Fixing cancer has to come before fretting over thin hair

QI was interested in an article in You magazine regarding ‘collagen supplements’ for thinning hair, but need reassurance that this remedy wouldn’t interfere with the tamoxifen I take to prevent breast cancer from returning. A The interaction between medications is a very significant issue: it can affect the effectiveness of the medicines as well as the extent of side effects. In the worst-case scenario, interactions between medications can cause toxicity, with serious health consequences. We are therefore always cautious about crosschecking medications. This applies equally to over-the-counter and alternative remedies like the collagen supplement mentioned. The issue is that complementary supplements are not extensively tested in the same way that drugs are, and interactions may still be unknown.

Theoretically, since collagen is a protein which naturally occurs in abundance in the body, it would be unlikely to interact with any drugs, but without clear data it is not possible to reassure definitively about interactions.

Of course treatment to prevent cancer trumps all other medications in terms of importance, so if the interactions with another treatment are unknown, it takes priority.

Thinning hair is a distressing issue and can have a huge effect on emotions and self-esteem.

It certainly warrants medical input to assess any latent cause, such as iron deficiency or thyroid disease. Unfortunately, hair thinning is a known consequence of a drop of oestrogen and can certainly be precipitated by the sudden reduction in oestrogen that tamoxifen causes. It is unlikely to respond to any treatment, whether prescribed or not, and would be expected to persist until the tamoxifen is stopped. QI have been taking a prescription drug called tamsulosin since being diagnosed with an enlarged prostate in 2000. I have a blood test to check my PSA levels annually, but recently I’ve started needing to go to lavatory more at night. Should I see my GP sooner, rather than wait for my usual appointment? I am 68. A An enlarged prostate is thankfully a benign condition, but it can cause troublesome lower urinary tract symptoms (LUTS). Commonly this would result in frequent visits to pass water, nightly toilet visits, urgency and changes in the stream and flow of urine. All of these, particularly the night-time passing of urine, can be inconvenient and problematic and it is for this reason we treat the condition, rather than due to any medical need.

As the prostate enlarges, it can narrow the urethra, the tube that carries urine out from the bladder: this accounts for the symptoms. If the prostate enlarges in an area away from the urethra and the urine flow, no symptoms will occur.

Tamsulosin is a drug known as an alpha blocker and it relaxes the muscle of the prostate and the bladder entrance, allowing urine to flow more easily. If your symptoms are worsening despite this medication, other options do need to be explored with the GP or urologist.

Symptoms worsening imply the prostate has enlarged further and a PSA blood test could be used to evaluate this. This is not always a useful stand-alone test, but is valuable when compared to previous results to monitor a trend.

Alternative medications can be used, such as finasteride. This gradually shrinks the prostate gland but can take as long as four to six months to have a discernible effect.

Even in someone with a known prostate condition, more frequent urination may actually occur for an entirely different reason and this needs to be considered. Typically this could be due to a urinary tract infection or diabetes, as well as conditions affecting the bladder or kidneys.

About 25 per cent of men with an enlarged prostate will have no symptoms and will choose not to take any medication.