep-wake cycle through the circadian rhythm, a biological system of approximately 24 hours influenced especially by exposure to light. To re-adjust your schedules, it can help to: Progressively move your bedtime and wake-up time earlier. Expose yourself to natural light during the first hours of the day. Reduce exposure to intense light and screens before sleeping. Maintain some regularity in your schedules. Avoid excessively heavy dinners right before going to bed. Limit caffeine during the last hours of the day. Create a nighttime routine that helps the body anticipate rest. You don't need to apply all these strategies from the first day. As with nutrition, gradually regaining regularity is usually more realistic. The role of magnesium in rest Magnesium is an essential mineral that participates in hundreds of reactions in the body and contributes, among other functions, to the normal functioning of the nervous system, normal muscle function, and the reduction of tiredness and fatigue. It is naturally present in foods such as nuts, seeds, legumes, whole grains, green leafy vegetables, or cocoa. Therefore, nutrition is once again the foundation. When dietary intake is not sufficient or there is a situation where supplementation may be indicated, a magnesium supplement can be considered on an individual basis. At IVB Wellness, we have Magnesium Total, which combines two forms of magnesium, bisglycinate and malate, with Albion® minerals. This combination allows for the incorporation of magnesium in forms with good bioavailability. In any case, a supplement does not replace good sleep habits. Before supplementing, it is important to assess individual needs and consult with a healthcare professional. Returning to a routine also needs margin Returning to work, recovering schedules, organizing meals, school, training, pending tasks... September can involve quite a few simultaneous changes. Although the management of stress and anxiety falls within the scope of other healthcare professionals, there are lifestyle-related factors that are also part of health care. Getting enough sleep, maintaining an adequate diet, engaging in physical activity, and having some structure during the day can contribute to general well-being. And perhaps one of the most important points is to accept that not all habits have to return at once. Progressively recovering routines can be much more sustainable than trying to reproduce a perfect week from the first Monday. Checklist: get back to your routine in 7 days (without stress) If you could only do one thing each day this week, let it be one of these: ☐ Go to bed and wake up 15-30 minutes earlier than the day before. ☐ Plan at least 3-4 meals for the week and do your grocery shopping with a list. ☐ Fill the fridge with easy foods: fruit, plain yogurt, washed vegetables, eggs, cooked legumes, and quality protein. ☐ Get back to your usual breakfast, lunch, and dinner times. ☐ Move every day, even if it's just for 20-30 minutes. ☐ Prioritize good hydration from first thing in the morning. ☐ If you decide to use supplementation, always do so as a support to good habits and following the advice of a healthcare professional. You don't need to do it perfectly, just lay the foundations again. Frequently asked questions about returning to a routine How long does it take to get back into a routine? There is no single deadline, as it depends on each person and the habits we want to recover. Some routines can fit back into place in a few days, while others need several weeks. The important thing is not to do it quickly, but to gradually regain some regularity, without trying to change everything at once. Do I have to do a detox diet after the summer? No. Our body already has very effective detoxification systems (liver, kidneys, lungs, intestine, and skin). After the holidays, you don't need juices or restrictive diets, but to return to your usual habits. What if I gained weight during the holidays? Don't make impulsive decisions. A few days with different schedules or more social meals don't change your health. Get back to your routine for a few weeks before drawing conclusions. Can any food supplement help me? In some cases, supplementation can be considered when there is a specific need, especially if dietary intake is insufficient or a healthcare professional considers that it can provide value. In any case, it should always be understood as a complement to a healthy diet and habits. What really makes the difference After the summer, it is very tempting to want to start "from scratch," but the reality is that your health doesn't depend on one perfect week, but on what you do consistently over months and years. You don't need to compensate for August. You don't need to train twice as hard. You don't need to eat less. You just need to gradually recover those habits that you already know make you feel good. Returning to a routine can be an opportunity to take care of yourself again from a place of balance, without guilt and without extremes. Important information: Supplementation should never replace a healthy diet or good lifestyle habits. Before taking any food supplement, consult with a healthcare professional who can assess your situation individually, especially if you are pregnant, breastfeeding, taking medication, or suffer from any pathology.  

Alimentación en verano: cómo cuidar tu cuerpo sin mitos ni dietas restrictivas

Summer Nutrition: How to Take Care of Your Body Without Myths or Restrictive Diets

Every summer we hear the same thing: that we “need to get in shape for the beach,” that “I can’t wear a bikini with this body,” that “if I eat an ice cream, I’ll have to make up for it later,” or that “I’ll fix it after vacation”... As if our body needed to apologize for having enjoyed itself and having had a different routine.  This article leaves behind aesthetic pressure and the most common myths at this time of year, to focus on what truly influences your relationship with food and your body. Why is summer a more sensitive time regarding eating behavior? Summer brings with it greater body exposure (swimsuits, short and thin clothing, more plans away from home, among others), and that exposure can reactivate insecurities about the body that were already there. All of this leads to using food as a way to modify our body, since control over food is the “simplest” way to modify those insecurities.  Aesthetic pressure and the "bikini body" obsession: the myth that must be left behind Currently, the "bikini body" obsession is also camouflaged, wrapped in words like wellness or “the best version of yourself.” And although the packaging changes, the message remains the same: you have to “correct” your body before showing it off because it doesn’t fit the beauty standards imposed by society.  And what does that idea lead to? To restriction, hunger, binge eating, anxiety, guilt, avoiding social plans, prohibition, and the possible development of an eating disorder. Because you don’t need to modify your body to deserve to live through the summer, or any time of the year. You don’t need to lose weight to be able to wear a bikini or swimsuit.  What you really need is to give your body the energy it needs, eat sufficiently and flexibly, stay hydrated, rest, or move by listening to your body. But above all, stop waiting for it to meet certain conditions to start inhabiting it with respect and kindness.  Routine changes, vacations, and their impact on eating habits Summer also brings changes in schedules, meals away from home, travel, or more social life. And that’s okay: your body is capable of adapting to these changes without it being a problem. That problem appears when those changes generate anxiety for you or become an excuse to start a diet (again).  Eating in summer: myths that must be left behind Myth: "you have to eat less to be able to go to the beach"  Eating less than your body needs will cause you to accumulate hunger throughout the day and increase anxiety, often leading to binge eating or compulsive eating. The more forbidden a food is, the more desire it generates, and the more likely it is that when the food is present, you will eat it impulsively and it will feel like a loss of control.  Myth: detox or cleansing diets are necessary in summer  Your liver and kidneys are in charge of cleansing your body every day. Detox diets don’t eliminate anything that the body doesn’t eliminate on its own. The only thing achieved is reinforcing the idea that you have to "clean" the body because we have eaten something that "dirties" it. But this is not the case.  How to maintain flexible and sufficient nutrition in summer Food flexibility means being able to include any food without fear, without prohibitions, and without feeling that you have to "earn" permission to eat it. All of this refers to not skipping any meals because following your routine changes or an impromptu plan has come up. Remember that your body’s needs change every day, and knowing how to listen to and honor them is a huge act of self-care. It is completely natural for you to want something lighter one day and a larger amount another day.  Mindful eating: listening to the body instead of restricting  All of this goes hand in hand with what is worked on a lot in consultations: learning to eat connected to your own bodily signals (hunger, satiety, appetite) and not by external rules like diets, rigid schedules, or calories. Hunger, satiety, or wanting an ice cream on a Tuesday night are valid information about what your body needs at any given moment.  Warning signs: when concern for the body stops being healthy  Do you avoid plans because of how your clothes fit? Do you count calories at every meal? Do you punish yourself for having eaten "too much"? Does the mirror dictate your mood? If you identify with any of these questions, this no longer has to do with wanting to take care of yourself, but with something much deeper that deserves to be addressed. Do not normalize these types of behaviors just because "it’s normal in summer," because it shouldn’t be.  The role of nutritional support in times of greater aesthetic demand  Precisely because summer intensifies this pressure, it is a good time to have professional guidance if you notice that your relationship with food or your body is becoming complicated. Having tools and specialized support will allow you to enjoy it and live it more calmly. If, in addition to this guidance, you are looking for extra support to sustain yourself during this period of more changes and higher demands, a supplement like Magnesio Total de IVB can be a good ally: it contributes to your muscle and mental health, also helping you fall asleep.  Frequently asked questions about eating in summer  ¿Is it true that you lose your appetite in summer and have to force yourself to eat less?  The heat can naturally reduce your appetite somewhat, but that is not the same as eating less as a rule. The important thing is to listen to what your body needs at every moment and honor it.  ¿Should you avoid carbohydrates so you don’t "bloat" before the beach?  Occasional bloating is related to the rhythm of meals, stress, or routine changes, rather than carbohydrates themselves. Eliminating them doesn’t solve anything and can generate more anxiety for you.  ¿Is it advisable to diet before summer to prepare for the beach? It is neither necessary nor recommended. Restrictive diets do not improve health. In fact, if they worked, you would only need to do one in your whole life. What diets do cause is a more conflicted relationship with food.  ¿When is it advisable to see a nutrition professional? When eating becomes a constant source of worry, guilt, or control, or when body image dictates your day-to-day life, it is a good time to ask for help. A specialized professional can help you identify what is behind that discomfort and build a kinder relationship with food and your body.  Finally, I would like to remind you that eating in summer is about giving yourself unconditional permission to experience it with flexibility, without any food being a cause for guilt. We deserve to enjoy the summer as much as we can. 

Piernas pesadas: causas, síntomas y cómo aliviarlas de forma natural

Heavy legs: causes, symptoms, and how to relieve them naturally

Discover why heavy legs occur, what their most common causes are, and which habits, exercises, and supplements can help relieve the discomfort. Some people end the day with the feeling of having carried extra weight in their legs for hours. Their ankles seem more swollen, walking becomes less comfortable, and a hard-to-describe discomfort appears that is often summarized in two words: heavy legs. Although it is usually associated simply with fatigue, this sensation can have different origins. Spending many hours sitting, working on your feet, heat, certain hormonal changes, or specific circulatory problems are some of the factors that can contribute to their appearance. The good news is that, in many cases, small changes in daily habits can help improve the inconvenience In this article, we are going to look at what are they heavy legs, what are their causes most frequent, when to consult with a healthcare professional and what strategies can help relieve symptoms. What are heavy legs and when to worry Heavy legs do not constitute a disease in itself, but rather a symptom that can appear for different reasons. Some people describe it as a constant feeling of tired legs bloating or difficulty maintaining the same lightness when walking they had at the start of the day. In many cases, this sensation progressively worsens as the hours pass and is usually more noticeable in the afternoon or at night. One of the most common causes is the chronic venous insufficiency a condition in which the veins have difficulty returning blood from the legs to the heart. When this occurs, pressure within the venous system increases, and fluid can accumulate in the tissues, promoting the appearance of edema, heaviness, and discomfort.   Difference between muscle fatigue and venous insufficiency Not every feeling of tired legs necessarily implies a circulation problem. temporary muscle fatigue. In these cases, the discomfort usually improves with rest and disappears in a short time. However, when the feeling of heaviness occurs repeatedly, is accompanied by bloating, worsens when standing or sitting for long periods, and improves when elevating the legs deserves to be valued by a healthcare professional.   Main causes of tired legs The feeling of heavy legs is rarely due to a single factor. Most commonly, it appears as consequence of several elements acting at the same time. Sedentary lifestyle The calf muscles act as a real pump that helps push blood back up to the heart. When we pass many hours of immobility, whether sitting in front of a computer or standing during the workday, this mechanical support decreases and venous return becomes less efficient. That is why it is not uncommon for discomfort to appear precisely at the end of the day. The heat and the summer months heat promotes the dilation of blood vessels can make venous return even more difficult prone to water retention, the discomfort can become even more apparent. Hormonal factors Pregnancy, certain phases of the menstrual cycle, or menopause can affect venous circulation and promote the onset of symptoms in some women. Although are not the only cause, sí pueden contribuir a que las molestias aparezcan con mayor facilidad. Chronic venous insufficiency: warning signs Chronic venous insufficiency is one of the most common causes for heavy legs other symptoms may appear such as ankle swelling, pain, itching, cramps, or visible varicose veins.   Symptoms associated with heavy legs Swelling, pain, and a feeling of heaviness The feeling of heaviness rarely appears alone. It is frequently is accompanied by other symptoms which can vary considerably from person to person. In some people, the bloating and the feeling of heaviness itching, cramps or feeling of tension. may appear varicose veins or progressive skin changes cuando existe una enfermedad venosa más avanzada.   When to consult a doctor Although heavy legs are usually associated with mild or moderate issues, there are situations where it is advisable to seek a medical evaluation. Por ejemplo: Sudden swelling of a single leg. Severe or persistent pain. Progressive worsening of symptoms. Significant skin changes. Appearance of wounds or ulcers. How to relieve heavy legs at home When we talk about heavy legs, daily habits often have more of an impact than many people realize. Position, hydrotherapy, and draining massages  Elevate your legs whenever possible Elevate your legs for a few minutes can promote venous drainage and provide temporary relief, especially after long workdays or during the hottest months. Avoid prolonged periods of immobility try to take short breaks to move around regularly. Incluso unos pocos minutos de caminata pueden marcar la diferencia. Take care of your hydration and lifestyle Maintain proper hydration and engage in regular physical activity contribute to creating a more favorable environment for vascular health. If you are interested in this topic, you may also find our useful item about how to prevent water retention in summer. Exercises to improve venous return  Walk regularly is one of the simplest and most effective strategies to promote venous return. Every step activates the calf muscles and helps pump blood back to the heart, reducing the feeling of congestion in the legs.   Natural nutrition and supplements for heavy legs Diet alone does not correct established venous insufficiency, but it can play a role in part of a global strategy oriented towards circulatory well-being. In fact, maintaining a healthy weight and following a balanced eating pattern can help reduce some factors that contribute to worsening symptoms. Key nutrients for  venous circulation Some plant compounds, especially certain flavonoids and polyphenols, han despertado interés por su posible papel en la salud venosa. naturally present in fruits, vegetables, and various plant extracts traditionally used for circulation care. Evidence-based plants: horse chestnut and other plant extracts Among the supplements studied for chronic venous insufficiency, the horse chestnut is probably one of the ingredients with the best scientific backing. In 2012, Pittler and Ernst published a Cochrane review that analyzed 17 clinical trials and concluded that horse chestnut seed extract seemed to improve symptoms such as pain, edema, and the feeling of heaviness in people with chronic venous insufficiency. The results were consistent with what was observed years earlier by Diehm and colleagues, who in 1996 directly compared this extract with compression stockings for 12 weeks. At the end of the intervention, both groups showed similar reductions in edema, while the results were less favorable in the placebo group. More recently, in 2020, Martínez-Zapata and collaborators reviewed the available evidence on different phlebotonics used in chronic venous disease. After analyzing dozens of clinical trials, they observed a modest reduction in edema the effects on other clinical outcomes were less consistent. horse chestnut, rutin, or plant extracts rich in polyphenols CircuDren, una formulación que combina varios de estos compuestos dentro de una estrategia global orientada al cuidado de la circulación. Preventive habits for the feeling of heavy legs sum of small habits than of a single specific measurement. As we have previously mentioned, the staying physically active, take care of body composition, promote good hydration, and pay attention to vascular health are strategies that can help reduce the occurrence of discomfort over time. Frequently asked questions about heavy legs (FAQ) Do heavy legs always indicate poor circulation? No. Although venous insufficiency is a common cause, heat, a sedentary lifestyle, standing for long hours, or certain hormonal changes can also play a role. Does walking help relieve heavy legs? Yes. The contraction of the calf muscles promotes venous return and can help reduce the feeling of heaviness. Do compression socks work? Yes. They are one of the most widely used conservative measures for chronic venous insufficiency and have extensive clinical support.   What can I take for tired legs? Some plant extracts, such as horse chestnut, have shown promising results in clinical studies. However, they should be considered a complement within a broader strategy that includes healthy habits and physical activity. References Cesarone MR, Belcaro G, Rohdewald P, Pellegrini L, Ippolito E, Scoccianti M, Ricci A, Dugall M, Cacchio M, Ruffini I, Fano F, Acerbi G, Vinciguerra MG, Bavera P, Di Renzo A, Errichi BM, Mucci F. Prevention of edema in long flights with Pycnogenol. Clin Appl Thromb Hemost. 2005 Jul;11(3):289-94. doi: 10.1177/107602960501100307. PMID: 16015414. Diehm C, Trampisch HJ, Lange S, Schmidt C. Comparison of leg compression stocking and oral horse-chestnut seed extract therapy in patients with chronic venous insufficiency. Lancet. 1996 Feb 3;347(8997):292-4. doi: 10.1016/s0140-6736(96)90467-5. PMID: 8569363. Martinez-Zapata MJ, Vernooij RW, Simancas-Racines D, Uriona Tuma SM, Stein AT, Moreno Carriles RMM, Vargas E, Bonfill Cosp X. Phlebotonics for venous insufficiency. Cochrane Database Syst Rev. 2020 Nov 3;11(11):CD003229. doi: 10.1002/14651858.CD003229.pub4. PMID: 33141449; PMCID: PMC8094625. De Maeseneer MG, Kakkos SK, Aherne T, Baekgaard N, Black S, Blomgren L, Giannoukas A, Gohel M, de Graaf R, Hamel-Desnos C, Jawien A, Jaworucka-Kaczorowska A, Lattimer CR, Mosti G, Noppeney T, van Rijn MJ, Stansby G, Esvs Guidelines Committee, Kolh P, Bastos Goncalves F, Chakfé N, Coscas R, de Borst GJ, Dias NV, Hinchliffe RJ, Koncar IB, Lindholt JS, Trimarchi S, Tulamo R, Twine CP, Vermassen F, Wanhainen A, Document Reviewers, Björck M, Labropoulos N, Lurie F, Mansilha A, Nyamekye IK, Ramirez Ortega M, Ulloa JH, Urbanek T, van Rij AM, Vuylsteke ME. Editor's Choice - European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022 Feb;63(2):184-267. doi: 10.1016/j.ejvs.2021.12.024. Epub 2022 Jan 11. Erratum in: Eur J Vasc Endovasc Surg. 2022 Aug-Sep;64(2-3):284-285. doi: 10.1016/j.ejvs.2022.05.044. PMID: 35027279. Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2014 Jul 22;130(4):333-46. doi: 10.1161/CIRCULATIONAHA.113.006898. PMID: 25047584. Pittler MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency. Cochrane Database Syst Rev. 2012 Nov 14;11(11):CD003230. doi: 10.1002/14651858.CD003230.pub4. PMID: 23152216; PMCID: PMC7144685.  

1 2 3 4