Diabetes

15.06.2022 Category: General Health Author: Dr Richard Dawood

WHAT IS DIABETES? 

Diabetes is a lifelong condition that occurs when the body is unable to properly regulate the amount of glucose (sugar) in your blood. Poor control of diabetes can lead to high blood sugar levels and cause long term damage to your overall health and organs. 

WHAT HEALTH PROBLEMS DOES IT CAUSE? 

High blood sugar levels can cause a lot of damage to your body and if not managed correctly, may lead to many diabetic complications. This will cause long term health problems, especially if they go untreated. 

HOW DOES DIABETES AFFECT OTHER PARTS OF YOUR BODY?

Eyes: Retinopathy is a complication of diabetes caused by high blood sugar levels damaging the retina, often leading to vision impairment. It is the leading cause of blindness among working-age adults in the UK. As a consequence of diabetic retinopathy, swelling can take place, called diabetic macular oedema. People with diabetes are also more prone to develop cataracts and glaucoma at an earlier age, contributing to vision reduction.

Feet: Foot health is often a neglected area anyway but high blood glucose levels can lead to insensitivity in the foot and lower limbs, which means you lose the ability to feel pain and distinguish hot or cold.  It can also lead to less blood supply to your feet leading to poor circulation. 

Loss of sensitivity means that you may not notice if you have a minor cut, sore or wound and poor circulation means if you do get a cut or sore, it will take longer to heal and open wounds are more likely to become infected. This combination is why there is an increase in risk of amputation for those who are diabetic. Regular podiatry appointments are the best way to look after your foot health.

Heart: High blood sugar levels can also cause problems to your blood vessels which can sometimes lead to serious problems such as heart attacks and strokes. 

Kidneys: High blood sugar levels creates more difficulty for the kidneys to clear waste. This may lead to Diabetic Nephropathy, the deterioration of the kidneys.

HOW CAN DIABETES BE TREATED? 

There is currently no cure for diabetes, therefore, the best way to deal with diabetes is to get it properly managed and controlled. If you are diagnosed with type 1 diabetes, you must either inject or pump insulin into body to treat your diabetes. If you have type 2 diabetes, you may also have to use insulin, however, it can be managed through diet and lifestyle changes. 

HOW CAN YOU TEST FOR DIABETES?

An instant HbA1c test can confirm if you’re within the recommended range, or are considered pre-diabetic or confirm that you have diabetes. Using a small blood sample it will measure how well your blood sugar has been controlled over the last 3 months and provide a numerical reading.

As the HbA1c test provides 3-months insight, it is an important blood test for diagnosed diabetics. It provides a good indication of how well they are managing their diabetes.. 

Many people are more familiar with the glucose blood test – it measures the concentration of glucose molecules in your blood at a single point in time. The amount of glucose in your blood could also indicate whether you could be diabetic or not. People with diabetes can also use this test to manage their condition on a daily basis alongside regular HbA1C testing.

You can book an instant HbA1C test online at a cost of £54.50.

WHAT ARE THE SYMPTOMS?

When it comes to diabetes the symptoms are not always obvious and can often go unnoticed for long periods of time before being diagnosed. 

The most common symptoms include:

  • Feeling constantly thirsty or dehydrated 
  • Unintentional loss of weight and increased appetite (type 1)
  • Vision begins to blur
  • Numbness in your hands or feet (type 2)
  • Fatigue 
  • Urinating more frequently 

WHO IS AT RISK?

In the UK, type 2 diabetes is the most common type of diabetes, affecting over 90% of sufferers. The symptoms of diabetes are often mild, therefore, it’s important to be aware of the risk factors that could make you more susceptible to diabetes in the future. 

According to Diabetes UK, type 2 diabetes is twice more likely in people of African descent in comparison to people of European descent and six times more likely in South Asian communities, making them a high risk category in developing diabetes. Additionally, people of African – Caribbean and South Asian descent are also at risk of type 2 diabetes much earlier, usually over the age of 25. On the other hand, for Europeans the risk increases when over the age of 40. Other factors contributing to diabetes include being overweight, high blood pressure and genetics. 

Other general risk factors include:

  • Having high blood pressure
  • Carrying extra weight around your middle
  • Smoking 
  • Polycystic Ovary Syndrome (PCOS) sufferers
  • Those with a sedentary lifestyle
  • Drinking too much alcohol
  • Those with disturbed sleep – this includes those who do not get enough sleep and those whose sleep too much

 

If you have symptoms of diabetes or general concerns about your diabetic risk, you can book a GP appointment to discuss in more detail. 

Alternatively, you can book in for an instant HbA1c test with a nurse

 

Monkeypox Statement

30.05.2022 Category: General Health Author: Dr Richard Dawood

With monkeypox cases being recorded in over 20 countries across the globe, people are becoming increasingly concerned about its spread and transmission.

Following 2 years of the Covid-19 pandemic, this outbreak has reignited the public’s fear and uncertainty of infectious diseases. 

Whilst the media coverage of the monkeypox outbreak is alarming, we would like to reassure our patients that as it stands, the risk is still very minimal and vaccination is not advised as a precautionary measure. Whilst vaccines will undoubtedly be a key part of containing the outbreak, for now, only people who may have been exposed are being offered vaccination.

Our Medical Director & Travel Medicine Specialist, Dr Richard Dawood explains;

“Lots of people have been getting in touch with us to ask about a monkeypox vaccination, but this is not available privately. It is currently only being offered to anyone identified as a direct, close contact of a confirmed case deemed to be at sufficient risk.

The current outbreak does, however, highlight the need to think about your vaccine protection more generally, whether for travel or simply to protect your health and well-being, taking advantage of the best vaccines currently available.”

In a more general sense, it is never too late to catch up on childhood vaccinations, incomplete vaccination courses or any required boosters.

Your immune system naturally decreases with age and certain diseases are also more prevalent in older adults so there may be new vaccinations which are now suitable for you to consider for preventable diseases. Some health conditions can also weaken the body’s immune response, making you more vulnerable to infectious diseases, complications and hospitalisation. Therefore, it is important to ask your GP which vaccinations would be suitable for keeping you healthy.
 – For more information on wellness vaccinations.

If you are travelling soon and haven’t had a travel consultation with a travel nurse, perhaps it is time to consider one. Travel nurses are experts in travel health and will advise which travel vaccinations & medications you should consider based on the risk of where you are travelling to and your itinerary once there.
– For m
ore information on travel consultations.

To conclude, we’d like to dismiss a couple of dangerous myths about monkeypox that are unnecessarily scaremongering the public:

Myth 1: Monkeypox is as contagious as COVID-19 or smallpox

Fact: Monkeypox is far less contagious compared to smallpox, measles, or COVID-19.

Myth 2: Monkeypox is a new virus.

Fact: No, the monkeypox virus is not a novel virus. It’s a known virus and is generally seen in central and western African countries as localised outbreaks.

In summary, we, like the rest of the medical field, will be keeping a close eye on the progression of the Monkeypox outbreak and should our advice change based on new information, we will update this statement accordingly.

 

For more information on Monkeypox.

Chronic kidney disease (CKD) & Diet

08.03.2022 Category: Dietitian Author: Ruth Kander

Chronic kidney disease (CKD) is a long-term condition where the kidneys don’t work as well as they should. In some circumstances, the loss of kidney function can get progressively worse over time but CKD only reaches an advanced stage in a small proportion of people. Although the damage is irreparable, sometimes if changes are made, CKD can be halted with no further damage occurring.

Chronic Kidney disease (CKD) is divided into 5 stages.
Stage 1 is the earliest stage whereby tests have indicated some level of kidney damage. It is important not to ignore a stage 1 diagnosis as this is the time to take action and make lifestyle changes so that the condition does not worsen. With every increase in stage, more kidney damage has been detected up until the last stage, stage 5. Stage 5 means the kidneys have lost almost all their function and it will be time for thinking about dialysis or a transplant.

What to do if your recent blood test shows a reduced kidney function.
Don’t panic, absorb the diagnosis and understand this doesn’t definitively mean your kidneys will stop working altogether. CKD should not be ignored as it can get worse over time but with careful monitoring and management it can be maintained and you can live long fulfilling lives without being unduly affected by the condition.

It is important to review your lifestyle and in particular, your diet. With early stage CKD (stages 1-3) it is paramount to be as healthy as possible and have a healthy balanced diet.

What do  I mean by a healthy balanced diet?

This includes: 

  1. Consistently eating freshly cooked food for every meal
  2. Limiting your intake of processed foods and avoid highly-processed foods
  3. Reducing your daily salt intake
  4. Having considered balanced meals – your lunch and dinner meals should contain proteins, carbohydrates and vegetables. Your portion size will depend on your  weight and if you have diabetes
  5. Ensuring you have a minimum of 2-3 portions of fruits and vegetables each and every day
  6. Increasing your intake of plant based proteins such as beans, lentils, tofu, soya, seitan 
  7. Drinking lots of water to remain well hydrated (ensure your urine runs clear)
  8. Being as active as physically possible for you
  9. Avoiding non-steroidal medicines such as ibuprofen, naproxen etc.

What is a renal diet?
You may have heard of the term, renal diet. The term is used quite widely amongst those who have CKD, but personally, I am not a fan of this term. It doesn’t really mean much and can often be misused. People often think it means a diet of low protein, low salt, low potassium and low phosphate – which is pretty hard to do all at once and not always necessary. 

People newly diagnosed with CKD in particular often restrict their diet in a panic unnecessarily and in combination with online resources not being clear enough, this can cause a lot of confusion.

My advice would be to seek guidance from someone like myself, a dietician who can look at your lifestyle and individual health and work out a personalised diet plan. This will be much more achievable and as well as not feeling so overwhelming, you’ll only have to limit the foods you absolutely need to.

How do you monitor CKD?
The best way to monitor CKD is to have regular tests, either blood or urine. How often you require testing will be dictated by the stage of CKD. Your GP will determine what is best for you and it is best to ask them any medical and testing questions rather than your dietician who will focus solely on your lifestyle and diet.

______________

Ruth Kander is a kidney-specialist dietitian, to book an appointment with her please click here.

Taking Women's Health Seriously

07.03.2022 Category: General Health Author: Dr Belinda Griffiths

Women today lead incredibly busy lives. They run and organise homes and build successful careers, usually all whilst taking on the majority share of caring for their children and often their older relatives. It is therefore not uncommon for women to have little or no time to look after themselves, their health included.

In addition to not making time to prioritise their health, it seems that when women do put their health first and seek medical advice, they are less likely to feel heard and supported in comparison to their male counterparts.

A recent survey by The Department of Health and Social Care found that “more than 4 in 5 (84%) women they surveyed had experienced times when they (or the woman they had in mind) were not listened to by healthcare professionals.”

Based on the data they collected, ‘not being listened to’ appears to be present at all stages of the healthcare pathway. Specifically, many women told them: 

  • their symptoms were not taken seriously and/or dismissed upon first contact with GPs and other health professionals 
  • they had to persistently advocate for themselves to secure a diagnosis, often over multiple visits, months and years 
  • if they did secure a diagnosis, there were limited opportunities to discuss or ask questions about treatment options and their preferences were often ignored

Many women recalled their symptoms being dismissed upon first contact with GPs and other professionals; women felt they had to persistently advocate for themselves to secure a diagnosis, often over multiple visits, months and years; and post-diagnosis, discussions about treatment options were often limited, and some said their preferences were ignored. 

To make matters worse, there is some evidence that due to historical clinical trials being disproportionately male-orientated there is much less research into women-only health concerns and assumptions have been made that similar medical treatments will work for both sexes. The top reasons for the under-representation of women in trials were the belief that hormone fluctuations could influence results and concerns that fertility could be affected. A widely accepted negative repercussion, amongst others, being that women are much more likely to experience adverse side effects of medications because drug dosages have historically been based on clinical trials conducted on men.

A combination of these factors may explain why there is a gender gap in health outcomes, with women experiencing poorer health outcomes in comparison to men. We strongly believe in equality and ensuring health is a top priority for all.

Therefore, here are the top health symptoms women should never ignore:

1) Any change in bowel habit and/ or urination

This includes blood in the stools, unexplained persistent abdominal pain, weight loss, lumps around the anus, lack of appetite, blood in the urine or increased frequency of urination. These are all reasons for seeing your doctor ASAP as these symptoms could be due to bowel, bladder or ovarian cancer. All patients should have an annual faecal occult blood (FOB) test to exclude bowel cancer, which has increased in incidence in the UK for reasons unknown. Or if you are looking for a more in-depth investigation, you should request a colonoscopy which entails looking at the bowel with a colonoscopy. This is the gold standard, but an FOB is the next best thing and far less invasive as a first investigative option. It takes no time at all and is a good preventative check.

​​2) Any changes to the breast.

Any breast lumps, skin changes, nipple discharge, nipple changes or pain in the breast must be checked ASAP. Breast cancer is the most common type of cancer in the UK and often can present insidiously. Get to know what your breast feels like so that any subtle changes can be detected as early as possible.

3) Skin lesions that do not heal.

Any scab on the skin which does not heal, especially around the eyes, nose, ears and face should be checked. All these areas are the most sun-exposed, and, as such, are more at risk of skin cancer. If these lesions are picked up and treated early, scarring is minimal, but if left, then disfiguring scars and skin grafts may be necessary.

4) Bleeding after the menopause.

If you experience any bleeding after 1-year of your last menstrual period, you must visit your GP for further investigation. Bleeding after the menopause is not common and could be an indicator of cancer of the uterus, or the cervix. They will usually opt for a biopsy of the uterine lining to exclude both – don’t worry, this doesn’t hurt.

5) Always have regular cervical screens. 

Most people don’t find cervical screens painful, although they can feel somewhat uncomfortable. If you are concerned about the pain or you have previously found the procedure painful with the NHS, you can opt to book a private appointment. It is important that you don’t miss your appointment. 

6) Bleeding between periods.

At any age, you should never ignore bleeding between periods or after intercourse, as this can be a sign of cervical or uterine cancer. Whilst cervical cancer is monitored by regular screening, it is important to still get bleeding between periods checked out following a normal smear result. Cancer of the endometrium is becoming increasingly common in women who have not had children.

7) A persistent cough.

Regardless of gender, you should get a persistent cough checked out by your doctor, especially if you are coughing up discoloured sputum or blood.

8) Any unexplained changes to your body.

Any new indigestion, shortness of breath on exertion, neck or left arm pain requires follow up ASAP. Make sure a GP examines your chest and makes the appropriate investigations.

The same applies to calf pain or any pain in the chest. By taking a full history, examining you and doing quick and easy investigations, worrying conditions can be excluded, such as a pulmonary embolism or a heart attack.

Some recent examples of cases where other healthcare providers have failed our new female patients:

1) We saw a 36 year old who had not had a cervical screening for 5-years because the last one was so painful. The NHS advises a screening every 3-years but we advise yearly screenings to ensure any abnormalities are found as early as possible. 5-years is far too long!

2) We saw a woman who had a suspicious lump at her anal margin, which her usual GP had told her was part of her bladder. She wanted a second opinion because it had grown in size and was now painful. The patient was referred for an urgent assessment to exclude cancer.

3) We saw an 88 year old patient who was disfigured by a large basal cell carcinoma on her forehead, about which she was embarrassed. The patient had been seen by a dermatologist who had frightened her about having the lesion removed by saying she might not survive an anaesthetic. The patient wished that she had taken the risk and asked to be referred back, as the skin lesion was disfiguring and ruining her quality of life.

** The outcomes of these patients are yet unknown, but they are all certainly serious health concerns that should have been properly addressed long before now. 

We want to encourage women to take ownership over their health and be assertive when they feel that something has changed from our normal. If they feel like they are not being taken seriously or not being heard, they should seek a second opinion. 

If you cannot get an appointment with your usual GP or through the NHS, rather than waiting  for weeks and worrying about what it could be, make an appointment with a private GP who can usually see you on the same day! 

Put your mind at ease with private healthcare.

How to calm your flight anxiety before you fly

04.03.2022 Category: Travel Health Author: Lucy Mildren

Fear of flying, otherwise known as aerophobia, is an excessive worry about air travel. It is one of the most common forms of phobia and according to YouGov, around 24% of Brits have some form of anxiety about getting on a plane.

People suffering from fear of flying experience extremely anxious thoughts which are often so powerful they become physical symptoms. These can include shallow breathing, experiencing chest tightening, sweaty palms, feeling nauseated or lightheaded and sometimes these even develop into a panic attack, meaning many opt to avoid air travel altogether. 

For some, it will have been a lifelong problem that has meant never flying at all. For others, who have flown many miles in their lifetime, it is a problem that slowly creeps up on them over time. In both circumstances, the fear can be debilitating and symptoms often trickle into other areas of life. 

Like all phobias, there is little logic to support the anxiety that it causes – travel is in fact the safest form of transport and you are much more likely to die from a car accident than in a plane crash. Knowing that fact does little to ease the flying-related anxiety of an aerophobic sufferer. 

So, what can be done to overcome our fear of flying? 

Understand the reason why you’re a nervous flyer
Fear of flying is usually caused by a combination of factors. Understanding the root cause of your own phobia is perhaps the first step in overcoming it. Is it a fear of heights? Claustrophobia? Was it that film you watched as a child? Or has a particular world event sparked the fear? Many people suddenly developed a fear of flying after 9/11 for example. Figuring this out will then allow you to tackle it in the right way and using the appropriate techniques. 

Fight fear with knowledge
Some experts suggest the first strategy for everyone suffering from a fear of flying is learning about the aeroplane and the science behind flight. Our anxiety is fed by ‘what if?’ catastrophic thoughts. Once you become knowledgeable, your ‘what if’ thoughts will be limited by the facts. There are professionally designed courses that will explain aspects like air traffic control, anti-terrorism measures, and what happens during turbulence. Some courses use Virtual Reality (VR) to simulate a flight, explaining everything along the way with the aim of injecting logic into an illogical fear. 

Seek medical help for anxiety, fear and panic
From here, a form of therapy may help to identify and break anxiety cycles. There are many different types of therapy and choosing the right one for you will depend on your own needs and goals. Hypnotherapy and cognitive behavioural (CBT) are some of the most commonly used, but there are countless more to choose from. Deciding which is the most appropriate form of therapy can be daunting, so it may be helpful to seek advice from your GP or a travel nurse. 

For those who manage to make it onto the plane, there are quite a few, simple personal techniques that can be used to calm your nerves. 

Deep breathing techniques
Making a conscious effort to breathe slowly and deeply can interrupt panic. Deep breathing is known to trigger a comfort response and will help prevent hyperventilation. 

Distract yourself
Reading a book or listening to a good podcast can refocus your mind and attention.Distracting yourself from the fact that you are flying can be a great way to keep calm if you’re a nervous flyer.. Time tends to pass much more quickly when adequately distracted. 

Tell the flight attendants
Alerting the flight attendants of a nervous flyer could also help – with their training and expertise, they are ideally placed to provide reassurance and will regularly check in on you during the flight. 

Avoid coffee and wine
Nervous flyers in general should avoid drinking coffee and wine before and whilst flying. Both can leave you more dehydrated than normal. The extra caffeine in coffee can aggravate anxiety issues and the Dutch courage wine offers will pass leaving you more susceptible to jet lag. Stick with water where possible. 

Tea really does help
It’s very British to recommend tea to make everything better, but there are many different herbal teas available which can help with relaxation, reducing stress and calming anxiety. Peppermint, camomile, lemon balm and lavender teas are the most commonly used.

We advise nervous flyers and people with aerophobia to seek further information and guidance from their GP who will be able to make a formal diagnosis and treatment options.

For more advice and information you can book a travel consultation appointment.

How to avoid fragility as we age

03.03.2022 Category: General Health Author: Dr Belinda Griffiths

Ageing is an inevitable part of living. As we age, many physical and psychological changes affect our overall health and these vary from person to person.

The general myth is that as you age, you become more fragile and that this is unavoidable. This is most certainly not the case. There are always things we can do to help keep healthy in our older years and these changes can slow down or even prevent certain health conditions from developing.

The term “fragile” is defined as not “strong or sturdy; delicate and vulnerable” and is most often used to describe older ladies. One particular age-related health issue that supports this description would be osteoporosis. 

Osteoporosis is a degenerative disease that weakens and thins the bones which makes them fragile and more likely to break and is becoming increasingly common. It is much more prevalent in women than men due to the menopause directly affecting hormone balances and this directly affects bone density. It is important to prevent osteoporosis as we age as 75% of fractures due to osteoporosis occur in people aged 65 and over. 

There are several things you can do to help prevent osteoporosis:

1) Do regular, weight bearing physical activity.
The lack of regular exercise will result in loss of bone and muscle, so adults who are inactive are more likely to have a hip fracture than those who are more active. Adults should aim to do at least two and a half hours of moderate-intensity exercise every week. Weight bearing and resistance training are a particularly great way of improving bone density and helping to prevent osteoporosis. 

2) Eat plenty of calcium and Vitamin D containing foods.
Your diet is very important and the nutrients we get from the food we consume will affect how strong our body is. Eat plenty of dairy, seeds, eggs, oily fish, protein, fruit and vegetables. Additionally, try to get at least 15-minutes of sun exposure per day to increase your Vitamin D intake. As we know in the UK, such sun exposure is not always possible during the winter months and, if this is the case, taking a daily Vitamin D supplement is advised. 

3) Maintain a healthy weight.
As you get older, you start to lose lean body mass like muscle and bone density and this can start to happen yearly from the age of 30. Being underweight weakens your bones so it is important to keep your weight in a healthy range. A good indication, although not exact, is your BMI. For most adults, a healthy BMI range is between 18.5 and 24.9, so try not to let your BMI fall below 19.

Those who suffer from eating disorders such as anorexia and bulimia are at a higher risk of fragility due to the conditions causing further bone density loss. This can happen to anorexic and bulimic sufferers of all ages.

Older people should aim to consume a varied diet, consisting of enough calories for maintaining a healthy weight. 

4) Limit your consumption of alcohol.
We’d recommend that you drink no more than a maximum of 2 units of alcohol per day. Any more than this has been demonstrated to increase the risk of bone fracture. Alcohol abuse has detrimental effects on bone health and increases a person’s risk of developing osteoporosis.

5) Stop smoking and definitely don’t start!
Smoking is a known risk factor for osteoporosis as it increases bone mass loss. In fact, smoking doubles the risk of hip fracture.

Generally, being healthy is the key to avoiding fragility and in particular preventing osteoporosis as we age. Having an annual health medical can highlight any areas of concern. They can monitor the progression of any pre-existing health issues, as well as detect arising conditions in the early stages. You can book your annual medical online

In addition to making healthy lifestyle choices, it is also important to book a doctor’s appointment should you notice any changes to your health. The sooner a health concern is addressed, the easier it is to treat. You can book a GP appointment online.

 

 

What is "Blue Monday"?

17.01.2022 Category: General Health Author: Dr Will Cave

Blue Monday happens every year on the third Monday of January. It is supposedly the most depressing day of the entire year, based on a crude calculation of bad weather, long nights, back to work dread and post-Christmas debt.  

It does sound very plausible but Blue Monday is in fact, a myth! 

The phrase “Blue Monday” was coined by Sky Travel in 2005 as a way to sell holidays in January. They highlighted all the seasonal negatives to reinforce the benefits of booking a holiday – a clever marketing trick. 

But can we really pinpoint the most depressing day of the year?

There is no actual scientific studies that have ever backed up any claims about Blue Monday being true or that there could even be a “most depressing day of the year”. This does make sense because this would be different for each and every one of us based on personal circumstances and the variables are extensive.

Perhaps then instead of selecting just one day of the year to highlight depression, we should be thinking about mental health, specifically poor mental health, everyday.

Depression is more than simply feeling unhappy or fed up for a few days. It can be long lasting and the symptoms range from mild to severe. Once accessed by a doctor, they will conclude the severity of your depression.

A simplified description follows: Mild depression will have some impact on your daily life, moderate depression has a significant impact on your life and severe depression makes it almost impossible to get through daily life.

Sometimes there’s a trigger for depression. Life-changing events, such as bereavement, losing your job or giving birth, can bring it on. Other times, it can be linked with family history, people with family members who have depression are more likely to experience it themselves. But you can also become depressed for no obvious reason. It is quite complex and each person is unique.

There are many symptoms of depression and the combination is unpredictable. They can be categorised at physiological, physical and social symptoms.

Some examples of psychological symptoms of depression include:

  • continuous low mood or sadness
  • feeling hopeless and helpless
  • having low self-esteem
  • feeling tearful
  • feeling irritable and intolerant of others
  • having no motivation or interest in things
  • finding it difficult to make decisions
  • not getting any enjoyment out of life
  • feeling anxious or worried
  • having suicidal thoughts or thoughts of harming yourself

Some examples of physical symptoms of depression include:

  • moving or speaking slower than usual
  • changes in appetite or weight (usually decreased, but sometimes increased)
  • constipation
  • unexplained aches and pains
  • lack of energy
  • low sex drive
  • changes to your menstrual cycle
  • disturbed sleep – for example, finding it difficult to fall asleep at night or waking up very early in the morning

Some examples of social symptoms of depression include:

  • avoiding contact with friends and taking part in fewer social activities
  • neglecting your hobbies and interests
  • having difficulties in your home, work or family life

The most common symptoms of depression tend to be a low mood, feelings of hopelessness, low self-esteem, lack of energy, problems with sleep and a loss of interest in things you used to enjoy but it can be any number of symptoms listed above. 

It’s important to seek help from a GP if you think you may be depressed. The sooner you see a doctor, the sooner you can be on the way to recovery. 

For more information on GP services at Fleet Street Clinic, click here.

How To Lose Weight Safely And Successfully

14.01.2022 Category: Dietitian Author: Dr Belinda Griffiths and Ruth Kander

Weight loss has become a thriving industry and we’re bombarded constantly with unhealthy FAD diets, weight loss programmes, influencers selling teas and pills all promising to help us lose weight. Many of these are promoting quick fixes which are not advised by doctors or dieticians. It can be really hard to know what information to trust. To help navigate the sea of information (and misinformation!) surrounding weight loss, we have asked one of our GPs, Dr Belinda Griffiths, and our dietitian, Ruth Kander, their advice on how to lose weight safely and successfully. 

Firstly, it is important to note that weight loss should be consistent and gradual as it can be dangerous to lose too much weight too quickly. Dr Griffiths suggests that “a safe weight loss is 1-2 lbs or 0.5-1kg per week… Greater weight loss than this per week can lead to malnutrition, exhaustion, increased risk of gout and gallstones.” There is also an increased risk of developing an unhealthy relationship with food which, in extreme circumstances, could lead to eating disorders. 

Ruth added, “Losing weight gradually and at a healthy rate is key.” Remember, it’s all about consistency! Perseverance will amount to healthy lifestyle changes which will allow you to achieve your weight loss goal. 

Don’t underestimate diet

Both Dr Griffiths and Ruth agree that diet is the most important factor when it comes to weight loss. As Ruth explains; “having a healthy balanced diet that is lower in calories than our body uses is a good way to start the weight loss journey. If we don’t reduce calorie intake, one won’t lose weight:.”  – this is known as being in a calorie deficit. The amount of calories that will result in weight loss will vary from person to person and depend on the amount of exercise the individual does. In order to lose weight, you will need to burn more calories than are consumed and therefore restricting your calorie intake is the simplest way of losing weight. 

Foods to focus on

Ruth recommends that “people should focus on a variety of foods when trying to lose weight”. While Dr Griffiths suggests, “focusing on a range of lean proteins (including meat and fish), vegetables, high fibre foods (such as quinoa, bran flakes etc) and fruit in moderation”. Vegetarians can substitute in lentils, nuts, beans and tofu instead of meat and fish. In general, high calorie foods such as fried food, cakes, biscuits, chocolate and sugary drinks should be avoided. 

Let’s get physical!

Although weight loss is still achievable without much exercise, incorporating exercise into your lifestyle will not only aid weight loss, but will generally improve your overall health. Any exercise is better than none whether it be tennis, swimming, or even walking, “whatever you are capable of, just do it!” is Dr Griffiths advice. Ideally, a combination of exercise is best for weight loss – this includes cardio / fat burning and resistance or weight training. Get those steps in! An easy way to incorporate more exercise into your daily routine is by aiming to walk at least 10,000 steps per day. This easy change can make a big difference and remember, as Dr Griffiths says “the more exercise you do, the greater calories are burned” – it’s as simple as that!

Don’t forget about NEAT movements! 

NEAT (or Non-exercise activity thermogenesis) movement refers to the physical movement we do day-to-day that isn’t necessarily planned exercise and “encompasses the energy that we expend by simply living”.This includes the calories we burn breathing, eating, sleeping etc. Dr Griffiths suggests that “you can increase NEAT movement easily in your everyday life by making simple changes such as taking the stairs rather than the lift, by standing rather than sitting, by walking instead of taking the train/ bus/ tube or even by carrying bags rather than having items delivered”. It all adds up! These simple swaps will increase the number of calories you burn and help facilitate weight loss. 

What to do when you plateau

The first stint of weight loss can make it seem a little too easy as you tend to lose weight more easily in the beginning, but a common issue lots of people face is when weight loss reaches a plateau. This is where you stop losing weight to the same extent you were before, or stop losing weight for a period of time. This can feel disheartening and more often than not, people tend to give up at this stage. Dr Griffiths states at this point “it is a case of persevering with calorie restriction and regular exercise and gradually weight loss will resume.” If it doesn’t, Ruth suggests “ looking at what you’re eating to see if anything has slipped”. She states “maybe you’re not taking into consideration extra calories here and there” but they all add up. See if there are any areas of your diet where you could be a little stricter, or consider starting or upping your exercise. 

Sleep and Stress

A good night’s sleep and keeping your stress levels down will be your friend when it comes to weight loss. “In order to lose weight, you need to be in the correct frame of mind and life circumstances” says Ruth. Research has shown that you tend to eat more and make poorer food choices, including seeking comfort food, when you are sleep deprived. This is because not getting enough sleep “disrupts the hormones in your brain (Leptin and Ghrelin) that control appetite” says Dr Griffiths. 

Stress can also play a part in weight loss as Dr Griffiths explains that “stress increases cortisol levels which increases gastric acid output and makes you feel anxious and hungry”. Ruth adds “there is also a theory that being stressed can limit weight loss in terms of hormonal activity in the hypothalamic-pituitary axis which can lead to the release of hormones that can limit weight loss”. Keeping it simple, “to lose weight, good sleep and minimal stress would be ideal”. 

Final thoughts

Trying to lose weight can seem complicated, confusing and difficult, but when you really break it down, the ingredients to losing weight successfully are actually very straightforward. If you stick to these simple rules and you are patient and consistent, the weight will come off and you will achieve your goals. 

If you feel that you are doing everything right and you still aren’t losing weight, or are even putting weight on, there could be something else causing this. You may have an undiagnosed underlying medical condition and we’d advise you to visit your GP to make sure everything is well. 

If you would like any extra support with your weight loss, why not book an appointment with Ruth. Or if you have any concerns over your health, please book an appointment with one of our GPs.

Arthritis in Winter

11.01.2022 Category: General Health Author: Dr Will Cave

Arthritis is a common condition that causes pain and inflammation in joints. It is not a single disease but an informal way of referring to joint pain or joint disease. There are more than 100 types of arthritis and related conditions. There are thought to be 10 million people with some form of arthritis in the UK. It is the most common cause of disability in the UK and can affect people of all ages but it does occur more frequently as people get older.

Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms can range dramatically from person to person, with some experiencing mild symptoms with occasional flare ups to those who experience constant debilitating pain everyday. The sad truth is that there is no cure for arthritis, so it is all about pain management and how to best reduce flare ups.

The impact of the weather on the symptoms of arthritis has been debated for many years and people tend to report more arthritis flare-ups in the winter, but the reason why is not specifically known.

Quite often sufferers will state that their symptoms get worse when the weather is damp and cold and some state they are able to tell when the weather is about to change based on their arteritis symptoms worsening.

Even if there is currently nothing to support this scientifically, this doesn’t remove the pain felt by sufferers and so rather than comment on where this is true or not, let’s look at ways to reduce flare ups in winter.

Our top 4 tips:

1. Stay warm
When the temperature drops both inside and outside, dress warmly. Make sure all arthritis prone areas are kept warm.

2. Stay hydrated
Drink plenty of water throughout the day. Even mild dehydration might make you more sensitive to pain.

3. Take warm baths
A warm bath or visiting a heated swimming pool will ease joint pain and comfort you. If you visit a heated swimming pool, gentle exercise will also help your mobility.

4. Stay active
It is now clear that active people experience less joint pain than those who are sedentary. If you are experiencing an arthritic flare then reduce your usual activity (but don’t stop altogether) and use simple anti-inflammatory medication such as ibuprofen if it is safe for you to do so.

 

Enjoy winter while taking the above precautions for Arthritis.
If you are facing extreme discomfort and pain in your joints due to arthritis, book an appointment with a GP to discuss your options.

Beat the January blues

05.01.2022 Category: General Health Author: Dr Will Cave

If you are feeling sad at the start of the year, don’t worry, you are not alone. 

Although it comes around every year, we always seem to be caught off-guard by what has now commonly become known as “The January Blues”.

The January blues is another name for situational depression and is associated with the way we think and feel. Around this time of year, the weather is cold and gloomy, the days are shorter and the nights are longer, plus you may be experiencing post-Christmas exhaustion, debt and perhaps even dread going back to work. 

Symptoms of the January blues are things such as low mood and sadness, lack of motivation, tiredness and low energy. These are all normal feelings, if temporary. 

Most likely, your negative mood will be brought on by the anticlimax of reality after the exciting events of December & the New Year. Ever heard that old phrase, “don’t cry because it has ended, but smile because it happened”? Find comfort in knowing that you are absolutely not alone in feeling blue in January. In fact, many people in the UK feel especially down in January but the good news is that the January Blues are temporary and typically only last a couple of weeks. You don’t need to take any medication as your thoughts and feelings should naturally return to normal.

If it doesn’t and you are experiencing prolonged or worsening thoughts and feelings, you may actually have Seasonal Affective Disorder or SAD, which is different. SAD is clinical depression caused by a person’s biology. It is much longer-lasting, sometimes months on end and likely to occur every year in winter. You should see a doctor to discuss your symptoms as if you have SAD, a range of treatments are available to assist recovery. More information on SAD can be found here.

Remember, please be kind to yourself and know that you’re not alone.

 

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Reasons Weight Gain May Not Be Your Fault

21.12.2021 Category: General Health Author: Dr Belinda Griffiths

Most people experience fluctuations with their weight and it is common to gain weight naturally as we age. For the most part, diet changes, eating more or reducing exercise are the main causes for gaining weight. However, if a person gains weight in a short period of time for no reason, this could be the sign of an undiagnosed, underlying health condition. There are several conditions and circumstances that are known to cause weight gain, some of which can be serious and require medical attention. 

Here are just some medical conditions which can cause sudden weight gain:

Polycystic ovary syndrome (PCOS) 

This is a hormonal condition which affects the way a woman’s ovaries work. A common symptom of PCOS is weight gain, particularly around one’s middle. Weight gain is rarely the sole symptom, it is usually part of multiple symptoms including acne, excessive hair, irregular periods and/ or thinning hair. PCOS makes women less sensitive to insulin or cause insulin-resistance which can lead to weight gain and secondary conditions such as diabetes.

Hypothyroidism

A common cause of unexplained weight gain in men and women comes from having an underactive thyroid. This is because when a thyroid is underactive it doesn’t produce enough thyroid hormones, which in turn affects your metabolism, slowing it down. Hypothyroidism can be diagnosed with a thyroid function test and if diagnosed, it can be easily treated with a replacement hormonal tablets. 

Cushing’s syndrome

This is a rare hormonal disorder which is caused by elevated levels of cortisol in the body. Cortisol is responsible for regulating metabolism and appetite, which means elevated levels can slow down your metabolism as well as increase hunger, both of which can cause weight gain.

Insomnia / chronic lack of sleep

Being sleep deprived can result in making poor food choices, including seeking unhealthy foods and eating more than usual. This is thought to be because a lack of sleep disrupts the hormones in the brain (Leptin and Ghrelin) that are responsible for appetite. 

Medication 

Certain medications affect metabolism which can cause weight gain and weight loss. Medications such as steroid medication can cause weight gain, bloating and swelling due to water retention. 

Lipoedema

This is a problem caused by an issue with the lymphatic system that causes an abnormal build-up of fat in the legs and sometimes the arms. This usually results in the upper body being generally a much smaller size compared to the lower half of the body but typically affects both sides of the body equally. This condition can also be painful and cause tenderness or heaviness in the limbs. Lipoedema mainly affects women and it is rare in men. 

Chronic stress, depression and/ or anxiety

Mental health issues can sometimes cause people to turn to food as a coping mechanism, often triggering compulsive eating behaviours. Additionally, higher cortisol levels are often found in people with depression which is known to increase appetite and the motivation to eat. Antidepressant medication can also increase hunger as they interfere with serotonin levels – a neurotransmitter that regulates appetite. 

Menopause

Women going through the menopause often experience weight gain. Changing hormone levels affect the way the body stores fat and can cause women’s bodies to store, rather than burn, calories. Women also generally need less calories after the menopause, and so, if you do not adjust your calorie intake, you are likely to put on weight. 

PMS

During PMS (premenstrual syndrome), progesterone levels surge and dip which are known to increase appetite (the cause of which are unknown). PMS can also cause weight gain as a result of water retention. 

While many of these causes are rare, they are possible and anyone experiencing unexplained weight gain should visit their GP to rule out anything that may require medical care or treatment. It’s always best to be on the safe side! And if everything is normal, your GP can provide you with tips and advice on how to manage your weight gain. 

 

If you are experiencing unexplained or sudden weight gain, or think you might be displaying symptoms of the conditions mentioned above, please book a GP appointment today.