I suffer intensely itchy skin that’s spread from my scalp down my back, face and arms to under my breasts
WHILE it is a largely preventable condition, around 13.6million of us are at risk of type 2 diabetes.
Closely linked to obesity, it can lead to problems including heart disease, stroke, erectile dysfunction and tooth loss.
But carrying excess body weight isn’t the only risk factor.
So is having a family member diagnosed with diabetes or high blood pressure.
People of South Asian, African-Caribbean or Black African descent are up to four times more likely to be diagnosed.
Smoking, PCOS, mental health conditions and having gestational diabetes (in pregnancy) all raise your chances too.
This is type 2 diabetes prevention week, so grab a tape measure to check your risk.
A healthy waist size in most men is 37in (94cm) or below, or 35in (90cm) for those of South Asian descent.
For women of all ethnicities, a healthy waist size is less than 31.5in (80cm).
If you are above these thresholds, then it is worth taking steps towards getting healthier.
You can take a look at the free NHS 12-week weight-loss programme or, if you’ve tried that sort of thing before, speak to your GP to see what support is available to you.
MY ENDLESS ITCH
Q: I HAVE suffered with itchy skin for months.
It started on my scalp and the nape of the neck.
It then spread down my back, to the sides of my face, shoulders, arms and under my breasts.
It is severe and keeps me awake at night. I am so tired.
I’ve been given antihistamines and Eurax cream but the itch and rash is worsening.
I have only seen a nurse and been advised to see a pharmacist.
I’m a 70-year-old woman.
Please can you help me?
A: The widespread nature of your itching, along with the fact that it’s not improving with your prescriptions, suggests that there might be an underlying medical condition.
This could be a condition which originates in the skin itself – such as eczema, psoriasis or a fungal infection of the skin – or it could be a systemic illness.
Allergies, hormonal imbalances or medication side-effects could also be causing or contributing to your symptoms.
Which came first – the itch causing the rash, or the rash causing the itch?
Either way, it is important to have it properly assessed and likely have some blood tests too.
GP surgeries are strained at the moment and the truth is that most practices are struggling to provide the great quality of care that they want to.
This means that patients need to advocate for themselves more than ever before.
In your case, the fact that your itching is severe and affecting your quality of life so much makes it important, so I would definitely recommend scheduling an appointment to see your GP.
There’s no harm in seeing a pharmacist in the meantime, who may be able to help.
Pharmacists train for four years and gain lots of knowledge in treating patients with minor illnesses in addition to their expertise in medicines.
The pharmacist may be able to identify a fungal infection on the skin and advise appropriate antifungal treatments, or they may suggest mild corticosteroids if they suspect an inflammatory skin condition such as eczema.
The good news is that most itchy skin conditions will improve once the cause is known and properly treated.
DO I NEED LONG-TERM ANTIBIOTICS?
Q: I HAVE had ankylosing spondylitis for 50 years and it was under control with anti-inflammatory medication.
Then I was told to stop taking it because it was affecting my kidneys.
Tramadol and co-codamol gave little relief and prednisolone left me with insomnia after a few weeks.
I am just about to start taking adalimumab (Imraldi) and would like to know if my doctor should put antibiotics on my prescription as my immune system will be compromised.
A: Ankylosing spondylitis is a chronic inflammatory disease primarily affecting the spine, causing pain, stiffness, and potentially leading to fusion of the vertebrae over time.
It’s a shame your kidneys were being affected by the anti-inflammatories as it sounds like they helped a lot.
Imraldi is a biologic medication that helps to reduce inflammation by blocking a specific protein.
You are right that it can also affect how your immune system works.
However prophylactic antibiotics (to prevent, rather than treat infection) are not usually required or prescribed with Imraldi.
It is important, however, to be vigilant for signs of infection, and if you think you have an infection at any time you should let your medical team know immediately.
It is important not to take antibiotics unless necessary.
Overuse can cause bacteria to change and become resistant to the antibiotics meant to kill them, making antibiotics less effective – this is known as antibiotic resistance.
This can limit the antibiotics we can use to treat people and results in more serious, sometimes life-threatening infections.
When you do need antibiotics, it is also important to complete the prescribed course, even if you start feeling better.
This ensures all bacteria are killed and prevents the development of resistant strains.
My advice is to have a chat with your specialist medical team – the specialist nurse is usually most accessible.
Find out the exact advice for yourself concerning any future infections and use of antibiotics.
HOPE FOR ALZHEIMER’S
A COMMON hormone already produced by the body could stop early-stage Alzheimer’s.
Leptin is released by fat cells and is involved in appetite regulation.
Researchers at the University of Dundee have discovered that a small part of the hormone can reduce the effects of toxic proteins called amyloid and tau, which build up in the brain and lead to memory loss and Alzheimer’s disease.
Professor Jenni Harvey said: “We’re working at the level of synapses which are the communication points in the brain because synapses are affected early in the disease process, when Alzheimer’s is still reversible.
“We have found that applying leptin can block the ability of amyloid and tau to interfere with synapses and memory loss, and it can prevent the unwanted effects of these cellular changes.”
The researchers discovered six amino acid fragments out of the 167 within the hormone that slow or stop the disease.
This has enabled scientists to design a potential drug template. But it could be a few years before any new leptin-based drugs become available.
Prof Harvey said: “Developing drugs is not a quick process, most drugs take around ten years.”
There are 900,000 people in the UK with dementia and it is predicted to rise to 1.6million by 2050.
NIGHTMARES IN LUPUS
NIGHTMARES and “daymares” could be an early warning sign of lupus.
A study by University of Cambridge and King’s College London looked at people with lupus, a disease which causes the immune system to attack tissues and organs, as well as other chronic inflammatory autoimmune disorders.
Researchers asked almost 700 patients to list the order in which 29 neurological and mental health symptoms, including depression, hallucinations and loss of balance, usually occurred.
The survey found three in five patients with lupus and one in three with other rheumatology-related conditions had a spike in vivid, distressing nightmares before having hallucinations.
They added that they thought this happened when they were “overwhelmed” and “the more stress my body is under, the more vivid and bad the dreaming would be”.
Experts said it had long been suspected that nightmares and hallucinations were linked with the disease, which counts US pop singer Selena Gomez among its sufferers.
Angie Davidson, of the Lupus Trust, said: “Many patients have talked about having these sort of symptoms without knowing it was part of their disease.
“It’s a fantastic breakthrough in recognising another area of lupus.”
TIP OF THE WEEK
A FEW words of warning now it’s finally sandal season.
Don’t cut your toenails with scissors, as this is more likely to lead to painful ingrown toenails. Use toenail clippers – and see a pharmacist if the nails look like you might have a fungal infection.
Q: I HAVE been taking an oestrogen-blocking drug for three years after being diagnosed with breast cancer.
I have awful muscle and back pain and I’ve also noticed my scalp has become very flaky and red around the hairline.
Could this be caused by the drug?
A: The short answer is yes, it certainly could be.
Blocking oestrogen can affect any and every organ and system of the body because oestrogen plays a role in how all parts of the body function.
Oestrogen-blocking drugs, such as Tamoxifen, help to lower the risk of breast cancer coming back in people who have a type of breast cancer which is hormone-receptor-positive.
They do this by blocking the oestrogen receptors, which stops oestrogen from telling the cancer cells to grow.
Tamoxifen can reduce the risk of breast cancer coming back by 40 to 50 per cent in post- menopausal wo- men and by 30 to 50 per cent in pre- menopausal women.
It can reduce the risk of a new cancer developing in the other breast by about 50 per cent.
The downside, though, is that it also blocks the oestrogen receptors in other tissue, and this can cause a whole range of negative side-effects, many of which are the same as menopause.
It can lead to changes in muscles and joints, causing pain and stiffness.
Oestrogen also helps keep the skin healthy, so dry and inflamed skin can certainly be a side-effect of taking this medication.
Having said that, it’s important not to ignore other potential causes such as psoriasis, which can cause red, flaky skin (and joint pain sometimes) but is very treatable.
Your pharmacist can advise you on over-the-counter treatments for psoriasis and I recommend making a routine appointment with your GP surgery to discuss your symptoms in more detail.
If the symptoms do turn out to be side-effects of medication, that can be very helpful for consideration of the length of treatment.