Episode 67 - Hair Loss

Hair Loss

 

Speaker 1: 00:00 This is Dr Chad Edwards and you’re listening to podcast number 67 of against the grain.

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Speaker 3: 00:58 Hello. Hello everybody. This is the Super Tall Marshall Morris and today I’m joined with Dr. Chad Edwards, who believes that 80 percent of medical recommendations are crap technically speaking, here he is the author of revolutionize your health with customized supplements. He served in the US army. He is the founder of revolution health.org and the against the grain podcast as well as being a board certified physician. Dr Edwards, your reputation precedes you now at this point? I believe

Speaker 1: 01:34 again, as always, I’m like, who are you talking about? Are you doing today? Are you feeling pretty good? I am feeling really good. It’s been kind of a long week, but I’ve had several shifts in the emergency room this week and which is good and bad. Sure. It’s, you know, uh, you know, I’ve got to maintain some of that because it, it really helps me expand in the functional medicine realm. It adds, I think, some validity to when I say, you know, what you’re doing is crap if you’re not like in the realm. If you’re just out there doing something completely way different, it’s a good thing. And I think my patients benefit from it. It helps Kinda keep those horizons broad. So,

Speaker 3: 02:12 um, real quick question, we are going into the fall here. Okay. And for a lot yesterday at nine, 22 to be exact and well, I mean, but who’s keeping track? Um, so the thing that I wanted to address with you real quick is

Speaker 1: 02:28 who are you rooting for this football season? Gosh, you know, I’m a, that’s so tough on that. Well, you’re going to upset most of the people listening except for one core segment. Whatever your answer is. And here’s the thing, I, I grew up and Oh, you football fan. So I don’t get into pro too much, you know, born and raised in Tulsa. We don’t have a professional team here. Sure. We kind of have to latch on to Dallas cowboys and uh, I, I just never could really get into it. So I’ve always, I root for the big 12, you know, unfortunately, I don’t think that the big 12 is doing all that hot. Um, so I, I like, Ooh, but I went to Osu for medical school. I like Osu also, you know, so you know, maybe it’s just maybe in schizophrenia or maybe it’s me not wanting to commit, but I like, ooo, I like Osu.

Speaker 1: 03:18 I want both of them to succeed. I want them to do well, you know, how do I not hate one of them? I don’t know. It’s one of the many ways that I’m just weird. Well, I then I probably shouldn’t bring up that my team, the real Osu Ohio state does pummeled Oklahoma as they did. So now let’s get into it. What is the hot topic for the podcast episode today? What are we talking about? Yeah, so I had a patient come in this week that had actually been seeing my nurse practitioner and she came in for a hair loss, you know, her hair was thinning and when I looked at her I was like, you know, I don’t know what your hair looked like before, but I mean your hair looks good. And she kind of saw that look on my face and she was like, don’t be fooled by this.

Speaker 1: 03:56 I have hair extensions. And so she did have hair extensions and when, when she showed me her hair was, uh, was quite thin, uh, you know, beyond that, I don’t know what she looked like before I was taking over because courtney or our nurse practitioner moved to Florida, uh, so we don’t have her anymore. So she was coming to me to help you manage or for me to help her manage her hormones. And she was saying that we did hormone pellets and her hair loss got worse, you know, so what in the world could be happening and so, you know, as she was talking through this, I was like, you know, this is, it’s a common thing that I get women specifically that will come in for hair loss and what can we do about that? And so I figured it’d be a good thing to talk about hair loss for women in this podcast.

Speaker 1: 04:37 Uh, so that’s what we’re talking about today. So are we talking about what’s causing hair loss or ways to defend against hair loss, or what is it? Why is this a hot topic that all the listeners need to hear? Well, we do so many bioidentical hormones, it’s one of the side effects that we can get a, you know, when we’re trying to optimize testosterone in our female patients, uh, certainly in our men patients as well, just many times to different mechanism for hair loss, although it can be very similar at the same time, um, but because we do a lot of hormones, it’s a known side effect that you can, some women can have and, but then they also, we do so much thyroid that many women will come in just with, you know, my hair is thinning or maybe one of their symptoms or you know, one of the listeners, I mean, you may have some hair loss and have nothing to do or you don’t.

Speaker 1: 05:25 You’re not thinking that it’s thyroid or you’re not thinking that it’s hormone related. So what is this now to separate? We’re not talking about universal causes of hair loss. I’m not going to cover the whole spectrum. We don’t have enough time to do that. Uh, I’m going to talk about generalized hair loss on the top of the head. There are some conditions like Alopecia Areata, which is a little patches of hair loss. There are some conditions like Alopecia Universalis or totality where you don’t have any hair from head to toe. You don’t have eyebrows, you don’t have underarm hair, pubic hair, you don’t have anything. Note not a hair follicle on your body, so we’re not going to get into that. Uh, the, uh, many of those are autoimmune related. There’s some conditions associated with those. So that’s not what we’re talking about here. What we’re talking about is the, the woman that comes in and she’s, her hair is thinning and what do you do about it?

Speaker 1: 06:16 Uh, and then we’ll talk about how it’s related to thyroid and to the hormone replacement therapy that we do in the clinic and what can we do about it. So pretty much the spectrum on that, but it’s that little niche that it’s not, it’s not patches. Alopecia Areata is those patches where, you know, it looks like you’ve got a hole in your hair production. And there’s this bald spot right there. A totally different mechanism for what causes that. So we’re not getting into those kinds of things, so. So why would hormones in the first place affect hair loss? But that’s, we’re definitely gonna get into that. I figured the, the best way to start with this would be to talk about the phases of hair. You know, some people think that your hair is just there, you know, and, and it’s constantly in this growing state, you know, it.

Speaker 3: 07:01 I thought it was just Kinda, you know, like how you used to to do that elementary school science experiment with the potato and the grass seed and he grabbed the hair on top of the potato. Maybe that was just my school. Nobody else did that, but um, I just thought it just Kinda, you know, just sprouted out and just kind of came out and it just would keep going until it never stopped.

Speaker 1: 07:19 Chicha Chia. Exactly. You’re with me now. I got it. All right. I got it. I wanted, I always wanted the Obama Chia hid. I thought that was a good idea. There you go. Anyway. Um, okay. So hair, hair itself, it’s not in this constant phase of just having a hair follicle and it just begins growing and it grows at one inch a year or whatever the rate is for different people, but it. And it just keeps growing longer and longer and one inch a year. Oh, I just made that. Oh, okay. Yeah, it’s longer. It’s more than that probably for some people. Maybe not everybody. Sometimes I wish my hair wouldn’t grow at all because then I wouldn’t have to go get it. Cut. There you go. It’s a pain. I don’t have time for that. What I need. I need a mobile barber. I need them to come to my office and cut my hair at lunchtime.

Speaker 1: 08:10 I think. I think we might be able to go into business together about that because I don’t. I’m not joking. In fact that one of my other good friends, he has the same issue and it might be. I might need to get a haircut at the first of the month and it might be three weeks because I just can’t find time to do it. Sure. I know that sounds stupid, but it’s true. Sure. So, and then of course the time I can, it’s when everybody else can too. So the lines out the door. Nah, ain’t nobody got time for that. Exactly. I got to go. Anyway. So the, your hair doesn’t grow in this constant, you know, each other. When I say here, I mean a hair follicle, one hair strand, it doesn’t begin it’s life and grows at a set rate throughout the life of the hair and it stays there forever.

Speaker 1: 08:50 That’s just not what happens. There are actually two phases to, to your hair and you have a growth phase and a resting phase in the growth phase is called Antigen a n a g and Antigen. And typically on average, that’s about three years, uh, of, of the lifespan of the hair. Three years of this growth phase. Then you have a resting phase which is called intelligent t e l o g e n. and that’s actually about three months. And you have this in that period of time where you’re in the telogen phase, uh, that resting hair stays in its follicle. So it’s almost like it’s a dead hair, so to speak, uh, even though here is dead, but anyway, uh, so that resting hair stays in its follicle until it’s pushed out by a new antigen hair. Almost like, you know, your child, you’re a kid to an adult tooth.

Speaker 1: 09:44 What am I trying to say? Yeah, yeah. My, my children, teeth, whatever it is. Um, anyway, uh, so the, as the new hair grows in, it will bump that one out and you can tell because the hair, you know, it has the follicle with it and you know, the, the whole thing. So for the average person, you know, on your, on your head, you’ve got hair that cycles, uh, so it, there are across the top of your head, you’ll have five to 15 percent of your hair are in the telogen phase at any given time. So it’s not like, you know, from front to back all 100 percent of your hairs are in antigen or intelligent. They’re, each follicle is kind of doing its own thing and five to 15 percent of those will be in the telogen phase at anytime. That’s why, you know, you might lose 100 hairs off your head a day and that’s just normal because it’s in this constant state of, uh, of a cycle.

Speaker 1: 10:38 There is a condition and this is the first condition that we’ll talk about and it’s called telogen, effluvium. And that is where we got these two different phases, the antigen, the intelligence, and if fluvial means outflow. And so basically something happens and we’ll talk a little bit about that where all of the hairs on your head will go into this telogen phase and basically stopped growing and just kind of shocks everything. It’s like those fainting goats. So something that happens, I’ll just go back and fall over. So it’s Kinda like the same thing, but because those hairs will often stay in place until the new anogen phase kicks in, they will often stay there. So you’ll get this latency period where you have an event that happens that causes all your hairs to go into this shock, a intelligent phase, uh, at the kind of, at the same time.

Speaker 1: 11:28 And then, uh, the anogen phase will kick in and you’ll start growing new hairs. And when that happens is when all the hair starts falling out, so it’s not something happened on Friday. My hair fell out on Tuesday. That’s not it. That’s not telogen effluvium, telogen effluvium standard intelligent effluvium will last less than six months. So some, some single inciting events. And there are a few that can, can trigger this things like there’s some kind of physiologic stress and that can be nonspecific. We don’t know exactly. You know, there’s just, here’s what we’ve seen associated with these things, a psychological stress. So if you have a lot of psychological, mental, emotional type stress that can trigger this hormonal changes and that’s a big thing that we deal with in our clinic. So thyroid hormones, sex hormones, those kinds of things can certainly trigger these things.

Speaker 1: 12:18 And there’s a whole host of medications, things like Beta blockers, anticoagulants, retinoids, propofol, euro sale, which is a thyroid related medication. Carbamazepine, immunizations, all kinds of things can shock the system and put it into this telogen effluvium phase. And you’ll see a large number of these, of these hairs. I’ll go into this phase at the same time. And uh, you know, it’s, you might have between one and six months between when you had this inciting event and when all the hair starts shedding, so it can be very difficult to identify that inciting event. And we’ll talk about after we come back from our break in a minute, we’ll, we’ll talk about what do we do about this. There’s another type of hair loss called Anagen effluvium. So again, Effluvia means the outflow or the outpouring and that is what we would see you with, like a patient with chemotherapy.

Speaker 1: 13:08 It’s targeting the hair in its growth phase instead of in the telogen phase. And so there you will see fairly rapidly a large shedding of hair, uh, whereas, you know, with the telogen effluvium it can be a, a big latency period. Um, and when you have that Anagen effluvium, then you can, it can change the type of your hair so you can have straight hair before you go into this antigen effluvium for any number of reasons. And you might come back with curly hair, it can be complete. It’s just completely different. It’s kind of screws things up. I think. I would look better or worse with curly hair only if you think you might look better, but only if you, um, you dyed it red or orange, orange yet, like a go with the Ronald Mcdonald thing and just rock it. I think I could do that.

Speaker 1: 13:57 I think you could rock it. I don’t know that you would look better, but I think you’d rock it about that for an answer. Um, and so that’s one of the big ones that we see and when we have patients that come in with that, and we’ll talk a little bit more about this after the break in a minute, but when the key to that is identifying what caused this and then you fix that and it takes care of the telogen effluvium. Uh, but the key thing here, it takes time. It just takes time. This is don’t expect we give you a medication or a supplement or change something or put you on hormones. And then a week later you come back and you have a thick, full head of hair. It, this takes time. Sure. And I imagine it takes quite a bit of time just because of the rate at which hair grows.

Speaker 1: 14:42 Yeah, exactly. And we will get this, um, this gradual thickening. I mean, just, you know exactly like what you’re talking about that nothing’s damaged. This will come back. We’ll just have to figure out what’s going on and, and get that fixed. Now, you know, we talked about the standard telogen effluvium last up to six months. Anything over six months is considered chronic intelligent effluvium. We go kind of down a little bit different pathway, but again, got to identify the cause. Sure. Just like with everything else we do in functional medicine, what caused this? Sure. Uh, so the last kind of lop show that we’re going to talk about is an androgenic alopecia. So androgens are male hormones, testosterone, dihydrotestosterone, and basically the, the dihydrotestosterone, uh, targets the hair follicle a little bit differently and can cause hair loss. Generally it’s in this male pattern baldness type, a kind of hair loss.

Speaker 1: 15:42 And there’s a lot of things that we can do for that male or female. And it can still be androgenic. And when you’re aggressive with replacing testosterone and try to optimize those because patients so often feel so much better that you may need to manage some of these hormones that are causing, that could be causing or exacerbating some of the hair loss for women. So last thing I’ll say before the break is that obviously there is an association with thyroid and uh, and hair loss. And for a long time I looked at why and there’s actually a study. Let me see if I can pull this up real quick. There’s actually a study that shows, let’s see, this was journal of Clinical endocrinology and metabolism from 2008 and they showed that the human hair follicles are direct targets of thyroid hormones. And specifically we’re talking about t three that can modulate a multiple hair biology parameters.

Speaker 1: 16:39 So when it turns on, when it turns off it’s growing intelligent antigen, those kinds of things and can also affect hair color in regards to its pigmentation. So thyroid directly impacts hair growth or a or loss. So that’s another important thing to consider. It’s not really an androgenic hair loss, but that would be another thing to consider as well. So I know that we’ve done a few podcasts on the thyroid in the past and so for anybody that’s interested in, hey, you know, I’ve heard my doctor mentioned that, or maybe I need to look into that a little more. You can go back and listen to those episodes, but we’re going to take a quick break here and when we come back I want to learn more about how the different hormones really affect, uh, the hair growth and hair loss. Absolutely.

Speaker 2: 17:30 Are you tired and fatigued? Are you frustrated with doctors because they just don’t seem to listen? Do you want to fix your pain without surgery? If you answered yes to any of these questions, then we are the clinic for you. We offer prolotherapy PRP or platelet rich plasma therapy and stem cell injections, ivy nutritional therapies, bioidentical hormone therapy, and functional

Speaker 1: 17:50 medicine to get you back on track to optimal health. Call our clinic at nine one, eight, nine, three, five, three, six, three, six. Or visit our website@wwwdotrevolutionhealth.org to schedule your appointment today. Okay. We are back with Dr Chad Edwards and we’re talking about one of, uh, we’re talking about a hairy topic here or an. Yeah, well, hopefully Harry hopefully carry at least a hot topic in that his hair and hair loss and hair regrowth in restoration. Right? And so, uh, in the first half of the podcast episode here, um, we were talking about the different types of hair loss and uh, the different phases that hair go goes through. Um, but really all the listeners are wondering, Dr Edwards, how this is me, you’ve spent the first half of this episode talking about me and now they want to know how do I fix it? Yeah. So this is the fun part because this is where we get to make a difference and understand there are other reasons that you can have hair loss.

Speaker 1: 18:52 We’re just covering a few of them and some things that we really need to consider, but it’s not this big, oh my gosh, my hair’s falling out. I don’t know what’s going on. And, uh, it’s not like there’s this, you are not alone, you’re not the only one that’s experiencing this. Uh, we see a lot of this and there are things that we can do about it. So that’s what we’re going to get into here. Okay. So you’ve broken it down into the five steps of restoration, the five steps of restoration. And so as we go through, we’re gonna, we’re gonna number each one and then we’ll recap them at the end. But why don’t you get us into this first one here? Yeah. So the first one is evaluating why do you have hair loss? Is this something that was triggered by a physical or a psychological stress?

Speaker 1: 19:36 Is there a, you know, major hormone change, not just too much hormones, but is there a major hormone change? So having, going from too low, too high, too high, too low or anything like that can shock the system and cause the, uh, the issues. Are there medications that could be causing this? So we’ve got to identify why do you have hair loss, you know, a lot of our patients and it as a side effect of the testosterone or the pellets that we use for hormone replacement. We do use other forms of hormone replacement, but you know, specifically with dealt with pellets, uh, one of the potential side effects is hair loss or thinning of hair. So what do we do about that and how do we adjust for that? And that’s part of these five things. But is that the real cause you, just because you were started on testosterone replacement does not mean, you know, as a female it does not mean that the reason for your hair loss is testosterone.

Speaker 1: 20:27 So we have to know what it is we’re dealing with. If you had a psychological stress, we’ve got to make that go away. The physiological stress, make that go away. Medications, we may need to adjust the medications, get rid of some medications, which is, we’re going to try to do that as much as we can anyway when possible. Uh, so identify the underlying cause and treat that. That’s a tradition. I mean, that’s just a standard functional medicine approach to anything. So here, step one, identify the cars, work on that. Step two is so common and that’s what we’ve talked about. All of these podcasts in the past or many of these podcasts in the past about thyroid health and function. We know that t three specifically targets the human hair follicle and it has a big effect on the hair follicle when we look at, you know, I was trained to look at thyroid and I don’t want to rehash all the podcasts that we did and the next, you know, five minutes.

Speaker 1: 21:20 But, uh, basically I was trained that Tsh is all you need for thyroid management. Uh, but what I have seen is that patients do much, much, much better when you optimize their t three, the, I’ve had patients where they, they came in and they were on t three only replacement because of, you know, a number of conditions, number of issues. Uh, and we have to monitor that very closely, uh, and which, which we do. We watch those things, we monitor them, but those patients can feel fantastic when their t three levels are optimal, but their t four may be absent and their tsh may be completely suppressed. So t three is the hormone you need. That’s what needs to be measured. That’s what needs to be adjusted. So step number two is optimized t3. Yeah. Okay. Yup. That’s a. that’s a really good way of saying that a tsh alone isn’t going to do it.

Speaker 1: 22:13 We got optimize t three and there are other things, nutritional factor, all kinds of things. I mean it’s multiple podcasts that we’ve done are targeting that issue. Optimize t three. Okay, so step three is basically a supplement and it is a supplement that helps to enhance type one collagen. Type one Collagen is important for a lot of things. We’ve done a lot of podcasts on prolotherapy and how important that is and type one Collagen is foundational for ligaments and tendons and prolotherapy is targeting those things. It’s essential type one collagen. For bone health, it is the rebar, if you will, of the concrete in the highway. It’s, you cannot have optimal bone health without having that, uh, that a matrix of Collagen, it imparts much of the structure of the bone and it’s, you know, the structure of bone is not just this calcium or calcium hydroxy appetite, a concentrate.

Speaker 1: 23:09 It is, there’s multiple things to it. And type one Collagen is essential. Uh, so it’s good for that. Uh, it’s also good for your skin and it’s good for your nails and is good for your hair. Um, or that you have those, those things are composed of type one collagen. So there is a supplement that is a silicone and coleen stabilized Ortho. Silly, silly, sick solicit. Um, Ortho solicit. Yeah. Orthos, holistic acid, a Osa, so, but it’s silicone and coleen stabilized Orthos allistic acid, uh, so that there are randomized placebo controlled, double blinded studies showing benefit with skin. We’re reducing fine lines and wrinkles with bones, increasing bone, mineral density as well as increasing the strength of hair and nails. So I think it’s very important to add in a sub and we’ve got a very good one in our clinic. I absolutely love it.

Speaker 1: 24:08 We see excellent results with a bone mineral density. We may have talked about it in, in the, uh, osteoporosis, a podcast, but fantastic stuff does a great job. A step four is another supplement. Biotin, you want to make sure that you’ve got, you know, good 5,000 micrograms one to two times a day. Uh, so you’ve got to settlements here. Three is the, uh, the silicone stuff for is biotin. And then the last step is in regards to the androgens and how they affect us. So, so often, you know, we’ll put people on a testosterone replacement because if find that they generally do better, but the conversion of testosterone to another androgen called dihydrotestosterone can lead to increased hair loss and there’s an enzyme that converts testosterone to dihydrotestosterone or Dht and that’s five Alpha reductase. Lots of commercials out there, or at least there have been in the past for a medication known as propecia.

Speaker 1: 25:12 And you can use propecia for preventing the conversion of testosterone to dihydrotestosterone. And it is FDA indicated for preventing or reducing hair loss for men, uh, and there may be, if I remember correctly, they may have added the indication for women as well, but you can use that, especially in the realm of testosterone replacement. You can use this, uh, propecia for inhibiting the conversion of testosterone to dihydrotestosterone. So that’s something that we can do and it’s one milligram daily or every other day. So that would be something to consider there. I’m using, there are some supplements that are, that are very good. The one that comes to mind is saw Palmetto, uh, but there are others. We’ve got one specifically in our clinic that’s just, again, fantastic. Hopefully we’ll have this up on the store before too long, uh, which we’re making great progress on the store by the way.

Speaker 1: 26:10 Uh, but hopefully we’ll have that supplement up. Does a really nice job at preventing or slowing that conversion of testosterone to dihydrotestosterone, which is both good for prostate issues in men, but it’s also good for hair loss and we’ve got that issue in women on testosterone. The supplement. Great idea. And I would probably start there before I went onto propecia. Uh, there are some solutions that can be compounded that have estradiol and progesterone. You can, there’s one that has a Latanoprost, which is another name for a latiece. Someone will use that for their eyelashes and can help their igert lashes grow thicker, but it also has minoxidil, which is another known a medication for growing new hair. And, uh, we’ve been using that for men for, for quite a while. Uh, and you can combine that as a solution, rub it on the top of your head and, uh, and you can grow some new hair that way. And then the last thing is another medication called spironolactone and generally all prescribed that as 50 milligrams twice a day. So take 100 milligram tablet, cut it in half, and use that twice a day. And it protects that hair follicle from the dht or that I had wrote testosterone. And we’ll also send benefit with, um, some of the acne that can be associated with testosterone replacement. So several different things that we use for combating the issues with sex hormones or testosterone, a under that fifth, a number five umbrella.

Speaker 3: 27:36 Sure. So I want to recap these for everybody that’s listening. Okay? The first step to hair restoration, okay? It, maybe you’re losing some hair, maybe your hair’s, maybe you’re not going so far as to saying you’re losing hair. Maybe your hair’s just thinning, thinning, thinning. Um, the first is to evaluate why you can’t treat just the symptom, okay? You got to treat what’s causing the symptoms, right? Right. And that’s functional medicine one-on-one. Step number two is optimized t three. You can’t just evaluate tsh. You got to also evaluate an optimized t three. That’s exactly right. Okay. Number three is supplement type one Collagen, okay? The same stuff that’s making up your bones, same stuff that makes up your nails and, uh, your skin, and it also affects your hair. So you need that type one Collagen as well. It’s a supplement that enhances type one, cuts it, it’s a supplement that enhances the type one college does a great job.

Speaker 3: 28:38 Okay? Number four is a biotin. Okay? And uh, you’re saying that for somebody that’s experiencing this hair thinning, you’re saying 5,000 micrograms a day, one to two times a day, one to two times a day? Yeah. Okay. And then lastly is managing the sex hormones and testosterone, the basically interceding in between the conversion of testosterone to dihydrotestosterone. You got it. Boom. I’m almost starting to sound like I know what I’m talking about. It’s amazing. I’m like Marshall’s mini medical school and I’m so excited. Well in it’s in. Ladies and gentlemen, I have zero medical background here and so I know that if I’m able to follow along here, hopefully you are as well. If at any point they have questions, the listeners have questions like I probably will afterwards. I’ll ask you off air, where can they go for more information or how can they get in contact with you? So obviously, yeah,

Speaker 1: 29:37 or our website revolution health.org. There is an email that you can, in fact there’s a link on the website. You can send us questions if you need a, you can always call our clinic at nine. One, eight, nine, three, five, three, six, three, six, a and obviously, you know, schedule an appointment, come in and see us if you are, if you’re having hair loss, there’s you, you need a thorough lab evaluation that is looking at all of your hormones, all of your thyroid issues, all of those kinds of things, and let us try and get to the bottom of why you’re having thinning hair and let’s get that fixed. But remember it takes time. It is not an overnight solution with we identify it and get the right solution. It could take several months to gain success. I think I’d like black curly hair for the next episode. You think we could make that happen? Yeah, but we’re going to have to induce baldness first and then puts you in a Anagen effluvium and if that doesn’t work, we might have to do it again and again until we get the right combination or are we just buy me awake? Well, that would work. Dr Edwards. Thank you so much. Thanks Marshall. Have a great weekend.

Speaker 2: 30:33 Thanks for listening to this week’s podcast with Dr Chad Edwards. Tune in next week where we’ll be going against the grain.