Dr Sarah’s surgery

Dr Sarah Brewer talks statins and natural pain relief

NOSEBLEEDS

QRecently, I keep getting nosebleeds and have read somewhere that they could be caused by high blood pressure. Is this true?

AHaving untreated high blood pressure (hypertension) can strain delicate blood vessels in the nose to increase the chance of a spontaneous bleed. ENT surgeons reached this conclusion by analysing studies involving over 8,600 people. The risk of nosebleeding was found to be 53% to 86% greater in people with hypertension than in those with normal blood pressure. Some studies have shown that nosebleeds can also be a sign of so-called ‘masked’ hypertension, in which blood pressure readings are normal when measured in the surgery but raised at home or at night. It’s important to take recurrent nosebleeds seriously, as they can be a warning sign that you are at increased risk of a stroke. A study in Finland, for example, found that the risk of stroke was almost three times higher for those with a history of nosebleeds than it was for those without. If you have recurrent nosebleeds, do see your doctor as there may be an underlying cause. There’s lots of information about high blood pressure on my website, mylowerbloodpressure.com.

NATURAL PAIN RELIEF

QI have painful sacroiliac joints that cause discomfort in my lower back. Tests have ruled out arthritis and my only option seems to be to take painkillers long term. Can you suggest any alternatives?

AAs someone who has experienced sacroiliac pain, I can share what helped me. I take turmeric and omega-3 fish oil supplements to help with pain and inflammation, and massage the joint with Amber Ointment (£6.99, healthy2u.co.uk). I also use a medical device (£249.99, arc4health.com) that you wear on your arm or ankle for three hours a day. This generates a microcurrent that reduces pain and stimulates healing. It can be used to treat acute pain due to migraine or sacroiliitis and long-term pain, such as that caused by fibromyalgia or arthritis. A study of 1,949 people found that 93% achieved significant pain reduction. It’s not cheap but it works for me.

STATIN SAFETY

QMy doctor wants me to take a statin, but my cholesterol is only slightly raised. I’m worried about side effects. Would anything else help lower my cholesterol?

AAt least nine out of 10 people who take a statin don’t develop side effects. If your doctor recommends treatment, it’s a good idea to follow their advice. If side effects do occur, such as fatigue, muscle pain or weakness, there are ways around this, such as switching to a different statin or, with your doctor’s permission, taking the statin every other day (which does not seem to alter the cholesterollowering effect). Other ways to reduce side effects include taking a coenzyme Q10 supplement or a vitamin D supplement. If you would prefer to try another cholesterol-lowering method first, then plant sterol supplements block cholesterol absorption from the gut to lower levels by around 15%. Oat beta glucan supplements also have a cholesterol-lowering action.

‘A probiotic supplement can boost immunity’

STAYING WINTER WELL

QMy dad has the lung condition COPD due to smoking. Inhalers reduce his breathlessness, but every winter he gets a bug that makes it worse, and he needs antibiotics. Can anything boost his immunity?

AChronic obstructive pulmonary disease causes shortness of breath, coughing, wheezing and winter bronchitis. While COPD can’t be cured, conventional treatments can help control symptoms. If he has frequent exacerbations, this is a National Institute for Health and Care Excellence (NICE) indication for referral to a specialist to rule out bronchiectasis (enlargement of airways) and review treatment options.

For good immunity, it’s important to have a healthy, varied diet. If his appetite is reduced, he may benefit from a multivitamin and mineral supplement. Vitamin D is especially important in winter. A probiotic supplement can also boost immunity. To help reduce the need for antibiotics, research shows that pelargonium extracts, such as Kaloba Cough & Cold Tablets (£9.25, Boots) can relieve upper respiratory tract infections, including bronchitis. A study of 199 people with COPD found that adding pelargonium to their treatment for six months (under medical supervision) significantly improved breathing difficulties and quality of life and decreased antibiotic use.

LEGAL CANNABIS

QI’m thinking of taking CBD oil for anxiety as I’ve read positive things about it. I’m a bit wary as it’s a cannabis extract. Is it legal?

ACBD oil is a wellbeing supplement that’s growing in popularity in the UK. It contains cannabidiol, which is extracted from non-marijuana strains of cannabis known as industrial hemp. Once extracted, cannabidiol is purified and added to olive oil, coconut oil or hemp seed oil to aid absorption. This blend is what is known as CBD oil. As CBD is not psychoactive or addictive, it is legal to take. CBD works by enhancing the effects of brain neurotransmitters (such as serotonin and dopamine), and helps to reduce anxiety and generate feelings of wellbeing. It also promotes relaxation, deep sleep and reduces pain perception. Always choose a reputable brand. I take Healthspan CBD oil

(£18.99, healthspan.co.uk) as I am a consultant for the company and know it is 100% natural and certified free from psychoactive ingredients. If you have a medical condition, it’s important to talk to your doctor and to check for interactions if you are taking any prescribed or over-the-counter medicines. CBD interacts with liver enzymes that break down many drugs, so interactions can lead to higher than expected levels of prescribed drugs, which could cause

side effects.

NO PERIODS

QI haven’t had a period for two months now, although I am definitely not pregnant. I am 42 and had to stop the pill a few months ago due to migraines. My doctor says it should sort itself out, but I am worried.

AOne of the most common causes of absent periods is stopping

the oral contraceptive pill. This is thought to result from the pill dampening down the release of hormones from the hypothalamus and pituitary gland in the brain. Periods usually restart on their own within a few months, but if they take longer to return, there is usually another cause that was masked by the effects of the pill, such as having polycystic ovary syndrome or an early menopause. Having a negative pregnancy test doesn’t necessarily rule out pregnancy, either. Go back to see your doctor if your periods haven’t returned within three months.