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Hi @ggrens5922 Thanks for letting me know you found this video interesting! Best PHARMACIST Fi :>

Hi @davidlunn4861, I am very sorry to hear of this difficulty for you. Here in Australia, if you are having difficulty getting an appointment with a doctor, for some types of medical conditions a pharmacist may be able to call the doctor's clinic on your behalf, to request an appointment sooner. Perhaps you could consider asking a pharmacist in the UK whether they might please be able to help you in this way? I hope you have a good treatment outcome. Best PHARMACIST Fi

Thanks @ggrens5922 :>

Hi @ggrens5922 , Thankyou for your question. There are some types of food or drinks that may interact with certain types of medicines (for example, grapefruit and grapefruit juice interact with some types of medicines), so it is a good idea to ask a pharmacist to please run an interactions check on any medicine or health product that you take, or are thinking about taking in future. Here is a link to my video about this, in case it may be of interest: th-cam.com/video/ckRihqtel-4/w-d-xo.htmlfeature=shared Best PHARMACIST Fi :>

Hi @daviddalejofoodie7025 I am very sorry to hear you are experiencing gout. A sudden change in uric acid level (either a sudden increase, or a sudden decrease (sudden decrease in uric acid level may be caused by either significant changes in food and drinks, or by a sudden large increase in dose of a urate-lowering medicine)) may trigger a gout attack for some people - so unfortunately it is possible that suddenly stopping drinking alcohol and suddenly switching to foods which are less likely to raise uric acid level, might have triggered your gout attack. However, if you are able to consistently have foods and drinks that are less likely to increase uric acid level significantly, as well as having gout treatment, once your uric acid level becomes consistently lower (rather than changing), that should then reduce risk of gout attacks. The fact that a sudden drop in uric acid level may cause a gout attack for some people, is also the reason that, early on in gout treatment, modern dose schedules for urate-lowering medicines are starting on lower doses, and increasing the dose more gradually (until 'target uric acid level' is reached and maintained, so the gout urate crystals can then start to melt, then once they have been melted and if uric acid level is kept at target level life-long, gout attacks should then no longer happen). You might find my other videos about gout in this '10 Things You May Not Know About Gout' playlist interesting - especially the ones about what (including a range of things other than some types of foods and drinks) may increase gout attack risk, and why we need the uric acid level blood test to know if gout treatment is working or not: th-cam.com/play/PLwyYRbsDY3jsgC6QHx6rkExPACfQbu9Du.html I hope this info may be helpful for you, and you are welcome to ask questions about it if anything is unclear or needs more explaining. Best PHARMACIST Fi :>

Thank you so much for responding. I will definitely check out your other videos

Hi @@davidalejofoodie7025 You are very welcome. I hope the other videos are helpful, and hope you have a good treatment outcome. Best PHARMACIST Fi :>

Thanks @ggrens5922!

Hi Night Walker @nightwalker7198 Thankyou for your very interesting question! I will do some research over the next 1-2 weeks and get back to you as soon as I have a range of answers (I expect a range of answers, as I expect a range of different causes to potentially be involved, including some types of factors that may influence our natural microbiome of our feet - especially the types of bacteria and fungi, which I am guessing might potentially be influenced by things like our blood circulation, some types of medical conditions, blood sugar levels, our foods and drinks, what types of footwear we use, whether our feet are mostly moist or dry, the temperature range our feet are mostly in, what types of surfaces our feet are on when not in footwear, and more...). It will be very interesting to see whether or not much research has been done on this topic, and I hope to have some answers (or at least ideas) for you some time in the next fortnight, when I have finished a big video I am currently editing. Best PHARMACIST Fi :>

@pharmacistfi thank you. It's an annoying infliction lol

Hi crabby paddy @crabbypaddy5549 Thankyou for your question about causes of gout. Here are links to my videos about the wide range of things that may potentially cause gout or trigger gout flares, and there is more info about potential gout causes in the description sections of these videos as well: th-cam.com/users/shortsaeFzWMTciDY?feature=share th-cam.com/users/shorts65IuNvDjE3o?feature=share th-cam.com/users/shorts65IuNvDjE3o?feature=share One of the most common causes of gout (via causing a high uric acid level) is having uric acid transporters in our kidneys or intestines which are slower at getting rid of uric acid from our body than some other people’s transporters, due to genetic differences between people. Another potential contributor to a high uric acid level is that certain types of foods and drinks may increase our body’s production of uric acid (like cane sugar or corn syrup in drinks and foods; alcohol; fruit juices; or the purines in meats, seafoods or beer). For some people with uric acid transporters in their kidneys that are slower at getting rid of uric acid, changing their main foods and drinks to significantly reduce their uric acid production may not quite be enough to bring down their uric acid level to ‘target level’. Also, some people may not wish to try significantly changing what they eat and drink. These are some of the reasons why most people with gout need to take a urate-lowering medicine (such as allopurinol, if it is suitable) life-long, because keeping uric acid level consistently at ‘target level’ is necessary to melt gout urate crystals, and also necessary to prevent gout urate crystals from re-forming in future, in order to prevent gout flares from being able to happen. Please note that there are more potential causes of gout in the videos via the links above, and if you think any of them might apply to you, as soon as possible, ask a doctor for advice about the most likely cause/s of your gout and the best personalized management option/s for you (and remember to make decisions about medicines together with the doctor, not on your own - to try to be as safe as possible). I hope this info may be helpful, and you are welcome to ask questions if you like. Here is a link to my ’10 Things You May Not Know About Gout’ SHORTS video series, in case that info may also be of interest: th-cam.com/play/PLwyYRbsDY3jsgC6QHx6rkExPACfQbu9Du.html Best PHARMACIST Fi

Hi IlluminiousSky @IlluminiousSky Thankyou for your question about how gout is usually treated. Please check out my videos #2, #4 & #5 about gout treatment in this ’10 Things You May Not Know About Gout’ playlist of SHORTS videos (th-cam.com/play/PLwyYRbsDY3jsgC6QHx6rkExPACfQbu9Du.html), and their description sections which also have even more gout treatment info, plus videos #6, #7 & #8 about a wide range of things that may contribute to gout development (gout causes may be different for different people, but some of the most common causes are genetic differences in transporters in our kidneys or intestines that make us a bit slower at getting rid of uric acid from our body, and certain types of foods and drinks increasing our body’s uric acid production)… but all 10 videos have info that is worth knowing about gout. As you will see in the videos, most people with gout will need to have a urate-lowering medicine (for example, allopurinol, if it is suitable for the person) prescribed by a doctor for them to take long-term (usually life-long), to gradually reduce their serum uric acid level (which may also be called ‘serum urate level’, and this is a blood test usually done a few times during the process of the doctor gradually increasing the person’s urate-lowering medicine dose (to try to prevent potential side effects) from a low starting dose up to eventually get to the personalized ‘maintenance dose’ needed to bring their body's uric acid level down to ‘target level’), so the gout urate crystals can be melted (melting the urate crystals happens if uric acid is kept consistently at target level and may take anywhere from 6 months to more than a year, depending on how established the gout is), then once the gout urate crystals are melted, the urate-lowering medicine is continued at a personalized maintenance dose that keeps uric acid level consistently at target level life-long, to prevent urate crystals from being re-formed in future (with a serum uric acid blood test at least once a year to check if the urate-lowering medicine dose is still suitable or whether it might need adjustment - for example if our kidney function gets slower or if our main types of foods and drinks change significantly). Depending on how advanced the person’s gout is, the doctor will usually also prescribe a low dose of a type of anti-inflammatory medicine (if it is suitable for the person’s health conditions and does not interact in a risky way with their other medicines - for example: colchicine may be suitable for some people, or an NSAID medicine like naproxen or indomethacin may be suitable for some people) to try to prevent gout flares for the first 3 to 6 months of the person being on the urate-lowering medicine, because the changes in our uric acid level, when the urate-lowering medicine dose is being increased by the doctor and urate crystals are melting, may trigger gout flares while we still have some urate crystals (this is why modern urate-lowering medicine dose schedules usually start with a low dose of the urate-lowering medicine, then gradually increase the dose, to try to avoid gout flares which large increases in urate-lowering medicine dose may trigger in some people). Once the gout urate crystals are melted and if uric acid level is kept consistently at target level, gout flares should no longer be able to happen from then onwards, so the anti-inflammatory medicine should no longer be needed from then onwards. I hope this info may be helpful for you, and you are welcome to ask questions about it if you like. I hope you have a good treatment outcome. Best PHARMACIST Fi :>

You are welcome, @ggrens5922 . Best Fi :>

Thanks ggrens5922 :>

Hi @binartiknahipon247 Thankyou for sharing your experience of a food trigger for a gout flare, which you have noticed. Here is a link to my video about the different ways some types of foods and drinks may increase our risk of gout and gout flares: th-cam.com/users/shorts65IuNvDjE3o?feature=shared and here is a link to my video about 15 things which may increase our risk of gout or gout flares (plus there are also more things in the video's description section): th-cam.com/users/shortsaeFzWMTciDY?feature=shared Here is a link to my other videos about gout, in case you might also find them interesting: th-cam.com/play/PLwyYRbsDY3jsgC6QHx6rkExPACfQbu9Du.html I hope you get a good treatment outcome. Best PHARMACIST Fi :>

Hi @suecameron3124 You are very welcome - thanks for letting me know this video was helpful! Best PHARMACIST Fi :>

Hi Benford Kawiliza @benfordkawiliza5852 I am sorry to hear that it sounds like you are having a lot of gout pain. Although this channel is just for general info about medicines (not personal medicines advice), I notice from your message that you might be concerned about the serum uric acid level you had after one month of febuxostat, so I can give you a bit of general info about uric acid levels, then some questions you are welcome to ask your doctor, to help you find out more about your gout treatment options and plan your treatment together with the doctor. As you probably know, the gout treatment serum uric acid ‘target level’ is ‘less than 6mg/DL’ (which is equivalent to less than 0.36mmol/L), so 4.6mg/DL has achieved that aim and is still within serum uric acid reference range (‘reference range’ is the range of different serum uric acid levels that healthy people may have; for example, the lower end of serum uric acid reference range for men in Australia is about 3.4mg/DL (0.2mmol/L), and for women the lower end of serum uric acid reference range in Australia is about 2.5mg/DL (0.15mmol/L) (in the current Royal College of Pathologists of Australasia website’s serum uric acid test info on 17 Sep 2023). I have put some general info, from the 2016 EULAR gout management guidelines and the 2020 American College of Rheumatology gout management guidelines, into the description section of this video for you, stating that the writers of these gout guidelines are unsure whether it may or may not be safe to have a uric acid level of ‘3mg/DL or less’ for a prolonged time during gout treatment (‘prolonged time’ meaning several years), but I have not been able to find any information suggesting a uric acid level within the lower part of the serum uric acid reference range might be a concern. If you or your doctor have any information about this, I would be very interested if you would like to share it with me. If your concern was about how quickly febuxostat had an effect on uric acid level, the Uloric brand febuxostat prescribing information (from the USA’s FDA website) and the UK’s SmPC medicine information about Adenuric brand febuxostat, mention that febuxostat’s effect on serum uric acid level can be measured 2 weeks after starting it, so febuxostat appears to usually have its effect quite quickly. However, if your concern was about how much your uric acid level was reduced, quickly, by febuxostat treatment *ask your doctor whether or not it may be suitable to re-start febuxostat in future - and if they say yes, you could then ask your doctor whether or not it might be suitable to start febuxostat on a lower dose in future, to try to enable a more gradual reduction of uric acid level (with the aim of reducing risk of gout flares early in urate-lowering medicine treatment, as per the 2020 American College of Rheumatology Guideline for the Management of Gout) - and remember to only make medicine decisions together with your doctor, not on your own. You could also consider asking your doctor, as soon as possible, to please share with you things like: *why they advised you to stop febuxostat? (for example, did you get a potentially serious side effect or medicine interaction - if so, does febuxostat need to be avoided in future?), and *what is their plan for your gout treatment? for example: *do they plan to re-start you on febuxostat, or do they plan to start you on a different urate-lowering medicine (if there is a urate-lowering medicine that is suitable for you)? and *in order to treat your current gout pain and/or to try to prevent gout flares that may happen (due to changes in uric acid level) during the first 3-6 months of taking a urate-lowering medicine: have they prescribed for you a different type of medicine, such as an anti-inflammatory medicine? (if there is an anti-inflammatory medicine that is suitable for you? - but please note that an anti-inflammatory medicine (for example: colchicine, or an NSAID like indomethacin or naproxen, or a corticosteroid like prednisone, or prednisolone) may not be suitable for some people (because of some types of medical conditions or some types of interacting medicines), so if a doctor is considering whether or not to prescribe an anti-inflammatory medicine for you, make sure they know all your medical conditions, and every medicine and health product you are currently taking and have taken in recent weeks). I hope this info may be helpful for you, and you are welcome to ask questions about it if you like. I hope you get a good treatment outcome. Best PHARMACIST Fi

Hi @TomHerdman-lx8nk That is good to hear you did not get that side effect. I hope your treatment is going well. Best, PHARMACIST Fi :>

@rahul38196 Hi Rahul Pixels, Thankyou for your question. Here is a link for you, to my video about colchicine side effects and interactions (including interactions to avoid with some types of medicines, grapefruit, and grapefruit juice): th-cam.com/video/deO0BMqNwWM/w-d-xo.html The medicine interactions part of that video starts from 4 minutes onwards and there is also more info in the description section of that video about some more types of interactions which were not covered during it. I hope the info in the video and description section via the link above is helpful for you, and you are welcome to ask me questions about it if anything seems unclear or needs more explanation. If you found that video helpful, you might also find other videos (including some other videos about colchicine) in my playlist of videos about gout interesting: th-cam.com/play/PLwyYRbsDY3ju2-aCCW8SBu6fcOxitCfCJ.html Best PHARMACIST Fi

Pharmacy Fi, wow thank u so much for your detailed response. I will definately show this to my hubby so he can chat with his doctor. He currently has only a primary care physician...but we might start looking for a reputable Rheumatologist if he isn't satisfied with the doctors answers. Again, many thanks. Yes, 18 yrs. with my Lilly was very special. I probably will never get over her loss. When my heart is ready, I do plan on getting another Maltese but she will never replace Lilly. ❤

Hi @@KatieHellOnHeels8277 You are welcome - I hope your husband has a good treatment outcome. I think I know what you mean about a dog like Lilly not being 'replaceable', but when you are ready, I hope you can find a lovely dog to make you smile (I really appreciate that Denver makes me smile or chuckle multiple times a day with his cute, quirky ways) :>

Hi feras almalki @ferasalmalki5925 Thank you for your interesting question. As I mention in this video (th-cam.com/video/ARAc_95da18/w-d-xo.html ), because of the very specific way colchicine works, if a neck problem is not from gout, then colchicine is not suitable for most common types of pain (except for a few painful conditions where colchicine is used - like Familial Mediterranean Fever or Pericarditis). However, if a neck problem was due to a gout flare in the neck, then colchicine may reduce the inflammation and pain of that gout flare (but please note that some people must not take colchicine - so only take colchicine if a doctor has prescribed it specifically for you and that doctor knows: *every medicine you are taking (to avoid very risky medicine interactions with some types of medicines), and *all your medical conditions (because colchicine must not be taken with some types of medical conditions), and *how well your kidneys and liver are working (people with reduced kidney or liver function need a lower dose of colchicine). Gout in the neck is not common, but it has happened to some people, as you can see in this article (www.ncbi.nlm.nih.gov/pmc/articles/PMC6745074/ ), which you are welcome to show your doctor, and you could ask the doctor whether or not they might be interested to test for gout (for example via a uric acid blood test), and I also recommend to ask the doctor to consider referring you to a rheumatologist (a rheumatologist is a medical specialist who knows even more about medical conditions of the joints and muscles than regular doctors), who might consider more tests to find out what is causing the neck problem. Please note that in the article above, where they talk about ‘cervical’ disc, they mean disc ‘of the neck’, because doctors call the neck the ‘cervical spine’. Please also note that for treatment of gout, colchicine is only a temporary medicine, for preventing gout flares or for treating gout flares in the early phase of taking the main type of gout medicine: a urate-lowering medicine (for example: allopurinol, if it is medically suitable for a person), and there is more info about gout treatment in these videos: th-cam.com/play/PLwyYRbsDY3jsgC6QHx6rkExPACfQbu9Du.html th-cam.com/video/N6jCa795bLg/w-d-xo.html th-cam.com/video/ytvAJQxA4c0/w-d-xo.html th-cam.com/video/rO6oyMT9PpU/w-d-xo.html I hope this info may be helpful for you, and I hope you get a good treatment outcome. You are welcome to ask questions about this info if anything is unclear. Best PHARMACIST Fi :>

Hi Medical Science @medicalscience1528 Thanks so much for your kind words! Best Fi :>

Hi netkotreći 313 @netkotreci3135 I am sorry to hear it sounds like you have been through a lot of pain in the past 12 years. This TH-cam channel is not for personal medicines advice, but although I cannot advise whether allopurinol may or may not be suitable for you, I do recommend that you ask a doctor for a referral to a rheumatologist (a rheumatologist is a specialist doctor who helps people with medical conditions involving joint pain) if it is affordable where you live. If you cannot see a rheumatologist, I recommend to ask a doctor for a uric acid level blood test as soon as possible, to find out whether your current dose of urate-lowering medicine (for example: allopurinol or febuxostat) may or may not be enough to bring your uric acid level down to ‘target level’. As I mention in my video ‘Allopurinol - How Does that Work’ (th-cam.com/video/ytvAJQxA4c0/w-d-xo.html ), gradually getting uric acid level down to ‘target level’ then keeping uric acid level at ‘target level’ consistently life-long, is the only way most people can melt gout urate crystals (melting gout urate crystals may take 6 to 12 months or more at ‘target uric acid level’) and then prevent future gout attacks from ever happening by then keeping uric acid level at ‘target level’ life-long. The reason I suggest getting advice from a rheumatologist is that if your gout started as early as 19 years old, and if a urate-lowering medicine dose was not high enough to get uric acid level to ‘target level’ and stop gout flares yet, it might be especially important to gradually get to the right personalized dose of a urate-lowering medicine to treat gout effectively, and a rheumatologist is likely to know even more about gout than a regular doctor. For example, if a rheumatologist or doctor decided allopurinol was suitable for you, then: *if your uric acid level was above ‘target level’ on your current allopurinol dose, your doctor may advise gradually increasing the allopurinol dose by small amounts (the doctor would tell you the allopurinol amount to increase and how often, as long as you have no significant side effects), with a uric acid level blood test approximately every 2 to 5 weeks, until you reach an allopurinol dose that keeps your uric acid level consistently at 'target level' - which would be the allopurinol dose to continue long-term, with an annual uric acid blood test to check whether or not it is still the right allopurinol dose to keep your uric acid level at 'target level'; whereas *if your uric acid level was at or just below ‘target level’ on your current allopurinol dose, your doctor would be likely to recommend continuing your current allopurinol dose long-term (as long as you have no significant side effects), with an annual uric acid blood test to check whether or not it is still the right allopurinol dose to keep your uric acid level at 'target level'. Here is a link to my video about uric acid level blood tests which you might also find interesting (and you are welcome to show your doctor the information for doctors in the 'description section' of that video if you would like to use that info to talk with your doctor about getting a uric acid level blood test): th-cam.com/users/shortsE9ROcao5Amw?feature=share You could also show your doctor the info for doctors in the 'description section' of the following video about modern allopurinol dose schedules - and ask the doctor whether it may or may not be suitable for you: th-cam.com/users/shorts5r-j1AlRS0Q?feature=share Here is a link to my full playlist of gout SHORTS videos: th-cam.com/play/PLwyYRbsDY3jsgC6QHx6rkExPACfQbu9Du.html I hope this info may be helpful for you, and you are welcome to ask me questions about it if anything is unclear or if you would like more explanation. If you have not already seen my response to your earlier question under my video ‘Allopurinol - How Does that Work’ (th-cam.com/video/ytvAJQxA4c0/w-d-xo.html), you might also find that interesting. Best PHARMACIST Fi

Hi Cthuwu :} @SwedePotato314 You are welcome. I am very glad to hear the info was helpful for you - thankyou for letting me know! Thank you for sharing some of your experience, and I am sorry to hear you had a medicine interaction. I would be interested to know which antidepressant interacted and what type of symptoms happened, if you feel comfortable to share this info (I would prevent the message from being publicly visible), but if you prefer not to share specific medicine details, I totally understand, and that is OK, too. Best PHARMACIST Fi

Hi Laveshia Yarborough-Wall @laveshiayarborough-wall8232 Thankyou for sharing your recent experience with Paxlovid. As you probably know, temporary change in taste in a person’s mouth is one of the common potential side effects some people get from Paxlovid. Sorry to hear it sounds like you experienced this side effect. I recommend asking a doctor’s advice about stomach or intestine gas, in case they may or may not want to run tests to try to find out what might be causing it (especially if you have any other symptoms like: pain in the stomach, intestines or liver area/s, nausea, vomiting, diarrhoea, fatty feces, or black or red blood in feces (feces means poop or poo)). Here is an article about stomach and intestine gas, in case it might be of interest: my.clevelandclinic.org/health/diseases/7314-gas-and-gas-pain Hopefully this may not apply to you, but I wonder if it might be of interest that a recent Stanford University research project (www.cell.com/action/showPdf?pii=S2666-6340%2822%2900167-2 ) suggested that in some people, a mild to moderate COVID-19 infection might potentially infect their intestines for weeks to months after their nose, throat and lung symptoms stop (for example, about 13% of people studied still had positive feces PCR tests 4 months after infection, and about 4% of people studied had positive feces PCR tests 7 months after infection). This same Stanford research also found that having positive COVID-19 feces PCR tests long-term may be associated with symptoms like abdominal pain (stomach or intestines area pain), nausea, or vomiting, so if you get any of these symptoms, consider showing your doctor the Standford article above and the 2 articles below, and ask the doctor's opinion on whether or not it might be suitable to test intestines-related organ function (such as blood tests to check liver & pancreas function) - thankfully this does not happen to most people, but as you can see in the links below, people who have had COVID-19 are more likely to develop type 2 diabetes due to pancreas problems than people who have not had COVID-19, and some people get liver problems from COVID-19 ( www.cedars-sinai.org/newsroom/verified-covid-19-infection-increases-diabetes-risk/ , www.ncbi.nlm.nih.gov/pmc/articles/PMC9846934/ ). Just to be clear - I am not saying you have these problems, I am just letting you know that some people get them, so you are aware of them. I hope this info may be helpful, and you are welcome to ask me questions about it if you would like more info or explanation of anything. Best PHARMACIST Fi

Hi @ggrens5922 Quite possibly; and not something you want to use long-term if you are trying to minimize risk of harm to your lungs. Here in Australia, a nicotine e-cigarette or vaping product might be prescribed for some people as the last option to switch to, if a lot of attempts to quit smoking with other treatment options have not worked yet. Studies where people used vaping to quit smoking tobacco cigarettes have had mixed results - some people report finding it easier to quit smoking with an e-cigarette or vaping product than other treatment options, but not everyone. Some research suggests that added flavors might make it harder to quit an e-cigarette or vaping product - especially for younger people (for example, in May 2023 the FDA recently denied approval of approximately 6500 e-cigarette and vaping liquid products for this reason: www.fda.gov/tobacco-products/ctp-newsroom/fda-issues-marketing-denial-orders-approximately-6500-flavored-e-cigarette-products ; the following research article provides some examples of risks of harmful chemicals being produced when some common flavors are heated during the vaping process: pubs.acs.org/doi/10.1021/acs.est.7b02205 ). I hope this info may be of interest, and there are more links to recent research in the description section, above. Best PHARMACIST Fi

Hi jah0524, @jah0524 Thankyou for sharing your recent experience with Paxlovid - that is good to hear you did not feel tired or short of breath from COVID-19 while you were on Paxlovid, which suggests Paxlovid may have been working well for you. However, that is also interesting that your resting heart rate got lower during that time. Slower heart rate is one of the potential heart effects of COVID-19 infection, so it might potentially have been caused by COVID-19 (changes in heart rhythm from COVID-19 may affect different people differently - for example, COVID-19 might make some people's heart rhythm get faster, &/or more irregular, or slower - depending on the person; here is an article about this which you might find interesting: news.llu.edu/health-wellness/covid-19-can-affect-way-your-heart-beats-here-s-what-look-out-for ). However, although slower heart rhythm has not yet been listed as a possible side effect of Paxlovid, because Paxlovid is a new medicine, it is possible that some side effects have not yet been reported - so I recommend that you consider reporting your experience of slower heart rate to the medicine regulator in your country (for example, the FDA if you live in the USA (phone 1800 332 1088 or use the FDA MedWatch online reporting form at www.accessdata.fda.gov/scripts/medwatch/index.cfm?action=reporting.home ), or the TGA if you live in Australia (phone 1300 134 237 or use the Adverse Event Reporting online form at aems.tga.gov.au/privacy/ ), or if you are in the UK, you could use the MHRA Yellow Card reporting page yellowcard.mhra.gov.uk/ ), and as well as stating that you took Paxlovid for COVID-19, also tell the medicine regulator about any other medicines, herbal products, or other health products/supplements if you were taking any at that time and/or in the fortnight before starting to take Paxlovid, and how long it took for the low heart rate to start after you first got COVID-19 symptoms, and how long it took for the low heart rate to start after you first started Paxlovid, plus how long the low heart rate lasted (e.g. approximately how many hours, days, or weeks?), and whether your heart rate went up and down much during that time or stayed low during that time. By giving the medicine regulator in your country all this info, it may help them try to figure out whether getting a slower heart rate might be more likely due to: (a) COVID-19 infection affecting heart function, or (b) a side effect from a different medicine or health product being made more noticeable by a Paxlovid interaction temporarily increasing the amount of that other medicine or health product in your body, or (c) Paxlovid possibly having a new potential side effect. Because you had a slower heart rate while fighting COVID-19, I also recommend asking your doctor about whether they might like to consider ordering an ECG (electrocardiogram) to check your heart function (if you have not already had that done since getting COVID-19). Also, if your heart rate ever becomes unusually slower again in future, it would be a good idea to get checked by a doctor as soon as possible, as they may want to do an ECG at that time, to figure out if the electronic conduction pattern of your heart is safe or whether any treatment might be needed. I hope this info may be helpful for you. Best PHARMACIST Fi :>

Hi Sean Peters @AiMF1X3R Thankyou for sharing your experience with this very painful condition, and I am sorry to hear you have been through a lot in the past year. Because there are often also other factors contributing to gout, even with diet and exercise changes, most people with gout need to take a 'urate-lowering medicine' life-long (for example: allopurinol, if it is suitable). Please see videos 2, 4 & 5 of this '10 Things You May Not Know About Gout' SHORTS series for some very important new gout treatment info that may be helpful. Also, video #6, which I'm posting this week, contains 15 things which may increase our risk of gout or gout flares (not just drinks and foods) - so you might find that interesting, too. If a doctor gives a person with gout a set dose of allopurinol without tailoring their dose personally to them in order to bring their uric acid level down to the 'target level', this may lead to some people with gout not getting treatment success ('success' meaning to never get another gout flare after all urate crystals have been melted - which may take 6 months or more after target uric acid level has been reached and is then maintained consistently). So, if your doctor has not yet talked about gradually getting uric acid to the 'target level' (using uric acid blood tests to guide gradual changes of urate-lowering medicine dose until target uric acid level is reached and then maintained consistently, life-long), it would be a good idea to ask the doctor about that, and video #5 of this series also has some info about that if you are interested. I hope you have a good treatment outcome. Best Fi :> p.s. sorry this SHORTS comment section didn't let me copy and paste from a word document (which is how I prefer to type comments) - so that is why only your name and handle (which I typed in) were in the message I posted last night! ;>

@@pharmacistfi 👋

@@AiMF1X3R Please find full version of my reply, now visible in my first reply, above. Best Fi :>

Hi Jimmy Kilgore @jimmykilgore9647 Thank you for your question. When you say ‘Naturally’, I am guessing you might mean via changes to drinks and food, or via herbal medicines, or both? Whether gout can be managed just through significant changes in drinks and foods may depend on a person’s genetics (please see my new video via this link: th-cam.com/users/shortsYBmE7OdaPZk?feature=share for more info about this). If you are wondering about whether any herbal medicine gout treatment options are as effective as modern medicine gout treatment options: not enough research has been done to test this yet, so there are not currently any herbal medicines in the guidelines doctors follow to choose treatments for gout, from which I make my videos (for example: the current American College of Rheumatology Guideline for the Management of Gout, and the current section on Gout in Australia’s Therapeutic Guidelines). Some interesting substances from plants are being discovered in recent years by researchers in China, some of which might potentially have a role in treating gout in future, if large scale research in humans is carried out and if it shows: *how they work, and *if they work at least as well as current modern medicines, and *if their side effects or medicine interactions risks are not more risky than current modern medicines. However, keep in mind that one of the anti-inflammatory medicines doctors prescribe for some people in the early stage of gout treatment, called colchicine, is an example of the fact that the words ‘herbal’ or ‘natural’ do not always mean ‘safe’. The modern medicine 'colchicine' has been created because herbal medicines containing colchicine are too risky. The modern medicine colchicine tablet contains a much more accurate and specific amount of colchicine (still taken from a particular plant) than herbal medicines made from parts or extracts from the same plants - because parts or extracts of those plants have varying amounts of colchicine in them (varying between individual plants, and also varying depending on the time of year it is grown - for example, they tend to have a higher colchicine concentration in summer), and because the treatment amount of colchicine is so small (0.5 or 0.6 milligrams per tablet (depending on which country you live in) and some people with kidney problems need to take even less than this) - that means that a small variation in the amount of colchicine in part of a plant or plant extract could be the difference between reducing inflammation and pain or not, and also the difference between getting no side effects, or some side effects, or causing a slow and painful death (this is no exaggeration - people have died from eating leaves of a plant that contains colchicine). However, as I mentioned in my video ‘Colchicine - How Does that Work?!’, it should be noted that the modern medicine tablets containing colchicine still have a serious toxicity risk if too much is taken for a person’s kidney or liver function level, so it is important to have kidney and liver function blood tests to help the doctor choose the correct dose of colchicine, if colchicine is suitable for a person (please note that colchicine is not suitable for everyone - for example, some people cannot take colchicine due to a potentially serious medicine interaction with an important medicine they are already taking). I hope this info may be helpful. You are welcome to ask questions about this info if anything is unclear. Best Fi :>

Hi Neal Anderthal @nealanderthal528 You are very welcome, and thanks for commenting! Best Fi :>

Hi OVXX Thanks for commenting. If you still get the cough but have not yet had your lungs checked for any possible medical conditions that could potentially be causing a cough, I recommend asking a doctor to please help with this. Here in Australia, a lot of doctors can do lung function testing (which may also be called 'spirometry') - which involves the patient breathing out into a machine a few times, then if a condition like asthma is suspected - using an inhaled reliever medicine, then doing the same types of breaths out into the machine again and seeing if any of the measurements are different. These types of measurements are used by a doctor to see how well the person's lungs are working, and whether or not they might get good benefit from certain types of medicines (for example: people with some types of lung conditions like asthma or COPD may benefit from one or more different types of inhaled medicines to improve how well the air moves in and out of their lungs by widening the air tubes in the lungs - by reducing inflammation in the walls of the air tubes or by relaxing muscles that surround the air tubes), or spirometry might also help a doctor to know if a referral to a respiratory specialist might be needed (a respiratory specialist is a doctor who specialises in medical conditions of the lungs, so they have even more knowledge about diagnosing and treating a wide range of lung conditions). A wide range of different things might potentially cause a cough for different people, and treatment would depend on a doctor finding out what is causing the cough. Some examples of things that might cause a cough include: asthma reactions (to things like air pollution from things like vehicles or factories or fire, smoking or breathing other people's smoking, cold air, some cleaning products, dust in houses or from some animals, mould, exercise, pollen from trees or plants or grasses, etc.), or an allergy to a food ingredient, or reflux of acid from the stomach into the throat (which may also be called 'heartburn' or 'gastro-oesophageal reflux disease' or 'GORD'), or some genetic conditions of the lungs, or infections by some types of viruses or bacteria, or some types of heart conditions, or potential side effects from a few types of medicines (if you take any medicines, I recommend asking your doctor to please check if dry cough is a potential side effect of any of them, and if so - whether you could change to a different medicine which does not potentially have that side effect; and remember to make medicine decisions together - with the doctor, asking the doctor to please advise you about the benefits versus risks of each treatment option). I hope this info may be helpful. Best Fi :>

@@pharmacistfi wow thanks so much for the advice! ill get myself checked :)

@@OVXX666 You are welcome, & good on you for getting checked. I hope it leads to a good outcome for you :>

Hi Jon Harry @jonharry6293 I agree, and I hope my video has not given the impression of being against allopurinol. I made this video to help people find out that, like a lot of other commonly used medicines, allopurinol has some rare risky side effects (rare meaning it only happens to less than 1 in 1000 people who take allopurinol), because I think everyone deserves to know to get emergency medical attention immediately if they ever get risky side effects from a medicine, because getting medical attention as soon as possible may help enable better health outcomes from medicine problems - so it is a very good idea to find out the exact symptoms of risky side effects to look out for, for each of our medicines. I also made this video to advise people about some uncommon but serious medicine interactions to avoid. If you might be interested in some more info about allopurinol, I will be covering things like the very interesting way it works, the importance of uric acid level monitoring to get the right specific dose for a person, and the range of gout-related problems allopurinol may help prevent (which may not just be in our joints), in a video called ‘Allopurinol - How Does that Work?!’ and in some of my upcoming series of SHORTS videos called ’10 Things You May Not Know About Gout’, in the next month. Best Fi 🙂

Hi Renny Chaitlal ( @xreria ) I hope you are well. Only take colchicine if a doctor has prescribed it for you, because some people must not take colchicine (people with some types of kidney or liver problems or some medicine interactions, have become very unwell or died from taking the standard dose schedule of colchicine) - so it is very important to tell the doctor about everything you are currently taking and have taken in recent weeks (including every medicine and herbal medicine and any other health products like supplements - so the doctor can check whether or not you have any serious medicine interactions), and a doctor should check your kidney and liver function (with blood tests) before you start colchicine - to help the doctor know whether or not colchicine may be suitable for you, and if it is suitable - what dose schedule to give you (because dose schedules are different for people with different levels of kidney function or liver function). Please also see my video called ‘Some Need-to-Know Info! Colchicine for Gout (Part 1)’ for some other important things which I advise to talk about with a doctor about colchicine, via this link th-cam.com/video/N6jCa795bLg/w-d-xo.html I hope this info is helpful for you. Please note that this TH-cam Channel is for general education about medicines, not personal medicines advice, but you are welcome to ask me any general questions about this info if you like. Best Fi

Hi 15 @user-bg6wx8ix2u Thank you for your question. This is good timing, as I was planning to create a video about indomethacin (which is also called indometacin in some countries; brand names in the USA include: Indocin, Indocin SR, or Tivorbex; brand names in Australia include: Indocid or Arthrexin) in the next month, but now that I know it may be of interest to you, I will try to get that video completed in the next fortnight! Indomethacin is a non-steroidal anti-inflammatory drug (NSAID), so some people with certain types of medical conditions or medicine interactions must not take it, but if a doctor advises indomethacin is suitable for a person to treat gout flares &/or reduce how often gout flares happen, then the person may find indomethacin helps reduce the painful inflammation of gout flares (please note that it is important to tell the doctor about all medical conditions you have ever had - to help them weigh the potential treatment risks versus potential treatment benefits of an NSAID like indomethacin - especially tell the doctor about any history of unusual bleeding or bruising, or any medical conditions affecting the heart, blood pressure, kidneys, liver, stomach, intestines, brain, allergies, asthma, COPD, or any history of not producing enough of some types of blood cells; & also make sure the doctor knows about all medicines, herbs, supplements & other health products you are currently taking and have taken in recent weeks so they can check for any medicine interactions). Like the other medicine options for treating painful gout flares (for example: colchicine or corticosteroids), an NSAID like indomethacin does not get rid of the urate crystals of gout - it only reduces our body’s painful inflammatory immune system response to the crystals, so most people will need to take a 'urate-lowering' medicine life-long to gradually melt the urate crystals and then prevent urate crystals from ever forming again (for example: allopurinol - if their doctor considers allopurinol is suitable for the person), in order to stop gout attacks permanently. During the first 6 months or more of treatment with a urate-lowering medicine (like allopurinol), because urate crystals are being melted, this causes some changes in a person's uric acid level, which may trigger some acute gout flares. So, to reduce or prevent gout flares during this time - a doctor may prescribe an NSAID like indomethacin, or colchicine, or a corticosteroid, and whether one of these 3 types of medicines is suitable or not for a person will depend on things like: what medical conditions a person has, the person’s levels of kidney and liver function, whether the person is taking any seriously interacting medicines, and whether the person is more or less likely to get acute gout flares than other people. Like a lot of commonly used medicines, indomethacin has some potentially serious (and in some cases potentially life-threatening) side effects to watch out for and get emergency medical attention immediately if they ever happened - so I recommend asking your doctor or pharmacist to please print or email you some medicine information about indomethacin, and read the section about side effects - so you know what symptoms to look out for and what to do about side effects if they ever happened to you. Indomethacin also has some risky medicine interactions to try to avoid - so I also recommend asking your pharmacist to please run an interactions check on their computer for you - for everything you are currently taking and have taken in recent weeks (including medicines from the doctor, supermarket or pharmacy, and also any herbal medicines, supplements, and other health products). If any interactions are found, your pharmacist can advise you of whether they may be serious or not, and if any interactions may be significant, your pharmacist could help you contact your doctor to figure out whether any medicine changes may be needed or not, and exactly how to make medicine changes if they are needed. Please check back to this channel for my upcoming video about indomethacin in my ‘Some Need-to-Know Info! ’ playlist, and if you have any further general questions about indomethacin, I will be happy to answer them (please note that this channel is only for general info about medicines, not personal medicines questions). You might also find my upcoming series of 10 SHORTS videos called ’10 Things You May Not Know About Gout’ interesting, too. Best Fi :>