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Wheat & Gluten Sensitivity (Non-Celiac Gluten Sensitivity & Wheat Allergy)

“Gluten sensitivity” can mean three different things — celiac disease, wheat allergy or non-celiac gluten (or wheat) sensitivity — and they are treated very differently. Get tested for celiac disease before you cut out gluten, do not diagnose yourself, and call 911 for a severe allergic reaction.

Call 911 right away (999 in the UK) if you or your child has signs of a severe allergic reaction after eating wheat, or anything that might contain it. The NHS lists swelling of the throat and tongue, trouble breathing or very fast breathing, trouble swallowing, a tight throat or hoarse voice, wheezing or coughing, feeling faint, dizzy, confused or fainting, and blue, grey or pale skin, and you may also have a swollen, raised, itchy rash (NHS). MedlinePlus adds hives, vomiting and loss of consciousness, and calls anaphylaxis a medical emergency (MedlinePlus).

  • If you have been prescribed an epinephrine auto-injector (called adrenaline in the UK), use it straight away, follow your allergy action plan, and call for an ambulance even if you start to feel better. Do not drive yourself to the hospital (NHS). Lie down, and do not stand or walk, even if you feel better (NHS).
  • Sudden, severe belly pain; vomiting blood or blood in your stool; a hard, tender belly; or being unable to move your bowels, especially with vomiting need medical help immediately (MedlinePlus). The NHS adds black, sticky stools or being unable to pass stool or wind at all (NHS).
  • Losing a lot of weight for no reason, bleeding from the bottom or bloody diarrhea call for an urgent appointment (NHS). Unintentional weight loss is also one of the reasons the NHS gives for celiac testing (NHS).

Please do not try “a little wheat to see what happens” if you have ever had hives, swelling, wheezing or fainting after eating it. Ask for an allergy evaluation first.

Get tested for celiac disease before you start a gluten-free diet — and please do not diagnose yourself. NIDDK says doctors don’t recommend starting a gluten-free diet before testing, because the diet can change the results (NIDDK). The NHS says you need to keep eating gluten while you are tested, and should not start the diet until a specialist confirms the diagnosis, even if a blood test is positive (NHS). If you have already cut out gluten, ask your doctor how to be tested properly.

Three different problems with similar names

Many people say they are “sensitive to gluten.” Gluten is a mix of proteins in wheat, rye, barley and crosses of those grains (FDA), and wheat contains other proteins and carbohydrates too. Three conditions can look alike from the outside:

Because the first two can be serious, the safest order is to rule them out first.

Wheat allergy

Wheat is one of the foods most often behind food allergies (NHS, MedlinePlus), and U.S. law requires packaged foods to name wheat on the label when it is an ingredient (FDA).

  • Symptoms. Food allergy symptoms usually start within a few minutes to two hours of eating: hives, an itchy rash, tingling in the mouth, swelling of the face, lips or tongue, vomiting or diarrhea, belly cramps, coughing or wheezing, and dizziness. They can vary from one reaction to the next (MedlinePlus).
  • Special forms. A 2026 review describes wheat-dependent exercise-induced anaphylaxis, brought on when wheat is eaten along with exercise, alcohol or anti-inflammatory pain relievers, and baker’s asthma from workplace exposure. It reports wheat as the leading cause of food-induced anaphylaxis in adults, though prevalence varies by region (Park et al., 2026).
  • Diagnosis. A provider takes a history and may use skin testing, blood testing, a food elimination diet and/or an oral food challenge, which MedlinePlus calls the most accurate food allergy test (MedlinePlus). The 2026 review notes that standard skin tests and some blood panels may miss some cases of wheat allergy (Park et al., 2026). A positive result does not by itself prove wheat is causing your symptoms (The Pricer), so an allergist should interpret it.
  • Treatment. There is no cure for food allergies; the only way to prevent a reaction is to avoid the food. Medicines include antihistamines for mild symptoms and epinephrine for anaphylaxis, and a medical alert bracelet is a good idea (MedlinePlus). The NHS says your specialist will give you an allergy action plan and advises carrying two auto-injectors at all times if prescribed (NHS). Oral immunotherapy has been tried for children with wheat allergy but worked less well than for other foods (Park et al., 2026).
  • Children often outgrow it. In one clinic study of 103 children, wheat allergy had resolved in 29% by age 4, 56% by age 8 and 65% by age 12 (Keet et al., 2009). Only an allergist can say when it is safe to try wheat again.
  • Gluten-free is not the same as wheat-free. The FDA allows a “gluten-free” label on a food made with a wheat-derived ingredient that has been processed to remove gluten, as long as the finished food has under 20 parts per million (FDA). That definition is about gluten, not every wheat protein, so ask your allergist whether gluten-free products are safe for you and read the “Contains wheat” statement (FDA). MedlinePlus also notes that some people with wheat allergy may react to certain wheat proteins in cosmetics (MedlinePlus).

Non-celiac gluten sensitivity: what is known and what isn’t

People with this condition report digestive and whole-body symptoms after wheat- or gluten-containing foods. A 2015 expert panel describes both intestinal and non-intestinal symptoms (Catassi et al., 2015); a 2025 review describes a mix of IBS-like symptoms with “brain fog,” headaches and tiredness (Maimaris et al., 2025). The honest picture from the research is mixed:

  • It is common to believe you have it, harder to prove. About 10% of adults worldwide report gluten or wheat sensitivity, but in controlled challenge studies only about 16 to 30% of them had symptoms specifically triggered by gluten. The 2025 Lancet review says fermentable carbohydrates and nocebo effects (symptoms linked to expecting a food to cause harm) contribute considerably in many cases, that there is no biomarker, and that it remains a diagnosis of exclusion (Biesiekierski et al., 2025). That does not mean your symptoms are imaginary — it means the trigger may not be gluten.
  • An early trial pointed to gluten. In a double-blind trial of 34 people with IBS and no celiac disease who felt better gluten-free, 13 of 19 (68%) given gluten reported poorly controlled symptoms, compared with 6 of 15 (40%) given placebo (Biesiekierski et al., 2011).
  • The same team, a stricter design. When 37 people were first put on a low-FODMAP diet, symptoms improved, then worsened to a similar degree with gluten or an unrelated protein; gluten-specific effects showed up in only 8% (Biesiekierski et al., 2013).
  • A wheat sugar, not the protein. In a crossover trial of 59 people who thought they were gluten sensitive, fructans (a fermentable carbohydrate found in wheat) caused more symptoms than gluten, and gluten did not differ from placebo (Skodje et al., 2018).
  • Putting studies together. A meta-analysis of 11 re-challenge studies found about 30% of people relapsed after gluten (range 7 to 77%), and overall the relapse rate was not significantly different from placebo. Studies that followed the 2015 expert (“Salerno”) criteria found a higher rate after gluten than placebo, 40% versus 24% (Lionetti et al., 2017).

Bottom line: some people really do react to wheat, gluten may be the cause for only a minority of them, and other wheat components such as fructans and amylase-trypsin inhibitors are suspected (Maimaris et al., 2025).

IBS, FODMAPs and why bread can upset a gut without gluten being the cause

NIDDK notes that some people with IBS have more symptoms after eating gluten even though they do not have celiac disease, and that a doctor may suggest trying to avoid gluten or a low-FODMAP diet. FODMAPs are hard-to-digest carbohydrates, and wheat and rye products are on the list of foods that contain them. The low-FODMAP diet is usually tried for a few weeks, after which foods are slowly added back to see which ones you can eat (NIDDK). See our Irritable Bowel guide.

  • A network meta-analysis of 13 trials (944 people) ranked a low-FODMAP diet first against a habitual diet for IBS symptoms, but noted that most trials did not study re-introduction and personalization (Black et al., 2022). A 2025 analysis of 28 trials found the most evidence for a low-FODMAP diet, with other diets promising but less studied and most comparisons low or very low confidence (Cuffe et al., 2025).
  • The NHS says there is no test for IBS, but your doctor may test for celiac disease and other problems (NHS), and lists IBS in adults as a reason for celiac testing (NHS).

When to see a provider (not an emergency): the NHS says to be tested for celiac disease if you have persistent unexplained digestive symptoms, tiredness all the time, unintentional weight loss, severe or persistent mouth ulcers, unexplained iron, B12 or folate deficiency anemia, type 1 diabetes, autoimmune thyroid disease, or a parent, brother, sister or child with celiac disease (NHS). Children with celiac disease may not grow as expected (NHS). See a provider about any suspected food allergy (NHS), and about bloating or stomach pain that does not go away or keeps coming back (NHS).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Testing to sort out celiac disease, wheat allergy and gluten sensitivity (blood tests, biopsy, allergy tests, supervised diet trials), then a plan to match: strict avoidance plus an emergency plan for wheat allergy, a lifelong gluten-free diet for celiac disease, and dietitian-guided elimination and re-introduction for suspected sensitivity or IBS. Allergy testing: one clinic lists a food skin-prick panel at $340 plus $80 to $230 for a new-patient visit, per The Pricer. Medicare covers dietitian visits (medical nutrition therapy) only for diabetes or kidney disease. Celiac tests and dietitian fees: cost estimate being researched. Celiac disease and wheat allergy are managed by avoiding the trigger; there is no cure for food allergies. Gluten sensitivity has no test, and in controlled trials only a minority of people who think they react to gluten do so specifically.
Chiropractic Spinal adjustment has no known role in diagnosing or treating wheat allergy, celiac disease or gluten sensitivity. Be cautious of food-sensitivity tests from any office. About $55 to $100 for a self-pay follow-up visit and $90 to $200 for a first visit, per The Pricer. Medicare covers only spinal adjustments for a subluxation. We found little research, only single case reports. Never let a chiropractic visit replace celiac testing or delay emergency care.
Acupuncture Fine needles at acupuncture points, sometimes tried for bloating, cramps and other IBS-type symptoms. It is not a treatment for allergy or celiac disease. About $90 to $185 per follow-up visit paying cash, per The Pricer. Medicare covers acupuncture only for chronic low back pain. We found little research on acupuncture for wheat or gluten problems. For IBS, NCCIH calls the research mixed: it did not beat sham needling.
Herbal medicine No herb, enzyme pill or supplement treats celiac disease or wheat allergy or makes gluten safe. The practical job is checking supplements for hidden wheat or gluten. Cost estimate being researched. Peppermint oil has some short-term evidence for IBS symptoms, and probiotics are inconclusive, per NCCIH. We found little research on either for gluten sensitivity.
Massage therapy Hands-on work on tense muscles for comfort and relaxation. It has no role in treating wheat allergy, celiac disease or gluten sensitivity. One national chain: about $125 to $160 for a 60-minute massage for non-members and about $65 to $90 for members, per The Pricer. Prices vary by location. We found little research on massage for these conditions. If you have wheat allergy, ask about wheat-containing oils or lotions first.
MBHA Wellness Coach A food-and-symptom diary, label reading, preparing for a dietitian-guided trial, cross-contact at home, eating out, and coping with the stress of a restricted diet. Cost estimate being researched. Supports — never replaces — testing, an allergist and a dietitian. Habits make a safe elimination diet easier to follow.

Approach 1 of 6

Conventional medicine (AMA)

Conventional care starts by working out which of the three problems you have, because the treatment is different for each.

Step one: rule out celiac disease and food allergy

  • Celiac disease. Doctors most often use blood tests and biopsies of the small intestine (NIDDK). The 2023 American College of Gastroenterology guideline calls celiac antibody blood tests very helpful for initial screening and says a biopsy is required in most people to confirm; a no-biopsy approach is suggested only for selected children (Rubio-Tapia et al., 2023). If you do not have the DQ2 or DQ8 gene variants, celiac disease is very unlikely, but having them does not mean you have it (NIDDK).
  • Wheat allergy. A doctor or allergist may use skin tests, blood tests, an elimination diet and/or an oral food challenge (MedlinePlus).
  • Be wary of buy-it-yourself tests. The NHS says some tests sold to diagnose food intolerances are not recommended: there is limited evidence they are accurate, and they may tell you to avoid many foods, which can be harmful (NHS).

Step two: a plan that matches the diagnosis

  • Celiac disease: a lifelong gluten-free diet guided by a doctor or registered dietitian (NIDDK); see the Celiac Disease guide.
  • Wheat allergy: avoidance, an allergy action plan, antihistamines for mild reactions and an epinephrine auto-injector for severe ones (NHS). We list no doses; your allergist sets these.
  • Suspected gluten or wheat sensitivity, with celiac disease and allergy ruled out: the NHS describes a diet in which you avoid the suspect food and then, after a few weeks, eat it again to see whether symptoms return, with a food and symptom diary, ideally with a dietitian (NHS). The 2025 Lancet review says management should balance dietary change with recognition of psychological factors while ensuring nutritional adequacy (Biesiekierski et al., 2025). See Elimination and challenge diets.

What it costs

One clinic lists a food skin-prick panel at $340 and a new-patient visit at $80 to $230; a 17-food blood panel at one national lab is listed at $209 (The Pricer). Medicare Part B pays for medical nutrition therapy with a registered dietitian only if you have diabetes or kidney disease (or a kidney transplant within 36 months) and a doctor refers you (Medicare.gov). Celiac blood tests, biopsy and dietitian fees: MBHA cost estimate being researched.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

We found no research showing that spinal adjustment or other chiropractic care treats wheat allergy, celiac disease or non-celiac gluten sensitivity, and we found little research of any kind linking the two. A PubMed search turned up only individual case reports, which cannot show that a treatment works.

What we found, and a caution

  • One case report from a chiropractic teaching clinic describes a man with muscle twitching and stomach upset whose diet was changed based on IgG food-sensitivity testing. His symptoms improved, but the authors note that celiac disease testing was not done (Anderson et al., 2014). A single case cannot show what caused the improvement. It does illustrate the NHS warning that buy-it-yourself intolerance tests have limited evidence behind them (NHS).
  • Whoever you see, MBHA suggests asking for celiac testing and, if you have ever had an allergic reaction, an allergist before you remove foods.

Safety

NCCIH says serious side effects from spinal manipulation, such as artery tears in the neck that can lead to a stroke, are very rare (NCCIH). None of this changes the need for emergency care for an allergic reaction or severe belly pain.

What it costs

The Pricer lists about $55 to $100 for a self-pay follow-up visit and about $90 to $200 for a first visit (The Pricer). Medicare Part B covers only spinal adjustments by a chiropractor to correct a subluxation, and does not cover other services or tests a chiropractor orders (Medicare.gov).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture has been studied for IBS-type digestive symptoms. We found little research on it for wheat allergy, celiac disease or gluten sensitivity.

What the research says

  • IBS. A 2012 Cochrane review of 17 trials found no benefit over sham acupuncture for symptom severity or quality of life. Trials comparing acupuncture with medicine or with no specific treatment found larger improvements, but those were at high risk of bias because people knew which treatment they had (Manheimer et al., 2012). NCCIH calls the research on acupuncture for IBS mixed and not conclusive (NCCIH).
  • Wheat and gluten problems. The only item we found was a single case report: a woman with hives, eczema and constipation had 36 acupuncture sessions and later started a gluten-free diet. Her symptoms resolved, but she was also taking steroid medicine, and the authors report that blood typing after the acupuncture pointed to celiac disease and dermatitis herpetiformis (an itchy, blistering skin form of it), which had gone undiagnosed (Ohlsen, 2011). One report cannot show which step helped, and it shows how a celiac diagnosis can be missed.

Safety

Relatively few complications are reported, but they have come from non-sterile needles and improper treatment, and the FDA requires sterile, single-use needles (NCCIH). Acupuncture is not a way to treat or test for an allergy.

What it costs

The Pricer lists about $90 to $185 per follow-up visit, up to about $230 for a first private visit, and community acupuncture around $50 to $90 (The Pricer). Medicare Part B covers acupuncture, including dry needling, only for chronic low back pain (Medicare.gov).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb, enzyme or supplement has been shown to treat celiac disease or wheat allergy or to make gluten safe to eat, and we found little research on them for gluten sensitivity.

“Gluten-digesting” enzyme pills

In a laboratory study of five commercially available digestive enzyme supplements, the products left the gluten pieces that trigger celiac disease largely intact (Janssen et al., 2015). A review of 14 glutenase products found that thirteen claimed to break down gluten, and concluded the claims have no scientific basis (Krishnareddy et al., 2017). Both studies were about celiac disease. We found little research on enzyme pills for gluten sensitivity or wheat allergy, so do not rely on one to “cover” a meal.

Hidden wheat or gluten in supplements

NIDDK lists vitamin and nutrient supplements among products that can contain gluten (NIDDK), and MedlinePlus lists supplements as places to look for hidden sources (MedlinePlus). In the U.S., dietary supplements are covered by the law that requires wheat to be named on labels (FDA), but NCCIH warns that what is on a supplement label may not be what is in the product (NCCIH). If you are allergic to wheat, ask your pharmacist or allergist before starting any new product.

For IBS-type symptoms

NCCIH says there is some evidence that enteric-coated peppermint oil capsules may reduce IBS symptoms over the short term, though they can cause reflux and heartburn and should not be taken by people with a hernia or GERD. Some probiotics may help IBS, but the evidence is not conclusive, and other herbal products are too little studied for conclusions (NCCIH). These are IBS findings; we found little research for gluten sensitivity itself. Tell your doctor about everything you take, and see our medication safety guide.

Approach 5 of 6

Massage therapy

Massage can ease tense muscles and help you relax. We found little research on massage for wheat allergy, celiac disease or gluten sensitivity, and no reason to expect it to change how your body reacts to wheat.

What the research says

NCCIH’s summary of the evidence covers pain conditions such as low-back, neck and shoulder pain, knee osteoarthritis and headaches, not digestive or allergic conditions (NCCIH). Its page on IBS lists massage only as one example of a physical approach and describes no studies of it for IBS (NCCIH).

Safety and cost

  • The risk of harm from massage appears low, but rare serious problems — a blood clot, nerve injury or broken bone — have been reported, some with vigorous deep-tissue work or in older adults (NCCIH).
  • If you have a wheat allergy, ask what oils, lotions or scrubs a therapist uses. MedlinePlus notes that some people with wheat allergy may react to certain wheat proteins in cosmetics (MedlinePlus).
  • Prices vary by location. At one national chain, franchise price lists show about $125 to $160 for a 60-minute massage for non-members and about $65 to $90 for members, whose memberships run about $70 to $90 a month (The Pricer). Tips are extra.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Sorting out a possible wheat or gluten problem takes organization and patience. An MBHA Wellness Coach can help you with the everyday parts, alongside — never instead of — testing and your care team.

Another approach

Getting tested the right way

A sensible order, to bring to your own provider (this is general information, not a personal plan):

  1. Keep eating gluten and see your provider. Describe your symptoms, when they start after eating, and any family history of celiac disease. NIDDK says celiac disease is not diagnosed on symptoms alone because they resemble other conditions such as IBS and lactose intolerance (NIDDK).
  2. Celiac blood tests, then a biopsy if needed. The NHS says that if antibodies are found, you are referred to a gastroenterologist, and that it is sometimes possible to have celiac disease without these antibodies. If symptoms continue despite a negative blood test, the doctor may still refer you (NHS).
  3. Allergy evaluation if you have had hives, swelling, wheezing or other reactions. See Wheat allergy above for the tests. Keep in mind the 2026 review’s note that standard tests can miss some wheat allergy (Park et al., 2026).
  4. If both are negative: your provider may suggest a supervised elimination and re-introduction. In the 2015 “Salerno” criteria, experts recommend assessing the response to a gluten-free diet and then a double-blind, placebo-controlled gluten challenge in a crossover design, with a one-week washout, and counting a change of at least 30% in one to three main symptoms as a positive result (Catassi et al., 2015). A 2025 review calls these protocols impractical for routine clinical use (Maimaris et al., 2025), so ask your provider what a simpler version would look like.

Another approach

Elimination and challenge diets with a dietitian

An elimination diet takes out a suspected food for a set period, then puts it back to see what happens. Done well, it is a real diagnostic tool; done alone, it can mislead and can be risky.

  • How the NHS describes it. Avoid the food you might be intolerant to, then after a few weeks start eating it again to see whether symptoms return, while keeping a food and symptom diary. A doctor may refer you to a dietitian (NHS).
  • Why a professional helps. The NHS warns against cutting foods out of your or your child’s diet without advice from a doctor or dietitian, because you could miss vitamins and minerals, which matters especially for growth in children (NHS).
  • Why re-introduction matters. In the trials above, symptoms were not specific to gluten (Biesiekierski et al., 2013, Skodje et al., 2018). NIDDK describes slowly adding FODMAP foods back, since you may be able to eat some of them (NIDDK). Without a structured re-introduction you could end up avoiding foods you do not need to.
  • Not for suspected allergy. If a food has caused hives, swelling or breathing trouble, an allergist should decide whether and how to re-test it. MBHA does not suggest trying this at home.
  • Insurance. Medicare covers dietitian visits only for diabetes or kidney disease (Medicare.gov); check with your own plan.

Another approach

Is gluten-free healthier? Nutrition and cost

A gluten-free diet is the treatment for celiac disease, but if you do not have celiac disease or another gluten-related problem, your doctor may not recommend it. NIDDK says researchers have found no evidence that a gluten-free diet promotes better health or weight loss in the general population, and that starting it without advice may leave you short of fiber, iron and calcium, because some packaged gluten-free foods are higher in fat and sugar (NIDDK).

  • Nutrient gaps. A 2025 review says that, across celiac disease, wheat allergy and gluten sensitivity, a gluten-free diet can lead to shortfalls of iron, folate, vitamin B12, vitamin D, calcium, zinc and magnesium, less fiber, and changes in gut bacteria. Relying on processed gluten-free foods may raise cardiometabolic risks, and in children an unmonitored diet may impair growth and development (Capra et al., 2025).
  • Product quality. A survey of packaged products in India found gluten-free versions were more expensive and often had less protein and fiber and more fat; U.S. shelves may differ (Mehtab et al., 2024). NIDDK says packaged gluten-free foods tend to cost more, and restaurants may charge more (NIDDK).
  • Heart health. In a long study of nurses and other health professionals without celiac disease, long-term gluten intake was not linked to coronary heart disease; the authors noted that avoiding gluten may reduce whole grains and said promoting gluten-free diets among people without celiac disease should not be encouraged (Lebwohl et al., 2017).

Another approach

Labels, cross-contact and eating out

How strictly you need to avoid wheat or gluten depends on your diagnosis. Celiac disease and wheat allergy need careful avoidance; we did not find a standard for gluten sensitivity, so ask your care team. These are the practical points the sources describe.

  • What “gluten-free” means. It is a voluntary claim (FDA). The FDA’s definition requires, among other things, less than 20 parts per million of gluten — a labeling standard, not a recommended amount to eat. The FDA says this is the lowest level that can be consistently detected with valid methods, and that most people with celiac disease tolerate foods with very small amounts (FDA). The rule does not apply to foods regulated by USDA, such as meat and poultry, or to most alcoholic beverages (NIDDK).
  • Allergen labels. Packaged foods must name wheat in the ingredient list or a “Contains” statement. “May contain” or “produced in a facility” statements are voluntary. The law does not apply to food put in a wrapper after you order it at the point of purchase, and the FDA has not set a threshold level for any allergen (FDA).
  • Cross-contact happens when gluten-containing food touches gluten-free food, and it can occur when food is grown, processed, stored, prepared or served. At home, NIDDK suggests storing and preparing gluten-free foods separately from family members’ foods that contain gluten (NIDDK).
  • Oats. Oats do not contain gluten, but they can be contaminated if produced alongside wheat, barley or rye (NHS). For celiac disease, NIDDK says cross-contact is common, so choose oats labeled gluten-free and ask your dietitian about them (NIDDK).
  • Eating out. NIDDK suggests checking menus online or calling ahead, telling the server about your condition, asking about ingredients and preparation, and asking to speak to the chef (NIDDK). The FDA suggests asking what the restaurant means by “gluten-free,” what is in the item, and how it is prepared (FDA). If you have a food allergy, the NHS advises telling restaurant staff and carrying your auto-injectors (NHS).

Another approach

Children

Please do not put a child on a gluten-free or wheat-free diet on a guess.

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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