Ex­er­cise high’ not ad­dic­tive

The Weekend Australian - Travel - - Health - THE DOC­TOR LINDA CAL­ABRESI

IN a sense, yes, your body can get used to the en­dor­phins pro­duced by stren­u­ous phys­i­cal ex­er­cise and, yes, you can ex­pe­ri­ence symp­toms when the sup­ply of th­ese en­dor­phins is in­ter­rupted. Re­search has shown ex­er­cise can play a part in al­le­vi­at­ing de­pres­sion. This is thought to be re­lated to the ef­fect of en­dor­phins and ex­plains the na­ture of your symp­toms when you were no longer ex­er­cis­ing. Also, en­dor­phins have a role in pain re­lief — given you were ill and prob­a­bly in some de­gree of dis­com­fort, this would have felt worse be­cause of the lack of your nat­u­ral anal­gesics. The good news is that, as far as I’maware, this sort of ad­dic­tion has never caused any real prob­lems — so no re­hab nec­es­sary. I ama 72-year-old man, of Chi­nese ori­gin, a non-smoker and non-drinker di­ag­nosed with di­a­betes in mid-2000. With Di­ami­cron, strict di­etary con­trol and reg­u­lar phys­i­cal ex­er­cise I have man­aged to keep my HbA1c lev­els within 6 to 7 per cent. Re­cently I de­vel­oped mi­croal­bu­min­uria and have been com­menced on an ACE in­hibitor. If my HbA1c read­ings demon­strated good con­trol, which I be­lieve they did, why did I de­velop pro­tein in my urine? YOU are quite right when you say that your gly­cated haemoglobin con­cen­tra­tions (HbA1c) were in a range that rep­re­sented good con­trol. The HbA1c re­flects what your av­er­age blood sugar level has been over the two to three months. The tar­get is gen­er­ally un­der 7 per cent. Un­for­tu­nately, while good con­trol can sig­nif­i­cantly re­duce the risk of de­vel­op­ing di­a­betic com­pli­ca­tions, it can’t elim­i­nate the risk en­tirely and, as un­fair as it seems, this ap­pears to be the sit­u­a­tion in your case. That said, mi­croal­bu­min­uria is in­dica­tive of very early kid­ney dam­age. You have no way of know­ing how much dam­age was done to your kid­neys prior to your di­a­betes di­ag­no­sis and treat­ment. Hope­fully, by main­tain­ing your cur­rent good con­trol over your blood sugar lev­els and the ad­di­tion of the ACE in­hibitor (which has been proven to be kid­ney-pro­tec­tive) the de­te­ri­o­ra­tion of your kid­neys can be slowed dra­mat­i­cally, per­haps halted. I ama 48-year-old wo­man. Over the past six months I de­vel­oped a red fa­cial rash which has been di­ag­nosed as rosacea. I have been pre­scribed a low-dose an­tibi­otic, but would rather not take it as I am­prone to thrush. Can you sug­gest any nat­u­ral reme­dies? AS far as I amaware there are no nat­u­ral or herbal prod­ucts that have been sci­en­tif­i­cally proven to help in rosacea — but there are mea­sures you can take to help lessen the in­flam­ma­tion and red­ness. Th­ese in­clude avoid­ing get­ting over­heated — so avoid over­dress­ing, very hot show­ers or baths, and di­rect sun­light. Some­times fa­cial flush­ing is trig­gered by spicy foods which should there­fore be avoided. Sim­i­larly, al­co­hol can cause the same re­ac­tion and if this is the case with you, again avoid­ance is best. The rosacea will also be made worse by sub­stances that di­rectly ir­ri­tate the skin, such as harsh soaps and skin washes. While rosacea can of­ten ap­pear like acne, acne cleansers that con­tain sub­stances such as ben­zoyl per­ox­ide, sal­i­cylic acid or al­co­hol may ac­tu­ally make the rosacea worse. Linda Cal­abresi is a GP and ed­i­tor of

Send your queries to linda.cal­abresi@medobs.com.au

Med­i­calOb­server. I ama 46-year-old wo­man, fit and healthy. I pad­dle up to 15km twice a week and com­plete a stren­u­ous walk ev­ery other day. Re­cently I was ill with a virus for a few days so could not do any phys­i­cal ac­tiv­ity. I be­came a lit­tle de­pressed al­though I had com­pletely re­cov­ered. Is it pos­si­ble to be­come ad­dicted to the high’’ feel­ing you get af­ter do­ing phys­i­cal ex­er­cise?

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