Ask the doctor:

Professor Kerryn Phelps answers readers’ questions on osteoarthritis, ovarian cancer, mouth ulcers and heartburn, and gives a reminder about the flu shot.

readers’ health questions

QMy friend has been diagnosed with Graves’ disease at the age of 35. I read that it is more common in women than men. Why is that? What can she do to improve her symptoms and can the disease have an impact on her fertility? K.I.

Graves’ disease is an autoimmune thyroid condition which causes the thyroid gland to become overactive, speeding up your body’s metabolism. It needs the supervision of a GP and usually also a specialist endocrinologist. Graves’ disease affects women 10 times more often than men. We don’t really know why, but sex hormones may play a role. Pregnancy has to be planned and Graves’ disease must be well-controlled before becoming pregnant, or the mother risks complications such as miscarriage, pre-eclampsia and pre-term birth. There are also risks for the baby unless pregnancy is planned and carefully managed.

QMouth ulcers (or aphthous ulcers) can certainly be associated with stress and exhaustion. Depending on any other symptoms, your doctor may test you for coeliac disease or inflammatory bowel disease. Consider also deficiencies of iron, folate and B vitamins.

QI keep developing mouth ulcers. I read that it is mostly due to stress, but I feel fine. What are the other causes? S.P. My two-year-old daughter has eczema on and off, but it gets worse during winter. I am reluctant to use steroids as I am worried about the side effects on her skin. Are they safe? L.O.

Look for potential food allergens. The most likely one is gluten (a protein in wheat, oats, rye and barley) and a trial of a gluten-free diet may help her skin condition. The probiotic lactobacillus rhamnosus LGG may help, too. Moisturise daily with a non-scented moisturiser with natural ingredients. Steroid creams may be necessary.

QI am 43 years old and I’ve been told by my doctor that I have osteoarthritis. Is this common for someone my age? As this is a degenerative disease, I am concerned that I won’t be able to walk much longer. What can I do to combat it? R.M.

Osteoarthritis can certainly occur in someone of your age. You need to make sure you are at the lighter end of your healthy weight range and that you undertake a targeted exercise programme aimed at strengthening the muscles supporting your joints. Maintaining flexibility is also important and yoga or tai chi can be helpful for this. Some supplements help pain management (fish oil, glucosamine/chondroitin and turmeric).

QI am sorry to hear this. I hope they are receiving expert cancer care. Ovarian cancer is tricky because the early signs may be very subtle. Look out for abdominal or pelvic pain, abdominal bloating, urinary frequency or urgency, fatigue, lower back pain, vaginal bleeding between periods or after menopause, or change of bowel habit.

QMy mother and best friend have both been diagnosed with ovarian cancer in the past few years. What are the first signs? Y.D. My husband is 65 and has recently been having terrible acid reflux and heartburn. He has tried a few antacids, but nothing seems to be helping. What do you recommend he do? S.D.

He needs to see his GP. He will have testing for helicobacter pylori stomach infection and probably be referred for a gastroscopy to exclude peptic ulcer or cancer. He will also have a heart check as some heart conditions can be mistaken for indigestion.