Blueberry antioxidants and febuxostat

[d q]

@nobody – hope your well. Being on Febuxostat longer then me your experience may help. My blood results have come back and the hemoglobin has recovered slightly so things seem ‘reasonably stable’. The one result that baffled me and the rheumatologist for that matter is the uric acid level climbed up to 512ummol which is almost as much as it was when I was taking 20mgs. So going by the numbers we have:

20mgs – 514ummol
30mgs – 491ummol
40mgs – 487ummol (blood test mid Jan)
40mgs – 512ummol (blood test end Jan)

Another extremely strange result. I have tried to backtrack my diet to a few days before the test and cannot find any possible diet impacting indices for the increase. Totally bewildered. Another point is that when my uric acid was at its lowest (487ummol) so was my hemoglobin. There seems to be some sort of link. We know Uric Acid does have antioxidant properties and I’m beginning to think that the more we reduce my UA levels the more I’m potentially reducing my antioxidant defense mechanism causing the hemoglobin to reduce slightly.

My rheumatologist said go to 60mgs for a few weeks then go to 80mgs. Now I’m not too sure about this plan because of my abdominal pains and my next abdominal scan is at the end of this month. I was thinking more drop to 20mgs (since the results were similar) and see if the pain subsides and then work again from there.

@keith your input would help too if you have any ideas or research articles that suggest that UA may play a vital role in protecting cells from oxidants / free radicals?

We are getting technical here but potentially on a steep learning curve.

Thanks.

[Keith Taylor]

Totally bewildered.

Time of day?
Number of minutes since last meal?
Or just a “blip” in the test procedure? Sub-prime results seem to be quite common in all medical literature that I’ve read. So that is why I advise self-testers to ignore highs and lows and focus on moving average. But for professional lab tests, most doctors respond with “come back in two weeks for another test”

any ideas or research articles that suggest that UA may play a vital role in protecting cells from oxidants / free radicals?

Which of the results of a search for antioxidant uric acid would you like me to expand on? It aint a suggestion, it’s a medical fact. Uric acid is a powerful antioxidant. So, if we have a shit diet low in natural antioxidants, our body has to produce more antioxidants to balance that. As far as I’m aware, the only antioxidant we can manufacture is uric acid. (I don’t mind being corrected if I’m wrong on that)

As my mum (91 today) always says “look after your phenolics and your urates will look after themselves”

[Keith Taylor]

However, I’ve just read an alternative view:

Increased fruit and vegetable consumption is associated with a decreased incidence of cardiovascular diseases, cancer, and other chronic diseases. The beneficial health effects of fruits and vegetables have been attributed, in part, to antioxidant flavonoids present in these foods. Large, transient increases in the total antioxidant capacity of plasma have often been observed after the consumption of flavonoid-rich foods by humans. These observations led to the hypothesis that dietary flavonoids play a significant role as antioxidants in vivo, thereby reducing chronic disease risk. This notion, however, has been challenged recently by studies on the bioavailability of flavonoids, which indicate that they reach only very low concentrations in human plasma after the consumption of flavonoid-rich foods. In addition, most flavonoids are extensively metabolized in vivo, which can affect their antioxidant capacity. Furthermore, fruits and vegetables contain many macro- and micronutrients, in addition to flavonoids, that may directly or through their metabolism affect the total antioxidant capacity of plasma. In this article, we critically review the published research in this field with the goal to assess the contribution of dietary flavonoids to the total antioxidant capacity of plasma in humans. We conclude that the large increase in plasma total antioxidant capacity observed after the consumption of flavonoid-rich foods is not caused by the flavonoids themselves, but is likely the consequence of increased uric acid levels.

Which is the abstract from:
Lotito, Silvina B., and Balz Frei. “Consumption of flavonoid-rich foods and increased plasma antioxidant capacity in humans: cause, consequence, or epiphenomenon?.” Free Radical Biology and Medicine 41, no. 12 (2006): 1727-1746.

Unfortunately, there are over 700 follow-ups to that report, with some contradictions at first sight. So, my earlier view might be a simplification.

Ultimately I still feel that my approach is sound. Because I believe that we should adopt a healthy diet. Then adjust for problems with uric acid, blood pressure, cholesterol, etc if that healthy foundation does not achieve the right results. So that adjustment might be more dietary adjustments, herbal supplements, or medical interventions. But, the main problem still remains: can we truly determine what is a healthy diet?

Anyway, a friend often accuses me of overthinking and I believe I’m doing this now. Because you have a hypothesis, @d_q that your uric acid and hemoglobin levels are linked. So, I suggest the first step is to analyze the data and see if that is true. Then we can think about possible causes and effects and potential solutions.

[nobody]

I’m fine, thanks. The remaining febuxostat side-effects seem to be subsiding very slowly.

Your hemo result is good news. The small drop in the previous test may have been a fluke. I wouldn’t make too much of it.
As of yet, you don’t have enough data to substantiate a link between SUA and hemo but you are having enough tests now that any correleation should become apparent before too long.

I’m sorry but my experience isn’t going to be very useful. I’ve already told you the following but to recap…
I noticed 20mg seems to do most of the work that 40mg does. The litterature agrees. There are diminishing returns. But doubling the dose should still have more of an effect than that!
Then again your SUA should have been lower on 20mg to begin with. So it may be that febuxostat doesn’t work very well on you for whatever reason. You’ll find out for sure if you stick with it a while longer.
There is noise in test results. But you’ve had enough tests to be reasonably sure that your SUA isn’t dropping as quickly as it should.

The simplest explanation for your tests in my opinion is that you’re still dissolving unburied (so to speak) crystals and that part of the reason it’s taking so long is that you are an under-excreter.
Do you remember how many months it took for allopurinol to drop your SUA well under its current range?

The way forward seems to be: increase the dose until side effects become unacceptable, wait some more… and if your UA is still too high, either try allopurinol again or try to combine febuxostat with a drug that increases UA excretion.
I think it would make sense in your sitaution to increase your febuxostat does slower than your doc recommends so as to isolate unambigously any dose-dependent side-effects and allow your body some time to adapt. You’ve been on 40mg a while now… how about trying 50mg?

[Keith Taylor]

You’ve opened up a can of worms here @d_q

Because I started to look for good food sources for antioxidants (below). Then I noticed flaxseed, onion, and cherries on the list which have all shown benefits for gout sufferers. So I thought I should look at blueberries for gout. But I’m perplexed to the point of suspecting a conspiracy.

My only significant find so far is a clinical trial NCT01532622, “Impact of Blueberries on Uric Acid and Quality of Life”. But this completed in October 2013 and I can’t find any results or references to results. Which leaves me wondering if blueberries can help lower uric acid. So why do I suspect a conspiracy?

Because the research is sponsored by U.S. Highbush Blueberry Council! So maybe they didn’t get the results they were looking for? 😮

Do Blueberries help your Uric Acid?

Antioxidant Activity and Total Phenolics of Methanolic Extracts of Plant Products
From Velioglu, Y. S., G. Mazza, L. Gao, and B. D. Oomah. “Antioxidant activity and total phenolics in selected fruits, vegetables, and grain products.” Journal of agricultural and food chemistry 46, no. 10 (1998): 4113-4117.

Name – Antioxidant Activity – Total Phenolics
solin gum – 82.1 – 1422
flaxgum 1 – 78.6 – 1354
solin seed – 61.6 – 473
flaxseed – 60.6 – 509
flaxgum 2 – 58.5 – 328
flaxgum 4 – 58.3 – 338
flaxgum 3 – 53.7 – 377
blueberry – 92.1 – 4180
red onion scale – 90.2 – 10548
sunflower hull, purple – 88.9 – 9747
sweet cherry – 82.5 – 2098
potato, purple – 60.8 – 781
horseradish oil – 99.1 – not detected
sea buckthorn – 93.6 – 1112
echinacea flower heads – 81.5 – 5467
echinacea root – 77.7 – 3841
ginseng root – 69.1 – 347
horseradish root – 57.4 – 481
buckwheat hulls – 94.9 – 3900
potatoes (R. Burbank) – 80.0 – 437
sunflower seed – 72.9 – 1601
wheat germ – 64.9 – 349
buckwheat seed – 63.7 – 726
fibrotein MK11-DDG – 82.3 – 1241
fibrotein MK43 – 63.4 – 169
fibrotein MK37 – 56.0 – 213

[d q]

@nobody – I’ve got 2 updates and the first one starts here:
Every time I try to convince myself the very reason for these results are uric acid crystals are dissolving another part of my brain seems to convince me otherwise (or put simply, this drug isn’t working for me). As you say however it did take a long time for Allopurinol to start to bring my UA levels down. The abdominal pains which have moved from my back to my front are becoming extremely troublesome and my rheumatologist simply said if you can tolerate the pains then press on to 60mgs. He also mentioned that I am on half the “recommended dose” despite having to read up on what was the maximum dose was for Febuxostat – not very convincing! As you say, they simply take a systematic approach and very few professors see colours beyond black and white. For that matter the only doctor that has been extremely supportive and thoughtful seems to be my GP! I finally built the courage to confront my rheumatologist and ask him why all of he’s team including himself are not prepared to give me a 24hour uric acid test to see if I am just an under-excreter and he said the best advice would be to see what a Nephrologist has to say as he is concerned that my UREA is too low at 5.1 which puzzles me as the scale seems to be from 1.7 – 8.3 and mine sits firmly in the middle! He says the depending on what the Nephrologist says we can do the 24hr UA test. So I am waiting for the appointment for that.

Update 2: I’ve been under the weather recently with a bad case of the flu. Anyway, things are finally on the mend. I took the opportunity to see if those abdominal pains would go away when going back to 20mgs and they did for about a week and have now returned so either a)Side effect from Febuxostat in general or b)Something else that I haven’t put my finger on yet. My next blood test is due in about 10 days so I will check what my UA levels are on 20mgs again and then as you say potentially go straight to 50mgs if they are still in the 500’s – maybe February has dissolved enough to drop this slightly (I really really hope that is the case).

I’ve got a few questions I really hope you can help me answer;
1. Out of interest, let’s just say the maximum dose I can take with Febuxostat is 20mgs and my UA levels remain at 515ummol (down from 585). Could this ‘potentially’ be enough to keep gout attacks at bay? I know people can have UA levels as high as 700ummol and not have gout but let’s say the maximum I can get mine down to without hemo side effects or major abdominal discomfort could I possibly get away with being gout free on 515ummol for example?

2. At 515ummol is there absolutely no way crystals could be dissolving but at a much much longer period of time?

3. Out of curiosity, what does your ‘urea’ results show? I just want to know why the professor wants to refer me to a kidney specialist based on this number.

4. Your general opinions (if any) on the above.

@Keith –

Anyway, a friend often accuses me of overthinking and I believe I’m doing this now. Because you have a hypothesis, @d_q that your uric acid and hemoglobin levels are linked. So, I suggest the first step is to analyze the data and see if that is true. Then we can think about possible causes and effects and potential solutions.

I wanted to post a separate topic or at the very least a separate reply as I think I may have some interesting findings with regards to this.

Your opinions on the above would also be appreciated.

Thanks guys.

[nobody]

Hi!

There seems to be a consensus about what SUA number you should aim for: 350 to 360. I guess 390 might be low enough if your are very patient and as long as you consistently test under 400. But curing gout by lowering your SUA to 500-ish? My opinion: forget it!
Some crystals could dissolve at 500-ish. Trouble is: crystals would likely build up in the colder parts of your body at the same time.
What 20mg febuxostat could do for you IMO is:
1) make your gout milder in the long run and more importantly keep the worst long-term outcomes at bay
2) possibly allow you take some drug that boosts excretion (because the risk of kindney stones would be lower), the combined effect of the drugs hopefully being enough to bring your SUA down to the recommended value

As to what you perceive as side effects:
1) as long as you can’t substantiate them with objective data, there is a chance they could be (partly) psychological or simply unrelated
2) you don’t mention what you’ve dried to make them go away (very different diets in terms of fat, fiber, gluten and so forth, drugs that help with digestion or digestive pain in various ways, whatever else you can think of)
3) my experience has been that the non-gouty side-effects get better over time

You always have the option of trying allo again.
But I think you should stick to febuxostat (and preferably to a dose higher than 40mg at that) if the side effects are bearable and there is no objective red flag like crazy liver function numbers. All your suffering will be for naught if you quit the drug before you obtain conclusive data.

My urea was only tested once that I know of, in the ER. The value was a bit lower than yours but they might have used a different scale and the value might have been out of whack seeing in what sorry state I was in. Certainly other test results were out of whack. My SUA wasn’t tested at the time and might have been out of whack as well.
Maybe something else can give you a more useful answer about their urea tests…

[d q]

@nobody – I have to say, a perfect response to what I needed to know.

Moving on slightly;

Yes, I would have assumed 500 or so wouldn’t be enough to cut it (well for dissolving crystals anyway). It’s bizarre how the hospitals I get tested at have an upper limit of +/-450 ummol or so. It doesn’t make any sense if crystals could potentially form at lower levels. Who creates these stupid reference values!
On another note, I started on 50mgs. Blood test due in about 8 days.

1) This is reassuring. Next blood test coming up and if the haemoglobin has been impacted on the higher dose (50mgs) then I guess we are onto something very interesting. Maybe a separate topic/thread all together.

2) I mentioned this treatment option to the ‘rheumatologist professor ‘ who has referred the situation to a Kidney specialist in order to get he’s opinion before potentially going on combined therapy. He also wants a second opinion on the urea situation.

Side affects:

1) Being an experimental person like you, I decided to reduce the 50mgs to 20mgs for a few days to see if the pain would reduce and it did albeit slightly. Psychological well let’s elaborate further. I went on to stopping Febuxostat completely for 2 days and guess what, nearly all abdominal and back pains stopped. Little pain remains but I didn’t want to go a further day without it in order not to disrupt the blood test in 10 days time. So, I’ve gone back to 50mgs today and will be watching closely to see if the pain returns. I know this may not cement side effect position but it’s certainly something I’ll try again later and then we can possibly conclude theories. How we proceed from there is another story however but as you say, if the hemo is not affected I may just have to soldier the pain until it subsides (if it does like yours did). On another note, -I’m hoping the 10 days at 50mgs is enough to re-adjust values for a reasonably accurate result..??

2) I did try incorporating much more fruit in my diet and I have increased my intake of full fat yogurt. but in all honesty I didn’t make many changes as I was almost dead certain this was a drug effect and not my diet. After all, I was visiting the toilet on a daily basis with no issues prior to starting Febux and thought there was no reason to after starting Febux [diet being the same].

3) We will definitely find out if after starting the 50mgs again today will bring back those pains. If it does, then as you say, maybe it will just take time to go away (providing the hemo holds up). If the pain doesn’t come back then I guess it is back to the drawing board to find other possible reasons. Either way, if these pains do return testing the start stop treatment is not conclusive and will probably have to be done again to confirm.

I completely agree with you in trying to stick with the Febuxostat side of things. Allopurinol is always there for another attempt but I really want to keep that as a last attempt (despite the convenience of the tablet dosages). I’ve gone for 50mgs as we both suggested and not for the 60mgs the rheumatologist has asked me to and I’ll be testing myself soon. Hopefully all numbers remain in the safe zone. I completely agree on the suffering for nothing analogy if I stop too. Thanks for encouraging me by the way – I appreciate it.

No worries about the Urea results. If you do happen to find any please let me know. I just want to cross check numbers. p.s. what was the reason for the ER..?

Top man mate – thanks.

[nobody]

My understanding of these SUA references values is that they’re designed to flag abnormal values in the general population (cancer could cause your SUA to increase for instance), not values that would be too high if the patient was prone to gout.

I’m not suggesting your diet may have caused abdominal pain. But I adjusted my diet a bit since taking febuxostat. It’s as if I couldn’t digest some foods as easily now that I’m taking the stuff. Your problem might of course be completely different…

I was in the ER because of a pretty advanced internal abdominal infection with swelling and stuff. Like, I would almost pass out when standing up. So I had some unusual blood test values as you might imagine.

[d q]

Out of curiosity, what changes did you make to your diet and was it help with bowel movements or to aid further UA level control?

Also, now that I’m back on 50mgs, will 10 days be enough (after my two day break to test pain levels) to re-adjust UA levels for accurate results?

Sorry about your ER visit buddy. I’ve been there a few times in my life including for my first ever gout attack. Did they ever tell you why you had the swelling? Allopurinol allergy or side effect?

Be well.

[nobody]

I’d assume a two-day break is no big deal but your body seems not to work like mine so who knows what a break might do in your case?

The dietary changes I’m talking about were primarily done to reduce abdominal pain. I think it’d be best if you tried various things for yourself but I would first look at anything that can possibly cause “mechanical” difficulties (anything that causes significant gas, whole peanuts, oats that aren’t well-cooked and so forth). But maybe a low-grade food allergy of some kind is contributing to your pain for instance so I’d just try a bunch of random changes over time. What would it cost you?

About that ER visit, it was an infection so I guess the proximate cause was immune response. Anyway, antibiotics probably saved my life. Nothing to do with any side effects (or at least nothing I’m aware of).

[Jean Clyne]

I am going to throw another couple of thoughts into the ring for you, no answers but perhaps some more questions. Would using febuxostat cause any existing kidneystones to dissolve, would that cause abdominal or back pain, I believe those are 2 symptoms of kidney stones. Have you had an ultrasound or any tests to rule out kidneystones. Abdominal discomfort, pain, gas, diarrhea can also be caused by lactose intolerance for injecting milk and other dairy. Have you upped your dairy as it is supposed to be good to help lower uric acid levels? I take lactic acid tablets to help digest dairy, it is a pretty common condition in adults. Have you ever had any food allergy testing, could it be an allergy or sensitivity to something you are eating? Hope you find some answers. Here in Canada, the docs are not going as much by uric acid results but more on symptoms and needling any affected joints to detect the presence of ua crystals, I just had a friend diagnosed with gout and her doc said they are not doing much testing of ua levels any more because for many people they are not a reliable indicator. Go figure.

[d q]

@nobody –

I’d assume a two-day break is no big deal but your body seems not to work like mine so who knows what a break might do in your case?

I have now moved up to 60mgs 2 days ago and the pains seem to have returned albeit mildly alongside the slow bowel movements. It seems there is a link. I will definitely conduct this test again soon after my blood test next week as I need to keep things fluid for now. We shall find out soon 🙂

But maybe a low-grade food allergy of some kind is contributing to your pain for instance so I’d just try a bunch of random changes over time. What would it cost you?

I’ll give a few things a try next week. From the brief test I did reducing the Febuxostat all systems were GO again with regards to bowel movements and less pain. It just seems as if there is a strong link with dose increases.

About that ER visit, it was an infection so I guess the proximate cause was immune response. Anyway, antibiotics probably saved my life. Nothing to do with any side effects (or at least nothing I’m aware of).

At least your fit and well now. That’s what matters. On another note, I believe Urea is part of the Renal tests so assuming you’ve been doing liver and renal tests when checking your urate levels you should have a few results. When I get the information from the Nephrologist about these numbers I’ll let you know so we both benefit.

@Jean – Interesting point however when taking Allopurinol for over 6 months and dropping my UA levels to +-280ummol I didn’t have any such pains, so doubtful on the kidney stones issue. Besides, from what I understand, kidney stone based pain is excruciating whereas my pains are more dull and uncomfortable. I have had an ultrasound yes, and all abdominal organs seem OK. If they were specifically looking for kidney stones however I don’t know. I have largely increased my dairy intake of full fat yogurt hoping it is helping with UA clearance. I have reduced it slightly now to see if it makes a difference. I just have a strong feeling it is the Febuxostat but unfortunately I can’t retest stopping as my blood test is so close. I completely agree with you about UA testing being an indicator rather then a diagnosis. People can have levels of 700ummol and never get gout so joint aspiration is the number one way to get a diagnosis. Getting a joint aspiration test however isn’t always so simple as appointments can take time and by then the inflammation has reduced (or drugs have been taken to reduce inflammation/pain) which results in nothing to aspirate unfortunately. Thanks for your recommendations mate.

Cheers.

[nobody]

If you do notice bowel movement trouble, my recommendation is not to wait any longer and take something that “mechanically” helps with transit. There’s no sense in making the febuxostat dose increase harder on your body than it needs to be. And it’s harder to restart transit than to keep it going. In doubt, ask a pharmacist of your GP. You will likely only need a small amount so don’t start with the generally recommended dose.

[d q]

You are absolutely right with regards to not making Febuxostat harder for myself. Can you point me in the direction of a product or remedy as I am not entirely sure I understand what ‘mechanically’ means here..?

Thanks mate.

[nobody]

What I meant is something that affects mechanical properties as opposed to something that acts through the nervous system for instance.
If you already tried to up your fiber intake and it didn’t help, you also know you have little use for something that works like fiber.
That would leave you with a number of popular options. Best ask your GP or a pharmacist…

[d q]

@nobody – thanks for that. I will try a few different approaches to this. I’m just confused as to how this was fine before Febuxostat (daily visits and single stool as opposed to every other day and smaller stools). I’m almost positive its a side effect of the drug but maybe a small diet change can help.

On another note, I was due my blood test today but purposely delayed it until later in the week to make sure the 60mgs had taken its maximum effect as I haven’t really been on it long enough to really warrant a change in hemo either.

[nobody]

I had constipation on only 40mg. Just take your pharamacist’s or GP’s recommendation. Problem solved. It may also help with abdominal pain. But I recommend you start with a lower dose than generally recommended.
Hopefully your system will get used to that side effect and you will in time be able to discontinue the product that helps with transit.

[d q]

Thanks mate. Will do.

Doing well otherwise?

[nobody]

I’m not doing regular blood tests anymore but subjectively, I’m good.
I’m still getting a little abdominal pain as well as occasional low-level gout-like symptoms but that’s no big deal. I’m not sure I’m out of the woods yet but I haven’t used the painkillers the benighted folks across the pond are so afraid of for about 6 months now, nevermind the stuff which is actually harmful (AKA anti-inflammatories).

[d q]

Why the reduction in blood tests? Have numbers settled since starting Febux..?
I too am getting used to the abdominal pains, once I get the latest blood results this week I’ll be in a better position to try and go cold turkey on the drug to see if the pains go or not finally confirming what’s causing them. Yep, I also am still getting these low-grade gout symptoms. I have the great days when I forget I have gout (no pain at all), the average days where pains come and go and the bad days where I’m too scared to push things and try and keep relaxed were possible. I think my pains are probably due to the now lower UA levels keeping gout at bay but no low enough to really get dissolving them. Out of curiosity, what are your current UA levels and how long have you been taking Febux..?

Thankfully I haven’t had to use anything recently but do take the occasional colchicine tablet if I get too paranoid that something is coming. And what painkillers may these be that the people across the pond are so afraid of prescribing?

If I remember correctly you always were a colchicine only man 🙂

[nobody]

Clearly, when I said “low-grade” I meant something different than you do because what you’re talking about is more than a minor nuisance. Maybe I should have said “very-low-grade”.
Crystals take a long time to go away even with very low blood tests.
I’m not going to talk about painkillers Keith doesn’t talk about. None of us wants to be extradited on terrorism charges or something.

[d q]

Sometimes I feel you try exceptionally hard to distance your situation from mine whilst there is no need to. Believe me I completely understand we are suffering different levels of pain and different extremities of gout and different side effects. Maybe my typing style is a quick to compare and concur.

Relax sir, its a forum, not a court room.

[nobody]

Our bodies do work differently (take your persistently high SUA tests for instance). So yes, I do try to discourage you from generalizing from my experience. Maybe that’s unnecessary but better safe than sorry, eh?
Sometimes I’m also trying to avoid needlessly rubbing salt in the wound (so to speak), hence strategic silences. As far as I can tell, you’re already doing the best you can to reduce your SUA.

It’s only a forum but it’s still a venue in which we are discussing medical issues. You have the NHS but doctors cost me more than lawyers so it is a rather serious matter as far as I’m concerned. And money aside, some of the drugs discussed here have killed a lot more people than gout.

[d q]

So yes, I do try to discourage you from generalizing from my experience. Maybe that’s unnecessary but better safe than sorry, eh?

Yes, but generalising is not what I am doing. Patients with similar symptoms and/or side effects are what help researchers and pharmaceuticals build trends, occurrences and even those little leaflets with so called infinite ‘side effects’ you get in medication packs. Either way, its fine.

Sometimes I’m also trying to avoid needlessly rubbing salt in the wound (so to speak), hence strategic silences. As far as I can tell, you’re already doing the best you can to reduce your SUA.

For what it’s worth – thank you. On some occasions though knowing numbers and names does help with the motivational aspect of helping people overcome gout – the so called ‘keep up the good work factor’.

It’s only a forum but it’s still a venue in which we are discussing medical issues. You have the NHS but doctors cost me more than lawyers so it is a rather serious matter as far as I’m concerned. And money aside, some of the drugs discussed here have killed a lot more people than gout.

Nobody is going to take you to court or get Interpol to stop you at the border or whatever nonsense that is worrying you so immensely. Your just giving advice based on your experiences (in which you always type in your disclaimers anyway). There is no need to overthink this.

Anyway, water under the bridge.

[Author]

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