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ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION

ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION

Ask a doctor about a prescription for ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION

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Doctor

Tomasz Grzelewski

Dermatology20 years of experience

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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Doctor

Alina Tsurkan

Family medicine12 years of experience

Dr. Alina Tsurkan is a licensed family medicine physician based in Portugal, offering online consultations for adults and children. She provides professional primary care, with a focus on prevention, accurate diagnosis, and long-term management of acute and chronic conditions.

Dr. Tsurkan supports patients with a wide range of health issues, including:

  • Respiratory infections: cold, flu, bronchitis, pneumonia, and lingering coughs.
  • ENT conditions: sinusitis, tonsillitis, otitis (ear infections), sore throat, allergic rhinitis.
  • Eye conditions: allergic or infectious conjunctivitis, red eyes, irritation.
  • Digestive issues: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), constipation, bloating, nausea.
  • Urinary and reproductive health: urinary tract infections (UTIs), cystitis, prevention of recurrent infections.
  • Chronic diseases: hypertension, elevated cholesterol, weight management.
  • Neurological complaints: headaches, migraines, sleep disturbances, fatigue, general weakness.
  • Children’s health: fever, infections, digestive issues, follow-ups, vaccination guidance.

She also provides:

  • IMT medical certificates for driving licence exchange in Portugal.
  • Personalised preventive care and wellness consultations.
  • Interpretation of test results and medical reports.
  • Follow-up care and medication review.
  • Support in managing multiple coexisting conditions.
  • Remote prescription management and medical documentation.

Dr. Tsurkan’s approach is evidence-based and holistic. She works closely with each patient to develop an individualised care plan that addresses both symptoms and root causes. Her goal is to empower patients to take control of their health and maintain well-being through lifestyle adjustments, routine check-ups, and early intervention.

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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION

Introduction

Package Leaflet: Information for the Patient

Erbium Citrate (169Er) Colloidal CIS bio international 111 MBq/ml Injectable Suspension

Erbium Citrate (169Er)

Read this entire leaflet carefully before starting to use this medication because it contains important information for you..

  • Keep this leaflet, as you may need to read it again.
  • If you have any questions, consult the nuclear medicine doctor who is supervising the procedure.
  • If you experience side effects, consult the nuclear medicine doctor, even if they are side effects not listed in this leaflet. See section 4.

Contents of the Leaflet:

1. What is Erbium Citrate (169Er) Colloidal CIS bio international and what is it used for

2. Before using Erbium Citrate (169Er) Colloidal CIS bio international

3. How to use Erbium Citrate (169Er) Colloidal CIS bio international

4. Possible side effects

5. Storage of Erbium Citrate (169Er) Colloidal CIS bio international

6. Package Contents and Additional Information

1. What is Erbium Citrate (169Er) Colloidal CIS bio international and what is it used for

This medication is a radiopharmaceutical for therapeutic use only.

Erbium Citrate (169Er) Colloidal CIS bio international is indicated in adults for the treatment of arthritis during inflammatory flare-ups of small joints in the hands and feet, when intra-articular treatment with corticosteroids fails or is contraindicated.

Administration of Erbium Citrate (169Er) Colloidal CIS bio international involves receiving a small amount of radioactivity. Your doctor and the nuclear medicine doctor consider that the clinical benefit you will obtain from this procedure with the radiopharmaceutical outweighs the risk due to radiation.

2. What you need to know before starting to use Erbium Citrate (169Er) Colloidal CIS bio international

Erbium Citrate (169Er) Colloidal CIS bio international must not be used:

  • If you are allergic (hypersensitive) to Erbium Citrate (169Er) or to any of the other components of this medication (listed in section 6).
  • If you are pregnant or think you may be pregnant.
  • If you are breastfeeding your child.
  • In children and young patients under 20 years of age.
  • If you have an infection in the joint to be treated.
  • If you have local infections or skin disorders in the injection area.
  • If you have recently had a synovial cyst rupture.

Warnings and Precautions

Be especially careful with Erbium Citrate (169Er) Colloidal CIS bio international and consult the nuclear medicine specialist:

  • If you have undergone a procedure with X-ray contrast media in the last 3 days
  • If you are a woman of childbearing age

Before administration ofErbium Citrate (169Er) Colloidal CIS bio internationalyou should avoid pregnancy by using an effective contraceptive method for several months after treatment.

Children and Adolescents

Inform your nuclear medicine specialist if you are under 20 years of age.

Use of Erbium Citrate (169Er) Colloidal CIS bio international with other medications:

Inform the nuclear medicine specialist if you are taking, have recently taken, or may need to take any other medication, including those purchased without a prescription.

Inform your nuclear medicine doctor if you have undergone a procedure with X-ray contrast media in the last 3 days, as it may interfere with the treatment outcome.

Pregnancy and Breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your nuclear medicine specialist before receiving this medication.

You must inform your nuclear medicine doctor before administration of Erbium Citrate (169Er) Colloidal CIS bio international if there is any possibility that you are pregnant, if you have a delayed period, or if you are breastfeeding. In fact, Erbium Citrate (169Er) should not be administered to pregnant or breastfeeding women. If you are a woman of childbearing age, you should use effective contraceptive measures before receiving this medication and maintain them for several months after treatment.

In case of doubt, it is essential to consult the nuclear medicine specialist who will supervise the procedure.

Driving and Using Machines

Driving vehicles or using machines is not recommended due to joint immobilization after administration.

Erbium Citrate (169Er) Colloidal CIS bio international contains less than 23 mg of sodium (1mmol) per dose; this is essentially "sodium-free".

3. How to use Erbium Citrate (169Er) Colloidal CIS bio international

There are strict rules for the use, handling, and disposal of radiopharmaceuticals. Erbium Citrate (169Er) Colloidal CIS bio international will only be used in controlled facilities. This product will only be handled and administered by trained and qualified personnel to use it safely. These individuals will take special care in the safe use of this product and will inform you of their actions.

The nuclear medicine doctor who supervises the procedure will decide the amount of Erbium Citrate (169Er) Colloidal CIS bio international to be used in your case. This will be the minimum amount necessary to achieve the desired effect. The generally recommended amount for administration to an adult is 10 to 80 MBq (Megabecquerel, the unit used to express radioactivity) depending on the joint to be treated.

Administration ofErbium Citrate (169Er) Colloidal CIS bio international and performance of the procedure

Erbium Citrate (169Er) Colloidal CIS bio international is injected directly into the small joints of the hands and feet by your nuclear medicine doctor.

Several joints can be treated simultaneously or successively.

A repeat injection of the radiopharmaceutical into a joint should not be done until at least six months have passed.

After administration of Erbium Citrate (169Er) Colloidal CIS bio international, you should:

  • Have the joint immobilized for 2 days (splints or bed rest)
  • Use an effective contraceptive method for several months after treatment to avoid any pregnancy.

Your nuclear medicine doctor will inform you if you need to take any precautions after receiving this medication. Consult your nuclear medicine doctor if you have any questions.

If you have received moreErbium Citrate (169Er) Colloidal CIS bio internationalthan you should have:

Overdose is unlikely because you will receive a single dose of Erbium Citrate (169Er) Colloidal CIS bio international per joint, controlled with precision by the nuclear medicine doctor who supervises the procedure. However, in case of overdose, you will receive appropriate treatment.

If you have any questions about the use of Erbium Citrate (169Er) Colloidal CIS bio international, ask the nuclear medicine doctor who supervises the procedure.

4. Possible side effects

Like all medications, this medication can cause side effects, although not everyone will experience them.

The most frequently observed side effects after synoviorthesis with Erbium Citrate (169Er) Colloidal CIS bio international are:

  • Very common (may affect more than 1 in 10 people): pain, inflammation at the injection site, acute arthritis (reappearance of inflammation during the first week after administration).
  • Common (may affect up to 1 in 10 people): fever, dysfunction of joint mobility, skin pigmentation.
  • Very rare (may affect up to 1 in 10,000 people): redness, severe skin disorder with blisters.
  • Frequency not known (cannot be estimated from available data): secondary infection in the joint, joint inflammation, skin necrosis, rash, and itching.

This radiopharmaceutical will release small amounts of ionizing radiation, which is minimally associated with the risk of cancer or genetic defects.

Reporting side effects

If you experience any type of side effect, inform your nuclear medicine specialist, even if it is a side effect not included in this leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es.

By reporting side effects, you can contribute to providing more information on the safety of this medication.

5. Storage of Erbium Citrate (169Er) Colloidal CIS bio international

You will not need to store this medication. This medication is stored under the responsibility of the specialist in appropriate facilities. The storage of radiopharmaceuticals will be carried out in accordance with national regulations on radioactive materials.

6. Package Contents and Additional Information

Composition ofErbium Citrate (169Er) Colloidal CIS bio international

  • The active ingredient is Erbium Citrate (169Er).
  • The other components are: nitric acid, sodium hydroxide, sodium chloride, and water for injectable preparations.

Appearance of Erbium Citrate (169Er) Colloidal CIS bio international and package contents

Erbium Citrate (169Er) Colloidal CIS bio international is presented as an injectable suspension, in a multidose vial.

Package size: 15 ml glass vials, sealed with a rubber stopper and aluminum cap. Contains between 0.1 and 10.0 ml, corresponding to an activity between 11 and 1110 MBq at the calibration date and time.

Marketing Authorization Holder and Manufacturer:

CIS bio international

RN 306 - Saclay

B.P. 32

F-91192 Gif-sur-Yvette Cedex

FRANCE

You can request more information about this medication by contacting the local representative of the Marketing Authorization Holder:

Curium Pharma Spain, S.A. Avda. Dr. Severo Ochoa, 29

28100-Alcobendas

Phone: 91 4841989

This leaflet was last revised in June 2020

Detailed information about this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/

The following information is intended only for healthcare professionals:

The complete technical data sheet for Erbium Citrate (169Er) Colloidal CIS bio international is included as a separate document in the product packaging to provide healthcare professionals with additional scientific and practical information on the administration and use of this radiopharmaceutical.

Please consult the Technical Data Sheet.

Online doctors for ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for ERBIUM CITRATE (169Er) colloidal CIS BIO INTERNACIONAL 111 MBq/ML INJECTABLE SUSPENSION – subject to medical assessment and local rules.

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Doctor

Tomasz Grzelewski

Dermatology20 years of experience

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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Doctor

Alina Tsurkan

Family medicine12 years of experience

Dr. Alina Tsurkan is a licensed family medicine physician based in Portugal, offering online consultations for adults and children. She provides professional primary care, with a focus on prevention, accurate diagnosis, and long-term management of acute and chronic conditions.

Dr. Tsurkan supports patients with a wide range of health issues, including:

  • Respiratory infections: cold, flu, bronchitis, pneumonia, and lingering coughs.
  • ENT conditions: sinusitis, tonsillitis, otitis (ear infections), sore throat, allergic rhinitis.
  • Eye conditions: allergic or infectious conjunctivitis, red eyes, irritation.
  • Digestive issues: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), constipation, bloating, nausea.
  • Urinary and reproductive health: urinary tract infections (UTIs), cystitis, prevention of recurrent infections.
  • Chronic diseases: hypertension, elevated cholesterol, weight management.
  • Neurological complaints: headaches, migraines, sleep disturbances, fatigue, general weakness.
  • Children’s health: fever, infections, digestive issues, follow-ups, vaccination guidance.

She also provides:

  • IMT medical certificates for driving licence exchange in Portugal.
  • Personalised preventive care and wellness consultations.
  • Interpretation of test results and medical reports.
  • Follow-up care and medication review.
  • Support in managing multiple coexisting conditions.
  • Remote prescription management and medical documentation.

Dr. Tsurkan’s approach is evidence-based and holistic. She works closely with each patient to develop an individualised care plan that addresses both symptoms and root causes. Her goal is to empower patients to take control of their health and maintain well-being through lifestyle adjustments, routine check-ups, and early intervention.

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Taisiya Minorskaya

Family medicine12 years of experience

Dr Taisiya Minorskaya is a family medicine doctor with an official licence to practise in Spain and over 12 years of clinical experience. She provides online consultations for adults and children, combining evidence-based medicine with a personalised, modern European approach.

She helps with:

  • Viral infections and cold symptoms (flu, sore throat, cough, runny nose)
  • Review and adjustment of antibiotics
  • Skin rashes and allergic reactions
  • Chronic condition flare-ups, high blood pressure, headaches, fatigue
  • Lab and test interpretation
  • Medication review and adaptation to European standards
  • Patient navigation: what tests are needed, which specialists to see, when an in-person visit is required
Dr Minorskaya also specialises in the diagnosis and management of gastrointestinal conditions, including bloating, abdominal pain, chronic nausea, IBS, and SIBO. She supports patients with unexplained physical symptoms that may be linked to somatisation or stress, helping them find relief and improve quality of life.

She offers care for people undergoing GLP-1 therapy (Ozempic, Mounjaro, and others) for weight management. Her support follows Spanish clinical guidelines, from treatment planning and side effect counselling to regular follow-ups and coordination with private or public healthcare providers.

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Yevgen Yakovenko

General surgery11 years of experience

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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Antonio Cayatte

General medicine43 years of experience

Dr Antonio Cayatte is a physician in General and Acute Medicine with over 30 years of experience across clinical care, medical research, and education. He offers online consultations for adults with a wide range of symptoms, both acute and chronic.

His clinical background includes:

  • assessment of sudden or unclear symptoms
  • ongoing care for chronic conditions
  • follow-up after hospital discharge
  • interpretation of test results
  • medical support while abroad
Dr Cayatte earned his degree from the University of Lisbon and taught internal medicine at Boston University School of Medicine. He holds active medical registrations in both Portugal and the UK and is a Fellow of the American Heart Association.

Consultations are available in English and Portuguese. Patients value his clarity, professionalism, and balanced approach to evidence-based care.

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Jonathan Marshall Ben Ami

Family medicine8 years of experience

Dr. Jonathan Marshall Ben Ami is a licensed family medicine doctor in Spain. He provides comprehensive care for adults and children, combining general medicine with emergency care expertise to address both acute and chronic health concerns.

Dr. Ben Ami offers expert diagnosis, treatment, and follow-up for:

  • Respiratory infections (cold, flu, bronchitis, pneumonia).
  • ENT conditions such as sinusitis, ear infections, and tonsillitis.
  • Digestive issues including gastritis, acid reflux, and irritable bowel syndrome (IBS).
  • Urinary tract infections and other common infections.
  • Management of chronic diseases: high blood pressure, diabetes, thyroid disorders.
  • Acute conditions requiring urgent medical attention.
  • Headaches, migraines, and minor injuries.
  • Wound care, health check-ups, and ongoing prescriptions.

With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

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Andrei Popov

General medicine6 years of experience

Dr. Andrei Popov is a licensed pain management specialist and general practitioner based in Spain. He provides expert online care for adults dealing with both chronic and acute pain, as well as a wide range of everyday health concerns.

He specialises in diagnosing and treating pain conditions that affect quality of life, including:

  • Chronic pain lasting more than 3 months.
  • Migraines and recurring headaches.
  • Neck, back, lower back, and joint pain.
  • Post-traumatic pain following injury or surgery.
  • Nerve-related pain, fibromyalgia, and neuralgia.
In addition to pain management, Dr. Popov helps patients with:
  • Respiratory infections (colds, bronchitis, pneumonia).
  • High blood pressure and metabolic conditions such as diabetes.
  • Preventive care and routine health check-ups.

Online consultations last up to 30 minutes and include a detailed symptom review, personalised treatment planning, and medical follow-up when needed.

Dr. Popov’s approach is rooted in evidence-based medicine, combined with individualised care tailored to each patient’s history, lifestyle, and clinical needs.

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Tetiana Fedoryshyn

General medicine29 years of experience

Dr Tetiana Fedoryshyn is a senior general practitioner, certified nutritionist, and psychologist with over 29 years of clinical experience. She combines classical internal medicine with modern approaches in lifestyle medicine, functional nutrition, and emotional health support.

Her focus is on helping patients regain health through deep understanding of symptoms, personalised nutrition plans, and evidence-based correction of deficiencies, stress-related conditions, and metabolic imbalances. Dr Fedoryshyn works with adults experiencing chronic conditions, fatigue, hormonal disruption, and post-stress exhaustion.

She integrates medical analysis, psychological insight, and real-life behaviour change tools to offer treatment plans tailored to each patient’s biochemistry, mental state, and lifestyle.

Main areas of practice:

  • Chronic condition management and medical counselling
  • Weight loss programmes based on metabolic profiling
  • Diagnosis and treatment of micronutrient deficiencies
  • Recovery from stress, burnout, and hormonal imbalances
  • Emotional support and psychosomatic symptom care
Her approach is never one-size-fits-all – each consultation begins with a deep dive into your unique health history, test results, and emotional landscape. Consultations are available in Ukrainian, Polish, and Russian.
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Anna Biriukova

General medicine5 years of experience

Dr Anna Biriukova is an internal medicine doctor with clinical experience in cardiology, endocrinology, and gastroenterology. She provides online consultations for adults, offering expert medical support for heart health, hormonal balance, digestive issues, and general internal medicine.

Cardiology – Diagnosis and treatment of:

  • High blood pressure, blood pressure fluctuations, and cardiovascular risk prevention.
  • Chest pain, shortness of breath, arrhythmias (tachycardia, bradycardia, palpitations).
  • Leg swelling, chronic fatigue, reduced exercise tolerance.
  • EKG interpretation, lipid profile evaluation, cardiovascular risk assessment (heart attack, stroke).
  • Post-COVID-19 cardiac monitoring and care.
Endocrinology – Diabetes, thyroid, metabolism:
  • Diagnosis and management of type 1 and type 2 diabetes, and prediabetes.
  • Individual treatment plans including oral medications and insulin therapy.
  • GLP-1 therapy– modern pharmacological treatment for weight management and diabetes control, including drug selection, monitoring, and safety follow-up.
  • Thyroid disorders – hypothyroidism, hyperthyroidism, autoimmune thyroid diseases (Hashimoto’s, Graves’ disease).
  • Metabolic syndrome – obesity, lipid disorders, insulin resistance.
Gastroenterology – Digestive health:
  • Abdominal pain, nausea, heartburn, gastroesophageal reflux (GERD).
  • Stomach and intestinal conditions: gastritis, irritable bowel syndrome (IBS), indigestion.
  • Management of chronic digestive disorders and interpretation of tests (endoscopy, ultrasound, labs).
General internal medicine and preventive care:
  • Respiratory infections – cough, colds, bronchitis.
  • Lab test analysis, therapy adjustments, medication management.
  • Adult vaccinations – planning, contraindications assessment.
  • Cancer prevention – screening strategies and risk assessment.
  • Holistic approach – symptom relief, complication prevention, and quality of life improvement.
Dr Biriukova combines internal medicine with specialist insight, offering clear explanations, personalised treatment plans, and comprehensive care tailored to each patient.
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Mar Tabeshadze

Endocrinology10 years of experience

Dr. Mar Tabeshadze is a licensed endocrinologist and general practitioner in Spain. She provides online consultations for adults, offering medical support for a wide range of endocrine conditions and related health concerns.

  • Diagnostic consultations for suspected endocrine disorders
  • Management of thyroid conditions, including in pregnant women
  • Early detection and treatment of type 1 and type 2 diabetes, with personalised therapy plans
  • Obesity treatment: identifying underlying causes of weight gain, combining medication and non-pharmacological strategies, and long-term support
  • Diagnosis and treatment of endocrine-related skin, hair, and nail issues
  • Ongoing care for patients with osteoporosis, pituitary, and adrenal gland disorders
Dr. Tabeshadze takes a patient-centred approach based on evidence-based medicine. Her goal is to help patients achieve hormonal balance, manage chronic conditions effectively, and improve overall well-being through targeted, personalised care.
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