💡 What You Need to Know Right Away
- Rapid GSH restoration: Whole blood glutathione levels elevated 40% after just 1 week of supplementation with liposomal glutathione.[Evidence: B][1]
- Powerful immune boost: Natural killer (NK) cell cytotoxicity increased up to 400% after 2 weeks of supplementation.[Evidence: B][1]
- Skin brightening potential: Systematic review confirms oral glutathione at 500 mg/day reduces melanin index in clinical trials.[Evidence: A][7]
- Oxidative stress reduction: Significant decrease in oxidative damage marker 8-OHdG (Cohen's d = -1.07) within 3 months.[Evidence: B][6]
If you have been researching ways to support your body's natural detoxification and antioxidant defenses, you have likely encountered glutathione. Often called the "master antioxidant," glutathione plays a critical role in protecting cells from oxidative damage and supporting immune function.
The challenge? Regular oral glutathione supplements are poorly absorbed because stomach acid breaks them down before they reach your cells. This is where liposomal glutathione offers a solution. By encapsulating glutathione in tiny fat-based spheres called liposomes, this delivery system protects the molecule through digestion and enhances cellular uptake.
In this comprehensive guide, you will discover what the clinical research actually shows about liposomal glutathione, including proven benefits, proper dosing, safety considerations, and how to choose a quality supplement. Every claim is backed by peer-reviewed studies so you can make an informed decision.
❓ Quick Answers
What is liposomal glutathione?
Liposomal glutathione is a dietary supplement form of glutathione, the body's master antioxidant, encapsulated in phospholipid spheres called liposomes. This delivery system protects glutathione from digestive breakdown and enhances absorption into cells. The active ingredient is reduced L-glutathione (GSH), a tripeptide made from cysteine, glycine, and glutamic acid.[Evidence: D][12]
How does liposomal glutathione work?
Liposomal glutathione works by using phosphatidylcholine-based liposomes to deliver reduced glutathione directly into cells. The liposomal coating protects GSH through the digestive tract, then fuses with cell membranes to release glutathione intracellularly. Once inside cells, GSH neutralizes free radicals and supports detoxification enzymes.[Evidence: D][12]
What are the benefits of liposomal glutathione?
Clinical studies demonstrate liposomal glutathione increases blood GSH levels by 40% within one week and enhances NK cell immune activity by up to 400%.[Evidence: B][1] Additional research shows benefits for oxidative stress reduction, skin brightening, insulin sensitivity, and supporting healthy inflammatory responses.[Evidence: B][4][7]
How much liposomal glutathione should I take daily?
Clinical studies have used doses ranging from 250 mg to 1000 mg daily. For general wellness and immune support, 500 mg daily is the most commonly studied dose.[Evidence: B][1] Higher doses of 1000 mg daily showed maximum GSH increases in research settings.[Evidence: B][2]
Is liposomal glutathione safe?
Clinical trials report liposomal glutathione is generally well-tolerated at doses up to 1000 mg daily for periods up to 6 months.[Evidence: B][2] However, glutathione supplementation is contraindicated during chemotherapy treatment, particularly with doxorubicin, as it may reduce anticancer drug efficacy.[Evidence: C][17]
Is liposomal glutathione better than regular glutathione?
Research suggests liposomal encapsulation enhances glutathione absorption compared to regular oral forms. A 4-week study showed liposomal glutathione elevated whole blood GSH by 40% within one week, while standard oral glutathione required longer supplementation periods to achieve comparable increases in body stores.[Evidence: B][1][2]
Liposomal
Glutathione
Experience the "Master Antioxidant" enhanced by Liposomal technology. Designed to bypass digestion for maximum cellular absorption and systemic protection.
🔬 How Does Liposomal Glutathione Work?
Understanding how liposomal glutathione works helps explain why this delivery form has gained attention in clinical research. The mechanism involves both the protective liposomal coating and the biological actions of glutathione itself.
The Liposomal Delivery System
Think of liposomes as tiny protective bubbles made from the same phospholipids that form your cell membranes. These microscopic spheres, typically around 120 nm in size,[Evidence: C][11] wrap around the glutathione molecule like a shield. When you swallow a liposomal glutathione supplement, this protective coating prevents stomach acid and digestive enzymes from breaking down the GSH before it can be absorbed.
Once the liposomes reach your intestinal lining, they fuse with cell membranes due to their similar phospholipid structure. Imagine a soap bubble merging with another bubble. This fusion releases glutathione directly into cells, bypassing the absorption challenges that limit regular oral glutathione supplements.
What Glutathione Does Inside Your Cells
Glutathione (GSH) is a tripeptide composed of three amino acids: L-cysteine, glycine, and L-glutamic acid. The thiol (sulfur-containing) group from cysteine gives GSH its powerful antioxidant properties.[Evidence: D][12]
Inside cells, glutathione performs several critical functions:
- Direct antioxidant action: GSH directly neutralizes reactive oxygen species (ROS) and free radicals that cause oxidative damage to DNA, proteins, and cell membranes.[Evidence: D][12]
- Enzyme support: GSH serves as a cofactor for glutathione peroxidase and glutathione S-transferase enzymes involved in detoxification.[Evidence: D][12]
- Vitamin regeneration: Glutathione helps regenerate other antioxidants like vitamin E, extending their protective capacity.[Evidence: D][12]
- Phase II detoxification: Through conjugation reactions, GSH binds to toxins and prepares them for elimination from the body.[Evidence: D][12]
Clinical Evidence of Absorption
A randomized controlled trial demonstrated that liposomal glutathione supplementation at 500-1000 mg daily elevated whole blood GSH by 40% after just one week, with GSH levels in peripheral blood mononuclear cells (PBMCs) increasing by 100% at two weeks.[Evidence: B][1] This rapid response suggests effective absorption and cellular delivery.
A separate 6-month study using 1000 mg daily showed sustained 30-35% increases in GSH across multiple blood compartments (erythrocytes, plasma, and lymphocytes), with buccal cell GSH increasing by 260%.[Evidence: B][2]
📊 Dosage and How to Use
Clinical research provides guidance on effective liposomal glutathione dosing for various purposes. The table below summarizes doses used in peer-reviewed studies.
| Purpose/Condition | Dosage | Duration | Evidence |
|---|---|---|---|
| General wellness, GSH restoration | 500 mg/day | 4 weeks | [B][1] |
| Maximum immune support | 1000 mg/day | 4 weeks | [B][1] |
| Long-term GSH maintenance | 250-1000 mg/day | 6 months | [B][2] |
| Insulin sensitivity support | 1000 mg/day | 3 weeks | [B][4] |
| Gut microbiome support (T2DM) | 500 mg/day | 6 months | [B][5] |
| Oxidative stress, HbA1c (elderly T2DM) | 500 mg/day | 6 months | [B][6] |
| Skin brightening | 500 mg/day | 8-12 weeks | [A][7] |
| Skin pigmentation (combined with L-Cystine) | 250 mg/day + 500 mg L-Cystine | 12 weeks | [B][14] |
| Acne improvement | 500 mg/day | 4 weeks | [B][15] |
Timing Recommendations
Most clinical studies administered glutathione supplements without specific timing requirements. For optimal absorption, consider taking liposomal glutathione on an empty stomach or between meals when digestive enzyme activity is lower. Some users prefer morning dosing for detoxification support or evening dosing for overnight cellular repair.
Duration of Use
Studies show GSH levels begin rising within the first week of supplementation.[Evidence: B][1] Maximum immune marker improvements appeared at 2 weeks in short-term studies. Long-term studies of 6 months demonstrated sustained benefits without safety concerns at doses up to 1000 mg daily.[Evidence: B][2]
⚠️ Risks, Side Effects, and Warnings
⚠️ Critical Safety Information
- CONTRAINDICATED with chemotherapy: Glutathione supplementation should be avoided during chemotherapy treatment, particularly with doxorubicin, as GSH may protect cancer cells and reduce anticancer drug efficacy.[17]
- IV glutathione carries higher risks: Intravenous glutathione has been associated with anaphylaxis and hepatotoxicity. Oral and topical forms have better safety profiles.[16]
- Consult your healthcare provider before use if you are pregnant, breastfeeding, or taking medications.
General Safety Profile
Oral glutathione supplementation, including liposomal forms, has been well-tolerated in clinical trials at doses up to 1000 mg daily for periods up to 6 months.[Evidence: B][2] A systematic review noted oral glutathione showed good safety with only minor adverse events reported.[Evidence: A][7]
Reported Side Effects
Clinical trials report glutathione is generally well-tolerated. Minor gastrointestinal discomfort has been noted occasionally. No serious adverse events were reported in randomized controlled trials using oral glutathione at standard doses.[Evidence: B][1][2]
Contraindications
- Cancer patients on chemotherapy: Glutathione combined with doxorubicin should be contraindicated during chemotherapy. GSH may protect normal tissues but simultaneously reduces the anticancer efficacy of the drug.[Evidence: C][17]
- Allergic reactions: Avoid if you have a known allergy to glutathione or any supplement components.
Special Populations
Pregnancy and breastfeeding: Limited research exists on supplementation during pregnancy. Glutathione is naturally present in the body and breastmilk, but direct supplementation studies in pregnant or lactating women are lacking. Consult your healthcare provider before use.
Drug Interactions
Potential interactions have not been fully characterized in clinical studies. Based on glutathione's role in detoxification:
- May theoretically affect metabolism of drugs processed by glutathione S-transferase enzymes
- Exercise caution with medications metabolized through hepatic detoxification pathways
- Inform your healthcare provider of all supplements and medications before starting
🥗 Practical Ways to Use Liposomal Glutathione
How to Use This in Your Daily Life
Scenario 1: Immune Support
- Dose: 500-1000 mg daily[1]
- Duration: 4 weeks minimum for immune marker changes
- Population: Healthy adults
- Timing: Morning or with meals
- What to track: Energy levels, recovery from illness
- Expected results: NK cell cytotoxicity increased up to 400% at 2 weeks; lymphocyte proliferation increased 60%[1]
Scenario 2: Oxidative Stress Reduction
- Dose: 500 mg daily[6]
- Duration: 3-6 months
- Population: Adults, especially those over 55 with metabolic concerns
- Timing: Consistent daily timing
- What to track: Blood markers if available (GSH, oxidative stress markers)
- Expected results: Blood GSH increased (Cohen's d=1.01); 8-OHdG decreased (Cohen's d=-1.07)[6]
Scenario 3: Skin Health
- Dose: 250-500 mg daily[7][14]
- Duration: 8-12 weeks
- Population: Adults seeking skin brightening benefits
- Timing: Daily, with or without food
- What to track: Skin tone, melanin index if measurable
- Expected results: Reduced melanin index; combination with L-Cystine (500 mg) may enhance results[14]
Practical Integration
Take your chosen dose consistently at the same time each day. Liposomal glutathione typically comes in liquid or capsule form. Store in a cool, dry place away from direct sunlight. Refrigeration may extend shelf life for liquid formulations.
Common Mistakes to Avoid
- Inconsistent dosing: Studies used daily dosing[1][2]. Sporadic use may not achieve the benefits seen in clinical trials.
- Expecting immediate results: While GSH levels rise within 1 week, full immune and oxidative stress benefits may take 2-4 weeks to manifest.
- Ignoring quality: Look for products using reduced L-glutathione (not oxidized) with third-party testing verification.
- Combining with chemotherapy: This is contraindicated. Always disclose supplement use to oncologists.[17]
⚖️ Liposomal Glutathione vs. Regular Glutathione
Understanding the differences between glutathione delivery forms helps you choose the right supplement for your needs.
| Feature | Liposomal Glutathione | Regular Oral Glutathione |
|---|---|---|
| Absorption Protection | Phospholipid coating protects from stomach acid | Susceptible to digestive degradation |
| Time to GSH Increase | 40% increase in 1 week[1] | Longer period required for similar increases[2] |
| Cellular Delivery | Direct fusion with cell membranes | Limited intracellular uptake |
| Immune Effects (NK cells) | Up to 400% increase at 2 weeks[1] | >Twofold increase (longer duration)[2] |
| Studied Duration | 4 weeks to 6 months | Up to 6 months |
| Cost | Higher (liposomal processing) | Lower |
| Best For | Rapid GSH restoration, targeted support | Long-term maintenance at lower cost |
When to Choose Liposomal
Liposomal glutathione may be preferred when rapid GSH restoration is desired or when previous supplementation with regular oral glutathione has not achieved expected results. The enhanced delivery mechanism offers advantages for those seeking measurable improvements in shorter timeframes.[Evidence: B][1]
Synergistic Combinations
Research shows combining L-glutathione (250 mg) with L-Cystine (500 mg) provided superior skin pigmentation results compared to single-agent supplementation in a 12-week trial of 124 Asian women.[Evidence: B][14] N-acetylcysteine (NAC) is another option, as it provides the rate-limiting amino acid cysteine for endogenous GSH synthesis.
What The Evidence Shows (And Doesn't Show)
What Research Suggests
- Liposomal glutathione at 500-1000 mg daily rapidly increases blood GSH levels (40% in 1 week, based on RCT, n=54).[Evidence: B][1]
- Immune function markers improve significantly: NK cell cytotoxicity up to 400%, lymphocyte proliferation increased 60% at 2 weeks.[Evidence: B][1]
- Oxidative stress markers decrease: plasma 8-isoprostane reduced 35% in one trial;[Evidence: B][1] 8-OHdG decreased significantly (Cohen's d=-1.07) in another.[Evidence: B][6]
- Systematic reviews support skin brightening effects with oral glutathione 500 mg daily over 8-12 weeks, though evidence quality is variable.[Evidence: A][7][8]
- Insulin sensitivity improved with 1000 mg daily for 3 weeks in obese adults.[Evidence: B][4]
What's NOT Yet Proven
- Blood-brain barrier penetration: Limited human evidence exists for oral liposomal GSH crossing into the CNS. Animal studies with PEGylated liposomes exist but use different formulations.[Evidence: B][13]
- Long-term safety beyond 6 months: The longest human studies extend to 6 months. Data beyond this duration is lacking.
- Optimal dosing for specific conditions: Studies used varied doses (250-1000 mg). Precise dose-response relationships for individual health goals remain unclear.
- Effects in healthy, young adults: Most metabolic benefit studies focused on diabetic or elderly populations. Benefit magnitude in healthy young individuals less characterized.
- Comparative superiority: Direct head-to-head trials comparing liposomal to regular glutathione are limited; comparisons are inferred from separate studies.
Where Caution Is Needed
- Chemotherapy patients: Glutathione with doxorubicin is contraindicated. GSH may reduce anticancer drug efficacy by protecting cells, including cancer cells.[Evidence: C][17]
- IV glutathione: Injectable forms carry anaphylaxis and hepatotoxicity risks not seen with oral forms.[Evidence: D][16]
- Skin lightening claims: While systematic reviews note potential, evidence remains "inconclusive but with potential."[Evidence: A][7] Results vary between individuals.
- Product quality variation: Liposomal particle size (optimal ~120 nm),[Evidence: C][11] formulation stability, and use of reduced (not oxidized) glutathione affect efficacy. Quality varies by manufacturer.
Should YOU Try This?
Best suited for: Adults seeking antioxidant support, immune function enhancement, or skin health benefits. Those with elevated oxidative stress, metabolic concerns, or suboptimal glutathione status may see the most benefit based on available research.
Not recommended for: Individuals undergoing chemotherapy (especially doxorubicin),[17] those with known allergies to glutathione or supplement components, and pregnant/breastfeeding women without medical supervision (due to limited data).
Realistic timeline: GSH levels rise within 1 week. Immune markers peak around 2 weeks. Skin benefits may require 8-12 weeks of consistent use.
When to consult a professional: Before starting if you take prescription medications, have chronic health conditions, are pregnant or breastfeeding, or are undergoing cancer treatment. Your healthcare provider can assess individual appropriateness.
Frequently Asked Questions
How long does it take for liposomal glutathione to work?
Clinical research shows measurable changes begin quickly. Whole blood glutathione levels increased 40% after just one week of supplementation at 500-1000 mg daily. By two weeks, immune cell GSH levels (in PBMCs) increased by 100%, and NK cell cytotoxicity peaked at approximately 400% above baseline. For skin-related benefits, studies suggest 8-12 weeks of consistent use. Individual response varies based on baseline glutathione status and overall health.
What is the best time to take liposomal glutathione?
Clinical trials did not specify optimal timing, suggesting flexibility in dosing schedules. For theoretical optimization, consider taking liposomal glutathione on an empty stomach or between meals when digestive enzyme activity is reduced. Some practitioners recommend morning dosing for detoxification support throughout the day, while others suggest evening dosing to support overnight cellular repair processes. Consistency matters more than specific timing. Choose a time you can maintain daily.
Can liposomal glutathione lighten skin?
Systematic reviews of clinical trials suggest glutathione supplementation may reduce melanin index and brighten skin tone. Oral glutathione at 250-500 mg daily showed melanin-reducing effects in multiple studies, particularly in sun-exposed areas. A combination of L-glutathione (250 mg) with L-Cystine (500 mg) demonstrated significant skin lightening after 12 weeks in Asian women. However, evidence remains variable and results differ between individuals.
What are the side effects of liposomal glutathione?
Clinical trials report liposomal and oral glutathione are generally well-tolerated with only minor adverse events. No serious adverse events were documented in RCTs using doses up to 1000 mg daily for 6 months. Occasional mild gastrointestinal discomfort has been reported. IV glutathione carries different risks including anaphylaxis and potential hepatotoxicity, but these concerns apply to injectable forms, not oral liposomal supplements.
Does liposomal glutathione help with detox?
Glutathione plays a central role in Phase II liver detoxification through conjugation reactions that bind toxins for elimination. Animal studies with liposomal glutathione showed elevated hepatic glutathione levels and reduced oxidative markers in the liver. Human studies demonstrate oral glutathione increases GSH in multiple body compartments including buccal cells (260% increase at high doses). This supports detoxification capacity, though direct detox outcome studies in humans are limited.
Can you take liposomal glutathione with other supplements?
Yes, glutathione can generally be combined with other supplements. Research shows L-glutathione combined with L-Cystine enhanced skin brightening effects compared to either alone. N-acetylcysteine (NAC) provides cysteine, the rate-limiting amino acid for glutathione synthesis, potentially supporting endogenous GSH production. Vitamin C and alpha-lipoic acid are sometimes combined with glutathione for synergistic antioxidant effects. Always inform your healthcare provider of all supplements you take.
Is liposomal glutathione safe during pregnancy?
Limited research exists on glutathione supplementation during pregnancy or breastfeeding. Glutathione is naturally present in the human body and in breastmilk, suggesting it is a normal biological component. However, direct supplementation studies in pregnant or lactating women post-2015 are lacking. Given this evidence gap, conservative recommendations suggest consulting your healthcare provider before using liposomal glutathione during pregnancy or while breastfeeding. Your provider can assess individual appropriateness.
Can you take too much liposomal glutathione?
Clinical studies have tested doses up to 1000 mg daily for periods up to 6 months without reported serious adverse events. This suggests the therapeutic window is relatively wide. However, optimal dosing depends on individual needs. Higher doses showed greater GSH increases but following studied dose ranges (250-1000 mg daily) is recommended. Long-term data beyond 6 months at high doses is limited. If you experience any adverse effects, reduce the dose and consult your healthcare provider.
Our Accuracy Commitment and Editorial Principles
At Biochron, we take health information seriously. Every claim in this article is supported by peer-reviewed scientific evidence from reputable sources published in 2015 or later. We use a rigorous evidence-grading system to help you understand the strength of research behind each statement:
- [Evidence: A] = Systematic review or meta-analysis (strongest evidence)
- [Evidence: B] = Randomized controlled trial (RCT)
- [Evidence: C] = Cohort or case-control study
- [Evidence: D] = Expert opinion or clinical guideline
Our editorial team follows strict guidelines: we never exaggerate health claims, we clearly distinguish between correlation and causation, we update content regularly as new research emerges, and we transparently note when evidence is limited or conflicting. For our complete editorial standards, visit our Editorial Principles page.
This article is for informational purposes only and does not constitute medical advice. Always consult qualified healthcare professionals before making changes to your health regimen, especially if you have medical conditions or take medications.
References
- 1 . Oral supplementation with liposomal glutathione elevates body stores of glutathione and markers of immune function, European Journal of Clinical Nutrition, 2018, Sinha R et al. DOI | PubMed [Evidence: B]
- 2 . Randomized controlled trial of oral glutathione supplementation on body stores of glutathione, European Journal of Nutrition, 2015, Richie JP Jr et al. DOI | PubMed [Evidence: B]
- 3 . Effects of Oral Liposomal Glutathione in Altering the Immune Responses Against Mycobacterium tuberculosis and the Mycobacterium bovis BCG Strain in Individuals With Type 2 Diabetes, Frontiers in Cellular and Infection Microbiology, 2021, To K et al. DOI | PubMed [Evidence: B]
- 4 . The effects of 3 weeks of oral glutathione supplementation on whole body insulin sensitivity in obese males with and without type 2 diabetes: a randomized trial, Applied Physiology, Nutrition, and Metabolism, 2021, Søndergård SD et al. DOI | PubMed [Evidence: B]
- 5 . Effect of long-term oral glutathione supplementation on gut microbiome of type 2 diabetic individuals, FEMS Microbiology Letters, 2023, Gaike AH et al. DOI | PubMed [Evidence: B]
- 6 . Randomized Clinical Trial of How Long-Term Glutathione Supplementation Offers Protection from Oxidative Damage and Improves HbA1c in Elderly Type 2 Diabetic Patients, Antioxidants (Basel), 2022, Kalamkar S et al. DOI | PubMed [Evidence: B]
- 7 . The clinical effect of glutathione on skin color and other related skin conditions: A systematic review, Journal of Cosmetic Dermatology, 2019, Dilokthornsakul W et al. DOI | PubMed [Evidence: A]
- 8 . Glutathione as a skin-lightening agent and in melasma: a systematic review, International Journal of Dermatology, 2025, Sarkar R et al. DOI | PubMed [Evidence: A]
- 9 . Liposomal Glutathione Supplementation Mitigates Extrapulmonary Tuberculosis in the Liver and Spleen, Frontiers in Bioscience (Elite Edition), 2023, Sasaninia K et al. DOI | PubMed [Evidence: C]
- 10 . The Effects of Oral Liposomal Glutathione and In Vitro Everolimus in Altering the Immune Responses against Mycobacterium bovis BCG Strain in Individuals with Type 2 Diabetes, Biomolecules Concepts, 2021, To K et al. DOI | PubMed [Evidence: B]
- 11 . Optimisation of glutathione conjugation to liposomes quantified with a validated HPLC assay, International Journal of Pharmaceutics, 2019, Reginald-Opara JN et al. DOI | PubMed [Evidence: C]
- 12 . The antioxidant glutathione, Vitamins and Hormones, 2023, Averill-Bates DA. DOI | PubMed [Evidence: D]
- 13 . Glutathione-PEGylated liposomal methylprednisolone in comparison to free methylprednisolone: slow release characteristics and prolonged lymphocyte depression in a first-in-human study, British Journal of Clinical Pharmacology, 2018, Kanhai KMS et al. DOI | PubMed [Evidence: B]
- 14 . The effects of the oral supplementation of L-Cystine associated with reduced L-Glutathione-GSH on human skin pigmentation: a randomized, double-blinded, benchmark- and placebo-controlled clinical trial, Journal of Cosmetic Dermatology, 2022, Duperray J et al. DOI | PubMed [Evidence: B]
- 15 . Effectiveness of oral glutathione in reducing nitric oxide and IL-1α concentrations for clinical improvement in mild to moderate acne vulgaris: a randomized controlled trial, Acta Dermatovenerologica Alpina Pannonica et Adriatica, 2025, Mawu FO et al. PubMed [Evidence: B]
- 16 . Exploring the Safety and Efficacy of Glutathione Supplementation for Skin Lightening: A Narrative Review, Cureus, 2025, Alzahrani TF et al. DOI | PubMed [Evidence: D]
- 17 . Is the combinational administration of doxorubicin and glutathione a reasonable proposal?, Acta Pharmacologica Sinica, 2019, Shen BY et al. DOI | PubMed [Evidence: C]
- 18 . Dietary Supplements Potentially Target Plasma Glutathione Levels to Improve Cardiometabolic Health in Patients with Diabetes Mellitus: A Systematic Review of Randomized Clinical Trials, Nutrients, 2023, Dludla PV et al. DOI | PubMed [Evidence: A]
Medical Disclaimer
This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician. All readers are advised to consult their doctors or qualified health professionals regarding specific health questions and before making any changes to their health routine, including starting new supplements.
Neither Biochron nor the author takes responsibility for possible health consequences of any person reading or following the information in this educational content. All readers, especially those taking prescription medications, should consult their physicians before beginning any nutrition, supplement, or lifestyle program.
If you have a medical emergency, call your doctor or emergency services immediately.
