Ask the doctor: readers’ health questions answered

Professor Kerryn Phelps answers readers’ questions on headaches, the Paleo diet, high cholesterol, warts and more.

Q My eight-year-old son does swimming and keeps getting warts on his feet, despite wearing thongs around the pool area. Do you have any suggestions to stop this from happening? M.M., Vic. Warts are caused by human papillomavirus, a virus, which thrives in warm moist environments such as swimming pool surrounds and shower floors. Zinc deficiency can increase vulnerability, and supplementation (under medical advice) may help treatment and resistance to reinfection. He should wear thongs around the pool and in the change rooms. Don’t share towels, thongs, socks or shoes with others. Picking at the warts can increase their spread. Keep any warts covered with tape. Q I’m 42, but ever since I was in my early 20s I have suffered from bad headaches. My doctor has told me that they’re tension headaches because sometimes they last only a few minutes. I’m not sure why I get them. Can you help? L.P., Qld. This may be a tension headache. There are a number of other diagnostic possibilities. One is a condition called trigeminal autonomic cephalgia, which causes an excruciating pain on one side of the head and face. A neurologist could provide an opinion. Another possibility is that the pain is coming from a neck problem. This could be assessed by a manipulative physiotherapist specialising in neck problems. Q My sister has recently given birth to her first baby and has haemorrhoids. What is the best way to remove them? T.H., NSW. They may settle down with topical medication and increasing her intake of fluids and dietary fibre (fruits, vegetables and whole grains). If she is constipated, a stool-softening medication is often recommended temporarily. If they do not settle, there are surgical options, but these are not often necessary. Q My 18-year-old daughter started the Paleo diet about a month ago and has since lost six kilograms. She is a healthy weight, but I am concerned that she is missing out on lots of nutrients. Should I wean her off it? What are your thoughts on this diet? S.S., WA. The so-called Paleo diet consists mainly of meat, fish, vegetables and fruit and excludes dairy, grains, sugars (other than fruit or honey) and processed food. The focus on fresh ingredients is good, and the diet can improve blood sugar and cholesterol profiles in people with Type 2 diabetes. However, there is a risk of deficiency of calcium and B vitamins, which can be supplemented. Some people find the low carbohydrate content causes them to feel fatigued, especially if they exercise. Q I have been told I have high cholesterol after a routine blood test. I’m 35, eat well and have a body mass index (BMI) of 21. Could it be familial hypercholesterolemia? How can I lower my cholesterol aside from replacing butter with olive oil? Y.S., NSW. It is possible that you inherited your family’s hypercholesterolemia, or your family’s eating habits. Familial hypercholesterolemia is a relatively common inherited cause of premature coronary artery disease and it does need to be diagnosed and treated. First speak to your GP. See a dietitian for advice on a diet with low cholesterol and no trans fat. Your diet should be rich in whole grains, whole fruits, vegetables and legumes. Daily exercise is a must. Medication may be necessary. Q I feel like I can’t function without caffeine. I drink about four cups of coffee a day. Is this bad for my health? D.W., NT. If you feel so dependent on coffee, it’s an addiction for you. Some people experience withdrawal effects with as little as one cup of coffee a day. Unless you have a reason to avoid caffeine (heart arrhythmias, anxiety, high blood pressure, bladder problems, diabetes), I usually recommend no more than two cups of coffee a day, depending on the caffeine content, but many people can drink up to four without adverse effects.