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Coffee enemas carry significant health risks including rectal perforation, severe electrolyte disturbances that can cause cardiac arrhythmias, caffeine toxicity, dehydration, thermal burns, and serious infections

De Rosa S, Eposito F, Carella C et al (2018) Transcoronary concentration gradients of circulating microRNAs in heart failure

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If you are taking Metformin because you have high blood sugar levels, you need to first address the cause of the high blood sugar and the best way to do this is through your diet

and van Bladeren, P.J