Dear Doctor with Dr Chris Steele - Autumn 2018

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c e l e b r i t y

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Dear Doctor

with Dr Chris Steele

Is Stress



Gut Health



t i F g n i t t e G





Brain Healthy



Dr Chris Steele, MBE Live a longer, happier life with ITV This Morning’s resident doc

DD Cover_1_2018 op3f.indd 1

AUTUMN 2018 | £3.99 ISSN 1758-597X


07/08/2018 09:57

Eucerin® is the oldest dermocosmetic brand in the world.  Today, at the Eucerin® Research Centre in Hamburg, the  team of experts consisting of scientists, dermatologists and  pharmacists, unite over one hundred years of experience  in skin research with state-of-the-art technology. The effectiveness and gentleness of the carefully selected,   active ingredients has been tested in numerous clinical  and dermatological studies.

THREE STEPS TO KEEP YOUR SKIN SUN-PROTECTED 1. SELECT THE RIGHT PRODUCT Choose a product that provides UV and high-energy  visible light defence and is tailored to your skin type. 2. APPLY SUFFICIENT AMOUNTS Apply sufficient sunscreen and reapply at regular intervals. 3. USE PROPERLY Apply sunscreen thoroughly and do not forget often  neglected body areas. P LU S

*Helps to reduce of sunscree the intensity n st after washi ains ng

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F  ast-absorbing products  with non-greasy textures   for protecting oily,   blemish-prone skin.  Eucerin® Sun Oil Control  has an anti-shine effect   for up to 8 hours.

S  un protection with active  ingredient AGR helps to  protect against sun allergies.  After Sun Creme Gel  soothes and regenerates  sensitive skin. Su n







S  un protection with  Hyaluronic acid helps  reduce the signs of   Sun-induced skin ageing.   The Sun Fluid is also  suitable for protecting  sensitive skin after laser  and peeling treatments.





in e sk ron -p

ies erg all

Oily, ble mi sh





S  ensitive Protect Sun  Creme and Lotion are  tailored to the needs   of dry skin. Kids Sun Spray  is specially formulated for  sensitive children’s skin.

THE GOLDEN RULES OF SUN PROTECTION Follow these simple rules so that you can enjoy the sunshine without putting your skin at risk. Avoid sunbathing when the sun   is at its highest (11am-3pm)   in the UK. On holiday obtain   local information.

Apply sunscreen before you  go out in the sun. Reapply at  regular intervals, every 2 hours  and especially after swimming,  towelling and perspiring.

Keep babies and toddlers  out of direct sunlight.

Check your skin type and  use products with a high sun  protection factor (SPF 15   and above).

Cover up with clothing, a sun hat,  sunglasses, etc. for protection.

Avoid sunshine after peeling   or laser treatments or after taking  photosensitive medication.


Beiersdorf AG, 20245 Hamburg, Germany

16/05/2018 09:36

Live Goats Milk Kefir

Suitable for people who may be prone to eczema, psoriasis, rosacea, acne, IBS and allergies Chuckling Goat Limited.indd 1

24/04/2018 16:16


IMAGES © Cour tesy of ITV’s This Morning



ne piece of advice I have often given to patients reaching their 40s and over is: know your numbers. This means, know your cholesterol levels, your blood pressure levels and blood sugar levels. Currently, more than half of all UK adults have raised cholesterol. High levels of cholesterol can often go undetected until it’s too late, as it can have a serious impact on your health, playing a big role in everything from heart attacks to strokes. Visit your doctor or practice nurse once a year (around your birthday time) to ensure that your numbers remain healthy. Another major cause for concern today is the mental wellbeing of the nation. Around 12.5 million working days were lost due to work-related stress, depression

or anxiety in 2016/17. This phenomenon is not only bad for the economy, but is also making us physically ill. Prolonged periods of stress and anxiety can suppress the immune system and have been linked to heart disease and bad gut health. This is why it is so vital to carve space out of the day for yourself (me time), away from work commitments and social media, to do something enjoyable and stress-relieving like exercise, taking up a hobby or spending time with friends and family. If there is anything you take from this packed issue of Dear Doctor, reader, it’s that you make the rest of this year about you and your wellbeing—both physical and mental— so that you can enter the autumn and winter months refreshed, renewed and healthier than ever.

Dr Chris Steele, MBE

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06/08/2018 08:40





ITV This Morning's Dr Chris Steele shares his thoughts with Kayley Loveridge on mental health, sun safety and key medical breakthroughs

Today’s Common & Serious Conditions 17 From Ear to Ear

Even the most health-conscious individuals can overlook the wellbeing of their ears

21 Poor Blood Circulation

Poor circulation is a common grievance that causes narrowing of the blood vessels and arteries; left untreated, it could lead to a wider medical issue

22 What Is Diagnostic Imaging?

Diagnostic imaging is key in the early detection of major diseases such as cancer, and can, in some cases, prevent them from progressing further with treatment

26 Understanding Osteoporosis If left to progress, osteoporosis can have a debilitating effect

6 dear doctor with dr chris steele

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28 The Fight Against Antibiotic Resistance

Fast-acting and effective, it’s tempting to view antibiotic medicine as a modern-day panacea; but antibiotic resistance is on the rise

31 Tracking Eye Health

As eye problems rarely cause pain, it’s important to schedule regular eye tests to keep your vision in top shape and other health complications at bay

32 Blink of an Eye

There are many precautions people can take to reduce the sometimes debilitating symptoms of dry and itchy eyes

36 Detecting Common Thyroid Disorders Forming part of the intricate endocrine system, the thyroid gland plays an important role in regulating the body

38 Living with Ulcerative Colitis Ulcerative colitis may be a lifelong affliction, but with the right

treatment and care, you can continue to live a fulfilling, carefree life

40 Cancer Focus: Complementary & Alternative Cancer Therapies Dear Doctor takes a closer look at the current treatments available for cancer

Health & Fitness 46 CBD Oil’s Health Potential

Recent studies have suggested that CBD oil may be effective in aiding the treatment of some medical ailments, but what do we know so far?

48 Digesting the Facts

A healthy gut is important for more than simply regulating digestion— it influences everything from a functioning immune system and risk for chronic diseases to mood and sleep regulation

53 Probiotics or Prebiotics?

Both probiotics and prebiotics play a vital role in digestive health, but what are their differences?

IMAGES © Shutterstock; 123RF

10 Interview

07/08/2018 15:11




Lose Weight, Feel Great

According to YouGov, 48 percent of New Year’s resolutions were focused on losing weight in 2017—was yours?

Liven up Your Diet with These Unlikely Nutritious Foods

Some foods, which have a reputation for being unhealthy and fattening, are surprisingly healthy


The Pros & Cons of Detox Diets

‘Detox’ has been a major buzzword in the health and wellbeing industry in recent years, but what are detox diets, and how do they work?


Salt: The Facts


Get Fit Without Realising It


Why Choose Yoga?


Dear Doctor investigates the properties of salt and poses the question: how much is too much? Working out needn’t be boring; there are many ways to keep fit and have fun while doing it The practice of yoga extends much further than simply stretching and breathing; learn how this ancient practice can benefit you

Understanding Private Health Insurance

Approximately 11 percent of the population has private health insurance, but what does a ‘standard policy’ look like and how will you know if it’s right for you?




Hydrate Yourself

89 percent of Britain’s population are not drinking enough water to maintain healthy hydration levels

Breathe Easy

Unless addressed, indoor air pollution may increase the risk of major illnesses and—in some cases—premature death

Brain Health & Nutrition

Healthy food isn’t just good for the body, it’s great for the mind, too

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80 Healthy Smile, Healthy You

According to Bupa, up to nine in every 10 people have some degree of gum disease in the UK—tackle the problem with a healthy at-home routine

82 Essential Male Health Screenings

According to the Office for National Statistics, males accounted for 60 percent of all avoidable deaths in 2016. Track your health with our guide on essential check-ups for men

86 Is Stress Making You Ill?

A large body of research has indicated that high levels of stress induce illness, but how does this happen and what lifestyle changes can be made to reduce the possibility?

89 The Significance of Sleep

Not everyone enjoys a regular night’s rest, and this can damage their overall health and wellbeing

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90 Selecting the Perfect Duvet

Selecting the ultimate seasonal duvet that is suitable for your needs is vital for a restful slumber

92 Making Sense of Supplements

With the abundance of supplements on the market, it’s hard to know which ones to take—besides, does adding them to our diet really do us any good?

94 Digital Healthcare

A stretched NHS and long waiting times for appointments are pushing people to seek health advice through digital apps


96 Coping with Menopause

The menopause is a natural change in a woman’s life. Luckily, treatments and strategies exist to help you cope

Life Starts at 60+ 99 Buzz Ingredients for Anti-ageing From hydroxy acids to retinol, the list of ‘miracle’ skincare ingredients on the market is a long one


07/08/2018 15:11



102 The Silent Killer

High levels of cholesterol affect some 60 percent of the UK’s population


104 Stroke: Know the Facts

One stroke occurs every five minutes in the UK

106 Ageing Eyes

What are the most common conditions that occur as a result of ageing eyes?

PUBLISHER & CEO Kevin Harrington EDITOR Kayley Loveridge

108 Chronic Pain: An Epidemic

How can sufferers alleviate symptoms of chronic pain without medication?

SUB EDITOR Annalisa D'Alessio

110 Home Sweet Home

ART EDITOR Friyan Mehta

Choosing a care home is much like buying a new house

FEATURES WRITER Phoebe Ollerearnshaw

114 The Road to Wellbeing

Your emotional wellbeing is equally as important to your overall health as being physically fit


96 118

PUBLISHED BY Copyright © 2018, Celebrity Angels. All rights reserved

Enjoy a worry-free holiday with our tips for senior travellers

Dear Doctor with Dr Chris Steele Celebrity Angels Suite 2 143 Caledonian Road King's Cross London N1 0SL Tel: 020 7871 1000 Fax: 020 7022 1694

122 Non-surgical Facelifts

Thread lifts are achieving the same results as traditional facelifts

Medical Tourism 125 Medical Tourism: Lithuania

For sales enquiries call: 020 7871 1000


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Around 15,400 new melanoma skin cancer cases are diagnosed in the UK every year

121 The Holiday of a Lifetime

COVER IMAGE Courtesy of ITV This Morning

Copyright © 2018, Celebrity Angels. All rights reserved. All material in Dear Doctor with Dr Chris Steele magazine is wholly copyright and reproduction without the written permission of the publisher is strictly forbidden. The views expressed in this publication are entirely those of the authors and do not necessarily represent those of Celebrity Angels. The information in this publication is carefully researched and produced in good faith, however, neither the publisher nor the editors accept responsibility for any errors. The Celebrity Angels Series is published in the UK under licence by Damson Media Limited. Damson Media Limited is registered in England and Wales under registration no. 07869300.

118 Here Comes the Sun


Lithuania combines healing nature, affordability and quality healthcare standards

126 Medical Tourism: Germany

Medical facilities in Germany’s capital reported a 15 percent rise in patients travelling from abroad between 2013 and 2014

130 Medical Tourism: Belgium

Belgium’s allure to foreign medical tourists is influenced by its accessibility, comprehensive list of specialists and world-renowned healthcare system

07/08/2018 15:11

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JOCCA MASSAGE MATTRESS Enjoy a relaxing massage at the touch of a button and in the comfort of your own home with this Massage Mat from Jocca. Featuring 8 built-in motors spread across 4 separate massage zones, this Mattress can be set up quickly and easily for use on a bed, sofa or armchair, and folds away conveniently when not in use. This device also has 5 different massage modes and 3 adjustable intensities - all packed into a handy wired controller. Great for use on the neck, back, lumbar and thighs. Measures 172cm x 57cm hh hh hh hh hh

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07/08/2018 13:52


A Clean Bill of Health with Dr Chris Steele MBE

IMAGES © Cour tesy of ITV’s This Morning; Shutterstock

ITV This Morning’s Dr Chris Steele shares his thoughts with Kayley Loveridge on mental health, sun safety and key medical breakthroughs

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07/08/2018 10:40


Q. What key health and medical concerns are you noticing cropping up again and again in patients today? Are these any different to 10 or 20 years ago? Chris Steele: i think overall, medical complaints that are presented to doctors [today] aren’t massively different to what they were 10, 20 years ago. People present with the same complaints; back ache being the commonest, and throat infections, ear infections. i think maybe mental health issues like depression and anxiety…patients are more willing to come to their doctor and talk to them about those issues and ask for help [these days]. that’s the important thing. the difference is, patients will come in and ask you about conditions that they’ve read about in the papers and magazines. and there’s a huge amount of interest in health stories and the newspapers and magazines know that health is a big issue. they may go onto the internet to search and find information (which often is incorrect with regards to their own complaints), then come into the surgery, holding a printout from Google [laughs]. and that’s a thing that didn’t happen 10 or 20 years ago! the internet has made a difference, both good and bad. But at least people can use the internet to find things out for themselves. Q. People often get caught up in the fun of the summer months and may forget about health precautions (like sun safety) at this time of the year. What precautions should we be taking when it comes to our health during the summer months and why are they so important? CS: i think during the summer months the most important issue is protection against overexposure to sun rays. You’ve got two main types of rays and sunlight: UVa and UVB. whether the sun is shining or not, if it’s daylight out there, that’s sunlight coming through the clouds. the problem is that we are

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If it’s a sunny day, just get out for 10 minutes in the sun; 10 or 15 minutes in the sun will boost your vitamin D levels seeing an increase in skin cancers [which is] very different to how it was 20 years ago. what i have to tell patients is that in terms of applying sun screen, you’ve got to think of the skin protection factor (sPF). and really, you should be looking at a minimum of factor 15. i think maybe i should be a bit more specific here, as this is extremely important, the factor number protects you against UVB rays—they’re the rays that burn the skin and are implicated in skin cancer. UVa ages the skin but also has an effect on the skin, causing skin cancer. with UVa protection, you see that on the containers by looking for stars.

so when you look at sun screen, have a look at the back [of the bottle]; it will give you a star rating. You should go for the maximum star rating. if you’ve got a high factor and a high star rating, you’re getting good protection. Never allow children or teenagers to burn, because that is a major risk factor for skin cancer, years and years later. i know, [because] i’ve had skin cancer three times. and finally, on that, you should not lie in the sun or sunbathe between 11am and 3pm. at that time, the sun’s rays are at their most intense. Q. Research suggests that a large number of people in the UK experience stress regularly. How far do you think stress contributes to physical illness and what can we do to alleviate these feelings? CS: stress has always been around us. But these days, there are so many different causes of stress: it could be a marital breakdown, financial stress or the loss of a job. there dear doctor with dr chris steele 11

06/08/2018 08:42


ought to be more help available on the Nhs, rather than just prescribing medication. and we know there are lots of effective interventions out there; there’s one called cognitive behavioural therapy (cBt). it’s ‘talking therapy’, talking to patients and teaching them how to try and cope with the situations that are bothering them, be it anxiety, be it depression or whatever. relaxation techniques, like meditation, yoga. But you know, cBt, yoga and meditation—you can’t get these things easily on the Nhs. we’re terribly short of cBt therapists and we know it’s effective in anxiety and depression. it’s a non-drug intervention that does work and we haven’t got the facilities to help all patients with cBt or other relaxation techniques. and then another thing to overcome stress: get a hobby…a hobby is a distraction. i’ll tell you something again from my own experience. i went through a bad spell of depression, i was on anti-depressants and basically what i did was to take up pottery classes. Boy, did that help me, i could say it saved me.

they’ve had depression in the past. that does help because these guys are role models to some people. i think sports people coming out, sports men in particular, to help male patients [will help]. Men should not be ashamed of going to their doctor’s to say ‘i’m feeling depressed, doctor.’ Q. The multi-vitamin and supplement industry is massive and evergrowing, with just under half of all Britons admitting to taking a supplement daily. What are your thoughts on the consumption of extra vitamins? CS: i think for the majority of people who are buying these supplements, they are wasting their money and in fact, there was a study published last week that came to that conclusion. For example, vitamin B and vitamin c

CBT, yoga and meditation— you can’t get these things easily on the NHS. We’re terribly short of CBT therapists and we know it’s effective in anxiety and depression

Q. While more and more people are speaking about their experiences with mental health and raising awareness, NHS funding and waiting times for mental health services are at an all-time low. Could you tell us your thoughts on this? CS: this has been a long-term problem in the Nhs, and i could come up with one word: funding. when you talk to people, you know, they wouldn’t mind paying a little bit extra in their tax to improve the Nhs funding process. Maybe you could name a part of income tax ‘Nhs fund’. there should be more funding available, especially in mental health. the problem with mental health is that people don’t talk about it, there’s a stigma and mental health in men—oh my goodness! that’s a big problem. sports men are now coming out and admitting that they’ve had anxiety or

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06/08/2018 08:42


are water-soluble so you can’t store them in your body—you pass them straight out. so if you’re buying tablets that contain vitamin B and vitamin c, they’re going out into the toilet when you wee; you’ve wasted your money. i’d say this, except for one vitamin: vitamin d. Your body makes it in your skin when the skin is exposed to sunlight. it’s really accepted that most people in the UK are deficient in vitamin d. if it’s a sunny day, just get out for 10 minutes in the sun and that will boost your vitamin d levels. so that’s one that you should certainly consider taking: a vitamin d supplement, especially during the winter months. with pregnant women and children, i think you need to ask your doctor, because the advice will be dependent on the individual and what is pertinent to their health status. Q. Deteriorating health becomes more and more of a worry for people entering later life. Is there anything we can do from an early age to help prevent serious illnesses like dementia or cancers from occurring later in life? CS: My advice is this: know your numbers. everybody knows their waist size or their shoe size, but do you know your blood pressure? do you know your cholesterol? do you know your blood glucose levels? if you’ve got to the 40, 50 age group then you should go to your doctor or practice nurse and just say, ‘i need to know my numbers.’ these are three important factors that don’t usually give you any symptoms until something goes wrong. doing that, maybe once a year on your birthday, is a good time to take stock. see, by doing that, you’re addressing blood pressure, cholesterol and blood sugar; you’re addressing the major killers such as heart disease and stroke. and, of course, watching your blood sugar, you’re hopefully going to prevent diabetes which causes blindness, heart attacks, stroke, kidney failure

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and gangrene. the big health worry out there is obesity. Being overweight increases your risk of many, many different types of cancers and then you’ve got the strain on the heart. But the one thing that does cause me despair, is obesity. that’s through lack of exercise and unhealthy eating. Q. Do you have any predictions in terms of medical breakthroughs in the coming years? CS: Yes, there are some exciting areas, and one of those is immunotherapy and the treatment of cancers. that’s making great leaps forward. there have been some very promising results in the treatment of lung cancer, which is not an easy one to cure, breast cancer and prostate cancer. Basically, with immunotherapy you’re stimulating the patient’s own immune system to kill cancer cells rather than [using] toxic chemicals like with chemotherapy. chemotherapy is a toxic chemical; it kills cancer cells but it also kills your

hair cells and your white blood cells. to move away from toxic chemicals and give a drug that stimulates a patient’s own immune system to attack cancer cells is dramatic. the other area is stem cell therapy. i’m no expert there, but that’s an area that has a huge amount of research and progress made there, so those two areas are very exciting. Q. Finally, what top three life mantras do you have for staying (and keeping) healthy and happy? CS: From my point of view: diet. i certainly try to have a healthy diet, my wife’s a nurse—she does all the cooking, i don’t. i can’t even boil water without burning it! diet is extremely important. i don’t smoke and i don’t drink because these are two other big threats. there should be exercise in there. i’ve got to be honest, i don’t do a lot of formal exercise but i do walk when i can. healthy diet, no smoking, reduced alcohol consumption and being active are key. •

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06/08/2018 08:42

Health professionals, not salespeople Just like your doctor, we prescribe the best treatment for your hearing difficulties. One of our HCPC-qualified Audiologists will use the results of your hearing and listening assessment to let you know about the right technical, programming, and style choices for your ideal hearing solution – not just the most expensive.

Only pay for what you need, and nothing more You only pay for the services you want and need, and none of the extras you don’t. With the guidance of our Audiologists, we can help you to custom-build your own hearing care package by choosing the products and services that will benefit you the most.

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Better hearing is cheaper than you think. 2 hearing aids for


including assessment, fitting and rehabilitation

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You look after your health, so why don’t you look after your hearing? On average, people wait 10 years* before addressing their hearing loss. Studies show that leaving hearing loss untreated increases your chance of developing dementia** *Statistic taken from Action on Hearing Loss **Statistic taken from Lancet Research Commission.

Not just a hearing test - a hearing and listening assessment unlike any other Our Audiologists use a collection of assessments to determine exactly how any of your hearing difficulties could affect your ability to hear and understand. This ensures you get the best solution, programmed for your individual hearing needs. A full assessment in the comfort of your own home Based across the UK, our Audiologists can come directly to you to perform your full hearing and listening assessment. To take your first step to better hearing, book your free assessment by calling our team free on:

0808 302 4418 Claritas Health Ltd DPS.indd 3

“When the audiologist came, she was very friendly and informative and gave me a thorough hearing and listening assessment. Compared to other hearing tests I’d had in the past, the assessment was superb and in-depth.” Mrs. Cobley

12/04/2018 12:01


Listening out for

Hearing Problems

of diagnostic audiometry techniques. You will be given a full explanation of the results of the tests and the recommended solutions.

technological advances

Hearing aids will continue to get smaller and smarter. Whether they sit all in ear or behind the ear, modern devices are virtually invisible. In addition to their decreasing size, the newest hearing aids are very advanced in performance, offering users many practical benefits like wireless connectivity via bluetooth, mobile phone integration and are extremely easy to use and replace consumables.

how expensive are these technologies?

Prices and technology can vary across hearing aid manufacturers but new, revolutionary hearing aid price packages available, gives you access to the very best technology at a competitive price, and the option to spread the costs with interestfree credit payment options.

how long does the assessment last?


earn about when you should consider going for a hearing and listening assessment and discover more about the advances in technology helping to improve them.

when should you get checked up?

There are some common indications of hearing impairment. You may have hearing loss if you notice any of the following: • Having difficulty following conversations when there is more than one person speaking; • Complaining that people sound muffled or are mumbling; • You have more trouble hearing the voices of women and children; • Feeling stressed from straining to hear speech clearly; • You become annoyed or shorttempered with people because you can’t hear them; • Finding that you are becoming

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withdrawn from social situations that you once enjoyed; • Taking ototoxic medications that can harm the hearing system; • You suffer from diabetes, heart, circulation, or thyroid problems; • Having a history of exposure to loud sounds over a long period.

what to expect during a typical hearing & listening assessment? During an assessment, your audiologist will ask you a series of questions before examining your ears. The audiologist will then perform a full examination of the outer ear, and a safe and comfortable procedure, using an otoscope, to fully view the ear canal and eardrum. Your audiologist will check the health of your ears and identify any issues which could be causing your hearing and communication difficulties. Then, your hearing will be tested using a variety

Typically, a hearing test and fitting from the NHS or high street hearing aid provider lasts approximately 45 minutes. The length of a full hearing and listening assessment by Claritas Hearing is between an hour and a half and two hours. This ensures that the audiologist has the time to assess each of the key areas of communication decline in-depth; ascertain the patient’s level and degree of hearing difficulty; explain the results to the patient; and finally, talk through the best solutions. •


To take your first step to better hearing, book your free assessment by calling our team free on:

0808 302 4418

03/08/2018 14:38



Ear to

Ear Even the most health-conscious individuals can overlook the wellbeing of their ears—Dear Doctor investigates the best ways to protect your hearing


here are various factors that can contribute to hearing loss and damage, many of which are out of our control— namely old age and genetics. there are, however, some triggers that can be avoided, such as exposure to high noise levels, specific medications and the development of infection. we highlight some of the best ways to protect your hearing.

CheCk your presCription

ingredients included in certain medications can have a negative impact on your hearing and subsequently damage your ears—this is known as ototoxicity. always discuss the possible side effects of your prescription medication with your doctor and request an alternative form of treatment if you are concerned.

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Follow the 60:60 rule

having a sound reverberating directly into your ear canal can increase its volume by six to nine decibels. therefore, try to follow the 60:60 rule when using headphones—set the volume to 60 percent capacity and listen for no longer than 60 minutes per day.


The estimated amount of people suffering with some degree of hearing impairment or deafness in the UK Source: Action on Hearing Loss

Get reGular CheCk-ups

even if you are confident that your hearing is in good shape, regular check-ups conducted by your doctor are advisable. arrange a yearly ear inspection in order to assess your hearing and catch any problems early.

watCh your step

one of the major causes of ear damage is injury. head injuries, in particular, can inflict trauma to the temporal bones—which protect the ears—and dear doctor with dr chris steele 17

06/08/2018 08:43


potentially lead to hearing loss or longlasting issues.

Take control of your tinnitus Tinnitus is often described as a ‘ringing in the ears’, but it can also be a whizzing, roaring, buzzing, or another type of continuous noise. It may be high or low-pitched, and the volume may vary. In some cases, the tinnitus will fade within hours or days. But for others the sound continues for months or years, making it difficult to concentrate during the day or sleep at night, and causing real anxiety. Tinnitus affects around one in 15 people in the UK and many say it severely affects their quality of life. Research shows that treating people with the first signs of tinnitus means a better outcome

for them later. But even though tinnitus accounts for 750,000 GP visits a year in England, the lack of knowledge about treatment options means many sufferers are told to live with it, leaving some feeling desperate. There is currently no cure for tinnitus—however, there are several therapies that can help to reduce the effects. Evidencebased treatments are designed to work on the brain where the phantom sounds start from, or on the negative effect the symptoms have on the patient. Learn to take control of your tinnitus and visit


A common mistake people make when cleaning their ears is to use a cotton bud inside the ear canal—this technique can lead to a pierced eardrum or even spark an infection. Cotton buds should only be used to clean the ear’s exterior crevices. Instead, use gentle eardrops to resolve impaction issues and clear out excess wax.


Preempting situations that could cause your ears harm will help you to maintain healthy hearing in the long run. Bring earplugs in your bag and use them when necessary—particularly when you’re surrounded by noisy machinery or find yourself in a loud environment. While accidents cannot always be anticipated, try to use headgear when taking part in activities that could lead to a head injury, such as cycling or climbing. •



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IMAGES © Shutterstock

Tinnitus, which is often described as a ‘ringing in the ears’, is a condition that will affect 30 percent of people at some point in their lives—according to tinnitus. org. The number of people with persistent tinnitus is around 10 percent. It is not completely clear why tinnitus appears in some people, but it is generally associated with age-related hearing loss, inner ear damage, earwax buildup, ear infection and diseases like otosclerosis. Some of the most common treatments for tinnitus include sound therapy, cognitive behavioural therapy (CBT) and tinnitus retraining therapy (TRT), which aims to retrain the brain to tune out the sound

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HEALTH | “The machine has been fantastic, I suffer hardly any symptoms now. I am also a type 1 diabetic. Highly recommend.”

Suffering with Tired, The REVITIVE Circulation Booster® is a drug-free medical device designed to stimulate the muscles in your lower limbs to get your leg muscles pumping, which may help to reduce the feeling of tired and heavy legs and puffy feet and ankles. The muscles of the legs and feet contract and relax – acting like a ‘second heart’ to help pump the blood uphill from the feet and ankles, back towards the heart.

Phillip, out of 10 Blackpool


Heavy Legs & Puffy Feet HOW DOES IT WORK?


The REVITIVE Circulation Booster® has been designed and developed with leading UK universities. REVITIVE harnesses the power of scientifically-tested Electrical Muscle Stimulation (EMS) technology which has been used as a medical therapy for almost a century. Imperial College London’s vascular surgery department at Charing Cross Hospital London has conducted extensive clinical studies with the REVITIVE Circulation Booster® and advocate its use. The world-renowned research team at Imperial College London, is continuing to lead a 5-year clinical trial program to investigate the positive effects REVITIVE is having in a range of patient groups including diabetes and other issues common in an ageing population.

when doing every day tasks? If you or a loved one suffer with tired, heavy feeling legs and puffy feet and ankles it could be the result of insufficient muscle stimulation in your lower limbs. Tired, heavy feeling legs can affect the simple things we love doing like gardening, walking the dog or playing with grandchildren. It could also be the result of medical conditions such as arthritis or diabetes, or general immobility associated with age as it can get harder for your body to activate the muscles in your lower limbs. Whether heavy feeling legs and puffy feet is an occasional annoyance or is there more often, it can can hold you back. The REVITIVE Circulation Booster® is a drug-free medical device which uses scientifically-proven EMS technology to actively get your leg muscles pumping, which may help to reduce the feeling of tired, heavy legs and puffy feet and ankles.

Vascular Surgeon Recommended: “I recommend REVITIVE to anyone‡ suffering with the effects of poorer circulation - swollen feet & ankles, aching legs and feet.” Professor Jonathan Beard, Consultant Vascular Surgeon, Sheffi eld Teaching Hospitals

See how REVITIVE has helped people like you:

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EASY TO USE • To get the most out of your REVITIVE, there needs to be good muscle stimulation & hydration plays an important role - drink water & apply the FREE moisturiser • Place your bare feet on the foot-pads & use the controls to gradually increase intensity until you feel or see strong & comfortable contractions of the calf muscles • Sit back, relax & enjoy REVITIVE, drug-free professional strength therapy from the comfort of your own home

“I feel my knee’s improved dramatically – walking back up the hill from the newsagent has became easier so I’ve taken to walking at least half–an–hour a day again like I used to.”


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If you suffer from:

• Diabetes • Osteoarthritis

REVITIVE to anyone that has got problems with their legs - it really is a boost.”

• Poor Mobility • Muscle Weakness • A Sedentary Lifestyle • Are in Post Operative Recovery there is a REVITIVE suitable for your use! Speak to your healthcare professional today about the one & only Pharmacy recommended REVITIVE Medic or REVITIVE Arthritis-Knee


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UNSUITABLE IF YOU ARE: Fitted with a heart pacemaker or AICD, being treated for, or have the symptoms of, an Existing Deep Vein Thrombosis (DVT) or during pregnancy. Always read the label. Use only as directed. If you are uncertain about the cause of your symptoms or your symptoms persist, please consult your Doctor. *Free standard P&P worth £7.99 in England & Wales. Some areas of Scotland, Northern Ireland and other remote postcodes will incur a surcharge cost of £19.99. Next day or express deliveries will cost more, please ask our customer service team for a quote **If returned within 60 days, full refund of purchase price, minus collection fee of £7.99 (some areas of Scotland, Northern Ireland and other remote postcodes will incur a surcharge cost of £19.99). 1 trial per customer only and trial starts from dispatch date. ††If you suffer a long term illness or disability, you may be able to claim back the VAT. All quotes used are real however, to protect the identity of our customers, models have been used for the pictures. Copyright © 2018 Actegy Ltd. All rights reserved. REVITIVE and CIRCULATION BOOSTER are trademarks or registered trademarks of Actegy Ltd. Registered in England no. 4819502. Registered office Actegy Ltd, Reflex, Cain Road, Bracknell, RG12 1HL, UK. Please be aware your signed VAT relief declaration will be put on file for review by VAT officers who may contact you for validation. Call 0845 871 5989 for further advice. 15379369 05.18

Is REVITIVE for you?

Maurice, Diabetes sufferer: “I would recommend the

“On seeing Ian Botham use the REVITIVE on TV, I thought maybe that would be something that would help my wife. My wife has it for her tired and heavy legs and slight bit of puffiness on the ankles. I started using it because I get cramp in bed. We’ve been using it for nine months now and I wouldn’t be without it.” Len, Bognor Regis


If you suffer a long term illness or disability, you may be able to claim back the VAT, ask our friendly Customer Care team for details.

Mary: “Now I’m getting older I find my on our website legs don’t want to do quite what I want them to do. I used the REVITIVE before we went dancing and I found out I was able to do a lot more dancing that evening than I’ve done for some time.”

David, 72, Diabetes & Osteoarthritis sufferer

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Poor Blood Circulation Poor circulation is a common grievance that causes narrowing of the blood vessels and arteries; left untreated, it could lead to a wider medical issue


irculation is the process in which the heart pumps blood around the body. This delivers vital nutrients and oxygen to the body’s organs. Inadequate blood flow, known commonly as poor circulation, can cause a number of physical symptoms such as numbness or tingling in the extremities, swelling of the limbs and muscle cramps. Poor circulation isn’t a health issue in itself, but it can be a sign of a wider problem.


IMAGES © Shutterstock

Several conditions can lead to poor circulation, the most common being obesity, diabetes, arterial issues and heart conditions. Each of these ailments affects the natural flow of blood in one way or another. In the case of diabetes, poor circulation is accompanied by pain and lack of feeling in the limbs—especially the legs. Obesity can also lead to poor circulation; carrying excess weight can put strain on the lower extremities causing varicose veins and blood vessel issues. Chronic cold hands and feet could even be a sign of Raynaud’s disease. This condition causes the arteries in the hands and toes to narrow, making them less capable of circulating blood around these areas of the body.

IMPROVING CIRCULATION Making small changes to your lifestyle can have a huge impact on your circulation. Reduce your intake of saturated fats, stop smoking and avoid sitting stationary for long

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periods of time. Each of these is a huge contributor to poor blood circulation. One of the best-known ways to improve circulation is to take up regular exercise; cardiovascular exercises like jogging, swimming and cycling are especially effective. Exercise helps to improve the blood vessels’ capability to dilate and therefore function more efficiently. Other methods for improving circulation include: • • • • •

Eating oily fish (high in omega 3). Keeping iron levels balanced. Practicing yoga. Consuming antioxidant-rich foods. Wearing specialised support hosiery. • Using special equipment to promote blood flow such as leg massagers. •


Get your blood pumping round your body with this 3-minute circulation booster. Step 1: March on the spot for 20 marches. Keep shoulders back and tummy muscles pulled tight. Step 2: Continue marching and add shoulder rolls, going forwards 5 times then backwards 5 times. Step 3: Finish with 10 alternating knee lifts; bring each knee up to meet the opposing elbow.


06/08/2018 08:44

TODAY’S COMMON & SERIOUS CONDITIONS in Association with Alliance Medical Group

What Is

Diagnostic Imaging? Diagnostic imaging is key in the early detection of major diseases such as cancer, and can, in some cases, prevent them from progressing fur ther with treatment


iagnostic imaging refers to a wide range of typically non-invasive methods of identifying and diagnosing many medical complaints and diseases. imaging tests like Mri scans, X-rays, ultrasounds, fluoroscopy and ct scans allow radiologists and other physicians to view the internal anatomy of the human body in order to predict and detect major diseases like cancer early on. these detailed imaging tests have a proven track record of detecting and monitoring the progression of many things from broken bones through to

22 dear doctor with dr chris steele

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cancer and brain tumours. in these cases, this effective diagnosis method allows physicians to develop treatment plans for threatening diagnoses and, ultimately, achieve a higher chance of a successful cure rate for the patient because of more accurate diagnoses and earlier detection. along with diagnosing diseases, diagnostic imaging methods are particularly useful in identifying potential medical problems early on. according to the Nhs, from april 2017 to March 2018, there were 41.1 million imaging tests reported, demonstrating

how vital this method is in aiding the treatment of medical complaints. But, with Nhs waiting lists getting longer and demand for diagnostic imaging climbing, the possibility for early detection using this method is decreasing. For this reason, many patients seek private healthcare to reduce these extensive waiting times. elsewhere, some major corporations like alliance Medical Group are beginning to help fuse the private and public sectors together in a collaborative effort to make diagnostic imaging services more readily available to patients. in 2016, alliance Medical

06/08/2018 08:45

TODAY’S COMMON & SERIOUS CONDITIONS in Association with Alliance Medical Group

Group reached an important and innovative agreement with colchester General hospital to build a multimodality imaging centre at the hospital. this brought new and high-tech imaging services—including Mri, Pet/ct and nuclear medicine services—to its hub to increase the hospital’s diagnostic capacity. this collaboration improves patient access times to diagnostic imaging, while effectively working alongside the Nhs to bring better patient care to the public. as it currently stands, diagnostic imaging services in the Nhs are increasingly constrained as the demand outstrips the Nhs’ installed base of scanners and there is a shortage of radiologists. But with an increase in demand for such services, companies like alliance Medical Group can support the Nhs, ultimately alleviating its pressures and costs, while providing vital care to those who need it most.

IMAGES © Shutterstock


Magnetic resonance imaging—better known as Mri—is a scanning method that uses powerful magnets and radio waves to formulate a detailed image of the internal anatomy of the body. an Mri scan, conducted by a radiographer, is typically used to examine the brain and spinal cord, the bones and joints, the internal organs including the heart, and the breasts. during an Mri scan, a patient will be asked to lay flat on a bed that slides into the scanner; a large tube-like device. depending on the size of the area of the body being scanned, an Mri scan can take anything from 15 to 90 minutes to perform. Mri scans do not expose the body to X-ray radiation, meaning people who may be vulnerable to the effects of radiation (like babies and pregnant women) could use this method safely if necessary. while Mri scans aren’t suitable for everyone (for example, those with certain implants like pacemakers), research on this method of diagnostic imaging has found little evidence to suggest any risk associated with it.


ct is an anagram for ‘computerised tomography’ and refers to a diagnostic

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imaging method that uses X-ray beams to develop detailed and accurate images of the inside of the body from different angles. after the scan is completed, the radiologist will have a very detailed 3d image of the area of the body in question. ct scans are particularly useful in many stages of illness, from diagnosis and guiding further treatments to monitoring the progress of conditions. ct scans are typically recommended to diagnose muscle and bone disorders, locate tumours, infections and blood clots, and detect diseases like cancer, cardiovascular disease and lung nodules. this method of diagnostic imaging is also appropriate to use in quickly assessing people who have potential internal injuries from car accidents and other types of trauma.

3.58 million diagnostic imaging tests were reported to have taken place in March 2018 Source: NHS; Diagnostic Imaging Dataset Statistical Release

off body tissues. these waves reflect back to the probe in order to create a moving image that can be seen on a monitor. an ultrasound scan is typically carried out to monitor the health of a foetus, diagnose a medical condition and guide surgeons through performing procedures. •


an ultrasound (or sonography) uses high frequency soundwaves in order to produce a detailed image of the inside of part of the body. this type of scan uses a device (an ultrasound transducer) that produces sound waves that bounce

alliance Medical Group is europe’s leading independent provider of imaging services.

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Osteoporosis If left to progress, osteoporosis can have a debilitating effect. Learn about prevention and reading the signs

s, hip In 33% of case adults er ld o fractures in become cause them to paired and physically im to live y lose the abilit e year on y tl en independ ture ac fr e th after teoldos Source: wor rg porosisday.o


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can impede daily living and can often restrict an individual’s independence.


While osteoporosis can affect anybody, women tend to experience it more than men. Women are especially susceptible during the first few years following the menopause; this is due to a lack of oestrogen, a hormone that helps to prevent bone loss. Men and children can also develop the condition, although it is far less common. Some

of the most typical injuries in people with osteoporosis include wrist, hip and spinal bone fractures.


There are no obvious physical symptoms for osteoporosis, which means that it often goes unmanaged and undiagnosed. One of the primary signs of osteoporosis is the breaking of a bone as a result of a minor fall or accident. It is usually then that a physician will

IMAGES © Shutterstock


steoporosis is a term that describes the condition of weak, porous bones, which are prone to breakage and injury. Although bones tend to weaken naturally over time, those belonging to an osteoporosis sufferer will be especially thin and brittle for their age. In severe cases, a sneeze or cough can cause damage to the body, potentially provoking a rib fracture or partial collapse of one of the spinal bones (vertebrae). Repetitive bone fractures

06/08/2018 08:47


identify the condition. As the disease worsens, sufferers may notice pain in their back as a result of changes to the vertebrae. This is a common cause for chronic pain and may also materialise into a change in posture. If a doctor suspects that a patient is suffering from osteoporosis, they will usually suggest a dual energy X-ray absorptiometry (DEXA) as an effective means of detection.


If the diagnosis of osteoporosis has come as a result of a low impact fracture, the first priority will be to treat that injury. Most fractures will be treated in A&E; doctors will usually apply a cast or splint to allow the body part to heal. In some cases the breakage may need to be manipulated by a specialist before the cast is fitted. Warm baths and cold packs are known to aid the recovery of a facture. Another method for coping with a fracture includes transcutaneous electrical nerve stimulation (TENS)—a small battery-operated device that stimulates the nerves and reduces pain. Alternatively, your doctor may suggest some relaxation methods to make your recovery time more comfortable.


Having frequent eyesight checks can prevent unnecessary accidents from occurring in people with frail bones. Installing handrails in the house and living areas can also make moving from room to room safer and easier. If you are at risk of developing osteoporosis, take steps to keep your bones healthy and strong. This may involve tweaking your lifestyle or adapting your daily routine. Above all, try to take regular exercise and consume a healthy diet that is rich in calcium and vitamin D—both of which work to nourish and strengthen the bones. You may even choose to take supplements in order to keep your vitamin levels topped up. Experts also recommend giving up smoking—which is associated with an increased risk of osteoporosis—as an extra preventative measure. •

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06/08/2018 08:47


The Fight Against

Antibiotic Resistance

Fast-acting and effective, it’s tempting to view antibiotic medicine as a modern-day panacea; but antibiotic resistance is on the rise—prompting doctors to think twice before prescribing these drugs


ntibiotics are vital drugs for treating bacterial infections in both humans and animals. Under certain conditions, bacteria can adapt and find new ways to survive the effects of an antibiotic. For those seeking a quick-fix solution to their healthcare needs, antibiotics can seem like an efficient way to quell nasty infections. But misuse of these drugs is contributing to a sharp increase in antibiotic resistance, which means they are losing their efficacy at an increasing rate. the more we use antibiotics, the greater the chance bacteria will become resistant to them and they can no longer be used to treat infections. what’s more is we aren’t discovering new antibiotics at a fast enough rate to compensate for their growing obsolescence. driven by overuse and inappropriate prescription, antibiotic resistance is one of the most significant threats to patient safety in europe. to slow this trend down, it is fundamental to use antibiotics in the right way—to use the right drug, in the right dose, at the right time and for the right duration. ‘antibiotics should be taken as prescribed and never saved for later or shared with others,’ says Nhs

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choices. ‘the inappropriate use and prescribing of antibiotics is causing the development of resistance.’

What is the problem?

antibiotic resistance is just one strand of the overarching problem of antimicrobial resistance—a global concern, according to the world health organisation (who). ‘New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases, resulting in prolonged illness, disability and death,’ who states. ‘antimicrobial resistance increases the cost of healthcare with lengthier stays in hospitals and more intensive care required.’ the term ‘antibiotic resistance’ only applies to bacteria becoming resistant to antibiotics. according to Public health england (Phe), antibiotic consumption increased by 6.5 percent between 2011 and 2014 in england. Phe says many patients have been inappropriately prescribed an antibiotic to treat minor ailments, such as coughs, colds or sore throats.

Why do We need to act noW?

according to government statistics,

a failure to address the problem of antibiotic resistance could lead to an estimated 10 million deaths by 2050, costing £66 trillion. already across europe, an estimated 25,000 people die each year as a result of hospital infections caused by antibioticresistant bacteria. Global concern around the issue is exacerbated by the fact that discoveries of new classes of antibiotics are at an all-time low. only three of the 41 antibiotics in development are effective against the majority of modern multi-drug resistant bacteria. For this reason, the UK government takes the issue of antibiotic resistance as seriously as a flu pandemic or major flooding.

What can We do about it?

one of the principal actions we can take is to encourage responsible prescription of antibiotics. the vast majority—74 percent—of these drugs are prescribed by a doctor. there are a number of incentives in place to help healthcare professionals reduce antibiotic prescribing. in 2015, Phe advised Nhs england on the development of a Quality Premium for antibiotic use, which would encourage

06/08/2018 08:48


IMAGES © Shutterstock

Did you know? Global failure to address the problem of antibiotic resistance could result in 10m deaths by 2050, costing £66tr

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clinical commissioning Groups (ccGs) to reduce prescribing of antibiotics by at least one percent. as patients, we can think twice before we ask our doctors to prescribe us antibiotics, especially for minor ailments like the common cold; the common cold is caused by a virus, which antibiotics cannot treat. if your body can fight off the infection on its own, it’s always better to let it. seek advice from your pharmacist about how you can treat minor illnesses before going to your doctor.

efforts in raising awareness

european antibiotic awareness day (eaad) is held every year on 18

November. the europe-wide public health initiative encourages the responsible use of antibiotics. Phe is responsible for coordinating all eaad activities in england. antibiotic Guardian, an antibiotic resistance awareness campaign, invites visitors to its website to become ‘antibiotic guardians’ and make a pledge about how they plan to make better use of antibiotics. without effective antibiotics, many routine treatments and procedures will become progressively more dangerous, the campaign explains. From chemotherapy to basic broken bones, a host of ailments and treatments rely on access to functioning antibiotics. For those who want to take steps to help save these important medicines from becoming obsolete, the antibiotic Guardian website offers a series of pledge messages to choose from. one reads: ‘For infections that our bodies are good at fighting off on their own, like coughs, colds, sore throats and flu, i pledge to talk to my pharmacist about how to treat these symptoms first rather than going to the GP.’ By encouraging people to become antibiotic guardians, we can go beyond simply raising awareness and encourage people to take just one concrete personal action, leading to much wider changes in behaviour. • dear doctor with dr chris steele 29

06/08/2018 10:00

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Eye Health

As eye problems rarely cause pain, it’s important to schedule regular eye tests to keep your vision in top shape and other health complications at bay


ccording to research, nearly half of all sight loss is avoidable, yet six million people in the UK are still living with sight-threatening conditions. eye tests can do a lot more than just detect problems with your vision; if done regularly, they can spot a wide range of health conditions—including diabetes—before they become bigger issues. the Nhs and the royal college of optometrists recommend individuals undergo an eye test at least once every two years. if you fall under a specific group, these tests may be offered for free by the health service.

IMAGES © Shutterstock

What happens during an eye test? although these appointments are generally tailored to a patient’s individual needs, there are a few routine exams you can expect. pre-test. during a pre-test, an optical assistant will use various diagnostic equipment. Using a tonometer, they will blow a puff of air onto the surface of the eyes to measure the internal pressure, allowing your potential risk of developing glaucoma to be assessed. an auto refraction test will determine whether you’re short or long-sighted. lastly, a photograph of the back of your eyes will be taken using digital retinal photography. this will be useful in monitoring changes in your eyes over time. Optometrist check. during your optometrist visit, your vision will be measured using a retinoscope and by

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reading a test chart through different strength lenses. a Volk lens will check the retina, optic nerve and its vessels to make sure they are healthy. Your eyes will also be scanned for abnormalities or scratches on the surface with a slit lamp. if you require it, your optometrist may also perform a visual field check, during which your ability to detect flashes of light in your peripheral vision will be tested. this exam is crucial in detecting early glaucoma or problems associated with headaches. at the end of the test, your optometrist will also look for signs of other medical conditions as well as ask you about your health and wellbeing. they will talk you through your results and evaluations and recommend the best options and treatments for your needs. •

Your optometrist is there to help, so note down any questions you have and take them on the day. If you’ve noticed any changes to your vision, developed visual symptoms such as blurriness, floaters, flashing lights or seeing double, or have any eye health concerns, be sure to let them know —Optical Express dear doctor with dr chris steele 31

06/08/2018 10:03


Blink of an Eye There are many precautions people can take to reduce the sometimes debilitating symptoms of dry and itchy eyes

Known causes & Triggers

there are a number of known causes for dry eyes; the most common ones being air conditioning or heating, prolonged exposure to computer 32 dear doctor with dr chris steele

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screens, seasonal allergies, extreme weather and certain medications like antihistamines. dry eyes can also be a symptom of a wider problem such as diabetes or rheumatoid arthritis. in some cases, the problem may be physical; for example, an inability to blink or a restriction of the tear ducts. the risk of developing dry eyes significantly increases with age—it is especially common during the female menopause.

TreaTing The problem

People experiencing persistent dry eyes should consult an eye care professional to determine the cause, which will guide the treatment strategy. if medication is the cause for discomfort, your physician may suggest an alternative that is not associated with dry eyes. some individuals may choose to amend their lifestyle in order to resolve the problem.

One suggested method of tackling dry eye at home is to use a humidifier. This ensures that you keep a consistent level of moisture in the atmosphere whether you have the central heating on in the winter or are using air conditioning or fans in the summer months

IMAGES © Shutterstock


ry eyes occur when the quantity or quality of one’s tears fail to keep the eye adequately lubricated. it can also be triggered if one’s tears evaporate too quickly. tears are made up of water, fatty oils, mucus and over 1,500 types of protein that smooth the eye’s surface. with each blink, basal tears bathe the cornea—the outer surface of the eye—acting as liquid protection against infection. dry eyes are often accompanied by an itchy or gritty feeling, sensitivity to light, blurred vision, fatigue, poor night vision and redness. if the condition is recurring or prolonged, it can be extremely frustrating for the sufferer.

—Oliver Wooding, Product Portfolio Manager, Clinitas Soothe, Altacor

06/08/2018 10:20


Clinitas dry eye ®

soothing solutions For the symptoms of dry eye which may include gritty, itchy, stinging sensations and persistent discomfort around the eyes, problems often aggravated by lifestyle, environment, age, gender and health.

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THE SCIENCE Sodium Hyaluronate (HA) is a very effective, well tolerated and well proven active ingredient used in products for dry eye. Clinitas Soothe and Soothe Multi contains 0.4%, the highest level available in the UK. Created by biotechnology synthesis the viscoelastic, moisturising, lubricious and protective qualities of Sodium Hyaluronate are ideal for alleviating dry eye irritations and burning.

Buy online at or at high street pharmacies and opticians

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this may involve less screen time and more periodic breaks from the computer during working hours. wrap around sunglasses should be worn to shield your eyes during hazardous weather conditions. cutting down on smoking and avoiding second-hand smoke is also recommended for reducing dry eye symptoms. ove-the-counter drops and ocular lubricants are effective for less severe cases. extreme instances of dry eye may require surgery in order to prevent tears from draining away easily—your optometrist should be able to advise the best course of action for your circumstance.


while dry eye may be uncomfortable, it doesn’t usually lead to any serious problems. the two main complications

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of dry eye syndrome are conjunctivitis and inflammation of the cornea. Conjunctivitis when the transparent layer of cells that covers the white part of the eyeball and the inner surfaces of the eyelid (known as the conjunctiva) becomes inflamed or swollen. this can lead to excessive itching, pink discolouration and a white discharge around the eye. Inflammation of the cornea Known as keratitis, this is the irritation of the cornea: the convex outer layer of the eyeball that shields the eye from the outside environment. the cornea is made up of several layers and is lubricated by the tear film. inflammation of the cornea can be extremely painful, especially when blinking. •

Remember Performing regular eye baths and warm lid compressions can be very beneficial—try to weave these into your weekly routine. Taking omega 3 supplements may also help reduce dryness in the eye area. Get plenty of sleep and stay hydrated with water throughout the day. Finally, be sure to remove contact lenses and excess makeup at the end of each day for optimum eye health

06/08/2018 10:20

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Common Thyroid Disorders Forming par t of the intricate endocrine system, the thyroid gland plays an impor tant role in regulating the body—learn to detect the most common disorders in this area

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1 in 20

IMAGES © Shutterstock


he thyroid is a small, butterfly-shaped gland located at the base of the neck. It manufactures hormones that control the body’s metabolism and growth such as triiodothyronine (T3) and thyroxine (T4). Several different problems can arise if the thyroid gland isn’t working as it should. Dear Doctor explores these conditions in more detail. •

The amount of people in the UK who suffer from thyroid disorders Source: British Thyroid Foundation

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Hyperthyroidism refers to a thyroid that produces too much of its hormones. This can cause several unpleasant symptoms including restlessness, a racing heart, irritability, anxiety, shaking, brittle hair and nails, thin skin, muscle weakness, weight loss and increased sweating.

Diagnosis A blood test is the preferred method for diagnosing hyperthyroidism. It measures the level of T4 and thyroid-stimulating hormone (TSH). High T4 levels and low TSH levels indicate an overactive thyroid gland.

Treatment Antithyroid drugs such as methimazole are prescribed to stop the gland from producing its hormones. Doses of radioactive iodine aim to destroy or damage the thyroid gland. Surgery can remove the thyroid entirely. Medical practitioners usually prefer the first option; damaging or removing the thyroid can lead to a hormone deficiency and may require supplements to be taken on a regular basis.


Hypothyroidism is the complete opposite of hyperthyroidism. In this case, the thyroid cannot produce enough of its regular hormones. Common symptoms include dry skin, constipation, fatigue, depression, memory problems, intolerance to cold, weight gain, weakness, slowed heart rate and—in severe cases— coma. Hypothyroidism can cause other serious complications such as high cholesterol and atherosclerosis (clogged arteries), leading to a higher risk of angina or heart attack.

Diagnosis Like hyperthyroidism, the condition is detected through a blood test. The test will track T4 and TSH levels; a high TSH reading and a low T4 reading indicate an underactive thyroid.

Treatment The main form of treatment for hypothyroidism is a course of hormone medication. Your doctor may take some time working out the correct dosage because hormone levels can differ greatly from person to person.


Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, is the most common cause of hypothyroidism. The condition can occur at any time, although it’s most frequently seen in middle-aged women. It involves the body’s immune system mistakenly attacking the thyroid gland, impeding its ability to produce hormones. Symptoms of the disease are often subtle at first. They include fatigue, depression, enlarged thyroid, constipation, pale and puffy face, mild weight gain, irregular menstruation and dry skin.

Diagnosis A blood test is the most accurate way to confirm Hashimoto’s disease. Increased levels of TSH combined with low levels of T3 or T4 will help to indicate the problem. Because Hashimoto’s disease is an autoimmune disorder, the blood test will also indicate if there are any abnormal antibodies attacking the thyroid.



IMAGES © Shutterstock

Goiter is a noncancerous enlargement of the thyroid gland; its main cause is an iodine deficiency in the diet. Goiter is conversely caused by—and a symptom of—hyperthyroidism. Mild cases of goiter may not reveal any symptoms. Progressed cases may involve swelling or tightness in the neck, coughing, wheezing, difficulty swallowing and hoarseness of the voice.

Diagnosis A routine physical examination conducted by a doctor will identify a case of goiter. Meanwhile, an

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ultrasound of the thyroid can reveal swelling or nodules. A blood test can also monitor hormone levels to confirm a diagnosis.

Treatment While goiters aren’t usually a huge cause for concern, they can lead to more serious conditions if left untreated. If iodine deficiency is the cause, doctors may prescribe small doses of iodine to resolve the problem. Radioactive iodine can be used as a way of shrinking the gland in more serious cases.

Hashimoto’s disease cannot be cured but its symptoms can be treated. Usually, doctors will recommend taking thyroid hormone replacement medication. In rare circumstances, surgery may be deemed necessary if the swelling is uncomfortable or cancer is suspected.


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Living with

Ulcerative Colitis Ulcerative colitis may be a lifelong affliction, but with the right treatment and care, you can continue to live a fulfilling, carefree life


lcerative colitis (Uc) is a chronic condition that is characterised by bouts of abdominal pain, diarrhoea and urgency to use the toilet. Uc is one of the two main forms of inflammatory bowel disease—the other being crohn’s disease. with this long-term disorder, small ulcers can develop in the large intestine (bowel) and the rectum. these ulcers can sometimes bleed and produce mucus, proving to be very painful for the sufferer. other symptoms include loss of appetite, rapid weight loss, excessive tiredness,

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1 in 420 The estimated proportion of people affected by ulcerative colitis in the UK, which equates to roughly 146,000 sufferers Source:

high temperature and general feelings of being unwell. People with Uc often experience long periods of good health, known as remission, as well as relapses—also known as ‘flareups’—where symptoms are amplified or more frequent.

Common Causes

although there has been vast research into the topic, it still isn’t completely clear what causes Uc. Uc is thought to be an autoimmune condition caused by irregularities in the immune system— the body’s natural defense against

06/08/2018 10:55


In the news A drug called tofacitinib, which has previously been used to treat rheumatoid arthritis, can now be administered to those with ulcerative colitis. Earlier this year, the Food and Drug Administration (FDA) expanded its approval of the drug, which goes by the brand name Xeljanz. It is now rumoured to become the first oral medication approved for chronic use in the treatment of the inflammatory bowel disease

infection. This theory stipulates that the immune system mistakenly identifies harmless bacteria inside the colon as dangerous and proceeds to attack the healthy tissue—causing inflammation. The reason behind this reaction still remains unknown, although most believe it’s a combination of genetic and environmental factors. According to the NHS, more than one in four people with UC have a family history of the condition.

IMAGES © Shutterstock


UC can start at any time, though it often appears between the ages of 15 and 25 or in later life—between the ages of 55 and 65. Medical sources tend to agree that the condition affects men and women equally. The risk of developing UC is said to be greater if a close family member also suffers from it, making genes a considerable factor. The significance of genes is further supported by the fact that UC is common in white people of European descent and rarer in people of Asian backgrounds. UC

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is predominant in urban areas and developed countries, although the number of those affected in developing nations is steadily increasing.


When UC flare-ups rear their ugly head, other parts of the body can be affected, too. Common signifiers of a flare-up include: • Painful or swollen joints • Sore and irritated eyes • Mouth ulcers • Patches of painful or swollen skin In more severe cases, flare-ups may also include symptoms such as: • Irregular heartbeat • Shortness of breath • Fever • Blood in the stool


There is no definitive cure for UC; but treatments are designed to relieve symptoms and stop them from returning—this is known as ‘maintaining remission’. For most

patients, maintaining remission can be achieved through certain medications such as aminosalicylates (ASAs), corticosteroids and immunosuppressants. Mild to moderate symptoms can be treated at home with these medicines, while severe flareups may require treatment in hospital. Serious cases of UC can cause the colon to stretch, become enlarged or develop a hole; in such cases, close medical attention will be necessary. If a person’s quality of life is being affected and medications aren’t tackling the problem effectively, a portion of the intestine may be removed via surgery.


If you suspect that you are suffering from UC, contact your doctor as soon as possible in order to get a definitive diagnosis. A blood or stool sample will help to determine the verdict. If necessary, you may be referred to a hospital for further testing. Once diagnosed, your medical practitioner will guide you on a treatment plan that is appropriate for your condition. • DEAR DOCTOR WITH DR CHRIS STEELE 39

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Cancer Focus:

Complementary & Alternative Cancer Therapies According to Cancer Research UK, incidence rates for all cancers are projected to rise by two percent in the UK between 2014 and 2035. Dear Doctor takes a closer look at the current treatments available for this growing health concern


ancer is a group of diseases that instigate abnormal cell behaviour within the body. cancer cells divide and multiply uncontrollably, which can lead to a growth called a tumour. common signs and symptoms of cancer include abnormal bleeding, a lump on the skin, unexplained weight loss, a

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persistent cough and irregularities in bowel movement.

What causes cancer?

cancer is caused by damage to the dNa, which determines how cells behave. the risk of developing cancer depends on a number of factors including genes, environmental

1 in 2

The proportion of people that will develop some form of cancer during their lifetime Source: Cancer Research UK

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influences and lifestyle choices. Cancer Research UK reports that around four in 10 cancer cases could be prevented by making lifestyle changes such as: • Quitting smoking • Eating a balanced, healthy diet • Enjoying the sun safely • Retaining a healthy body weight • Staying active • Cutting down on alcohol • Avoiding infections like HPV and hepatitis • Avoiding chemicals like asbestos and pesticides


Chemotherapy, radiation therapy and surgery are still the main treatment methods for fighting cancer. All conventional cancer treatments must go through rigorous testing to ensure that they work effectively.

Chemotherapy Chemotherapy is a type of anticancer drug treatment that works systemically by circulating through the body via the bloodstream. Chemotherapy kills cancer cells that are in the process of splitting. The type or combination of drugs being administered will determine the stage at which cells are targeted and destroyed. The treatment is available via injection, drip or in capsule form. Chemotherapy has some common side effects which can be very unpleasant for patients including weakness, hair loss, thinning skin, diarrhoea, loss of appetite and vomiting.

Remember A cancer diagnosis is never an easy time— when it comes to treatment, preparing for what may lie ahead is key. Have a clear plan, practice healthy habits, expect changes in your appearance and reinforce the network of people you have around you

8.8 million The number of deaths, globally, that cancer was responsible for in 2015 Source: World Health Organisation

result of radiotherapy. Treatments in this field are constantly being finetuned, making them more effective than ever before. Intensity-modulated radiotherapy (IMRT) is a good example of this progression. It allows doctors to shape rays very closely around a tumour and reduce the impact of radiation on nearby healthy cells.

Surgery Surgical cancer treatments involve the removal of cancerous tissue. Patients’ suitability for surgery may depend on the type of cancer they have, the size and stage of the disease and the location of the tumour. If cancer is localised to one particular area and hasn’t spread, surgery will likely be recommended. There are some types of cancer that surgery is not suitable for such as leukemia (blood cancer) and lymphoma (cancer of the lymphatic system). If a tumour is located near a blood vessel or delicate tissue, it may be deemed too dangerous to remove.

IMAGES © Shutterstock

Radiotherapy Radiotherapy harnesses high-energy radiation in order to target human DNA and kill cancer cells. It can be used as the sole treatment for curing cancer (curative radiotherapy) or may be combined with other treatments like chemotherapy. Radiotherapy is generally considered the most effective treatment for cancer after surgery, although its efficacy can vary from person to person. Patients will frequently suffer skin reactions, swelling, hair loss and tiredness as a

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In recent years, the oncological industry has been shaken up by the emergence of new forms of treatment. It is generally agreed that more research is needed in this area to develop these up-and-coming therapies.

Immunotherapy Immuno-oncology is a young field on the frontier of cancer therapy that is rapidly gaining support. Unlike other treatments that directly target cancer cells, immunotherapy triggers the body’s natural immune system. It is this natural defense that attacks the dangerous cancer cells in the body. Immunotherapy can be administered via injection, drip or oral prescription. ‘Immunotherapy is going to be a critical and essential component of cancer care,’ said Dr. Philip Greenberg, head of immunology at Seattle’s Fred Hutchinson Cancer Research Centre.

Virotherapy Virotherapy is a treatment that uses biotechnology to penetrate serious diseases. A specific virus is introduced to the system and attacks the malignant tumour cells in the body and destroys them. Virotherapy is extremely promising in its effects and is being used increasingly in hospitals. However, it does not yet have the rigorous Stage III clinical trials behind it that conventional methods do.

surrounding tissue. Proton therapy is painless, but some patients have been known to suffer from fatigue and skin problems.


Unfortunately, there is currently not enough evidence to confirm that CAMs can cure or assist in cancer treatment. At present, the availability of CAM treatments on the NHS is limited. Before deciding on using a CAM therapy alongside traditional cancer treatments, patients should find a CAM practitioner that is on a register accredited by the Professional Standards Authority for Health and Social Care (PSA). This means that the practitioner holds certain qualifications and meets the demanding standards set by the PSA.

Complementary medicine These are therapies that are used alongside conventional medical treatments in order to cope with their side effects. For instance, using acupuncture to lessen the side effects of chemotherapy. Other examples include aromatherapy, vitamin supplements, visualisation and yoga.

Alternative medicine Alternative medicine treatments tend to be used in place of conventional medical treatments. For instance, using a special diet to treat cancer instead of anti-cancer drugs that are prescribed by an oncologist. Other examples include laetrile, Gerson therapy and vitamin-boosted or restricted diets. •

How can CAMs help? According to Cancer Research UK, there is a growing body of research to suggest that some CAMs may help to control some symptoms of cancer and the side effects of traditional treatments for the disease. Some patients may also use CAMs as a means to feel positive about their ongoing cancer treatment and remain hopeful

Proton therapy Proton therapy has become a hot topic within the medical community over the last few years. It is actually a type of radiotherapy. With conventional radiotherapy, high-energy beams of radiation destroy cancer cells but can also damage the surrounding tissue. This can lead to some distressing physical side effects and, in some cases, organ failure. Proton therapy uses beams of sub-atomic particles to the same cell-destroying effect. However, this form of therapy results in much less damage to the 42 DEAR DOCTOR WITH DR CHRIS STEELE

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Integrative Treatments Why include the BudWig Protocol in your cancer treatment?

The objective of the Budwig protocol is to treat the root cause of diseases, not just the symptoms. Dr. Budwig discovered that microbes and fungus, toxins, nutritional imbalance as well as a compromised immune system are all major factors that contribute to cancer. She developed a protocol that works at reversing the negative effects of these factors.

Who Was dr. Johanna BudWig?

Dr. Budwig’s was a German biochemist, a pharmacist, and author. Her tenacity, passion, and diligence aided her to make a massive contribution to medical research, leaving behind an indisputable legacy which to this day helps save lives. She developed a diet and protocol that has proven to be a very effective natural method to treating cancer.

What is Behind the success of the BudWig diet?

Nutrition rich foods improve cellular biooxygenation, thus empowering the body itself to ward off the toxins, pathogens, and microbes that contribute to cancer. An advantage to the Budwig Diet is that you will still be able to eat many of your favorite meals by simply using healthy and organic ingredients.

the BudWig center’s natural treatments for cancer

The Budwig Center, located in the south of Spain, is helping people treat cancer with natural methods and remedies based on the research of Dr. Johanna Budwig.

What the BudWig center offers cancer Patients

Our primary goal at the Budwig center is not just to help each patient recover from cancer

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using natural methods, but also to provide education. Dr. Budwig herself was known for spending quality time with each patient, educating them on how they can take control of their health themselves. She thus empowered each patient physically, mentally and emotionally and this is a principle that we continue to follow at the Budwig center.

Budwig protocol and how to make it a part of their life. • We have a dedicated kitchen area where we provide daily meals and also teach patients how to make Budwig diet recipes. •

hoW the BudWig Programs helP you

• We use personalized tests which give a complete analysis of a patient’s condition in order to establish which remedy and dosage will be most effective for them. • Because toxins are a key factor that hinders proper cellular bio-oxygenation we provide an array of effective detox treatments that improve the function of the organs, especially those that are responsible for the elimination of toxins and debris. • Our weekly group discussions give our patients an opportunity to connect with others while at the same time enabling them to gain an in-depth understanding of the

ContaCt us For a Free Consultation Are you in need of some guidance and direction to choose the right treatment for your condition? Then don’t hesitate. Get in touch with one of our Budwig Therapists. Visit our website for more information: Email us at

06/08/2018 08:57


Bring CBD into your life today!


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CBD Quality Standards

Why the UK could become a global medical cannabis leader


n a few short years taboos surrounding cannabis have been laid bare and open for critical analysis. Like many topical issues before, the digital world has allowed people to share their experiences with the world. The quantity and quality of anecdotal evidence has reached a critical point where the potential for cannabis can no longer be ignored. Not too long in the past, the accepted rational opinion was that cannabis is bad. Cannabis is bad for your health, bad for your career opportunities, bad for society and surely bad for your own personal health and well-being. Over 60 years ago in Jerusalem a young scientist, Professor Raphael Mechoulam discovered CBD, THC and the endocannabinoid system. 60 years later this research is now reaching the people that need it the most. Medical cannabis patient programs are being approved by governments across the world. In the UK medical cannabis programs have not taken root in part due to the issues surrounding THC (psychoactive) parts of the plant. CBD however, the non-psychoactive and safe compound is 100% legal when cultivated from the hemp plant. Today the new truth is that cannabis in its many forms and varieties can in fact lead to better health which consequently can have a positive impact on society at large. The consumer challenge is to be able to identify quality products that can be trusted to be safe. There are dishonest

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companies peddling unsafe and incorrect formulations, there are companies selling over-priced products to naïve and vulnerable consumers. The global industry requires global standards to ensure and fight for consumer rights. In the UK CBD is sold as a food supplement. Consumers in the UK demand the highest production standards when it can impact health. The UK is the first country with a selfregulating body specifically for CBD. The mission is to lay the groundwork for how CBD should be researched, cultivated, produced and sold. The UK is now emerging as a leader in the medical cannabis world by focusing on CBD and its many health benefits. Just as with all food supplements, help and guidance from the NHS is unlikely to come. People currently rely upon both recommendation and personal research to find the product and company to entrust with their health. As the medical cannabis and CBD markets mature, inevitable consolidation will take place. Those companies with proven effective products and compassionate company ethos are the brands likely to thrive, and don’t be surprised if many are from the UK. Author: Clifton Flack, founder CiiTECH Ltd, a British Israeli medical cannabis company.

17/05/2018 16:49


CBD Oil’s

Health Potential Recent studies have suggested that CBD oil may be effective in aiding the treatment of some medical ailments, but what do we know so far?


annabidiol (cBd) is one of over 60 chemical compounds naturally found in the marijuana (cannabis) plant—a category known as cannabinoids. cBd oil is typically extracted from the resin glands of the marijuana buds and flowers. it can also be extracted from hemp—an industrial, fibrous form of cannabis. a common misconception surrounding cBd oil is that it can make the consumer ‘high’, however, this is not the case. the compound in marijuana that causes a psychoactive high is called tetrahydrocannabinol (thc), which can only be found in very minute traces in cBd oil. From 2016, when the government’s healthcare watchdog approved its use as a medicine under license, cBd oil has been legal to buy in the UK. cBd is usually bottled and comes with a pipette; however, it can also come in other forms, for example, as a chewing gum, hand soap or as vape oil for e-cigarettes. in recent years, the medical community has set out to unlock the medical potential of cBd oil and unearth its health benefits.

• Antipsychotic effect—the american Journal of Psychiatry, 2017. • Reduces anxiety—National institute on drug abuse, 2015. • Regulates nausea—British Journal of Clinical Pharmacology, 2011. • Fights cancer—British Journal of Clinical Pharmacology, 2012. • Improves seizures and related neurological conditions—British Journal of Clinical Pharmacology, 2012. • Improves Alzheimer’s symptoms— Journal of Alzheimer’s Disease, 2014.

Possible drawbacks

in spite of the discoveries being made in regards to cBd oil, there still remains a lack of knowledge on its long-term effects. at present, there is little regulation to govern products on the market, meaning that ingredients, manufacturing processes and potency can vary dramatically. while a preliminary report from the world health organisation (who) stated that ‘no public health problems […] have been associated with the use of pure cBd’, the Fda is yet to approve cBd products for any purpose. there

are several potential side effects of taking cBd oil, which include nausea, drowsiness, diarrhoea, dry mouth, vomiting and bloating. likewise, drug interaction is possible if cBd is used alongside other common medications. ongoing medical studies have produced promising results, however, more research must be acquired before cBd oil is deemed safe and beneficial in the long term. •


The amount of new users of CBD oil every month Source: Cannabis Trades Association UK

Potential health benefits

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IMAGES © Shutterstock

these are just some of the potential benefits of cBd oil: • Relieves pain and inflammation— Journal of experimental Medicine, 2012. • Promotes cardiovascular health—British Journal of clinical Pharmacology, 2013.

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Billy Caldwell: the landmark case Billy Caldwell from Castlederg, Northern Ireland was the first Briton to be prescribed CBD oil on the NHS. The 11-year-old suffered from violent seizures caused by epilepsy, which often amounted to 100 attacks per day. On the brink of death, Caldwell was issued CBD oil from specialists in the US in the hopes that it would provide him with some relief—this treatment then continued in the UK. Ten months since receiving his first dose, the child has been seizure-free

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The UK: a leading producer

Findings by the UN International Narcotics Control Board (INCB) stated that the UK produced approximately 95 tonnes of legal cannabis in 2016—accounting for 44.9% of the world total. A significant part of this production goes towards a cannabis-based medicine called Sativex. At present, Sativex is only available on prescription by the NHS in Wales


06/08/2018 11:00


Digesting the Facts

A healthy gut is important for more than simply regulating digestion—it influences everything from a functioning immune system and the risk for chronic diseases to mood and sleep regulation

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Trillions of beneficial bacteria, viruses, fungi, archaea and eukaryotes live in the gastrointestinal tract and are collectively referred to as gut flora, or the microbiome or microbiota. According to the National Center for Biotechnology Information (NCBI), these living microorganisms represent some 500 different species and are commonly known as the ‘second human genome’. The microbiome is increasingly being recognised as an organ in and of itself within the scientific community, too, with its own separate complex physiology and pathology. If the microbial population structure of the gut is altered, this ‘organ’s’ health may be damaged, affecting the rest of the body in turn. The gut flora population is at the helm of digestive functioning— something that has been known for a while now. The microbiota produces powerful enzymes that break down the food we eat, extracting vital nutrients for the body and offering protection by absorbing harmful bacteria from food. This complex ecosystem of microbes and microorganisms is responsible for more than just regulating healthy digestive processes, though. While meaningful research and studies into the microbiome are currently in its embryonic stages, some major breakthroughs and discoveries have emerged in recent years that are beginning to demonstrate its crucial role in our overall health and


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wellbeing. We now know that healthy gut flora offers protection by keeping harmful, disease-causing bacteria from entering the gut. It also works by regulating and supporting the immune system and promoting healthy brain functioning. If the microbiome is disrupted, however, it can have a devastating impact on health. Disruption occurs as a result of lifestyle and diet changes or illnesses, making it less able to protect the body from disease. Recent research has suggested that poor gut health may be linked to certain chronic diseases including ulcerative colitis (inflammation of the colon and rectum) and Type 2 diabetes. It has also been linked to eczema and common allergies including asthma. It is important to note that no two microbiomes are the same and there is no one-size-fits-all route for maintaining a healthy gut. However, experts tend to agree that the majority of digestive problems derive from lifestyle choices such as the food we eat, smoking and high levels of stress. Many external factors like food intolerances and digestive conditions such as coeliac disease and Crohn’s disease affect the way in which an individual should approach treating personal digestive health issues.

Kefir for a healthy gut Ever heard the phrase, ‘You are what you eat?’ Well, it’s a lie. Actually, you are what you absorb . This is determined by the health of the bugs inside your gut, in your microbiome. If those bugs are damaged by antibiotics or sugar, they can’t function properly to break down your food. So the most powerful thing that you can do before adopting any new eating programme, is to start out with a nine-week course of goat’s milk kefir, to heal your gut. Look for live, unflavoured kefir made with real kefir grains and hypoallergenic goat’s milk, available from By: Shann Nix Jones, author of The Kefir Solution: Natural Healing for IBS, Depression and Anxiety.

IMAGES © Shutterstock


he term ‘gut health’ has been circulating within the wellness industry as the buzz word of recent years, and industry sales of digestive system-related products have hiked as a result. Global market intelligence publisher Euromonitor estimates that the sale of digestive medicines and products in Britain is expected to reach about £333 million by 2021. But where has the sudden commercial interest in our digestive health come from and what can we do to improve our own?

06/08/2018 11:16



Interesting ideas have been circulating within the scientific community about how a healthy microbiome may play a role in promoting good sleep. While no definitive or conclusive studies have been carried out, this emerging possibility is proving to be intriguing. A 2017 study led by researchers at Kent State University in Ohio found that poor sleep quality is linked to disrupted gut flora. They concluded that lower levels of vital bacteria in the phylum Verrucomicrobia may contribute to metabolic dysfunction and conditions like obesity. Author of The Diet Myth (2015), Tim Spector, said in a recent interview with the Guardian, ‘We know that people who live with depression and people who sleep poorly both have abnormal microbes in the gut, which would suggest there is a very real connection here between all three.’


The gut-brain axis—a biochemical signalling that occurs between the gastrointestinal tract and the brain— has been the subject of much study lately. The human brain has a symbiotic relationship with the bacteria in the gut, which produce various chemicals that influence brain function, including memory. The gut microbiome is also responsible for producing the majority of neurotransmitters including hormones

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Bimuno® DAILY is a supplement which contains a unique active ingredient; B-GOS®. It naturally feeds and stimulates the growth of good bacteria in your gut. The main ingredient, a galactooligosaccharide, works by selectively increasing the level of bifidobacteria and other health-promoting bacteria found in the gut. Bimuno® is for anyone who wishes to support their digestive health and overall wellness.

serotonin, dopamine and acetylcholine which are central to regulating our thoughts and feelings. A study published by the National Institutes of Health (NIH) analysed two groups of adults who had irritable bowel syndrome (IBS) and diarrhoea and mild anxiety/depression. The researchers found that those who had taken the probiotic Bifidobacterium longum NCC3001 over a period of time saw reduced levels in their depression when compared to the control group, who had taken a placebo. This conclusion demonstrates how a disrupted gut microbiome may be at the centre of some neurological conditions like depression, anxiety and behavioural issues. It also illustrates how vital maintaining and nourishing the gut’s microbiota is to minimising risks.


Some prescribed medications can lead to side effects that may disrupt the functioning of the digestive system. These side effects can cause common digestive complaints including diarrhoea, indigestion or constipation. The NHS advises that those who have stomach ulcers or suffer with indigestion should also avoid non-steroidal antiinflammatory drugs (NSAIDs) such as ibuprofen or aspirin. This is because NSAIDs can disrupt the composition and balance of the gut’s microbiome and can cause stomach ulcers and bleeding to occur. Paracetamol may offer a safer alternative, but it is important to seek medical advice if digestive health complaints persist or if you are unsure. • DEAR DOCTOR WITH DR CHRIS STEELE 51

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Probiotics or Prebiotics?

Raw & natural liquid probiotics

Both probiotics and prebiotics play a vital role in digestive health, but what are their differences?

IMAGES © Shutterstock


robiotics are characterised as a large number of different strains of live bacteria and yeasts found in certain foods and supplements. These add to the bacteria that already exist in the gut. Taken in adequate quantities, some studies have shown that probiotics may aid good digestion, offer vital protection from allergies, boost immunity and reduce the risk of obesity. The most common strains of probiotic bacteria to be found in many commercial products are derived from the bacterial genus Lactobacillus and Bifidobacterium. According to the British Nutrition Foundation, studies on these particular strains have been shown to have a positive impact on gut physiology by ‘creating a more favourable environment in the gut’. It is key to note, however, that for probiotics to have an effective impact on the composition of the microbiome, they must be able to survive travelling through the acidic intestinal tract first, before they can multiply and thrive in the gut. While the possibility for survival does vary from strain to strain, the British Nutrition Foundation suggests

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regularly consuming probiotics to boost the efficacy. Probiotics can be taken as a supplement, or they may be found in live yoghurt and fermented foods such as kefir, miso and sauerkraut. Prebiotics, on the other hand, are non-live, non-digestible plant fibres that nourish and fertilise existing gut bacteria in order for it to multiply and thrive. Unlike probiotics, prebiotics are able to resist stomach acid, meaning they are more likely to reach the intestinal tract in order to benefit the health of the gut. While more research is needed in this area, some sources claim that prebiotics have numerous health benefits. These include reducing the risk for some cardiovascular diseases, strengthening the immune system and even helping to prevent the onset of Type 2 diabetes. Prebiotics occur naturally in many fruits and vegetables including bananas, garlic, asparagus and artichokes. Interestingly, both probiotics and prebiotics work synergistically, meaning that consuming both together will have more of an effective impact on gut flora than simply consuming one or the other. •

Rawbiotics is a live, raw, vegan, allnatural, gluten-free liquid probiotic. Enjoy a morning shot of friendly bacteria to start your day off the healthy and balanced way. Unlike regular freeze-dried tablet-form probiotics, Rawbiotics is presented as a live liquid form and therefore doesn’t need to be freeze-dried to survive. Rawbiotics is the most raw, natural and effective form of probiotic, allowing maximum nutrition absorption in the body and gut, where 70 percent of the immune system is stored. The science behind Rawbiotics is revolutionary and more than 15 years of research has gone into it. Rawbiotics is great for general wellbeing, energy levels, alertness, regulating metabolism and brighter skin. Aditionally, Rawbiotics Gut supports digestive problems such as bloating, IBS, Crohn’s, intolerances, coeliac disease and constipation. “This is now part of my everyday routine and I couldn’t live without it!”—Lucy


06/08/2018 11:17


MIND YOUR WEIGHT To lose weight and keep it off you just “eat less and move more”, right? Wrong. Lasting weight loss is more about what’s going on in your mind than about what’s going into your mouth. With LighterLife’s unique approach, you get to reshape both your body and your relationship with food, with a highly effective cognitive behavioural therapy programme plus simple, nutritious diet plans. The result? Fast, healthy weight loss and a new outlook on food and yourself, so you really can live lighter.


sk anyone why they overeat, and once you get past the inevitable “I love food”, you’ll find they often start talking about boredom, stress, anxiety, unhappiness, even happiness. Now, ask them the best way to lose weight and they’ll suggest dieting, going to the gym, taking medication, even having bariatric surgery. And that’s the problem: the reasons we overeat are so often emotionally driven, yet our go-to “solutions” are mostly physical. There’s no doubt that losing weight means altering your energy balance – eating less, exercising more – but without challenging your current mindset you’ll never get that far. By realising the control you have over the way you are and act, you can master your power to change any aspect of your life, including your relationship with food. Cognitive behavioural therapy (CBT) is a proven way of doing just this. For over 30 years LighterLife has been pioneering CBT for weight loss: enabling people to address the underlying, unhelpful thoughts that drive feelings and cravings, in turn reducing reliance on compulsive behaviour like mindless eating. In combination with food replacements that provide the essential nutrition for good health during weight loss, and high levels of support for both weight loss and weight maintenance, it’s a highly effective programme, as over 400,000 LighterLifers have found out.

POWERFUL THINKING After relocating to Spain a few years ago, Claire Barratt found herself alone all day with her baby daughter while her husband worked long hours in his new job. “I had no support network and I started to eat to block out my

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negative emotions,” she remembers. In January 2016, back in the UK, weighing 21st 7lb and at rock bottom, she knew she needed something different from the basic diets that hadn’t worked in the past. At LighterLife, Claire found her answer –a very-low-calorie diet (VLCD) to rapidly shift over 10st, plus a CBT group led by an experienced counsellor to help her st understand why she’d Claire lo been overeating. “The VLCD worked r ining fo wonders, and my group mainta a year over offered the support and insight I’d never experienced before – the counselling was key to my success. For the first time I was facing my food problems and tackling them head-on.”


10st 4l

HEALTHIER LIVING While Paul Donnelly was shocked at being diagnosed with type 2 diabetes aged just 40, worse was to come. After four years on medication his weight ballooned to 17st and he was told he’d probably be dead by 50 if he continued on the same path. “I joined LighterLife to save my life,” he says simply. Within a month of starting his VLCD plan and group CBT, Paul t s had shed 2st and was off his lo Paul medications. Two years on, his blood sugar has never once r ining fo mainta a year spiked above the limit. “I was over told that type 2 diabetes was for life. I wholeheartedly challenge that: I am living proof you can put type 2 diabetes into remission. The LighterLife VLCD played a massive part and attending my group was vital.”

6st 3lb

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CBT SUCCESS Actress Denise Welch lost 2st with LighterLife before her wedding in July 2013, and she’s been maintaining her healthy weight ever since. After battling with drink for years in an attempt to self-medicate against crippling depression, she gave up alcohol, only to replace it with food. “It was classic cross-addiction,” she says, “but while you can give up drinking you can’t give up eating. Having sobered up, I had to learn how to manage food before I slid into long-term obesity. “I saw LighterLife’s CBT groups as a brilliant opportunity to change my thinking, and so my love affair with CBT began. It changed everything for me. I learned to pause lost Denise before eating and ask myself if I was really hungry, r or whether I was tired, stressed, in ining fo mainta4 years r e v o need of comfort. In other words, I got in touch with my reasons for eating. Now I accept that managing my weight is a journey, not a destination. I’ll always live with a desire to overeat, but I know how to deal with it. While I still get bouts of depression, I handle them now by applying the life skills I learned in my CBT group, and I feel far stronger for it.”

Since losing over 10 stone my energy levels have increased and

I feel amazing


THE LIGHTERLIFE DIFFERENCE • You can lose up to a stone a month on our expert weight-loss plans. • Our unique behaviour-change solution helps you identify your overeating triggers and work out new ways to manage them without sabotaging yourself with food. • We have the highest quality food replacements, so you have the nutrition to ensure your body works with you, rather than fighting hunger all the time. • You develop the skills to manage your weight long-term, with our personalised support system to keep you on track.

e Best vfaolu ast f r £ for ilb s lo s we ght ’s n on ITV as prove oney: Save M Series 1 ealth Good H

Get started today Call: 0800 2 988 988 Visit:

* Each of our clients' results and stories are unique to them and their experience of LighterLife. Your own results will be personal to you and may vary.

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18/05/2018 14:06


Lose Weight,

Feel Great

According to YouGov, 48 percent of New Year’s resolutions were focused on losing weight in 2017—was yours?


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For sustainable weight loss, national guidelines recommend that a reduction in calorie intake of roughly 600 calories per day is needed. This has the potential to trigger a weekly loss of about 0.5 kilograms. Surb Kaur at Gullón believes that, ‘Eating a wide variety of foods in the right proportions and consuming the right amount of food and drink to maintain a healthy body weight, combined with regular physical activity, minimizing consumption of cholesterol, salt, sugar and saturated fat can aid the process of losing weight.’ Nowadays, there are various popular diets that involve removing or severely limiting specific foods. While these can be effective in the short-term, they can leave the body lacking crucial

nutrients, making them unsustainable. Extreme versions of restrictive diets can even lead to lack of energy, fatigue, irritability and dizziness. ‘While any weight loss will require a change to eating habits, it shouldn’t mean missing out on nutrients or cutting out whole food groups. Aim for regular meals and a balanced diet but also take care with your portion sizes,’ says Victoria Taylor at the British Heart Foundation. Follow Dear Doctor ’s easy steps to losing weight.


Planning a week’s worth of meals in advance is both economical and conducive for weight loss. Carefully strategise your daily intake of calories so that you don’t stray or indulge in something ‘naughty’.

IMAGES © Shutterstock


our weight can have a significant impact on your overall health and selfesteem. Obesity has been linked to several serious health conditions including heart disease, stroke, high blood pressure, gout, diabetes, cancer, gallbladder disease and asthma. If you are wondering whether your current weight is considered healthy, calculating your body mass index (BMI) is a good starting point. BMI metrics seek to gauge your body fat content using your weight and height. For a more accurate reading, measure your waist circumference so that your body shape is taken into account. Visit the NHS website to use its online BMI healthy weight calculator.

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Treat yourself to guilt-free snacking with delicious sugar-free biscuits Gullón’s scrumptious range of healthy sugar free biscuits are made with only the best quality ingredients, high in fibre and high in oleic sunflower oil.

* Food is considered “sugar-free” if the content of sugar is equal or less and 0.5 grams of sugar per 100 grams of product.

The range is available at


For more information visit: Gullon.Rev1.indd 1

06/07/2018 11:59



Many individuals consume a healthy diet overall but struggle with overeating. Measure your portions according to weight and calories. Some people find it useful to eat from a small plate to ensure portions are controlled.


There’s a plethora of salt, fat, sugar and E-numbers lurking on supermarket shelves. Consuming excessive amounts of any of these categories will hinder your progress. When shopping, check the label to ensure that the products you buy fit into your new healthy lifestyle.


High-fibre foods are notorious for making you feel fuller for longer— perfect for those wanting to lose weight. Fibre is derived from plants

and can be found in fruits, vegetables, oats, wholegrain bread, brown rice and pasta, beans, peas and pulses.


A common tendency for individuals trying to slim down is confusing being thirsty with being hungry. Most health associations recommend drinking two litres of water a day in order to keep hydrated and alert.


Nature has an astonishing way of highlighting the nutritional properties of plants—colours tend to signify these properties. By eating an array of colourful fruits and vegetables you can provide your body with all the nutrients it needs.


Eating regular meals at the same time each day can help dieters avoid

unnecessary snacking. Skipping meals will only hinder your good work and prompt the body to store fat when you consume your next meal.


Over time, excessive drinking can contribute to weight gain. Alcohol contains a lot more calories than you may think; a typical glass of white wine, for example, is about 82 calories.


It is the combination of healthy diet and regular, exertive exercise that makes for an effective weight loss plan. Choose a pastime that suits your schedule and stick to it. Try to mix up aerobic and anaerobic activities for a well-rounded fitness plan. Remember, official government guidelines advise individuals to complete at least 150 minutes of exercise a week. •

a ps

Healthy food sw

Swap a turkey sandwich (220 calories) for an open turkey sandwich (110 calories) Swap mayonnaise (2 tbsp = 188 calories) for yoghurt (2 tbsp = 59 calories) Swap cheddar (28 grams = 114 calories) for feta (28 grams = 75 calories) Swap scrambled eggs (2 = 182 calories) for poached eggs (2 = 144 calories)

Swap whole milk (250 millilitres = 155 calories) for semi-skimmed milk (250 millilitres = 83 calories) Swap white rice (100 grams = 130 calories) for cauliflower rice (100 grams = 34 calories) Swap Coca-Cola (330 millilitres = 139 calories) for Diet Coke (330 millilitres = 1 calorie)


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06/08/2018 12:42


Liven up Your Diet with These Unlikely

Nutritious Foods

IMAGES © Shutterstock

Some foods, which have a reputation for being unhealthy and fattening, are surprisingly healthy—Dear Doctor investigates


ea, coffee, red wine and chocolate may all seem like dieting disasters. Most people associate them with gaining weight or treating themselves. But these seeming indulgences—alongside fatty fish and mushrooms—can have properties that facilitate our body’s fight against disease and infection. It’s true. Some of these

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‘superfoods’ are rich in antioxidants, which are believed to combat cancer-causing ‘free radicals’ (unstable molecules that damage cells). Others, on the other hand, promote heart health with their rich omega 3 content and may even be able to cheer you up when you are feeling down. Dear Doctor has compiled a list of the top five most unlikely nutritious foods. DEAR DOCTOR WITH DR CHRIS STEELE 59

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Perhaps one of the most unlikely nutritious foods is tea—any variety that derives from the leaves of the Camellia sinensis, including black, green, white and oolong. While the jury is still out on some of the potential health benefits of tea, there appears to be compelling evidence for its ability to reduce the risk of heart disease and lower cholesterol. Tea’s ‘magic’ ingredient is catechins—a type of flavonoid from the family of disease-fighting antioxidant phytochemicals (biologically active compounds) also found in fruits, vegetables and red wine. But not every cup of tea is bursting with antioxidant goodness. The longer you brew your tea, the more of those coveted health extracts your beverage will contain. Interestingly, tea with caffeine boasts more phytochemicals. And iced tea, which is typically diluted, is not as good a health source as hot tea. If you add milk or sugar to your tea, do so sparingly—these additions can turn a naturally noncaloric beverage into a high-calorie one.


Dark chocolate We have some good news for chocolate lovers. According to a study published in Hypertension, small portions of dark chocolate may help reduce blood pressure, LDL—the ‘bad’ cholesterol—and the risk of diabetes by boosting insulin sensitivity. These health benefits arise due to the flavonoids found in dark chocolate— similar to those found in tea, red wine, fruits and vegetables. In another study, reported in the Journal of the American Medical Association, researchers found the flavonoids in dark chocolate helped prevent stiffening of blood vessels in adults aged 50. A well-conducted 2012 review of the best available evidence on the effects of chocolate on blood pressure concluded that cocoa products— including dark chocolate—may help slightly lower blood pressure. The chocolate used in the above studies contains high levels of flavonoids and has a bittersweet taste—very different to the creamy, milk chocolate many Brits enjoy. The flavonoids derive from the cocoa bean’s extract, which has a naturally bitter taste. If you choose dark chocolate with a high (70 percent) cocoa content, you’ll get more of these health-enhancing antioxidants. Of course, all chocolate—including dark, white and milk—has both positive and negative attributes. Synthetic chocolates like Dairy Milk are high in saturated fat and sugar, which can lead to weight gain. Still, dark chocolate can be a tasty treat to replace other sugary snacks with little or no nutritional value whatsoever. So you can enjoy small portions of dark chocolate as part of a balanced and healthy diet.

Drinking too much coffee is not great for your overall health and wellbeing. This caffeine-rich beverage—which acts as a stimulant—artificially increases your heart rate and can interfere with sleep. However, cutting it out completely may be unwise. There are a surprising number of benefits to be reaped from drinking coffee—both caffeinated and non. A growing number of studies suggest those who drink coffee are less likely to have Type 2 diabetes, Parkinson’s disease and dementia. A 2005 study of more than 193,000 people found that those who drank over six or seven cups of coffee daily were 35 percent less likely to have Type 2 diabetes than those who drank fewer than two cups daily. Coffee also contains minerals such as magnesium and chromium, which help the body use insulin, the hormone which controls blood sugar (glucose) levels. Coffee may even counter several risk factors for heart attack and stroke. The same positive effects can also be observed in decaffeinated coffee. 60 DEAR DOCTOR WITH DR CHRIS STEELE

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06/08/2018 11:18


Fatty fish It’s hard to believe a food called ‘fatty’ could be healthy, but when it comes to fish, the fattier the better. Cold water fatty—or oily—fish such as salmon, trout, sardines, tuna, mackerel and herring are rich in omega 3 fatty acids, a type of unsaturated fat that promotes health in many ways. Several studies now support the idea that omega 3 fatty acids can lower cholesterol and triglycerides (blood fats) as well as reduce the inflammation associated with an increased risk of heart disease. The UK Scientific Advisory Committee on Nutrition said a ‘large body of evidence’ suggests that fish consumption—particularly oily fish—reduces the risk of cardiovascular disease. Oily fish is a good vitamin D source; it also contains some B vitamins and selenium. But there have been inconclusive claims for oily fish’s effect on prostate cancer. Generally speaking, all types of fish are good for you. To meet your omega 3 requirements, eating fatty fish at least once or twice a week is recommended.

Mushrooms Most of us associate a colourful diet with a healthy diet. ‘Eat your greens’, we are continuously told. For this reason, you may think mushrooms just add flavour and have no real nutritional value. However, they are the only vegetable source of vitamin D—a nutrient many people are deficient in these days. We all know vital vitamin D can be soaked up through the sun’s rays. But what if the drizzly British weather and a hectic work schedule don’t allow for a relaxing sunbathe? A study found one serving (four to five white button mushrooms) could boost vitamin D levels after exposure to just five minutes of sunlight. In addition, many popular mushroom varieties such as white and portobello are good sources of B vitamins like riboflavin and niacin. Nine recent studies, published in the FASEB Journal, cited the following health benefits of mushrooms: weight management, improved nutrition, increased vitamin D levels and improved immune system function. Like carrots, green tomatoes, peppers, pumpkins and other whole foods, mushrooms are high in antioxidants. This means they can help fight against harmful free radicals and, in turn, combat cancer. One cup of grilled portobello mushrooms and one cup of stir-fried shiitake mushrooms provide about three grams of fibre, which benefits the immune system and reduces the risk of heart disease and metabolic syndrome.

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Evidence suggests moderate consumption of red wine may help people live longer, fight against certain cancers, improve mental health and enhance heart health. But can an indulgent beverage really be beneficial to our wellbeing? A lot of studies, which claim red wine can be good for us, cite the presence of resveratrol—a compound believed to offer a number of benefits—as one of the main reasons. The resveratrol in wine comes from the skins of red grapes. Blueberries, cranberries and peanuts are also sources of resveratrol; and it can even be found in supplement form. Evidence suggests that, in some instances, resveratrol may boost cardiovascular health and protect against cancer. Small quantities of alcoholic drinks, and especially red wine, appear to boost levels of omega 3, the fatty acids believed to protect against heart disease. In 2006, scientists in the UK found that procyanidins—compounds commonly found in red wine—help keep blood vessels healthy. Red wine has also been linked to the prevention of all sorts of cancers from prostate to lung. Setting this aside, it is vital to remember that drinking too much alcohol can have disastrous effects on your life and health, contributing to addiction, depression, mental health issues, fatty liver disease and more. While you can enjoy the odd glass of red—safe in the knowledge it may actually do your health some good—you should never drink to excess. • DEAR DOCTOR WITH DR CHRIS STEELE 61

06/08/2018 14:39


The Pros & Cons of

Detox Diets

‘Detox’ has been a major buzzword in the health and wellbeing industry in recent years, but what are detox diets, and how do they work?


s a result of celebrity endorsement, detox diets have developed quite a following. The basic premise of a detox is to rid the body of harmful toxins that appear in processed foods, alcohol, caffeine, sugar and fat. Detox supporters are celebrating

the method’s ability to help people lose weight, reduce cellulite, regain vitality, improve digestion and generally feel healthier. However, there is a flip side to the detox revolution—we explore the pros and cons of this fascinating fad. •


Beware Avoid extreme detox diets like those that involve drinking only liquids or cutting out food groups entirely. Intense fasting can pose a serious risk to your health


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Cons • They are surrounded by inconclusive evidence. At present, there is not enough conclusive medical evidence to support the claims that detoxing can aid weight loss or improve digestion. • They may interfere with natural processes. Humans have a number of natural bodily functions in place that already flush out bad toxins. The liver detoxifies chemicals in the body while the kidneys remove waste and regulate the balance of electrolytes— detox diets may interfere with this. • They can cause reduced energy. Low-calorie detoxes can often cause a lack of energy. Depriving the body of essential sustenance means that calories are burned quicker. • They can cause changes in mood. It isn’t uncommon for detoxers to report feeling ‘cranky’ or out of sorts in the midst of a cleanse cycle. This is caused by chemical imbalances, hunger and sudden changes in diet.

IMAGES © Unsplash (Brooke Lark)

• They are nutrient-focused. The foundation of most detox diets is to supply the body with more nutrients and cut down on foods with excessive fat, sugar and salt content. • They retrain your palate. Adapting your diet for short periods of time can retrain the palate and eliminate junk food cravings. • They can potentially cause weight loss. Many people report that detoxes have the potential to kick-start weight loss when paired with a healthy exercise routine—it isn’t clear whether these effects are long-term. • They can identify food sensitivities. Detoxes can be used to detect food intolerances. By reintroducing individual elements to your diet, you can ascertain what your problem foods are.

06/08/2018 12:16

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25/05/2018 09:47



The Facts Dear Doctor investigates the proper ties of salt and poses the question: how much is too much?


alt is a white crystalline powder containing sodium and chloride. Although it has many functions within the chemical industry, it is most commonly used within the food sector as a seasoning and preservative. Guidelines from the Food Standards Association (FSA) state that adults should consume no more than six grams of salt per day, which equates to 2.4 grams— or approximately one teaspoon. Unfortunately, the average adult in the UK consumes 8.1 grams per day, according to the NHS. Eating too much salt has been linked to elevated blood pressure, which can lead to wider health problems like coronary heart disease. High blood pressure (hypertension) can also put you at higher risk of suffering a stroke.


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can come as a surprise, however, are the high levels of salt lurking in other everyday items such as cereal and jarred sauces. In fact, the British Heart Foundation states that ‘around three quarters of the salt we eat has already been added to our food before we buy it’. An extra 10 percent of our daily intake derives from the salt we add to our meals for seasoning. The final 15 percent comes from foods in which it occurs naturally. Foods that are always high in salt include anchovies, bacon, cheese, olives, pickles, prawns, salami, smoked meats, soy sauce and stock cubes.



Salt and sodium shouldn’t be confused with one another. Some food labels may include the figures for both, while others may state the sodium content only. In order to discern the amount of salt from a sodium reading, multiply the amount by 2.5. For example, one gram of sodium per 100 grams is equal to 2.5 grams of salt per 100 grams. The World Health Organisation (WHO) recommends ‘a reduction in sodium intake to reduce blood pressure and risk of cardiovascular disease, stroke and coronary heart disease’.

Most people are aware of the high salt content in certain foods like crisps and dry-roasted nuts. What

When food shopping, always check the label of products before buying.

06/08/2018 11:22


Even seemingly healthy foods can contain high levels of salt. Look at the figure for salt per 100 grams. High traces of salt are more than 1.5 grams per 100 grams—these will be colour-coded in red. Medium traces of salt will include between 0.3 grams and 1.5 grams of salt per 100 grams— these will be colour-coded in amber. Low traces of salt will fall below 0.4 grams per 100 grams and these will be colour-coded in green. If you don’t feel confident interpreting food labels by yourself, try the Change4Life Food Scanner app. Simply scan the product’s bar code and it will display the amount of sugar, saturated fat and salt of the everyday item in a straightforward way.


It’s undeniable that salt can work to make a dish more flavourful, but having too much in our diet can pose a serious health risk. Instead of adding extra salt to each meal, try and improve the flavour with other seasonings like fresh herbs and spices. Garlic, paprika, parsley, sage and lemon all work well to transform the flavour of a dish. Making sauces and stocks from scratch is another great way to reduce your salt intake and track your daily allowance. Over time, your palate will become attuned to your low-salt lifestyle and you will crave less salty food and seasoning. •

Guidelines Age 0-6 months 7-12 months 1-3 years 4-6 years 7-10 years 11+ years

Target average salt intake (grams a day) <1 1 2 3 5 6

Did you know? As a nation, we consume 183,000,000kg of salt per year. This is equivalent to 240,000,000 standard 750g table salt containers or 18,000 double-decker buses Source: NHS Choices Salt Survival Guide


IMAGES © Shutterstock

The amount cardiovascular disease costs the UK economy per year Source: British Heart Foundation

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06/08/2018 11:22


Get Fit

Without Realising It

t’s a common misconception that running on a treadmill is the only effective form of exercise, but this couldn’t be further from the truth. Exercise is classed as any activity that elevates the heart rate and requires a degree of physical effort. Whilst improving stamina and heart function, regular exercise can also strengthen the lungs. Conventional forms of exercise—like jogging and weight lifting—come easy to some people.


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These, however, may be less compatible with others. We demonstrate the alternative methods for getting fit that will improve your health and wellbeing whilst inciting fun in the process.


Individuals in search of a low intensity exercise should consider learning a new craft such as carpentry, carving, sculpting or glassblowing. All these activities involve a moderate amount

of physical effort and are renowned for building arm and upper-body strength. Plus, physically creating something by hand can be extremely rewarding— especially when that involves the opportunity for artistic expression.


Perhaps you are in want of a distraction when you exercise? Spending too much time in an indoor gym may make your fitness routine seem repetitive.

IMAGES © Shutterstock


Working out needn’t be boring; there are many ways to keep fit and have fun while doing it

06/08/2018 11:24


Keep on track Follow our simple tips to keep you on track with your active regime.

Mix it up

Make small changes to your daily routine like opting to cycle or walk instead of using public transport to work. Socialise with energetic pastimes; for instance, arrange a stroll through the park instead of a sit-down coffee.

Buddy up

Encourage friends to begin a new activity with you. Having others there for support will increase your chances of sticking with it.


Take advantage of online deals and voucher websites; these allow you to sample new activities at a fraction of the price.

Rest time to play time

Holidays needn’t be unhealthy. Pick an active vacation filled with adrenaline-focused pursuits rather than a lazy beach holiday.

Gaining a new perspective can easily be accomplished with a change of pace and some inspiring scenery. Head into the wild and enjoy the spectacle of nature with a rural walk. Hiking guides can advise you on the best trails to follow and the degree of difficulty to suit your fitness level. Not only will you get your heart pumping, but you can also take in the wondrous sights that surround you.


Commencing a new hobby can be a daunting prospect for some people, especially if doing it alone. Instead, opt for a team sport that is heavily focused on group participation. Joining a group of likeminded peers is a fantastic way to make friends and stay motivated. There is nothing quite like the intense feeling of camaraderie felt between teammates who push each other to excel. Popular team games include badminton,

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basketball, football, rugby, lacrosse, netball and water polo.


Dance is a great form of exercise as it provides both aerobic and anaerobic movements. Aerobic actions include swaying, twirling and jumping, while anaerobic actions consist of squatting, balancing and lifting. Whether you practice jazz, interpretive, hip-hop or ballet dance, a single session will help you work up a sweat, offering a complete and effective workout. Learning a new dance routine is also perfect for helping you forget that you are even exercising.


If you prefer a professional to take the lead, book a specialist exercise class. Lessons range in difficulty and style and cater to a mixed crowd.

Traditional classes include spinning and circuits whilst more adventurous offerings include trampolining, pole dancing, mixed martial arts, fencing and trapezing. Instant feedback from an instructor is proven to be motivational, encouraging people to push themselves harder. Some establishments offer free trial sessions so that you can ascertain whether the class is right for you, too.


Contrary to popular belief, yoga and Pilates require a considerable amount of strength and determination. There is a huge emphasis on posture in both practices; some poses can take years to master. Not only do they work on flexibility and balance, but they also concentrate on core strengthening exercises and muscle toning. Additionally, regularly practicing yoga offers effective relief from stress. • DEAR DOCTOR WITH DR CHRIS STEELE 67

06/08/2018 11:25


Why Choose Yoga? The practice of yoga extends much further than simply stretching and breathing; learn how this ancient practice can benefit you


oga is an ancient hindu practice, a discipline that combines controlled breathing, simple meditation and the adoption of different bodily poses, otherwise known as ‘asanas’ in sanskrit. this exercise has steadily become a worldwide phenomenon, where individuals practice to improve their health and gain a sense of relaxation. But why should you choose yoga?

Improved flexIbIlIty

consistently practicing yoga can improve flexibility, increase range of motion and lengthen muscles. as the body gradually becomes accustomed to withstanding physical stress and becomes stronger, you may notice that you become less prone to injury. Yet, being naturally flexible is not a prerequisite for participating in yoga; there are different styles and levels to suit all abilities. iyengar yoga, for example, is a great alignment-based practice that can help people striving for better flexibility while ashtanga yoga develops physical strength.

StreSS reSponSe

AnxIety relIef

a multitude of studies and reviews indicate that yoga can help with anxiety and depression. Mindfulness techniques modulate a stress response system, which, in turn, reduces psychological arousal. this reduces the heart rate, lowers blood pressure and eases respiration. the meditation aspects of yoga have a similar effect to other self-soothing techniques like socialising with

IMAGES © Shutterstock

Many people turn to yoga to alleviate stress with sessions often focusing

on identifying key areas of pain and discomfort around the body. some reviews even claim it’s efficacious in reducing the impact of exaggerated stress responses. an interesting study conducted in 2008 by the University of Utah investigated yoga’s effect on natural stress responses. the study involved 12 people who were experienced in yoga, 14 people suffering from fibromyalgia—a condition characterised by a hypersensitivity to pain—and 16 healthy volunteers. the participants were subjected to varying levels of thumbnail pressure. the results revealed that the yoga practitioners had the highest pain threshold and the lowest pain-related brain activity.

68 dear doctor with dr chris steele

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06/08/2018 15:00


Popular poses

For flexibility: cow face pose

For stress relief: channel-cleaning breath pose

Sit with your legs crossed. Rest the arms gently on each knee with the hands facing upwards. Inhale gently through the nostrils whilst sitting in the position. Repeat five times, then return to regular breathing.

In the beginning

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Enter this seated pose by reaching one arm up and over the shoulder, bending the elbow so that it reaches down towards the spine. Reach the other arm underneath and up towards the spine. Connect the hands if possible. Legs are locked over one another with toes facing backwards—feel it stretch multiple areas of the body.

For hip flexors: lord of the dance pose

Stand straight on one foot and lift the opposite heel up towards the buttocks whilst bending the knee. Reach the arm opposite the bended knee back and hold the elevated ankle; reach the other hand out straight in front of you and balance.

friends or listening to music. Deep breathing exercises can help to calm anxious thoughts and regulate the stress hormone, cortisol.


Yoga may not be the first activity that springs to mind when it comes to weight loss, however, it is a valuable aid for strengthening core muscles and reducing body fat. Leigh Crews, media expert from the American College of Sport Medicine, believes that ‘choosing one of the vigorous, flowing styles of yoga such as Ashtanga, Vinyasa or Power Yoga is the smart choice. These classes traditionally last 90 minutes and most definitely have a cardiovascular benefit. You will burn calories, tone and stretch your muscles and provide weight-bearing exercise for your bones with these forms of yoga’. Yoga also has the potential to promote a healthier mental attitude, which can shape better eating

For abs: plank pose

Place hands flat on the floor directly beneath the shoulders and extend the arms. Lift the body using muscles in the legs and core so that the head is aligned with the feet and hold. The dolphin plank pose strengthens the core, arms and thighs; enter this variation by placing both hands and elbows on the floor before lifting.

habits. According to Beth A. Lewis, associate professor at the University of Minnesota School of Kinesiology, ‘many individuals eat more when they are feeling stressed and yoga can help combat stress, which can influence one’s energy intake’.


The health benefits of yoga extend much further than you may think. The practice is now being used to combat the side-effects of radiation treatment, as seen in a study by the University of Texas. Research found that yoga helped women undergoing radiation therapy reduce fatigue, improve mental outlook and regulate their cortisol levels. Another study published in 2014 by Ohio State University found that yoga aided women who had completed cancer treatment by reducing inflammation, increasing energy and improving mood. • DEAR DOCTOR WITH DR CHRIS STEELE 69

06/08/2018 15:00

You are in safe hands with HSF health plan

With HSF  health plan, your healthcare is in safe hands. We provide healthcare for you and your family. Take advantage of over 30 benefits including money back for treatment on: l

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HSF health plan is the trading company of the Registered Charity, The Hospital Saturday Fund a Registered Charity in the UK No 1123381 and in Ireland No 20104528. HSF health plan Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.

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01/08/2018 09:51


Understanding Private Health Insurance

5.1 million The approximate number of people with private health or medical insurance in the UK Source:

Approximately 11 percent of the population has private health insurance, but what does a ‘standard policy’ look like and how will you know if it’s right for you? NHS. All drugs will have been tested and approved by the National Institute for Health and Care Excellence (NICE). Long-term care Long-term care or recurring illnesses aren’t usually covered on private policies. Comprehensive policies may include psychiatric treatment, although this varies between insurers.

IMAGES © Shutterstock


ost UK residents are entitled to free healthcare on the NHS. Of course, the other option is to go private. Private health insurance pays for some or all of the medical bills if you are treated privately. It gives you a choice in the level of care that you receive, along with how and when you receive it. It is important to note, however, that private medical insurance doesn’t always provide coverage for everything. Dear Doctor guides you on what to expect from a standard health insurance policy.


The extent of your cover will depend on your provider and the plan you sign up for, although there are certain elements that are included in most policies.

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Inpatient treatment Most policies cover inpatient treatments. These may involve a stay overnight in a hospital bed, testing or surgery. Outpatient treatment Outpatient treatments may also be included, covering things such as doctor consultations and diagnosis tests. Cheaper policies cover fewer types of outpatient treatments. Hospital accommodation & nursing care A stay in hospital and limited nursing care are usually covered in a standard policy. Exclusive drugs Some policies allow patients access to drugs that are not available on the

Extras Some health insurance policies will offer extras such as complementary therapies, home nursing, a 24-hour helpline and a private ambulance. A comprehensive policy is far more likely to offer these bonuses.


While it is true that some private healthcare insurance plans can be pricey, not all insurance providers charge high premiums. For those looking for cheaper alternatives, research smaller, independent insurance providers for health plans better suited to your financial situation. Which? advises that those seeking cheaper private healthcare insurance can also reduce their costs by cutting out unnecessary elements of an insurance plan. These may include reducing extensive hospital choice lists or removing outpatient cover. Some health insurance providers offer discounts and rewards at point of renewal if you stay fit and healthy, too. • DEAR DOCTOR WITH DR CHRIS STEELE 71

06/08/2018 11:29


Benenden Health

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You may not have heard of Benenden Health before. We’ve been described as the health industry’s best kept secret. But that’s set to change. We’ve been around for 110 years longer than the NHS. Originally available for those who work in the public sector, now anyone can benefit from our affordable alternative to health insurance, for just £10.25 a month. We help our 800,000 members avoid the worry and complications that waiting for medical assistance on the NHS can often bring by providing them with speedy access to medical experts. In 2017, we offered services 78,733 times to our members, some with lifechanging results.

how we can helP:

Often, all we need is a bit of reassurance from a qualified professional, but appointments are not readily available and waiting times can be too long. From day one: • Our 24/7 GP and Psychological Wellbeing helplines are invaluable to our members. Members of your immediate family can talk to a qualified practitioner.

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You can even call us when you’re abroad! Typically, an online or telephone consultation with a private GP costs £20 for 10 minutes or £40 for 20 minutes†. Benenden Health members can use our GP 24/7 Advice and Psychological Wellbeing helplines as often as they need to, from day one of membership. • Our GPs can also prescribe some medications over the telephone. These are private prescriptions so separate charges apply. After six months of membership*: • You can ask for diagnosis if your wait on the NHS is over three weeks. • We can also help with over 250 types of treatment and surgery, should you face a wait on the NHS longer than five weeks. • Supported by a nationwide network of physiotherapists, you can benefit from on-going telephone support as well as face-to-face sessions.

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As a not-for-profit mutual society, we exist solely for the benefit of our 800,000-strong membership. What’s more we’ve been highly commended by Moneywise – Customer Service Awards 2018 (Most Trusted Health Insurance Provider).

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Our members can use the ‘outstanding’ rated Benenden Hospital in Kent^. We also work with a UK-wide network of hospitals and clinics:

 700 physiotherapy clinics  500 facilities for diagnosis  26 hospitals for surgery *Limits and exclusions apply †Push Doctor, September 2017 ^ In 2017, Benenden Hospital received the highest rating of ‘Outstanding’ from the Care Quality Commission (CQC) which is the independent regulator of health and social care in England.

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£10.25 per person, per month

When you’re ill, you don’t want to wait Especially when you don’t know what’s wrong with you, but for many of us costly private health insurance just isn’t an option. Benenden Health is not insurance. Through membership we complement the

0800 414 8296* quote DEARDR deardr

NHS by offering speedier access to private healthcare when there’s a wait. We provide a 24/7 GP helpline from day one and after six months of membership access to private diagnosis, treatment, surgery and physiotherapy°. All of our 800,000 members pay the same monthly fee of £10.25. Everyone is accepted with no medical questionnaires necessary and no exclusions for pre-existing medical conditions at the point of joining. °

Minimum wait times, medical procedure and condition limits apply.

£10 M&S for you and anyone added to your membership when you quote DEARDR at the point of join.†

* Please note that your call may be recorded for our mutual security and also for training and quality purposes. Lines are open 8am – 5pm, Monday to Friday (except Bank Holidays). Benenden Health is a trading name of The Benenden Healthcare Society Limited. † £10 M&S gift card when you join and a further £10 M&S gift card for every family member or friend added to your membership at the point of join. You must, quote DEARDR at the point of joining. To qualify for the incentive, applications must be received before 31st October and all new members must remain with Benenden Health at the point gift cards are sent. Gift cards will be sent via post within 52 days of the new member joining. Gift cards offer applies to people included in this promotional mailing. Offer subject to availability. No alternative to this promotion will be offered. The Benenden Healthcare Society Limited is an incorporated Friendly Society, registered under the Friendly Societies Act 1992, registered number 480F. The Society’s contractual business (the provision of tuberculosis benefit) is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority, FRN 205351. Verify our registration at The remainder of the Society’s business is undertaken on a discretionary basis. No personal recommendation has been given on the suitability of this product, if in doubt you should seek independent advice. Registered Office: The Benenden Healthcare Society Limited, Holgate Park Drive, York, YO26 4GG. Data Protection: At Benenden Health, we look after your details carefully. We adhere to the requirements of the UK Data Protection Act 2018 and are registered on the public register of data controllers which is looked after by the Information Commissioner’s Office. We are keen to keep you informed about how we use your information and have a ‘Privacy Notice’ which makes clear, in one place, what these uses are. Our Privacy Notice is available at Changes to the Privacy Notice are made occasionally, so please revisit our website and read it through again from time to time. A printed copy is also available on request.

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26/07/2018 14:20


Hydrate Yourself Shocking figures by the Royal National Lifeboat Institution suggest that 89 percent of Britain’s population are not drinking enough water to maintain healthy hydration levels


drink the equivalent of eight glasses of water per day. They suggest that 70-80 percent of daily water intake come from fluids and the remaining come from foods with a high water content like cucumbers, lettuce, watermelon, strawberries and oranges.


Water is expelled from the body in a multitude of ways including simply breathing, sweating, vomiting and through digestion. There are several tell-tale signs that indicate we might be dehydrated. These include having a dry, sticky mouth, constipation, feelings of dizziness, fatigue and lack of energy, muscle fatigue, headaches and feeling thirsty. Perhaps the most prominent sign of dehydration can be found in the colour of urine: if a person is dehydrated, their urine will appear dark yellow or brown in colour. Young children and the elderly are at a greater risk of dehydration, though anyone may become dehydrated in dry, hot conditions. According to the NHS, people are also at a higher risk of dehydration if they have diabetes, drink too much alcohol or have been taking diuretic medicines that work to increase the passing of urine. •

When to call 999 Call 999 or go to A&E if you have these signs of severe dehydration: • You feel disoriented or dizzy • Have not passed urine for 8 hours • Seizures • Feeling unusually tired

IMAGES © Shutterstock

ater accounts for approximately 60 percent of an adult’s body weight and around 75 percent of a child’s. It is unsurprising, then, that keeping hydrated is vital for all aspects of human health. Water regulates body temperature, lubricates the joints, protects the organs and tissues within the body, and carries vital nutrients and oxygen to the cells. This simple beverage is also key in aiding healthy digestion, helping to break down foods and dissolve vital minerals and nutrients for the body to absorb easily. Moreover, water aids the liver and kidneys in excreting bodily wastes through sweating, urination and faeces. Interestingly, the human brain is made up of a huge 73 percent of water, so proper hydration is key to healthy cognitive functioning (like the ability to learn and retain memories). According to Psychology Today, dehydration may even impact short-term memory functioning and the recall of long-term memories. The European Food Safety Authority recommends that men consume the equivalent of at least 10 glasses of water per day, while women should

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06/08/2018 14:43


Breathe Easy Unless addressed, indoor air pollution may increase the risk of major illnesses and—in some cases—premature death



While it is virtually impossible to eradicate all air pollution in the home, there are various measures people can 76 DEAR DOCTOR WITH DR CHRIS STEELE

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Air For Life take to reduce it to a healthier, more sustainable level. Invest in an air purifier Air purifiers work to remove contaminants from air in the home including cigarette smoke, pollen, mould spores and dust. Stop smoking Smoking in the home (or allowing others to smoke in your home) could exacerbate symptoms in asthma sufferers, increase the risk of cardiovascular diseases and increase the likelihood of sudden infant death syndrome (SIDS) occurring. Go natural Some household cleaning products have harsh chemicals that emit fumes into the air. Swap these for more natural products with less chemicals. Clean regularly Vacuum and wipe surfaces regularly to avoid dust and pollutant buildup. ∞

Air For Life Technology started with NASA in 1994. A revolutionary ionizing technology called PCO (Photocatalytic Oxidation) was developed in order to extend the life of fruits and vegetables in the space shuttle. Air For Life AHPCO®, developed by Prof. N. Ghosh, produces millions of human-friendly negative ions, more than any other purifier or ioniser on the market today. These ions destroy on contact impurities in the air such as dust, pollen, pet dander, VOC’s (volatile organic compunds), bacteria (including MRSA) and viruses such as H1N1). Leaving 99.9% clean, fresh, safe air and surfaces. Most purifiers contain filters such as HEPA filters that cannot trap small bacteria and viruses. Air For Life Sanifiers® contain NO FILTERS and can kill the disease causing bacteria and viruses that pass through filters. IMAGES © Shutterstock

n eye-opening 2016 report by the Royal College of Physicians and the Royal College of Paediatrics and Child Health found that both outdoor and indoor air pollution causes at least 40,000 deaths a year in the UK. This report might come as a shock to those who initially recognise air pollution as existing in the outside world only, caused by everything from car exhaust fumes to industrial pollutants. Perhaps even more concerning, is that 92 percent of the world’s population lives in areas where air quality levels exceed the current limits set by the World Health Organisation (WHO). For this reason, according to WHO, air pollution poses the single biggest environmental health risk to individuals today. Air pollution— both inside and outside the home—is implicated in some serious health concerns including respiratory diseases, cancer, heart disease and stroke, ultimately killing about one in eight people each year. Simply put, air pollution occurs as a result of excessive levels of toxic chemicals or compounds being introduced to the air. Seemingly unsuspicious household items and furnishings like gas stoves, heaters, new furniture and everyday cleaning products emit potentially dangerous chemicals into the environment. Beyond this, dust, mould and smoking indoors can also seriously damage health, with young babies, children and seniors most susceptible to the effects of air pollution.

For more information visit and for the latest updates follow us on Facebook, Instagram and Twitter @airforlifesaver.

06/08/2018 16:28


Brain Health & Nutrition

IMAGES © Shutterstock


Healthy food isn’t just good for the body, it’s great for the mind, too—we uncover the link between nutrition and brain health

hese days, increasing numbers of healthcare professionals are asking about their patients’ diets. traditionally, they did not draw the link between nutrition and brain health, but new studies suggest diet may shape cognitive performance and help combat degenerative diseases of the brain. research published in Journal of alzheimer’s disease indicates panax ginseng is clinically effective in the cognitive performance of alzheimer’s patients. a very large body of evidence now suggests diet is just as important to brain health as it is to physical health. this emerging research reveals what we eat may affect our mental performance and mood. in turn, the way we shape our diets could improve

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our brain health and allow for better concentration, mental performance and clearer thinking.

A growing ideA

Until recently, the idea of brain nutrition was barely credible in the healthcare world. aside from a few studies examining how omega 3 fatty acids may balance mood, research on the topic was thin on the ground. But new investigations show certain natural ingredients, such as antioxidants, B vitamins, acetyl l-carnitine (alcar) and zinc can support memory and improve cognitive function and mental agility. according to award-winning nutritional therapist, author and broadcaster christine Bailey, ‘[this] range of vitamins,

minerals and other nutrients [is] known to help with focus and concentration and with energizing our body and our brain.’

green teA goodness

our brains only use around 20 percent of the oxygen contained within our bodies, making us highly susceptible to free radical damage. But according to Parkinson’s UK, antioxidants (like those found in green tea) can negate this adverse impact and protect the brain from ageing. Further research showed that eGcG, the principal bioactive component found in green tea, induces reduction in the accumulation of amyloid beta (aβ)—the main components crucially involved in alzheimer’s disease syndrome. however, unless we consume

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06/08/2018 14:41


Have brain fog? BrainZyme can help!

BrainZyme®, the UK’s first Nutritional Cognitive Enhancer (NCE), is a brain food supplement with scientifically proven and naturally-sourced ingredients. These capsules start to work quickly, in under one hour, and can help support memory and your ability to think clearer, boosting concentration and providing nutritional energy for your brain and body. Top British nutritional scientist Dr Laura Wyness says: ‘Many of the vitamins and minerals included [in BrainZyme] are helpful in providing short-term support for areas where there might be shortfalls in nutrients related to areas such as cognitive function, mental performance, psychological function and energy-yielding metabolism; helping to release energy from the foods we eat and reducing tiredness and fatigue.’ BrainZyme is available from Weldricks Pharmacies or from


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large quantities of fresh fruits and vegetables or green tea each day, we are unlikely to get enough of the antioxidants we need to prevent premature ageing of the brain. An investigation from the British Medical Bulletin states antioxidants via concentrated supplements could be a viable option. Consuming supplements with matcha green tea—which has higher levels of EGCG compared to normal green tea—could also help boost brainpower and slow down degenerative brain diseases.


Found in asparagus, alcar is a mitochondrial energy optimiser, supporting energy production at the cellular level. Alcar is a powerful antioxidant that protects brain cells and neurons. Categorised as a nutraceutical, alcar is believed to be a potent brainbooster, improving clarity of thought, focus, mood and memory. Researchers at the University of York found positive results in clinical trials using alcar to help people with Alzheimer’s disease. Their results reported alcar improved mild cognitive impairment or prevented deterioration.


The phenomenon known as ‘brain fog’, whose symptoms include

confusion, forgetfulness and lack of focus and mental clarity, could be caused from a vitamin B12 deficiency. Three B vitamins—folic acid (B9), B6 and B12—when taken together can help strengthen brainpower. Trials are currently underway which could solidify the theory that a lack of these vitamins may be linked to dementia and Alzheimer’s disease. A 2013 randomized trial, published in PLOS ONE, concluded that the accelerated rate of brain atrophy in elderly people with mild cognitive impairment could be slowed by treatment with B vitamins. According to the study, 16 percent of those over 70 suffer from mild cognitive impairment and half of these develop Alzheimer’s disease.


The health properties of zinc are well-known. But aside from improving skin conditions and healing wounds, scientists now believe zinc may play an important part in memory formation and cognitive stability. Zinc advances communication between the neurons and hippocampus—a major component of the brain—and may also prevent cognitive decline in those over 50. Another study, published in the British Journal of Nutrition, found significant benefits of both 15 and 20 milligrams of zinc on cognitive function in healthy middle-aged men and older adults. •

06/08/2018 12:23

BrainZyme can help: Scientifically Proven to Support Concentration, Mental Performance & Energy* Supports your Brain Health with Enhanced Brain Nutrition Supports Your Memory** Works Within An Hour Vegan, Gelatin-Free & Carb/Sugar/Cruelty-Free What's inside BrainZyme capsules that makes them so good? It’s a combination of high-quality natural-sourced ingredients with a scientific formulation - featuring research from leading neuro-cognitive and nutrition experts including the 18 member panel at EFSA.

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Healthy Smile, Healthy You According to Bupa, up to nine in ever y 10 people have some degree of gum disease in the UK—tackle the problem with a healthy at-home routine


PERIODONTAL CONDITIONS Periodontal conditions are disorders that affect the supporting structures of the teeth. They are usually catalysed by poor oral hygiene and can lead to pain, discomfort and reduced function in the affected area. Gum disease Gum disease is a very common condition where gums become swollen, sore or infected. There are three main types of gum disease; these are gingivitis, 80 DEAR DOCTOR WITH DR CHRIS STEELE

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periodontitis and acute necrotising ulcerative gingivitis (ANUG). Gingivitis Gingivitis is the least serious form of gum disease; it is usually caused by a buildup of plaque. The condition is characterised by inflammation of the gums and signs of bleeding when brushing. If you remove plaque and treat gums properly, gingivitis will usually remedy itself. Periodontitis If gingivitis goes unacknowledged, the inflammation can spread to the

ligaments or bones that hold teeth in place—this is called periodontitis. In this case, the disease will cause the gums to recede, leading to infection, abscesses and tooth loss. ANUG ANUG is a serious form of gum disease that has a tendency to develop very suddenly. It causes swelling, painful ulcers, bad breath, difficulty swallowing, general feelings of illness and a metallic taste in the mouth. This condition requires immediate treatment from a dentist. •

IMAGES © Shutterstock

ever underestimate the importance of a healthy smile. Our teeth fulfil a multitude of functions: they help us chew and digest food, talk and pronounce words clearly and even provide our face with its shape. It is therefore rational that we do everything in our power to care for our teeth and gums. Keeping your mouth clean and healthy is relatively straightforward; sticking to a simple routine will prevent most dental problems. Try the following: • Brush twice a day with a fluoride toothpaste. • Avoid rinsing after brushing—this washes away integral fluoride from teeth. • Clean between teeth once a day using interdental brushes or floss. • Uphold good eating habits like consuming less sugary food and drink. • Schedule regular check-ups with your dentist.

06/08/2018 11:30

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Essential Male

Health Screenings According to the Office for National Statistics, males accounted for 60 percent of all avoidable deaths in 2016. Track your health with our guide on essential check-ups for men


national online survey in 2011 by Men’s Health Network (MHN) and Abbott Laboratories revealed that most men ignore symptoms of treatable health conditions. Apparently, men often wait six months to a year to visit their doctor after experiencing common disease symptoms. Peter Baker, chief executive of Men’s Health Forum believes this is because ‘men are less aware of their symptoms than women and are more reluctant to seek help […] which means their symptoms are more advanced and harder to treat’. In light of this, Dear Doctor lists the essential health checks for men—detailing when and why they are required.



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Hearing test Hearing exams usually involve wearing headphones that are connected to an audiometer. Patients are required to signal when they hear different sounds that are played to them on various frequencies. The audiologist may also check for fluid behind the eardrum as part of the test. After birth, there are very few routine hearing checks. From 18 years old, book yourself a test every five years until 45—after that, book one every three years.

HEART HEALTH Blood pressure test A blood pressure test involves attaching a cuff to the upper arm. The cuff is inflated, restricting the blood flow, and is gradually released. The NHS says that healthy adults over 40 should have their blood pressure checked every five years. If you are at risk of hypertension (high blood pressure), your tests should be scheduled once a year.

IMAGES © Shutterstock; 123RF

Glaucoma test This exam checks the fluid pressure of the eyes; there are two ways of testing this, either via tonometer or non-contact tonometer. The former involves numbing the eyes with medicated drops and using a specialised tool to read the pressure. The latter involves a small machine that emits a puff of air into each eye. How much the eyes resist indicates the pressure reading. If you are 40 years or older you should arrange eye check-ups every one or two years.

06/08/2018 11:31


Men are less aware of their symptoms than women and are more reluctant to seek help — Peter Baker, chief executive of Men’s Health Forum Cholesterol test A complete cholesterol test, also called a lipid panel, involves taking a sample of blood—usually in the morning and occasionally after fasting the night before. If your cholesterol levels are outside the normal range, you may be at high risk of heart disease, stroke and atherosclerosis. From 20 years old, this test should be taken every five years.

DIABETES Blood glucose test This test involves taking a small sample of blood: usually a small prick to the finger. The test measures the amount of glucose that lies within the blood, indicating whether you suffer from diabetes. Diabetes is a lifelong affliction, identifying it early will help guide treatment and future lifestyle choices. Individuals aged between 40 and 70 or those that are overweight or suffer from high blood pressure should arrange this checkup frequently.

PROSTATE HEALTH Digital rectal exam (DRE) A DRE can seem embarrassing but the test itself is quick and pain-free. The examination involves a medical practitioner feeling the prostate

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through the wall of the back passage (rectum). The test is used to detect problems of the prostate such as prostate cancer. A DRE is administered if the following are reported: constipation, incontinence and bleeding or pain in the bottom. Men over the age of 50 are urged to schedule this test every five to 10 years.

SEXUAL HEALTH Chlamydia and gonorrhoea, two of the most common sexually transmitted diseases, can be detected via a urine sample. Collecting samples via a cotton swab is another common method. The frequency of this checkup should depend on your sexual activity. If you don’t have a regular partner but do have casual sex, get checked every six months. Schedule a sexual health check each time you start a new relationship.

HIV TEST HIV testing usually involves a blood test or point of care test. The first involves taking blood from a vein; results are then sent off to a laboratory. The latter involves collecting a saliva sample or a spot of blood being taken from the finger. In this case, the results are produced within minutes. The NHS encourages

certain groups to have HIV tests once a year; these include: men who have intercourse with men and men of black African descent. If having unprotected sex, HIV tests should be more frequent. •

Mind power A 2016 survey conducted by Men’s Health Forum found that the majority of men would take time off work for a worrying physical symptom, but only 1 in 5 would do the same over concerns for their mental health. Suicide is a leading cause of death in men under 50, which has prompted various male public figures to speak out on the topic. Stephen Fry, Prince Harry and Zayn Malik have all publicly shared their experiences and battles with mental illness. Such acts are gradually working to quash the stigmas that surround the topic, but there’s still a way to go. If you feel as though you are suffering from mental illness, speak to your doctor or find a local support group. Specialised charities can also provide useful advice and encouragement—try Safeline, Mental Health UK or Mind.


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Is Stress Making You Ill? A large body of research has indicated that high levels of stress induce illness, but how does this happen and what lifestyle changes can be made to promote mental and physical wellbeing?



of people in the UK reported that they ate too much or unhealthily due to feelings of stress Source: Mental Health Foundation 2018 Study*

available 24 hours a day may actually be contributing to the rising levels of stress seen throughout the nation’s workforce in recent years. stress is a physical response that occurs when the body feels threatened or under attack. when this happens, the body’s fight or flight response is resurrected and the brain releases various stress hormones including adrenaline, cortisol and norepinephrine. small doses of these hormones can be beneficial in terms of problem-

IMAGES © Shutterstock; (*out of 4,619 respondents)

ost of us are familiar with the daily rat-race of modern life and the ‘work, eat, sleep, repeat’ narrative that wholly encapsulates the UK’s current work and social climate. while technologies have advanced in leaps and bounds in the last decade, leading to better healthcare and communication, the flip side of it means that no one ever truly ‘switches off’. the ability to scan through work emails at home and be virtually

86 dear doctor with dr chris steele

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solving and safety, but when high stress levels remain in the body for prolonged periods of time, they can actually suppress the immune system. Physical manifestations of stress include mood swings, headaches, lethargy and fatigue, a rapid heartbeat, chest pain and cold sweats. stress may also be a prominent contributing factor in an increase in colds and infections and a loss of libido. the most recent labour Force survey conducted by the government shows a steady rise in work-related stress and anxiety from 2014 through to 2017, which is particularly concerning. Personal wellbeing aside, work-related stress actually presents a huge cost to the British economy—a staggering 12.5 million working days were lost due to work-related stress, depression or anxiety in the year 2016/17. so, can stress make a person physically ill? the answer among the scientific community is a resounding ‘yes’. in a comment about the nature of stress in the workplace, the labour Force survey said, ‘longitudinal studies and systematic reviews have indicated that stress at work is driven largely by psychosocial factors and is associated with common conditions such as heart disease and anxiety and depression and may play a role in some forms of musculoskeletal disorders.’


the workplace isn’t the only circumstance in which this potentially harmful emotion rears its ugly head. causes of stress occur for a whole host of reasons including family relationships and friendships, education, employment, housing and money. leading mental wellbeing charity, the Mental health Foundation, released statistics in their 2018 Mental health Foundation survey earlier this year which analysed responses from over 4,000 participants—the largest-known mental wellbeing survey of its kind. they found that the causes of stress are varied and dependent on both age and personal circumstances. almost a quarter of those who reported feeling stressed during the past year cited debt as the primary cause. a large 49 percent of participants felt that comparing themselves to others contributed to high levels of stress. Perhaps unsurprisingly, 36 percent of women in that category felt that this was related to their appearance. the survey also found that 60 percent of 18 to 24-yearolds have higher stress levels as a result of feeling pressure to succeed professionally, compared to just 17 percent of 45 to 54-year-olds and six percent of the over 55s.

Eco-thErapy So-called ‘eco-therapy’ refers to spending time in the outdoors and around nature. Numerous studies have indicated the beneficial and restorative potential of walking or exercising outside as a natural way to induce calm for those who suffer with stress, anxiety and even depression

Clever guts

ample research has been carried out to determine the relationship between the brain and the gut, and while there is much yet to be discovered, scientists have found that the two are intrinsically linked. according to harvard health Publishing, ‘a person’s stomach or intestinal distress can be the cause or the product of anxiety, stress or depression.’ this interesting discovery shows that stress can cause physical pain in the stomach like cramps and bloating and contribute to disrupted bowel movements. to help reduce feelings of stress and anxiety, experts increasingly agree that a healthy gut microbiome is key. enrich your diet with gut-friendly foods including kefir, live yoghurts and fermented foods like sauerkraut to promote the growth of healthy and beneficial gut flora.

log off

a cornerstone 2010 study by the institute of Psychological sciences at the University of leeds found a close relationship between internet use and depression. the aptly named ‘digital detox’ refers to refraining from using a mobile device for a period of time. the benefits of this include improved sleep and concentration and reduced feelings of stress and anxiety. a digital detox can be whatever suits you best: delete or deactivate social media apps including Facebook and twitter for a month, or leave your phone at home completely while on holiday. •

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The Significance of


According to The Sleep Council, the average person spends about a third of their life asleep—but not everyone enjoys a regular night’s rest, and this can damage their overall health and wellbeing


leep deprivation is more common than you think. Poor sleep not only impacts your productivity; it also has a detrimental impact on your general health. The NHS Choices website states that one in three of us suffers from poor sleep, making this a widespread problem. Regular sleep disruption puts you at risk of serious health conditions such as obesity, heart disease and diabetes—and it shortens your life expectancy. It’s now clear, says NHS Choices, that a solid night’s sleep is essential for a long and healthy life. For this reason, it is vital to know how to get the best night’s sleep possible.


To tackle a problem, first of all, you have to know what is causing it. Poor sleep can be attributed to a host of things, with stress, computers and taking work home often blamed. A variety of factors can cause restless nights including health conditions such as sleep apnoea—or blocked breathing— and clinical insomnia. In most cases, it’s down to bad sleeping habits.

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According to The Sleep Council, teenagers from 12-18 need eight to nine hours; adults aged 18-65 should get between seven and nine hours and, lastly, older people aged 65 and over need between seven and eight hours of sleep per day.

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HOW ADJUSTABLE BEDS CAN HELP YOU WITH SLEEP Posture If you sleep on your side, a slightly raised backrest and legrest will perfectly align your body for a good night’s sleep.


A good night’s sleep can have the following positive benefits on your overall health: • Boosts immunity. • Encourages weight loss. • Boosts mental wellbeing. • Prevents diabetes. • Increases sex drive. • Wards off heart disease. • Increases fertility.

While the occasional sleepless night will make you feel tired and irritable, it won’t harm your long-term health. However, after several nights without sleep, the mental effects start to become more serious and prolonged periods of poor sleep can cause serious physical health problems. •

Breathing For back sleepers, a slightly raised backrest on a five-section adjustable bed will tilt your head forward which opens your airways to facilitate healthy breathing and reduce snoring. Circulation An adjusted mattress position encourages blood flow and circulation, preventing the buildup of pressure on the skin. Raising the legrest also drains fluid from the feet, a necessity for some medical conditions. Comfort Orthopaedic beds provide comfort, not just when sleeping, but also throughout the day. The backrest allows you to sit upright in bed to ease the likes of reading and eating. The legrest can also be raised to take the pressure off achy legs. Provided by Alpine HC


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Selecting the

Perfect Duvet

Selecting the ultimate seasonal duvet that is suitable for your needs is vital for a restful slumber


he importance of a quality duvet should never be underestimated—but how do you know which is suitable for you? we demystify the task of buying a duvet with our guidance on the basics.

Tog raTings

tog ratings are based on a duvet’s ability to trap in warm air; as a rule of thumb the higher the tog rating, the warmer the duvet. For a summer duvet, look for anything between 2.5 and 4.5 tog. For winter, a tog rating between 10.5 and 14 is most appropriate. For temperate seasons like autumn and spring, a seven to 10 tog rating is ideal. Buying multiple duvets may not be a viable option for some, in which case all-season duvets are a great choice—these consist of two separate duvets that are connected, one lightweight and one regular.

Filling maTerials

there are two types of duvet stuffing: natural and synthetic. choose one that will suit your needs and provide you with the highest level of comfort.

Synthetic synthetic duvets are often hypoallergenic, making them a logical choice for those with allergies to feathers, down or dust mites. synthetic duvets are also easier to wash than their natural counterparts. the two main synthetic fillings are 90 dear doctor with dr chris steele

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How often should you change your duvet? The Sleep Council recommends that duvets should be replaced after 5 years or so; however, this is dependent on the product you buy. Inexpensive hollowfibre duvets may need replacing every 2 years hollowfibre and microfibre. the fibres in hollowfibre duvets trap in warmth; these tend to be thicker and more wire-like in texture. hollowfibre duvets are usually coated with an antiallergy treatment. Microfibre duvets include very fine fibres, giving them a more luxurious feel. these tend to be more lightweight than feather-filled types. synthetic duvets are, however, somewhat less durable than natural options. •

IMAGES © Shutterstock

Natural Natural duvets are usually more soft and breathable than synthetic materials. they tend to be filled with feathers or down, which is the fluffy feathers from the breast area of the bird. down is lightweight and offers the best level of warmth; canadian and hungarian down are both popular choices. other natural options include silk and wool: both are durable and hypoallergenic. wool duvets are extremely effective at regulating body temperature. wool fibres wick heat and moisture away from the body. Natural duvets may come with a hefty price tag but are long-lasting and high quality.

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Making Sense of


he UK’s supplement market is worth nearly three quarters of a billion pounds. In recent years, there has been a massive boom in supplement availability and use. Products that were once the preserve of specialist health stores have become readily accessible in large supermarket chains and on the internet—as availability has grown, inevitably, so have sales. But most people don’t need to take vitamin supplements; they get all the vitamins and minerals they need from a healthy and balanced diet. In fact, many people take supplements unnecessarily, which could be harming their health. The Department of Health (DoH) does, however, advise supplement use in a few important cases: growing children between six months and five years old should take vitamins A, C and D. Supplement use is also recommended for those with certain deficiencies, which could be caused by a number of factors. For example, very strict vegetarians or vegans may need supplementary B12, while pregnant or breastfeeding women should take folic acid and vitamin D. Still, the huge range of dietary supplements on offer makes the area something of a minefield for consumers. Dear Doctor provides a breakdown on what you need to know.

Did you know? Fish oil supplements are big business. They are the best-selling product in the UK’s supplement market, with sales worth just over £139m in 2009—a rise of almost 40% since 2004

But women trying to conceive and pregnant women up to 12 weeks should take a 400 microgram folic acid supplement each day. Folic acid can help reduce the risk of neural spine defects such as spina bifida. The DoH also advises pregnant women to take vitamin D supplements and avoid anything containing vitamin A (retinol), as this can harm developing babies. Pregnancy supplements may be bought from pharmacies and supermarkets or prescribed by a doctor. You may be eligible for free vitamins through the Healthy Start Scheme. The NHS advises individuals should also eat foods that contain folate— the natural form of folic acid—such as leafy green vegetables. Pregnant women should also consider taking 10 micrograms of vitamin D. For more information, visit the NHS website.

IMAGES © Shutterstock


With the abundance of supplements on the market, it’s hard to know which ones to take—besides, does adding them to our diet really do us any good?


On the whole, eating a healthy, varied diet will give you all the nutrients and vitamins you need during pregnancy.


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Vitamins for children

Growing children—in particular those who don’t eat a varied diet—sometimes don’t get enough vitamins a and c. it’s also hard to get enough vitamin d through diet alone. the doh recommends that all children aged six months to five years are given vitamins a, c and d every day. Breastfed babies should be given a daily vitamin d supplement from birth, but those on infant formulas should not be given additional supplements, as formulas tend to be fortified with various nutrients. having too much of some vitamins can be harmful; stick to the dose recommended on the label.

Vitamin d

Vitamin d is essential in regulating the body’s levels of calcium and phosphate—key nutrients that keep bones, teeth and muscles healthy. a lack of vitamin d can lead to bone deformities such as rickets in children and bone pain in adults.

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Most people can get enough vitamin d in the UK between the months of late March/early april until the end of september, as the body creates it from direct sunlight on the skin. everyone— including breastfeeding and pregnant women—should consider taking a daily supplement containing 10 micrograms of vitamin d during the autumn and winter months.

fish oils

Fish oil supplements are high in omega 3 fatty acids, which are vital in maintaining good health. omega 3 fats are essential fatty acids, meaning the body can’t make them and they must be obtained from diet or external sources. Fish oils are particularly recommended for adults; several studies have found a correlation between omega 3 and healthier cholesterol levels, a lower risk of dementia and reduced vascular risk. however, pregnant women should

be careful with fish oil supplements, especially cod liver oil, as it contains vitamin a, which can harm unborn babies. if you are unsure, always speak to your doctor before taking these supplements. •

All-nAturAl supplements There is a wealth of natural, herbal and organic supplements available— like Echinacea to improve colds, flax seeds to lower cholesterol and ginkgo to improve memory—which boast a range of benefits. However, herbal supplements are not generally subjected to the same scientific scrutiny as their mainstream counterparts. For this reason, always be wary before taking them and consult your doctor if you are unsure

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Healthcare A stretched NHS and long waiting times for appointments are pushing people to seek health advice through digital apps

myCOPD Currently the only NHS-approved app—which has been demonstrated to improve clinical outcomes— myCOPD is designed to help people with chronic obstructive pulmonary disease better manage their condition. Through the app, users will be able to perfect their inhaler technique, improve their breathing, reduce episodes and exacerbations and track their medicines. According to the NHS, the app alone is responsible for 94 DEAR DOCTOR WITH DR CHRIS STEELE

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correcting 98 percent of inhaler errors without any other type of clinical intervention. It can also allow clinicians to check in with their patients remotely.

COVE Currently being tested by the health service, this app is centred around the relationship between music and emotions. Users are able to create music to capture their mood and express their feelings—these recordings can then be saved or sent to others. The app is designed for those who struggle to put their emotions into words.

CHILL PANDA Focused on improving mental health and wellbeing, this app is also currently being tested by the NHS. Geared towards teaching relaxation methods, the technology within this app allows users to record their heart rate and receive suggestions on tasks and playful activities—such as breathing and light exercises—to promote a peaceful state of mind.

Did you know? Some Clinical Commissioning Groups (CCGs) around the UK have developed their very own apps. Through these apps, patients may be able to book doctor appointments, order prescriptions, view their medical records and get self-help advice. Visit the NHS website to check if your local area is covered

UP YOUR EXERCISE GAME There are countless apps on the market focused on exercise and physical activity. Even though government guidelines state individuals must complete at least 150 minutes of exercise a week, some still struggle to find the time—or inspiration—to hit that target. Apps like iPrescribe Exercise create a 12week exercise plan based on personal information while the Active 10 app will help users get into the habit of walking for 10 minutes a day. •

IMAGES © Shutterstock


n addition to making healthcare more accessible to the general public, mobile apps have made it easier for patients to manage their own health and wellbeing and for staff to monitor care coordination. An evolving NHS, the widespread use of technology as well as a need to lower costs are all factors driving up the use of this specialised technology. But which apps are safe to use and tested by professionals in the medical field?

06/08/2018 11:36

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Coping with Menopause The menopause is a natural change in a woman’s life; for many, it is a period of vast adjustment. Luckily, treatments and strategies exist to help you cope


ince Bank of England’s deputy governor recently described the UK economy as ‘menopausal’ in May 2018, there has been a public outcry from women across the nation. While an apology was offered in its wake, the comment raised an important question. Does the menopause really mean that women are past their peak of productivity? The answer: certainly not. In fact, it simply means that women are entering a new phase of life—one that may even be seen as liberating and more dynamic.


• Hot flushes • Night sweats • Vaginal dryness and discomfort during sex • Insomnia and disrupted sleep • Anxiety and depression • Reduced libido • Difficulty with memory and concentration


A healthy regime can go a long way in helping you cope with the menopause. Menopausal women are at higher risk of heart disease and osteoporosis, so

Antiquated logic The Victorians believed that there was a direct link between the womb and the brain, spurring them to claim that women were predisposed to insanity during ‘the change’

experts advise consuming a diet low in saturated fat and salt. Regular exercise should help convert stress into energy and boost vitality. For bouts of anxiety, consider seeking help from a counselor or menopause coach—they may provide you with effective relaxation techniques. Physical symptoms may be treated on a direct basis, your doctor can advise on specific medications to combat sweating, vaginal discomfort and insomnia. Finally, stay up to date with health screenings offered by the NHS in your age bracket for added peace of mind. •

Predominantly, women experience the menopause between the ages of 45 and 55. During this time, the ovaries stop producing eggs and the reproductive hormone oestrogen. It is this disruption of the hormonal balance that causes periods to cease and several symptoms to arise. At this stage, women are no longer able to conceive naturally. Contrary to popular belief, the menopause isn’t limited to older women. The NHS reports that around one in every 100 women experiences it before the age of 40; a condition known as premature menopause. Premature menopause can occur as a result of a hysterectomy or certain cancer treatments; it may even be hereditary.



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Menopause affects women in very different ways. Some individuals can suffer a range of severe symptoms while others may experience none. Common symptoms include:

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Cooling Hot Flushes & Night Sweats A staggering 75% of women suffer needlessly with hot flushes and night sweats during their menopause. But now, with the launch of Become™ Cooling Vests and Knickers, this figure can be drastically reduced. On a mission to liberate those experiencing hot flushes, extreme chills and night sweats, BecomeTM have fused together innovative, patent pending Anti-Flush TechnologyTM with stylish design, resulting in wearable clothing that can be worn during the day or throughout the night.

d As love e s o by Lo ’s Women Andrea n McLea

Created by women, for women, within a leading femtech company, Become™ understands the worst symptoms of menopause are hot flushes and night sweats. As a result, it’s left no stone unturned during its two-year development process to offer the most advanced materials, equipped to support women going through their menopause. 87% of women loved Become™ Clothing. For many, the discovery was life changing. Make your hot flush cooler NOW with Become™’s Cooling Knickers and Vests in wearable shades of Biscuit or Black. Also available is a NEW Limited-Edition Cooling Cami in a summerready Grapefruit Shade, featuring delicate lace detail.

Anti-Flush Knickers (Black/Biscuit), RRP £19.00 Anti-Flush Vest (Black/Biscuit), RRP £39.00 Limited Edition Anti-Flush Cami (Grapefruit) £45.00

Shop a variety of sizes online at Dear Doctor readers can get an exclusive 10% discount using code DDTEN at the checkout.

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Primal is a natural beauty brand formulated to help maintain healthy hair and skin. Ethically sourced and made with care, the ingredients are simple, pure and 100% natural – just as its name and Mother Nature intended. Inspired by nature, Primal Beauty uses 100% natural, ethically-sourced premium quality ingredients to produce its range which consists of 100% unrefined Coconut Oil, natural Shea Body Butter, Shea Butter with Cocoa Butter, and 100% natural Black Soap. Created by serial entrepreneur Sandra Brown-Pinnock, owner of Xsandy’s hair and beauty brand of stores in SE London, Primal Beauty is her latest venture and contribution to the growing natural (green) beauty industry. Product Range

L-R: Black Soap Shampoo; Pure Shea Butter & Cocoa Butter; Raw Coconut Oil; Intensive Detangling Conditioner; Hydrating Leave-in Conditioner; Pure Shea Butter enriched with Vitamin E Oil

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Buzz Ingredients for Anti-ageing

From hydroxy acids to retinol, the list of ‘miracle’ skincare ingredients on the market is a long one—so which ones should we incorporate into our beauty routines?

IMAGES © Shutterstock


hen it comes to reducing visible signs of ageing, there are a few ‘superhero’ ingredients in most creams and serums that can deliver real results. As we get older, the passage of time takes a toll on our skin. According to research, after the age of 20, one percent less collagen—the protein providing skin its firmness and elasticity—is produced by the skin each year. By our 40s, collagen production ceases altogether, the skin’s exfoliation process weakens— causing dead cells to accumulate— elastin fibres break and the transfer of moisture decreases. As bleak as this outlook may sound, a solution does exist in the form of a solid anti-ageing skincare routine. A lot of time and money has gone into this field of research; beauty labs around the world have found a number of

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Beauty sleep Although our skin may need some additional help in the form of a targeted anti-ageing skincare routine, we should never underestimate the power of a good night’s sleep. A lack of sleep causes the body to release more cortisol— the stress hormone responsible for collagen breakdown—and inhibit the production of the human growth hormone (HGH) which repairs tissue and restores cells

skin-saving active ingredients that can go some way in turning back the clock on ageing skin.


Retinol and retinoic acid, both derivatives of vitamin A, are among the most common ingredients found in skincare products. Able to tackle several imperfections such as fine lines, enlarged pores, sun damage and acne, retinol is hailed as the foremost miracle ingredient for youthful skin. It works by increasing cell turnover and stimulating collagen and elastin production, leaving skin looking hydrated and even-toned. This ingredient is suitable for almost any skin type—gradually introduce it into your beauty regimen, prepping with moisturiser beforehand. However, using retinol-based serums may make your skin more sensitive to UV exposure. DEAR DOCTOR WITH DR CHRIS STEELE 99

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• Protect your skin from the sun by limiting exposure and applying SPF creams • Choose makeup products with built-in sunscreen • Use moisturiser • Don’t smoke


An active ingredient mainly used in products for wound healing, stretch marks and wrinkles, peptides are made out of short and long chains of amino acids—the building blocks of proteins. They help the skin to repair and regenerate itself by acting as moisture-binding agents. Results include skin that is firmer, younger, smoother and revitalised. Peptidebased creams can be used during the day or at night and should be preceded by a thorough skin cleanse.


Alpha hydroxy acids (AHAs)—such as glycolic acid and lactic acid—are widely used by skin specialists for minimising wrinkles and blemishes and can be found in cleansers, moisturisers and exfoliating agents. In addition to removing dead skin cells, these active ingredients can also reduce cell adhesion on the top surface of the dermis, protect the skin from sun damage, help with the absorption of important components of creams and serums and act as an anti-ageing agent. According to Harvard Medical School, AHAs 100 DEAR DOCTOR WITH DR CHRIS STEELE

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also increase blood flow to the skin, ensuring nutrient delivery to its cells and carrying away metabolic waste. Consider AHA-based creams and serums or speak to a skin specialist about higher-strength facials for a revitalised complexion.


This specific vitamin is known for having antioxidant properties, making it a vital molecule for an anti-ageing skincare regime and overall skin health. In addition to limiting the damage caused by UV light exposure, the vitamin also regulates the synthesis of collagen. Several studies have linked increased vitamin C intake in diet with better skin appearance and notable decreases in wrinkling. In terms of topical application of the molecule, the use of a serum containing vitamin C for a period of over 12 weeks can lead to a decrease in wrinkling, reduced protein fibre damage, a reduction in the skin’s roughness and an increase in collagen production. However, to reap its full benefits when taken in supplement form, vitamin C’s best results are seen when it is combined

Did you know? After the age of 20, 1% less collagen is produced in the dermis each year Source: Dartmouth Journal of Science

with other micronutrients such as zinc and vitamin E.


Tea extracts, specifically from green and red tea, can have rejuvenating effects on ageing skin. These ingredients can help to reduce inflammation, build collagen and reduce cell damage by impeding the harmful exposure to the sun’s rays. Such benefits are all thanks to a biological compound found in tea called polyphenol. A sub-group of polyphenols, known as catechins, help destroy free radicals, in turn slowing down the ageing process. These compounds can be found in most serums and anti-ageing creams. •

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The Silent Killer

According the NHS, high levels of cholesterol affect some 60 percent of the UK’s population


he first thought when it comes to cholesterol is often negative, yet this fatty substance, also known as a lipid, is essential for good health and the normal functioning of the body. Cholesterol is a naturally occurring waxy substance within the cells in the body. It forms a protective barrier within our cells, plays a key role in hormone production and aids the liver in producing bile which is vital for healthy digestion. Above-average levels of cholesterol become increasingly common in people as they reach their 40s, 50s and 60s. As we age, it is imperative to undergo regular blood cholesterol checks and keep our lifestyle under control to reduce the risk of cardiovascular disease.


Cholesterol can be generally divided into groups of ‘good’ or ‘bad’. It’s when too much ‘bad’ cholesterol—which sits above five millimoles per litre of blood (>5mmol/L)—builds up in the body that it becomes potentially harmful to our health. 102 DEAR DOCTOR WITH DR CHRIS STEELE

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Did you know? More than half of all adults in England have raised cholesterol (more than >5mmol/L) Source:

Cholesterol is carried to and from cells via proteins; when combined, they form lipoproteins. When medical professionals talk about ‘good’ or ‘bad’ proteins, they are referring to the two major types of lipoprotein: high-density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL—or the ‘good’ cholesterol— travels via blood cells to the liver, delivering unneeded cholesterol and eliminating bad cholesterol along the way. HDL reduces the risk for serious conditions such as heart attacks, angina and stroke—a group

of conditions collectively referred to as cardiovascular disease. LDL, on the other hand, can prove to be harmful if high levels reside in the body. LDL can cause plaque buildup in the walls of the arteries, subsequently restricting the blood flow to the heart, which can lead to heart disease. According to the British Heart Foundation, research now shows that other bad elements of cholesterol, collectively referred to as non-HDL cholesterol, need to be taken into consideration when measuring cholesterol levels. Non-HDL cholesterol includes intermediate-density lipoprotein (IDL), very low-density lipoprotein (VLDL)—which is produced in the liver and travels through the bloodstream to supply body tissue with triglycerides—and lipoprotein(a). High levels of all of these types of cholesterol provide a clear indicator for the risk of developing heart disease.


High levels of bad cholesterol tend to

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occur as a result of unhealthy lifestyle choices or as a symptom of ageing. However, in some circumstances, high levels of LDL may be inherited. This condition is called familial hypercholesterolaemia (FH) and according to the NHS, around one in 500 people in the UK are thought to be affected—that’s about 120,000 people. FH is caused by a faulty gene and affected people have increased levels of cholesterol from birth as a result. If left untreated, individuals with FH are more susceptible to developing cardiovascular disease.


There are many factors that can contribute to high blood cholesterol, including:

Eating an unhealthy diet.

While some foods (such as eggs) naturally contain cholesterol, the levels found are unlikely to affect blood cholesterol levels as they are also low in saturated fats. Eating large amounts of saturated fat found in dairy foods and meat is what may contribute to significant changes in cholesterol levels.


Smoking causes serious harm to our health for multiple reasons; it is also a risk factor for increased levels of cholesterol. A chemical found in cigarettes called acrolein inhibits HDL from delivering cholesterol from fatty deposits in the body to the liver. This leads to atherosclerosis (narrowing of the arteries).

Family history of heart disease.

Statistically, those with close relatives who have suffered with coronary heart disease are more likely to have higher levels of cholesterol themselves. •

LOWERING CHOLESTEROL WITH DIET Making positive diet changes can help lower cholesterol in the blood. Experts recommend significantly reducing the amount of saturated foods you consume and increasing your daily intake of fibre. Current guidelines state that adults should aim for at least 30g of fibre every day. Fibre can be found naturally in fruits, vegetables, wholemeal bread, beans, lentils, nuts, seeds and potatoes with their skins on. Try to avoid foods high in saturated fats such as cakes, biscuits, meat pies, sausages or fatty cuts of meat and dairy products like cheese and cream. Replace these ‘bad’ fats with unsaturated fats such as seeds, nuts, oily fish and avocados

IMAGES © Shutterstock

Triglycerides constitute another fatty substance in the blood and are stored within the body’s fat cells. This substance can also be found in dairy products like milk and cheese, meat and certain cooking oils. High levels of triglycerides can (like high levels of LDL) narrow the walls of the arteries, leading to heart disease. Increased amounts of triglycerides are often a result of consuming a diet high in fat and sugar, obesity and high consumption of alcohol.


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07/08/2018 10:00



Know the Facts One stroke occurs every five minutes in the UK, but what is this life-threatening condition and what can we do to prevent it?


n 2016 almost 38,000 people in the UK died from stroke. a stroke, often referred to as a ‘brain attack’, occurs when blood supply to the brain is cut off. Blood carries oxygen and essential nutrients to the brain and without them, brain cells can become damaged or die. the after effects of the attack vary greatly from person to person, but it can cause significant alterations to the way in which we think and feel. stroke can also affect cognitive functions like reading, writing, speaking and language. it can cause loss of bowel and bladder control, vision problems and memory loss and may leave survivors with disabilities.

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£26bn The cost of stroke to society each year


stroke survivors in the UK

1 in 8

strokes are fatal within the first 30 days Source:

Causes & treatments

there are two main types of stroke: ischaemic stroke and haemorrhagic stroke. ischaemic strokes are by far the most common and are responsible for 85 percent of all incidents. this type of stroke occurs when a blood clot or other substances block blood flow to the brain. Blood clots typically appear in areas of the brain where arteries have been narrowed or blocked, usually because of fat deposits or plaque buildup, a condition otherwise known as atherosclerosis. treatment for ischaemic stroke may include thrombolysis whereby a drug called alteplase is administered to break

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Foods that may trigger a stroke

and atrial fibrillation (irregular heartbeat) are also risk factors for experiencing stroke.

What can i do to Reduce my Risk of stRoke?

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concerns about your health and having a stroke can cause stress, but there are various lifestyle changes you can implement to lower the risk, including: • Stopping smoking. • Eating a healthy, fibre-rich diet full of grains, pulses, wholemeal, fatty fish and fruits and vegetables to lower cholesterol—a key contributing factor to stroke. • Reducing alcohol consumption to no more than 14 units per week spread over three days or more. • The NHS recommends that those who have been diagnosed with an underlying condition that is known to increase the risks of stroke to take medication as prescribed. • Visit a doctor for routine health checks. •

the clot down to allow blood flow to the brain. according to the stroke association, 10 percent more patients who receive thrombolysis treatment in the hours following ischaemic stroke survive and live independently. More rarely, patients may receive a thrombectomy, an operation that physically removes the blood clot from the brain (suitable for just 12 percent of ischaemic stroke patients). haemorrhagic stroke occurs because of a burst artery, causing bleeding within or on the brain. although this type of stroke is not very common (occurring in just 15 percent of incidents), it is very dangerous and may even result in death. haemorrhagic stroke can be caused by numerous factors including high blood pressure, aneurysms (thin, weak artery walls that are more susceptible to collapse, especially if sufferers have high blood pressure) and cerebral amyloid angiopathy, a condition whereby the amyloid

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protein builds up inside blood vessels in the brain. haemorrhagic stroke patients may require medication to reduce blood pressure in the brain and to prevent further strokes from occurring. in some cases, surgery may be necessary to remove excess blood from the brain or to repair damaged blood vessels.

Risk factoRs

stroke can happen to anyone at any age, but research by the stroke association shows that the lifethreatening condition most typically occurs in older people over the age of 55, with men at higher risk of stroke at a younger age than women. in addition to age, statistics published by the charity this year show that ethnic minorities and people from deprived areas have an increased risk of experiencing stroke than caucasian people and those from wealthier areas. Medical predispositions such as high blood pressure, diabetes

Act F.A.S.t there are many warning signs and symptoms of stroke to look out for; F.a.s.t is an acronym that can help you to identify the symptoms and warning signs of stroke: face. has their face fallen or drooped on one side? aRms. can the person raise their arms or do they feel numbness in one arm? speech. is their speech slurred or are they unable to speak? time. if you notice any of the above symptoms, it is time to dial 999 immediately

dear doctor with dr chris steele 105

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Ageing Eyes Our eyesight naturally deteriorates over time, but what are the most common conditions that occur as a result of ageing eyes? Decreased colour perception Cells in the retina that are responsible for colour perception decline in sensitivity as we age. This means that colours tend to lose their vibrancy; for example, blue objects may start to appear washed out.


Posterior vitreous detachment It is common for the vitreous membrane—the gel-like substance that fills the eye—to separate from the retina in later life, this is known as posterior vitreous detachment (PVD). PVD causes flashes of light or spots to appear in the vision. These symptoms usually subside after six months or so and the condition does not tend to cause sight loss.

Reduced pupil size As a result of ageing, the muscles that control pupil size lose their strength. Pupils therefore become smaller and less responsive to changes in ambient light.

Dry eyes Over time, tear ducts produce fewer tears. This can cause stinging, burning or scratchiness. The problem is usually resolved with artificial tears or restorative eye drops. Loss of peripheral vision Loss of peripheral vision is very common among seniors. The scope of our normal field of vision decreases by one to three degrees every decade, causing peripheral vision to become obstructed. 106 DEAR DOCTOR WITH DR CHRIS STEELE

CS29A.Eye Health Age.indd 106

Did you know? People in their 60s need 3 times more ambient lighting for comfortable reading than people in their 20s Source:

Glaucoma Glaucoma refers to damage to the optic nerve caused by the pressure of fluid inside the eye. It comes with very few symptoms, therefore, regular eye tests are key for diagnosis and early treatment.


There are several common eye conditions that appear with age including:

Diabetic retinopathy This is a complication of diabetes that affects the eyes. It occurs due to damage made to the blood vessels of the light-sensitive blood tissue, causing vision problems.

Macular degeneration A condition defined by blurred vision in the centre of the visual field. During the early stages of macular degeneration, there are no other obvious symptoms, so eye check-ups are best for diagnosis.

Cataract Cataracts are characterised by a clouding of the lens in the eye, which leads to a decrease in vision. Symptoms include blurry vision, faded colours and sensitivity to bright lights. •

IMAGES © Shutterstock


ubtle changes in our eyes occur as we age and these alterations can cause deterioration of our sight. Dear Doctor outlines the visual effects of time and how one can work to prevent them.

06/08/2018 16:43

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Chronic Pain: An Epidemic

Around 28 million people in the UK have experienced chronic pain for three months or more—but how can sufferers alleviate symptoms without medication? HEAT & COLD

For short-term relief for common chronic conditions such as back pain, the NHS suggests using hot or cold compression packs. Heat applications help to increase the flow of blood and vital nutrients to the affected area. Cold compresses, on the other hand, work to decrease inflammation, muscle spasms and pain. Cold therapy shrinks blood vessels which reduces bleeding and swelling.



CS30A.Chronic Pain.indd 108

sufferers living with chronic pain, there are also drug-free methods of pain relief available, too.


The NHS advises that those with severe pain continue to work and exercise as much as possible. This is because leading a sedentary life can cause more harm than good. Inactivity can further stiffness and lead to weaker bones. Swimming is a low-impact aerobic exercise that experts encourage chronic pain sufferers to do. A study published in Archives of Physical Medicine and Rehabilitation demonstrated that over a 12-week period, swimming actively reduced pain levels in fibromyalgia sufferers aged 18 to 60 more than those who walked as a mode of exercise.

Mindfulness Mindfulness refers to paying attention to the present moment. It has been long associated with benefiting mental wellbeing, but how can it help alleviate chronic pain? As with acupuncture, this area of study requires more clinical studies to decide its efficacy, but, according to a review published by the National Institutes of Health in 2016 (Mindfulness Meditation-based Pain Relief: A Mechanistic Account; by Fadel Zeidan and David Vago), mindfulness attenuates chronic pain by acting as a mindfulness meditation-based analgesia. •

IMAGES © Shutterstock


hronic pain can be characterised as a persistent pain that lasts for more than 12 weeks, despite taking medication or undergoing treatment. Chronic pain usually occurs as a result of injury or a symptom following surgery, but, in some cases, can arise for seemingly no reason at all. Some conditions where chronic pain is typical include diabetes, arthritis, irritable bowel syndrome, back pain and fibromyalgia (a condition that causes widespread pain and tenderness across the body). According to a leading organisation, the British Pain Society, an astonishing 43 percent of Britain’s population experiences chronic pain, while around 14.3 percent experience moderate or severely disabling chronic pain. While medication tends to be available to

Acupuncture While more research is needed to ascertain the medical benefits of acupuncture, the NHS surmises that it is a safe alternative to traditional medicine. The National Institute of Health and Care Excellence recommends the use of acupuncture for chronic tension-type headaches or migraines. This alternative therapy has been used to treat chronic pain and musculoskeletal conditions like joint pain and arthritis; it works by inserting fine needles in specific pressure points on the body to relieve pain.

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Home Sweet Home

Choosing a care home is much like buying a new house: it requires thorough research and consideration to make sure your new living arrangement is suitable for your specific needs council. a qualified care specialist will carry out the assessment either over the phone or face to face. this step is especially important for those that require financial support. having a professional overview of your needs will help you to narrow down suitable care homes.

IdentIfy your needs

consider what elements are most important to you. You might be particularly keen on a prime location with a nice view or one that’s close to your relatives. Maybe it’s a spacious room or a fully equipped social area that you want the most. compile a list of your wishes and rank them in

Before you commence your search, it’s a good idea to identify your needs. if you believe that you require extra care or attention, arrange a care needs assessment. this service is usually provided by the social services department in your local 110 dear doctor with dr chris steele

CS30.Care Home.indd 110

ConsIder your requIrements

order of importance. once you start reviewing care providers, use this checklist to base your decisions on.

do your researCh

Be thorough in your research for care homes. in the UK, there are four watchdogs that are charged with inspecting care providers. each delivers publicly available reports that provide valuable insight into how well care homes across the country are managed. check for points that have been raised by inspectors and whether staff turnover is high—these can indicate a poor working environment. You should also read reviews of the places you are interested in. ask friends and family

IMAGES © Shutterstock


electing a care home can feel like a daunting task; before taking the plunge, there are some considerations to take stock of. think about choosing a care home sooner rather than later—this will avoid any hasty decision-making when the time comes. Follow our step-by-step guide to choosing the right care home for you.

06/08/2018 16:44


Visiting a care home: questions to ask Here are just some of the questions you should be asking when visiting a prospective care home:   

for recommendations—they might also have some useful insights.


After taking every element into account—location, fees, hygiene, facilities and accessibility—write a shortlist of your favourite care homes. Order them by appropriateness and include a side note on their biggest draws and drawbacks. Implementing this methodical structure will ensure a straightforward decisionmaking process.


Visit all of the homes on your shortlist in order to acquire as much information about them as you can. A website or brochure can only reveal so much, experiencing the environment first-hand is far more adequate. Seeing a residential home for yourself, you should be able to get a true sense of its culture and the condition it’s in. Request to see a standard room as well as a tour of

CS30.Care Home.indd 111

the whole facility. If possible, try to speak to some of the care home’s existing residents. Be inquisitive; ask plenty of questions and jot down some notes for comparative purposes later on. After visiting, whittle down your options to help make a final decision.


If you decide that a care home isn’t for you, there are alternatives. You may simply want to repurpose your home for your lifestyle. If necessary, you can install a chair lift and handrails around the house along with any other useful aids. Alternatively, you may consider getting at-home support; this involves scheduled visits from a care worker whereby they check your progress and offer assistance if needed. Some retirees find that sheltered housing better suits their needs. This consists of private independent units with some shared facilities and a warden. •

 

  

 

What level of care is available? What are the main facilities? How are fees calculated and how often are they reviewed? Are residents tied into a contract for a minimum period? Who provides the food? Can I sample the menu while I am here? Does the home use agency staff? If so, what is the ratio to permanent care workers? What are the rules on having visitors? Is there a communal lounge and a quiet area on site? What security measures are in place? Are residents allowed to keep pets? Is there a procedure for giving feedback or raising complaints? How are the accessibility measures within the home? Are there grab rails and stair lifts? Is there somewhere to make private telephone calls if necessary? Do all residents have internet access? Are there any additional costs that I should be aware of? Is there a residents’ committee? How often does it meet?


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life starts at 60+

114 dear doctor with dr chris steele

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07/08/2018 08:35

life starts at 60+

The Road to


Feeling well is not just about being physically fit— your emotional wellbeing is equally as impor tant to your overall health


here’s no shame in struggling with your feelings. there are several steps you can take to promote your emotional wellbeing and places you can turn to if you think you need help. it’s never too early—or late—to speak to someone about the way you’re feeling. read on for practical tips and advice on how to foster emotional wellbeing in later life.

The imporTance of culTure & creaTiviTy

IMAGES © Shutterstock

research by age UK, published in april 2018, attempts to answer the question: ‘what makes later life worth living?’ Using a rich data source—the Understanding society survey— alongside cutting-edge statistical techniques, the charity produced the index of wellbeing in later life. Perhaps unsurprisingly, the index demonstrated that people with good social networks, health and financial resources are more likely to enjoy high levels of wellbeing. overall, the research’s strongest message is the importance of maintaining ‘meaningful engagement’ with the world around us in later life. a number of things—from

CS31.Emotional Wellbeing.Rev1.indd 115

social, creative or physical activities, to work or belonging to a community group—can contribute to this sense of meaningful engagement. Most striking, however, is the index’s finding that creative and cultural participation is the singlebiggest factor in older people’s emotional wellbeing. age UK consequently concludes, for those with very low emotional wellbeing, having something creative to do can really help. the terms ‘culture’ and ‘creativity’ are, of course, hard to define. For the purposes of age UK’s investigation, data collected in the Understanding society survey—on the number of cultural activities each respondent had attended—was used as an indicator for both terms. however, the research makes the critical distinction between simply visiting or attending a cultural event and actually taking part in it. so, what is the relationship between participation and wellbeing in later life? Not unexpectedly, the investigation shows engagement in all activities is higher among people in the top

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life starts at 60+

20 percent of the index’s wellbeing spectrum. in other words, those who actively take part in cultural activities are more likely to benefit from them emotionally. there is, therefore, a clear link between participation and wellbeing. ‘creative and cultural participation is important to older people: we need to promote it, enable older people to access it and increase the opportunities to take part,’ age UK maintains.

of helpful service providers to get you up-and-running. Keeping yourself busy is key in nurturing and upholding your emotional wellbeing. if you don’t have any friends or family nearby, there might be a local social group you can attend. in many areas, you’ll find friendship centres which organise regular activities and outings.

Eating & drinking wEll

Many local organisations have classes specifically for older people— check your local library, University of the third age or local council for details. You can also volunteer to use your experience to help others, which can be a doubly rewarding endeavour.

what we eat and drink has a direct impact on how we feel. to promote emotional wellbeing, eat plenty of fresh fruits and vegetables and try not to fill up on sugary or fatty foods. Many of us enjoy a drink every now and then, and it is tempting to think alcohol will lift our spirits. But alcohol is actually a depressant that can affect your mood. try to limit the amount of alcohol you consume and keep at least two days a week alcohol-free.

rESEarch an intErESt or lEarn SomEthing nEw

crEatE StructurE & SEt yourSElf goalS regardless of how small, goals can help you feel a sense of achievement

and motivation. Your goals could be as minor as completing a crossword puzzle, gardening or reading one chapter of a book a week. Planning days out and activities will also give you something to look forward to and keep you feeling positive. •


older people in the UK live alone, of whom more than 2m are aged 75+ Source: Age UK

15 cigarettes Loneliness can be as harmful to our health as smoking this many cigarettes a day Source: Age UK

thE importancE of Staying activE a plethora of research highlights a clear link between physical activity and emotional wellbeing. doing exercise releases endorphins, which can lift your mood and make you feel happy. Plus, you’ll do wonders for your physical health in the process. remember: it is never too late to get active. start small by going on short walks and keep intensity levels to a minimum. You can always build up slowly. whatever you choose, something is always better than nothing.

Stay in touch & mEEt pEoplE these days, with the internet and abundance of communication technologies, there really is no excuse for losing touch with family and friends. if you don’t have broadband installed, there are plenty

116 dear doctor with dr chris steele

CS31.Emotional Wellbeing.Rev1.indd 116

Lonelinessnely at some

will feel lo ly Most people lives. It’s a deep t stage in their os m in rience that— personal expe ut B . es ss ully pa cases—thankf le, mber of peop nu g in ow for a gr it e, can ose in later lif particularly th ve a d istence an ha define their ex ct pa significant im eing on their wellb

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life starts at 60+

Here Comes the Sun


t is a common myth that the ‘British sun’ is not as strong or damaging as the sun in warmer climates, but, even on cloudy, cooler days, this couldn’t be further from the truth. according to cancer research UK, over-exposure to ultraviolet (UV) radiation from the sun and sun beds is the main cause of skin cancer. almost 90 percent of melanoma cases (the most aggressive form of skin cancer) in the UK could be prevented by practicing sun safety and avoiding sunbeds.

UV damage high levels of exposure to UV rays cause significant harm by damaging the dNa of the skin’s cells. skin cancer occurs when the damage alters the dNa of the genes that promote skin cell growth. 118 dear doctor with dr chris steele

CS32A.Sun Safety.indd 118

9 in 10

people diagnosed with malignant melanoma skin cancer in England and Wales survive their disease for 10 years or more Source: Cancer Research UK

there are two main types of UV rays: UVa and UVB. UVa rays account for about 95 percent of the UV radiation that reaches the surface of the earth. it deeply penetrates the skin, damaging and ageing skin cells and is attributed to long-term skin damage including wrinkles and sun spots. sun beds are known to emit high levels of UVa rays, the dominant ‘tanning rays’ (up to 12 times that of the sun), which are

associated with an increased risk of skin cancer. according to the skin cancer Foundation, individuals who use tanning beds are two and a half times more likely to develop a type of skin cancer called squamous cell carcinoma (scc). UVB rays have more energy than UVa rays and can directly damage skin cells. Besides being the chief cause of sunburn and damaging the outer layer of the skin, UVB rays are responsible for most cases of skin cancer. Perhaps the least talked-about rays, UVc rays, may be the most harmful of them all. these rays, however, are unable to penetrate the ozone layer and do not reach the earth’s surface.

SP-what? sunscreen is a key line of defence against the sun’s damaging effects.

IMAGES © Shutterstock

According to Cancer Research UK, around 15,400 new melanoma skin cancer cases are diagnosed in the UK ever y year, yet Brits are still not convinced of the damaging effects of the British sun

07/08/2018 08:38


Sun protection factor (SPF) is a measurement of a sunscreen’s ability to prevent UVB rays from harming the skin. SPF15 is able to prevent around 93 percent of incoming UVB rays from damaging the skin; SPF30 blocks around 97 percent of UVB rays and SPF50 filters out around 98 percent of all incoming UVB rays. Sunscreen is suitable for anyone over the age of six months old and experts recommend that people use a daily broad-spectrum sunscreen that protects the skin from both UVA and UVB rays. Most cosmetic products today including moisturising creams, lotions and makeup contain a sunscreen of at least SPF13-15 for added protection. If the days are particularly warm and prolonged exposure to the sun is expected, or if spending time in an outdoor swimming pool or sea, then experts recommend reapplying sunscreen at least once every two hours.

Know your ABCDEs Self-monitoring moles is encouraged as part of a daily check for signs and symptoms of skin cancer. The ABDCE rule is a useful checklist to rule out the possibility of skin cancer:


Check for moles that appear asymmetrical in shape Is the border of the mole jagged or uneven? Benign moles are usually smooth and even Does the mole vary in colour? Malignant moles tend to comprise of different shades of tan, brown or black If the diameter of the mole is larger than seven millimetres, then seek medical advice Has the mole evolved in shape or size?

SUN SAFETY MYTHS 1. Sunburn isn’t possible on cloudy days. UV rays can penetrate through the clouds. If the UV Index indicates a sun strength of three or above, then the sun is strong enough to cause sunburn. Visit to see how strong the sun’s rays are in your area. 2. A tan can protect the skin from sun damage. According to Cancer Research UK, tanned skin only provides an SPF of about three, which is not enough to protect against the sun. 3. Applying after-sun will repair damage caused by sunburn. Applying after-sun lotion will not reverse the damage to the DNA already made by UVA or UVB rays. If you notice that your skin is getting red or burnt, it is essential to get out of the sun. 4. Higher SPF means more protection. No SPF offers 100 percent protection from the sun and SPF, whether 15 or 50, should offer high enough protection (if used correctly) wherever you are in the world. Make sure to buy sunscreen with at least four-star UVA protection, too. •

CS32A.Sun Safety.indd 119

mmer During the su ep in the in the UK, ke t of the shade and ou 11am and sun between est times 3pm, the hott of the day DEAR DOCTOR WITH DR CHRIS STEELE 119

07/08/2018 08:38

ARE YOU A CANDIDATE FOR PDO THREAD PROCEDURES? PDO thread treatments can be classed into three types depending on your desired effect and skin type. REJUVENATION TYPES of treatments include those where the intent is to improve skin health through stimulation of collagen production and vascularization. This can take up to 3 months for visible effects to occur and some people report improving for the better part of a year. SKIN TIGHTENING is another popular use of PDO threads. Sagging skin is a common sign of aging and techniques for treating the lower face, jawline, and neck are well established. THE PDO “THREAD-LIFT” is the most talked about treatment. Using stronger threads with barbs, a skilled practitioner can safely and gently lift the skin to attain immediate effects due to the physical lifting of the treatment area. Not all people are candidates for all three treatments and the Thread-Lift is no substitute for a surgical face lift. HOW TO FIND A DOCTOR? It is important your practitioner considers your skin type, budget, and expectations before a PDO treatment and be sure you have been fully informed and reviewed and signed the supplied consent form. Be sure your practitioner has been properly trained and remember a referral is one of the best compliments!


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07/08/2018 15:51


The Holiday of a

Lifetime E

Enjoy a worry-free holiday with our tips for senior travellers

ven the most experienced travellers can face unexpected challenges when organising a trip; as we get older, these obstacles tend to evolve. Follow our senior travel tips to ensure that your holiday is stress-free and the best it can be.

Book wisely

strategically booking your trip in offpeak and shoulder seasons can save a huge amount of money. Plus, popular holiday destinations tend to be far less busy and chaotic during these periods. the climates are frequently cooler and therefore more pleasant for sightseeing trips. Plan well in advance to ensure that you get the best air, train or boat fare possible. the prime booking window for flights is between 12 and 121 days before your trip.

IMAGES © Shutterstock

Consider your mediCation

organising your prescriptions ahead of travelling will save you a lot of unnecessary anxiety. stock up on your prescription from your doctor; request enough to cover your trip with an additional reserve for emergencies. Your medical practitioner can best advise on how to counteract the upcoming disruptions to your routine. different countries will also have different rules for what they consider to be ‘controlled substances’—check the regulations of your destination well in advance and

CS32.Later Life Holidays.Rev1.indd 121

ensure you comply. Pack the majority of your medication in your main suitcase and the rest in your carry-on luggage for easy access. Make sure everything is properly labelled and keep a copy of your original prescription with you when travelling.

share your itinerary

if you are travelling solo, share your holiday itinerary timetable with a close family member or friend. Notify your concierge or porter of your daily excursions so that they know what time to expect your return. inform a neighbour of your trip and ask whether they can keep an eye on your home during your absence.

Be prepared

whether you decide to discover the cotswolds or explore the serengeti, make your health a priority. Pack appropriate outfits for the designated climate: loose cotton clothing for humid conditions and warm woolen garments for cold environments. Bring a supply of mosquito repellent for locations that require it. certain destinations such as rainforests and jungles demand a higher deet content than others—be wary of this when selecting a product. carry protective sunscreen with sPF 30 or higher to shield you from damaging UV rays during your trip. Pack a medical kit with bandages, antiseptic, sterile

syringes, electrolyte sachets and diarrhoea and constipation tablets.

think aBout aCCessiBility

accessibility can be a worry for some individuals with low mobility. if you are travelling within the UK, check that your accommodation is compliant with the National accessible scheme (Nas); a scheme that rates accessibility of visitor accomodation. if your trip is overseas, consider an escorted holiday scheme such as a cruise or coach tour. For more severe disabilities, consult a specialised operator such as limitless travel, access at last or

Get Covered

investing in quality travel insurance is vital in safeguarding you in the event of an accident, illness, flight cancellation or other unforeseen circumstances. once you turn 65, you may find it more difficult to obtain a reasonably priced package. Unfortunately, insurers inflate their prices once people enter into this age bracket. thoroughly comparing operators will help you to locate the best deal possible. declare any recent treatments or existing medical conditions to your insurer when obtaining a quote. if you fail to declare something and suffer a reoccurrence or flare-up, your cover may be voided. Keep in mind that certain activity-based trips may require a special form of cover. • dear doctor with dr chris steele 121

07/08/2018 14:59




Cosmetic surgery, while effective, comes with a high expense and long recovery time. Less invasive procedures—like thread lifts—are achieving the same results

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CS32A.Non-surgical Facelifts.indd 122

material. Pdo threads are introduced deep into the skin to produce three main effects: instant skin lifting, cellular renewal through collagen stimulation and skin tightening.

DetaIls of the proceDure

Pdo thread lifts can be designed to suit each patient’s needs. common areas that it tackles include the under-eye area, eyebrows, crow’s feet, cheeks, nasolabial folds, nasojugal folds, neck and jowls. the procedure itself involves numbing the area in question


The fall in surgical facelifts and neck lifts carried out in 2016-17 compared with the number seen in the previous survey Source: British Association of Aesthetic Plastic Surgeons (BAAPS)

with a local anaesthetic. Pdo threads are then inserted via blunt-tipped needles known as cannulas. once the threads are anchored in the skin, they are lifted upwards and the excess thread is cut away. the entire session can take anywhere between 15 and 40 minutes. there can be a degree of discomfort during the procedure but— due to improvements to the method— the pain experienced by patients is usually minimal.

Is It safe?

thread lifting is surprisingly safe when compared to other skin rejuvenation methods such as fillers or Botox. the side-effects are far milder due to the nature of the dissolvable threads, which reduce the risk of infection. in rare cases, patients may notice the formation of nodules, damage to the salivary glands or the migration of the Pdo threads. in such cases, threads can be quickly removed in order to resolve the issue. •

IMAGES © Shutterstock


osmetic trends are gradually moving away from harsh surgeries and towards less invasive anti-ageing options. the thread lift is one such practice that has gained popularity in recent times. thread lifting was once associated with unpleasant side-effects such as thread breakages and infection. however, most options today are minimally invasive and are said to make a dramatic difference to the face, neck and jowls. thread lifting is a cosmetic procedure that inserts threads deep under the skin to realign sagging tissue, add definition and introduce facial contours. the procedure requires no incisions and is performed using local anaesthesia—the popular procedure is commonly dubbed a ‘nonsurgical facelift’. Presently, there are several techniques that have been developed to meet patient expectations—one of the most popular options is the Pdo thread lift. in this case, threads are made of polydioxanone (Pdo)—an absorbable

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customer service, with patient satisfaction being a top priority. City hospitals in Lithuania, particularly in the capital Vilnius, tend to have advanced facilities—perhaps more than those in rural or suburban areas. Nevertheless, most medical clinics and hospitals are well equipped to perform complicated surgeries. ‘Lithuania is rated one of the top countries in the world for the quality of its health and hygiene. This helps make the country very attractive for people who want to improve their health or get quality healthcare services for a fraction of the price,’ says Aaron Zukauskas, director of Body Bureau.


Medical Tourism:


Lithuania combines healing nature, affordability and quality healthcare standards—no wonder it’s become a hub for medical tourism


ithuania has one of the fastestgrowing economies in Europe. This Baltic country offers a wealth of medical services to foreign visitors at extremely competitive prices. It’s no wonder, then, that Lithuania has become a medical tourism hub, attracting clients from all over the globe—particularly those from the US, Middle East and western Europe.

IMAGES © Shutterstock


Tourist-focused private clinics are a growing industry in Lithuania. The healthcare system conforms to EU directives and quality requirements. The country’s physicians speak numerous languages and have often broadened their qualifications overseas. Lithuanian hospitals are known for high-quality

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Lithuania’s biggest selling point is the affordability of its medical procedures. According to, prices in Lithuania can be ‘as low as 25 percent of the cost of other countries’. Seeking medical treatment in Lithuania is most cost-effective for those travelling from within the EU. Budget flights are readily available and decrease the overall budget of the trip. The country is also extremely affordable in terms of eating, drinking and sightseeing. ‘Some eligible travellers can even get NHS-funded private treatment abroad thanks to the EU Cross-border Healthcare Directive—helping them skip waiting lists at home,’ says Zukauskas.


Cosmetic and bariatric surgeries are the most popular treatments for visitors to Lithuania. Tourists also make the trip for low-cost dental work; around 80 percent of Lithuanian dentists are in private practice. This country is also a top centre for cardiology in eastern Europe.


Between 2012 and 2014, the total number of patients visiting Lithuania from abroad was up by 42.3% Source: Body Bureau

As a holiday destination, Lithuania is a hidden gem. With over 3,000 lakes and expansive forestland, it’s a nature lover’s paradise. Spa resorts and natural springs are an enticement for medical patients hoping to recuperate after their procedures. The Lithuania Baltic Sea resorts of Neringa and Palanga are revered for their wellness and treatment industries. • DEAR DOCTOR WITH DR CHRIS STEELE 125

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Medical Tourism:


Medical facilities in Germany’s capital reported a 15 percent rise in patients travelling from abroad between 2013 and 2014, and ďŹ gures have been climbing ever since


erman healthcare is one of the best, most advanced and accessible in the world. The nation invests more financial resources into the development of its medicine than any other country in the EU. Germany also puts a huge emphasis on supportive aftercare and recovery. It therefore comes as no surprise that medical tourism is flourishing in this western nation.


Germany owes its shining healthcare reputation to the unparalleled convergence of science, research, 126 DEAR DOCTOR WITH DR CHRIS STEELE

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DID YOU KNOW? Germany has an average of 380 physicians per 100,000 patients, which is higher than the averages for both the US and Canada Source: World Health Organization

industry and medicine that is cultivated there. The medical standard of German clinics and hospitals is extremely high. A key attraction for potential foreign patients is the innovative treatments on offer. Complex medical procedures that are not accessible in less developed countries can be obtained in Germany. Due to high levels of funding, state-ofthe-art technology is available to those that require it. There are more than 2,000 hospitals in the country, which treat 18.5 million people annually. States own most of the university hospitals, while municipalities play a role in public

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Medical TourisM

150,000 The estimated number of international patients who visit Germany for medical treatment each year Source: Medigo

health activities and own approximately half of all hospital beds. the number of private for-profit hospitals in Germany has grown steadily over the years and is set to increase further. Germany’s leading medical position has triggered an influx of visitors from all over the globe, although ‘the international patients come primarily from the russian and arabic speaking countries,’ says Falk erzgräber from charité, one of the largest university hospitals in europe.

IMAGES © Shutterstock

SpecialiStS & SpecialtieS

‘the capital region offers a unique network of renowned specialists and sophisticated facilities,’ explains Burkhard Kieker of visitBerlin. Private cosmetic surgeons operate in all the major German cities, with physicians undergoing many years of intensive training. this attracts the attention of tourists travelling from countries throughout europe and the Us. such clients also tend to seek elective surgeries and dentistry procedures in Germany. at present, Germany is showcasing more advanced results in treatments of cancer, blood disorders, cardiovascular

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diseases and transplants than ever before. Patients with severe cases of such disorders are therefore more inclined to make the journey. ‘over the past three years, we have seen the number of international enquiries more than double. all of our departments are in demand, but especially innovative treatments in oncology and surgery,’ said erzgräber. staff in German hospitals tend to be highly qualified with considerable experience in their specialisation. extra support is an option for patients with complex conditions; this can come in the form of a personal medical assistant. Meanwhile, German hospitals are at the forefront of employing organic pharmacies and medicines.

procedure coStS

while the quality of German healthcare is unparalleled, procedures may carry a considerable price tag. the cost of medical procedures is much higher than other medical tourism destinations such as in asia or eastern europe. the first thing to note is that most German hospitals require the bill to be paid in full prior to receiving treatment. if an insurance company

is footing the bill, they will reimburse the patient afterwards. Very few facilities in Germany advertise their procedure prices. the government does, however, fix procedure prices in a catalogue known as the G-drG (German diagnostic-related Group) codes. Private and overseas patients can access care based on the G-drG codes. alternatively, they can pay for a more premium package, which may involve a private room or treatment by a chief doctor. in this circumstance the patient would incur what is known as GoÄ fees, which can almost double the cost of treatment.

Keep in mind...

Visas & insurance Most non-eU nationals will require a visa to visit Germany. those having complex procedures should apply for a medical visa. Passports should be valid for at least six months from the date of departure. Privacy issues Patients that value their privacy should consider that most German medical facilities do not provide curtains around their beds. they also do not often issue a gown during examinations. it is expected that patients bring their own towels, pyjamas and other necessities with them. Hidden costs treatments or procedures that require follow-up sessions may invite additional costs. similarly, post-treatment medical records will be supplied in German and will likely involve an extra fee for translation. • dear doctor with dr chris steele 127

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Regional chemotherapy (RCT) breaks through chemoresistance in solid tumours


hemotherapy has been and still is one of the most common treatment methods in cancer therapy. In systemically metastasised tumours, it is considered the treatment of choice because the primary lesion as well as distant metastases are expected to be reached by the therapy. The problem however is, the larger the targeted volume to be treated, the larger the quantity of cytotoxic drugs that have to be administered in order to achieve tumour-toxic drug levels at the target sites. This often is associated with intolerable side-effects, which even can amount to life-threatening toxicity. Quality of life can be impaired by fatigue, tiredness, nausea, diarrhoea, neurological symptoms, increased bleeding tendency, haemorrhages and reduced immune defence. Regional chemotherapy is performed with intraarterial administration of drugs into selective organs or body segments by intraarterial infusion or perfusion in an isolated circuit. By means of this, two goals of regional chemotherapy are realised: First, chances of response are substantially improved due to delivery of higher amounts of drugs and drug exposure at the target site without the systemic side-effects of conventional therapies. Cancers that have advanced beyond surgical cure, resistant and nonresponsive to systemic chemotherapy in

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many cases become responsive again, shrink and become resectable. In systemic diseases with distant metastases, non-responsive to conventional chemotherapy, good palliation or prolongation of life can be achieved by treating specifically the area that is most life-threatening as for example liver metastases. In tumours responsive to elevated drug exposure as for example liver or lung metastases from breast cancer, regional chemotherapy can achieve rapid shrinkage of metastases within few treatments and does prolong life. The second goal, which is not less important, is maintenance of quality of life. “If in cancer therapy, the patient suffers more than his tumour, something is wrongâ€?. Regional chemotherapy by itself, since it is limited to an organ or an area of the body, does not cause major systemic toxicity by itself. Moreover, an additive procedure, which is chemofiltration in combination with regional chemotherapy, again reduces systemic toxicity by means of a haemofilter, eliminating chemotherapeutics in the venous return from the intraarterially treated tumour bearing area. Good results have been achieved and documented in tumours of the head and neck, lungs, breast, liver, pancreas, ovaries, bladder, anal carcinoma, melanomas and sarcomas. •

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Medias Klinikum GmbH & Co KG, Krankenhausstr. 3a, 84489 Burghausen/Germany

Tel. +49 (0) 8677 9160-0, Fax +49 (0) 8677 9160-120 E-Mail: Website: www.

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Medical TourisM

Medical Tourism:


Belgium’s allure to foreign medical tourists is influenced by its accessibility, comprehensive list of specialists and world-renowned healthcare system


the proportion of dutch visitors that make up the entirety of Belgium’s medical tourism market. French visitors come in second, taking up 17% of the market. other medical tourists hail from the UK, Germany, italy, romania and luxembourg source:

PoPular TreaTmenTs

considering the wealth of medical professionals that reside within the country—especially the capital— treatment prices are considered extremely competitive. cosmetic surgery, dental work and organ transplants are among the reputed procedures Belgium is known for. heart bypass surgery is another popular procedure there. For such procedures, short waiting times can mean the difference between life and death.


ith some of the most up-to-date medical treatments on offer, Belgium has steadily built a reputation that is almost unparalleled in the west. Until recently, Belgium had not deemed it worthwhile to promote its medical services outside of europe. however, all that is changing. Belgium is putting greater emphasis on catering to patients from abroad and ensuring that they receive the best care possible at a fair price. the response to this campaign has been staggering; now the country welcomes scores of medical tourists each year. accessibility plays a big hand in Belgium’s appeal to foreigners. reaching the nation is straightforward; 130 dear doctor with dr chris steele

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great transport links exist via eurostar trains and low-budget european flight carriers.

The healThcare sysTem

Belgium has a large proportion of private hospitals, the independent status of which means profits are directly invested back into new technology and equipment. the nature of Belgium’s healthcare system ensures that there is a comprehensive selection of specialists from which to choose from. the high volume of health providers significantly reduces waiting times for patients. this is a considerable draw for those suffering from long waits for healthcare elsewhere.

IMAGES © Shutterstock

surgical exPerTise

exhaustive training programmes that are provided in Belgium drive the high level of surgical expertise there. doctors are often fluent in english and a selection of other languages, making foreigners feel safe and understood. Brussels is the epicentre of europe’s medical industry; it retains a sturdy reputation of practicing some of the most innovative technologies and techniques known today. all doctors are trained for a minimum of seven years, with specialists undergoing as many as 12 years of studies. the standard of treatment is exceedingly high—especially in terms of surgical procedures—and there is a huge emphasis on hygiene and post-operative care. according to a european heart Journal analysis, Belgium was classed first for heart treatments amongst 24 fellow european countries. •

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The Hip and Knee Clinic in Gent, Belgium, has over 30 years’ experience in delivering joint replacement surgery of the hip and knee. The clinic also has an excellent reputation in treating patients from all over the world, using moveUP technology. Their recipe for success, achieving 99% satisfaction*, consists of: • The combination of world-class surgeons using cutting-edge surgical techniques and smart rehabilitation based on advanced profiling and intelligent use of data. • The remote rehabilitation and medical followup is achieved through the use of a new and clinically proven moveUP digital coach.

• moveUP is a CE-certified RecoTech® application that uses wearable devices (activity tracker and tablet), advanced technology (including artificial intelligence), and a healthcare team of dedicated physical therapists and surgeons. • The moveUP App determines the patient’s profile, takes into account their expectations and offers a daily personalised recovery service. At the Hip and Knee Clinic, the patient is in full control of their complete journey and can rely on 24/7 help and assistance worldwide by using the moveUP application. *Van Overschelde PP, Fitch DA. Patient satisfaction at 2 months following total knee replacement using a second-generation medial-pivot system: follow-up of 250 consecutive cases. Ann Transl Med 2016. doi: 10.21037/ atm.2016.08.41

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