THE DOC REPLIES

What is Hashimoto’s disease? It’s on my medical records but my doctor said it was “just a posh name”.

This is a name for autoimmune thyroid disease. The thyroid is located in the neck and controls how quickly the body works, but it can become over or underactive. Sometimes the body produces autoantibodies. These autoantibodies fight against the thyroid and diminish its production. Sometimes they do the opposite and cause too much hormone to be produced. If you have an underactive thyroid, it is likely you will be on long-term thyroid treatment. An overactive thyroid sometimes gets better itself but can need surgery or radioactive iodine treatment.

For a long time I’ve been bothered by bladder problems. I find it difficult to pass water, despite my prostate being, according to the GP, a normal size.

The prostate does tend to get bigger in your 50s and 60s and this can cause you to go to the toilet more often. It can also affect the flow and the pattern. The fact that your prostate is normal on examination is good. It still does not rule out a little bit of enlargement. It could be infection or a neuromuscular problem of the bladder which makes it a bit irritable. You state specifically that you have difficulty passing water. This could be either hesitancy or poor flow, I suggest you go back to your doctor. If they have not already done it, they can check other things including flow studies to see if medication might be useful.

I’m on 5mg Warfarin daily for atrial fibrillation. Will I be OK to go on a seven-hour flight?

Warfarin is often given to people who have atrial fibrillation. This is a heart irregularity which increases the risk of blood clotting, and therefore of stroke. Warfarin reduces the risk of stroke. There is absolutely no problem with you having a flight. It is important that you tell your insurance company of your condition and medication.

I have a ringing in my ears which sounds like waves. The doctor said he could do nothing for me. It’s making me feel dizzy.

It sounds like you are describing tinnitus. This can be caused by problems in the ear canal, the ear drum itself or the middle ear. It can be related to wax, infection or catarrh. These are treatable. Sometimes it can be part of the aging process, in which case it may be difficult to fix. There isn’t a medical cure. ENT Clinics can offer you masking devices or advice as to how to manage it.

What exactly is ME? I have a relative who has just been diagnosed but I don’t know much about it.

Myalgic encephalitis has many other names, one of the most common being chronic fatigue syndrome. Nobody knows what causes it. There has been much research done on possible infectious, auto-immune, vitamin or dietary causes. It is not something one can test for so it is what we might call a diagnosis of exclusion – ruling out other conditions. In other words, nothing else can be found but the symptoms are in keeping with other people who describe this condition. It is characterised by excessive physical tiredness often with associated mood changes and sometimes aches and pains. Treating it involves a lot of support rather than drugs. The outlook can really vary from patient to patient.

I’ve been troubled by shoulder pain and have been told to stop eating cheese as I have too much calcium in my bones. What could be wrong?

Shoulder pains are very common and can have a variety of causes, including muscular, bony and capsular related. You mention you have too much calcium. High levels of calcium can be associated with many illnesses and sometimes with illnesses of the bones. It would be unusual to be advised to stop eating cheese completely and I cannot see a relationship to your shoulder pain. Visit your doctor and ask about the calcium.