Nutrition During Liver Cancer Treatment: How Dietitians Support a Working Liver

The plate was full and the room was quiet. His daughter had cooked the roast chicken he used to ask for on Sundays, and he sat looking at it the way you might look at a hill you once climbed easily. Two bites, then a polite hand over the fork. Nobody at the table said what everyone was thinking: he has lost weight again.

Scenes like this play out in kitchens everywhere once a liver cancer diagnosis arrives. Families reach for food because food is love and because they want to do something. Yet nutrition during liver cancer treatment is unusually tricky, because the organ that is sick is also the organ that runs the body’s food economy. Eating more is not always the answer, and eating less is rarely the answer either.

This is where dietitians earn their place on the team. Their work is quieter than surgery and less visible than a scan, but it changes how well a person tolerates everything else. Here is what they actually do, and why it matters.

What the liver does with your food, and why cancer treatment changes the math

Picture the liver as a processing plant that sits just downstream of your gut. Almost everything you swallow passes through it first. The liver stores sugar as glycogen (a compact form of glucose kept in reserve), manufactures albumin (a blood protein that holds fluid inside blood vessels), makes bile (the fluid that lets you digest fat) and breaks down toxins, including ammonia produced when protein is digested.

A healthy liver holds enough glycogen to cover roughly an overnight fast. When cancer and the scarring that often accompanies it shrink the working portion of the organ, that reserve becomes smaller and less reliable. The body then does something that feels counterintuitive: it starts breaking down muscle for fuel far sooner than it would in a healthy person. A night without food can behave, metabolically, like a much longer fast.

Doctors call the result sarcopenia, which simply means loss of muscle mass and strength. It matters for two reasons. Muscle is where much of the body’s protein reserve lives, and people with less muscle generally tolerate surgery, embolization procedures and drug therapy less comfortably. Weight on the scale can even stay stable while muscle quietly disappears, because fluid gathering in the abdomen or legs masks the loss.

The Mayo Clinic notes that most primary liver cancers develop in a liver already damaged by long-standing disease such as hepatitis or cirrhosis. That background is the whole reason nutrition here needs a specialist’s eye rather than general healthy-eating advice. The same meal that is harmless for a person with a healthy liver can worsen fluid retention, confusion or blood sugar swings in someone whose processing plant is running at partial capacity.

Why nutrition during liver cancer treatment is different from other cancers

Most cancer nutrition advice assumes the digestive organs are working normally and the challenge is simply getting enough in. With liver cancer, two problems arrive together: the tumor, and the compromised organ around it. That combination reshapes almost every piece of standard guidance.

Take salt. In many cancers, a salty broth is a perfectly good way to coax appetite. In someone with portal hypertension (raised pressure in the vein that carries blood from the gut to the liver), extra sodium can drive fluid into the abdomen, a condition called ascites. Take protein. The old reflex was to limit it whenever the liver struggled; today, as the next sections explain, that reflex is considered outdated for most people. Take supplements. A vitamin that is harmless for a healthy adult can, at high intakes, add strain to a liver that is already struggling to clear compounds.

Blood sugar behaves differently as well. Because the liver both stores and releases glucose, people with advanced liver disease can swing between high readings after meals and low readings after a long gap without food. Dietitians therefore think in terms of rhythm and distribution rather than totals alone.

There is also the question of what treatment is planned. According to the NHS, options for liver cancer range from surgery and ablation to procedures that block the tumor’s blood supply, targeted drugs, immunotherapy and, for some, transplant. Each carries its own pattern of nausea, appetite loss, taste change or bowel disturbance. A nutrition plan that ignores which of these is coming is a plan written for a different patient.

What a dietitian for liver cancer actually does at the clinic

A registered dietitian is a health professional trained to translate medical nutrition science into what a real person can eat on a Tuesday. In liver cancer care, the first appointment is usually more assessment than advice. Expect questions about weight over the past six months, clothes that fit differently, how many meals are being finished and how long the overnight gap runs. Some clinics measure handgrip strength or use a simple squeeze device, because grip tracks muscle health better than a bathroom scale when fluid is present.

From there the dietitian builds a picture rather than a diet sheet. Where is the person losing ground: appetite, nausea, early fullness from a swollen abdomen, taste changes, fatigue that makes cooking impossible? Each cause has a different fix, and a generic “eat more calories” instruction can miss all of them.

The role extends beyond the patient. Dietitians speak with the oncologist about whether weight loss might affect the choice or timing of a procedure, with the pharmacist about foods that interact with prescribed medicines, and with the family about how to help without turning every meal into a negotiation. Where swallowing or absorption is severely limited, they advise the team on whether nutrition support through a feeding tube or, rarely, a vein is worth discussing.

What a dietitian does not do is override the medical plan. They will not tell someone to stop a diuretic because it dulls appetite, or to take a herbal product to “support” the liver. Their recommendations flow back to the treating team, which owns every decision. The best of them also know when the right advice is to stop counting and simply enjoy a favorite meal.

Who is referred to a dietitian first, and who is usually asked to wait

Not everyone with liver cancer sees a dietitian on day one, and that is not neglect. Teams prioritize referrals according to risk, and understanding the logic helps patients ask for support at the right moment.

Early referral is common when there is unintended weight loss, visible muscle wasting, fluid in the abdomen or legs, a history of confusion linked to liver disease, or a planned major operation. Surgeons increasingly ask for nutrition work before resection or transplant so that a person arrives with more reserve; this is sometimes called prehabilitation, meaning preparing the body ahead of treatment rather than repairing it afterwards. People starting drug therapies known to cause diarrhea, mouth soreness or taste change are often referred at the same time as the prescription is written.

Those usually asked to wait tend to have small tumors under surveillance, stable weight, a good appetite and no signs of liver failure. For them, general advice from the oncology nurse is often enough, with a referral triggered if anything changes. Some people are also asked to hold off on specific dietary changes for a short stretch, for example the fasting window before a procedure or the days when a new medicine is being introduced and its side effects are still being read.

Two caveats matter. First, waiting is a scheduling decision, not a judgment that nutrition does not matter. Second, anyone who notices their belt loosening, meals shrinking or energy fading should say so at the next visit rather than waiting to be asked. Referral pathways are meant to be flexible, and the treating team can move someone up the list whenever the picture shifts.

The protein question: why the old advice to cut back has been abandoned

For decades, anyone with a struggling liver was told to go easy on protein. The reasoning seemed sound. Digesting protein releases ammonia, the liver normally clears it, and when clearance fails, ammonia contributes to hepatic encephalopathy, a state of confusion, drowsiness and personality change described in detail by the Cleveland Clinic. Less protein, the thinking went, meant less ammonia.

The problem is that muscle also clears ammonia, and starving someone of protein shrinks the very tissue that helps. People placed on low-protein diets grew weaker, lost more muscle and did not clearly become less confused. Current specialist guidance for cirrhosis and liver cancer therefore no longer recommends routine protein restriction. Dietitians instead aim for protein at every meal and snack, spread across the day so the liver never faces a large load at once.

Which proteins? All count, though some are gentler. Dairy and plant sources such as beans, lentils, tofu, nuts and eggs are often better tolerated by people prone to encephalopathy than large portions of red meat, partly because of their amino acid mix and the fiber that travels with plant protein. Fish, poultry and lean meat remain useful; the emphasis is on variety and distribution rather than exclusion.

Practical translation looks ordinary: yogurt or eggs at breakfast, a lentil soup or cheese with lunch, a palm-sized portion of fish or chicken at dinner, milk or a nut butter snack before bed. When appetite is poor, dietitians may suggest fortifying foods, for instance stirring milk powder into porridge or soup, so protein rises without the plate getting bigger. How much protein a specific person needs depends on weight, fluid status and treatment, and that number comes from the team, not a chart.

Small meals, a bedtime snack, and why timing matters more than totals

If one habit defines liver-focused nutrition, it is closing the overnight gap. Because the liver’s glycogen store is small and unreliable in advanced disease, the body starts pulling on muscle within hours of the last meal. A snack shortly before sleep, containing both carbohydrate and protein, gives the body something else to burn through the night. Many specialist teams treat this as a routine part of care rather than an optional extra.

Daytime follows the same principle. The National Cancer Institute’s patient guidance on eating during treatment suggests five or six small meals or snacks instead of three large ones, partly because a swollen abdomen or a nauseated stomach tolerates small volumes better, and partly because steady fuel keeps blood sugar from swinging. For liver patients, the advice doubles as protection for muscle.

What might a day look like? A modest breakfast within an hour of waking, a mid-morning snack, a light lunch, an afternoon snack, an early dinner and a bedtime bite. None of these needs to be elaborate. Toast with peanut butter, a small bowl of cereal with milk, crackers with cheese, a banana with yogurt, a boiled egg: the point is regularity, not recipes.

Timing also interacts with treatment. Procedures usually require a period without food beforehand, and some drug therapies are taken with or apart from meals. Dietitians help rearrange the schedule so that a required fast does not turn into a lost day of nutrition. On days when nausea is worst, they often advise eating whatever is tolerable at whatever hour it is tolerable, because a cold sandwich at midnight beats an empty stomach on principle.

Salt, fluid and ascites: what to eat with liver cancer when the belly swells

Ascites, the buildup of fluid in the abdominal cavity, is one of the more distressing complications of liver disease. Clothes stop fitting, breathing feels shallow, and the sensation of fullness arrives after a few mouthfuls. It happens because pressure rises in the veins around a scarred liver while albumin, the protein that holds fluid in the bloodstream, falls. Fluid leaks into the space around the organs.

Salt is the dietary lever here. Sodium makes the body hold water, so reducing it helps the kidneys shed fluid and helps any diuretic medicine (a class of drugs that increases urine output) do its job. The dietitian’s task is to find where the salt is hiding, because most of it is not in the shaker. Bread, cheese, cured meats, sauces, ready meals, canned soups and takeout food carry the bulk of it. Cooking from fresh ingredients, flavoring with herbs, citrus, garlic and pepper, and reading labels usually cut intake substantially without leaving food bland.

Fluid restriction is a separate question. Some people are asked to limit drinks when blood sodium falls low, but many are not, and cutting fluids without instruction can cause dehydration and kidney strain. Follow the team’s guidance exactly; do not improvise.

Two practical habits help everyone. Weighing at the same time each morning, in similar clothing, gives the team an early signal of fluid change that is more useful than how the abdomen looks. And eating small, protein-rich portions more often works around the early fullness that ascites causes. The Cleveland Clinic and other centers describe procedures to drain fluid when it becomes uncomfortable; whether and when that is appropriate is a decision for the treating physician.

How each treatment type changes what you can eat: a side-by-side view

Liver cancer is treated in several different ways, and each leaves a distinct nutritional footprint. The table below summarizes the patterns dietitians most often plan for. It is a map, not a forecast; many people experience only some of these effects, and the intensity varies widely.

Treatment	What it involves	Common nutrition challenges	Typical dietitian focus
Surgical resection	Removing the part of the liver containing the tumor	Post-operative appetite loss, early fullness, wound healing demands	Protein at every meal, small portions, building reserve beforehand
Ablation	Destroying the tumor with heat or cold through a needle	Short-lived nausea, fatigue, low-grade fever	Easy fluids and soft foods for a few days, then normal pattern
Embolization (TACE, TARE)	Blocking the tumor’s artery, sometimes with chemotherapy or radioactive beads	Post-embolization syndrome: pain, nausea, fever, appetite dip	Anti-nausea timing, hydration, fortified small meals
Targeted or immunotherapy drugs	Oral or infused medicines acting on tumor growth or the immune system	Diarrhea, taste change, mouth soreness, hand-foot skin reaction that limits cooking	Bland low-fiber choices during diarrhea, texture and temperature adjustments, ready-prepared food
Radiotherapy	Focused external radiation to the tumor	Nausea, fatigue, reduced appetite	Light meals before sessions, snacks afterwards
Transplant	Replacing the liver with a donor organ	High protein needs for recovery, strict food safety, food-medicine interactions	Food hygiene, avoiding grapefruit and similar interactions, gradual return to normal eating

One theme runs through every row: the plan changes as the treatment phase changes. A person recovering from embolization needs different advice in the first three days than in the third week, and someone on an oral targeted drug may need a fresh plan each time the dose is adjusted by the prescriber. The NHS overview of liver cancer treatment is a useful neutral summary of what each option involves.

Food safety when your defenses are lower

People with advanced liver disease and those receiving cancer treatment share a vulnerability: infections that a healthy body would shrug off can become serious. Food is one of the most controllable sources of that risk, and dietitians spend real time on it.

Raw or undercooked shellfish deserve special mention. Oysters and other raw molluscs can carry Vibrio bacteria that cause severe bloodstream infection in people with liver disease; public health agencies including the CDC single out liver disease as a major risk factor. The safe rule is simple: shellfish should be thoroughly cooked, every time.

Beyond shellfish, the usual precautions apply with extra seriousness. Unpasteurized milk, soft cheeses made from raw milk, refrigerated pâté and smoked fish, deli meats eaten cold, raw or runny eggs, rare meat and unwashed produce all carry organisms such as Listeria and Salmonella that hit harder when immunity is reduced. Sprouts and pre-cut melon are frequent culprits people do not expect.

Kitchen habits matter as much as ingredient lists. Separate boards for raw meat and ready-to-eat food, hot food kept hot and cold food kept cold, leftovers refrigerated promptly and eaten within a couple of days, and hands washed before handling anything that will not be cooked. Reheat until steaming throughout, not merely warm.

Alcohol belongs in this section too, though for a different reason. It is processed by the liver, worsens scarring and interacts with many cancer medicines. For someone in liver cancer treatment, the medically consistent advice is to avoid it entirely; any exception should be discussed openly with the treating team rather than assumed.

Supplements for liver cancer: what the evidence actually shows

Few topics generate more hopeful questions than supplements. Milk thistle, turmeric extracts, green tea capsules, “liver detox” blends and high-dose vitamins are all marketed as liver support. The honest summary is that none has been shown in high-quality trials to improve outcomes in liver cancer, and several carry real risk for a damaged liver.

Start with vitamin A. The NIH Office of Dietary Supplements explains that preformed vitamin A accumulates in the liver, and that chronic high intakes can cause liver damage; people with existing liver disease are more susceptible. Multivitamins and cod liver oil are common hidden sources. Iron is another concern: many people with chronic liver disease already store excess iron, and adding more without a documented deficiency can worsen liver injury.

Herbal products are a separate problem. Because they are regulated as foods rather than medicines in many countries, their contents can vary between batches, and some have been linked to liver injury in case reports collected by NIH’s LiverTox program. Green tea extract concentrates and certain bodybuilding blends appear repeatedly in those reports. Milk thistle, the most popular “liver herb,” has been studied for decades; the NIH’s National Center for Complementary and Integrative Health summarizes the evidence as insufficient to show benefit for liver disease.

None of this means every supplement is forbidden. Documented deficiencies, for example of vitamin D or certain B vitamins, are common in liver disease and are treated when found. The distinction is between correcting a measured gap under medical supervision and taking something because a label promises support. The safe path is to list every product, including teas and powders, and let the treating team and pharmacist review each one.

What the following days and weeks usually look like after treatment starts

Timelines vary enormously, so what follows describes typical patterns rather than a schedule to expect. The value is in knowing which phase you are in, because the nutrition advice shifts with each.

The first few days after a procedure such as ablation or embolization are usually about comfort. Nausea, low-grade fever and abdominal pain are common in what clinicians call post-embolization syndrome, and appetite dips accordingly. Dietitians typically advise fluids first, then soft, bland, frequent small portions, and they coordinate with the team on timing anti-nausea medicine (a class of drugs that blunts the vomiting reflex) so that it works before a meal rather than after. Nobody is expected to hit protein targets on day two.

Over the next two to six weeks, as side effects settle, the focus returns to rebuilding. This is when muscle loss from the acute phase is recovered, or not, and where the bedtime snack and protein distribution earn their keep. After surgical resection, the remaining liver regenerates over weeks to months, and the demand for protein and energy stays elevated throughout that stretch.

For people on ongoing oral targeted therapy or immunotherapy, the pattern is cyclical rather than linear. Diarrhea, taste change or mouth soreness may recur with each cycle, so the plan becomes a set of responses: what to eat on a bad-bowel day, what to keep in the freezer for a low-energy week, how to adapt flavors when everything tastes metallic.

Throughout, teams typically review weight, strength and blood tests at each visit and adjust. Any of these timelines can stretch or compress depending on the individual, and the treating team is the right source for what to expect in a specific case.

What people often get wrong about nutrition during liver cancer treatment

Misinformation clusters around cancer nutrition, and liver cancer attracts some particularly harmful versions. Correcting them is part of the dietitian’s job.

The first myth is that “sugar feeds cancer,” so all carbohydrate should go. Every cell uses glucose, and cutting carbohydrate does not starve a tumor; it does, however, remove the fuel that spares muscle in someone whose liver cannot release glycogen reliably. Complex carbohydrates spread through the day are protective, not dangerous.

The second is that fasting or juice cleanses will “rest” or “detox” the liver. The liver is the detox organ; nothing in a juice replaces that function, and prolonged fasting accelerates the muscle breakdown described earlier. There is no evidence that any cleanse improves liver cancer outcomes.

The third is the protein restriction reflex covered above. A relative who remembers older advice may still urge a low-protein diet, with good intentions and poor results.

The fourth is that loss of appetite reflects a failure of willpower. Appetite is governed by inflammation, hormones, medicines and a swollen abdomen pressing on the stomach. Nagging does not fix it; small portions, timing and treating nausea do.

The fifth is that natural means safe. Herbal blends and high-dose vitamins pass through the same overworked liver as any medicine and can add injury.

A quieter mistake is treating salt as a flavor problem rather than a fluid problem. Ready meals and bread can add up to more sodium than any shaker, and people often cut the wrong thing. Finally, some assume that a stable weight means all is well, when fluid gain may be concealing steady muscle loss. Grip strength and a photograph of the upper arm from a few months ago often tell a truer story than the scale.

Questions to ask your care team about your liver cancer diet plan

Appointments are short and memory is unreliable when you are anxious. Writing questions down beforehand turns a rushed visit into a useful one. These are the ones dietitians most often wish patients had asked earlier.

• Am I losing muscle, and how are you measuring that beyond my weight?
• Should I be eating a snack before bed, and what should it contain?
• Roughly how should my protein be spread across the day, and are there sources you would rather I favor or limit?
• Do I need to limit salt, and if so, where is the salt in what I currently eat?
• Have I been asked to restrict fluids, or is it only salt?
• Which of my treatments is likely to affect appetite or bowels, and when should I expect that?
• Are there foods that interact with any of my prescribed medicines?
• Is there any supplement, tea or herbal product I currently take that you would like reviewed?
• Do I have a documented deficiency of any vitamin or mineral that needs correcting?
• What food safety rules apply to me specifically, given my treatment and liver function?
• When should I be re-referred to the dietitian if things change?
• What signs would make you want to hear from me between appointments?

Bring a two- or three-day food diary if you can, including drinks and anything eaten overnight. It does not need to be neat. A photograph of each plate on a phone works well and removes the guesswork that makes nutrition assessments vague. If a family member does most of the cooking, ask whether they can attend; the person holding the frying pan is the one who needs the information.

Every answer you receive should come from, or be confirmed by, the people treating you. This article can prepare you for that conversation, but it cannot replace it.

When to call your doctor

Most nutrition problems during liver cancer treatment unfold slowly and can wait for the next scheduled visit. A handful cannot. The signs below warrant a same-day call to the treating team or, where stated, urgent emergency care.

• New confusion, unusual drowsiness, slurred speech, personality change or sleep reversal (awake at night, asleep by day). These can signal hepatic encephalopathy and need prompt assessment.
• Vomiting blood, or passing black, tarry or visibly bloody stool. This may indicate bleeding from swollen veins in the esophagus or stomach and is an emergency.
• Rapid swelling of the abdomen over days, new breathlessness, or sudden weight gain that is clearly fluid.
• A fever during or shortly after treatment, especially with chills or abdominal pain, since infection in ascitic fluid or the bloodstream can escalate quickly.
• Inability to keep fluids down for a day, or diarrhea severe enough to cause dizziness, very dark urine or a dry mouth.
• Deepening yellow color in the skin or eyes, or urine turning dark brown while stools turn pale.
• Severe or worsening abdominal pain, particularly after a procedure.
• Sudden inability to eat at all for more than a couple of days, or weight falling noticeably week to week.

If any of these appears alongside a fall, a head injury, chest pain or difficulty breathing, treat it as an emergency rather than a phone call.

Less dramatic changes still deserve mention at the next visit: meals shrinking, clothes loosening at the shoulders while tightening at the waist, taste changes that make protein foods unpleasant, or a bedtime snack that has quietly been dropped. Dietitians can address each of these, but only if they hear about them. The decision about what any symptom means, and what to do next, always rests with the team providing your care.

Frequently asked questions

What should I eat with liver cancer if I have no appetite?

Eat small amounts often rather than trying to finish a full plate. Choose foods that carry protein and energy in a small volume, such as yogurt, eggs, nut butter, cheese, milky drinks or fortified soups, and keep something easy within reach for whenever appetite briefly returns. Cold foods are often easier when smells trigger nausea. Tell the team if appetite loss persists; anti-nausea timing and a dietitian review usually help more than willpower.

Are there foods to avoid with liver cancer?

Raw or undercooked shellfish, unpasteurized dairy, cold deli meats, raw eggs and undercooked meat carry infection risks that are higher when the liver and immune system are compromised. Alcohol should be avoided entirely. If fluid is collecting, high-salt foods such as processed meats, ready meals and canned soups are usually limited. Grapefruit and some herbal products can interfere with certain medicines, so check every item with the pharmacist or dietitian.

Is a low-protein diet still recommended for liver problems?

No. Current specialist guidance does not recommend routine protein restriction for people with liver disease or liver cancer, because it accelerates muscle loss and muscle helps clear ammonia. Protein is instead spread across the day in modest portions, and plant or dairy sources are often favored for people prone to confusion. The right amount for an individual depends on weight, fluid status and treatment, and should come from the treating team.

Why do dietitians recommend a snack before bed?

Because a damaged liver stores too little glycogen to cover the overnight fast, the body starts using muscle for fuel within hours of the last meal. A bedtime snack that combines carbohydrate with protein, such as cereal with milk, toast with peanut butter or crackers with cheese, gives the body an alternative fuel through the night. Many liver teams treat this as a routine part of care rather than an optional extra.

Does a liver cancer diet plan need to be low in salt?

Only when fluid is collecting in the abdomen or legs, or when the team advises it for blood pressure or kidney reasons. Salt makes the body retain water, so limiting it helps control ascites and supports any diuretic medicine. Most sodium hides in bread, cheese, processed meats, sauces and ready meals rather than in the shaker. If no fluid problem exists, moderate salt is usually fine; the team sets the target.

Can supplements or herbal remedies help my liver during treatment?

No supplement or herb has been shown in high-quality trials to improve liver cancer outcomes, and several can harm a struggling liver. High-dose vitamin A, extra iron without a documented deficiency, green tea extract and some herbal blends have all been linked to liver injury. Documented deficiencies, for example vitamin D, are corrected under supervision. List everything you take, including teas and powders, and let the team review it.

How will I know if I am losing muscle rather than weight?

Weight alone can mislead when fluid is gathering in the abdomen or legs, because fluid gain can hide muscle loss. Clues include clothes loosening at the shoulders and thighs while tightening at the waist, weaker handgrip, difficulty rising from a chair and visibly thinner upper arms compared with older photographs. Dietitians may measure grip strength or arm circumference. Mention any of these changes at your next visit.

What should I eat in the days after an embolization or ablation procedure?

Comfort comes first. Nausea, low-grade fever and abdominal discomfort are common for a few days, so fluids, then soft bland foods in small portions, are the usual advice. Ask the team about timing anti-nausea medicine before meals rather than after. Protein targets can wait until the acute phase settles, typically within the first week, after which the focus returns to rebuilding with regular protein and a bedtime snack.

Is it safe to fast or do a juice cleanse to rest my liver?

No. The liver is the body’s detox organ, and no juice replaces its function. Prolonged fasting removes the steady fuel that spares muscle in someone whose liver cannot release stored glucose reliably, so cleanses tend to accelerate the muscle loss that treatment already threatens. There is no evidence that any cleanse improves liver cancer outcomes. If a fast is required before a procedure, the team will specify exactly how long.

When should I ask to see a dietitian for liver cancer?

Ask as soon as you notice unintended weight loss, shrinking meals, fluid in the abdomen or legs, or before a major operation or new drug therapy. People with stable weight and a small tumor under surveillance are often given general advice first and referred if anything changes. Referral is a scheduling decision rather than a judgment about importance, and the treating team can move you up whenever the picture shifts.

References

• MedlinePlus: Liver Cancer
• Cleveland Clinic: Hepatic Encephalopathy
• NHS: Liver cancer

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.