Newsletter "Your Health"
- Do you need vitamin pills?
- Asthma patients. Treat that runny nose!
- Constipation. The facts
- What to do before falling pregnant
- How to prevent falls in the elderly
- Which health insurance policy is best for me?
- What should I do if I have chest pain?
- What are ‘probiotics’ used for?
- Does my child need allergy tests?
- Could your child be depressed?
Vitamins are natural substances your body needs to grow and stay healthy. There are 13 vitamins: A, C, D, E and K and 8 different B vitamins.
Are you vitamin deficient?
Most people can get all the vitamins and other nutrients they need by eating a healthy diet. Research has shown that most people taking vitamins in Australia are unlikely to actually need them.
Vitamins are not a substitute for a healthy diet. When taken in pills, supplements do not deliver the same health benefits as when supplied in the diet.
If your diet is poor, first try to improve it. Try to eat a range of foods such as fruit, vegetables, wholegrains, seafood, lean meat and low-fat dairy foods.
However, if you still have a poor diet, you may need a daily multivitamin. The frail aged, children who are fussy eaters or those with certain medical conditions or multiple food allergies may also benefit.
Vitamins for specific purposes
Certain vitamin supplements are of proven benefit for specific situations:
- Vit. B12 for strict vegetarians.
- Folate before falling pregnant.
- Vit. B1 (thiamine) for heavy drinkers.
- Vit. C for smokers.
- Vit. D for those with insufficient sun exposure or dark skin and the elderly.
- Vits. A, C, E and zinc can slow the progress of macular degeneration.
However, many claims for benefits from vitamins are not valid. Research has shown that vitamin C does not prevent colds. Vitamins A, C and E have not been shown to prevent cancer or heart disease.
Vitamins are natural but are not necessarily safe. High doses of vitamin A can be toxic to the liver and cause birth deformities. Vitamin E prolongs bleeding after surgery and in people on warfarin (a blood thinning drug).
It is a good idea to check with your GP before taking vitamin supplements.
www.nlm.nih.gov/medlineplus/vitamins.html
Asthma patients. Treat that runny nose!
Four out of 5 asthma sufferers have allergic rhinitis: a runny and blocked nose, itching of the nose and eyes and sneezing. Recent research has found that effectively treating the nasal allergy can significantly reduce asthma symptoms and prevent asthma attacks.
Allergic rhinitis is an inflammation of the lining of the nose due to allergy to inhaled substances (allergens). In some people, it is caused by pollens from grasses, weeds or trees, especially in spring and summer. In others, it can occur all year round due to allergy to house dust mite, pets or moulds.
Why treat allergic rhinitis?
Allergic rhinitis can be quite disabling. As well as the above symptoms, it can cause sore throat, hoarseness, snoring, headaches, coughing, throat clearing and loss of smell. It can disrupt sleep, leading to fatigue and poor concentration at work or school.
Allergic rhinitis is of special concern for people with asthma. The inflammation in the nose stimulates the production of white blood cells in the bone marrow. These cells attack the lungs causing asthma attacks and reduced lung function.
How is it treated?
The first step is to try to avoid your allergic triggers. Allergy tests (skin prick testing or ‘RAST’ blood tests) can help identify them. Go to www.allergy.org.au for more details.
Corticosteroid nasal sprays are the most effective therapy and are recommended first-line in most cases. They work best if taken continuously and take up to 2 weeks to work fully. The higher dose sprays are script-only and have a good safety record.
Antihistamine tablets or nasal sprays can be used alone or in combination with corticosteroid sprays. Other treatments include ipratropium spray (for runny noses) and salt-water irrigation. Immunotherapy (a course of injections or drops under the tongue) can give lasting relief.
CONSTIPATION. THE FACTS.
Most people open their bowels between 3 times a day and 3 times a week. It is not necessary to open your bowels every day, as many believe.
Constipation is when you have a reduced number of bowel motions and/or pass small, hard stools. It is usually caused by a lack of dietary fibre, fluids and exercise and is more common in women and the elderly.
Many medicines cause constipation e.g. antidepressants, painkillers, iron and calcium tablets. Sometimes a medical condition is the villain e.g. irritable bowel syndrome, depression, thyroid disease and bowel cancer.
How to prevent constipation
- Eat foods high in fibre (‘roughage’) such as vegetables, fruits, nuts, brown rice, wholegrain cereals and breads. Sometimes a commercial fibre supplement is needed e.g. sterculia or ispaghula husk, or you can add psyllium or unprocessed bran to food. Increase your fibre intake gradually to avoid bloating or flatulence.
- Drink 6-8 glasses of fluids daily.
- Try to walk at least 30 minutes daily.
- Go to the toilet when you feel the urge.
When to see the doctor
If your constipation is not improving or you are unwell, consult your GP to exclude any underlying medical condition. Ask if any of your medicines may be playing a role.
Bowel cancer is a very uncommon cause of constipation. However, you may need investigation if you have a recent change in bowel habits (esp. older patients), bleeding from the bowel, tummy pain or weight loss.
What is the role of laxatives?
If the above strategies are not effective your GP may advise a ‘laxative’, either a bowel stimulant (contracts the bowel) or stool softener. Some people require lifelong treatment (stimulants should not be used long term). Sometimes a suppository or enema (inserted into the bottom) is required.
www.gesa.org.au
WHAT TO DO BEFORE FALLING PREGNANT
Over 50% of pregnancies in Australia are unplanned, exposing many unborn children to harmful medications, herbal treatments, infections and other chemicals. Give your baby the best possible start to life. Consult your GP before you fall pregnant to discuss:
Lifestyle and general issues
- Smoking. Reduces fertility, causes miscarriages and low birthweight babies.
- Alcohol and illicit drugs. Even a little can lower fertility and damage your baby.
- Review all your medications (drugs, herbal remedies, vitamins) with your GP.
- Have a Pap smear now if you are due.
- Consider private health insurance.
- Is there a family history of birth defects?
Vaccination requirements
- Are you immune to rubella and chickenpox? If not, get vaccinated before pregnancy.
- Influenza vaccination should be given if you are likely to be pregnant in winter.
- Whooping cough shots advised for both partners before pregnancy or after birth.
Dietary matters
- Eat a healthy, well balanced diet.
- Aim for a normal weight to improve fertility and reduce pregnancy complications.
- Avoid foods which can cause ‘listeriosis’ e.g. pate, or fish with high mercury content.
Folate (folic acid) is vital
All women planning pregnancy should take a daily folate supplement (0.5mg) starting one month or more before conception. Folate reduces the risk of ‘neural tube defects’ (NTD), such as spina bifida. Some women, e.g. those with diabetes or a family history of NTD, need 5mg of folate per day.
Folate (possibly combined with multivitamins) may also reduce the risk of cleft lip/palate, limb, kidney and heart defects.
Some preparations of folate and vitamins are designed specially for pregnancy. Check with your GP to be sure you are using an effective and safe combination.
Many women are lacking in iodine. Use iodised salt for cooking to boost your intake.
www.birth.com.au
HOW TO PREVENT FALLS IN THE ELDERLY
One-third of people aged 65 and over fall every year. Falls can cause serious bone fractures, leading to loss of independence and a need for institutional care. However, many falls can be prevented and the severity of injury can be reduced.
Most falls are due to physical frailty or impaired balance. Regular exercise, specifically in the form of balance training (e.g. tai chi) is the single most effective strategy to prevent falls. Other strategies include:
- Avoid sleeping pills and other drugs that make you sleepy or affect the brain.
- Home safety issues. Install good lighting and handrails. Remove loose mats, cords and other objects from the floor. Replace worn carpets. Repair cracked or uneven paths. Consider a home safety assessment by an Occupational Therapist.
- Cataract surgery if your vision is impaired.
- Keep your bones strong. Are you having sufficient calcium and vitamin D?
- Hip protectors (firm pads worn over the hips) help prevent hip fractures.
- Consider comfortable flat shoes with non-slip soles, a walking stick and personal alarm. Avoid bifocal or multifocal glasses.
See your GP if you have a fall
Your GP can check for any underlying medical cause. Falls can be triggered by a drop in blood pressure, a stroke or heart condition. Illnesses like arthritis, dementia or Parkinson’s disease can increase your risk of falling.
A new Australian Government website now makes it easier to find the right private health insurance. At www.privatehealth.gov.au you can search all the policies offered by Australian health insurers and compare their features and prices.
The site also provides comprehensive information on how private health insurance works and topics like the types of policy available, the Medicare Levy Surcharge, the tax rebate, waiting periods, gap cover and names of hospitals with which each fund has agreements.
WHAT SHOULD I DO IF I HAVE CHEST PAIN?
A pain, discomfort or tightness in the chest, arms, neck or jaw, especially with breathlessness, nausea or sweating, could be a heart attack.
- If the symptoms last 10 minutes or more call 000 (or 112 from your mobile) for an ambulance, not your doctor. Don’t drive yourself or get someone else to drive you to hospital.
- Chew or swallow one aspirin tablet while waiting.
- If you have heart disease, use a glyceryl trinitrate tablet or spray every 5 minutes.
Don’t assume the pain is indigestion – that could be a fatal mistake!
WHAT ARE ‘PROBIOTICS’ USED FOR?
Probiotics are ‘friendly’ harmless bacteria or yeast that can provide health benefits. They are taken in capsules or powders or in some foods, such as yogurt or milk.
There is growing evidence that they may have a role in treating gastroenteritis, traveller’s diarrhoea, irritable bowel syndrome, diarrhoea or thrush caused by antibiotics, and some other conditions.
Probiotics are generally well tolerated. Side-effects are uncommon.
http://nccam.nih.gov/health/probiotics
DOES MY CHILD NEED ALLERGY TESTS?
The first step in managing allergic conditions is to identify the triggers (allergens). Sometimes the causes are obvious. However, in other cases, allergy testing may be required.
Testing may be useful for the following allergic conditions:
- Urticaria (hives). Very itchy, white or red bumps like mosquito bites, usually caused by food or drug allergy. Common food allergies in children are egg, milk, peanuts and other nuts, soy, wheat, fish and shellfish.
- Eczema. A dry, red, itchy rash. It can be aggravated by foods and contact with allergens such as pets and pollen.
- Allergic rhinitis (hayfever) and asthma. Usually due to inhaled pollens, house dust mite, pet hair or mould.
- Anaphylaxis. A life-threatening allergic reaction with difficulty breathing, wheezing and collapse. Caused by foods, insect stings and some drugs.
Allergy tests
The common tests are:
1. Skin Prick Tests (SPTs).
A drop of the suspected allergen is placed on the forearm and a small prick is made through the drop with a needle. If the child is allergic to the substance, a small lump like a mosquito bite appears. SPTs are slightly uncomfortable, but usually well tolerated, even by small children.
2. RAST tests
RAST tests are done on a blood sample, particularly when SPTs are not available or are not possible due to skin disease.
Once allergens are identified, the first step is to try to avoid them. If this fails and drug treatment is also unsuccessful, immunotherapy (desensitisation) may help reduce the allergic reaction. This requires regular injections, or drops under the tongue for 3-5 years. It is used most for hayfever, asthma and bee or wasp stings.
Ask your GP if testing may help your child or visit www.allergy.org.au.
COULD YOUR CHILD BE DEPRESSED?
Feeling sad or unhappy is common in young people and usually goes away quickly. However, by the age of 18, up to 1 in 4 children will have had a major depression – a more lasting and serious condition. How can you tell if your child is clinically depressed?
Depression not always obvious
Young people may try to hide or mask their feelings. Signs of depression include:
- No longer enjoying things they used to.
- Irritable or anxious all the time.
- Losing or gaining weight.
- Sleep problems and lack of energy.
- Reduced concentration.
- Feeling worthless and/or guilty.
- Thinking about death and suicide.
Other clues include alcohol or drug abuse, doing badly at school, social withdrawal, eating disorders, excessive sleeping and violent or aggressive behaviour.
Treatment of depression
Counselling by your GP or other health professional is the cornerstone of treatment. Antidepressant medication may be recommended in more severe cases.
Talking to a friend or parent, attending a support group or using a relaxation strategy (e.g. meditation) can also help.
How parents can help
- Listen if your child wants to talk. If not, don’t try to force the issue.
- Encourage your child to see their GP or another health professional.
- Let your child know you care.
- Don’t blame yourself.
- If your child is feeling suicidal, take them seriously and seek urgent help.
- Learn more about depression at www.beyondblue.org.au.
Young people can ring Kid’s Help Line (1800 55 1800) or Lifeline (131 114) or visit www.reachout.com.au.
