Fingertip numbness needs study
Linda Calabresi is a GP and editor of MedicalObserver. Send your queries to firstname.lastname@example.org For many years I have had numbness in my fingertips. It does seem to be increasing recently and is most debilitating. There is no pain, nor do I have cramps. Do you have any suggestions for this 72-year-old desperate woman? YOU really need a thorough medical checkup, including a full history and examination before the cause of your numbness can be accurately predicted. However, speaking generally, the commonest cause of numbness of the fingers is nerve compression either at the wrist (as in carpal tunnel syndrome), at the elbow (where the ulnar nerve can be affected), or higher up— such as in thoracic outlet syndrome. Having said that, it is far less common that you would get this in both hands at the same time and to the same degree. Consequently, it would be worthwhile looking for an underlying medical condition that could be responsible. Such conditions would include diabetes, low blood calcium levels, and vitamin B12 deficiency. You can get low calcium as a result of damage to your parathyroid glands or vitamin D deficiency. Vitamin B12 deficiency can be caused by low dietary intake of foods that contain the vitamin, or absorption problems. I aman 81-year-old woman, 158cm, weigh 50kg and my only problem (touch wood) is osteoporosis. I amon Actonel and two calcium tablets with vitamin D daily. A few weeks ago I read a news article stating that women should stop taking calcium supplements after a study showed they increased the risk of heart attack by 40 per cent. How valid was this study, and should I indeed stop taking these supplements? THE study to which you refer is one that was conducted at the University of Auckland and involved 1500 post-menopausal women who were randomly assigned to take either calcium or a placebo for five years. Media reports stated that after five years, 36 women on the calcium supplements had heart attacks compared to 22 on the placebo (dummy) tablets. The study findings certainly seem to suggest that the calcium supplements were associated with an increased risk of heart attacks, but before we start taking everyone off these tablets there are a few factors to consider. Firstly, the study has not yet been published in a peerreviewed journal, which means that it hasn’t yet come under the scrutiny of experts who will determine the validity of the research. Also, it should be noted that there have been studies that show the opposite. For example, a study published in the prestigious journal Circulation earlier this year found that calcium/vitamin D supplements did not increase or decrease the risk of stroke or heart attack in post-menopausal women over a seven-year period. So where does that leave you? Probably the first step is to discuss this with your doctor. You need to know your overall risk of heart attack. If you are at high risk it’s probably best not to take any chances. If you are at very low risk, then you have to weigh up the risk/benefit ratio. I ama 48-year-old man. Recently I was prescribed simvastatin for my high cholesterol. Two months later my cholesterol level was 3.2, down from seven. How necessary is it that I keep taking the simvastatin? I’Mafraid in the absence of any radical lifestyle change, it would appear the only reason your cholesterol level has fallen within the normal range is because of the simvastatin. If you were to cease the medication your cholesterol level would again rise, along with your risk of having a stroke or heart attack. All in all, I’d stick with the drug if I were you.