Is a poor diet the cause of my anaemia?

QAFTER fighting off a nasty virus, I now have anaemia and I’ve been prescribed a two-month supply of iron tablets. I am 79. After taking them for more than two weeks, I can’t see much improvement. Can you explain what anaemia is? Should I change my diet?

AANAEMIA is a lack of red blood cells or haemoglobin in the bloodstream. Haemoglobin is the protein within red blood cells that carries oxygen around the body, so if you are lacking it, you are going to feel tired, weak and even short of breath. It can occur with blood loss, and commonly we see anaemia in young women with very heavy periods. We also see it after surgery or childbirth for the same reason.

Crucially, in an older person with anaemia, it is important to consider blood loss that we can’t see. It may come from the bowel or stomach and would usually warrant investigation to rule out a tumour. According to NHS guidelines, an unexplained iron deficiency is enough reason to initiate a colonoscopy in a patient over 60 to rule out colorectal cancer. This can be an early sign before other symptoms present.

Dietary causes of anaemia occur in people not eating enough iron, an essential component of haemoglobin. Red meat or green vegetables are good sources of iron. Vitamin C is also important for the uptake of iron, so it is important to make sure you have this in your diet too. Doctors often recommend taking iron tablets with orange juice for this reason.

Anaemia may not be caused by iron deficiency – it can be caused by a lack of B12, which is also essential for healthy red blood cells, and this should be quantified on any blood tests. This type of anaemia requires treatment with B12, which is given in injections at the GP surgery.

QI HAVE a cold sore on the side of my nose that keeps coming back. It’s unsightly and lasts for a week or more. Cold-sore creams bought over the counter don’t seem to prevent it.

ACOLD sores are the visible sign of a herpes virus known as HSV-1. People are normally infected in childhood and then the virus lies dormant in a nearby nerve, occasionally becoming active and creating a cold sore. Flare-ups are known to be triggered by stress, menstruation, fatigue and sunlight – and it is for this reason that sunblock is recommended.

The HSV-1 virus specifically thrives in the inner skin of the mouth, known as the mucosa, although recurrences can then appear on any part of the face and may account for a nose lesion. Usually, in between episodes the skin would be completely clear.

With any skin issue that is difficult to treat, it is always worth asking if the diagnosis is correct.

A recurring lesion on the side of the nose could be recurrent eczema, impetigo, or seborrheic dermatitis. None of these conditions responds to cold-sore creams and would require prescribed treatments.

Recurrent cold sores or HSV-1 are difficult to treat and we know that over-the-counter creams are not effective. Preventative antiviral medication can be offered by a specialist. The Herpes Virus Association website (herpes.org.uk) offers advice about recurrent cold sores.

OSADLY there were three cases of meningitis last month at the University of Surrey and one student died. Two of these cases have been confirmed as meningitis B, which is usually the most serious form of the illness. All 4,200 full-time undergraduates will be offered the meningitis B vaccine: this is a precautionary but very sensible measure. The closest associates of those diagnosed have already been given antibiotics to protect them. It is still rare to see clusters of meningitis but terribly distressing and frightening for everyone when it does happen.

OAFTER the Easter weekend, GP surgeries in my area were sent a message by the local hospital advising them that more than 100 patients were facing a two-and-a-half-hour wait. They requested GPs refer emergency cases only. I think this should be done more, with the message spread even wider to the public across social media. The factors over-burdening the NHS are multiple and varied, but I really believe a very frank, stark message like this would put some unnecessary users off visiting A&E.