Products & Information

What fatty liver actually is

A healthy liver contains a little fat. When fat makes up more than about five to ten per cent of the liver's weight, it is called fatty liver, or hepatic steatosis.

There are two broad kinds. Non-alcoholic fatty liver disease is linked to weight, blood sugar, cholesterol and diet, and it is by far the more common. Alcohol-related fatty liver is caused by drinking. The distinction matters because the treatment differs, but the early stages look similar on a scan.

Fat alone is not the danger. The concern is what can follow: inflammation (steatohepatitis), then scarring (fibrosis), and in a minority of people, cirrhosis. Each of those steps takes years, which is why finding it early matters so much.

Symptoms people notice

Early fatty liver usually causes nothing at all. When symptoms do appear, they are vague and easy to dismiss:

• Tiredness that does not improve with rest
• A dull ache or feeling of fullness under the right ribs
• Loss of appetite, or feeling full quickly
• Nausea, particularly after fatty food
• Difficulty concentrating

Because the symptoms are so unremarkable, fatty liver is most often picked up on an ultrasound, or when a routine blood test shows raised liver enzymes.

Why it happens

• Carrying extra weight, particularly around the abdomen
• Type 2 diabetes or insulin resistance
• High triglycerides or abnormal cholesterol
• A diet heavy in refined carbohydrates, sugar and fried food
• Regular alcohol use
• Very little physical activity
• Certain medicines, and some inherited conditions

A point worth knowing in India: fatty liver turns up frequently in people who are not overweight by the usual measure. Waist circumference and blood sugar are often more telling than body weight alone.

How doctors treat fatty liver

There is no single tablet that dissolves liver fat. Treatment is built on changes that are unglamorous and effective, with medicines used to support them and to manage whatever else is going on.

Losing around seven to ten per cent of body weight, gradually, is the intervention with the strongest evidence behind it — it can clear fat and reduce inflammation. Stopping alcohol entirely is non-negotiable if alcohol is part of the picture. Controlling diabetes and cholesterol matters because they drive the same process.

Alongside that, doctors commonly use antioxidant and hepatoprotective support — silymarin, N-acetyl-cysteine and related agents — and treat the associated conditions directly. Your doctor will usually repeat liver function tests and sometimes a fibrosis assessment to see whether things are moving in the right direction.

What helps, day to day

• Cut sugary drinks and refined carbohydrates first — they affect liver fat faster than dietary fat does
• Aim for 150 minutes of moderate activity a week; brisk walking counts
• Build meals around dal, vegetables, whole grains and protein rather than rice or roti alone
• Lose weight slowly. Crash dieting can make liver inflammation worse
• Stop alcohol completely
• Be cautious with painkillers and unprescribed supplements — the liver processes all of them

Questions people ask about fatty liver

Leamex products used in this area of care

• Adymex 400Tablets
• Livomex-XLSuspension

What neuropathy feels like

Nerves carry two kinds of traffic: sensation inwards and instructions outwards. Damage shows up in both.

• Burning, or a feeling of walking on sand or pins
• Tingling and 'ants crawling' sensations, often worse at night
• Numbness — the feet feel dead or distant
• Sharp, electric-shock pains that come without warning
• Weakness, or feet that catch on steps
• Loss of balance in the dark, because the feet cannot report back

Symptoms usually start in the toes and move upwards in both feet — the classic 'stocking' pattern. Hands come later, if at all.

Why nerves get damaged

• Diabetes — years of high blood sugar damage the small vessels that feed nerves. This is the leading cause
• Vitamin B12 deficiency, which is widespread in vegetarian diets and in long-term metformin users
• Regular alcohol use
• Underactive thyroid
• Kidney disease
• Certain medicines, including some used in tuberculosis and chemotherapy
• Nerve compression, such as a slipped disc or carpal tunnel

How it is treated

Treatment runs on two tracks at once. The first is removing the cause: getting blood sugar under control, correcting a B12 deficiency, stopping alcohol, treating the thyroid. This is what stops the damage progressing, and nothing else substitutes for it.

The second is supporting repair and controlling symptoms. Doctors commonly prescribe methylcobalamin, the active form of B12 that nerve tissue uses, often with alpha lipoic acid, an antioxidant studied specifically in diabetic neuropathy. Where pain is significant, specific neuropathic pain medicines are added — ordinary painkillers work poorly on nerve pain.

Recovery is slow. Nerves regenerate at roughly a millimetre a day at best, so improvement is judged over months, not weeks.

Foot care that prevents amputations

This section matters more than any medicine on this page. When feet lose sensation, injuries go unnoticed, and a small unnoticed wound is how most diabetic foot amputations begin.

• Look at the soles of both feet every single day, using a mirror if you cannot bend easily
• Never walk barefoot, including inside the house
• Check inside footwear with your hand before putting it on
• Test bath water with your elbow, not your foot
• Keep feet dry between the toes and moisturise the heels
• Get any cut, blister, crack or colour change seen the same week — not next month

Questions people ask about nerve pain & numbness

Leamex products used in this area of care

• Neuromex-PlusCapsules
• Calmex-K2 7 (Calmex-K27)Softgel Capsules

What reflux actually is

A ring of muscle sits where the food pipe meets the stomach, and it is supposed to stay shut except when you swallow. When it relaxes at the wrong moment, stomach acid travels upwards. The stomach is built to handle that acid; the food pipe is not.

Separately, if the stomach empties slowly, food and acid sit around longer and pressure builds — which is why bloating, fullness and reflux so often arrive together, and why doctors sometimes treat both the acid and the motility.

Symptoms

• Burning behind the breastbone, often after meals or lying down
• Sour or bitter fluid coming into the throat
• Belching and a bloated, overfull feeling
• Nausea
• A persistent dry cough, hoarseness, or a lump-in-throat feeling
• Chest discomfort — which must be distinguished from heart pain

If chest pain is heavy, spreads to the arm or jaw, or comes with sweating or breathlessness, treat it as a possible heart problem and seek emergency care. Do not assume it is acidity.

Common triggers

• Large meals, and eating late at night
• Fried and very spicy food
• Tea, coffee and carbonated drinks
• Smoking and alcohol
• Extra weight around the abdomen
• Lying down within two to three hours of eating
• Certain medicines, especially painkillers and some blood pressure tablets
• Stress and irregular meal timing

How it is treated

Mild, occasional reflux is managed with timing and portion changes and an antacid when needed. Persistent symptoms are usually treated with a proton pump inhibitor such as pantoprazole, which reduces acid production and lets the food pipe heal. Where bloating and slow emptying are prominent, a prokinetic such as domperidone may be added.

Two things are worth knowing. First, proton pump inhibitors work best taken 30 to 60 minutes before breakfast, not after meals — a large share of people take them at the wrong time and conclude they do not work. Second, they are meant to be reviewed. Long-term unsupervised use is linked to low magnesium, low vitamin B12 and other problems.

What helps without a prescription

• Eat smaller meals, more often
• Finish dinner three hours before lying down
• Raise the head end of the bed by six inches — pillows alone do not work, they bend you at the waist
• Lose weight around the middle if there is any to lose
• Stop smoking
• Keep a one-week diary of what you ate and when symptoms came; the pattern is usually obvious

Questions people ask about acidity & reflux

Leamex products used in this area of care

• Paromex-DSRCapsules

Wear versus inflammation

Osteoarthritis is mechanical. Cartilage — the smooth surface that lets bone glide on bone — thins with years, load and injury. It typically affects knees, hips, the lower back and the hands, hurts more as the day goes on, and eases with rest. Morning stiffness is brief, usually under half an hour.

Rheumatoid arthritis is immune. The body attacks the lining of its own joints. It tends to affect the small joints of hands and feet, symmetrically, and morning stiffness lasts well over an hour. Joints look visibly swollen and feel warm, and people often feel generally unwell and tired.

That last pattern needs early specialist assessment. Treatment started early in rheumatoid arthritis prevents joint destruction that cannot be undone later.

Other common causes

• Sprains, strains and sports injuries
• Gout — sudden, severe pain often starting in the big toe
• Low back pain from muscle strain or a disc problem
• Tendon and ligament injuries from repeated use
• Pain after surgery, while tissue is healing
• Age-related stiffness without significant joint damage

How joint pain is treated

For acute pain with swelling — a sprain, an injury, recovery after surgery — treatment aims at the inflammation. Anti-inflammatory medicines are used for short courses, sometimes combined with proteolytic enzymes intended to clear the inflammatory fluid that makes an area feel tight.

For long-term wear, the approach is different and slower. Cartilage-support formulations containing collagen peptides, chondroitin and hyaluronate are used over months rather than days. They are not painkillers, and expecting overnight relief from them is the commonest reason people abandon them too early.

For inflammatory arthritis, disease-modifying medicines prescribed by a rheumatologist are the treatment. Nothing available over a pharmacy counter substitutes for them.

The part that is not a tablet

For an arthritic knee, strengthening the muscle around it does more than any supplement. Weak quadriceps mean the joint absorbs load the muscle should have taken.

• Straight-leg raises and sit-to-stand practice, daily
• Walking and cycling rather than stairs and squatting
• Losing weight — each kilogram removed takes several off the knee
• Avoiding deep squatting and sitting cross-legged on the floor for long periods
• Warmth before activity, ice after, if swelling is the problem
• A physiotherapist's assessment early, rather than after years of pain

Questions people ask about joint pain & arthritis

Leamex products used in this area of care

• Enzomex-RBTablets
• Tendomex-LTablets

What happens to bone

Throughout life, bone is broken down and rebuilt. Up to around the age of thirty, building wins and bone density peaks. After that the balance slowly tips the other way. In women, the years around menopause accelerate the loss sharply as oestrogen falls.

Osteopenia is the stage where density has fallen but not yet to the level called osteoporosis. It is a useful warning rather than a diagnosis to panic about — most of what prevents progression is available to anyone.

Who is at risk

• Women after menopause, and men over sixty
• A parent who fractured a hip
• A small, thin frame
• Low calcium intake, common where dairy is limited
• Vitamin D deficiency — widespread in India despite the sunshine
• Long-term steroid use
• Smoking and regular alcohol
• Thyroid or parathyroid disorders
• Long periods of inactivity or bed rest

Vitamin D deficiency deserves a note. Indoor work, covered clothing, pollution and darker skin all reduce how much vitamin D the skin makes, and deficiency is very common across Indian cities.

How it is managed

Treatment starts with the raw materials: enough calcium, enough vitamin D, and enough protein. Adults generally need around 1000 mg of calcium daily, rising to about 1200 mg after menopause and over seventy. Food sources come first — milk, curd, paneer, ragi, til, almonds, green leafy vegetables and small fish eaten with bones.

Where diet cannot reach it, supplements are used. Doctors increasingly prescribe combinations that pair calcium with active vitamin D and vitamin K2-7, on the reasoning that vitamin D helps absorb calcium while K2 helps direct it into bone rather than into soft tissue.

In established osteoporosis, specific bone-preserving medicines are prescribed after a bone density scan. Those are a separate decision made with your doctor, and supplements do not replace them.

What builds bone, practically

• Weight-bearing exercise — walking, stair climbing, light resistance work. Bone thickens in response to load
• Balance work such as standing on one leg; preventing the fall matters as much as strengthening the bone
• Fifteen to twenty minutes of sunlight on arms and face, several times a week
• Enough protein at each meal
• Stopping smoking, and limiting alcohol
• Fixing trip hazards at home — loose mats, poor lighting, wet bathroom floors

Questions people ask about bone weakness

Leamex products used in this area of care

• Tendomex-LTablets
• Calmex-K2 7 (Calmex-K27)Softgel Capsules

What they look like

Depression is more than sadness. It is a persistent flatness that lasts most of the day, most days, for two weeks or more, and it takes the pleasure out of things that used to provide it.

• Low mood, or feeling empty and numb
• Losing interest in things you normally enjoy
• Sleeping badly, or sleeping far too much
• Appetite and weight changing noticeably
• Exhaustion that rest does not fix
• Difficulty concentrating or making small decisions
• Guilt, or feeling worthless
• Thoughts that life is not worth continuing

Anxiety shows up differently: constant worry that is hard to switch off, restlessness, irritability, a racing heart, tight chest, churning stomach, sweating, and broken sleep. In India it very often presents physically — as headaches, stomach trouble, or palpitations that investigations find nothing wrong with.

How treatment works

Treatment usually combines medicine and therapy, and the combination works better than either alone for most people.

Antidepressants such as SSRIs take two to four weeks to start working, and up to six to eight weeks for full effect. This delay is the single biggest reason people stop too early and conclude the medicine failed. Sometimes a short course of an anti-anxiety medicine is added at the start to cover that gap, and then withdrawn.

Talking therapy — cognitive behavioural therapy in particular — gives you tools that outlast the prescription. Where a therapist is not available locally, Tele-MANAS offers free counselling by phone in multiple Indian languages.

Treatment usually continues for months after you feel better, because stopping as soon as mood lifts is the most common route back to relapse. Any change to the dose should be planned with your doctor and tapered.

What helps alongside treatment

• Regular sleep and wake times, even at weekends
• Daily movement — even a twenty-minute walk has measurable effect
• Sunlight in the morning
• Telling one person you trust, so you are not managing it alone
• Cutting alcohol, which reliably deepens depression
• Limiting late-night screen use and doom-scrolling

None of these replace treatment. They make treatment work better.

Free help in India

Tele-MANAS is the Government of India's national mental health helpline, run by the Ministry of Health and Family Welfare. It is free, available 24 hours a day, and offers support in a wide range of Indian languages. Call 14416 or 1-800-891-4416.

If someone is in immediate danger, call 112 or go to the nearest emergency department.

Questions people ask about anxiety & depression

Leamex products used in this area of care

• Esco-PlusTablets
• Trypmax-CZTablets

What an allergy is doing

An allergy is the immune system reacting hard to something harmless. It releases histamine, which produces the immediate sneezing, itching and runny nose, and leukotrienes, which produce the slower, stubborn part — blocked nose and narrowed airways.

That is why one medicine often is not enough. Antihistamines handle the histamine arm well and the leukotriene arm poorly, which is why combinations are used where congestion or chest symptoms dominate.

Common triggers in India

• Dust mites in bedding, mattresses and soft furnishings
• Pollen, with seasonal peaks in spring and autumn
• Mould, particularly through the monsoon
• Cockroach debris — a major and under-recognised trigger
• Pet dander
• Vehicle exhaust and construction dust
• Smoke from cooking fuel, incense and cigarettes
• Sudden cold air, and strong perfumes

Symptoms at each end

In the nose and eyes: bouts of sneezing, a clear runny nose, blocked nose, itching in the nose, throat and ears, and red, watery eyes. Children often rub the nose upwards repeatedly.

In the chest: cough, especially at night or after exercise, wheeze, breathlessness and chest tightness.

On the skin: urticaria — raised itchy weals that appear and fade within hours, often moving around the body.

How it is treated

Avoiding the trigger comes first where it is possible. Then antihistamines, of which the modern non-drowsy ones such as fexofenadine are preferred for daytime use. Nasal steroid sprays are the most effective single treatment for persistent allergic rhinitis and are under-used, largely because people expect instant relief and stop before the spray has had its several days to work.

Leukotriene blockers such as montelukast are added where congestion is prominent or asthma coexists. For asthma, inhaled preventers are the foundation of treatment, and a reliever inhaler is for attacks only.

One safety point worth repeating: montelukast carries a warning about mood and behaviour changes in both adults and children — agitation, sleep disturbance, low mood. If you notice a change in yourself or your child after starting it, contact your doctor.

Reducing exposure at home

• Wash bedding weekly in hot water and sun-dry it
• Replace heavy curtains and carpets in the bedroom where possible
• Keep windows shut on high-pollen mornings and during nearby construction
• Fix damp patches and clean bathroom mould
• Deal with cockroaches properly rather than repeatedly
• Do not smoke indoors, and ventilate the kitchen while cooking

Questions people ask about allergy & asthma

Leamex products used in this area of care

• Fexomex-MTablets

Causes worth ruling out

Most persistent fatigue has a findable cause, and several of the commonest are cheap to test for.

• Iron deficiency anaemia — extremely common in Indian women
• Vitamin B12 deficiency, particularly in vegetarians and long-term metformin users
• Vitamin D deficiency
• Thyroid disorders, especially an underactive thyroid
• Undiagnosed or poorly controlled diabetes
• Chronic infection, including tuberculosis
• Depression and anxiety, which very often present as fatigue
• Poor sleep, including obstructive sleep apnoea
• Kidney or liver disease

Tests worth asking about

If tiredness has lasted more than a month, a reasonable first panel is a complete blood count, ferritin, vitamin B12, vitamin D, thyroid function, fasting blood sugar or HbA1c, and basic kidney and liver tests. It is inexpensive, widely available, and it either finds the answer or narrows it considerably.

Where nutritional support fits

Once serious causes are excluded — or treated — nutritional support has a real role. It helps most in convalescence after an illness or surgery, where appetite is poor, in growing children with limited diets, and in demonstrated micronutrient shortfalls.

Formulations combining a B-complex with antioxidants such as lycopene and vitamins C and E, plus zinc and other trace minerals, are used in that setting. A liquid is often better accepted than a tablet where appetite is poor.

What they do not do is fix anaemia, an underactive thyroid or untreated diabetes. Taking a tonic for months while one of those goes undiagnosed is the outcome worth avoiding.

Supporting immunity, realistically

• Sleep seven to eight hours — the strongest lever anyone has
• Eat protein at every meal; immune cells are built from it
• Correct a vitamin D deficiency if you have one
• Stay physically active, moderately and regularly
• Keep vaccinations up to date, including the annual flu shot if your doctor advises it
• Manage long-term stress — it measurably suppresses immune function

Nothing 'boosts' immunity beyond normal. The realistic goal is removing what is holding it below normal.

Questions people ask about weakness & low immunity

Leamex products used in this area of care

• Lycomex-LSyrup
• Livomex-XLSuspension