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I have belly fat n body inflammationI
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Nutrition
Question #30819
127 days ago
552

I have belly fat n body inflammationI - #30819

Tosca viegas

After Menopause started with issue.age 57 .had osteoporosis femur leg very weak muscle .L4 L5 issue bone density problem .after taking allopathic i start gain weight..my weight is 64 kg .Iwant to be 58,kg .my height is5:5feet .all tis happened inLondon atCovid time now inMumbai. C4 c5 problem .my skin has turned dark with no glow n shine . please help mei have no muscle power cnt bend n needs support to get up .I am scared my family members died of bone metatasis

Age: 57
Chronic illnesses: None
PAID
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Dr. Prasad Pentakota
I am Dr. P. Prasad, and I have accumulated over 20 years of experience working across multiple medical specialties, including General Medicine, Neurology, Dermatology, and Cardiology. Throughout my career, I have had the opportunity to diagnose and manage a wide range of health conditions, helping patients navigate both acute and chronic medical challenges. My exposure to these diverse fields has given me a comprehensive understanding of the human body and its interconnected systems. Whether it is managing general medical conditions, neurological disorders, skin diseases, or heart-related issues, I approach every case with careful attention to detail and evidence-based practices. I believe in providing accurate diagnosis, patient education, and treatment that is both effective and tailored to the individual’s specific needs. I place great emphasis on patient-centered care, where listening, understanding, and clear communication play a vital role. Over the years, I have seen how combining clinical knowledge with empathy can significantly improve treatment outcomes and patient satisfaction. With two decades of continuous learning and hands-on experience, I am committed to staying updated with the latest medical advancements and integrating them into my daily practice. My goal has always been to deliver high-quality, ethical, and compassionate medical care that addresses not just the illness but the overall well-being of my patients.
127 days ago
5

Can start on Trayodashanga guggulu Lakshadi guggulu Peedantaka vati-1 tab each twice daily after food with lukewarm water Peedantaka oil - gentle massage to be done Triphala churna-1 tsp with warm water at night

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Start with 1) cap. Evanova 1-0-1 after food with water and 2) Shatavari ghanvati 1-0-1 after food with water 3) laxadi guggul 1-0-1 after food with water Massage with ashwagandha oil+kshirbala oil on body muscle.

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NO NEED TO WORRY,

Start taking these medications, 1.Varunaadi kwath 20ml with equal amount of Lukewarm water empty stomach twice in a day. 2.Medoharvidangaadi lauh 1-1-1 3.Lakshadi guggulu 2-0-2 for chewing.

Follow up after 45 days.

If you have any doubt, feel free to ask.

Take care😊

Kind Regards, Dr.Isha Ashok Bhardwaj.

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Dr. Khushboo
I am a dedicated Ayurvedic practitioner with a diverse foundation in both modern and traditional systems of medicine. My journey began with six months of hands-on experience in allopathic medicine at District Hospital Sitapur, where I was exposed to acute and chronic care in a high-volume clinical setting. This experience strengthened my diagnostic skills and deepened my understanding of patient care in an allopathic framework. Complementing this, I have also completed six months of clinical training in Ayurveda and Panchakarma, focusing on natural detoxification and rejuvenation therapies. During this time, I gained practical experience in classical Ayurvedic treatments, including Abhyanga, Basti, Shirodhara, and other Panchakarma modalities. I strongly believe in a patient-centric approach that blends the wisdom of Ayurveda with the clinical precision of modern medicine for optimal outcomes. Additionally, I hold certification in Garbha Sanskar, a specialized Ayurvedic discipline aimed at promoting holistic wellness during pregnancy. I am passionate about supporting maternal health and fetal development through time-tested Ayurvedic practices, dietary guidance, and lifestyle recommendations. My approach to healthcare emphasizes balance, preventive care, and customized wellness plans tailored to each individual’s constitution and health goals. I aim to create a nurturing space where patients feel heard, supported, and empowered in their healing journey. Whether treating seasonal imbalances, supporting women’s health, or guiding patients through Panchakarma therapies, I am committed to delivering care that is rooted in tradition and guided by compassion.
127 days ago
5

) tab. Navaka Guggulu-2 tab. Before food with honey 2.Vidanga +Triphala+Chopachini Churna+Pippalimula+Katuki (each 1 gm)+Tamra Bhasma- 30mg+Shankha Bhasma- 200mg — after food 3 times with takra ya chaach 3) Tab. Varunadi kashaya-10 ml 3 times a day with water Yoga Therapy Asanas Surya Namaskara-Start with 5-10 rounds increase up to 25-30 according to capacity.

Uttanapada Chakrasana (3 rounds) Akarna Dhanurasana (1 minute on each side) Sarwangasana (3 minutes) Ushtrasana (2 minutes) Halasana (1minute) Udarsanchalana (3 rounds) Matsyasana(1 minute) Trikonasana (1 minute on each side) Ardhamatsyendrasana (2 minutes on each side) Veerasana (1 minute on each side) Paschimottasana (1 minute) Shavasana (when needed)

Pranayama Bhastrika (Bellows) Suryabhedi pranayama Kapala bhati (breathing that revitalizes the body) Diet and Lifestyle Pathya: Green vegetables, use of barley and whole wheat, regular exercise, brisk walk for 2-4 km per day, regular practice of powder massage, bio-purification once in a year. Apathya: Avoiding the sweet, sour, salt, oily, cold foods, sedentary and luxurious life

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Hello Tosca ji,

I understand your concern. After menopause, due to hormonal changes and aging, many women face problems like belly fat, bone weakness (osteoporosis), muscle loss, disc issues (L4–L5, C4–C5), dark skin, and inflammation. But dont worry we are here to help you out 😊

✅AYURVEDIC PLAN OF TREATMEMT

✅FOR BONE SUPPORT

Asthi Dhatu support: 1 Lakshadi Guggulu 2-0-2 – helps in osteoporosis & fracture healing. 2 Ashwagandharistha 30ml-0-30ml – nourish muscles, reduce weakness. 3 Godanti bhasma 1 pinch with warm. Water after lunch – improves bone density & calcium absorption.

Diet: 👉Take warm milk with turmeric + a pinch of black pepper. 👉Include sesame seeds, ragi, almonds, figs, dates (in moderation). 👉Use ghee daily – nourishes joints & tissues.

✅FOR BELLY FAT AND INFLAMMATION

1 Triphala 1 tsp at night with warm watet – detox & reduce belly fat.

2 Medohar guggulu 2-0-2 after food – reduce inflammation + fat.

3 Dry ginger + turmeric + black pepper tea – improves metabolism & reduces inflammation.

✅FOR SPINE AND JOINT ISSUES (L4–L5, C4–C5)

External therapies ( To be done in nearby panchakarma t 1 Abhyanga (warm oil massage with Mahanarayan taila or Dhanwantaram taila). 2 Swedana (mild steam). 3 Panchakarma like Kati Basti / Greeva Basti (oil pooling on spine).

✅ Home support 👉Apply warm sesame oil + pinch of turmeric on back & joints before bath. 👉Gentle yoga stretches (Bhujangasana, Makarasana) – avoid forward bending.

✅FOR. SKIN GLOW AND PIGMENTATION

👉Aloe vera juice (20 ml empty stomach) – cools Pitta, improves skin. 👉Manjisthadi ks tab 2-0-2 after food – purify blood, reduce pigmentation. Face pack: Sandalwood + rose water + turmeric.

✅ Diet & Lifestyle

Prefer warm, fresh, homemade meals – khichdi, soups, green vegetables. Avoid: excess sugar, refined foods, packaged foods, deep fried items. Walk daily (15–20 min, slow pace). Practice gentle yoga + pranayama (Nadi Shodhana, Bhramari) – reduces stress & improves healing. Maintain regular sleep – essential for bone healing & weight balance.

With consistent care, your weight can reduce gradually, bones strengthen, inflammation settles, and skin regains natural glow.

Wish you a good health😊

Warm. Regards Dr Snehal Vidhate

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1.Boton-DQ tablets 1 tab twice daily with milk 2.Balarishta 20 ml with 20 ml water twice daily after meals 3.lakshadi guggulu 1 tab twice daily after meals 4.Mahamamsha tail + dhanwantaram oil- massage on the affected area with warm oil

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Hi Tosca viegas this is Dr Vinayak as suffering from chronic bone related disorder it is highly necessary to take panchakarma treatment along with oral medication. Rx tab spiner 1-0-1 after food Rasnasaptaka kashaya 2tsp twice after food Pain nivaran churna 1tsp twice after food Lakshadi guggulu 1-0-1after food Pain nivaran churna

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Addressing multiple health issues, particularly those that arise post-menopause, requires a comprehensive approach. For the bone health issues, Ayurveda focuses on balancing the Vata dosha, which is primarily involved in conditions related to bones and joints. You might benefit from incorporating more Vata-pacifying foods into your diet, such as warm, cooked meals that are mildly spiced. Opt for foods like soups, stews, and porridges. Include healthy fats like ghee and sesame oil in moderation, which helps to lubricate joints and improve bone health.

Weight management can be challenging due to hormonal changes, especially after menopause. Triphala is an excellent Ayurvedic remedy for detoxification and can aid in weight management by improving digestion and metabolism. You can take 1 teaspoon of Triphala powder mixed with warm water at night before bedtime.

For muscle weakness, incorporating Ashwagandha can be helpful. It is known for its rejuvenating properties and can support muscle strength. A recommended dosage might be 1 teaspoon of Ashwagandha powder stirred into warm milk, consumed daily.

Your skin concerns may improve through external and internal Ayurvedic treatments. Consider using a herbal oil like Kumkumadi tailam for facial massage to enhance glow and health of your skin.

Engage in gentle exercise like yoga, which can greatly benefit bone health and muscle strength, focusing on poses that support the spine and help increase flexibility gradually.

For the spinal issues, ensure you’re sleeping on a firm mattress and sitting with appropriate back support. Gentle stretching exercises specifically for the neck and lower back could be beneficial, but they should be guided by a physical therapist to ensure safety.

If theres’ a concern about bone metastasis, it is crucial to consult with an oncologist or specialist for regular monitoring and appropriate treatment. Remember while Ayurveda can complement your treatment regimen, it should be part of a broader care plan in consultation with your healthcare providers.

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HELLO TOSCA VIEGAS,

BONE WEAKNESS (osteoporosis)= after menopause, estrogen drops-> bones lose calcium-> they become thin, fragile, and painful

SPINAL ISSUES (L4-L5, C4-C5)= the cushioning discs in your spine are weaker-> causes stiffness, pain, and difficulty bending

MUSCLE WEAKNESS= without enough protein and strengthen activity, muscles shrink, making it hard to get up without support

WEIGHT GAIN (mainly belly)= metabolism slows after menopause-> fat shifts to the abdomen-> linked with inflammation

SKIN DARKENING/DULLNESS = weak digestion, stress, and hormonal changes-> skin loses glow

INFLAMMATION AND FEAR= chronic stress and poor gut health worsen inflamation. The fear of family history adds mental stress, which itself harms bones and hormones

IN AYURVEDA

VATA INCREASED= bone loss, weakness, dryness, pain

KAPHA INCREASED= belly fat, heavinesss, sluggishess

AGNI (digestive fire) low= poor nutrient absorption -> skin dullness, fatigue

TREATMENT GOALS -strengthen bones and joints -improve muscle tone and stamina -reduce belly fat and inflammation safely -restore skin glow and digestion -calm fear, improve sleep, balance hormones

INTERNAL MEDICATIONS

1) ASHTI SHRINKHALA (HADJOD ) + LAKSHA GUGGULU= 1 tab each twice daily after meals for 3 months =builds bone density, heals fractures, improves calcium absorption

2) DASHMOOLA KASHAYA= 25 ml with warm water twice daily before meals for 3 months =reduces pain, stiffness, and inflamamtion

3) ASHWAGANDHA + SHATAVARI CHURNA= 1 tsp each with 1 glass warm milk at night for 3 moths =muscle strength, hormone support, reduce fatigue

4) TRIPHALA CHURNA= 1 tsp at bedtime with warm water =detox, improves digestion, prevents constipation-important for bone health

5) ARJUNA POWDER= 1 tsp with warm water daily for 3 mnoths =supprots circulation, heart health, post menopausal balance

EXTERNAL TREATMENT

1) OIL MASSAGE with warm sesame oil daily at home =improves circulation, nourishes joints

2) followed by hot water shower

DIET -warm, soft, nourishing foods= khichdi, soups, stews -Calcium rich = sesame seeds, ragi, almonds(soaked), figs, milk with turmeric -Proteins= moong dal, panner, lentils, sprouts (lightly cooked) -spices to aid digestion = ginger, turmeric, cumin, coriander, ajwain -herbal teas= cumin-fennel-coriander water

AVOID -cold/raw salads, excess curd, fried food, white flour, sugar, processed foods -too much tea/coffee

YOGA ASANAS -tadasana= posture correction -setu bandhasana= stregthens spine -supta baddha konasana= relaxes hips -avoid forward bending or jerky twists

PRANAYAM -Anulom vilom= balances hormones -Bhramari= calms anxiety -Deep diaphragmatic breatihng= reduces belly fat, improves lung capacity

HOME REMEDIES -GOLDEN MILK =warm milk + 1/2 tsp turmeric + pinch black pepper at night -SESAME SEED MIX= dry roast black sesame, powder take 1 tsp daily with honey or milk -METHI WATER= soak 1 tsp fenugreek overnight chew in morning- reduces inflamamtion -AMLA= fresh daily= vitamin c for collagen and bones

INVESTIGATION NEEDED -Bone mineral density (DEXA scan) every 1 year -serum calcium, vitamin D, phosphorous -Thyroid function -Lipid profile -fasting blood sugar

This is not just about weight loss- your body is asking for strength, nourishment, and steady support. With Ayurveda, the path is slow but deep. Medicines will rebuild bone and muscle over months, diet will reduce belly fat and inflamation, therapies will ease pain and yoga breathing will restore calm

Balance is the goal, not extremes. Don’t starve yourself, don’t over-exercise. Gentle, consistent care will bring back glow, energy, and confidence

DO FOLLOW

HOPE THIS MIGHT BE HELPFUL

THANK YOU

DR. MAITRI ACHARYA

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Trayodashanga guggulu 1-0-1 Lakshadi guggulu 1-0-1 Ashwagandha churna -1/2 tsp with warm milk at night Dashamoola aristha 2 tsp -0-2 tsp with equal water

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Dr. Hemanshu Mehta
I’m Dr. Hemanshu, a second-year MD scholar specializing in Shalya Tantra (Ayurvedic Surgery), with a focused interest in para-surgical interventions such as Agnikarma, Viddhakarma, and Kshara Karma. My academic and clinical journey is rooted in classical Ayurvedic surgical wisdom, complemented by a modern understanding of patient care and evidence-based approaches. With hands-on training and experience in managing chronic pain conditions, musculoskeletal disorders, hemorrhoids, fistula, and other ano-rectal conditions, I provide treatments that emphasize both relief and long-term wellness. I am deeply committed to offering individualized treatment plans that align with the patient’s prakriti (constitution), disease progression, and lifestyle factors. I believe healing is not limited to procedures alone; it also requires compassion, communication, and continuity of care. That’s why I ensure each patient receives personalized guidance—from diagnosis and therapy to post-treatment care and preventive strategies. I also incorporate Ayurvedic principles like Ahara (diet), Vihara (lifestyle), and Satvavajaya (mental well-being) to promote complete healing and not just symptomatic relief. Whether it's managing complex surgical cases or advising on conservative Ayurvedic therapies, my goal is to restore balance and improve the quality of life through authentic, safe, and holistic care. As I continue to deepen my clinical knowledge and surgical acumen, I remain dedicated to evolving as a well-rounded Ayurvedic practitioner who integrates traditional practices with modern sensibilities.
118 days ago
5

KIDNLY START

LAKSHADI GUGGULU= 1-0-1 after meals

ASTHI POSHAK VATI= 1-1-1 after meals

DASHMOOLARISHTA= 20 ml with water twice daily after meals

MAHAYOGARAJ GUGGULU= 1-0-1

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I am an Ayurvedic doctor currently practicing at Ayushakti Ayurveda—which honestly feels more like a learning ecosystem than just a clinic. Being here has changed the way I look at chronic conditions. You don’t just treat the label—you go after the cause, layer by layer, and that takes patience, structure, and real connection with the person sitting in front of you. Ayushakti has been around 33+ years, with global reach and seriously refined clinical systems. That means I get to work with protocols that are both deeply rooted in traditional Ayurveda and also super practical for today’s world. Whether I’m managing arthritis, asthma, skin issues like eczema or psoriasis, hormone trouble, gut problems, or stress overload—my first step is always a deep analysis. Prakriti, doshas, ahar-vihar, past treatments—everything gets mapped out. Once I’ve got that picture clear, I create a plan using herbal medicines, detox programs (especially Panchakarma), Marma therapy if needed, and definitely food and routine corrections. But nothing’s random. Each piece is chosen for *that* person. And I don’t just prescribe—I explain. Because when someone knows *why* they’re doing a certain thing, they stick with it longer, and the results hold. One thing I’ve learned while working here is how powerful Ayurved can be when it's structured right. At Ayushakti, that structure exists. It helps me treat confidently and track results properly. Whether I’m working with a first-time visitor or a patient who’s been dealing with the same thing for 10 years, my goal stays the same—help their system return to a natural, sustainable state of balance. What I really enjoy is seeing how people’s mindset changes once they start to feel better. When they stop depending on just temporary relief and start building their health from within—that’s when the real shift happens. And being part of that shift? That’s why I do this.
5
140 reviews
Dr. Sara Garg
I am someone who believes Ayurveda isn’t just some old system — it’s alive, and actually still works when you use it the way it's meant to be used. My practice mostly revolves around proper Ayurvedic diagnosis (rogi & roga pariksha types), Panchakarma therapies, and ya also a lot of work with herbal medicine — not just prescribing but sometimes preparing stuff myself when needed. I really like that hands-on part actually, like knowing where the herbs came from and how they're processed... changes everything. One of the things I pay a lot of attention to is how a person's lifestyle is playing into their condition. Food, sleep, bowel habits, even small emotional patterns that people don't even realize are affecting their digestion or immunity — I look at all of it before jumping to treatment. Dietary therapy isn’t just telling people to eat less fried food lol. It’s more about timing, combinations, seasonal influence, and what suits their prakriti. That kind of detail takes time, and sometimes patients don’t get why it matters at first.. but slowly it clicks. Panchakarma — I do it when I feel it's needed. Doesn’t suit everyone all the time, but in the right case, it really clears the stuck layers. But again, it's not magic — people need to prep properly and follow instructions. That's where strong communication matters. I make it a point to explain everything without dumping too much Sanskrit unless they’re curious. I also try to keep things simple, like I don’t want patients feeling intimidated or overwhelmed with 10 things at once. We go step by step — sometimes slow, sometimes quick depending on the case. There’s no “one protocol fits all” in Ayurveda and frankly I get bored doing same thing again and again. Whether it’s a fever that won’t go or long-term fatigue or gut mess — I usually go deep into what's behind it. Surface-level fixes don’t last. I rather take the time than rush into wrong herbs. It’s more work, ya, but makes a diff in long run.
5
55 reviews
Dr. M.Sushma
I am Dr. Sushma M and yeah, I’ve been in Ayurveda for over 20 yrs now—honestly still learning from it every day. I mostly work with preventive care, diet logic, and prakriti-based guidance. I mean, why wait for full-blown disease when your body’s been whispering for years, right? I’m kinda obsessed with that early correction part—spotting vata-pitta-kapha imbalances before they spiral into something deeper. Most ppl don’t realize how much power food timing, digestion rhythm, & basic routine actually have… until they shift it. Alongside all that classical Ayurveda, I also use energy medicine & color therapy—those subtle layers matter too, esp when someone’s dealing with long-term fatigue or emotional heaviness. These things help reconnect not just the body, but the inner self too. Some ppl are skeptical at first—but when you treat *beyond* the doshas, they feel it. And I don’t force anything… I just kinda match what fits their nature. I usually take time understanding a person’s prakriti—not just from pulse or skin or tongue—but how they react to stress, sleep patterns, their relationship with food. That whole package tells the story. I don’t do textbook treatment lines—I build a plan that adjusts *with* the person, not on top of them. Over the years, watching patients slowly return to their baseline harmony—that's what keeps me in it. I’ve seen folks come in feeling lost in symptoms no one explained… and then walk out weeks later understanding their body better than they ever did. That, to me, is healing. Not chasing symptoms, but restoring rhythm. I believe true care doesn’t look rushed, or mechanical. It listens, observes, tweaks gently. That's the kind of Ayurveda I try to practice—not loud, but deeply rooted.
5
771 reviews
Dr. Karthika
I am currently a PG 2nd yr student in the dept of Shalakya Tantra at Parul Institute of Ayurveda and Research, batch 2024. I joined right after UG—no break—straight into PG (regular batch). I did my undergrad from Rajiv Gandhi Ayurveda Medical College (2017 batch, CCRAS syllabus under Pondicherry Univ). Somehow managed to secure 2nd rank university-wide back then, which I didn’t totally expect. Right now, my core interest lies in the Ayurvedic and integrative management of eye disorders. I’ve got decent exposure to both classical texts and clinical practice. From anatomy to pathology, I try to stay grounded in both the traditional Ayurvedic view and also the modern opthalmic understanding, especially with conditions related to the cornea, retina, and anterior segment. During PG deputation in 2nd year, I handled like 200+ OPD patients daily within 1–2 hrs (felt crazy at first but got used to the pace). I’m also trained hands-on in cataract and cornea surgeries under supervision. Not calling myself a surgeon yet, but I did get a good amout of surgical exposure in the PG postings. In terms of academics, I got 82% in the first-year PG exams—distinction score—secured department 1st and university topper at Parul Institute. Sometimes I do wonder if all this speed actually lets me go deep into each case but I’m learning to balance efficiency with proper patient care. Honestly I think that’s the biggest challenge in clinical ayurveda today—staying rooted in shastra while also being practically useful in today's overloaded OPDs. Anyway, still got a lot to learn, but I try to show up with clarity, humility and the will to keep improving every day.
5
237 reviews
Dr. Maitri Bhavesh Kumar Acharya
I am Dr. Maitri, currently in my 2nd year of MD in Dravyaguna, and yeah, I run my own Ayurvedic clinic in Ranoli where I’ve been seeing patients for 2 years now. Honestly, what pulled me into this path deeper is how powerful herbs really are—when used right. Not just randomly mixing churnas but actually understanding their rasa, virya, vipaka etc. That’s kinda my zone, where textbook knowledge meets day-to-day case handling. My practice revolves around helping people with PCOD, acne, dandruff, back pain, stiffness in knees or joints that never seem to go away. And I don’t jump to giving a long list of medicines straight away—first I spend time figuring out their prakriti, their habits, food cycle, what triggers what… basically all the small stuff that gets missed. Then comes the plan—herbs (single or compound), some diet reshuffling, and always some lifestyle nudges. Sometimes they’re tiny, like sleep timing. Sometimes big like proper seasonal detox. Being into Dravyaguna helps me get into the depth of herbs more confidently. I don’t just look at the symptom—I think okay what guna will counter this? Should the drug be snigdha, ushna, tikta? Is there a reverse vipaka that’ll hurt the agni? I ask these questions before writing any combo. That’s made a huge diff in outcomes. Like I had this case of chronic urticaria that would flare up every week, and just tweaking the herbs based on sheetala vs ushna nature... helped calm the system in 3 weeks flat. Not magic, just logic. I also work with women who are struggling with hormonal swings, mood, delayed periods or even unexplained breakouts. When hormones go haywire, the skin shows, digestion slows, and mind gets foggy too. I keep my approach full-circle—cleansing, balancing, rejuvenating. No quick fixes, I tell them early on. What I’m hoping to do more of now is make Ayurveda feel practical. Not overwhelming. Just simple tools—ahara, vihara, aushadha—used consistently, with some trust in the body’s own healing. I’m still learning, still refining, but honestly, seeing people feel in control of their health again—that’s what keeps me rooted to this.
5
606 reviews

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Amelia
6 hours ago
Really appreciated the clear advice! Practical and without side-effects was exactly what I needed. Thanks a ton!
Really appreciated the clear advice! Practical and without side-effects was exactly what I needed. Thanks a ton!
Sage
1 day ago
Really detailed and helpful response. Cleared up a lot about using Ayurveda alongside other treatments. Appreciate the clarity!
Really detailed and helpful response. Cleared up a lot about using Ayurveda alongside other treatments. Appreciate the clarity!
Hannah
1 day ago
Wow, really clear and helpful guidance! I truly appreciate the honest and detailed breakdown. Feeling more reassured about next steps. Thanks much!
Wow, really clear and helpful guidance! I truly appreciate the honest and detailed breakdown. Feeling more reassured about next steps. Thanks much!
Lila
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That response was super helpful! Appreciate the clear advice on alternative treatment, gives some hope. thanks a ton!
That response was super helpful! Appreciate the clear advice on alternative treatment, gives some hope. thanks a ton!