Appearance: white to yellow crystals. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment. These medications include antidepressants such as selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, and monoamine oxidase inhibitors. A small amount of selenium is added during the glass manufacturing procedure, where it removes the green tint produced by the iron impurities. Apart from beneficial effects, its application can cause diverse side effects. This information is for educational and informational purposes only and is not medical advice. Call your doctor if you experience any unusual symptoms while you are taking this medication. Although Lithium is useful for the human body, excessive intake of Lithium is not recommended as this chemical element can cause diarrhea, nausea and tiredness due to its toxicity. It works as a mood stabilizer and can help decrease the intensity of manic episodes while also making the symptoms of depressive episodes less severe. Is exercise more effective than medication for depression and anxiety? LiCdGeSeand LiCdSnSe: Strong Nonlinear Optical Response in Quaternary Diamond-Like Selenide Networks. The American Association of Psychiatric Pharmacists disclaims any and all liability alleged as a result of the information provided herein. Sometimes, a doctor may have difficulty telling whether a person is depressed or experiencing cognitive dulling due to lithium treatment. Lithium is a drug that doctors prescribe to people with bipolar disorder. Measure liquid medicine carefully. Please review before taking this medication. What is the latest research on the form of cancer Jimmy Carter has? n-butyllithium, C 4 H 9 Li is the key reagent produced on large scale, commercially. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Lithium is an effective mood stabilizer. Li 2 Se (MW 92.84) InChI = 1S/2Li.Se InChIKey = PEXNRZDEKZDXPZ-UHFFFAOYSA-N (nucleophilic agent for synthesis of organic selenides 1, 2). If you notice any other effects, check with your healthcare professional. Stop taking lithium and seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Ionic bonds are formed when positively charge cation (Li+ ) is attracted towards negatively charged anion (S2u2212 ). Stop using sodium chloride and call your doctor at once if you have a serious side effect such as: nausea and vomiting; stomach pain; or. Any other psychiatric or medical problems you have, All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have. LICENSED GRANTED TO MAKE UNLIMITED PAPER COPIES FOR INTERNAL USE ONLY. However, it does act on the central nervous system. The above information is believed to be correct but does not purport to be all inclusive and shall be used only as a guide. Lithium affects the flow of sodium through nerve and muscle cells in the body. Last medically reviewed on October 1, 2019, This article explores what lithium is and the conditions it can treat. privacy practices. Typical and custom packaging is available. Ask your doctor before making any changes in how or when you take your medications. Can diet help improve depression symptoms? O Barium sulfate . Therefore, doctors do not recommend that a person nurses their child while taking lithium. Lithium levels should be monitored monthly in early pregnancy and weekly near delivery. Lithium carbonate tablets USP, lithium carbonate capsules USP, lithium oral solution USP. No currently available medication can treat a lithium overdose. Organic Synthesis Lithium is also used in organic synthesis at both laboratory and industrial scales. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. Acute Control: Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Medically reviewed by Philip Thornton, DipPharm. Although not specifically important, many materials are assessed on the basis of their Li 2 O content. The number of electrons in each of Lithium's shells is [2, 1] and its electron configuration is [He] 2s1. The following are trademarks of NAMI: NAMI, NAMI Basics, NAMI Connection, NAMI Ending the Silence, NAMI FaithNet, NAMI Family & Friends, NAMI Family Support Group, NAMI Family-to-Family, NAMI Grading the States, NAMI Hearts & Minds, NAMI Homefront, NAMI HelpLine, NAMI In Our Own Voice, NAMI On Campus, NAMI Parents & Teachers as Allies, NAMI Peer-to-Peer, NAMI Provider, NAMI Smarts for Advocacy, Act4MentalHealth, Vote4MentalHealth, NAMIWalks and National Alliance on Mental Illness. tell your doctor and pharmacist if you are allergic to lithium or any other medications. The Write the formulas of these compounds and state their use. Also tell your doctor if you or anyone in your family have or have ever had Brugada syndrome (a disorder that can cause a potentially fatal irregular heart rhythm) or if anyone in your family has died suddenly with no explanation before the age of 45 years. It does not represent any guarantee of the properties of the product. Rare kidney problems have been associated with long-term use of lithium. See reverse side of invoice or packing slip for additional terms and conditions of sale. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Hyperparathyroidism can affect the bodys ability to detect calcium, leading to a condition called hypercalcemia in which a persons calcium levels become too high. Vacuum up spill using a high efficiency particulate absolute (HEPA) air filter and place in a closed container for disposal. -Usual dose: 1800 mg/day Avoid drinking alcohol or using illegal drugs while you are taking lithium. Can poor sleep impact your weight loss goals? , each unit cell has 4 units.[1]. It has the highest specific heat and electrochemical potential of any element on the period table and the lowest density of any elements that are solid at room temperature. Even though data suggest that the risk of Ebsteins anomaly from first trimester use of lithium is very low, an ultrasound of the heart is recommended at 16 to 20 weeks of gestation. Lithium is widely used in medicine and the therapy is often long term. -Extended release formulations: 900 mg orally in the morning and at nighttime Early side effects of high lithium levels . The information in this document is based on the present state of our knowledge and is applicable to the product with regard to appropriate safety precautions. [1] References[edit] 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. -Maintenance dose: 900 to 1200 mg/day tanker trucks. Lithium is a member of the alkali group of metals. Below are the recommended starting dosages of lithium for bipolar I disorder. Research and sample quantities and hygroscopic, oxidizing or other air sensitive materials may be packaged under argon or vacuum. Lithium (atomic symbol: Li, atomic number: 3) is a Block S, Group 1, Period 2 element with an atomic weight of 6.94. Avoid over the counter and prescription pain medications that contain nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen (Motrin, Advil) or naproxen (Aleve, Naprosyn) because these medications can increase the risk of toxicity from lithium. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. The risk increases with high levels of lithium. -Extended release formulations: 600 mg orally in the morning and at nighttime Talk to your doctor if you notice you are urinating more frequently than usual. 2022 The American Association of Psychiatric Pharmacists (AAPP) and the National Alliance on Mental Illness (NAMI). Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. pails, fiber and steel drums to 1 ton super sacks in full container (FCL) or truck load (T/L) quantities. AAPP and NAMI make this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. URL of this page: https://medlineplus.gov/druginfo/meds/a681039.html. A woman who is taking lithium and planning on becoming pregnant should talk to her doctor. Taking lithium increases the risk of a birth abnormality called Ebsteins anomaly. If you miss a dose of lithium, take it as soon as you remember, unless it is closer to the time of your next dose. -Extended release formulations: 900 mg orally in the morning and at nighttime Copyright 1996-2023 Cerner Multum, Inc. Available for Android and iOS devices. Because of its high reactivity, elemental lithium does not occur in nature. fine hand movements that are difficult to control, movements that are unusual or difficult to control, fast, slow, irregular, or pounding heartbeat, hallucinations (seeing things or hearing voices that do not exist), painful, cold, or discolored fingers and toes, swelling of the feet, ankles, or lower legs, shaking of a part of your body that you cannot control, muscle weakness, stiffness, twitching, or tightness. All FDA black box warnings are at the end of this fact sheet. Lithium is in a class of medications called antimanic agents. Room Temperature Intrinsic Ferromagnetism in Epitaxial Manganese Selenide Films in the Monolayer Limit. You should not breast-feed while using this medicine. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Only use equipment tested and approved under appropriate government standards.Protective Gloves: Rubber glovesEye Protection: Safety glasses or goggles, Full face protectionBody Protection: Protective work clothing. 1 For large-scale preparations, reduction of Se . Registered Trademark. Explore the different options for supporting our mission. Save my name, email, and website in this browser for the next time I comment. Lithium oxide ( Li. If Material Is Released/Spilled: Wear appropriate respiratory and protective equipment specified in special protection information. Do not change the amount of salt you consume in your diet. One of the most common applications of selenium is in the glassmaking industry. A person usually takes lithium 13 times per day, with or without food. Long-term Control: Copyright 2021 NAMI. F Sodium chloride side effects. Simultaneous Detection of Mitochondrial Hydrogen Selenide and Superoxide Anion in HepG2 Cells under Hypoxic Conditions. dry mouth, increased thirst or urination; This is not a complete list of side effects and others may occur. Mayo Clinic does not endorse companies or products. Glassmaking Industry. Get emergency medical help if you have signs of an allergic reaction to lithium: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. A person should always follow the recommended dose of lithium, as too much can cause lithium toxicity. All rights reserved. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. [Ge6Se12]n chains constructed by ethane-like [Ge2Se6]6- clusters. EPA Applications/Systems. The origin of the name Selenium comes from the Greek word "Seln," meaning moon. It forms a solid yellow-white deliquescent powder. Discontinuing caffeine use may increase lithium levels. Long-term Control: Do not use lithium without telling your doctor if you are pregnant. 1. You may need urgent medical care. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. However, you should not flush this medication down the toilet. Your doctor may tell you not to take lithium or may monitor you more carefully for side effects. Follow these directions carefully. Other short term side effects that a person may experience when first taking lithium include: Another potential side effect is cognitive dulling, which is when a person does not feel as sharp or alert as they once did. What is a proper diet to go on with lithium? Tell your doctor if you have been sweating excessively, or if you are sick with fever, vomiting, or diarrhea. It is not known how lithium works to stabilize a person's mood. -Regular release formulations: 300 mg orally 3 to 4 times a day Learn the common signs of mental illness in adults and adolescents. The origin of the name Lithium comes from the Greek wordlithose which means "stone." It is approved for the treatment of bipolar disorder (also known as manic depression). Lithium is a member of the alkali group of metals. Can diet help improve depression symptoms? Lithium can be life changing for those who find bipolar disorder difficult to manage, but its use does come with side effects. -Extended release formulations: 600 mg orally in the morning and at nighttime Thus, lithium and sulfur form an ionic bond. Preparative Methods: reduction of Selenium with Lithium in liquid ammonia produces red-brown Li 2 Se after NH 3 . Treatment generally involves monitoring the person, correcting their electrolyte levels, and performing dialysis to filter their blood. Lithium may also be helpful when prescribed off-label for depression, especially when combined with antidepressant medications. If you become pregnant while taking lithium, call your doctor. A doctor will often prescribe a low initial dose of lithium. Early signs of toxicity include: vomiting, diarrhea, drowsiness, muscle weakness, or loss of coordination. Your doctor may have to change the doses of your medication or monitor you more carefully for side effects. Risk assessment should be performed to determine if air-purifying respirators are appropriate. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Version: 6.01. fluoxetine, quetiapine, lamotrigine, Seroquel, Abilify, Prozac, aripiprazole, olanzapine, risperidone, Depakote. Elevated lithium levels can result in a range of unpleasant symptoms. [83] ), while Instead, they tend to opt to monitor a womans lithium levels very closely. 1907/2006 (REACH). A person should also seek urgent medical care if they are having suicidal thoughts, thinking of self-harming, or feel that they are a danger to themselves or other people. If a person already taking lithium becomes pregnant, they should discuss their lithium dosage with a doctor. Objective. 3 Reaction of Se with 2 equiv Lithium Triethylborohydride in THF gives a suspension of Li 2 Se. All rights reserved. The lithium atom has a radius of 152 pm and a Van der Waals radius of 181 pm. Lithium is in a class of medications called antimanic agents. Lithium Selenide (LiSe) is generally immediately available in most volumes. Lithium is for use in adults and children at least 7 years old. They may also wish to talk with a mental health professional about other care. So, when lithium and sulfur combine, it forms an ionic bond. In its elemental form, lithium is soft enough to cut with a knife its silvery white appearance quickly darkens when exposed to air. Keep the bottle tightly closed when not in use. LITHIUM CHLORIDE AS A SUBSTITUTE FOR SODIUM CHLORIDE IN THE DIET: Observations on Its Toxicity | JAMA | JAMA Network In view of the increasing emphasis on restriction of sodium intake in the management of cardiac decompensation and other conditions, a harmless substitute for s [Skip to Navigation] Chemistry. Symptoms of severe lithium toxicity include increased temperature, seizures, and low blood pressure. The dose usually ranges from 600 mg to 1200 mg daily, but some people may require higher doses depending on weight or symptoms. Too much lithium over time can also cause serotonin syndrome, an accumulation of serotonin in the body that can be life threatening. What is the formula for lithium selenide? Lithium toxicity can occur if a person takes too much of a lithium-containing medication. Gitlin, M. (2016). Lithium toxicity is closely related to lithium blood levels and can occur at doses close to therapeutic levels; lithium levels should be monitored closely when starting the medication or if individuals experience side effects of the medication. energized behavior. Compared to other metals, it has one of the lowest boiling points. Do not stop taking lithium without first speaking to your health care provider. 2 O) or lithia is an inorganic chemical compound. Lithium selenide is an inorganic compound that formed by selenium and lithium. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Drug information provided by: IBM Micromedex. A lithium-sparing effect of the NSAID sulindac is reported here. Generic alternatives may be available. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Copyright, 2023. Shipping documentation includes a Certificate of Analysis and Safety Data Sheet (SDS). To make sure this medicine is safe for you, tell your doctor if you have ever had: an abnormal electrocardiograph or ECG (sometimes called an EKG); Some medicines can interact with lithium and cause a serious condition called serotonin syndrome. Do not blow dust off clothing or skin with compressed air.Ventilation: Provide sufficient ventilation to maintain concentration at or below threshold limit. Lithium a mood stabilizer that is a used to treat or control the manic episodes of bipolar disorder (manic depression). It is a white solid. Lithium For Bipolar Disorder - Pros And Cons Unclear, Bipolar disorder treatment: New evidence may explain limits of lithium. Platinum (II) chloride, also known as platinum dichloride, is a inorganic compound used as raw material or precursor on the synthesis of other platinum compounds. In this article, we outline some of the more common short term and long term side effects of taking lithium. It has the highest specific heat and electrochemical potential of any element on the period table and the lowest density of any elements that are solid at room temperature. It is a selenidewith a chemical formula Li2Se. Remove any contaminated clothing. Lithium can cause side effects that may impair your thinking or reactions. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, https://link.springer.com/article/10.1186/s40345-015-0028-y, https://www.hindawi.com/journals/crim/2015/473931/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5164879/, https://cks.nice.org.uk/hypercalcaemia#!topicSummary, https://www.nami.org/learn-more/treatment/mental-health-medications/lithium, https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/017812s028,018421s027lbl.pdf, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61842-0/fulltext, Cardiovascular health: Insomnia linked to greater risk of heart attack. Lithium selenide has the same crystal form as other selenides, which is cubic, belonging to the anti-fluorite structure, the space group is F m 3 m {\displaystyle Fm{\bar {3))m} , each unit cell has 4 units. These glands are chiefly responsible for regulating calcium levels in the body. Lithium is safe for people over the age of 7 years old. Lithium helps to strengthen the health and resilience of neurons, demonstrating neurotrophic and neuroprotective effects in a wide range of clinical and translational models. Remove contact lenses if present and easy to do. Your doctor may increase or decrease the dose of your medication during your treatment. Two cases are presented in which sulindac antirheumatic therapy was commenced during stabilized lithium treatment for recurrent endogenous depression. Off-label means that it hasnt been approved by the Food and Drug Administration for this condition. Active. It is usually manageable with a correct diagnosis and suitable treatment and, Bipolar disorder involves extreme changes of moods and other symptoms. inability to have or keep an erection. Tell your doctor about all your current medicines. If these tests indicate even slight issues with the kidneys, a doctor may prescribe a lower dosage of lithium. What is the proper formula for lithium sulfate? Your provider can explain how these different treatments work with the medication. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking lithium. You can easily become dehydrated while taking lithium, which may affect your dose needs. Lithium can also be an effective treatment for unipolar depression. Lithium is a mood stabilizer medication that works in the brain. Follow these directions carefully. The number of electrons in each of Selenium's shells is 2, 8, 18, 6 and its electron configuration is [Ar] 3d10 4s2 4p4. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Liquid solution . Compared to other metals, it has one of the lowest boiling points. What is the chemical formula for lithium selenide? It is important to discuss the risks and benefits of treatment with your doctor and caregivers. If you need surgery, tell the surgeon ahead of time that you are using this medicine. fainting fast, pounding, or irregular heartbeat or pulse frequent urination increased thirst slow heartbeat stiffness of the arms or legs troubled breathing (especially during hard work or exercise) unusual tiredness or weakness weight gain Rare Blue color and pain in the fingers and toes coldness of the arms and legs dizziness eye pain headache Bipolar disorder involves episodes of depression and/or mania. Do not stop taking lithium without talking to your doctor. Wash thoroughly before eating and smoking. Hypothyroidism is another concern for those taking lithium. American Elements produces to many standard grades when applicable, including Mil Spec (military grade); ACS, Reagent and Technical Grade; Food, Agricultural and Pharmaceutical Grade; Optical Grade, USP and EP/BP (European Pharmacopoeia/British Pharmacopoeia) and follows applicable ASTM testing standards. Your doctor may tell you not to take lithium if you are taking this medication or will monitor you carefully for side effects. This medicine is available only with your doctor's prescription. This impairment can cause a condition called nephrogenic diabetes insipidus (NDI). All Rights Reserved. Lithium is a mood stabilizer medication that works in the brain. MNT is the registered trade mark of Healthline Media. The method is somewhat limited by scale and produces flammable byproducts. Below are the EPA applications/systems, statutes/regulations, or other sources that track or regulate this substance. Selenium was discovered and first isolated by Jns Jakob Berzelius and Johann Gottlieb Gahn in 1817. Solubility: sol water; sparingly sol THF, ABTin(II) SelenideSnSeLithium OxideLi2OLithium SulfideLi2SLithium SelenideLi2Se240 more rows, NamesMolar mass92.842Appearanceclear crystalDensity2.0 g/cm3Solubility in waterhydrolysis30 more rows. This content does not have an Arabic version. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Copyright 2023 IBM Watson Health. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). 4301 Wilson Blvd., Suite 300 According to an article in the journal Case Reports in Medicine, lithium-induced hyperparathyroidism is four times more likely to occur in women than in men. Elevation of serum lithium levels due to sulindac was not seen. Lithium pregnancy and breastfeeding warnings. Ask an American Elements Materials Science Engineer, Tungsten(IV) Diselenide, Lithium Intercalated, Molybdenum(IV) Diselenide, Lithium Intercalated, Germanium Arsenide Selenide Telluride Sputtering Target, Germanium Arsenide Selenide/Indium Selenide Sputtering Target, Germanium Arsenide/Indium Selenide Sputtering Target, Germanium Selenide/Indium Selenide Sputtering Target, Germanium Antimony Selenide Telluride Sputtering Target, Publish your research on the American Elements website, Case Studies of selected key technologies invented or co-invented by American Elements in just the 1st two decades of this century, (5N) 99.999% Lithium Selenide Sputtering Target, P223-P231+P232-P260-P264-P270-P271-P273-P280-P301+P310-P304+P340-P314. O Lithium selenide . -Regular release formulations: 600 mg orally 3 times a day, in the morning, afternoon, and nighttime Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Do not take more or less of it or take it more often than prescribed by your doctor. People living with bipolar disorder who wish to become pregnant face important decisions. Regarding breastfeeding, caution is advised since lithium does pass into breast milk. Hazard Class: 4.3 Substances which, in contact with water, emit flammable gasesSecondary Class: 6.1 Toxic substancesPacking Group: PG IIUN Number: UN3134Proper Shipping Name: Water-reactive solid, toxic, n.o.s. Some of the side effects that a person experiences when first taking lithium tend to disappear with time. That is, for example, some people may experience tinnitus at levels below 2.0 mEq/l. COPYRIGHT 1997-2022 AMERICAN ELEMENTS. Hypothyroidism (low levels of thyroid hormone) may occur with long-term lithium use. In some cases, drinking too much liquid can be as unsafe as not drinking enough. Sodium affects excitation or mania. All rights reserved. This branded product is no longer on the market. Overdose can occur if you take only slightly more than a recommended dose. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment. You may opt-out of email communications at any time by clicking on If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). Chemistry questions and answers. You may also contact the poison control center at 1-800-222-1222. Last Updated: January 2016. Learn about its symptoms, causes, and what to do here. Is the ketogenic diet right for autoimmune conditions? In a person with hypothyroidism, the thyroid gland does not produce enough hormones. Lithium is a common treatment for bipolar disorder. Hypercalcemia can lead to further complications, such as osteoporosis and cardiovascular issues. Solutions are packaged in polypropylene, plastic or glass jars up to palletized 440 gallon liquid totes, and 36,000 lb. Do not take two doses at one time. Li3Ge3Se6: the first ternary lithium germanium selenide with interesting ? Although the associated symptoms above provide an idea of what to expect, it is important to realize that side effects can happen at different blood concentrations. Instead, the best way to dispose of your medication is through a medicine take-back program. Apart from beneficial effects, its application can cause diverse side effects. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. Not all possible drug interactions are listed here. Talk to your doctor about the risks of using this medication for your condition. If a person experiences worrying symptoms while taking lithium, they should talk to their doctor. People who take lithium require regular blood tests as lithium can build up in the blood and become toxic at high levels. Dilithium selenide; lithium selenidolithium. Lithium is often a long-term treatment for bipolar disorder. Safety Data Sheet according to Regulation (EC) No. According to the package insert for lithium, prolonged use of this drug can affect the ability of the kidneys to concentrate urine. View the history of American Elements on Wikipedia, Additive Manufacturing & 3D Printing Materials, Thin Film Deposition & Evaporation Materials, Explore Life Science & Organic Chemistry Products, Discover New Opportunities at Ultra High Purity, Question? O Sodium chloride . Doctors will not usually suggest stopping lithium treatment during pregnancy. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.