DR ELLIE CANNON: Have blood pressure tablets made me lose my appetite and should I be worried?

Recently, I was put on a blood pressure tablet called amlodipine. Suddenly, no matter whether or not I eat, I feel full. I have totally lost my appetite. Personally, I’m quite happy about it, as I’m overweight and it means I’m no longer tempted to snack. But it’s very odd. Should I be worried?

Medications frequently have side effects and it is not always obvious who will get them or how severely. Often, they can be mild and settle down in a week or so.

Amlodipine is a commonly used blood pressure tablet but changes in appetite or satiety are not listed as known side effects.

It is known to cause digestive issues such as constipation, heartburn, nausea and abdominal pain – any of which may affect appetite or how your stomach feels.

With a new problem like this, perfectly timed to starting a medication, I would usually give it two to four weeks to subside.

Amlodipine is a commonly used blood pressure tablet but changes in appetite or satiety are not listed as known side effects, says Dr Ellie

But feeling full all the time should be investigated if it persists. If it is due to the tablets, there is thankfully a huge range of other blood pressure medications the GP can offer.

And our appetite can change for a whole host of reasons such as nervousness, stress and other physical health conditions.

But specifically feeling too full to eat can be a worrying sign that the stomach is under pressure and fills up too quickly, for example if there’s a tumour there. This could be a problem within the stomach or something pressing on the stomach from another abdominal organ. That’s why it does need to be checked out by a doctor.

I have been getting rashes under my breasts which are sore and stop me from wearing a bra. My doctor said I have something called intertrigo and gave me a special spray for it. However, it doesn’t seem to be making any difference. Can you help?

Intertrigo is a type of skin rash usually found where there is skin-to-skin contact, often in areas such as under the breasts, the armpits or in the groin.

In larger people it may also occur in skin folds of the abdomen and, in babies, in neck folds. Fungal and yeast infections thrive in these areas because they are warm and moist, and the air can’t circulate properly. It does tend to be sore, with itching or burning a common complaint.

The first stage of treating this is somehow to limit the contact from skin on skin and reducing the heat and moisture in these areas.

The area under the breasts needs to be dried thoroughly after washing and kept as cool as possible with lightweight clothing.

A barrier cream may be helpful. These are normally thick white creams, often used as nappy cream, available from high street pharmacists.

Antifungal creams are also often used alongside something anti-inflammatory to reduce soreness and inflammation – a mild steroid cream, for example. Antifungal and steroid creams are sold in pharmacies.

If it is very bad despite treatment, it may be worth using antifungal tablets while also continuing to use the barrier creams. These would be given on prescription from the doctor.

Sometimes intertrigo is also infected with bacteria, so another line of treatment may involve taking a swab from the sore skin and treating with an appropriate antibiotic.

Intertrigo is worse in people with type 2 diabetes or in patients taking regular steroid tablets or immunosuppressants. If this is the case, it may only be stronger treatment from the GP that will work.

In the past few months it feels as though I’ve been hit with extreme exhaustion, which seems to have come from nowhere. It happens at 5pm most days and by 9pm I need to go to bed. I am female, 49 and in good health. I’m also very active. What could be causing it?

There are a few common and obvious causes that could happen to a woman at 49 to make her inexplicably exhausted. The first one would be menopause.

When the female hormones change and particularly the oestrogen levels drop, women can feel incredibly tired – unlike anything they have experienced before. This can also be worsened by the heavier periods of the perimenopause – the transitional stage before the menopause when hormones fluctuate – which may cause iron deficiency, known as anaemia. Tiredness is a symptom of that.

This can also happen if you don’t get enough iron in the diet – which can be a problem for vegans. Certain types of deficiency in another vitamin called B12 also occurs with an autoimmune condition called pernicious anaemia, which means the body doesn’t absorb B12. Anaemia, from any cause, can be picked up with a simple blood test.

Another common cause of exhaustion in the mid-40s would be an underactive thyroid.

This affects about one in 50 people and is when the thyroid gland in the front of the neck does not produce enough of the hormone thyroxine responsible for maintaining metabolism.

Other symptoms of thyroid hormone deficiency include constipation, weight gain, muscle aches and hair loss.

Extreme or persistent exhaustion can also happen after viral infections, such as Covid.

We don’t hit adults, so why smack our children?

I was disappointed to see that the Government rejected a call last week to ban smacking children. So, in England, it remains legal to hit a child if it is a ‘reasonable punishment’.

This isn’t the case in Scotland and Wales. I know a lot of people think it’s no big deal to smack a child and many older adults have the attitude of ‘I was smacked and turned out OK’. Others think teens are unruly because they lack discipline.

I reject all of those arguments. Studies show that there are long-term psychological repercussions of smacking for many kids. Most importantly, what kind of lesson are we teaching children if we resolve arguments with physical force?

As Sir Peter Wanless, chief executive of the NSPCC, said last week: ‘It cannot be right that in this country it is illegal to hit an adult but equal protection is not given to a child.’

Government polls suggest that about two-thirds of Britons agree with me. I’m interested to know how true that figure is.

Gambling addicts need to talk

It might surprise you that one of the most common mental health problems I see in middle-age people is gambling addiction.

Studies estimate that about two million people are at risk, as it is such an easily accessible habit. So I’m working with the charity GambleAware this week to try to get people to think hard before placing a bet, and to talk about gambling habits with their loved ones.

One of the most disturbing statistics I have learned is that three-quarters of those worried that a loved one is addicted don’t talk to them about it. It’s difficult, but it is vital. Don’t start a conversation by blaming them for losing money. Instead, talk about how much you care about them and your concerns.

GPs have local support group information, or try the National Gambling Helpline (0808 8020 133) for advice.