If I’m too old to have HRT, how can I stop night time sweats? DR ELLIE CANNON answers your questions

I am 74 and suffering terribly with night sweats. The doctor says there is nothing she can do as I am too old for HRT.

Night sweats are one of the most common symptoms of the menopause, related to the drop in fertility hormones. But the menopause is not always to blame. 

Night sweats can, in fact, be a red-flag symptom – an indication of something serious going on, specifically, a type of cancer called Hodgkin lymphoma, as well as serious infections such as tuberculosis.

It is especially crucial that older patients are fully investigated as generally the risk of cancer rises with age.

Night sweats are one of the most common symptoms of the menopause, related to the drop in fertility hormones, writes DR ELLIE CANNON

Don’t worry Trinny, your Covid hair will grow back 

Trinny Woodall is not the only patient to ask her GP about Covid-related hair loss – I’ve had many come to me with the same problem.

The 57-year-old style guru told her Instagram followers last week of her trip to the doctor to ask about the clumps she was losing, post-virus.

I’d tell Trinny what I tell all my patients: don’t panic. It is very common to lose hair after a period of severe stress or illness, and it will grow back, usually within six months.

Trinny Woodall is not the only patient to ask her GP about Covid-related hair loss

Trinny Woodall is not the only patient to ask her GP about Covid-related hair loss

While we’re on the subject, please don’t start spending shed-loads on fancy shampoos and treatments that claim to beat hair loss. 

Other than treatment for underlying conditions, such as iron deficiency or thyroid disease, there is no quick fix.

Ask your GP if you suspect these are the culprit. Otherwise, sadly, it’s just a waiting game. 

Another warning sign is if there’s also unexplained weight loss. A GP should do blood tests and a chest X-ray for patients with night sweats, at the very least.

There are other, less serious underlying conditions that could be in play. These includes problems with the thyroid – the little butterfly-shaped gland in the neck – as well as side effects of medication and, sometimes, anxiety. 

If nothing is flagged up, simple lifestyle changes, such as avoiding spicy food, caffeine and alcohol, are worth a try.

Obviously, cooler pyjamas, lighter blankets and sleeping with the window open will help.

In terms of treatment, hormone replacement therapy won’t usually be prescribed to a woman in her 70s as, in older women, the risks usually outweigh the benefits. But another, non-hormonal medication called clonidine can control sudden changes in temperature.

The benefits aren’t huge, however, and would need to be weighed up against side effects such as dizziness.

I am 71 and for the past two years have been experiencing intermittent nausea that suddenly comes over me, immediately followed by a full body shiver. I can be sitting up in bed or making dinner – it’s over within seconds. Why is this happening?

Minor health complaints, emerging once in a while, present a dilemma for doctors. While we obviously want our patients to be on the lookout for early warning signs of something serious, we don’t want to encourage unnecessary worrying. This can, in itself, cause health problems, by way of stress and anxiety.

Fleeting, random symptoms that last for seconds are unlikely to be serious – especially if they are not getting worse or more frequent over a number of years.

Random waves of nausea can be related to a whole host of underlying issues: from blood pressure changes to anxiety, side effects of medication or momentary heart-rhythm changes. 

Infections can also cause nausea, but in this case, it is typically combined with shivering and lasts for at least a good few minutes.

A GP could order blood tests and investigations such as a heart scan, or ECG, which could pick up some of the underlying causes – but not all. A heart-rhythm change could be missed on a basic heart scan – even one that monitors the heartbeat for 24 hours, if it is fleeting.

Blood tests, meanwhile, can give a picture of overall health and rule out inflammation, which can be sign of a serious disease.

Random waves of nausea can be related to a whole host of underlying issues: from blood pressure changes to anxiety, side effects of medication or momentary heart-rhythm changes, writes DR ELLIE CANNON

Random waves of nausea can be related to a whole host of underlying issues: from blood pressure changes to anxiety, side effects of medication or momentary heart-rhythm changes, writes DR ELLIE CANNON

Spare jabs shouldn’t go to waste 

Some of my patients have asked if their children or grandchildren should queue up at vaccination centres or pharmacies on the off-chance there are doses going spare at the end of the day.

They assume it’s unethical to skip the queue, denying older, vulnerable people a jab.

Go for it, I say. There’s no fair or organised way to divvy up spare doses and they are better in an arm than in a bin.

Plus, there seems to be limitless supply at the moment, so it’s not like you’re stealing a vaccine from a vulnerable person.

Ultimately, the more people who are vaccinated, the better off we all are.

So, if you get a chance to have the jab – whatever your age – take it!

Often, a thorough discussion with the doctor about symptoms and potential triggers is more useful than a battery of tests.

Commonly, there is an obvious trigger – perhaps certain foods or even temperature. Keep a detailed diary of any random symptoms over a few months, documenting what you were doing and how you were feeling at the time. 

You could use at-home testing kits to spot changes in heart rate, blood pressure or temperature. Log this information too. Often patients are surprised to find a pattern, which they can discuss with their GP.

I’ve suffered constant back pain for ten months and rely on daily doses of strong painkillers. Despite not examining me in person, my GP says I have a trapped nerve in my back, but won’t refer me for an MRI scan to prove it. Should I push for a proper examination?

Sadly, with many GP surgeries opting against face- to-face appointments for Covid-safety reasons, this situation is becoming more and more commonplace.

Back pain is one of the most common problems I see in clinic, with more than two-thirds of all adults suffering lower back pain at some point. 

For most people, the discomfort lasts about six weeks. But for some, the agony comes with other unpleasant symptoms, like sciatica, where the pain spreads to the back of the body and legs, alongside pins and needles. 

WRITE TO DR ELLIE

Do you have a question for Dr Ellie Cannon? 

Email DrEllie@mailonsunday.co.uk

These sensations imply nerves in the spine are trapped, perhaps by a bulging disc – which provides cushioning between the bones. Even in these cases, pain should resolve within a few weeks.

In rare cases, cancers can form in the bones of the spine. More common is a fracture, caused by bone-thinning disease osteoporosis. 

This is one of the reasons why an examination is so important, so that patients can be referred for an X-ray or MRI scan of the spine if necessary.

It is worth knowing, however, that MRI often doesn’t deliver the answers patients hope for.

Many struggling with pain are surprised to see their MRI is totally normal. Even so, there’s a lot that can be done, including referrals to physiotherapy, pain clinics and spinal orthopaedic specialists.

Ten months is more than enough time to qualify for a referral. Most doctors would do so after a couple of months.

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