Ask Dr Ellie I’ve been told to cut down but I still have a craving for alcohol

I AM struggling to control my alcohol consumption, despite a blood test showing I had raised liver enzymes and the doctor ordering me to cut down. Is there any medical solution that can help me stop craving a drink? My willpower alone isn’t enough.

IT IS incredibly hard to ask for help with an alcohol addiction, so even vocalising the fact you need it is a big deal.

And while it might seem like a huge step to take, groups such as Alcoholics Anonymous are often very successful. It’s not just about willpower: it’s what’s known as a 12-step programme that relies on peer support. There are regular meetings where no one is judged, and everyone tries their best to help one another.

There are other types of support, too: anyone can call the Alcohol and Drugs freephone helpline on 1800 459 459 from Monday to Friday between 9.30am and 5.30pm or email helpline@hse.ie.

GPs can offer regular advice and counselling, and may set goals and talk through safe strategies for cutting down, too.

Withdrawing from alcohol can cause physical problems, so we advise cutting down slowly to make sure it’s safe. We also prescribe specific vitamins, such as thiamine, to prevent some of the problems that can arise — insomnia and nausea, for instance.

Complete abstinence can seem like an impossible task at the outset, but smaller steps could be easier, such as switching to lower-alcohol beverages.

WHEN I bump my arm or hand, even in quite a minor way, blood spots appear — they last about three weeks and sometimes I look like I’m covered in bruises. I’ve visited the GP but they can’t offer any explanation and don’t even seem worried. Can you give me any advice?

AS WE get older our skin becomes thinner and more fragile, so marks and bruising can become more common.

Bruising or blood spots occur when the tiny blood vessels beneath the skin are broken by an impact injury, but small knocks on fragile skin might be enough to cause them.

It is sometimes a hereditary problem, but it can also be linked to medications, particularly those that thin the blood and prevent clots — warfarin or clopidogrel, for instance.

If marks are developing at an increasing rate, it would not be unreasonable to talk to the GP about why it is happening. It is important to bring up any other issues, such as bleeding gums.

Blood tests can help to elicit the cause. For somebody with new bruising or blood spots, we can perform liver function tests, blood cell platelet tests and screen for blood clots.

Platelets are the smallest cells in the blood and they act to prevent and stop bleeding. If there is a problem with their levels, it can lead to more bleeding and bruising under the skin. Issues with platelets can arise for a variety of reasons that may lead to blood spots. As people age, this can, in rare cases, be due to cancer or diseases of the blood.

LAST week I woke up and noticed a small swelling at the back of my head, near the bottom of my skull. It’s sore when I press on it. My partner looked and can’t see a lump or bump, but it’s making me worried as I am sure I can feel that it is raised. Could it be something serious?

I ALWAYS say that lumps are an important reason for a consultation with the doctor. Almost all of those I see in the clinic are harmless and benign, but it is still vital that a doctor checks them.

We have glands at the back of the head called occipital lymph nodes. They help fight infections, and swell when we are ill with colds and the flu. The most common lump on the head would be a sebaceous cyst. The cysts feel like a smooth, round lump just under the skin, and are normally quite soft. They are harmless and not normally removed unless they cause repeated infections.