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.

Australian Women’s Weekly NZ - - CONTENTS -

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.

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