ASK THE DOC

Specialist surgeon and lecturer Dr Sarah Rayne answers your questions about hypothyroidism, nail splitting and fatty liver disease.

Specialist surgeon and lecturer Dr Sarah Rayne answers your questions

I have hypothyroidism, which my medical aid scheme lists as a chronic condition. Does this mean I’m at risk of life-threatening events? How can I improve my health?

An underactive thyroid gland is a common problem for women as they get older. Even though the gland is small, it has enormous impact on the functions of the body: it regulates your temperature and your heart, how your body uses energy, and how it builds and breaks down tissue. Not having enough thyroid hormone will make you ill; if you don’t replace it, you’ll be continually ill, which is why your medical aid acknowledges that hypothyroidism is a chronic condition and that it should pay for medication for the rest of your life. That’s all the listing means in this case.

If you replace the thyroid hormone by taking a pill every day, you will be well. There’s very little you can do to improve or change your thyroid’s function. However, it’s important to have the levels in your blood checked regularly to make sure you’re taking the correct replacement amount.

My nails have been breaking since I stopped hormone replacement therapy (HRT). Is there anything I can do?

While we’re all too aware of the more evident effects of menopause, such as hot flushes and mood swings, subtler signs of a decrease in female hormones can take you by surprise. Oestrogen helps support connective tissue such as that found in your hair, nails and skin. That’s why your skin and hair often become drier and your nails break, peel or split more easily. One study found a significant decrease in the blood supply to the nail bed in women post-menopause. This is what causes changes to the nails.

There’s little evidence that anything exists to ‘fix’ this symptom. Calcium is unrelated in clinical studies, although there’s interest in biotin, a B-complex vitamin.

It’s more useful to take better care of your nails: limit your use of nail polish remover as it dries them out, and keep nails short to avoid breakage. Protecting your hands when washing dishes, or cleaning as well as moisturising them, will help. Staying well hydrated will ensure that your nails are hydrated too and might limit splitting.

Nails tell doctors a lot about your general health, and can indicate anything from anaemia to liver and heart diseases. So if you notice changes, tell your doctor.

I’ve been diagnosed with fatty liver disease. Can it be reversed?

A healthy liver is made up of cells that make and break down important products for the body. It also stores vitamins, protein and energy. But sometimes these cells are replaced by fat cells, which doesn’t help the liver function. If more than five percent of your liver is made up of fat cells, you have a fatty liver. It may be alcohol-related liver disease (ARLD) or non-alcohol fatty liver disease (NAFLD).

More than one in three people have some amount of fat in their liver. It’s related to diabetes, high blood pressure and being overweight or obese, and is more common after the age of 50. In the initial stages, fatty liver is harmless, but as it progresses, you may feel tired and experience abdominal pain or general weakness.

It’s easier to avoid future complications such as liver inflammation (steatohepatitis), liver fibrosis or liver failure than it is to reverse a fatty liver. While there’s no medication for it, there are lifestyle choices you can make that will contain its advance, including losing weight (losing more than 10 percent of your body weight may remove some of the fat), eating healthily and exercising regularly. If you have high blood pressure or diabetes, make sure it’s being managed.

It’s especially important to be careful about taking supplements or herbal remedies, as they may produce toxins that further damage the liver. Speak to the doctor who diagnosed you if you aren’t sure about what to take.