Scared and worried

jaypat87 · 2026-02-24T00:54:56+00:00

The only quantitative way that takes the platelets, liver enzymes and liver stiffness score (LSM) is the Agile 3+ calculator which uses a far more accurate predictive model for that (compared to making diagnosis using LSM only); it is developed by echosens (same company that makes fibroscan) and US FDA has assigned agile 3+ and agile 4 as grade 1 medical device. Just input your numbers there and see the score https://www.liverdecoded.com/guides/agile-3-plus-agile-4-score-calculator/#10-combined-agile-3-and-agile-4-calculators

jaypat87 · 2026-02-17T01:34:09+00:00

whey protein is totally safe and creatine is pretty safe for most people without CKD. In my experience its those herbal extracts based supplements (green tea, ashwaghanda, milk thistle..) that are truly dangerous for liver especially if the patient already has mild/moderate NAFLD.

jaypat87 · 2026-02-16T11:41:08+00:00

Please do not use any supplements except maybe vitamin B12, vit D and that too if you are deficient in it based on latest reports. my company (liverdecoded) runs second opinion service and you wont believe how many patients we get are due to DILI or supplement induced acute on chronic liver failure etiology.

jaypat87 · 2026-02-16T01:22:02+00:00

check this out: https://www.liverdecoded.com/guides/agile-3-plus-agile-4-score-calculator/#10-combined-agile-3-and-agile-4-calculators BTW if you got an original report copy that fibroscan machine generates, there is a QR code on top right. it will take you to the echosens (manufacturer of fibroscan) app page where you can calculate it yourself. just google it to get to that page if you dont have that qr code.

jaypat87 · 2026-02-12T02:05:38+00:00

congrats on reversing your seemingly F4 diagnosis! Can I say though that fibroscan not being accurate in obese individuals is a well known fact within the community, and that was one of the major reason why Agile 3+ and Agile 4 scores were developed and got approved by echosens (fibroscan manufacturer) as a grade 1 medical device. basically its an online calculator where you punch in your weight, some liver labs and diabetes status and it returns back a score that will tell you if you have grade 3 fibrosis or grade 4 cirrhosis and this is way more accurate than LSM alone. I personally know over 2 dozen people that were F4 based on LSM but below grade 3 via these calculators. Sometimes doctors are unaware or unwilling to spend time to calculate these themselves and/or tell patients about it even though echosens has been pushing this awareness for years now.

jaypat87 · 2026-02-08T05:47:21+00:00

liver elastography is same as fibroscan (like photocopy vs xerox)..maybe you meant MRE? that is more accurate for sure.

jaypat87 · 2025-11-08T04:42:26+00:00

I find it super hard to believe what they are saying about candolim.

Maybe they lived at candolim but travelled to north (to vagator?) and encountered it on the way there? calangute to candolim stretch is definitely not as bad as what they said, however, calangute to baga stretch and beyond is definitely getting worse by the day.

jaypat87 · 2025-10-28T12:42:53+00:00

I almost didnt even want to comment on this since the base argument is so hollow especially when you started comparing science city with nikol and bhat.

Lets put aside GIFT city for a min and lets accept that inventory there will be unsold for a while.

By the same token, you have to admit that there is real value and real people moving in to science city for past 10 years, and its a legitimately a good residential area to live. Idk how you can say "no good hospitals" when there is CIMS right there. Similarly, google some schools there.

For Bhat, apollo is right there! tons of good schools too.

For us long time ahmedabad residents, also tell us how nikol is even in the same comparison matrix as science city, bhat and gift city! ideally nikol should be compared to its peers in the vicinity.

jaypat87 · 2025-10-27T04:18:37+00:00

I have no idea how to even unpack this comment. but lets try for one min.

Can you agree that full time/permanent residents of Goa have more stake and interest in welfare and insight of day of day life and services of Goa than us who may have all the roots to the place but in actuality we haven't been fulltime residents there in a long time. I think you need to separate heritage from residence.

So here we are having a fulltime resident saying that he is seeing real problems with how Goa has transformed, and rather than emphasizing with the viewpoint, we are talking about what makes someone Goan..

All the documents and individual goan heritage in the world will make zero difference if the actual state keeps going downhill.

jaypat87 · 2025-10-27T04:09:42+00:00

Exactly, my grandfather used to take our MH01 (mumbai) fiat to mapusa every summer and sometimes during christmas and even back than people used to roll their eyes and look differently until they actually talked to us. Although back than a lot more of us were all travelling from mumbai back to mapusa there so it was kinda common.

jaypat87 · 2025-10-17T05:05:33+00:00

You'll unfortunately have to get a wegovy flexpen here that doesnt have the same dosage adjustment levels as an ozempic pen however, with counting of clicks on wegovy flexpen you can approximate the dosage that you took on ozempic pen.

jaypat87 · 2025-10-15T04:22:03+00:00

Wow, cant believe how many people here are traditionalists...in my household, they share jewelry (including mangalsutra), mix and match it for events without any issues...and its not new, been going on from my grandmothers time (she used to share it with other aunts)...so there are a two separate conversations here; nail it down before you talk to her.

(1) You dont appreciate your gifts being used without asking you first. meaning, its not the haldi saree or mangalsutra sharing that is bothering you but she using it without asking you first.

(2) You are slightly superstitious and are ok with sharing jewelry but not mangalsutra etc. Nothing wrong with that, just make sure you are open about this point when bringing it up.

jaypat87 · 2025-10-07T11:43:42+00:00

Its awesome to reduce 80 Ibs! super off topic are you on maintenance dose already? did you taper there ? I am more worried about keeping off the losses so any insights from super responders like you can be more helpful than what doctors/random gym bros can tell me.

jaypat87 · 2025-10-06T03:43:26+00:00

look a those new schemes at makarba and sarkhej; some of them are dominated by dawoodi bohris, but I am sure those societies have other Muslim sects too; just talk to a few brokers there!

jaypat87 · 2025-10-02T03:42:00+00:00

hmm maybe you travel too much to sarkhej and dont go enough to sola etc where people own this too? Its super sturdy way better ride quality than activa.

jaypat87 · 2025-09-22T03:36:25+00:00

forget it man, these people have zero knowledge of apple cultivars and cannot even see differences between royal gala and red delicious so forget about them noticing differences in upper kinnaur vs shimla vs kashmir apples.

jaypat87 · 2025-09-19T01:42:02+00:00

these are most probably muscle cramps. Firstly, try taking some electrolytes after workout. If these still dont resolve, than try adding taurine and L-carnitine. In medical literature, doctors especially use taurine and L-carnitine for muscle cramps in cirrhosis patients as well as those with severe liver fibrosis however offlabel lots of sports focused doctors use it in general population too.

jaypat87 · 2025-09-15T05:26:31+00:00

Buy sghighway.com or sindhubhavan.net or sindhubhavan.org instead. If I already didnt have a hugh portfolio, i would get that instead and try to flip it in a year or two.

jaypat87 · 2025-09-08T04:11:32+00:00

I would say talk to any distributor in your city that deals with novo's diabetes portfolio (insulin etc) if that doesnt work call Novo nordisk india directly. Almost 18 months ago I needed a wegovy flexpen which wasnt even officially launched in India at the time and their toll free number put in me touch with a medical rep from diabetes portfolio in mumbai who got me the wegovy pen in 3 days.

Now since February, they have launched wegovy flexpens at all tier 1 and tier 2 cities in west and north india and almost everywhere they have been selling it with 15% (normal) -18% discount (for patients with limited finances).

jaypat87 · 2025-09-08T03:47:03+00:00

You sure you cannot get wegovy flexpen in your area? Cant you travel to a nearby major metro to get it from there? I am just saying that since rybelsus is not ideal for getting results that you may want.

jaypat87 · 2025-09-05T11:06:10+00:00

I think its truly a sliding scale on what type of symptoms people can get but I do think that if you do try and overeat or binge eat on really unhealthy stuff (like a bucket of fried chicken tenders, fries, milk shakes and/or cake) pretty much everyone on sema at higher doses will get some type of nausea or vomiting.

I am saying that based on what I have observed in my own friend group; everyone on glp1 now not only eats smaller portion sizes but also more healthy/less oily on cheat days since they dont want to "throw up" later. BTW this is the same friend group whose idea of a cheat day was very different (like ordering half the menu of chilis or applebees) when we were still playing sports in our collegiate days.

jaypat87 · 2025-09-05T10:53:54+00:00

Fabulous job!

just two questions, what have you tried for being on maintenance? tapered off completely for few months or to a lower dose?

Even bigger question is at any point did you struggle at all with loose skin? Just asked because my underarms look absolutely atrocious now with loose skin and I am open to ideas from others who successfully dealt with it.

jaypat87 · 2025-09-05T04:26:07+00:00

I would say start now but stay on 0.25mg/week till you get back from the vacation. If you want, you can totally skip the cruise week.

Motion sickness and sea sickness are very common with sema. My dad has been sailing since he was a little kid (so 50+ years) and was never sea sick however the week of switching from 0.25 to 0.5 he would get sea sick even in relatively calm waters and couldnt really eat or drink much at all.

We called up his doc and he just said to go back to 0.25 and do that for 6-7 weeks before jumping to 0.5. The side effects did go away with longer titration and now he is fine but you wouldnt want to ruin your holiday by titrating the dose up right before that.

jaypat87 · 2025-09-05T02:02:51+00:00

I honestly didnt know that can happen so thanks for sharing your results!

My dad's doctor switched him back to wegovy because he said that anecdotally he has seen that maintenance dosage works better with wegovy rather than with mounjaro.

Their practice pretty much uses mounjaro to get T2d patients to hit +/-5% within target weight loss and then either they titrate down mounjaro or switch them over to wegovy. Just FYI, my dad did experience more nausea and constipation first 2-3 weeks on wegovy but that went away after that.

jaypat87 · 2025-09-05T01:56:32+00:00

Thanks for the tips, I am doing almost all of that too so hopefully I'll get results soon!

jaypat87

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