ONE in ten women suffer agonising pain from endometriosis but it is still a largely unknown condition.
It causes cells from the womb to grow in other parts of the body. As the womb lining breaks down and bleeds during a woman’s cycle, so does the endometrial tissue.
Dr Zoe Williams helps a reader who is worried about their enlarged heart[/caption]
This causes pain in affected areas, often the pelvis, that is so severe it interferes with normal life.
Other symptoms include very heavy bleeding, pain during sex or when using the toilet. Fatigue and fertility problems can also occur.
These symptoms are similar to lots of other conditions so it is important to give your GP as much detail as possible.
It takes an average of eight years and ten months for someone to get a diagnosis, partly due to lack of awareness among women and GPs, as well as because the only way to conclusively diagnose it is with key-hole surgery, a laparoscopy.
This Endometriosis Awareness Month, Holland & Barrett is encouraging women to use its free Menstrual Health Advice Line, where a specialist nurse can give advice. See its website for details.
Elsewhere, here is a selection of what readers have asked me this week. . .
Woes of fungal toes
Q: I’M a 47-year-old man and I’m really embarrassed by my toenails. Most of them are fungal and they smell bad.
I really hate my feet and won’t go on holiday because of it.
I have tried over-the-counter remedies but none have helped. It’s ruining my life.
A: I’M really glad that you have written in with this query. I’m sure many other people are in a similar situation.
We can tend to trivialise fungal nail infections and while an occasional bit of athlete’s foot or a mild fungal toenail infection can often be successfully treated with over-the-counter remedies from the pharmacist, the best treatment for a more significant infection like yours is likely to consist of a combination of oral antifungal drugs and support from a podiatrist.
When a fungal nail infection starts it tends to be just at the free edge – and at this early stage over-the-counter treatments such as amorolfine nail lacquer or tioconazole nail solution can be effective as long as you are also regularly filing and clipping the nail to remove the infected parts.
You must use it for long enough – which can be up to a year.
This is where people often go wrong, thinking that a few weeks is long enough – it’s not.
Even when the nail looks normal again there may be infection that you can’t see – so keep going.
Beyond that early stage, the fungus infection tends to spread down the side of the nail towards the cuticle and eventually the whole nail could be infected.
Infected areas often turn white or yellow, and become thickened and more crumbly.
With more advanced infections like this, the best plan of action is to make an appointment with your GP who may want to do a blood test.
This checks that your liver is in good health before starting a course of oral antifungal medication, which will likely last several months.
A further option is laser treatment, but this is not currently available on the NHS.
Q: FOR several months I have been suffering with a high temperature, diarrhoea, cold sweats and shaking. It seems to happen monthly.
Tests have shown blood in my urine and at one point my bowel movement was black.
Dr Zoe helps a reader who has been suffering with a high temperature, diarrhoea, cold sweats and shaking for several months[/caption]
I went to the hospital but they couldn’t find anything causing my problems.
I’m waiting for a camera examination in the bladder and a colonoscopy.
I am 54 and going through the menopause. Please can you shed some light on my problem, as other doctors don’t seem to know what’s wrong?
A: IT sounds as though you have been feeling dreadful – but that there are a lot of sensible tests due to take place, so your symptoms are being taken seriously.
It would be impossible – and potentially harmful – for me to start guessing what could be causing these symptoms collectively, so I won’t do that.
It does sound like there may be some abnormal hormone levels, and I don’t just mean the sex hormones – oestrogen and progesterone – implicated in menopause.
I mean things like thyroid hormone, adrenalin and gastrin, for example.
Your case highlights why it is very important that women in mid-age don’t just attribute new symptoms to menopause, because while menopause can cause a whole array of symptoms, so can many conditions which could present at this time of life.
So you have done the right thing, and I’m glad that you are being investigated thoroughly.
Did you have an X-ray of your kidneys to check for kidney stones?
Have you had any tests to check the health of your adrenal glands, which sit on top of the kidneys and produce adrenalin?
There is one condition that is at the back of my mind that I feel I should share with you, called MEN – which stands for multiple endocrine neoplasia.
It causes tumours to grow on the endocrine glands, of which there are several around the body.
I absolutely do not want to alarm or worry you in any way, but it may be worth checking with your medical team to ensure that they have excluded it.
Dizzy and tremors but no diagnosis
Q: I COLLAPSED at work in June 2024 after suddenly becoming very dizzy and sick and I lost control of my legs.
A reader has been left unable to work following problems with balance, dizziness and tremor in both hands[/caption]
I was taken to hospital and after three days was discharged with vertigo.
Since then I have had problems with my balance, dizziness and a heavy feeling in my left eye. I have also developed a tremor in both hands.
I have been referred to ENT but no one is coming up with what is wrong with me.
I have been unable to work and am getting fed up – life is bad right now.
A: Vertigo is a symptom and not a diagnosis. Is it a type of dizziness that gives a sensation that either you are moving (when you are still) or that your surroundings are moving (when they are not)?
Many people will have experienced a similar sensation while on a boat or after drinking too much alcohol.
The causes can be separated out into two main groups – peripheral vertigo is more common and is usually caused by a problem with the inner ear affecting the labyrinth or vestibular nerve (for example benign paroxysmal positional vertigo, vestibular neuronitis, labyrinthitis, and Meniere’s disease).
Central vertigo is uncommon and is usually caused by pathology in the brainstem and cerebellum (for example stroke, transient ischaemic attack, cerebellar tumour, and multiple sclerosis).
Did you have lots of tests while you were in hospital?
If so, they may have ruled out the worrying causes of vertigo at that time but perhaps the diagnosis still remains unknown, so working this out will be the aim of the ENT team that you see.
The commonest cause of vertigo is BPPV which stands for benign paroxysmal positional vertigo, where certain head movements exacerbate symptoms.
Whatever the cause, medicines may help to partly alleviate your symptoms.
Update doctors if any new symptoms come or any existing symptoms change.
Tip of the week
MAKE sure you get your child vaccinated against HPV, a virus linked to several cancers. It’s given in Year 8 and 9 but uptake has dropped, health officials say.
CURRY AND NICE! BOOST YOUR HEAT-GENERATING BROWN FAT
A SPICY curry followed by a cuppa might be the perfect meal to help you burn calories, experts suggest.
Experts say a spicy curry followed by a cuppa might help you burn calories[/caption]
Mark Gilbert, nutritionist for the 1:1 Diet by Cambridge Weight Plan, tells Sun Health: “White fat makes up the vast majority of the fat in your body. Having too much of it is unhealthy.
“If there’s one type of fat you probably want more of, it’s brown fat. Ironically, it can actually help you burn fat.”
Jess Hillard, sports nutritionist at supplements brand Warrior says: “Brown fat burns calories to produce heat through thermogenesis. It helps to keep the body warm by generating heat.”
Since brown fat burns calories to produce heat, it may contribute to weight loss or help prevent weight gain in slim people.
People with more brown fat may have a more efficient metabolism. While you can’t “gain” more brown fat, there may be ways to activate it so you can reap the benefits. Try these ideas . . .
CHILLIES: Contain compounds called capsaicin and capsinoids.
“These natural chemicals trigger a specific receptor in the body that controls temperature regulation and brown fat activity,” Mark says.
Capsaicin is a “potent activator” of brown fat, Japanese researchers wrote in the journal Frontiers of Endocrinology after reviewing the evidence.
They said capsaicin’s health benefits “including thermogenic and antiobesity activities” have been known for centuries.
GINGER: Mark says: “Various plants from the ginger family have been shown to boost brown fat.”
Overweight men who had hot ginger tea each morning had increased thermogenesis levels, and a reduced appetite, Columbia University researchers found.
FISH OILS: Among the many health benefits of oily fish, long-chain omega-3 fatty acids activate brown fat, says Jess. Oily fish include salmon and mackerel.
APPLES: “Chlorogenic acid is a chemical found in fruits like apples,” says Mark.
“Research published in the journal Food Science has shown it can help mice avoid gaining excess fat. Other studies have shown it leads to multiple signals which turn on calorie burning, including several which are related to brown fat.”
TEA: “Considering green tea helps with weight loss, it is very likely that at least one way it does so is through brown fat,” says Mark.
A 2023 review of rodent studies by Brazilian researchers supports that green tea may promote the conversion of white fat into brown-like (beige) fat.
Catechins – antioxidants found in tea, particularly green – were also shown to help stimulate thermogenesis.
