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SYNTHAMIN 9 REFORMULATED PERFUSION SOLUTION

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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 SYNTHAMIN 9 REFORMULATED PERFUSION SOLUTION

Introduction

Package Leaflet: Information for the User

SYNTHAMIN 9 REFORMULATED solution for infusion

Read all of this leaflet carefully before you start using this medicine because it contains important information for you.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or nurse.
  • If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack:

  1. What Synthamin is and what it is used for
  2. What you need to know before you are given Synthamin
  3. How Synthamin will be given to you
  4. Possible side effects
  5. Storage of Synthamin
  6. Contents of the pack and other information

1. What Synthamin is and what it is used for

Synthamin is a sterile solution that contains a large number of compounds called amino acids. These are the building blocks for proteins that are vital for your body. It also contains some chemical substances called electrolytes, which are very important for your body to function properly.

Together with other compounds such as minerals and vitamins, it is used to provide nutrition (food) directly into your blood when you cannot take food by mouth. It is important that you are given this medicine to help you improve.

It is usually given together with other nutrition solutions.

2. What you need to know before you are given Synthamin

Synthamin must not be given to you if you have any of the following conditions

  • If you are allergic to the active substances or to any of the other components of this medicine (listed in section 6).

medicine (including those listed in section 6).

  • If you have any disease in amino acid metabolism.
  • If you have high blood levels of sodium, potassium, magnesium and/or phosphorus.

Warnings and precautions

Talk to your doctor or nurse before you start using Synthamin

  • Synthamin will only be used if the solution is clear and the packaging is not damaged.
  • If symptoms of lung disorders appear.
  • If you have a fever or feel unwell.
  • Regular blood and urine tests will be carried out to ensure you are receiving the correct amount of the solution. If necessary, you will be given other treatments.
  • You will be closely monitored if you have liver, heart or kidney problems. Please inform your doctor about this.
  • You will be carefully monitored if you have diabetes.
  • If it is given to a very small child, more checks will be carried out.
  • If necessary, you may also be given a vitamin called folic acid, fatty acids (the building blocks of fats), and sugar solutions (such as glucose) to ensure your body has all the necessary elements for good health.
  • Synthamin must not be given at the same time as, before or after a blood transfusion through the same infusion equipment.
  • The combined administration of Synthamin injectable solutions with concentrated glucose solutions may lead to hyperglycemia, glucosuria, and hyperosmolar syndrome. Therefore, in patients receiving this treatment, routine glucose control in blood and urine should be carried out. In certain patients, exogenous insulin intake may be necessary.

If any abnormal signs or symptoms of hypersensitivity or allergic reactions appear, the infusion must be stopped immediately.

When used in newborns and children under 2 years, the solution (in the bags and administration equipment) must be protected from light exposure until the end of administration (see section 2).

Using Synthamin with other medicines

Tell your doctor or nurse if you are taking or have recently taken or might take any other medicines.

No interaction studies have been performed with Synthamin.

Due to the potassium content of Synthamin, special care is necessary in patients treated with potassium-sparing diuretics (e.g., amiloride, spironolactone, triamterene), with angiotensin-converting enzyme (ACE) inhibitors, with angiotensin II receptor antagonists, or with immunosuppressants tacrolimus or cyclosporin due to the risk of hyperkalemia.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, or think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine.

The safety of using amino acid solutions in pregnant or breastfeeding women has not been established. Your doctor will carefully weigh the benefits and possible risks before prescribing Synthamin.

Driving and using machines

Synthamin does not affect your ability to drive or use machines.

3. How Synthamin will be given to you

Use in adults

Your doctor will determine an infusion rate based on your needs and clinical condition, which will depend on your weight, your body's needs, the amount of sugar solution (such as glucose) that can be given to you, and the reason for your treatment.

The solution will be given to you through a slow drip injection (called infusion) into a large vein in your chest (the superior vena cava). The drip rate will not be more than 70 ml per hour and you will not receive more than 40 ml per kilogram of body weight in a day.

You will not receive blood transfusions through this tube.

Use in children

When used in newborns and children under 2 years, the solution (in the bags and administration equipment) must be protected from light exposure until the end of administration (see section 2).

In children, the dose of parenteral nutrition should be adjusted individually based on the patient's requirements for amino acids, electrolytes, and energy.

If you are given too much Synthamin

Since your doctor will be the one giving you Synthamin, it is unlikely that you will be given too much. However, if you think you have received more than you should, tell your doctor or nurse.

In case of overdose or accidental ingestion, consult the Toxicology Information Service. Telephone 915.620.420

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

There have been reports of a stinging pain and redness at the site where the medicine is given into your vein. Allergic reactions, including a severe allergic reaction called anaphylaxis, and other skin reactions (hives, rash, itching, redness), gastrointestinal reactions, and circulatory (shock) or respiratory reactions have also been reported.

The following may appear:

  • fever,
  • chills,
  • high blood pressure (hypertension) or low blood pressure (hypotension),
  • joint pain (arthralgia),
  • muscle pain (myalgia),
  • headache (cephalalgia),
  • increased levels of nitrogen in the blood (azotemia) or ammonia (hyperammonemia),
  • liver disorders.
  • vein irritation (thrombus formation, pain, redness, heat, inflammation, hardening).

Reporting of side effects

If you experience any side effects, talk to your doctor or nurse, even if it is possible side effects not listed in this leaflet. You can also report side effects directly through the Spanish Medicines and Healthcare Products Agency (AEMPS) website www.notificaRAM.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Synthamin

Keep this medicine out of the sight and reach of children.

When used in newborns and children under 2 years, the solution (in the bags and administration equipment) must be protected from light exposure until the end of administration (see section 2).

Do not store above 25°C.

Protect from light until immediately before use.

Do not refrigerate.

Do not use this medicine after the expiry date which is stated on the bag and carton after EXP. The expiry date is the last day of the month stated.

Discard partially used containers. Any remaining solution should be discarded by a healthcare professional.

6. Contents of the pack and other information

Composition of Synthamin

The active substances per 1000 ml are: Glycine 5.66 g, L-Alanine 11.40 g, L-Arginine 6.32 g, L-Phenylalanine 3.08 g, L-Histidine 2.64 g, L-Isoleucine 3.30 g, L-Leucine 4.02 g, L-Lysine hydrochloride 4.00 g, L-Methionine 2.20 g, L-Proline 3.74 g, L-Serine 2.75 g, L-Tyrosine 22 mg, L-Threonine 2.31 g, L-Tryptophan 99 mg, L-Valine 3.19 g, Sodium acetate trihydrate 4.32 g, Potassium phosphate dibasic 5.22 g, Sodium chloride 2.24 g, Magnesium chloride hexahydrate 1.02 g.

Approximate electrolyte concentrations (mmol/l) of the solution:

Sodium: 70

Potassium: 60

Magnesium: 5

Acetate (1): 100

Chloride: 70

Phosphate (as HPO4-2): 30

Amino acid concentration: 55 g/l

Nitrogen equivalence: 9.1 g/l

Protein equivalence: 57 g/l

Essential AA/Total AA ratio: 0.45

pH: approximately 6

Calculated osmolality (mOsm/l): 850

(1) Acetate is added as sodium acetate and/or as acetic acid for pH adjustment.

Appearance and packaging

Synthamin is a clear solution, free from visible particles. It is presented in Viaflex plastic bags. Each bag is packaged in a protective plastic overbag.

The bag sizes may be 500 and 1000 ml.

The bags are supplied in cartons, each containing the following quantities:

  • 10 bags of 500 ml
  • 10 bags of 1000 ml

Not all pack sizes may be marketed.

Marketing authorisation holder

Baxter S.L.

Pouet de Camilo 2, 46394 Ribarroja del Turia (Valencia)

Spain

Manufacturer

Baxter S.A.

Boulevard René Branquart, 80

7860 Lessines

Belgium

Date of last revision of this leaflet: March 2020

Detailed and up-to-date information on this medicine is available on the website of the Spanish Agency for Medicines and Healthcare Products (AEMPS) http://www.aemps.gob.es/

--------------------------------------------------------------------------------------------------------------------

This information is intended only for healthcare professionals

Posology and method of administration

Posology

The total daily dose of these solutions depends on the patient's metabolic needs and clinical response.

Probably, the best procedure to determine individual nitrogen needs is to determine fluid balance. Daily doses of amino acids of approximately 1.0-1.5 g/kg body weight in adults and 2-3 g/kg body weight in children, with an adequate amount of calories (around 180 kcal/g nitrogen or +/-30 kcal/g amino acids), are generally sufficient to meet protein needs and promote a positive nitrogen balance.

The use of higher doses, mainly in children, should be monitored by more frequent laboratory tests. The infusion rate should not exceed 0.1 g/kg per hour. The maximum infusion rate depends on the amino acid concentration used. In the case of Synthamin 9 (5.5% Amino Acids), it will be 140 ml/h.

It is necessary to ensure the maintenance of serum potassium levels. A potassium amount equivalent to 60-180 mEq/day may be indicated. It may be useful to add electrolytes and potassium, depending on the amount of carbohydrates administered and metabolized by the patient. It is important to frequently monitor serum electrolyte levels, mainly phosphate, magnesium, and chloride.

Individually, vitamins, trace elements, and other components (including glucose and lipids) may be added to the parenteral nutrition regimen to meet nutritional needs and prevent deficiencies and the development of complications.

The co-administration of a fat emulsion should be assessed when prolonged parenteral nutrition is required to prevent essential fatty acid deficiency (EFAD).

In the case of peripheral administration, the osmolality of the solution should be taken into account.

The solution should be visually inspected for particles and color before administration.

The infusion rate of the solution should be gradually increased during the first hour and adjusted according to the dose to be administered, the daily volume indicated, and the duration of the infusion.

The use of a final filter is recommended during the administration of parenteral nutrition solutions.

Method of administration

Hypertonic mixtures of amino acids and glucose are preferably administered through a central catheter. If the central route is not indicated, it can be administered peripherally to patients who need parenteral nutrition, amino acid solutions together with glucose solutions of appropriate concentration, and lipid emulsions at the same time.

Do not administer unless the solution is clear and colorless or slightly yellow and the packaging is in good condition.

When used in newborns and children under 2 years, the solution (in the bags and administration equipment) must be protected from light exposure until the end of administration.

Special warnings and precautions for use:

Exposure to light of parenteral nutrition solutions for intravenous use, especially after mixing with trace elements or vitamins, may have adverse effects on the clinical outcome of newborns due to the generation of peroxides and other degradation products.

When used in newborns and children under 2 years, Synthamin must be protected from ambient light until the end of administration.

Handling and preparation

Instructions for use of the Viaflex bag

Use an aseptic technique.

  1. Remove the Viaflex bag from its protective overbag at the time of use. Discard the oxygen absorber bag.
  1. Check for absence of leaks by pressing the Viaflex bag. Check the transparency of the solution and the absence of foreign particles.
  1. Hang the Viaflex bag. Prepare the administration equipment and close the flow regulator.
  1. Remove the protector from the outlet tube of the Viaflex bag and the protector from the spike of the administration equipment. Insert the spike of the administration equipment into the outlet tube of the Viaflex bag.
  1. Follow the instructions for use of the administration equipment to prime it and administer the solution.

In case of additions to the bag:

Use an aseptic technique.

Check the stability and compatibility of the additives.

Prepare the injection point of the bag.

Puncture the injection point and inject the additives using a syringe or a reconstitution device.

Mix the contents of the bag and the additives.

Inspect the final mixture for color and foreign particles.

Check the bag for absence of leaks.

Ensure that adequate storage conditions are met for the additive.

Administration of the infusion:

Do not administer blood before, at the same time, or after, through the same infusion equipment due to the risk of pseudoagglutination.

Do not connect bags in series to avoid a gas embolism due to residual air in the primary container.

Discard after a single use.

Discard any remaining portion.

Do not reconnect partially used bags.

Special precautions for disposal and other handling:

When used in newborns and children under 2 years, it must be protected from light exposure until the end of administration. Exposure of Synthamin to ambient light, especially after mixing with trace elements or vitamins, generates peroxides and other degradation products that can be reduced if the product is protected from light exposure.

Baxter, Viaflex, and Synthamin are registered trademarks of Baxter International Inc.

  • Country of registration
  • Active substance
  • Prescription required
    Yes
  • Manufacturer
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Discuss dosage, side effects, interactions, contraindications, and prescription renewal for SYNTHAMIN 9 REFORMULATED PERFUSION SOLUTION – 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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Lina Travkina

Family medicine12 years of experience

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

  • Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
  • ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
  • Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
  • Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
  • Neurological and general symptoms: headache, migraine, dizziness, fatigue, sleep disturbances, reduced concentration, anxiety, asthenia.
  • Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

  • Preventive consultations and check-up planning.
  • Medical advice and follow-up consultations.
  • Test interpretation and diagnostic guidance.
  • Structured support for undiagnosed complaints.
  • Second opinion on diagnoses and treatment plans.
  • Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
  • Post-operative recovery support and pain management.
  • Preconception counselling and postpartum support.
  • Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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Jonathan Marshall Ben Ami

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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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Yevgen Yakovenko

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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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Doctor

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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Doctor

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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Doctor

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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Doctor

Maryna Kuznetsova

Cardiology16 years of experience

Dr Marina Kuznetsova is an internal medicine doctor and cardiologist with a PhD in medicine. She provides online consultations for adults with chronic and acute conditions, with a strong focus on cardiovascular health. Her approach is based on current clinical guidelines and evidence-based treatment strategies.

Areas of expertise:

  • dyslipidaemia and lipid metabolism disorders
  • prevention and management of atherosclerosis
  • blood pressure monitoring and antihypertensive therapy
  • arrhythmias: diagnosis, follow-up, and treatment adjustment
  • cardiovascular care and recovery support after Covid-19
Dr Kuznetsova helps patients manage cardiovascular risk factors, optimise long-term treatment, and gain clarity in complex health situations – all through accessible and structured online care.
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€50
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