In the middle of the night, as you get up again to use the bathroom again, you start to wonder if this is normal.
But in your 10 minutes with your doctor, you may never get to ask that question, or the one about the safety of the diet you are considering or why your hair is thinning. Instead, you may rely on what your friend says to guide your health decisions or struggle with mixed messaging about how to look and feel good.
With that in mind, as 2022 comes to a close, Dr. Jasmine Singh, an internal medicine specialist at Cleveland Clinic Weston Hospital, tackles the 10 health questions readers and patients often ask.
1. Is it okay to exercise with a cold?
The simple answer is: Let your body be your guide.
“As long as symptoms are mild, then exercising with a cold is fine,” Singh said. “Something that would not be advisable is exhausting yourself because rest does help recovery.”
For example, taking a walk when you have a runny nose or nasal congestion is okay, but working out when you have chest congestion or a hacking cough could make your illness worse.
If you are recovering from flu or COVID, as many people are at this time, Singh advises resuming your normal workout routine gradually as you begin to feel better. “People recovering from flu or COVID can be fatigued,” she said. “During that phase, do as much as you feel comfortable doing. Don’t overexert yourself because if you do, the next day you will feel wiped out.”
2. When you have the flu, how long will you be contagious?
The Centers for Disease Control and Prevention offers guidance on COVID, but the rules for the flu are fuzzy.
You are contagious 24 hours (1 day) before you show symptoms and up to 10 days after symptoms begin. You get flu from contact with droplets from the nose or throat of an infected person who is coughing or sneezing.
As a general guide, Singh says as long as you have symptoms, you can still spread the flu virus.
“Virus shedding peaks in the first couple of days, and someone can keep shedding up to 10 days,” Singh said. To go back work, you should be fever-free and if you still have any symptoms you should wear a mask around your co-workers, she advises.
3. In hot and humid Florida, does the SPF number of my sunscreen make a difference?
Sunscreen is a must in Florida to help prevent sunburn, skin cancer and premature aging.
The recommendation is for SPF 30 for people who are outdoors, playing sports or on the beach, Singh said. After that, the additional protection of a higher SPF is small.
However, if you are outside in Florida during the peak of the sun ? between 10 and 3? you might consider going higher than 30, Singh said. “The higher SPF does provide better protection, especially if you are predisposed to sunburns,” she said. “It’s important to apply 15 to 20 minutes before going out in the sun, and it’s important to reapply every two hours throughout the day.”
4. In sunny Florida, do I need to take supplemental Vitamin D?
Vitamin D helps build strong bones, and laboratory studies show it can reduce cancer cell growth, help control infections and reduce inflammation. The sun triggers Vitamin D production in the skin but even in sunny Florida that may not be enough.
“As people age, production of vitamin D in the skin is not as effective,” Singh said. “Also, we have been encouraging people to use sunblock so that limits vitamin D production as well.”
Most experts agree if you are over 50 you should aim for 800 to 1,000 IUs of supplemental Vitamin D a day.
“You don’t want to take mega doses,” Singh said. “Vitamin D is is fat soluble not water soluble which means you don’t excrete it in your urine.” If you take too much D, it can cause nausea, vomiting and kidney problems.
“It’s good idea to ask your doctor how much you should be taking and if you are older, your levels should be tested regularly,” she said.
5. Is hair loss a normal sign of aging or something more serious?
Some hair loss is normal for everyone at every age. Most people shed between 50 and 100 hairs a day. Your ability to grow hair slows as the body ages. Women tend to lose more hair strands per day than men
However, doctors say hair loss is a concern when it is patchy, clumpy or causes itching or burning.
“It’s important to consider the location, pattern, onset and progression,” Singh said. “If hair loss came on suddenly and is getting worse, it’s important to be evaluated.”
Singh said hair loss can be associated with thyroid issues, iron deficiency or sudden significant weight loss.
“Anything that is excessive and associated with symptoms should be evaluated,” she said.
6. What causes kidney stones and are they more common in Florida?
A kidney stone is formed from chemicals in your urine.
Singh said there is a higher prevalence of kidney stones in the South and the East regions of the U.S. but no one knows why for certain. “We do know fluid intake and fluid losses have a lot to do with it,” she said. “It could be in sunny Florida, fluid losses are more so you have to drink more water.”
Diet can be a factor. “You want to have a healthy diet, because if it’s high in sodium that’s a risk factor,” she said. Also, excessive vitamin C has been shown to increase the risk of kidney stones, she notes. “Vitamin C is water soluble, so you have to make sure you are drinking enough water to pee it out.”
7. What’s the best approach after an injury: Ice or heat?
Even a little bump or bruise can cause you to grapple with how to alleviate swelling and pain.
“The first 48 hours, ice it,” Singh said. “That’s better initially.”
Ice constricts blood vessels, which numbs pain, relieves inflammation and limits bruising. Using heat can increase inflammation and delay healing.
If you are dealing with a lingering injury (older than 6 weeks) then it is okay to use heat. “If it’s still painful, you definitely want to get evaluated to see what’s going on,” Singh said.
8. When when should you seek help if you are having sleepless nights?
If your nights are spent tossing and turning or making trips to the bathroom, you will want to know that aging causes many people to wake up more during the night.
But you need to look for other symptoms that can be associated with conditions like sleep apnea, such snoring and interrupted breathing. Also, getting up frequently to urinate, especially with men, could indicate prostate problems. And some people have restless legs syndrome, which may need medication.
“Things like those are red flags for serious issues,” Singh noted.
Even bad sleepers can take sleep hygiene measures, she said. She suggests making a sleep schedule and keeping to it as well as avoiding naps during the day. She also advises sleeping in a cool dark room, avoiding stimulants like caffeine or aggressive exercise late in the day or evening, avoiding a large meal close to bedtime, and steering clear of checking the time over and over again. In addition, she recommends avoiding alcohol close to bedtime. “Even though alcohol is supposed to relax you, when it’s near bedtime it actually stimulates and interferes with sleep.”
9. How long is stomach flu contagious, and how do you know if it’s just food poisoning?
As you are retching and swearing, you want to know how long this agony is going to last. Of course that depends on what you have.
Food poisoning comes on quickly — typically about two to six hours after you’ve eaten spoiled food. It runs its course quickly, too.
The stomach flu typically takes 24 to 48 hours to start causing symptoms like nausea, diarrhea and vomiting. What makes it different is that is also tends to brings fever or chills. You can be contagious with stomach flu from a few days up to two weeks.
“As long as you have symptoms, you are contagious,” Singh said.
10. What is safe dieting and what diets can cause harm to our bodies? Is it okay to cleanse by fasting from time to time?
As a new year arrives, people often resolve to lose weight, and many want to do it in a hurry. Singh advises against shortcuts.
“Any drastic change is hard to sustain year-round, and what happens is you get the yo-yo effect and put the weight back on,” she said. “If you’re not able to maintain the weight loss, you don’t get the benefit of it.”
Instead, she said, limit portion sizes and try to eat as healthy as possible. “We encourage patients to eat a good amount of vegetables and limit sugar. Eating a fair amount of protein is good and if someone is limiting carbs, that’s no problem.”
Some people will want to do a cleanse by fasting for a short period of time. If you do pursue a fast, always make sure to drink enough fluids to avoid dehydration.
Singh says that fasting and intermittent dieting is not necessary or helpful in the long run.
“We worry about people going on fad diets or intermittent diets and then not getting everything that they should be getting,” she said. “You lose the weight when you do that, but it’s hard to sustain and that’s where the benefit of dieting is.”
Sun Sentinel health reporter Cindy Goodman can be reached at [email protected].
