THE DOC REPLIES

I have anaemia and have been told drinking a glass of red wine will help. Is this true?

I’m not sure who told you this but it does not sound like medically-based advice. There are many different kinds of anaemia. The most common is iron-deficiency anaemia. This is usually caused by either a deficiency in the diet or some illness that causes poor blood production or blood loss. While there might be a little iron in red wine, it is not a standard treatment for anaemia. Anaemia can also be caused by deficiency of vitamins in particular vitamin B12 and folic acid. Again I am not aware that red wine is a primary source of either of these vitamins. If you have anaemia you should be heading to your doctor’s surgery rather than the off-licence!

I’ve been on HRT for a year, but now my period has returned. Is this normal?

Your doctor can prescribe HRT in a variety of ways. Oestrogen is the hormone that improves the symptoms, while progesterone is necessary if you still have a uterus. How these hormones are taken depends on your age and stage in the menopause. If you are well past the menopause your doctor is likely to prescribe a combination of these two pills taken continuously. In this situation most patients would not bleed. If, however, you are younger and still having occasional natural periods, then your doctor is likely to prescribe a preparation which perpetuates this cycle. If you are on one of the preparations where you are expected to bleed, then this is possibly what has happened. However, if you have had a year without bleeding and especially if you are on one of the preparations where every tablet is the same, then you should see your doctor.

My sister-in-law has had what seems like a nervous breakdown out of nowhere. What are the chances she’ll get back to being her old self?

Nervous breakdown is a rarely-used term nowadays. Sometimes a life crisis caused by events can lead to a period of anxiety and poor coping. This is often best managed by time, and support. Sometimes people have anxiety which may or may not have a direct cause. Input from a psychologist or use of varying online or reading resources in the management of anxiety might be useful. Probably more commonly it is an episode of depression that causes what people sometimes refer to as a nervous breakdown. Depression can result in a variety of symptoms including low mood, poor sleep, lack of motivation and anxiety. The person often needs to opt out of work and/or social situations for a while until they are better. Your sister-in-law would be wise to speak to her GP for assessment. It is very likely that with time and any required treatment she will return to normal.

What’s the difference between paracetemol and ibuprofen? Is one better for certain types of pain than the other?

Paracetamol is a pain killer and ibuprofen is an antiinflammatory. They actually have some crossover – paracetamol has some antiinflammatory qualities, and ibuprofen has pain killing properties. Paracetamol is safer for the stomach and less likely to interact with other medicines. Ibuprofen is likely to be better for inflammatory conditions such as muscle, or joint pains.

Can surgery fix a lazy eye? My grandson has one and I wonder what his options are. This eye muscle weakness results in the child presenting with a squint, which can be permanent or intermittent. What this means is that when the child looks at an object the “lazy eye” takes a second to catch up or sometimes doesn’t catch up. Sometimes challenging the lazy eye to do more work in early life (patching) is useful. In some cases surgery is useful although it tends to be more useful in preserving the vision if it is done at a younger age.