Leaf Pharma

Product Introduction

Temoside 100 Capsule is used in the treatment of a specific type of cancer of the brain. It is used to treat brain tumors if they return or get worse after standard treatment. It may be also used to treat other conditions, as determined by the doctor.

Temoside 100 Capsule should be taken empty stomach and at same time each day to make sure it has the best effect. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to.

Before taking it, tell your doctor if have bleeding, liver, or kidney problems or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your doctor know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. It may harm your baby. You and your partner should avoid becoming pregnant or fathering a child for several months after your treatment with it has stopped.

Uses Of Temoside Capsule

Brain tumor

Side Effects Of Temoside Capsule

Common Side Effects Of Temoside
·      Nausea
·      Vomiting
·      Constipation
·      Headache
·      Fatigue
·      Convulsion
·      Coordination disorder
·      Diarrhea
·      Dizziness
·      Fever
·      Hair loss
·      Hemiparesis (weakness on one side of the body)
·      Insomnia (difficulty in sleeping)
·      Loss of appetite
·      Memory loss
·      Rash
·      Viral infection
·      Weakness

Safety Advice

Alcohol

It is not known whether it is safe to consume alcohol with Temoside 100 Capsule.

Pregnancy

Temoside 100 Capsule is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks.

Breast Feeding

Temoside 100 Capsule is unsafe to use during breastfeeding. Data suggests that the drug may cause toxicity to the baby.

Driving

Temoside 100 Capsule may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.

Kidney

Temoside 100 Capsule is probably safe to use in patients with kidney disease. Limited data available suggests that dose adjustment of Temoside 100 Capsule may not be needed in these patients. Cautious use is advised in patients with severe kidney disease while they are taking Temoside 100 Capsule.

Liver

Temoside 100 Capsule should be used with caution in patients with severe liver disease. Dose adjustment of Temoside 100 Capsule may be needed. Limited information is available on the use of Temoside 100 Capsule in these patients. No dose adjustment is recommended in patients with mild to moderate liver disease.

Introduction To Abevmy 400mg Injection

Abevmy 400mg Injection is an anticancer medicine consisting of the active ingredient Bevacizumab. This medicine is developed to prevent the growth of tumors. It is indicated along with other chemotherapy drugs to treat metastatic breast cancer, brain cancer, cervical cancer, kidney cancer, lung cancer, and colorectal cancer. It is also used to treat cancers of the ovary, fallopian tube or primary peritoneal cancer. Abevmy 400mg Injection is not recommended for adolescents and children under the age of 18. Discuss with your doctor about the preservation of ovaries if you are planning for pregnancy in the near future as this medicine may cause fertility issues in women. It would be best to avoid breastfeeding your baby as this medicine may interfere with the growth and development.

Uses Of Abevmy 400mg Injection

Abevmy 400mg Injection is indicated to treat the following conditions:

Glioblastoma multiforme (brain cancer)

Persistent, recurrent, or metastatic breast cancer

Metastatic cervical cancer

Advanced kidney cancer

Metastatic colorectal cancer

Advanced non-small-cell lung cancer

Liver Cancer- Hepatocellular carcinoma

Cancers of the ovary, cervical, fallopian tube, or primary peritoneal cancer

How To Consume Abevmy 400mg Injection

Your physician or nurse will administer Abevmy 400mg Injection as an intravenous infusion. The infusion should be given immediately after the dilution.

Safety Advices For Abevmy 400mg Injection  

Pregnancy

Inform your physician before starting your treatment with Abevmy 400mg Injection in case, if you are pregnant or planning for pregnancy as this medicine may cause harm to the unborn baby and interrupt the formation of blood vessels.

Breast Feeding

It is recommended to avoid breastfeeding for a minimum of 6 months after your treatment with Abevmy 400mg Injection as this medicine may interfere with the growth of your child.

Lungs

Inform your doctor if you have any lung conditions before starting treatment with Abevmy 400mg injection

Liver

Inform your physician before starting Abevmy 400mg Injection if you have liver diseases to avoid any serious side effects.

Alcohol

Consult your doctor to know if it is safe to consume alcohol while you are on treatment with Abevmy 400mg Injection as only limited studies are available.

Driving

Avoid driving or using machinery while you are on your treatment with Abevmy 400mg Injection as it is related to cause dizziness or sleepiness. 

Side Effects Of Abevmy 400mg Injection
Serious
· Headache
· Vision changes
· Confusion
· Severe allergic reactions
· High Blood pressure
· Delayed wound healing following surgery
· Protein in urine
· Severe infections
· Blood clots in arteries and blood vessels of lungs
· Gut perforation
· Nosebleeds and bleeding risk
· Heart problems with an increase in heart rate
·  Mouth sores, dryness
· Shortness of breath

Common
· Numbness in hands or feet
· Weakness and lack of energy
· Diarrhoea, nausea, vomiting, abdominal pain
· Constipation
· Loss of appetite
·  Weight loss
· Changes in taste and speech
· Decrease in counts of white blood cells
· Fever
· Dry skin
· Back pain

Introduction To Abevmy 100mg Injection

Abevmy 100mg Injection is an anticancer medicine consisting of the active ingredient Bevacizumab. This medicine is developed to prevent the growth of tumors. It is indicated along with other chemotherapy drugs to treat metastatic breast cancer, brain cancer, cervical cancer, kidney cancer, lung cancer, and colorectal cancer. It is also used to treat cancers of the ovary, fallopian tube or primary peritoneal cancer. Use effective birth control during the treatment and for at least six months after the last dose. Abevmy 100mg Injection is not recommended for adolescents and children under the age of 18. Discuss with your doctor about the preservation of ovaries if you are planning for pregnancy in the near future as this medicine may cause fertility issues in women. It would be best to avoid breastfeeding your baby as this medicine may interfere with the growth and development.

Uses of Abevmy 100mg Injection

Abevmy 100mg Injection is indicated to treat the following conditions:

Glioblastoma multiforme (brain cancer)

Persistent, recurrent, or metastatic breast cancer

Metastatic cervical cancer

Advanced kidney cancer

Metastatic colorectal cancer

Advanced non-small-cell lung cancer

Liver Cancer- Hepatocellular carcinoma

Cancers of the ovary, cervical, fallopian tube, or primary peritoneal cancer

Safety Advices For Abevmy 100mg Injection  

Pregnancy

Inform your physician before starting your treatment with Abevmy 100mg Injection in case, if you are pregnant or planning for pregnancy as this medicine may cause harm to the unborn baby and interrupt the formation of blood vessels.

Breast Feeding

It is recommended to avoid breastfeeding for a minimum of 6 months after your treatment with Abevmy 100mg Injection as this medicine may interfere with the growth of your child.

Lungs

Inform your doctor if you have any lung conditions before starting treatment with Abevmy 100mg injection

Liver

Inform your physician before starting Abevmy 100mg Injection if you have liver diseases to avoid any serious side effects.

Alcohol

Consult your doctor to know if it is safe to consume while you are on treatment with Abevmy 100mg Injection as only limited studies are available.

Driving

Avoid driving or using machinery while you are on your treatment with Abevmy 100mg Injection as it is related to cause dizziness or sleepiness. 

Side Effects Of Abevmy 100mg Injection

Serious
· Headache
· Vision changes
· Confusion
· Severe allergic reactions
· High Blood pressure
· Delayed wound healing following surgery
· Protein in urine
· Severe infections
· Blood clots in arteries and blood vessels of lungs
· Gut perforation
· Nosebleeds and bleeding risk
· Heart problems with an increase in heart rate
· Mouth sores, dryness
· Shortness of breath

Common
· Numbness in hands or feet
· Weakness and lack of energy
· Diarrhoea, nausea, vomiting, abdominal pain
· Constipation
· Loss of appetite
· Weight loss
· Changes in taste and speech
· Decrease in counts of white blood cells
· Fever
· Dry skin
· Back pain

Introduction To Bevatas 400 mg Injection

Bevatas 400 Injection is an anticancer medicine that is used alone or in combination with other medicines for the treatment of various types of cancers. This medicine works by inhibiting the blood supply to the tumour, which provides nutrients and oxygen to the cancer cells. Thus it slows down the growth of cancer cells. Bevatas 400 Injection can show side effects like body ache, sweating, tiredness, diarrhoea, nausea, vomiting, stomach pain, decreased blood cell count, weakness, etc. Avoid driving vehicles and operating machines after receiving this medicine as it can make you feel dizzy. Bevatas 400 Injection is administered by a qualified healthcare professional in a clinic or a hospital setting. Your dose and duration of the treatment will be decided based on the severity of your condition. Do not stop receiving this medication without consulting your doctor, as it may worsen your condition. Bevatas 400 Injection is not recommended if you are allergic to it. Inform your doctor about all your current medications and pre-existing medical conditions before receiving this medicine. This will help your doctor to adjust your dose to avoid undesired effects. Consult your doctor if you are pregnant or are breastfeeding..

Uses Of Bevatas 400 Injection

Colorectal Cancer

Bevatas 400 Injection is used in the treatment of colorectal cancer. The colon and rectum are parts of the large intestine. Colorectal cancer occurs when tumours form in the lining of the large intestine.

Non-Small Cell Lung Cancer

Bevatas 400 Injection is used in the treatment of non-small cell lung cancer. It is a type of lung cancer characterised by symptoms such as a persistent cough, shortness of breath, weight loss, coughing up blood, etc.

Glioblastoma Multiforme

Bevatas 400 Injection is used in the treatment of glioblastoma multiforme, a type of brain cancer characterised by symptoms such as headache, drowsiness, nausea, blurred vision, seizures , mood swings, changes in behaviour and personality, etc.

Renal cell carcinoma

Bevatas 400 Injection is used in the treatment of renal cell carcinoma, which is the most common type of kidney cancer.

Cervical cancer

Bevatas 400 Injection is used in the treatment of cervical cancer, a cancer of the cervix (the lower part of the uterus that connects to the vagina). It is characterised by bleeding in between periods, foul-smelling white discharge, low back pain, lower abdominal pain, etc.

Ovarian Cancer

Bevatas 400 Injection is used in the treatment of cancer of the ovaries.

Fallopian Tube Cancer

Bevatas 400 Injection is used in the treatment of cancer of the fallopian tube, a female reproductive organ that transports the egg from the ovary to the uterus.

Peritoneal Cancer

Bevatas 400 Injection is used in the treatment of peritoneal cancer. It develops in a thin layer of tissue called the peritoneum that lines the abdomen.

Side Effects

Major & Minor Side Effects For Bevatas 400 Injection

·  Black or tarry stools
·  Bleeding gums
·  Body aches or pain
·  Burning, numbness, tingling in the arms and feet
·  Chest pain
·  Chills
·  Decreased urine output
·  Fever
·  Irregular breathing
·  Seizures
·  Sore throat
·  Sweating
·  Unusual bleeding or bruising
·  Unusual tiredness and weakness
·  Dizziness
·  Nausea and vomiting
·  Diarrhoea
·  Low blood cell count
·  Change in taste.

Introduction To Bryxta 400 Mg Injection

Bryxta 400 Injection is an anticancer medicine that is used alone or in combination with other medicines for the treatment of various types of cancers. This medicine works by inhibiting the blood supply to the tumour, which provides nutrients and oxygen to the cancer cells. Thus it slows down the growth of cancer cells. Bryxta 400 Injection can show side effects like body ache, sweating, tiredness, diarrhoea, nausea, vomiting, stomach pain, decreased blood cell count, weakness, etc. Avoid driving vehicles and operating machines after receiving this medicine as it can make you feel dizzy. Bryxta 400 Injection is administered by a qualified healthcare professional in a clinic or a hospital setting. Your dose and duration of the treatment will be decided based on the severity of your condition. Do not stop receiving this medication without consulting your doctor, as it may worsen your condition. Bryxta 400 Injection is not recommended if you are allergic to it. Inform your doctor about all your current medications and pre-existing medical conditions before receiving this medicine. Bryxta 400 Injection may remain in your body for 120 days.

Uses of Bryxta 400 Injection

Colorectal Cancer

Bryxta 400 Injection is used in the treatment of colorectal cancer. The colon and rectum are parts of the large intestine. Colorectal cancer occurs when tumours form in the lining of the large intestine.

Non-Small Cell Lung Cancer

Bryxta 400 Injection is used in the treatment of non-small cell lung cancer. It is a type of lung cancer characterised by symptoms such as a persistent cough, shortness of breath, weight loss, coughing up blood, etc.

Glioblastoma Multiforme

Bryxta 400 Injection is used in the treatment of glioblastoma multiforme, a type of brain cancer characterised by symptoms such as headache, drowsiness, nausea, blurred vision, seizures (fits), mood swings, changes in behaviour and personality, etc.

Renal cell carcinoma

Bryxta 400 Injection is used in the treatment of renal cell carcinoma, which is the most common type of kidney cancer.

Cervical cancer

Bryxta 400 Injection is used in the treatment of cervical cancer, a cancer of the cervix (the lower part of the uterus that connects to the vagina). It is characterised by bleeding in between periods, foul-smelling white discharge, low back pain, lower abdominal pain, etc.

Ovarian Cancer

Bryxta 400 Injection is used in the treatment of cancer of the ovaries.

Fallopian Tube Cancer

Bryxta 400 Injection is used in the treatment of cancer of the fallopian tube, a female reproductive organ that transports the egg from the ovary to the uterus.

Peritoneal Cancer

Bryxta 400 Injection is used in the treatment of peritoneal cancer. It develops in a thin layer of tissue called the peritoneum that lines the abdomen.

Side Effects

Major & Minor Side Effects For Bryxta 400 Injection

·  Black or tarry stools
·  Bleeding gums
·  Body aches or pain
·  Burning, numbness, tingling in the arms and feet
·  Chest pain
·  Chills
·  Decreased urine output
·  Fever
·  Irregular breathing
·  Seizure
·  ore throat
·  Sweating
·  Unusual bleeding or bruising
·  Unusual tiredness and weakness
·  Dizziness
·  Nausea and vomiting
·  Dirrhoea
·  Low blood cell count
·  Change in taste.

Product Introduction

Temoside 250 Capsule is used in the treatment of a specific type of cancer of the brain. It is used to treat brain tumors if they return or get worse after standard treatment. It may be also used to treat other conditions, as determined by the doctor.

Temoside 250 Capsule should be taken empty stomach and at same time each day to make sure it has the best effect. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to.

Before taking it, tell your doctor if have bleeding, liver, or kidney problems or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your doctor know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. It may harm your baby. You and your partner should avoid becoming pregnant or fathering a child for several months after your treatment with it has stopped.

Uses Of Temoside Capsule

Brain tumor

Side Effects Of Temoside Capsule

Common Side Effects Of Temoside
·       Nausea
·       Vomiting
·       Constipation
·       Headach
·       Fatigue
·       Convulsion
·       Coordination disorder
·       Diarrhea
·       Dizziness
·       Fever
·       Hair loss
·       Hemiparesis (weakness on one side of the body)
·       Insomnia (difficulty in sleeping)
·       Loss of appetite
·       Memory loss
·        Rash
·       Viral infection
·       Weakness

Safety Advice

Alcohol

It is not known whether it is safe to consume alcohol with Temoside 250 Capsule.

Pregnancy

Temoside 250 Capsule is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks.

Breast Feeding

Temoside 250 Capsule is unsafe to use during breastfeeding. Data suggests that the drug may cause toxicity to the baby.

Driving

Temoside 250 Capsule may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.

Kidney

Temoside 250 Capsule is probably safe to use in patients with kidney disease. Limited data available suggests that dose adjustment of Temoside 250 Capsule may not be needed in these patients. Cautious use is advised in patients with severe kidney disease while they are taking Temoside 250 Capsule.

Liver

Temoside 250 Capsule should be used with caution in patients with severe liver disease. Dose adjustment of Temoside 250 Capsule may be needed. Limited information is available on the use of Temoside 250 Capsule in these patients. No dose adjustment is recommended in patients with mild to moderate liver disease.

Introduction :
Temonat 100 Capsule is used to treat a particular kind of brain cancer. If a brain tumour returns or worsens after receiving regular treatment, it is utilised to treat it. According to the doctor's judgement, it may also be used to treat other disorders.
Temonat 100 Capsule should be taken empty stomach and at same time each day to make sure it has the best effect. Your doctor will determine the appropriate dosage and frequency of administration for you. This is based on the condition you are being treated for and is subject to change. You should follow your doctor's instructions to the letter.
The most common side effects of this medicine include nausea, vomiting, constipation, headache and fatigue. This medicine may reduce the number of blood cells in your blood thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells along with kidney, liver and heart function during treatment with this medicine.
Before taking it, tell your doctor if have bleeding, liver, or kidney problems or are taking any medicines to treat infections. Many other medicines can affect, or be affected by, this medicine so let your doctor know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. It may harm your baby. You and your partner should avoid becoming pregnant or fathering a child for several months after your treatment with it has stopped.
Uses :
Brain tumor
Benefits :
In Brain tumor :
An abnormal mass or cluster of cells called a brain tumour may be cancerous (malignant) or not (benign). Temonat 100 Capsule both kills or inhibits the growth of cancer cells and stops them from proliferating. You should talk to your doctor about the advantages and disadvantages of this powerful and extremely poisonous medication. While receiving this medication, you should abstain from alcohol consumption and consume lots of water to stay hydrated.
Side Effects :
Most side effects do not require any medical attention and disappear as your body adjusts to the medicine. Consult your doctor if they persist or if you’re worried about them.
Common side effects of Temonat :
NauseaVomitingConstipationHeadacheFatigueConvulsionCoordination disorderDiarrheaDizzinessFeverHair lossHemiparesis (weakness on one side of the body)Insomnia (difficulty in sleeping)Loss of appetiteMemory lossRashViral infectionWeakness

Information Of Radizide Temozolomide 100mg Capsules

Radizide Temozolomide 100mg Capsules is used to treat a specific kind of brain cancer. It is used to treat brain tumours that have returned or worsened following normal therapy. It may also be used to treat other diseases that the doctor determines.

Radizide Temozolomide 100mg Capsules should be taken on an empty stomach at the same time every day to get the optimum impact. Your doctor will determine the appropriate dose and frequency of administration. This can vary depending on what you are being treated for and may alter over time. You should take it precisely as prescribed by your doctor. Taking it incorrectly or in excess might result in significant negative effects. It may take a few weeks or months for you to notice or feel the advantages, but do not stop taking it until your doctor instructs you to.

How To Use Radizide Temozolomide 100mg Capsules

Before you begin taking Radizide Temozolomide 100mg Capsules, and each time you obtain a refill, read the Patient Information Leaflet provided by your chemist. If you have any concerns.Take this medication by mouth as prescribed by your doctor, generally once a day on a daily basis. With a full glass of water, swallow the pills whole.

Side Effects Of Radizide Temozolomide 100mg Capsules
· Red spots under the skin
· Signs of diabetes insipidus
· Piles
· Dry mouth
· Blisters on body or in mouth
· Skin peeling, skin eruption, painful reddening of the skin, severe rash with skin swelling
· Increased sensitivity to sunlight
· Urticaria (red, itchy skin)
· Increased sweating
· Change in skin color
· Vaginal bleeding or irritation
· Absent or heavy menstrual periods
· Breast pain
· Sexual impotence
· Shivering

Common Side Effects
· Nausea
· Vomiting
· Constipation
· Headache
· Fatigue
· Convulsion
· Coordination disorder
· Diarrhea
· Dizziness
· Fever
· Hair loss
· Hemiparesis (weakness on one side of the body)
· Insomnia (difficulty in sleeping)
· Loss of appetite
· Memory loss
· Rash
· Viral infection
· Weakness

Safety Advice Radizide Temozolomide 100mg Capsules

Alcohol

It is unknown whether drinking alcohol while taking Radizide Temozolomide 100mg Capsules is safe.

Pregnancy

Radizide Temozolomide 100mg Capsules should not be used during pregnancy because there is clear evidence that it causes a harm to the unborn child. However, in some life-threatening instances where the advantages outweigh the risks, the doctor may prescribe it..

Breast Feeding

It is not recommended to take Radizide Temozolomide 100mg Capsules while nursing. The medicine may induce toxicity in the newborn, according to the studies.

Driving

Radizide Temozolomide 100mg Capsules can make you drowsy and dizzy by lowering your alertness, affecting your vision, or making you sleepy and dizzy. If you have any of these symptoms, you should not drive.

Kidney

 In individuals with kidney difficulties, such as severe renal impairment,Radizide Temozolomide 100mg Capsules should be taken with caution. 

Liver

In patients with liver problems, Radizide Temozolomide 100mg Capsules should be used with caution. It is possible that the dosage does not need to be altered.

Introduction To Octride Depot 30mg Injection

Octride depot 30mg injection contains the active substance octreotide. It is a synthetic compound derived from somatostatin, a substance naturally found in the human body that inhibits the effects of certain hormones, such as growth hormones. It is used to reduce the amount of growth hormone produced by people with acromegaly who cannot be treated with surgery, radiation, or another medication. 

It is also used to control diarrhea and flushing caused by carcinoid tumors and vasoactive intestinal peptide-secreting adenomas. It is used to prevent complications following surgery of the pancreas gland.  It is also indicated to stop bleeding and to protect from re-bleeding from ruptured gastro-esophageal varices in patients suffering from chronic liver disease. This medicine is used to treat people with pituitary tumors that produce too much thyroid-stimulating hormone (TSH) when other types of treatment are not suitable or have not worked and after radiotherapy, to cover the interim period until the radiotherapy becomes fully effective.

Uses of Octride Depot 30mg Injection

To treat acromegaly
Relieve symptoms associated with some tumors of the GI tract
To prevent complications following surgery of the pancreas gland
To treat pituitary tumors that produce too much TSH

How to consume Octride Depot 30mg Injection

Always use this medicine as exactly prescribed by your doctor. Depending on the condition being treated, an infusion of Octride depot 30mg injection is given by either subcutaneous (under the skin) injection, intramuscularly (into the muscle of the buttocks), or intravenous (into a vein). A healthcare professional will always administer intravenous and intramuscular injections. If you are prescribed a subcutaneous injection, your doctor or other healthcare professional will explain how to inject the medicine under the skin.

Safety Advices for Octride Depot 30mg Injection  

Pregnancy

Octride depot 30mg injection will only be given during pregnancy if needed. Inform your physician if you are pregnant, suspecting pregnancy, or planning to get pregnant during the treatment. Use effective contraception during the treatment.  

Breast Feeding

Breastfeeding is not recommended in patients taking Octride depot 30mg injection because the medicine passes into the breast milk in small amounts and may harm your baby. Do not breastfeed during the treatment.   

Lungs

It is unknown whether Octride depot 30mg injection can be used in patients with lung disorders. 

Liver

Octride depot 30mg injection is contraindicated in patients with acute liver failure.  Dose adjustments are necessary if you have liver problems. Inform your physician if you have any liver disease before initiating the therapy.  

Alcohol

It is unsafe to drink alcohol while you take Octride depot 30mg injection because it may cause damage to your liver  

Driving

Octride depot 30mg injection does not alter your ability to drive and operate heavy machinery. If you feel dizzy, consult the doctor before driving or using machines. 

Side Effects of Octride Depot 30mg Injection

Common
· Diarrhea, flatulence
· Abdominal pain
· Back pain
· Tiredness
· Headache, nausea

Serious 
· Increased heart rate
· Changes in heart rhythm
· Increased or decreased blood sugar levels
· Changes in thyroid levels
· Vitamin B12 deficiency
· Gall stones