Something inside shoulders hurt when doing Heavy Chest ??

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    Something inside shoulders hurt when doing Heavy Chest ??


    Lately, I'm getting this problem ! Something inside my shoulder located in rear delt hurts everytime I do heavy chest exercises. I don't know if it's the rotator cuff or not but My shoulder clicks sometimes when moving

    any suggestions ?

    any supplements including hormones?

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    Quote Originally Posted by Markusrulezzz View Post
    Lately, I'm getting this problem ! Something inside my shoulder located in rear delt hurts everytime I do heavy chest exercises. I don't know if it's the rotator cuff or not but My shoulder clicks sometimes when moving

    any suggestions ?

    any supplements including hormones?
    yeah. go get an mri. in the mean time stop benching and when it gets better still stop benching. i havent flat benched in years. i incline only with bb but can do flat d-bells so that angle on shoulder can be altered

    also look at your routine now and past. make sure your ratio of push-pull is at least 1:1
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    I have same problem. If I do flat bench, I do it on the Smith and it doesn't hurt. I do pretty much all db now with some Smith and machine work
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    bringing your elbows in closer to your torso will take some pressure off the shoulders while pressing. but on the downside, it puts more weight on the triceps and off the chest.
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    so what is this problem ? looks like some people have experienced !

    Is there anyway you can get it fix ? surgery ? cortisone shots ?
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    I am coming off a tweak of my infraspinatus that sounds similar to what you describe. It happened during decline bb, and I believe that my shoulder joint (or, more specifically, my humerus was not in its proper place when I pressed). The reason I say that is because I periodically need to self adjust my shoulders to keep them in line. Anyway, I was lucky that it was not a tear, and two deep tissue sports massages a week apart got me back on track. Whether your problem is infraspinatus or not, make sure you are doing rotator cuff exercises for rehab, and also incorporate them into your weekly routine from now on.

    I also agree that you need to make sure that you are doing a 1:1 ratio of pressing and pulling movements to keep your shoulder balanced. Using PH's is not the answer.

    I quit doing flat bb press a while ago due to multiple shoulder injuries. I use db's exclusively for my flat movements and mix bb and db for incline and decline. Even with strict form, flat bb presses put you in a compromised position. Some people's body geometry can handle them better than others.
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    Quote Originally Posted by Markusrulezzz View Post
    so what is this problem ? looks like some people have experienced !

    Is there anyway you can get it fix ? surgery ? cortisone shots ?
    i know this sucks, but try benching on the smith. i dont get shoulder pain on the smith at all. but the thought of doing smith just makes me wanna
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    See your PCP, could be rotator cuff, anything from a tear to bursitis or something else entirely. You need a qualified medical opinion.
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    if you bring the bar to you chest like all the "hot shots" do then you may cause a shoulder impingement. keep it about 4-5 inches off your chest during your reps and this will keep you pecs engaged during the entire lift . taking alot of stress off your shoulders.
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    Quote Originally Posted by R1balla View Post
    i know this sucks, but try benching on the smith. i dont get shoulder pain on the smith at all. but the thought of doing smith just makes me wanna
    wtf? I feel like my body is being smashed in a trash compactor whenever I try to bench on a smith machine haha. But I guess it all depends on the person

    On topic, I'm sorry but I dont know what might be going on. Hopefully Zir Red will see this and chime in.
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    Ok, a couple of things to address.

    First is your problem. It sounds to me like an infraspinatus issue. What type of pain do you feel? Does it hurt when you reach back, say to put on a jacket or scratch between your shoulder blades? If yes, then likely infraspinatus. The pain will also radiate down the front of the shoulder and even down the arm toward the fingers.



    If it an intense pain this may be a sign of a more major injury, such as a 1st or 2nd degree tear. If it is more of a naggin pain, then it is most likely a tendon strain or tendonitis.

    What to do immediately: Stop the exercises that hurt and similar exercises. So, no more pressing, raises or flye movements for a few week.

    Ice the area to reduce inflammation. Get a dixie cup (the type with a tip for the bottom). Fill it and freeze. Then, peel off the bottom and use this to massage ice into the specific area.

    Get a topical NSAID cream. You can make one out of crushed up ibuprofen and DMSO or buy them online. Rub this on the area as well to reduce inflammation.

    What to do for the long term:
    First, if problem presists, see a sports doc/physical therapist! If not:
    Slowly reintroduce pressing, but only if the movement does not cause pain.
    Strengthen the infraspinauts by doing external rotations.
    Stretch the internal rotators (pecs, lats, anterior delts)
    Stretch the scapula protractors (serratus, pec minor)
    Strengthen the scapula retractors and depressors.


    Next, a couple of notes.

    First, the further the elbows are out during pressing does not mean greater pec recruitment. In fact, just the opposite, it means greater ANTERIOR DELT recruitment and greater RC tendon impingement.

    The same with the grip. A grip greater than 1.5x the acromial span (the boney process atop the shoulder) means a greater ant delt recruitment and greater RC tendon impingement.

    In fact, a grip 1.5x the acromial span with shoulders abducted to 45 degrees (picture doing a side/lateral raise...now stop 1/2 way up. Thats how far out your elbows should be) has been shown to result in the greatest pec recruitment with minimal impingement.

    Can send article..shoot me PM:
    The Affect of Grip Width on Bench Press Performance and Risk of Injury
    Green, Carly M.; Comfort, Paul

    Strength & Conditioning Journal. 29(5):10-14, October 2007.


    The Affect of Grip Width on Bench Press Performance and Risk of Injury. select a grip widt...

    + FavoritesPDF (192 KB)
    Abstract Abstract
    Abstract:
    summary: Bodybuilders, athletes, and recreational lifters select a grip width during the bench press that they believe will produce a greater force output. Research has demonstrated that a wide grip (> 1.5 biacromial width) may increase the risk of shoulder injury, including anterior shoulder instability, atraumatic osteolysis of distal clavicle, and pectoralis major rupture. Reducing grip width to <=1.5 biacromial width appears to reduce this risk and does not affect muscle recruitment patterns, only resulting in a +/-5% difference in one repetition maximum.

    (C) 2007 National Strength and Conditioning Association
    Next is the smith machine. The does a number of things on the body, including moving the placement of joints out of normal alignment during the exercise due to the fixed movement pattern of the bar. The merrit of the smith can be debated ad nauseum; however, I highly suggest AGAINST using the smith for nearly everything and can get into more detail at a later date.
    Last edited by ZiR RED; 03-23-2011 at 08:16 PM. Reason: expanding...
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    Try doing decline for awhile. It ended all my shoulder woes, and seems to give better pumps.
    True story:

    I give a f**K!!
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    I have an inflamed rotator cuff in my right shoulder. Your symptoms sound similar to what I experience on a bad day.

    My problem is inflammation, so i take Ibuprofen 2-4 pills, 3 times a day. Seems like alot but my orthopedic surgeon told me to do it. I try to keep it to 2-3 pills, 2-3 times a day, just to protect my stomach, but if its bad ill do 4.

    Also I ice it sometimes 2 or 3 times a day when its bad and do rotator cuff exercises constantly (while watching tv or laying in bed) with just my arm as weight.

    All these things have helped me alot to strengthen the rotator cuff and keep inflammation (and thus pain) to a minimum.

    Hope it feels better, I know how frustrating joint pain can be, it sucks a**
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    Quote Originally Posted by rayactr2k6 View Post
    I have an inflamed rotator cuff in my right shoulder. Your symptoms sound similar to what I experience on a bad day.

    My problem is inflammation, so i take Ibuprofen 2-4 pills, 3 times a day. Seems like alot but my orthopedic surgeon told me to do it. I try to keep it to 2-3 pills, 2-3 times a day, just to protect my stomach, but if its bad ill do 4.

    Also I ice it sometimes 2 or 3 times a day when its bad and do rotator cuff exercises constantly (while watching tv or laying in bed) with just my arm as weight.

    All these things have helped me alot to strengthen the rotator cuff and keep inflammation (and thus pain) to a minimum.

    Hope it feels better, I know how frustrating joint pain can be, it sucks a**
    The only problem with taking a lot of NSAID's is that there is a possibility of it inhibiting protein synthesis, and thus being counterproductive to building muscle. Not to mention the fact that some of them are hard on the liver. My point is that using pain relievers should not be the primary long term solution.
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    Quote Originally Posted by crux View Post
    The only problem with taking a lot of NSAID's is that there is a possibility of it inhibiting protein synthesis, and thus being counterproductive to building muscle. Not to mention the fact that some of them are hard on the liver. My point is that using pain relievers should not be the primary long term solution.
    I didn't know it inhibits protein synthesis. How does it do that?
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    i just looked it up. NSAIDs hurt gains. That sucks, looks like im gunna be doing more ice and exercises instead of ibuprofen
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    Yea, I have read many articles that they hinder your gains.


    But everytime I stretch the **** out of my shoulders, I don't get that pain as much !
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    Does anyone know of any other OTC anti-inflammatories that do NOT inhibit protein synthesis?
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    fish oil is anti-inflammatory. . .
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    how many grams of fish oil should we take ?
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    I'm not an expert on this, but I have read a lot of guys take 5-10 grams/day when training. I take 5g
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    Quote Originally Posted by crux View Post
    I'm not an expert on this, but I have read a lot of guys take 5-10 grams/day when training. I take 5g
    that would be five softgels of the stuff i have. You take 5 softgels at once or throughout the day?
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    Quote Originally Posted by rayactr2k6 View Post
    that would be five softgels of the stuff i have. You take 5 softgels at once or throughout the day?
    ud always get more out of it if you take throught out the day, same as protein

    It's like taking 200grams of protein at once vs trhu out the day... with the 200, ull absorb 30 and piss out 170
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    Quote Originally Posted by Markusrulezzz View Post
    any supplements including hormones?

    Yes seriously what you want to do is 2grams of tren. True say, stuff will fix you up.

    But honesty, sounds simply like form to me? Sounds like you're utilizing delts too much during your lift. It happens when form is not perfect when you go heavy over and over. Basically sounds like overworked delts to me.
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    Fish Oil ...

    I take 14 to 15 grams a day. I like the 1200mg caps - and I shove four down me three times a day.

    Works for me. Makes me feel good - and my skin is nice and smooth. Not oily - and I notice it doesn't peel much when I tan outside in the sun - even when I stay too long and overdo it. Mrs. Honda says my skin is more supple than hers - she's right - but she don't like fish oil and won't take it! LOL
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    Quote Originally Posted by HondaV65 View Post
    Fish Oil ...

    I take 14 to 15 grams a day. I like the 1200mg caps - and I shove four down me three times a day.

    Works for me. Makes me feel good - and my skin is nice and smooth. Not oily - and I notice it doesn't peel much when I tan outside in the sun - even when I stay too long and overdo it. Mrs. Honda says my skin is more supple than hers - she's right - but she don't like fish oil and won't take it! LOL
    That seems like it would get expensive with the brand i get. What brand do you use?
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    We don't piss out protein (unless your kidneys are failing) nor fats/lipids.

    The whole "you cant absorb xxx" is more of a ploy to help market protein powders than anything else.

    Excess aminos not utilized in protein synthesis will be converted by the liver into glucose or krebs cycle derivitives (similar to broken down fatty acids). These will either be: used for fuel, stored as adipose, or converted back into amino acids when aminos are needed.

    Fish oil is a lipid, and therefore stays in the body for a longer period of time. I really don't think you would notice any difference taking 1g 5x a day, of 5g once a day. The body is very good at making the most of what we put in it. That's one of the reasons our species is not extinct.

    Cost effectiveness: Cod liver oil. I buy a few 1 liter bottles at GNC for 15 bucks each. i take a swig each night. Each bottle lasts me about a month.

    Br
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    Quote Originally Posted by ZiR RED View Post
    We don't piss out protein (unless your kidneys are failing) nor fats/lipids.

    The whole "you cant absorb xxx" is more of a ploy to help market protein powders than anything else.

    Excess aminos not utilized in protein synthesis will be converted by the liver into glucose or krebs cycle derivitives (similar to broken down fatty acids). These will either be: used for fuel, stored as adipose, or converted back into amino acids when aminos are needed.

    Fish oil is a lipid, and therefore stays in the body for a longer period of time. I really don't think you would notice any difference taking 1g 5x a day, of 5g once a day. The body is very good at making the most of what we put in it. That's one of the reasons our species is not extinct.

    Cost effectiveness: Cod liver oil. I buy a few 1 liter bottles at GNC for 15 bucks each. i take a swig each night. Each bottle lasts me about a month.

    Br
    A pro fitness model who trains in venice golds told me you only absorb a certain amount of protein, depends on your body and it's between 1-40gs maximum unless you are on STEROIDS because they increase your protein synthesis
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    Quote Originally Posted by Markusrulezzz View Post
    A pro fitness model who trains in venice golds told me you only absorb a certain amount of protein, depends on your body and it's between 1-40gs maximum unless you are on STEROIDS because they increase your protein synthesis
    Yes, that is a very common misnotion, but ask him to prove it with some references, or at least some rational thought based on science.

    Yes, steroids increase protein synthesis, but do they increase intestinal function? Not likely.

    Since we all love to get our advice from pro bodybuilders/fitness models, how about we start listening to people who can back it up with some science:

    Protein: how much and how often?

    Layne Norton, BS Biochemistry, PhD

    From the time that the first physique enthusiasts & bodybuilders ever started choking down extra chicken breasts, steaks, and vile concoctions to increase their protein intake for the purposes of gaining muscle the question of just how much protein is optimal has been debated.
    Fast forward more than half a century and people still debate the same question without much of a consensus. Many people believe that protein is already over consumed by the typical person and bodybuilders and athletes have no need to take in extra, while there are those who will tell you that there is no upper limit to the benefits of protein.

    In reality the answer to this question probably lies well within the middle of these two extremes. The question of protein quantity at a meal and frequency of protein consumption has been debated almost as often as total protein consumption. Quite often we see the question, “what is the max level of protein that one can benefit from at a meal and how long often should I consume it?” Fortunately for us, this question actually has some data that we can start picking apart to get some general guidelines for protein size and frequency at meals.

    Many ‘experts’ or gym know it alls out there who will tell you to only consume “X” amount of protein at a meal because only “X” amount of protein can be absorbed by the body at a meal (I’m sure you’ve all heard this one before). Let this nonsense stop here and now. To begin with, this entire train of thought isn’t even on the correct track.
    Hell it didn’t even depart from the right train station! Assuming that you have a healthy digestive system the absorption of the amino acids from a meal containing protein is very efficient and almost never a limiting factor. Absorption only refers to nutrient uptake & absorption via the digestive track (most absorption occurring in the small intestine).

    If our digestive systems didn’t absorb most of what we eat than anytime you had a big meal you would have diarrhea like clockwork from the undigested material in the gut! It also makes very little sense from an evolutionary standpoint to be very wasteful with nutrients when primitive man may have only been able to eat one large meal in a day at times.
    Our species would not have survived very long if we were wasteful with nutrients and did not absorb amino acids beyond a certain level. In reality, the body has an extremely high capacity for amino acid absorption. What these people who spout this nonsense are really referring to is amino acid utilization. You see, even if we absorb 100% of the amino acids we ingest, that doesn’t mean they will all reach the skeletal muscle and input towards building muscle mass. In actuality a very small percentage are used for that role.

    The cells of the small intestine and liver extract a huge amount of amino acids for energy and their own synthesis of new proteins in first pass metabolism before they ever reach the bloodstream! Once in the bloodstream amino acids can also be taken up and utilized by other tissues such as the kidneys, heart, skin, etc.

    So it is not a question of how much protein/amino acids can be absorbed at a meal, rather the question is what level of protein at a meal gives the maximum benefit for muscle building? Essentially anything below this level would not maximally support muscle building, while at a protein intake above this level, the body would merely oxidize the excess amino acids for energy.


    In order to start answering this question of optimal protein intake at a meal we first must make clear as to what defines a “maximum level of benefit” from protein intake. Using rates of protein synthesis as a measure for this definition is logical as increased rates of protein synthesis would be required for the addition of new skeletal muscle tissue. To put it more plainly, in order to build muscle the body must increase the rate at which it synthesizes muscle tissue above the baseline rate.

    Decreasing the rate of skeletal muscle breakdown also can lead to increased tissue accrual, unfortunately data on protein breakdown is much more difficult to obtain, interpret, and it is much more variable than the synthesis data. It is very difficult to measure short term changes in skeletal muscle breakdown as it has a very slow turnover rate so the focus on this article will be on protein synthesis, which likely plays more of a regulatory role in tissue accrual/loss in muscle than degradation since synthesis is the more regulated energy dependant process.

    To find the optimal level of protein intake at a meal we must determine what the optimal level of protein at a meal for stimulating muscle protein synthesis is. It appears that maximizing skeletal muscle protein synthesis requires approximately ~15g of an essential amino acids1,2.

    It has been postulated that the amino acid leucine is responsible for the stimulatory effect of dietary protein on protein synthesis3 and 15g of essential amino acids would contain 3.2g of leucine. Thus in order to determine how much protein from a specific source is required to elicit the maximal response it may be useful to back calculate how much leucine is contained in the source.
    One could then determine how much of the source must be consumed in order to reach the leucine threshold. For example, whey protein is approximately 12% leucine per gram protein, therefore about 27g of protein from whey would need to be consumed to reach the threshold for maximal anabolism, whereas a source like chicken, which has a protein content of about 7.5% leucine would require 43g of protein to reach the leucine threshold required for maximal stimulation.

    So it appears that the maximum benefit level for protein at a meal is varies depending upon the source of protein. It is important to note that most of these studies were done on individuals who weighed approximately 155-165 lbs on average. So if you weigh less than this you might want to aim for the lower end of the threshold whereas if you weigh more you may want to aim for the higher end of the threshold.


    Protein Source Leu % of total protein) Amount of protein from source to reach 3.2-4.4g Leucine Amount of food source required
    Beef 8.0% 40g 133g (4.7oz)
    Chicken 7.5% 43g 139g (4.9oz)
    Pork 8.0% 40g 140g (4.9oz)
    Egg 8.6% 37g 296g (10.5oz) or approx 5 large eggs)
    Fish 8.1% 40g 170g (6.0oz)
    Whey 12.0% 27g variable depending upon whey powder type
    Casein 9.3% 34g variable depending upon casein powder type
    Milk 9.8% 33g 932g (33 oz) or approx 4 cups of milk


    Now there is the issue of meal frequency and time between meals. Assuming we maximize protein synthesis by achieving the required leucine/protein threshold, how long does the effect last? Several studies have shown that the duration of protein synthesis in response to an oral leucine dose or an essential amino acid infusion is approximately two hours long4,5.
    However, these are purified amino acid solutions and are likely to be digested rapidly and in the case of an infusion, no digestion is required at all. So it is possible that a whole food meal will have a different impact on the duration of protein synthesis than pure amino acids. Our lab has recently shown that the duration of protein synthesis in response to a complete meal containing protein, carbohydrates, and fats is approximately 3 hours long6.

    Therefore, it appears that a complete meal slightly prolongs the duration of protein synthesis. What is interesting about our findings is that while protein synthesis had returned to baseline after 3 hours, plasma amino acid levels were still elevated above baseline and plasma leucine was elevated almost 3x above baseline!
    Accordingly, the phosphoryation of the initiation factors 4E-BP1 & p70S6K followed plasma leucine levels and maintained elevated levels of phosphorylation at 3 hours (phosphorylation of these initiation factors is required to start the process of protein synthesis).
    Thus it appears that the signal to maintain elevated protein synthesis is still being ‘transmitted’ but for some reason protein synthesis is becomes refractory after a certain period of time.
    This is also supported by data from Bohe et al which showed that the duration of protein synthesis in response to an infusion of essential amino acids was only 2 hours long even though the essential amino acids were infused for six hours5! It is unlikely that eating another meal 2-3 hours after the first meal would be sufficient to induce another rise in protein synthesis since amino acid/leucine levels are already elevated anyway. It may therefore be more useful to consume larger amounts of protein at a meal and wait longer between protein doses than the typical 2-3 hours that is typically recommended in the bodybuilding community.


    Now I know you’ve probably spit your protein shake out all over your magazine, ruining it and now you are cursing me for 1) ruining your magazine and 2) telling you the bodybuilding meal eating protocol you’ve been following for so long may not be optimal for making gains. Well I apologize for ruining your magazine but I won’t apologize for busting on musclehead dogma; that is just what I do.

    There is some precedent for what I am recommending however. Arnal et al7 compared elderly women consuming either 4 small meals per day with their total protein intake evenly spaced out verses those that consumed the same amount of protein but with 80% of their total protein coming in one meal.
    The researchers found that the women consuming the large single dose of protein actually had greater nitrogen balance, protein turnover, and protein synthesis rates than the group consuming their protein across four evenly spaced meals. Now the total protein intake for both groups was only 60g so the group consuming protein evenly only consumed 15g at each meal. Still it is interesting that the group eating almost all of their total protein in one meal had better results.
    Perhaps the group consuming the small meals never reached the threshold required to initiate a significant response of protein synthesis at any meal whereas the bolus dose group ate enough protein in at least one meal to initiate have one significant increase in protein synthesis above baseline during the day.

    Now I am not in any way shape or form implying that we are better off just consuming one large protein meal per day. What I am implying is that it is better to consume larger protein doses spaced further apart and maximize protein synthesis, rather than consume smaller doses of protein throughout the day, since research has shown that protein synthesis will become refractory to constantly elevated levels of amino acids. It may be that a period where amino acids return to baseline or near baseline is required in order to initiate another bout of protein synthesis.

    I therefore suggest that one consume 4-6 larger protein doses per day instead of 6-8 meals and wait 4-5 hours between meals rather than 2-3 hours.

    At the moment, there is no clear way to overcome the refractory response. However, there is evidence that supplementing with free form amino acids with carbohydrates between meals may improve protein synthesis compared to normal meals alone8.

    It is possible that a free form amino acid supplement could spike plasma levels of amino acids to a far greater level than can be achieved with whole foods and perhaps this supraphysiological response is enough to overcome the refractory response. It is also possible that the carbohydrates in the supplement have an effect.

    The insulin time course in the experiment we performed lasted 3 hours, the same as protein synthesis. Additionally, Wolfe et al. also showed that the timecourse of insulin seemed to track protein synthesis during an essential amino acid infusion5. Perhaps maintaining elevated plasma insulin levels is required to prolong protein synthesis in response to a meal. In either case, it appears that supplementing with an amino acid supplement containing ~2-3g of leucine along with some carbohydrates (~20-30g) is an effective way to maximize muscle protein synthesis.

    Now I will be the first to admit that the research is just not specific or broad enough to address the size and frequency issue with absolute certainty, but I believe these recommendations are a good general starting point. What is clear is that certain protein sources have a stronger impact on protein synthesis than others, and also that it appears that keeping amino acids constantly elevated by smaller protein doses throughout the day may NOT be optimal. Hopefully future research will address more specifics with regards to these issues.

    1. Paddon-Jones D, Sheffield-Moore M, Zhang XJ, Volpi E, Wolf SE, Aarsland A, Ferrando AA, Wolfe RR. Amino acid ingestion improves muscle protein synthesis in the young and elderly.
    Am J Physiol Endocrinol Metab. 2004 Mar;286(3):E321-8.

    2. Tipton KD, Ferrando AA, Phillips SM, Doyle D Jr, Wolfe RR. Postexercise net protein synthesis in human muscle from orally administered amino acids. Am J Physiol. 1999 Apr;276(4 Pt 1):E628-34.

    3. Norton LE, Layman DK. Leucine regulates translation initiation of protein synthesis in skeletal muscle after exercise. J Nutr. 2006 Feb;136(2):533S-537S.

    4. Anthony JC, Lang CH, Crozier SJ, Anthony TG, MacLean DA, Kimball SR, Jefferson LS. Contribution of insulin to the translational control of protein synthesis in skeletal muscle by leucine.
    Am J Physiol Endocrinol Metab. 2002 May;282(5):E1092-101.

    5. Bohe J, Low JF, Wolfe RR, Rennie MJ. Latency and duration of stimulation of human muscle protein synthesis during continuous infusion of amino acids. J Physiol. 2001 Apr 15;532(Pt 2):575-9.

    6. Norton LE, Layman DK, Bunpo P, Anthony TG, Brana DV, Garlick PJ. The leucine content of a complete meal directs peak activation but not duration of skeletal muscle protein synthesis and Mammalian target of rapamycin signaling in rats. J Nutr. 2009 Jun;139(6):1103-9.

    7. Arnal MA, Mosoni L, Boirie Y, Houlier ML, Morin L, Verdier E, Ritz P, Antoine JM, Prugnaud J, Beaufrere B, Mirand PP. pulse feeding improves protein retention in elderly women. Am J Clin Nutr. 1999 Jun;69(6):1202-8.

    8. Paddon-Jones D, Sheffield-Moore M, Aarsland A, Wolfe RR, Ferrando AA. Exogenous amino acids stimulate human muscle anabolism without interfering with the response to mixed meal ingestion. Am J Physiol Endocrinol Metab. 2005 Apr;288(4):E761-7.
    Br
  

  
 

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