General Health Friday November 28, 2014

Dr Hilary Answers Your Questions: Part II

Got a sore foot, or a receding hairline? Curious about whether you can really catch a cold from the rain, or why you find doughnuts delicious? Well wonder no more, instead direct all your health related questions to our partner Medical Advisor, Dr Hilary Jones.

Following on from our first blog post in this series, Dr Hilary is back to answer your questions. Read on to find out what he had to say in part II.

1. I have had back pain for two months, I've seen my GP and an Osteopath and didn't get any results. I also now have tooth pain and recently was diagnosed with shingles. Could this all be connected?

Shingles is a viral infection that produces an itchy blistering rash on the skin. It may be followed on and off by pain for years afterwards in the area where the rash first appeared. Any part of the body may be affected, so if your shingles was in the head and neck area this could be related to your recent tooth pain. Since your back pain was some two months old it cannot be related to the shingles, even if the back area was the area affected by the rash. Since you saw an osteopath I presume that the GP and the osteopath diagnosed your back pain as mechanical, in which case after this length of time you need to go back for further tests.

2. Recently I developed severe pain in both my legs very suddenly. I went to A&E and they tested me for a DVT as there was no obvious reason why I would have leg pain. The test came back negative and the pain went away over the next couple of days. Any idea what it could have been?

I am not surprised the tests for DVT were negative as it is highly unusual for a deep vein thrombosis to cause pain in both legs. A sudden onset of pain in both legs is more likely to be due to a mechanical problem, such as a prolapsed intervertebral disk with central pressure on the spinal nerves, together with muscle spasm and referred pain downwards into the legs. This would also fit with the rapid resolution of the pain, but if it comes back again I would suggest a full examination from your doctor to investigate this further.

3. Does Vitamin C actually do anything to help a cold?

There is conflicting evidence as to the efficacy of vitamin C to prevent and treat the common cold. Some studies, however, have suggested that large doses can reduce the duration and severity of symptoms, although they do not conclude that vitamin C can protect against getting the infection. Other studies show that somebody would have to have low levels of vitamin C in the first place if the supplements are to help. Vitamin C supplements are probably best taken by those people who work in a constantly cold environment or who are involved in vigorous training, such as marathon runners. People with kidney disease should not take vitamin C supplements but, for other people who wish to, 500 mg per day is the maximum dose recommended.

4. Are eggs good for you or not? I read that you shouldn't eat more than three a day because they raise cholesterol, is that true?

No it is a myth that you have to restrict the number of eggs you enjoy every week. Cholesterol in the body does not come from the cholesterol in the food you eat but from saturated fats in the food that you eat, which is converted to cholesterol in your liver. Eggs are high in protein, low in saturated fat and low in carbohydrates, whilst being rich in vitamins and minerals. This makes them part of a healthy diet and an excellent choice for anyone who wishes to normalise their weight or slim down whilst providing the body with a range of essential nutrients.

5. How do female menstrual cycles synchronise, and why does this happen?

The synchronisation of female menstrual cycles refers to women living closely together who have their periods at the same time each month. Explanations for this have included the theory that pheromones may come into play, or that periods are determined by the phases of the moon. Neither theory has any plausible basis in science. The consensus of medical opinion is that cycles with different frequencies will repeatedly converge and diverge over time anyway, and that any synchronisation in any two female individuals is a coincidence. There is a high probability of synchronisation occurring by chance, and the fact that two or more women in close proximity are likely to talk about the timing of their periods would make any synchronisation appear extraordinary, and a topic of further discussion.

6. Why do I get breakthrough bleeding right after ovulation?

The mid cycle ovulatory bleed may well occur because of a sudden drop in oestrogen levels which occurs just before the egg is released. This could lead to a withdrawal bleed similar to that seen when an active oral contraceptive pill is switched for a placebo one. The withdrawal bleed at ovulation is not usually heavy or protracted, as oestrogen levels soon rise again straight after ovulation. Spotting of this kind is in fact more common in longer cycles.

7. Why does being cold make some people feel sleepy?

Significant hypothermia can certainly induce sleepiness, slower reactions, reduced judgement and tiredness but only when the body core temperature falls below 35° C. People who work outdoors in the cold weather for long periods, such as stallholders and motorcycle riders, may describe increased tiredness in cold weather but only usually after they have come in from the cold into a warmer environment. This is due to a transfer of blood to the skin, which reduces blood pressure and induces relaxation.

In other people, the feeling of being cold when tired may be explained by the body clock. The natural body clock controls body temperature, which fluctuates up to 2° a day, being lowest in the morning and highest in the evening. But the body clock keeps running even if someone stays up all night, so it is common for people to feel cold when they are most fatigued and then blame the temperature for making them feel tired.

8. I have a receding hairline. I am still only 23. What should I do?

In the vast majority of men, a receding hairline is due to your genetic makeup. The hair follicles on your scalp are genetically more sensitive to circulating testosterone, resulting in hair recession of the male pattern baldness type. Ask your doctor to make sure that you are not deficient in iron or thyroid hormone. If not, try Minoxidil foam (Regaine) or Finasteride (Propecia). The latter inhibits the formation of dihydrotestosterone in the body and will increase the number of scalp hairs in the first year, and help to stop any further loss thereafter. You might also like to investigate hair transplants, which today are very effective especially if you go for one before you lose too much hair.

9. I don't have diabetes, but sometimes my blood sugar drops really suddenly for no apparent reason. I'm not hungry, I haven't exercised but suddenly I feel very shaky and my limbs are heavy. The best way to treat this I've found is to eat a handful of jelly sweets. Why does this happen and how can I prevent it?

Your blood sugar fluctuates within a narrow range normally and your body controls it with the increased or decreased secretion of certain hormones such as insulin or glucagon. Greater swings and yo-yo fluctuations of your blood sugar are more likely if you are on a diet containing high GI foods. These allow sugar to be absorbed into the bloodstream quickly and is particularly true of sweets and chocolates. Jelly sweets may help in the short term for your symptoms, but you might be better off adopting a low GI, low sugar diet, so that your body can control blood sugar levels more smoothly.

10. Are eczema and allergies exacerbated by stress? Why does this happen?

The skin and the nervous system are derived from similar cells in the embryo and are closely related. This is why embarrassment can lead to blushing and why stress can make psoriasis worse. The release of inflammatory chemicals in the skin, which occurs in eczema and allergies, may also be influenced by the nervous system. For this reason, stress management and relaxation techniques are useful to master, as these will help your symptoms.

Let us know what you made of Dr Hilary's answers by leaving a comment below, or if you have your own burning question to ask him, please get in touch!
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