Chomping on raw apples makes my hands red and itchy and my lips tingle

Recently I was dealing with a pile of windfall apples and my hands became red and really itchy. I’ve also noticed that when I eat raw apples my lips feel tingly, but I have no problems eating apple pie. What’s going on? This sounds like oral allergy syndrome, a mild form of food allergy. It tends to be found in people who suffer from certain types of hay fever, especially those with symptoms in the spring from birch tree pollen.

The chemical in this that triggers the allergic reaction is similar to a protein found in several fruits, including apples, peaches and some other stoned fruits, as well as some vegetables like carrots and potatoes.

It’s reckoned that as many as 75 per cent of people who have birch tree pollen allergy have some symptoms of oral allergy syndrome, and touching a lot of raw fruit or vegetables, such as peeling apples or potatoes, can cause an allergic reaction in the skin. However, the protein responsible is destroyed by cooking, which is why you have no problem eating cooked apples.

Taking antihistamines can help the itching as prevention is better than cure. This means wearing gloves when preparing the raw culprit foods and not eating them until they have been cooked.

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Currently, breast screening is offered routinely on the NHS once every three years to women aged 50 to their 71st birthday. Up until recently it has been thought that screening younger women has not been cost effective as there are fewer cases and also their more dense breast tissue can make it more difficult to detect abnormalities.

However, it has now been recognised that significant numbers of women in their late 40s are being diagnosed with breast cancer, so some trials are being carried out to examine the effectiveness of offering women an extra screening between the ages of 47 and 49.

In addition, some women are also being offered an extra screening between 71 and 73.

Unfortunately these trials are only being carried out in limited areas, but it would be worth asking your GP what the situation is locally to you.

Otherwise the only reason for getting a mammogram at your age is if you have a strong family history of breast cancer, but this will need to be arranged by your local breast clinic.

GPs cannot generally refer patients for mammograms, even in patients who have found a lump – they have to be seen first by a clinic specialist.

It’s worth knowing that you won’t be invited as soon as you have turned 50 either, as the invitations are sent out by postcode. This means that some women don’t have their first mammogram until they are 52. Older women over 71 can continue with screening and it is a good idea to do so, as breast cancer becomes more common with increasing age.

However, instead of being sent an automatic invitation you have to ask to be continued on the screening programme. To do this, contact your local breast screening unit – your GP surgery will have the number. Like everything, Covid has disrupted the screening programme, so if you are due your three- yearly check, don’t be surprised if it is delayed a few months.

I’ve had a sore knee for ages and the X- ray my doctor arranged showed I have osteoarthritis. It also suggested I could have thin bones, so I have just had a DEXA scan and this has confirmed I have osteoporosis. My doctor has suggested I take alendronic acid, but I’ve read this can cause jaw and teeth problems, so is it worth it?

In osteoporosis, the bones become less dense, making them more prone to break or fracture. It’s a process that mainly affects older people, especially women after they reach the menopause, but it can occur at any age.

Bones are living tissues that contain cells that constantly make, mould, then reabsorb bone. In the childhood and adolescent years, bone forms faster than it is reabsorbed, but this process reverses as you get older, and after the age of 35 bone gradually thins, so that they become thinner and weaker.

The degree to which this happens varies between people, but if you have thinner bones to begin with, or lose a lot of bone, it can result in osteoporosis, where bones are particularly thin and at risk of suffering a fracture.

However, this is a silent process and does not cause any symptoms until you suddenly break a bone.

It doesn’t cause joint pain, though it can cause you severe back pain if one of the bones in the spine becomes crushed.

Your knee pain is caused by the wearing away of the cartilage cushions that protect the end of the bones – a condition known as osteoarthritis – and it won’t be helped by treatments designed for osteoporosis.

Bisphosphonates work by reducing bone reabsorption and can help to stop further bone loss. In some people they can help to rebuild a little new bone and they reduce the risk of breaking a bone too.

There is some evidence that they can increase the risk of osteonecrosis of the jaw, where an area of jaw bone loses its blood supply and dies, which can in turn lead to loss of teeth.

It’s a rare condition and is more likely to occur in those given intravenous bisphosphonates, especially after tooth extractions. So the risk with oral alendronic acid is very low, but it would be sensible to have a check- up and have any dental work you need done before you start any treatment.

If you have a health question for Dr Leonard, email her in confidence at yourhealth@ express. co. uk. Dr Leonard regrets she cannot enter into personal correspondence or reply to everyone