Navigating Weight Loss After Gallbladder Removal: Can I Take Wegovy?

Introduction

Facing the journey of weight management can be complex, and for many, it becomes even more nuanced after a significant medical procedure like gallbladder removal. You might be navigating new digestive realities, grappling with persistent weight challenges, and wondering what safe and effective options are available. The question of whether you can I take Wegovy if I had my gallbladder removed is a common and incredibly important one that we often hear. It reflects a proactive approach to health, seeking to understand how cutting-edge treatments interact with your body’s unique circumstances.

In this detailed guide, we embark on an exploration of Wegovy, a leading GLP-1 receptor agonist, and its suitability for individuals who have undergone a cholecystectomy. We understand that sustainable weight loss should be achieved through science, empathy, and a transparent approach, which is why we’re dedicated to providing you with clear, comprehensive information. You’ll discover how Wegovy works, the physiological changes that occur after gallbladder removal, and practical strategies for managing your health and weight. We’ll delve into the potential benefits, address common concerns regarding digestive symptoms, and emphasize the critical role of personalized, medically supervised care.

Our goal is to empower you with knowledge, ensuring you feel confident and supported in making informed decisions about your health. We believe that combining advanced medical science with modern technology is key to compassionate care that respects every individual’s unique journey. By the end of this post, you will have a thorough understanding of the considerations involved and how a personalized weight loss program, such as ours at TrimRx, can help you achieve your health goals safely and effectively. We will cover the function of the gallbladder, the mechanisms of Wegovy, the interaction between the two, and how we provide comprehensive support every step of the way.

Understanding Your Gallbladder and Life Without It

The gallbladder, though small, plays a crucial role in our digestive system. Nestled beneath the liver, this pear-shaped organ acts as a storage reservoir for bile, a digestive fluid produced by the liver. Bile is essential for the breakdown and absorption of dietary fats. When we consume a meal, particularly one rich in fats, the gallbladder contracts, releasing a concentrated surge of bile into the small intestine to facilitate digestion.

The Role of Bile in Fat Digestion

Without adequate bile, fats would pass through the digestive system largely undigested, leading to malabsorption of fat-soluble vitamins and essential fatty acids, as well as uncomfortable digestive symptoms. The gallbladder’s ability to store and release bile in concentrated bursts precisely when needed makes fat digestion highly efficient.

Cholecystectomy: Life After Gallbladder Removal

Gallbladder removal, medically known as a cholecystectomy, is one of the most common surgical procedures performed globally, often necessitated by gallstones or inflammation. While the surgery removes the storage unit for bile, it’s important to understand that your liver continues to produce bile. The key difference is that instead of being stored and released on demand, bile now flows continuously, in a less concentrated form, directly into your small intestine.

Adapting to a New Digestive Landscape

Most individuals adapt remarkably well to life without a gallbladder within a few months. However, some permanent changes occur:

• Continuous Bile Flow: Bile no longer provides concentrated bursts during meals, which can initially make fat digestion less efficient.
• Initial Digestive Changes: Some people experience digestive symptoms such as looser stools, increased gas, or bloating, especially after consuming fatty foods. These symptoms are generally temporary as the body adjusts.
• Risk of Bile Acid Malabsorption (BAM): For a subset of individuals (around 10-20%), the continuous flow of bile acids into the colon can lead to chronic watery diarrhea, urgency, and abdominal discomfort. This condition, known as bile acid malabsorption, requires specific management.

The Tendency for Post-Surgery Weight Gain

An often-overlooked consequence of gallbladder removal is the tendency for modest weight gain. Research indicates that many individuals experience an increase in body weight following a cholecystectomy. Studies have observed that patients may gain approximately 3-5% of their pre-surgery body weight within two years, correlating with an increase in BMI. This weight gain may be attributed to a combination of factors:

• Changes in Bile Flow and Metabolism: Altered bile acid metabolism can impact fat absorption and energy regulation.
• Dietary Adjustments: Some individuals adopt less healthy eating habits post-surgery, perhaps to avoid digestive discomfort, or due to a lack of guidance on appropriate nutrition.
• Reduced Physical Activity: Recovery periods can lead to temporary reductions in exercise, contributing to weight gain.
• Underlying Factors: The same metabolic factors that predisposed an individual to gallstone formation might also contribute to weight gain.

Recognizing these challenges is the first step toward effective weight management. This is precisely where modern, medically supervised approaches, like those we offer at TrimRx, can provide invaluable support.

Wegovy: A Powerful Tool for Weight Management

Wegovy, containing the active ingredient semaglutide, represents a significant advancement in the field of weight management. It belongs to a class of medications known as GLP-1 (glucagon-like peptide-1) receptor agonists. These medications mimic the action of a natural hormone, GLP-1, which is produced in the intestines in response to food intake.

How Wegovy Works to Support Weight Loss

Wegovy’s mechanism of action is multifaceted, addressing several key aspects of weight regulation:

• Appetite Regulation: By acting on the brain’s appetite control centers, Wegovy helps to reduce hunger signals, leading to decreased caloric intake. It helps individuals feel satisfied with smaller portions.
• Slower Gastric Emptying: Wegovy slows down the rate at which food leaves the stomach. This effect contributes to a prolonged feeling of fullness after meals, reducing the urge to eat frequently.
• Reduced Cravings: Many users report a reduction in food cravings, particularly for highly palatable, ultra-processed foods, making it easier to adhere to healthier dietary choices.
• Improved Blood Sugar Control: While primarily approved for weight management, semaglutide also enhances insulin secretion when blood sugar levels are high and suppresses glucagon secretion, thereby improving overall blood sugar control.

Clinical Efficacy of Wegovy

The effectiveness of Wegovy for weight loss is well-documented in extensive clinical trials. Participants taking Wegovy have demonstrated an average weight loss of approximately 15% of their body weight over 68 weeks, significantly outpacing placebo groups. For an individual weighing 200 pounds, this could translate to a loss of about 30 pounds, representing a clinically meaningful reduction that can lead to substantial health improvements.

Wegovy is typically administered as a once-weekly subcutaneous injection, with the dosage gradually increased over 16-20 weeks. This titration schedule is designed to minimize potential gastrointestinal side effects as the body adjusts to the medication. It is approved for adults with a BMI of 30 kg/m² or higher (obesity), or a BMI of 27 kg/m² or higher (overweight) with at least one weight-related condition such as high blood pressure or type 2 diabetes. This branded medication is FDA-approved for chronic weight management.

Wegovy and Gallbladder Removal: The Key Considerations

Now, let’s address the central question: can I take Wegovy if I had my gallbladder removed? The reassuring news is that for most individuals, the answer is yes. Wegovy is considered safe and effective for people who have had their gallbladder removed, provided it is prescribed and monitored by a healthcare professional. There is no direct contraindication for its use in patients post-cholecystectomy.

Efficacy Remains Intact

Wegovy’s primary mechanisms of action—regulating appetite in the brain, slowing stomach emptying, and impacting insulin and glucagon—do not directly involve the gallbladder. Therefore, the absence of this organ does not hinder the medication’s efficacy in promoting weight loss and improving metabolic markers. You can expect similar weight loss results to those with gallbladders, assuming proper adherence and lifestyle adjustments.

Potential Benefits for Post-Cholecystectomy Patients

For individuals who have undergone gallbladder removal, taking Wegovy can offer several distinct advantages:

• Counteracting Post-Surgery Weight Gain: As discussed, many people experience modest weight gain after cholecystectomy. Wegovy can actively help counteract this tendency, supporting effective and sustained weight loss.
• Improved Metabolic Health: Wegovy has demonstrated benefits beyond weight loss, including reductions in blood pressure, improved cholesterol profiles, enhanced insulin sensitivity, and decreased inflammation markers. These improvements can be particularly valuable for post-cholecystectomy patients, especially those with existing metabolic concerns, and may temporarily mitigate the increased cardiovascular risk observed in the two years following surgery for some individuals.
• Eliminating Future Gallstone Risk: While GLP-1 receptor agonists have been associated with an increased risk of gallstone formation in individuals with an intact gallbladder, for those who have had their gallbladder removed, this specific risk is eliminated.

Addressing Digestive Symptoms: A Nuanced Approach

While Wegovy generally works well without a gallbladder, understanding the interplay of the medication with your altered digestive system is important. Both gallbladder removal and Wegovy can impact digestion, and careful management is key to minimizing discomfort.

Common Post-Cholecystectomy Digestive Changes

After gallbladder removal, many individuals experience:

• Looser Stools or Diarrhea: This affects a notable percentage of patients long-term, often due to the continuous, less concentrated flow of bile into the intestines.
• Difficulty Digesting Fats: Especially initially, the body may struggle with larger amounts of dietary fat.
• Post-Meal Discomfort: Indigestion, increased gas, or bloating can occur.
• Bile Acid Malabsorption (BAM): In some cases, excess bile acids in the colon lead to chronic watery diarrhea, urgency, and abdominal pain.

How Wegovy Can Influence These Symptoms

Wegovy’s effects on the digestive system can interact with post-cholecystectomy changes in several ways:

• Slowing Gastric Emptying: The medication’s ability to slow down stomach emptying can actually be beneficial for those experiencing post-cholecystectomy diarrhea, as it allows more time for digestion and absorption.
• Nausea and Vomiting: These are common side effects of Wegovy, especially during the initial dose escalation phase. While not necessarily worse for those without a gallbladder, individuals with pre-existing digestive sensitivity might find them more noticeable.
• Constipation: Some people experience constipation with Wegovy, which is generally unrelated to gallbladder status.

It’s crucial to distinguish between typical adjustment side effects and more significant digestive issues. Most side effects are mild and tend to improve within a few weeks as your body adjusts to the medication.

Practical Strategies for Managing Digestive Symptoms

Successfully managing your weight loss journey with Wegovy after gallbladder removal often involves a proactive approach to dietary and lifestyle choices. We recommend these practical strategies to help optimize your digestion and comfort:

• Gradual Fat Introduction: Start with meals that are lower in fat and gradually increase your fat intake as your body adjusts. This allows your system to adapt to the continuous bile flow. Focus on healthy fats from sources like avocados, nuts, and olive oil.
• Smaller, More Frequent Meals: Eating smaller portions more frequently throughout the day can accommodate the continuous bile flow and the slowed gastric emptying effect of Wegovy.
• Soluble Fiber: Incorporating soluble fiber into your diet can be very helpful. Foods rich in soluble fiber (e.g., oats, psyllium husk, chia seeds, apples, berries, carrots) help bind to excess bile acids and regulate bowel movements, which can alleviate diarrhea.
• Hydration: Drink plenty of water throughout the day, ideally between meals rather than during them, to aid digestion and prevent dehydration, especially if you experience loose stools.
• Meal Timing: Allow 3-4 hours between meals to support Wegovy’s slowed gastric emptying and give your digestive system time to process food efficiently.
• Probiotics: Consider discussing with your healthcare provider whether probiotics might help restore a healthy balance of gut bacteria, potentially easing digestive discomfort.
• Avoid Irritants: Especially when first starting treatment, you may find it helpful to limit ultra-processed, spicy, or very greasy foods that can trigger digestive upset.

By adopting these strategies, many individuals without gallbladders can tolerate Wegovy well, achieve significant weight loss, and improve their overall metabolic health.

The TrimRx Difference: Personalized Support for Your Journey

At TrimRx, our journey began with a shared vision: to help individuals embrace healthier lifestyles by merging cutting-edge telehealth innovations with effective weight loss solutions. We understand that every individual’s health journey is unique, especially when navigating conditions like gallbladder removal while pursuing weight loss. Our platform is meticulously designed to be a user-friendly and supportive space where individuals receive personalized, medically supervised care—all crafted to make sustainable weight loss attainable and tailored to you.

Our Brand Story and Values in Action

We believe that sustainable weight loss should be achieved through science, empathy, and a transparent approach. This philosophy permeates every aspect of our service. Our brand personality is empathetic, innovative, trustworthy, supportive, results-oriented, and personalized. We offer compassionate care that respects every individual’s unique journey by combining advanced medical science with modern technology. When you partner with us, you’re not just getting a medication; you’re gaining a dedicated team and a comprehensive plan.

A Comprehensive and Transparent Approach

Our commitment to transparent service means our approach remains consistent, whether you’re starting a new medication or undergoing dosage changes. Your safety is our paramount concern. We work exclusively with FDA-registered and inspected pharmacies for the shipping of weight loss medications. It’s important to note that while we partner with these pharmacies for medication delivery, we do not provide actual medical supervision. Instead, we connect you with healthcare providers who offer the medical oversight and personalized care you need.

Our comprehensive service includes everything you need for a successful journey:

• Doctor Consultations: Access to qualified medical professionals for personalized assessment and guidance.
• Medication: Prescription weight loss medications, provided through FDA-registered and inspected pharmacies. For branded medications like Ozempic®, Zepbound®, and Wegovy®, we reference their FDA approval. For compounded medications like Compounded Semaglutide or Compounded Tirzepatide, we ensure they come from FDA-registered and inspected pharmacies, but we do not claim them to be FDA approved.
• Lab Work: Necessary lab tests to ensure your treatment plan is safe and effective for your body.
• Unlimited Support: Ongoing guidance and answers to your questions throughout your program.
• Shipping: Convenient delivery of your medication directly to your door.

All of this comes with no hidden fees, ensuring you have a clear understanding of your investment in your health.

Accessing Your Personalized Plan with TrimRx

For those seeking prescription weight loss medications, we offer a streamlined path to personalized care. Our product offerings in this category include:

• Compounded Semaglutide
• Oral Semaglutide
• Ozempic®
• Compounded Tirzepatide
• Oral Tirzepatide
• Mounjaro®
• Zepbound®
• Wegovy®

To determine your eligibility and receive a treatment plan specifically tailored to your needs, including considerations like having had your gallbladder removed, we encourage you to take our free assessment quiz. This quiz is the first step toward understanding how our personalized, medically supervised programs can support your unique weight loss goals.

Complementing Your Journey: Quick-Access Support

Beyond prescription medications, we understand that comprehensive wellness extends to daily support. For immediate access to supplements that can support your overall well-being during your weight loss journey, we offer:

• GLP-1 Daily Support: Designed to complement GLP-1 medications or support natural GLP-1 production.
• Weight Loss Boost: Formulated to provide an additional edge in your weight loss efforts.

These quick-access supplements are available for immediate purchase, offering flexible support whether you’re on a prescription program or simply seeking to enhance your general wellness.

Our aim is to provide a holistic approach that integrates medical science with lifestyle support, making your weight loss journey as smooth and effective as possible, even with specific health considerations like a past cholecystectomy. Your path to a healthier you starts with understanding and personalized action. We invite you to explore your options and take the first step by completing our free assessment quiz.

Strategies for Success: Beyond Medication

While Wegovy and other GLP-1 medications can be powerful tools, sustainable weight loss and optimal health, especially after gallbladder removal, are best achieved through a holistic approach. Medication works most effectively when combined with thoughtful dietary choices, regular physical activity, and overall lifestyle management. Our programs at TrimRx emphasize this integrated strategy, recognizing that medication is one component of a larger, supportive framework.

Dietary Adjustments for Optimal Digestion

Living without a gallbladder means your body handles fats differently. When considering Wegovy, dietary choices become even more crucial for managing digestive symptoms and maximizing weight loss results.

Mindful Fat Intake

• Focus on Quality Fats: Prioritize healthy fats found in avocados, nuts, seeds, fatty fish (like salmon), and olive oil. These are generally easier to digest in moderation than saturated or trans fats.
• Moderate Portions: Instead of completely eliminating fats, which are vital for nutrient absorption and satiety, consume them in smaller amounts spread throughout your meals.
• Avoid Trigger Foods: Pay attention to how your body reacts to very fatty, greasy, fried, or highly processed foods. These can often exacerbate digestive discomfort post-cholecystectomy and with GLP-1 medications.

Emphasizing Nutrient-Dense Foods

• Lean Proteins: Include lean protein sources such as chicken, turkey, fish, and plant-based proteins (beans, lentils, tofu). Protein is crucial for satiety and muscle maintenance during weight loss.
• Fiber-Rich Foods: Increase your intake of soluble fiber from fruits, vegetables, and whole grains. Soluble fiber helps regulate digestion, binds to excess bile acids, and promotes feelings of fullness. Insoluble fiber (found in vegetable skins, whole wheat) can also support bowel regularity but should be introduced gradually.
• Hydration: As mentioned earlier, consistent and adequate water intake is fundamental for digestive health, especially when adjusting to medication and dietary changes.

The Importance of Meal Timing and Frequency

• Smaller, More Frequent Meals: This approach can be particularly beneficial. It helps manage the continuous flow of bile and the slowed gastric emptying, preventing the digestive system from becoming overwhelmed.
• Mindful Eating: Eating slowly, chewing thoroughly, and paying attention to hunger and fullness cues can significantly improve digestion and reduce overeating.

The Role of Physical Activity

Regular exercise is an indispensable component of any weight loss journey, and its importance is amplified for those seeking to maintain a healthy weight after gallbladder removal.

• Enhance Metabolic Rate: Physical activity helps burn calories and build lean muscle mass, which boosts your metabolism, making it easier to lose weight and keep it off.
• Improve Digestive Function: Exercise can stimulate bowel motility, which may help alleviate constipation—a potential side effect of Wegovy—or other sluggish digestive issues.
• Reduce Weight Gain Risk: Regular movement helps counteract the tendency for modest weight gain observed post-cholecystectomy.
• Boost Overall Well-being: Beyond physical benefits, exercise is a powerful stress reliever and mood enhancer, contributing to mental resilience throughout your weight loss journey.

Aim for a combination of cardiovascular exercise (e.g., brisk walking, swimming, cycling) and strength training. Start gradually and consistently, listening to your body, and consulting with your healthcare provider about appropriate activity levels.

Embracing a Holistic Lifestyle

Successful, long-term weight management is not just about diet and exercise; it’s about nurturing a holistic approach to your health.

• Stress Management: Chronic stress can impact hormone levels, increase cravings, and hinder weight loss. Incorporate stress-reducing practices like mindfulness, meditation, yoga, or spending time in nature.
• Adequate Sleep: Prioritizing 7-9 hours of quality sleep per night is crucial. Sleep deprivation can disrupt hormones that regulate appetite (ghrelin and leptin), leading to increased hunger and cravings.
• Consistent Monitoring and Support: Regularly tracking your progress, monitoring for side effects, and staying in communication with your healthcare team are vital. Our programs at TrimRx are designed to provide this continuous support, helping you navigate challenges and celebrate successes.

By integrating these strategies into your daily life, you create a robust foundation for achieving and maintaining your weight loss goals effectively and safely. For additional support, consider our GLP-1 Daily Support or Weight Loss Boost supplements, available for immediate purchase to further complement your wellness journey.

When to Consult Your Healthcare Provider

While most people without gallbladders tolerate Wegovy well, certain symptoms warrant immediate medical attention. Your safety and well-being are paramount, and knowing when to reach out to your healthcare provider is crucial.

Urgent Medical Advice

Contact your doctor urgently or seek emergency care if you experience any of the following symptoms while taking Wegovy, especially if you have had your gallbladder removed:

• Severe Abdominal Pain: Intense or persistent pain that does not resolve, particularly if it radiates to your back. This could indicate pancreatitis, a rare but serious side effect of GLP-1 medications.
• Persistent Vomiting: Vomiting that lasts for more than 24 hours, or severe, uncontrollable vomiting. This can lead to dehydration and electrolyte imbalances.
• Signs of Dehydration: Extreme thirst, significantly dark urine, decreased urination, dizziness or lightheadedness upon standing, or a very dry mouth.
• Severe Diarrhea: More than 6 loose stools per day, especially if accompanied by other symptoms.
• Blood in Stool or Black, Tarry Stools: These are signs of potential gastrointestinal bleeding and require urgent evaluation.
• High Fever: Especially if accompanied by any digestive symptoms.
• Yellowing of Skin or Eyes (Jaundice): This can indicate liver issues or bile duct obstruction.

Routine Monitoring and Ongoing Support

For optimal safety and effectiveness when taking Wegovy without a gallbladder, establishing regular monitoring with your healthcare provider is essential. Our personalized programs at TrimRx ensure that you have access to the medical guidance you need throughout your weight loss journey.

• Initial Assessment: A thorough evaluation before starting any prescription medication to ensure it’s appropriate for your health history, including your cholecystectomy. This is where our free assessment quiz becomes invaluable.
• Review of Digestive Symptoms: Regular check-ins to discuss any digestive symptoms, particularly during dose increases. Your provider can offer advice on managing side effects or adjust your treatment plan if necessary.
• Ongoing Check-ins: Regular consultations, especially during the first few months of treatment, to monitor your progress, address concerns, and ensure you’re tolerating the medication well.
• Lab Work: As recommended by your doctor, certain lab tests, such as liver function tests, may be periodically conducted to monitor your overall health.
• Medication Review: If other treatments or supplements are added to your regimen, a comprehensive review will ensure there are no adverse interactions.

Remember, our commitment at TrimRx is to provide a supportive and results-oriented environment where you feel empowered to manage your health. Through our comprehensive service that includes doctor consultations, medication, lab work, unlimited support, and shipping with no hidden fees, we strive to make your path to sustainable weight loss clear and manageable. If you’re ready to explore how a personalized plan can work for you, take our free assessment quiz today.

Conclusion

Navigating weight loss after gallbladder removal, especially with the introduction of advanced medications like Wegovy, requires a thoughtful and informed approach. We’ve explored the vital role of your gallbladder, the profound physiological changes that occur after its removal, and the tendency for post-surgery weight gain. Crucially, we’ve confirmed that for most individuals, the answer to “can I take Wegovy if I had my gallbladder removed?” is a resounding yes. Wegovy offers significant benefits for weight management and metabolic health, even in the absence of a gallbladder, and can help counteract the weight gain often seen post-cholecystectomy.

We’ve delved into the nuanced interplay between Wegovy and a gallbladder-free digestive system, offering practical strategies to manage potential digestive symptoms effectively through dietary adjustments and lifestyle choices. This journey is not merely about medication; it’s about embracing a comprehensive, personalized path to wellness.

At TrimRx, our entire platform is built on the foundation of science, empathy, and transparency. Our commitment is to provide compassionate, medically supervised care, integrating cutting-edge telehealth innovations with effective weight loss solutions. We understand your unique challenges and are dedicated to making sustainable weight loss attainable through personalized plans. Our comprehensive service, including doctor consultations, medication sourced from FDA-registered and inspected pharmacies, lab work, unlimited support, and transparent shipping, ensures you have everything you need without hidden fees.

Your health journey is personal, and we are here to support you every step of the way. If you’re ready to explore a personalized approach to weight loss and discover if you qualify for prescription medications like Wegovy, we invite you to take our free assessment quiz. For immediate support for your overall wellness during your journey, consider our quick-access supplements like GLP-1 Daily Support or Weight Loss Boost.

Empower yourself with knowledge and a supportive partnership. Together, we can help you achieve your weight loss goals safely and effectively, leading to a healthier, more vibrant life.

Frequently Asked Questions

Will Wegovy make my digestive issues worse after gallbladder removal?

Not necessarily. While Wegovy can cause digestive side effects like nausea, vomiting, or constipation, these do not typically worsen post-cholecystectomy symptoms for everyone. In fact, Wegovy’s slowing effect on gastric emptying may actually help some individuals experiencing diarrhea after gallbladder removal by allowing more time for digestion. Most side effects are mild and tend to improve within a few weeks as your body adjusts. It’s crucial to discuss any persistent or severe digestive symptoms with your healthcare provider.

Do I need special dietary changes if taking Wegovy without a gallbladder?

Yes, combining dietary strategies tailored for both situations is beneficial. You’ll want to moderate your fat intake, spreading it throughout the day (a common recommendation for those without a gallbladder), while also focusing on protein-rich, nutrient-dense meals (beneficial for overall health and weight loss on Wegovy). Emphasize well-cooked vegetables, lean proteins, and soluble fiber. Avoiding ultra-processed, very spicy, or greasy foods, especially when starting treatment, can also minimize discomfort.

Is the dosing different for people without a gallbladder?

No, the standard Wegovy dosing protocol generally applies whether you have a gallbladder or not. This typically involves starting with a low dose (e.25 mg weekly) and gradually increasing it over 16-20 weeks to the maintenance dose (2.4 mg weekly). However, if you experience significant or bothersome digestive symptoms, your healthcare provider might recommend a more gradual transition between doses to help your body adjust more comfortably.

What digestive symptoms should I watch for that indicate a serious issue?

While mild nausea, constipation, or loose stools are common when starting Wegovy, certain symptoms warrant immediate medical attention. Watch for severe or persistent abdominal pain that doesn’t resolve, persistent vomiting (more than 24 hours), signs of dehydration (extreme thirst, dark urine, dizziness), severe diarrhea (more than 6 loose stools per day), blood in stool or black, tarry stools, or yellowing of the skin or eyes (jaundice). If you experience any of these, contact your doctor urgently.