<s>[INST] Hi doctor, I have fatigue issues. Can you suggest a health supplement. I was thinking of using Amway Nutrilite Siberian Ginseng With Ginkgo Biloba. Further I am currently having vitamin B12 and Vitamin D deficiency for which I am using specific supplement as suggested by my physician which includes Mecobalamin 1500 mcg and Cholecalciferol granules in addition to spending some time in sun. I further wanted to know whether Amway Nutrilite Siberian Ginseng With Ginkgo Biloba will react with any of the current medication. Also, I have attached my latest blood test reports. [/INST] Hi. I appreciate your efforts for uploading the laboratory reports (attachment removed to protect patient identity). 1. You are suffering from fatigue syndrome and the reason for that is you have low vitamin and nutrient levels, deranged liver functions (although little one), high cholesterol and deranged lipid profile. 2. Yes, you may use the Amway product. It is a good brand for dermatological and dietary supplements. But there is little to no research available from third party or independent unbiased researchers. So, the safety of dietary products and other drug interactions with your other medications are not much documented. 3. Your supplements are good for vitamins. 4. You have to lower your weight, increase physical activity and have to keep a check on your cholesterol levels to keep in normal range. 5. Try diet modifications too. If these things do not work I will suggest then to start some lipid lowering medicine like statin. 6. Avoid alcohol and smoking if you do. It is hazardous for your liver which already is not working good. 1. HbSAg (hepatitis B surface antigen) and Anti-HCV (human papillomavirus) both by ELISA (enzyme-linked immunosorbent assay). 2. Ultrasound abdomen complete. 1. Take capsule SeaMega for fatigue and your cholesterol. 2. Take Salmon fish in food. Revert back with the laboratory reports to an internal medicine physician online.---> </s>