Brief Answer:
My answer is as follows:

Detailed Answer:
Hello and thank you for your question, welcome to HCM. I carefully read your query.

Now, the pain you are sensing in your kidney area, since it is elicited from movement or exercise, it is an acute muscle soreness from assuming "bad" position during sleep, long hours of standing or spending hours in places with air conditioner. It will probably go away within few days, therefore I would not recommend any medication for this matter.

Now, since the blood pressure figures are those you provided, then an anti-hypertensive drug should be described. You already have concor cor which is a good and effective choice. I can see you are a 34 year old man, and young about these diagnoses. Obviously, you care a lot about your health and this may produce you some amounts of stress. Therefore, I would recommend you to switch from concor cor to propranolol in low doses. The latter is a beta-blocker, which also has anxiety-relieving properties.

The second question, it is fine if you take omega 3 and coQ, but the first one is greatly found in fish, while the latter is produces by the organism itself. To sum this up, there is no harm in taking these, but maybe you should try natural alternatives, since they are already there.

There are no interactions harmful to the kidneys, known until now, regarding these medications. As far as reflux is concerned, I would recommend you a protein pump inhibitor (PPIs: omeprazole, esomeprazole), twice daily in the first two weeks and once daily for two other weeks. As about the multivitamin, since your appetite is fine and you do not have problem with your bowel movements, my opinion is that it is really not necessary to take them.

Now, I would add this, the key which can cause all of these problems (fatty liver, hypertension, acid reflux) is obesity. I can assume you have undertaken all the measures to reduce your weight, still I will provide you my opinion:
- 60 minites of physical activity, daily, e.g. walking, running, biking, swimming, gym etc.
- alcohol should be reduced up to a maximum of 30 g ethanol a day (two beers, one glass of wine or one shot of heavy drinks)
- you should quit smoking (if you smoke)
- refrain from red meat, eat fish and chicken, more
- consume 200-300 g of fruit and green leafy vegetables a day.

I hope I was helpful and thorough with my answer. I am happy to help, if you have follow-up questions.

Best regards,
Dr. Meriton

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Brief Answer:
The combination does not replace concor cor

Detailed Answer:
Hi again and welcome back.

The natural alternatives to Omega 3 and CoQ 10 that I was referring to, is that by concentrating on eating fish more often you practically have taken omega 3, while the CoQ 10 is produced by the organism. Although many studies have come to the conclusion that they are helpful as strategies in primary and secondary prevention of the heart disease, it is not still proven whether it is their direct effect (without other drugs) that causes this benefit. That is why I shared my opinion that they are not harmful if they are taken, but they provide benefit on the metabolism only. No, the strategy of combining the three mentioned will not replace concor cor's action, since the latter directly acts on mechanism that lower the blood pressure figures. I would stick to the recommendation I provided in my original answer. Sneezing and runny nose is not a side effect of the supplement taken for the hepatosteatosis (fatty liver). They are rather because of a season flu or random allergy, which may cause them. Actually, you can try taking loratadin once a day before sleep, and see if the symptoms are ameliorating.

I hope my follow-up is helpful. If you do not have further questions, kindly close the discussion and rate the answer.

Kind regards,
Dr. Meriton

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Brief Answer:
No interactions

Detailed Answer:
Hi again.

Esomeprazole can be safely taken along with the above described drugs and supplements, so no need to be worried about in that domain. No, indeed esomeprazole may interact with some other drugs in the liver when it is metabolized, but no affect has been seen on hepatosteatosis. And, finally, while on Ursofalk, there is no need to add Syllimarine, especially not at this light grade of your fatty liver. I would recommend you, above all, that you should fight obesity, and the body weight parameters should be gradually brought under control.

I hope this is helpful.

Best regards,
Dr. Meriton

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