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This dehydration leads to reduced disc elasticity and increased susceptibility to mechanical stress, further accelerating degeneration and limiting the microenvironments capacity for regeneration [5][9][17]

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Annu Rev Med (2009) 60:35566

Supplementation of some vitamins at higher doses level can cause toxicity

Response: We thank all commenters for their careful consideration of the proposed approach to stratify the APCM codes, and we appreciate commenters' suggestions for specific types of beneficiaries who may require intensive care management resource utilization and warrant an additional APCM code level, including beneficiaries with complex illness