Serotonin is a neurotransmitter (a naturally occurring brain chemical) that aids in mood and behavior regulation, and boosting serotonin is one method of treating depression.
Quick Facts About Serotonin Syndrome
However, if you are taking an antidepressant that significantly raises serotonin, you may be at risk for a hazardous drug response known as serotonin syndrome, which many people say is capable of ruining people’s lives, hence why Healthsoothe’s title contains the phrase “How Serotonin Syndrome ruined my life.”
Serotonin Syndrome ruined my life – I don’t know if you have heard this before and you are wondering; what is the cause of this? What is Serotonin Syndrome? Can this be prevented? How can I recover from this if I have Serotonin Syndrome? What can I do to prevent this from never happening? And so on and so on…
The questions keep popping up on this issue, but don’t worry; today Healthsoothe will do its usual job of answering all these questions and more.
Even if you are already a victim of serotonin syndrome and you are looking for how to recover, this article is for you. Hence our title today – “How Serotonin Syndrome ruined my life and how I recovered.”
So we move.
- Firstly, let’s talk about a little on this Serotonin syndrome
- How Serotonin Syndrome ruined my life – Read what other people said on this
- Now, how has Serotonin syndrome ruined my life, or how can it ruin yours?
- How Serotonin Syndrome ruined my life and how I recovered
- What will happen if you miss significant doses of drugs that can increase serotonin and what do I do?
- What will happen if you overdose on drugs that can increase serotonin and what do I do?
- Drugs that can cause increased serotonin levels that you should avoid taking
- The conclusion on the issue of “how Serotonin Syndrome can ruin my life” by Healthsoothe
- Frequently Asked Questions on Serotonin Syndrome
Firstly, let’s talk about a little on this Serotonin syndrome
Firstly, before we go anywhere, you have to know what Serotonin syndrome is, especially if you didn’t know about it before.
Before we proceed on that, what do you understand about serotonin? Serotonin is a hormone that the body produces that aids in the regulation of attention, mood, social behavior, sexual desire, sleep, and hunger.
Serotonin, as a neurotransmitter, transports messages between nerve cells. It is made in the intestines and brain, but it is also found in the central nervous system (CNS) and blood platelets.
As a consequence, serotonin is thought to affect a wide variety of psychological and physiological activities.
Now serotonin syndrome; also known as serotonin toxicity, is a potentially fatal disorder caused by an excess of serotonin in your body, resulting in a variety of symptoms.
When a person takes a combination of serotonin-containing pharmaceuticals (such as Zoloft, Lexapro, both SSRIs, and Effexor, an SNRI), they are at a high risk of developing serotonin syndrome.
Taking one medicine to raise serotonin levels might sometimes result in serotonin syndrome in sensitive people.
To prevent this potentially fatal illness, you must discuss any drugs you are taking with your doctor before beginning any new ones.
Causes of serotonin syndrome
You should also be aware of the causes of this condition so that you may avoid falling into the group of individuals who are willing to tell their tale about “how serotonin syndrome ruined my life.”
When you understand the reasons for this condition, you can prevent it.
If a patient takes too many antidepressants, they might develop serotonin syndrome. Another reason is taking a new antidepressant before the previous one has been eliminated from the body.
However, the most prevalent reason is the addition of another sort of medicine. This may occur if a patient fails to inform their doctor that they are taking an antidepressant or if the practitioner is unaware of the risk.
The pain medicine Meperidine (better known by the brand name Demerol), the cough medication Dextromethorphan, migraine treatments called Triptans, and the recreational drug ecstasy are all examples of popular add-on pharmaceuticals that may lead to serotonin overdose.
Early reports of serotonin excess were made in the 1950s with the use of antidepressants known as Monoamine Oxidase Inhibitors (MAOIs). When new antidepressant medicines known as Selective Serotonin Reuptake Inhibitors (SSRIs) were extensively utilized, reports of serotonin syndrome rose.
Prozac and Paxil are examples of SSRIs. Serotonin Nor-epinephrine Reuptake Inhibitors (SNRIs), which include Cymbalta and Effexor, are another class of antidepressant medicines that boost serotonin.
Knowing the causes of serotonin syndrome, you should be aware of what to avoid, right?
Serotonin Syndrome Symptoms
Serotonin syndrome can cause a wide range of symptoms due to overdosing. They are;
- Neuromuscular problems like tremors, twitching, overactive reflexes, agitation, and muscle rigidity.
- Gastrointestinal symptoms like vomiting and diarrhea.
- Nervous system symptoms include overactive reflexes, heavy sweating, increased heart rate, increased body temperature, increased blood pressure, vomiting, diarrhea, and muscle spasms.
- Mental status changes like anxiety, restlessness, delirium, and disorientation.
- Other serotonin syndrome symptoms include shivering, clumsiness, confusion, and other mental changes.
Serotonin syndrome symptoms may vary from moderate to life-threatening. In severe circumstances, body temperature might skyrocket, muscles can fail, and a person can fall into shock.
You may experience symptoms within minutes or hours after beginning a new medicine or increasing the dose of an existing prescription.
Common and sometimes mild symptoms may include:
- Clumsiness
- Goosebumps
- Irregular heartbeat
- Fever
- Agitation
- Insomnia
- Confusion
- Restlessness
- Bradycardia (decreased heartbeat)
- Anxiety
- Vomiting
- Tachycardia (accelerated heart rate)
- Flushness of the skin
- Muscles rigidity
- Spurts of disorientation
- Tremors
- Throat and mouth dryness
- Nausea
- Hyperthermia
- Constipation (diarrhea or increased bowel sounds)
- Shivering
- Dilation of the pupils
- Sweating
- Muscle spasms (Jerking and twitching of the muscle)
- Unsteady eye movements
- Babinski sign (stretching upwards and outwards of the big toes on stimulation)
Severe symptoms may include:
- Delirium and disorientation
- Rapid heart rate and high blood pressure
- Loss of muscle coordination or twitching muscles
- Heavy sweating
- High fever (temperature greater than 103F/40`C)
- Convulsions with salivary foam in the mouth
- Seizures
- Unresponsiveness
- Loss of consciousness
- Coma
In severe cases, serotonin syndrome can be life-threatening.
If you are going through these symptoms or observe anyone with these symptoms, contact your healthcare provider or doctor immediately, and if possible, rush yourself or the person affected to the nearest hospital immediately.
How Serotonin Syndrome ruined my life – Read what other people said on this
I have never had serotonin syndrome but I will drop the experiences some have passed through with serotonin syndrome, and how this pars to the issue of “How serotonin syndrome ruined my life”
All three experiences of people who went through serotonin syndrome I will drop here is from the Beyond Blue forum, where people drop various health experiences they have encountered.
- The first one: Hi everyone, I was interested to hear about people’s experiences with serotonin syndrome. It is potentially fatal. It takes different forms and can differ in the degree of severity. Sometimes it has psychotic features, other times it doesn’t. This is rare. But I think it is more accurate to say that it is rarely diagnosed. I’ve had two episodes of serotonin syndrome in three months. For me, it had psychotic features (e.g. auditory hallucinations). It is incredibly disempowering to have this occur. When you know you are experiencing serotonin syndrome, especially when there are psychotic features. This is because your claims are discounted by nurses and psychiatrists, at least by those that don’t know you well, as claims of a psychotic person lacking insight. Even for me, a person with a Ph.D. in economics, with access to peer-reviewed journal articles pay-walled to most other people, I struggled to be taken seriously by those who didn’t know me. I finally had to take things into my own hands to improve my situation. I can only imagine how daunting and frustrating this would be for others. I’m not alone in my experience. I know of at least one person in the US that has written about this, although not a medical doctor herself, she is medically trained in neuroscience as a researcher. She identified this in her mother. However, as was my experience too, her claims were not believed. Unfortunately for her, her mother passed away as a result. My recent experiences and my heightened risk of further experiences mean that this is something I’m very passionate about making sure others don’t also have to suffer through. My psychiatrist apologized, still, it would have been good to avoid this entirely.
- The second one is from Doolhof: I experienced Serotonin Syndrome and was hospitalized for a week while the Drs tried to sort out what was happening. I blacked out, had a blood pressure of 220/110, and was taken to the hospital via ambulance. I had the shakes, was very unbalanced and un-coordinated for days, headaches, and nausea. My body does not tolerate some medications and certainly not combinations of medication. I am presently in the dilemma of my new medication causing heart palpitations and high blood pressure. The high blood pressure medication has problems of its own! Without medication, I tend to become suicidal. For the majority of people, medication does not cause any ill effects. It is important to let your Dr know exactly what is happening to you and seek help if required. Write down symptoms and when they occur for a more accurate diagnosis. The Drs try their best to assist us, as individuals our bodies cope differently. The Drs can’t predict how people will respond. Cheers all from Dools
- The third one is from Jesten: Hi. I haven’t done research into the syndrome but I have experienced it myself. When I had serotonin syndrome I couldn’t stop shaking, I felt my heart racing, my muscles tensed up and I felt sick. My GP never told me about the interaction between my meds and it wasn’t until I sought advice from a chemist that I heard of the syndrome. At the time I was questioned over why I took them together and lectured about it as they didn’t know what to do. Luckily I didn’t have psychosis symptoms.
Now, how has Serotonin syndrome ruined my life, or how can it ruin yours?
I am sorry that I cannot cite my personal experience with serotonin syndrome as I have never had it, but I have read many dropped or written-down experiences of others who went through serotonin syndrome.
I have dropped some of these experiences here in this article above, so if you didn’t already see or read it before, you can go back and read up on what they said on the issue of “How serotonin syndrome ruined my life.”
Now, I am not going to drop their experiences here again, but I am going to throw more light on the issue of “how serotonin syndrome ruined my life.”
So how does this syndrome do this? Some of the symptoms and consequences of serotonin syndrome are pretty severe, meaning they can be fatal or life-threatening.
Consequences of serotonin syndrome like convulsions with salivary foam in the mouth, seizures, unresponsiveness, loss of consciousness, coma, and loss of muscle coordination or twitching muscles can be debilitating and fatal.
They can hamper your health and everyday routine. They can make you unsociable, withdrawn, and even unrecognizable.
They can even diminish your cognitive ability and hamper your intelligence, thereby rendering you unfit for work, communication and even taking care of yourself.
Do I need to go further for you to get the picture or understand the concept of “how serotonin syndrome ruined my life”?
I mean the effects of this syndrome can be so devastating that it can render you almost useless to others, the society you live in as a whole, and even yourself.
How serotonin syndrome ruined my life – Yeah, it really can. So please be careful with certain medications you take into your body.
Read this article very well and know what you have to do to avoid this syndrome and as well as avoid the masses of people out in the cliché of “how serotonin syndrome ruined my life.”
How Serotonin Syndrome ruined my life and how I recovered
Once again, I am sorry that I cannot cite my personal experience with serotonin syndrome as I have never had it, but I have read many dropped or written-down experiences of others who went through serotonin syndrome.
I have dropped some of these experiences here in this article above, so if you didn’t already see or read it before, you can go back and read up on what they said on the issue of “How serotonin syndrome ruined my life.”
Now, I am not going to drop their experiences here again, but rather I want to let you know how to recover from serotonin syndrome.
Yes, you can recover. You can recover from serotonin syndrome. This article is not only for coming to read “How serotonin syndrome ruined my life”, but also to tell you that serotonin syndrome is not cancer or HIV and that you can recover from it if you set your mind to it.
You can see from some of the experiences I have dropped earlier how serotonin syndrome disturbed people and how some of them recovered.
So you can just read up on what they did to recover and follow in their footsteps. Apart from these, you also have to know how to diagnose, treat and prevent serotonin.
These are the main efficient recovery strategies that you must pass through to properly recover from the issue of “How serotonin syndrome ruined my life.”
How do I diagnose serotonin syndrome?
Believe it or not, there are a lot of health professionals out there who can’t detect or diagnose serotonin syndrome.
It isn’t because they aren’t good with their work, but the main problem is that serotonin symptoms are much like other ailments, and many people suffering from serotonin syndrome have died because of this.
Either the doctor prescribed the wrong medication for them or gave them the wrong treatments, which didn’t help at all.
A history of drug exposure and symptoms of serotonin excess is the best technique to identify serotonin syndrome. Because lab tests are ineffective, clinicians must be aware of the indications and symptoms.
According to the AACN Advanced Critical Care research, having a history of taking a serotonin-raising medicine as well as three of the primary symptoms or indicators of serotonin syndrome is sufficient to establish the diagnosis.
Blood tests may be performed to detect medications that increase serotonin levels.
How do I treat serotonin syndrome?
Serotonin syndrome is generally treated in a hospital. The first step is to discontinue any medicines that increase serotonin.
You may need anxiety medicine and muscular spasm relief, as well as Cyproheptadine, a treatment that inhibits serotonin synthesis.
Cyproheptadine is only accessible as an oral medication. We sometimes have to pulverize it and provide it through a nasogastric tube.
Cooling baths may help reduce body warmth. In extreme situations, fluids, blood pressure, and breathing assistance may be required. The majority of patients recover within 48 hours.
Treatment will vary in complexity depending on where the symptoms of serotonin syndrome lie on a scale of moderate to severe.
In moderate situations, physicians may advise the patient to discontinue the drug that is generating the increased serotonin levels as the initial line of treatment and will offer supportive care and potentially benzodiazepine sedation.
Medications will not be eliminated from the body, and patients will be closely watched for any adverse reactions or withdrawal symptoms.
External cooling methods, similar to those used to treat heat stroke, will be required for certain individuals with high body temperature or hyperthermia.
Because blood pressure varies so fast, short-acting medicines should be utilized when a patient’s blood pressure is very high or extremely low.
For more seriously unwell individuals, an IV and Cyproheptadine (Periactin), a medication that inhibits serotonin synthesis, are commonly used.
After the serotonin syndrome has resolved, doctors will decide whether or not to restart the serotonergic medication.
While you should not be concerned if you have been prescribed one of the above-mentioned serotonin-containing drugs, it is important to be aware of the impact that combined medications may have on one another.
How to prevent serotonin syndrome?
Before starting any new drugs, make sure all of your doctors, physicians, and caretakers are aware of all of your prescriptions. This is the best way to prevent serotonin syndrome.
If you’re taking a medicine that raises your serotonin levels, see your doctor before taking any over-the-counter medication or supplement.
LSD and bath salts are two more recreational substances connected to serotonin syndrome.
Inform your doctor of your complete medical history and medication list, including prescriptions, over-the-counter medications, herbals, supplements, and illegal substances, as well as dosages.
Any modifications should be updated regularly. Use a pill box to keep track of your meds and reduce the possibility of an accidental overdose.
Overall, it is important to be knowledgeable about your meds. It is critical to understand what you are taking, the active components, potential adverse effects, and drugs that should not be combined to prevent serotonin syndrome.
Pay careful attention to the directions on your prescriptions to ensure you’re taking them at the proper times.
If you have any concerns about your prescriptions, see your doctor to ensure that you are not combining drugs that might cause serotonin syndrome.
Knowing the risk and the symptoms should help you and your doctor avoid a potentially fatal serotonin excess.
What will happen if you miss significant doses of drugs that can increase serotonin and what do I do?
Nothing much will happen. Just that if you have missed significant doses of the drug you were taking, it will not be effective or potent enough to treat you for the ailment you took it for.
Do the following if you have miss dosed;
- If you forget to take one or more doses: take your next dose at the usual time and in the average amount. Do not take any more than your doctor prescribed.
- If you miss one dose, skip it and continue with your normal schedule.
- Do not increase the dosage to catch up with the missed doses.
- You should consult your doctor on what to do if you don’t know what to do.
What will happen if you overdose on drugs that can increase serotonin and what do I do?
If you overdose on such drugs, then you should know what you are signing up for. You are getting ready to join the league of those who have info and first-hand experience on the issue of “How serotonin syndrome ruined my life.”
When you overdose on medicines that raise serotonin levels, you are on the fast track to serotonin syndrome, which may cause severe symptoms such as intense perspiration, high temperature, convulsions with salivary froth at the mouth, and seizures, unresponsiveness, loss of consciousness, and even coma.
If you or someone you know is experiencing these symptoms, go to or take them to the closest hospital right once, since delayed treatment may result in death or permanent damage.
Drugs that can cause increased serotonin levels that you should avoid taking
If a patient takes too many antidepressants, they might develop serotonin syndrome. The following medications and substances, when taken together or in excessive concentrations, may cause serotonin syndrome:
- Bupropion (Zyban, Wellbutrin SR, Wellbutrin XL), is an antidepressant and tobacco-addiction medication.
- Tricyclic antidepressants like Amitriptyline and Nortriptyline (Pamelor).
- Hard and street drugs like LSD, cocaine, ecstasy, opium, and amphetamines.
- Serotonin Nor-epinephrine Reuptake Inhibitors (SNRIs) like Cymbalta/Drizzle Sprinkle (Duloxetine), Trazodone, Effexor (venlafaxine), Desvenlafaxine (Pristiq), Levomilnacipran (Fetzima).
- Herbal supplements: St. John’s wort, ginseng, and nutmeg.
- Monoamine Oxidase Inhibitors (MAOIs) like Isocarboxazid (Marplan) and Phenelzine (Nardil).
- Selective Serotonin Reuptake Inhibitors (SSRIs) like Prozac and Paxil.
- Anti-migraine medications like Carbamazepine (Tegretol, Carbatrol, others), Valproic acid, and Triptans, which include Almotriptan, Naratriptan (Amerge), and Sumatriptan (Imitrex, Tosymra, others).
- Antidepressants like Citalopram (Celexa), Fluoxetine (Prozac), Paroxetine (Paxil), and Sertraline (Zoloft).
- Cannabinoids.
- Pain medications: opioid medications including Codeine (Tylenol with codeine), Fentanyl (Duragesic), Hydrocodone Meperidine (Demerol), Oxycodone (Oxycontin, Roxicodone, Percocet, Percodan), and Tramadol (ConZip and Ultram).
- OTC cough and cold medications like Dextromethorphan (Delsym).
- Lithium drugs like Lithobid, a mood stabilizer.
- Anti-nausea medications.
- Linezolid (Zyvox), an antibiotic.
- Ritonavir (Norvir), is an antiretroviral medication used to treat HIV.
The conclusion on the issue of “how Serotonin Syndrome can ruin my life” by Healthsoothe
All serotonin syndrome is a potentially fatal neurological disorder induced by excessive serotonergic activity. It is distinguished by changes in mental state, autonomic instability, and neuromuscular hyperactivity.
The majority of recorded occurrences of serotonin syndrome occur in individuals who are using numerous serotonergic medicines or have had significant exposure to a single serotonin-augmenting substance.
It may occur if you:
- Inadvertently utilize drugs such as antidepressants or mood stimulants that are not appropriate for you, or use them at an excessively high dose.
- Combine two serotonin-boosting medications.
- Intentionally overdose on medication, particularly an antidepressant.
The situation usually happens when two or more medicines, illicit narcotics, or nutritional supplements that enhance serotonin levels are combined.
For example, you might take migraine medicine after already taking an antidepressant. According to a 2017 case study, several prescription drugs, such as opioid painkillers, may also raise serotonin levels.
Serotonin syndrome is a potentially fatal neurological disorder induced by excessive serotonergic activity. It is distinguished by changes in mental state, autonomic instability, and neuromuscular hyperactivity.
The majority of recorded occurrences of serotonin syndrome occur in individuals who are using numerous serotonergic medicines or have had significant exposure to a single serotonin-augmenting substance.
In 2002, the Toxic Exposure Surveillance System detected 26,733 instances of serotonin syndrome, according to a 2013 assessment published in the journal AACN Advanced Critical Care. 7,349 of the instances were classified as serious or severe, with 93 resulting in death.
There were 48,204 instances, 8,187 moderate or severe cases, and 103 fatalities only two years later. Early detection is critical to effective therapy.
One of the implications of this paper is that more individuals are using SSRIs than ever before, increasing the chances of developing serotonin syndrome, and that serotonin syndrome is often misdiagnosed.
More individuals are using numerous kinds of SSRIs or combining SSRIs and other serotonin-related medications, such as Triptans, which are often used for migraineurs. Serotonin syndrome may be lethal if not treated soon.
It is critical to screen for serotonin syndrome.
Additional information to assist you in choosing a reputable hospital for your care: Medicare has developed a program to prevent patient care mismanagement.
Each hospital receives a score based on the number of mishandled cases, which includes hospital-caused delirium as well as other instances.
In many hospitals, hospital-induced delirium is the new nomenclature for serotonin syndrome, and it may be recognized as the official cause of death.
Medicare gives a score to each ailment and totals the number of misdiagnoses and mismanagement incidents per facility. Hospitals that score above the 75th percentile get a pay cut from Medicare unless they improve their services.
I wish physicians were as well skilled in identifying serotonin syndrome as they are in writing serotonin medications.
Because physicians are so ignorant of how to diagnose serotonin syndrome, and because the consequences of that omission are catastrophic, it is essential to carefully explore your choices before receiving serotonin medications. Serotonin medications are recommended for everything, but their effectiveness is quite limited.
Eat meals that put you to sleep after lunch to receive serotonin without using medications: turkey has a lot of serotonin. Get out in the sun. The sun produces serotonin.
If you reside in a frigid place where the sun is scarce in the winter, consider purchasing a home sun-lamp. The light it emits causes serotonin to be released in your body.
Take a relaxing stroll, go shopping, watch children play in a park, or attend social functions. Anywhere with a high concentration of joyful friends or people, in general, can provide you with feel-good hormones that will assist alleviate any sadness.
There are several therapies for depression on the horizon, one of which is the same medication used for migraines and anxiety.
Alright, guys, that is it for now for “How serotonin ruined my life and how I recovered”. I hope Healthsoothe answered any questions you had concerning any issue on “How serotonin ruined my life”.
Feel free to contact us at contact@healthsoothe.com if you have further questions to ask or if there’s anything you want to contribute or correct to this article. And don’t worry, Healthsoothe doesn’t bite.
You can always check our FAQs section below to know more about “how serotonin ruined my life”.
And always remember that Healthsoothe is one of the best health sites out there that genuinely cares for you.
Frequently Asked Questions on Serotonin Syndrome
Is serotonin syndrome harmful in the long run or can it cause permanent damage?
Serotonin syndrome usually does not create any complications after serotonin levels have returned to normal.
Serotonin syndrome may cause unconsciousness and death if left untreated.
Is it possible to recover from serotonin syndrome?
Milder types of serotonin syndrome normally resolve within 24 to 72 hours after discontinuing serotonin-boosting drugs.
You may need to take drugs to counteract the effects of serotonin that is already present in your system.
What Is the Duration of Serotonin Syndrome?
The duration of serotonin syndrome is determined by the body’s serotonin levels.
In circumstances when serotonin syndrome is only moderate, symptoms may be relieved within 24 hours after ceasing the medicine causing the serotonin absorption.
However, certain antidepressants might prolong symptoms since serotonin levels can take weeks to recover to normal.
Is Serotonin Syndrome Common?
Yes. According to the Toxic Exposure Surveillance System of the American Association of Poison Control Centers, 8,187 persons were diagnosed with serotonin poisoning as a result of selective serotonin reuptake inhibitors (SSRIs) in 2004.
There were 103 fatalities in these incidents. However, given the scarcity of data on serotonin syndrome, it is probable that it is considerably more widespread than the data suggests since persons suffering from mild to severe serotonin poisoning often go untreated or unreported.
How long does it take to recover from serotonin syndrome?
You may feel better in one to three days if you have a moderate type of serotonin syndrome.
Some instances may last for many weeks, depending on which medication(s) produced the response and how long the medication(s) remain in your body.
Is Serotonin Syndrome Dangerous?
Serotonin syndrome may result in unconsciousness and death if medical care is not sought when serotonin levels get too high.
Intentional serotonin overdose with antidepressant medicines is one example of how serotonin syndrome may be lethal if not treated promptly.
Patients who intentionally swallow the substance usually get more hazardous effects than those who are accidentally exposed.
Furthermore, the inability to detect or misdiagnose serotonin syndrome is a prevalent concern.
The symptoms of serotonin syndrome are comparable to those of neuroleptic malignant syndrome, an uncommon and potentially fatal adverse drug response.
It is also critical to realize that if untreated, the symptoms of serotonin syndrome worsen rapidly.
Is it possible to reverse serotonin syndrome?
When you stop taking the drug that is causing the symptoms, the symptoms of serotonin syndrome normally go away.
Fortunately, there are no long-term or long-lasting consequences of serotonin syndrome, however, you should be cautious in the future to prevent serotonin syndrome.
Consult your doctor about prevention, particularly if you are using numerous serotonin-containing drugs.
Can serotonin syndrome cause brain damage?
A study shows that heat (hyperthermia) may be a cause of serotonin syndrome brain damage.
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The content is intended to augment, not replace, information provided by your clinician. It is not intended nor implied to be a substitute for professional medical advice. Reading this information does not create or replace a doctor-patient relationship or consultation. If required, please contact your doctor or other health care provider to assist you to interpret any of this information, or in applying the information to your individual needs.