ASK DR ZOE
My medication causes dizziness, is that normal? Dr Zoe answers your questions
Dr Zoe Williams has all the answers to help you sort those niggling health worries
AT what point does our child’s social media use become a concern?
It’s inevitable that our children will have phones and social media accounts.
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But the harm it may cause was further highlighted last week when a study showed that TikTok use could increase the risk of eating disorders.
After women aged between 18 and 28 were shown videos of weight-loss tips, small waists and workouts for eight minutes, their body image satisfaction “significantly decreased” compared to females shown videos about nature, cooking and animals.
It reiterates that it is a good idea for parents to regularly check the type of content their youngsters are watching.
Hopefully it is just dance routines and funny pranks.
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It is a good idea to make sure your kids step away from their phones often enough to touch base with reality, too.
Here’s a selection of what readers have asked me this week . . .
Pills combo makes me feel woozy
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Q) I HAVE been prescribed amlodipine, losartan and bisoprolol and been told it’s OK to take them all at once.
I do this first thing in the morning, but find it makes me feel woozy and dizzy for a couple of hours.
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What can I do? Or is it to be expected? I am a 77-year-old man.
A) All three of these medicines are used to treat high blood pressure (among other things) and they each work differently.
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Amlodipine, which can also be taken to prevent angina symptoms, and losartan, which can also treat heart failure and protect kidneys, both relax the blood vessels, but by different mechanisms.
Bisoprolol, also used for angina and heart failure, is a type of beta blocker which works by slowing down the rate and force of your heartbeat.
If a person requires medication to lower blood pressure, then usually one drug is started initially and the dose may then be increased.
If the highest dose has not achieved a healthy blood pressure, a second drug may be introduced, then a third.
But people’s natural blood pressure may start to improve on its own over time, and the requirements for medication may decrease.
This can happen as people get older, if they lose weight or if they make positive lifestyle changes, such as becoming more active, improving their diet or living with less stress.
It may well be that your blood pressure has come down over time. I would expect that you have your BP checked regularly, but it might be worth investing in your own machine so you can assess it while you are having these symptoms.
A low blood pressure certainly can cause symptoms of wooziness and dizziness.
If low BP is confirmed then your GP should review your medications and reduce or stop at least one drug.
Alternatively, ask your GP to arrange a 24-hour BP monitor, to get a better idea of what your blood pressure is like.
Urgent check is axed
Q) I HAD an ultrasound in gynaecology which showed I had a thickened endometrium at 22mm with some cystic components.
My GP said she would make my referral urgent. But I have since been told that I don’t meet the criteria for a two week wait and, because I’m not post-menopausal, this ruled me out regardless.
It is looking like November before I am seen. I am very worried that this is a long time to wait.
A) There are two types of referral processes that we can use as GPs.
There is the “urgent” two-week wait suspected cancer referral pathway, or the routine referral pathway.
Both of these can go down many routes to sub-departments within the hospital department.
A thickened endometrial lining in a postmenopausal woman would qualify them for a suspected cancer referral, because once a woman is no longer having periods there is no good reason for the lining of the womb to thicken.
Therefore endometrial cancer – or changes in cells that could progress to cancer – need to be ruled out.
In women who are still having periods, some variation in the lining is normal as it changes throughout different stages of the menstrual cycle.
So it tends to be less of a concern, and does not usually qualify for the two week wait.
But ten per cent of endometrial cancers do occur in premenopausal women. The big question in your case, therefore, is whether your thickened endometrium is at all suspicious for cancer or precancerous changes.
The measurement of 22mm is thicker than would be expected at any time in the cycle.
Despite this, non-cancerous causes are still most likely.
If there is an excessive amount of oestrogen in comparison to progesterone, it can lead to an overgrowth of cells or development of abnormal cells in the womb lining, which is known as hyperplasia.
My advice to you is to go back to your GP and see if they will refer you for a repeat ultrasound scan – to be timed for just after your period – which is when the endometrial lining should be at its thinnest.
If the lining remains much thicker than expected at this stage, then it definitely requires further investigation, and your GP can update your referral, or even speak to the gynaecology team at the hospital for advice.
Tip of the week
DID you know that simple balancing exercises every day can significantly reduce the risk of falls?
Try standing on one leg as you brush your teeth – left leg in the morning, right leg at night. Or get in the habit of putting on your socks while standing up. Do it next to the bed, in case you topple over!
Nothing seems to help my rash
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Q) FOR some months now I have had a rash, which started small on my leg. It now covers my body.
I have visited my GP and they say it is not shingles (I am 85).
I have had various creams prescribed, as well as anti-histamines and steroid tablets, but nothing seems to help. It is red, itchy and painful. I get no sleep and it is now affecting my quality of life. Can you help?
A) Thank you for sharing the images, which show a red, bumpy, patchy rash that appears to be on all parts of your body.
I was not able to see if it is also on your face, though?
I agree that this is not shingles, as shingles is not this widespread, and it is always on one side of the body (the left or right), not both.
I can see why your doctor would have tried treatment for allergic causes such as dermatitis.
But it certainly sounds as though these treatments have not been successful.
While rashes can be caused by conditions that originate in the skin, they can also be a symptom of a condition which comes from inside the body, called “systemic disease”.
There are many systemic diseases that can cause a widespread rash. These range from infections to autoimmune conditions, and even some underlying cancers, so it is important to go back to the GP for further investigations.
If no cause is found, then you may need a referral to a dermatologist who can do a skin biopsy, which can help to identify the cause of the rash.
In the meantime, I understand that this is impacting significantly on your quality of life, so here is some advice on how to manage inflamed skin.
Use an emollient as a soap substitute, as harsh soaps can irritate the skin.
Keep baths and showers relatively short, with warm, rather than hot, water.
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Oats are naturally soothing for the skin and a bath can be prepared by putting a handful of oats in a sock or stocking and wrapping it around the tap while running it so the water passes through the oats.
This should make the water look a little milky and cloudy.