DRMARTIN SCURR answers your health questions

A few years ago, my daughter in her thirties began to get very tired and had a hard time stumbling while running.

Her doctor diagnosed iron deficiency anemia and prescribed iron tablets for three months. This solved the problem, but for the past few weeks she was tired and stumbled again. Why did this happen?

PA Berry, Hertfordshire.

I think there are several factors here.

The average adult body contains about 4 g of iron, 70% of which is contained in hemoglobin, the oxygen-carrying pigment of red blood cells.

Iron deficiency anemia occurs when hemoglobin is below 11.5 g / dL in women and 13.5 g / dL in men, and iron stores are too low to produce normal amounts of red blood cells (each has a lifespan of only 120). It’s a day).

Red blood cells carry oxygen around the body, which can lead to fatigue and shortness of breath. The daughter’s stumbling may be due to this malaise.

Every day, the natural shedding of skin cells, hair, and intestinal mucosa results in the loss of about 1 mg of iron, which is constantly being updated. Women with menstruation lose about 2 mg daily during that period.

Also, studies have shown that athletes can lose iron by sweating from exercise, so it’s possible that your daughter is also losing iron by running.

You say in a long letter that she has a healthy diet, which helps, but there is a limit to the amount of iron that can be absorbed from the intestines.

Therefore, when iron stores fall, it is difficult to get them back without replenishment.

My advice is to take a daily full-strength (300mg) iron supplement available over-the-counter until hemoglobin far exceeds 11.5g / dL (her GP should have a blood test for this). Is to take from 1 to 2 tablets (same high dose) once or twice a week in the long run.

You also say that your daughter is a blood donor and wants to do so. Being anemia eliminates that direct possibility — the donor must have relatively high hemoglobin levels. No, I pay tribute to her good intentions.

For the past 6 months, I have been suffering from rosacea — when I eat or drink hot drinks, my face looks very red and worse. I have tried gels and 4 creams, but nothing to relieve them. I’m thinking of meeting a dermatologist personally. what can i do?

Barbara Craig, by email.

I sympathize because these symptoms obviously cause you great pain.

Rosacea is thought to occur because the immune system overreacts to the presence of skin-dwelling microorganisms, such as the demodex folliculorum.

This immune response causes vasodilators — hence the flushing of the skin.

Various factors can cause a relapse, such as exercise, drinking alcohol or hot drinks, and eating spicy foods. This is because they promote further dilation of blood vessels.

My preference was to prescribe an antibiotic known as tetracycline, which is commonly used to treat bacterial skin complaints.

There is no known bacterial cause for rosacea, but these drugs are thought to be useful because of their anti-inflammatory properties.

Treatment with oxytetracycline (250 mg, twice daily) or doxycycline (50 mg, once daily) for 4 to 12 weeks will sufficiently reduce the symptoms of rosacea and metronidazole gel (antibiotic) once the rosacea has healed. Allows you to continue treatment with. recurrence.

Another option, brimonidine, used to treat glaucoma and is now available as a gel, has had remarkable results. Studies have also shown that the anthelmintic drug ivermectin, available prescription as a 1% cream, is more effective than metronidazole gel.

Discuss these options with your doctor again. If this does not bear fruit, I agree that referral to a dermatologist is appropriate.

Write a letter to Dr. Scar

Write a letter to Dr Scurr at Good Health, Daily Mail, 2 Derry Street, London W85TT, or send an email to [email protected]. Dr. Scar cannot communicate personally.

Reply should be made in a general situation and always consult your doctor if you have any health concerns.

In my view: don’t forget to eradicate polio

Rumors of a local polio case brought fear to parents of babies and children when my parents got married shortly after World War II.

No prophylaxis or treatment was given, and some infected individuals experienced rapid and irreversible nerve damage.

I still have patients living with polio complications (such as paralysis of the lower limbs and arms) that developed in the 1950s.

In the worst case, the nerve supply to the muscles involved in breathing was affected, leading to life in the iron lung, a metal casing containing a mechanical pump. Thankfully, vaccination began in 1956.

There are several types of vaccines. A recent preferred option is an injectable vaccine made from killed poliovirus, as there are rare cases where the oral version (which will soon be discarded but used abroad) returns to infectious polio.

Last week, it was reported that modified poliovirus was repeatedly detected in sewers in an area of ​​London.

It should remind us of all of our childhood vaccination programs. Avoiding this, whether ignorant or observing conspiracy theories, is equivalent to child abuse.