Conditions we treat

Chronic medical conditions we treat:

Functional Medicine is the 21st-century approach to chronic diseases, finding and resolving the underlying causes of illness, and modifying lifestyles accordingly, for lasting optimal health and vitality.

We work diligently with our patients to resolve the following conditions:

The Vitality Clinic - Holistic treatment for chronic conditions

Dr Sharief Ibrahim
MRCP, FRCP, AFMCP

Happen when oil glands ducts get clogged under the skin resulting in pimples that often get infected. The condition affects 85% of teenagers due to hormonal changes. It also happens among stressed people & those with family history of the condition or taking steroid therapy.

Mainstream medicine treatment:

Prescribe various skin lotions that include retinol, salicylates & antibiotics cream. Patients often prescribed long courses of oral antibiotics & light therapy with variable temporary results.

Functional medicine approach:

Functional medicine strives to find the root cause of the disease. This could be related to diet, stress, toxicity, inflammation or hormonal imbalance.

I focus on restoring gut health to heal leaky bowel by adopting anti-inflammatory diet & avoiding food allergens. The treatment extends to replenish nutritional deficiencies, detoxify heavy metal, reduces stress & balance hormones.

In this way most of my patients get their pimples vanish along with symptoms of IBS & chronic fatigue.

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It is well documented in the medical literature that the over 40s lose muscle mass and gain fat. Their hormones become dominated by catabolic profle of insulin, cortisol and adrenaline while good anabolic growth hormone and testosterone plummet.

The mid-life crisis has also been expressed as significant decline in vitality. As statistics reported the normal person who follow normal living standards & takes regular healthcare advice declines at a normal rate Vitality curve.

He is expected to enjoy a peak vitality between the age 20 and 35. Beyond this age the vitality curve shows steep decline, putting people at risk of disability & dependency, at later life Dependency zone.

Conventional medicine treatment:

There is no known intervention to reverse or slow ageing process in the conventional medical culture.

Functional Medicine approach:

  • FM indicates that age has nothing to do with health & fitness. Since there are fit people at the age of 90 & very unfit people at the age of 20.
  • Slowing & reversing the ageing process depends on how good you are at reserving your cellular machineries to function at optimal level. FM can help you to find out which parts of your body are in perfect working order and those that require attention?
  • Knowing yourself early & taking appropriate action to reduce negative impact of mid-life health crisis would help you to extend your enjoyable life span prolong health span.
  • FM provide you with powerful tools to attain optimal health. These include maximising your nutrition, eliminating toxins, relieving any genetic blockages within your metabolic pathways.
  • You will benefit from taking simple actions such as adopting healthy diet, having adequate physical activity, enjoying restful sleep, lowing stress levels & having strong supportive social connections.
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These conditions start early in childhood, with 50% of eczema patients also suffering from asthma, hay fever (allergic rhinitis) and food allergies. Symptoms are triggered by environmental allergens such as seasonal pollens, dust mites, mould, and cat and dog dander. They can also be triggered by food allergens, such as cow’s milk, eggs, soy, gluten, nuts and shellfish.

Mainstream medical treatment:

  • Topical application of steroid creams such as hydrocortisone.
  • Topical application to calm local or generalised itching.
  • Various inhalers to relieve & prevent asthma symptoms
  • Oral steroids to slow down the immune system and anti-histamine pills.
  • Patients are generally advised there is no cure, only symptoms relief.

Functional Medicine approach:

Asthma, eczema and allergic rhinitis are autoimmune conditions related to the combination of a leaky bowel and an overactive immune system. They are frequently associated with a diet high in sugar and processed carbohydrates, or courses of antibiotics and allergens in gluten, cow’s milk or other dairy products.

  • The treatment aims to reduce inflammation, restore gut health and calm the immune system, with interventions that include an elimination diet, probiotics, vitamin D, anti-inflammatory fish oil and curcumin.

Leading to good recovery

“It’s been a pleasure to follow Dr Ibrahim’s advice – leading to good recovery from my symptoms. I feel much more energetic and walk freely without pain. In my 80s, I’m now able to cycle and attend to my garden and everyday jobs. Dr Ibrahim’s approach motivates you to lay the foundations for a long, happy, active life.”

Peter Wall
Tonbridge
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Auto-immune diseases are caused by a combination of leaky bowel syndrome and a hyperactive immune system that damages various body tissues such as joints, bowel, brain and kidneys.

Mainstream medical treatment:

RA: Steroids, cytotoxic drugs and biological agents to dump the immune system activity.

MS: various drugs to relax muscles.

Functional Medicine approach:

We aim to restore gut health applying for the 5Rs program - Remove allergens like gluten, dairy products or infections, Replace digestive enzymes, Repopulate the gut with friendly bacteria, Repair the gut wall with L-glutamine, Rebalance lifestyles with a healthy diet, enjoyable physical activity, adequate sleep and a reduction in stress levels. The process tends to calm and modulate immune system activity.

Holistic and preventative

“Dr Ibrahim’s approach is holistic and preventative – focused on reversal of chronic disease. He investigates problems and establishes a therapeutic relationship where the patient has ownership of actions. He can claim successful results, with many patients expressing pleasure with his enthusiasm and support.”

Brian Halliday
Senior Charge Nurse, Royal Victoria Hospital
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Conventional medicine views cancer as a genetic mutation. Hence the treatment is focused on cutting, poisoning or killing cancer cells.

Mainstream medicine treatment:

Surgery, chemotherapy, radiation therapy, hormonal therapy, immunotherapy.

Functional Medicine approach:

We approach cancer as a metabolic process that turns cancer cells to burn glucose via a fundamental process that does not require oxygen (glycolysis). These changes happen after cancer cells lose their sophisticated mitochondria energy generating system.

  • So, our approach focuses on correcting the metabolic process, restoring the mitochondrial function to burn fat in the presence of oxygen.
  • Many patients benefit from individual nutritional support (ketogenic diet), active detoxification – the interventions that enhance body oxygenation.
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These conditions were considered by mainstream medicine as purely psychiatric in origin.

Mainstream medical treatment:

Various types of antidepressant drugs that include tricyclic, SSRI and antipsychotic medications.

Functional Medicine approach:

  • Most patients suffer psychiatric symptoms due to imbalances in their neurochemistry. These can be traced to genetic variations or a deficiency of relevant amino acids.
  • The holistic approach works to restore gut health, provide suitable amino acids and powerful nutrients to bypass metabolic blockages.
  • (Patients usually find great difficulty withdrawing from their psychiatric medications if this is not done gradually and with extreme caution.)
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Upper digestive disorder:

There are top gut conditions that include acid reflux, fatty liver and high cholesterol.

Mainstream medical treatment:

The patient is prescribed anti-acid pills and cholesterol-lowering drugs (statins). Together with various high blood pressure and diabetic medications.

Functional Medicine approach:

  • Fatty liver, high cholesterol, high blood pressure and sugar all represent one condition known as metabolic syndrome. All of these symptoms are attributable to high insulin levels.
  • Therefore, the treatment focuses on adopting a healthy diet and modifying other lifestyle choices, such as physical activity, adequate restful sleep and the reduction of stress.
  • The patient usually loses a significant amount of fat and gets their biological markers normalised within a few weeks. They feel safe and reassured as they can stop taking long term medication.

Lower digestive disorders:

This includes gluten sensitivity, Inflammatory Bowel Syndrome (IBS), Crohn’s disease, ulcerative colitis.

Conventional medical treatment:

This focuses on symptoms treatment & reducing inflammation using immunosuppressive drugs of steroids and cytotoxic drugs.

Functional Medicine approach:

  • We restore gut health applying the 5Rs approach - the Removal of any allergens or infective agents, and we Replace digestive enzymes, Repopulate the gut with friendly bacteria, Repair the gut wall and Rebalance other lifestyle choices such physical activity, sleep and relaxation.
  • These interventions restore gut health and seal the leaky bowel to stop the auto-immune process. This will not only resolve distressing bowel symptoms but will have a positive impact on the body’s overall vitality and wellbeing.
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CFS is also referred to as myalgic encephalomyelitis (ME), present with extreme fatigue or tiredness that does not resolve with rest and is not related to any other medical condition.

Patients often complain of sleep disturbance and feel tired upon waking up in the morning. They gradually started losing brain function with poor memory & poor concentration. They suffer frequent illnesses such as sore throat, have frequent headache and postural dizziness.

The underlying cause is not clear but often related to viral infection or psychological stress. The diagnosis is made by exclusion after other causes of fatigue are ruled out.

Conventional treatment:

Symptomatic treatment for pain, headache and sleep disturbance. Most patients receive antidepressant therapy from their GPs or referred to a mental health clinic.

Functional medicine approach:

A very similar approach to MS & fibromyalgia. Advice patients to adopt anti-inflammatory diet of whole real food of fruits and vegetables. Eliminate common allergens such as gluten, milk and dairy products. Check for hidden bacterial, viral or yeast infections.

Management of chronic fatigue Focus on restoring mitochondrial function. These are intracellular energy plants vulnerable to damage by free radicals. CFS present with fatigue, memory loss, pain and accelerated ageing. Besides diet patients need to be supported with omega 3, curcumin, magnesium. They also require specific mitochondria food such as L-carnitine, alpha lipoic acid, CoQ10 & NAC.

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Patients present with pain and tenderness all over their body. Patients become extremely fatigued with sensitivity to pain and muscle stiffness. They have sleep disturbance, brain fog, difficulty with memory and concentration.

Mainstream medicine treatment:

Patients are generally referred to hospital to see a rheumatologist, neurologist or a psychiatrist. The treatment focus is on managing symptoms with a combination of drugs:

  • Pain killers, particularly the stronger ones such as codeine and tramadol.
  • Antidepressants like venlafaxine, paroxetine and fluoxetine.
  • Muscles relaxants, such as diazepam.
  • Anticonvulsants, such as Gabapentin.

Functional Medicine approach:

  • Many patients have been to every hospital department with no success.
  • Functional medicine ends their suffering by addressing the root cause of fibromyalgia.
  • The reasons can include gluten sensitivity, candida overgrowth or mercury toxicity.
  • I find that most of my patients have nutritional deficiencies, and some have an underactive thyroid or adrenal fatigue.
  • I also see many patients with genetic mutations such as MTHFR or absent GSTM1 or GSTP1.

Patient and thorough

“Dr Ibrahim was patient and thorough, providing a friendly, holistic service. My symptoms settled almost completely. I lost weight, my blood pressure became reasonably controlled and I feel happier and fulfilled. Dr Ibrahim is a highly motivating physician.”

Helen Collins
Tonbridge
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CVD presents with the partial or complete blockage of blood vessels. Patients with narrowed arteries present with effort-related chest pain (angina) that settles upon rest. The complete blockage leads to an acute vascular event such as a heart attack, stroke or critical limb ischaemia often requiring leg amputation.

Hardening of the arteries is due to the build-up of cholesterol plaques along the vessel wall. These, together with a clot formation, resulting in complete blockage.

Risk factors of CVD include obesity or being overweight, smoking, diabetes, high blood pressure and a family history of the disease.

Mainstream medical treatment:

  • Applying various pill regimes to control diabetes, high blood pressure and high cholesterol, including ACE inhibitors, beta-blockers, calcium channel blockers and cholesterol-lowering pills.
  • The protocol also includes blood thinning agents such as aspirin, warfarin or heparin injection to prevent blood clot formation.
  • Patients with critical ischaemia require invasive procedures such as angioplasty, stent insertion or even bypass surgery.
  • Studies have confirmed that treating the risk factors with pills has the only minor benefit or none at all.

Functional Medicine approach:

  • We take a holistic approach to review your symptoms and biological markers and to assess your cardiovascular risk in detail. These lead to the formulation of a precise, personalised, plan to reduce your risk of disease and improve your quality of life.
  • Patients aim to reduce inflammation, enhance insulin sensitivity to lower blood sugar and insulin levels.
  • You benefit from pursuing a healthy diet of real food, staying physically active, lowering your stress and building happy social connections.

Overweight with high blood pressure

“I was overweight with high blood pressure and borderline diabetes. In a few months, I’d lost two stone, my blood pressure had settled and my sugars were normal. At 77, I’m now mobile and energetic, have joined the gym, pool and aerobic classes. I recommend Dr Ibrahim for anyone with similar problems.”

Ronald Watson
Dundee
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High blood pressure (BP >140/>90) affects a third of adults, while another third are pre-hypertensive (BP 120-139/80-89). High blood pressure can result in acute complications such as heart disease and stroke or progress to chronic kidney disease or dementia. High blood pressure is known as the silent killer (the third most common cause of death) – the higher your blood pressure, the lower your life expectancy.

Mainstream medical treatment:

The British Hypertension Society recommends

  • ACE inhibitors as first-line for patients younger than 55.
  • Calcium channel blocker or thiazide diuretics are first-line therapy in patients over 55.
  • Beta-blockers are reserved for hypertensive with compelling indications such as atrial fibrillation.
  • Only a third of patients taking these pills get their blood pressure under control.
  • Hypertensive patients have to continue taking their blood pressure pills for the rest of their life.

Functional Medicine approach:

Hypertension is frequently related to obesity and belly fat. These factors result in high insulin levels and alter blood fats – lowering the good guy (HDL), increasing the bad guy (LDL), cholesterol and high triglycerides. These, together with inflammation and oxidative stress, resulting in the deposition of cholesterol plaques and the hardening of arteries Andy story part 1.

  • Patients are advised to attain a healthy weight and lower their insulin levels to normalise their blood pressure without having to take pills.
  • We help our patients to find the underlying cause of high blood pressure and to readjust their lifestyles to prevent and reverse hypertension. The steps involved probably include the consumption of real food, staying physically active, lowering your stress and building strong and happy social connections.

Leading to good recovery

“It’s been a pleasure to follow Dr Ibrahim’s advice – leading to good recovery from my symptoms. I feel much more energetic and walk freely without pain. In my 80s, I’m now able to cycle and attend to my garden and everyday jobs. Dr Ibrahim’s approach motivates you to lay the foundations for a long, happy, active life.”

Peter Wall
Tonbridge
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Abnormal lipid profile that include elevated total cholesterol or low-density lipoprotein (LDL) or low protective HDL cholesterol are serious risk factors for vascular disease. The risk extends to include high triglycerides (>1.7), apolipoprotein B (APOB) & lipoprotein LP(a).

These factors encourage build-up of cholesterol plaques along arteries (atherosclerosis) resulting in blockage of blood circulation leading to serious consequences Cholesterol.

Conventional medicine treatment:

Interfere late after the disease is fully established. It addresses one part of the problem: using statins to lower cholesterol. Statins are well known to cause side effects that include serious muscle damage (myositis), increases risk of dementia & type 2 diabetes.

Functional Medicine approach:

  • FM works to assess risk of disease early to provides a holistic approach to resolve the problem at root level.
  • cardiovascular disease is the outcome of multiple factors working together to cause the disease. These include inflammation, oxidative stress & abnormal lipid profile inflammation.
  • Therefore, FM focusses on lowering inflammation, oxidative stress & cholesterol levels. Also provides intervention to normalizes cholesterol particle size and numbers to reduce risk of blood clot formation: an important disease process in heart attack & stroke.
  • FM uses food as medicine. Taking anti-inflammatory & antioxidants diet of plant-based real food of fruits & vegetables lower your risk of disease. Again, excess consumption of carbohydrates may raise triglycerides. Cutting back on carbohydrates would lower your triglycerides & risk of vascular disease & prevent serious complications.
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We have seen many patients with heavy metal toxicity as their dominant disease process. This can happen among professionals such as dentists, builders or decorators, as well as among patients with multiple amalgam fillings. Patients present with lethargy, depression or autoimmune diseases such as thyroid disease or rheumatoid arthritis.

Mainstream medicine treatment:

Conventional medicine does not recognise any disease caused by heavy metal toxicity. Chelating agents are used to detoxifying iron in severe toxicity.

Functional Medicine approach:

  • We get the mercury fillings removed by a biological dentist.
  • We restore the patient’s optimal detoxification capacity before starting to remove the mercury. These precautions avoid mercury relocation to the brain.
  • Mercury detoxification begins at the cellular level, increasing bile flow and using binders to ensure complete elimination of mercury in the stool.
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Conventional medicine attributes migraine attacks to a pathological pattern of vascular dilatation, neural activation and muscle spasm.

Mainstream medicine treatment:

  • Acute symptoms are aborted by pain relief with non-steroidal anti-inflammatory drugs, paracetamol or morphine. This may be in addition to specific treatment with Sumatriptan, Rizatriptan or Zolmitriptan.
  • Patients also receive treatment to prevent acute attacks, including calcium channel blockers, B-blockers, antiseizure medications, antidepressants and muscle relaxants.

Functional Medicine approach:

  • We view migraine as an inflammation driven by genetic or acquired factors. These include poor diet or a food allergy (gluten, dairy and eggs). Some patients have a low capacity to activate essential vitamins and to eliminate toxins.
  • Migraine patients may benefit from anti-inflammatory omega 3, probiotics – natural antimicrobial agents that restore gut health. Others require mitochondrial food such as COQ10 or alpha lipoic acid. Patients with a hormonal imbalance benefit from enhancing their detoxification capacity.
  • We also advise our patients to rebalance their lifestyles to include physical activity, good sleep and relaxation.

Patient and thorough

“Dr Ibrahim was patient and thorough, providing a friendly, holistic service. My symptoms settled almost completely. I lost weight, my blood pressure became reasonably controlled and I feel happier and fulfilled. Dr Ibrahim is a highly motivating physician.”

Helen Collins
Tonbridge
Become a patient

Alzheimer’s Dementia (AD), Parkinson’s disease (Pd)

The progressive loss of neurones resulting in cognitive impairment and movement disorder.

Mainstream medicine treatment:

  • AD: pills to temporarily increase the level of a brain neurotransmitter (acetylcholine) necessary for cognitive function. Patients receive a prescription for Aricept.
  • Pd: medicines to temporarily increase the level of a brain neurotransmitter (Dopamine) essential for control of movements such as Sinemet or Madopar.

Functional Medicine approach:

We review the medical history and perform high-tech tests to find out the underlying cause(s). This could be genetic driven inflammation, infection, blood sugar dysregulation, heavy metal toxicity or hormonal imbalance. There are often complex issues related to energy production in the case of Parkinson’s disease. Many patients get better when the precise ingredients are delivered to correct the biological system.

Patient care

“This medical approach to patient care should be available for everyone.”

Andrea Lecky, Osteopath
Weybridge
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61.4% of adults in the UK are either obese or overweight, with 26.2% being obese and 2.9% being morbidly obese. Men are more likely to be overweight or obese (65.7% of men, 57.1% of women).

Being obese or overweight increases your risk of suffering from one or more chronic disease.

Mainstream medicine treatment:

Conventional wisdom views excess weight as the result of an energy imbalance and hence advises people to eat less and exercise more. This has resulted in a 95% failure of the weight management programs.

Functional Medicine approach:

  • We talk through your medical history and perform high-tech tests to find out the underlying cause(s) of your obesity or excess weight. These may include a deficiency of essential nutrients, an accumulation of toxins, stress, drugs (steroids), or a hormonal imbalance (underactive thyroid) obesity the modern plague.
  • Correction of the underlying issues can reset your metabolic machine to function as normal.
  • Recent studies confirm that your gut-friendly bacteria can determine your body weight and disease status. Balancing your microbiome might be the hidden cause of your obesity and diabetes.
  • Adopting healthy lifestyle choices of whole real food, physical activity, adequate sleep, low stress and sound, happy connections are vital to resolving this issue.

A understanding doctor

“A understanding doctor who really cares about his work Best description is a scientific detective because he got to the root of my condition when others were really just dealing with the symptoms.
It feels more like having an experienced coach than being under a doctor. 100% recommend you try hm.”

Richard swift
London
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Previously viewed as the joints being damaged through wear and tear, this condition is now seen as the joints’ destruction due to inflammation and damage by free radicals. It is frequently linked to modern food, such as sugar, processed carbohydrate and toxic fat.

Mainstream medicine treatment:

This provides symptomatic treatment with pain-relieving agents. These range from non-steroidal anti-inflammatory agents to morphine. Joint replacement is on offer for patients with severe joint damage.

Functional Medicine approach:

Joint pain can subside as a result of various dietary regimes and supplements. Adopting healthy lifestyles, including eating whole, unprocessed real food, enjoying good physical activity, getting adequate sleep, lowering stress and developing secure, happy social connections, certainly help.

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Most chronic diseases have an active stress component. Mental stress due to family, work and social matters are every days. However, the patient can present with physical stress related to abnormal glucose processing, toxin accumulation, infective agents or blockage of biochemical metabolic pathways.

Modern stress is pretty similar to our ancestor’s response when lions chased them in the jungle: the brain stimulates the adrenal gland to produce stress hormones – cortisol and adrenaline. These focus the blood circulation on supplying your mind and muscles for you to fight or flee the danger. They shut down flow to your gut and sexual organs as these are no longer a priority.

I see patients suffering from chronic stress daily in my medical practice. Chronic activation of the stress response makes them lose their digestive enzymes and good friendly bacteria, and they suffer from a leaky bowel – the hallmark of auto-immune diseases.

Mainstream medicine treatment:

  • Appreciate the extremes of adrenal function: adrenal failure (Addison disease) or excessive adrenal activity (Cushing syndrome).
  • Patients with Addison’s disease are supported with adrenal hormone replacement while Cushing’s disease is mostly treated with surgical interventions.

Functional Medicine approach:

  • We work diligently to find the underlying cause of chronic stress, assess its severity and supporting the adrenal gland and the rest of the body until the problem is resolved.
  • I find that many patients with mental stress get better when they change their perception or responses. Through medical history analysis and hi-tech tests, we see the underlying cause of their physical stress. These range from insulin resistance, toxin accumulation or a deficiency of essential nutrients.
  • The adrenal gland also needs support with adaptogens such as Quercetin, Rhodiola and Ashwagandha, together with high doses of vitamin C and pantothenic acid (vitamin B5).
  • Patients also benefit from stress relieving techniques such as deep breathing and meditation.
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The most common thyroid disease (Hashimoto’s disease) falls under auto-immune conditions.

Mainstream medical treatment:

  • Relies on one test (TSH) to assess thyroid gland function. This classifies patients as usual, under- or overactive thyroid function.
  • Carbimazole is the drug of choice to slow down thyroid activity. However, radioactive iodine destroys the thyroid cells and causes patients to have an underactive thyroid.
  • Every underactive thyroid patient requires Thyroxine replacement daily to stay functional.

Functional Medicine approach:

  • Hashimoto’s, the most common thyroid disease, is due to autoimmunity triggered by a leaky bowel. This allows undigested food to enter the bloodstream, resulting in a hyperactive immune system that damages the thyroid gland.
  • Our treatment focuses on restoring gut health, the underlying cause, implementing the 5Rs program: Remove food allergens (gluten, dairy product), Replace (digestive enzymes), Repopulate the gut with friendly bacteria, Repair (seal) the gut wall with L-glutamine, Rebalance lifestyle choices such as diet, physical activity, sleep and stress.
  • Many patients regain their thyroid function without having to take their thyroxine replacement for life.

Holistic and preventative

“Dr Ibrahim’s approach is holistic and preventative – focused on reversal of chronic disease. He investigates problems and establishes a therapeutic relationship where the patient has ownership of actions. He can claim successful results, with many patients expressing pleasure with his enthusiasm and support.”

Brian Halliday
Senior Charge Nurse, Royal Victoria Hospital
Become a patient

Type II diabetes affects 3.5 million people in the UK, with another half a million going undiagnosed. Being overweight or obese is a significant risk factor for developing this condition.

Type II diabetes occurs when your body’s cells become less sensitive to insulin, a pancreatic hormone that lets in glucose. This is called "insulin resistance".

Early symptoms include fatigue after a meal, sugar craving and weight gain. This can progress to thirst, frequent urination, fatigue and itching. Complications can include visual impairment, kidney damage and arterial disease.

Mainstream medical treatment:

  • The prescription of drugs to normalise blood sugar, as follows:
    • 1st line drug: Metformin.
    • 2nd line drug: sulphonylurea such as Gliclazide.
    • 3rd line drug: Glitazones.
  • Patients require a combination of pills and increasing doses of insulin to control their blood sugar. Diabetic medicines (except metformin) raise your insulin level, causing weight gain that worsens diabetic control and increases the risk of complications.
  • Patients have to take pills and insulin injections for the rest of their lives, while all the time, the disease progresses with complications such as heart attack, stroke, blindness and kidney failure all possible.

Functional Medicine approach:

  • We make an early diagnosis by checking the insulin level as your blood sugar is usually healthy in the early stages metabolic syndrome.
  • We find the underlying cause (through extensive historical analysis and high-tech tests), modify your diet and other lifestyles to prevent or reverse diabetes.
  • We use food as medicine to normalise blood sugar and HbA1c and lower your insulin level within a few weeks.
  • The lower insulin levels will help you to lose weight, reduce cholesterol, prostate size in men and infertility in women (insulin & other CDS).
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