Fumaria officinalis, Fumaric Acid, and Fumaderm Treatment for Psoriasis
DISCLAIMER: CONSULT WITH A DOCTOR BEFORE DECIDING ON A TREATMENT PLAN FOR ANY DISEASE OR INJURY.
In a discussion about psoriasis, fumaric acid is a more complicated topic than it should be. To make the discussion simpler, we will be dividing this topic into a consideration of 3 different products that contain fumaric acid:
- The plant known as Fumaria officinalis
- Fumaric acid supplements
- Prescription medications such as Fumaderm and Fumaric Acid Esters
- Chemically Modified / Synthetic Fumaric Acid as a Food Additive
If your doctor has prescribed a drug that consists of a Fumaric Acid Ester for the treatment of psoriasis, you should know that the side effects caused by this drug, namely gastrointestinal disturbances are precisely the symptoms that Fumaria officinalis, the plant medicine, is able to treat. Fumaria officinalis contains a number of substances besides just fumaric acid, after all. The other substances found in Fumaria officinalis work holistically to treat psoriasis in a manner that ultimately allows psoriasis patients to heal completely from their disease.
The same is true for Fumaric Acid supplements. Though Fumaric Acid as one isolated substance, is able to cause certain beneficial effects on the body, without the other substances that are found in the whole plant medicine, Fumaria officinalis, the effects are not as beneficial. If you have a choice between Fumaric Acid supplements and Fumaderm or other prescription medications, however, Fumaric Acid supplements are preferrable, but ideally, patients should look for Fumaria officinalis and combine this treatment with ox bile supplements, regular exposure to sunlight for more than 30 minutes per day, alkalizing of the body with sodium bicarbonate, or seawater, and/or Chlorine Dioxide treatment using the Classic Protocol 1000 or Protocol 1000 PLUS.
With that in mind, below is a discussion and comparison of Fumaria officinalis, Fumaric Acid Supplements, and Fumaric Acid Ester prescription medications such as Fumaderm.
Fumaria officinalis, also known as Fumitory, Earth Smoke, or Drug Fumitory is a plant with gray pointed leaves that gives the plant a “smokey” appearance. It is found throughout Europe on slopes and in wastelands. It is used primarily to treat gastrointestinal diseases or disorders and biliary tract disorders (disorders of the bile ducts in the gallbladder or liver). Fumaria officinalis is an herb that increases bile flow which is problematic in all psoriasis patients. Patients who take ox bile supplements may also benefit from taking Fumaria officinalis as an herbal preparation to encourage their liver to release more bile.
Fumaria officinalis is an excellent herbal supplement to take as a liver support in addition to taking ox bile supplements.
If bile is not released in appropriate quantities or at the appropriate times by the liver and gallbladder, patients may experience gastrointestinal problems including gas / flatulence, slow digestion, or a sensation of fullness as well as inflammatory bowel disease symptoms.
Many psoriasis patients receive a diagnosis of inflammatory bowel disease such as Crohn’s disease in addition to a diagnosis of psoriasis. Fumaria officinalis is an herbal cure for psoriasis that works specifically with the inflammatory bowel disease symptoms to treat the core of the disease.
In psoriasis patients the problem of disordered bile flow is related to other issues that are caused by a colonization of the liver by bacteria, viruses, Candida albicans, or other types of infectious pathogens. Bile flow problems in psoriasis patients are a chicken-or-the-egg situation that may be caused by colonization of the liver or gallbladder by pathogens or that may be the the cause of colonization by pathogens. But in either case, these pathogens that have colonized the liver and/or gallbladder have hijacked the normal functioning of these organs. A great deal of scientific research has substantiated the idea that psoriasis patients have colonies of one or more pathogens living in one or more organs of detoxification (which includes the liver, kidneys, skin, and intestines). And this pathogenic colonization (which differs only slightly from the technical definition of an “infection”) is at the core of the disease known as psoriasis.
Out of colony of millions of pathogens that are living as a community in the liver, a few pathogens may be released into the small intestine as an “intentional” process to hijack the patient’s immune system chronically. These pathogens that are released from the community/colony into the small intestine are partially digested by bile. Normally, in a person with normal bile levels, these pathogens would be totally digested by the bile, but in psoriasis patients, these pathogens are digested down to bits and pieces that remain partially intact and that are extremely irritating to the small intestine and colon.
Leaky Gut Syndrome in Psoriasis Patients
Peptidoglycans are a component part of these pathogens that infect psoriasis patients. They are among the bits and pieces that are leftover when these colonizing pathogens in the liver and/or gallbladder are partially digested by bile that has not been released in adequate levels into the digestive system. These peptidoglycans then irritate the small intestine and the colon and cause tiny holes to develop in the tissues of these organs (which is colloquially known as “leaky gut syndrome”), releasing these peptidoglycans into the blood. Once in the blood, these peptidoglycans travel to the skin where they irritate the tissues, causing the release of inflammatory cytokines. The skin, then develops one of the characteristic rashes that is known as “psoriasis”.
There are a diversity of different pathogens that scientists have identified as playing a role in psoriasis. The type of pathogen or pathogens that infect any given patient most certainly has an effect on the presentation of this disease and whether it manifests as plaque psoriasis, pustular psoriasis, inverse psoriasis, or guttate psoriasis. Indeed, the type of pathogen(s) that infect the psoriasis patient may also play a role in whether or not the patient develops symptoms of psoriatic arthritis or inflammatory bowel disease or not.
Fumaria officinalis vs. Fumaric Acid Nutritional Supplements and Fumaderm (Fumaric Acid Esters) in the Treatment of Psoriasis
Fumaria officinalis contains fumaric acid as one of many substances that affects the psoriasis patients in a positive way. The use of this plant to treat psoriasis is recommended over the use of Fumaric Acid Ester prescription medicationsb ecause the plant contains a number of substances that work together on the body in a holistic way that will reduce gastrointestinal irritation instead of causing it.
While fumaric acid esters in pharmaceutical products like Fumaderm cause digestive upsets that are pronounced enough for about 40% of patients to stop treatment, Fumaria officinalis is a plant medicine that calms digestive upsets in part by increasing bile flow, which in turn, digests colonizing pathogens fully instead of leaving peptidoglycans behinds to irritate the small intestine and the colon.
Fumaric Acid as a nutritional supplement and Fumaric Acid Esters as prescription medications such as Fumaderm do not cause the liver or the gallbladder to release more bile or to release bile at more appropriate times. Rather, Fumaric Acid supplements and Fumaderm merely alter the body’s immune response in a largely negative way by causing:
- Lymphocytopenia or low white blood cell count. Low levels of white blood cells means that the patient’s immune defenses are low. Patients with lymphocytopenia are vulnerable to developing infection.
- Eosinophilia or a higher than normal level of eosinophils. Eosinophils are a specific type of white blood cell. Having a high level of eosinophils often happens during a parasite infection, an allergic reaction, or cancer.
- Proteinuria – Protein in the urine. Proteinuria is a relatively common problem that often resolves by itself, but it can indicate that the body is dehydrated, that there is inflammation in the body, or it can happen in tandem with low blood pressure.
The combination of lymphocytopenia and eosinophilia seem to indicate that this drug has effects on the bone marrow. Nonetheless, scientific studies say that fumaric acid esters like Fumaderm have a good long-term safety profile. In Europe, fumaric acid esters are recommended as a first-line system treatment for moderate to severe plaque psoriasis. Though this may very well be true, Fumaric Acid Esters will not cure psoriasis because they don’t cause the body to produce more bile or release more bile as Fumaria officinalis can do. Without treatment that addresses the problem of disordered bile production or bile flow due to colonization of the liver or gallbladder by pathogens, the colony or colonies of pathogens in the body will remain in place and continue to cause the symptoms of psoriasis, arthritis, and inflammatory bowel disease.
Fumaric acid esters such as Fumaderm are classified as pregnancy category C. Animals studies have shown maternal weight loss and an increased number of miscarriages while taking the highest recommended dose of fumaric acid. Studies have not shown evidence of congenital malformations in women who have taken this drug during pregnancy. Women who are taking fumaric acid esters such as Fumaderm as prescription medication should wait for 30 days before trying to conceive.
Fumaric Acid, Fumaric Acid Esters, and Fumaria Plant Species as Immunomodulators in Psoriasis Patients
Fumaric Acid Esters are immunosuppressant medications. In other words, they lower a patient’s immunity, which causes patients to become more vulnerable to illness. Immunosuppression is considered to be the primary mechanism of action in Fumaderm, Tecfidera, and the other Fumaric Acid Ester medications. It is through immunosuppression that these drugs purportedly work to reduce psoriasis symptoms by up to 75% in 50% of patients who are able to continue on the medication for 16 weeks.
Studies have compared the effects of Fumaric Acid supplements and Fumaria species in treating inflammation and pain caused by autoimmune disease. These studies have shown that while Fumaric Acid does have some analgesic effects on the body, there are other bioactive compounds in Fumaria plant species that cause more pronounced anti-inflammatory and analgesic effects. The additional anti-inflammatory and analgesic effects of Fumaria indica or Fumaria officinalis are another benefit of taking this plant medicine above and beyond the positive gastrointestinal healing effects and anti-colonization effects of this herbal remedy for psoriasis. Fumaric Acid supplements and prescription Fumaric Acid Ester medications such as Fumaderm or Tecfidera do not possess the positive gastrointestinal effects on the body and they are able to reduce inflammation only by simultaneously suppressing the immune system.
Fumaria plants has been classified as a member of the same family of plants as Papaver somniferum, or opium poppy. However, the Fumariai plants in this family don’t contain noteworthy quantities of opium. Nonetheless, it’s important to note that the opium poppy has significant pain-killing properties and it works, in part, by altering cytokine production to reduce inflammation in the body.
Other Plants That Contain Fumaric Acid
Fumaria officinalis has anti-psoriasis effects not just because it contains fumaric acid, but because of the other bioactive components that make it a viable herbal remedy for any of the following health issues in addition to psoriasis:
- Kidney problems (it is a diuretic)
- Rheumatism and rheumatic disease
- Conjunctivitis and eye infections
Note that Fumaria officinalis can be used not only to treat the skin manifestations of psoriasis but also the kidney problems which are often a part of the core problem for psoriasis sufferers. Additionally, this plant treats rheumatism and arthritis along with constipation (through its bile producing action on the body)
Fumaria officinalis or Fumaria indica is now sold in Austria, France, Spain, and Germany as a tea or herbal extract and is commonly used as a treatment for dyskinesia of the biliary duct. In these countries, it is also known to relieve urinary discomfort and digestive problems, specifically those related to the liver and gallbladder.
Fumaric acid also exists naturally in bolete mushrooms and Icelandic moss and lichen. These plants may also have anti-psoriatic effects on the body.
Fumaric Acid Supplements
When the body is exposed to sunlight for more than 30 minutes per day, it produces natural fumaric acid. This natural fumaric acid, in turn, helps the liver and gallbladder sphincters work properly by releasing proper amounts of bile at the appropriate times. But when sunlight / full spectrum light hits the skin, it has other effects on the body besides just as a liver or gallbladder sphincter regulator. Sunlight also causes our bodies to release singlet oxygen species which are powerful anti-infection agents against bacteria, viruses, yeasts, parasites and other pathogens that have colonized our bodies in a manner that hijacks the immune system (so they can hide in the body for years at a time).
Fumaric Acid supplements do not appear to play a role in the creation of singlet oxygen species in the body, but they do react with singlet oxygens that are formed in the body as a result of sun exposure. Fumaric acid is an antioxidant, so it may cancel out the anti-infective effects of singlet oxygens produced by the body’s exposure to sunlight. +
However, Fumaric Acid nutritional supplements have been shown to have a positive effect on gut health, similar to Fumaria plants species such as Fumaria indica and Fumaria officinalis. In other words, exposure to sunlight leads to the creation of fumaric acid, which in turn, improves gut health. Patients who cannot get Fumaria herbal remedies for psoriasis such as Fumaria offficinalis or Fumaria indica, but who can get Fumaric Acid nutritional supplements may benefit from adding this product to their natural psoriasis treatment protocol.
Fumaric Acid as an Antioxidant
Reactive Oxygen Species medicine is an area of conventional medicine and intense scientific research at the moment. Through the use of Reactive Oxygen Species such as singlet oxygens and other free radicals that are administered to the body or produced naturally by the body, it is possible to cure infections and/or get rid of pathogenic colonies of bacteria, viruses, yeasts, and more. Free radicals and Reactive Oxygen Species are extremely small biochemical elements that are used in a variety of ways by cells in the body to not only kill infectious pathogens, but also to communicate from one human cell to another.
Most people today are familiar with pop culture idea that antioxidants are good and oxidants and free radicals are bad. In reality, both antioxidants and oxidants play important health-giving roles in the body. Having too many or too few of either oxidants or antioxidants can lead to chronic diseases like psoriasis.
Fumaric Acid is released by sunlight. Singlet oxygen species (that are able to kill colonies of pathogens in the liver, kidneys, and digestive system) are also produced by sunlight. Fumaric acid is an antioxidant which means that it can cancel out the effects of singlet oxygen species in the body. Perhaps Fumaric Acid is produced by the body to mitigate some of the negative effects of free radical production while simultaneously encouraging the liver and gallbladder to release any pathogenic infectious organisms that might have colonized them.
Fumaric Acid and Energy Levels in the Body
Fumaric Acid plays a role in the creation of energy in the mitochondria of cells. It is involved via malic acid in the process of adenosine triphosphate production (ATP) in cells.
Fumaric Acid Nutritional Supplements as Part of a Cure for Psoriasis
Fumaric acid is a substance that is naturally produced in the body when the skin is exposed to sunlight. This link between natural fumaric acid and sunlight provides yet another level of substantiation for the sunlight and seawater cure for psoriasis. But fumaric acid also supports the ox bile supplement cure for psoriasis because the natural, non-pharmaceutical form of fumaric acid that is sold over-the-counter as a nutritional supplement has beneficial effects on the gastrointestinal system, especially the gallbladder. Fumaric Acid nutritional supplements that are sold over-the-counter can be used to treat biliary dyskinesia.
Biliary dyskinesia is a motility disorder of the gallbladder and the sphincter of Oddi (which is the sphincter that releases bile from the gallbladder). In other words, biliary dyskinesia is a disorder in which the gallbladder and the gallbladder sphincter are not moving in unison such that bile is reliably released when it is needed for digestion.
People with biliary dyskinesia may have gallbladder pain in the upper right quadrant of the abdomen or in the mid-back on the right side of the body that radiates to the right shoulder area. Some patients may only have pain in the right shoulder or only in the middle of the back or upper abdomen. The pain may be sudden or it may occur chronically prior to treatment with Fumaric Acid. In some cases, the problem may lead to nausea and vomiting or a lack of appetite in children.
Fumaric Acid Esters as Prescription Medications for Psoriasis Patients
In Germany, Austria, and the Netherlands, Fumaric Acid Esters are a common prescription medication treatment for psoriasis, but these esters are different than natural fumaric acids produced in the body in response to sunlight or the fumaric acid by plants such as Fumaria officinalis. And they are different from the Fumaric Acid that is sold as a nutritional supplement over-the-counter. Fumaric Acid Esters are chemically modified to make them patentable and therefore profitable for Big Pharma and their effects on the body can be devastating for psoriasis patients.
In Germany, fumaric acid esters as prescription medications are sold under the brand name Fumaderm. In the U.S. these fumaric acid ester drugs are sold under the brand name Tecfidera. Fumaric acid esters may also be referred to as DMF (dimethyl fumarate).
In Germany, Fumaderm is a licensed version of fumaric acid. It combines dimethyl fumarate (DMF) with calcium, magnesium, and zinc salts. In the US, a delayed-release DMF medication has been approved by the FDA for use in relapsing multiple sclerosis. In other parts of Europe and in the United States, there are also standardized fumaric acid supplements and creams available despite the fact that this substance isn’t yet approved by the main pharmaceutical governing bodies of these countries.
Fumaric Acid Esters (Fumaderm / Tecfidera) are prescribed for a variety of autoimmune diseases including:
- Plaque Psoriasis
- Multiple Sclerosis
- Autoimmune Encephalitis
- Chronic Fatigue Syndrome
- Rheumatoid Arthritis
Dimethyl Fumarate and Fumaric Acid Esters are relatively small molecules that have effects on the body via the immune system. They act as immunosuppressants to modulate the immune system and reduce the production of inflammatory cytokines thereby reducing inflammation. At the time of this writing, at least 29 observational studies and 6 randomized controlled trials have been performed to evaluate Fumaric Acid Esters in the treatment of psoriasis.
Below are common names for Fumaric Acid Esters:
- Dimethyl Fumarate
- Fumaderm (Brand Name)
- Tecfidera (Brand Name)
According to studies that were paid for by pharmaceutical industries, Fumaric Acid Esters such as Fumaderm and Tecfidera are able to produce about a 75% improvement in about 50%-70% of patients who have been given the drug. I must point out that 50%-70% as a numerical range of patients who experienced partial improvement, but a not a full cure for psoriasis using Fumaderm or Tecfidera raises questions in my mind. Why is there a 20% range of 50 to 70%? With all of the money available to big pharmaceutical companies to study Fumaric Acid Esters scientifically, one would hope that they would be able to give patients a better sense of whether it will work to help them clear up 75% of their skin symptoms. This is especially important given the substantial health risks involved with taking these Fumaric Acid Esters.
The positive effects that are supposed to take shape in psoriasis patients after about 16 weeks of treatment. However, about 40% of patients have to discontinue their treatment with Fumaderm, Tecfidera, and other Fumaric Acid Esters due to digestive disturbances or flushing symptoms that occur or due to the fact that patients develop permanent or long-term immune system damage as a result of using these drugs. In the patients that continue with Fumaric Acid Ester treatment, there are significant adverse effects that must be considered including:
- Stomach cramping
- Flatulence / gas
- Skin flushing
- Burning sensations on the skin
- Sensation of heat in the skin
- Long-term reduced functioning of the immune system that persists even after treatment is discontinued
- Development of severe liver or kidney issues that persist even after the drug is discontinued
Fumaderm and Tecfidera users are warned in the informational pamphlets that they receive that these drugs can permanently lower their white blood cell count. This means that patients who take Fumaderm or Tecfidera may experience long-term or permanently immunosuppression even after they stop taking the drug. Patients who take these drugs may also develop permanent kidney or liver damage.
Fumaderm / Tecfidera Mechanism of Action in Psoriasis
When fumaric acid is ingested in one of its esterized forms, dimethyl fumarate (otherwise known as DMF), it travels through the body down to the small intestines where it is hydrolyzed. When it is hydrolyzed, almost all the DMF turns into MMF (monomethyl fumarate). Only a small percentage of the DMF emerges in the urine of the person who took it, and it always emerges in the form of DMF-glutathione. Some of the DMF enters the blood circulation and combines with intracellular glutathione to create this substance.
This interaction takes away glutathione from circulating immune cells. Reduced glutathione in the immune cells causes these cells to frequently express an anti-inflammatory protein called heme oxygenase-1 (HO-1). This expression inhibits pro-inflammatory agents such as tumor necrosis factor-a (TNF-a), interleukin-12 (IL-12), and IL-23. Thus, inflammation is reduced but unfortunately with immune function suppression at the same time.
Fumaric Acid as a Food Additive
In the US, Europe, Australia, and New Zealand, fumaric acid is an approved food additive. It is at times a preservative, an artificial flavor, or even a coagulant/thickener. This synthetic, chemically modified version of fumaric acid is derived from malic acid. Fumaric acid as a food additive may cause digestive upsets including nausea, diarrhea, and abdominal pain. Indeed, because the fumaric acid food addictive causes these digestive upsets, it stands to reason that they may even contribute to the development of autoimmune diseases like psoriasis, lupus, or rheumatoid arthritis if they are consumed regularly over a long period of time. Patients who accidentally ingest this synthetic food additive regularly may develop any number of health issues that have their roots in a disordered gastrointestinal tract.
Administration of Fumaric Acid Esters (Fumaderm and Tecfidera)
According to the pharmaceutical industry, Fumaric Acids should only be taken in their esterified forms. Although this substance is made naturally in the body, individuals with psoriasis may benefit from taking fumaric acid nutritional supplements that are available over-the-counter or better yet, they may benefit from using Fumaria officinalis as an herbal cure for psoriasis, but the pharmaceutical company does not want consumers to know that.
Administration of Fumaderm / Tecfidera / Dimethyl Fumarate and Other Fumaric Acid Esters
Many psoriasis sufferers cannot get a prescription for Fumaderm / Tecfidera because doctors are not allowed to prescribe these drugs to people with severe intestinal disorders or to anyone with a diagnosed liver or kidney problem. The drug is likely to worsen the problem. And because most psoriasis sufferers have severe gastrointestinal issues, few patients even qualify for a prescription for this medication.
The maximum daily dosage of Fumaderm is 720 mg.
It is always advisable to combine either Fumaria officinalis as an herbal remedy for psorias or fumaric acid nutritional supplementation that is purchased over the counter with other psoriasis treatment methods such as ox bile supplementation and also a diet free of nightshades, in order to effectively cure the disease quickly. Psoriasis patients should consider doing Jim Humble’s Classic Protocol 1000 and / or Protocol 1000 PLUS. Many patients have reported success in treating their psoriasis using Fumaria officinalis along with ox bile supplementation and Chlorine Dioxide treatments (and/or sunlight and seawater treatments).
Due to the severe side effects / adverse events caused by Fumaderm / Tecfidera / Dimethyl Fumarate drugs and other Fumaric Acid Esters that can be permanent, we recommend that readers look into the Fumaria officinalis as an herbal cure for psoriasis or, if this plant medicine is not available in your area, seek out a Fumaric Acid nutritional supplement over-the-counter that has not been “esterified”.
Related Posts for Psoriasis Sufferers:
Ma, R. et al. (2018). The Growth and Protein Expression of Inflammatory Bowel Disease-Associated Campylobacter concisus Is Affected by the Derivatives of the Food Additive Fumaric Acid. Retrieved January 13, 2022 from https://www.frontiersin.org/articles/10.3389/fmicb.2018.00896/full
Balak, D. M. W. (2015). Fumaric acid esters in the management of psoriasis. Retrieved January 13, 2022 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683116/
Guy’s and St. Thomas (2014). Taking Fumaderm® (fumaric acid esters) to treat psoriasis. Retrieved January 13, 2022 from https://www.guysandstthomas.nhs.uk/resources/patient-information/dermatology/fumaderm-to-treat-psoriasis.pdf
Schilling, S. et al. (2006). Fumaric acid esters are effective in chronic experimental autoimmune encephalomyelitis and suppress macrophage infiltration. Retrieved January 13, 2022 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1942010/
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Levin, S., Rimmer, K., Vargas, W. S. (2020). Chapter 6- Neuroimmunologic disorders in pregnancy. Retrieved January 13, 2022 from https://www.sciencedirect.com/science/article/abs/pii/B9780444642400000064
Toouli, J. (2002). Biliary dyskinesia. Retrieved January 13, 2022 from https://pubmed.ncbi.nlm.nih.gov/12095476/#:~:text=Biliary%20dyskinesia%20is%20a%20motility,of%20gallstones%20in%20the%20gallbladder.
Wikipedia (2022). Fumaria officinalis. Retrieved January 13, 2022 from https://en.wikipedia.org/wiki/Fumaria_officinalis
Raafat, K. M. & El Zahaby, S. A. (2020). Niosomes of active Fumaria officinalis phytochemicals: antidiabetic, antineuropathic, anti-inflammatory, and possible mechanisms of action. Retrieved January 13, 2022 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195756/
Shakya, A. et al. (2014). Role of fumaric acid in anti-inflammatory and analgesic activities of Fumaria indica extracts. Retrieved January 13, 2022 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4576815/
Wikipedia (2022). Papaveraceae. Retrieved January 13, 2022 from https://en.wikipedia.org/wiki/Papaveraceae
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Chase, H. S. et al. (2012). Anti-inflammatory effects of Hylomecon hylomeconoides in RAW 264.7 cells. Retrieved January 13, 2022 from https://www.europeanreview.org/wp/wp-content/uploads/1213.pdf
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European Medicines Agency, Committee on Herbal Medicine Products. (2011). Assessment Report on Fumaria officinalis L., herba. Retrieved May 20, 2021 from: https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-report-fumaria-officinalis-l-herba_en.pdf
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