I suffer from nightmares that wake me up. I read that they can be caused by a dairy intolerance, but I don’t have any other symptoms. Do you think this might be what’s behind them?
Dr Ellie Cannon replies: Some research suggests lactose intolerance, where the body has trouble breaking down dairy, can increase the frequency and severity of bad dreams, but this isn’t common enough for them to be considered a symptom.
Instead, most people with lactose intolerance experience bloating, abdominal pain, diarrhoea and excessive gas.
The simple way to find out if a symptom is due to an intolerance is to exclude that food from the diet from two to four weeks, and see if the issue resolves itself.
Nightmares tend to be worse in women and are more common in people with anxiety, depression or those suffering from stress.
They also typically get worse when people are sleep-deprived.
So anyone suffering from bad dreams should try to go to bed earlier and improve their sleep environment. This might mean blackout blinds to reduce light in the bedroom and a fan to cool it down, or avoiding phones and tablets an hour before bedtime.
Prescription medicines, including certain antidepressants and beta blockers, can trigger nightmares. Patients should talk to their pharmacist to see if the medication they take is linked.
Some research suggests lactose intolerance, where the body has trouble breaking down dairy, can increase the frequency and severity of bad dreams
Nightmares are also a known feature of post-traumatic stress disorder (PTSD), a mental health condition caused by experiencing or witnessing a distressing event. It can lead to persistent negative thoughts and feelings, and is usually treated with talking therapy and antidepressants.
GPs can refer anyone with suspected PTSD to a psychologist for diagnosis and treatment.
My wife, 80, gets terrible hot flushes, but does not want to take HRT. What should she do instead?
Dr Ellie Cannon replies: It is important that anyone experiencing hot flushes tells their GP, because they are not always triggered by the menopause. While most women go through the menopause in their 50s, the hot flushes linked to it – sudden feelings of heat on the face, neck and chest – can continue for decades, even into their 80s.
However, they can also be triggered by thyroid issues, certain prescription medicines and the skin condition rosacea.
In rare cases, it can also be a symptom of some cancers.
If hot flushes are triggered by menopause, the best treatment is hormone replacement therapy, or HRT – gels, tablets and patches that replace the lost female sex hormones oestrogen.
But not all women can take HRT. Those who have had breast cancer, especially, should avoid it, as it can raise the risk of their disease returning.
But for those who can’t use hormones, there are other options. One is a medicine called clonidine, which reduces the blood pressure, so also lowers the risk of flushing. However, it is unsuitable for those with already low blood pressure. Certain antidepressants, including paroxetine, can reduce the severity of hot flushes.
Excitingly, there are a number of new medicines which are about to be rolled out to treat hot flushes, including a tablet called elinzanetant, which was approved for use in the UK last month.
It is likely to become available on the NHS within the next few years.
My husband was diagnosed with osteoarthritis and the pain has got much worse in recent months. However, he’s been told it will take six months to see a physiotherapist and even longer to see a specialist in hospital. He is 70 – should he go private?
Dr Ellie Cannon replies: Osteoarthritis is an agonising condition which requires a specialist – but there are also steps patients must take themselves to stay healthy.
It is caused by wear and tear of the joints, which is why it is common among older people. Gradually joint tissues are worn down, so do not bend and move as smoothly as before, causing pain and stiffness.
Often it occurs in the hands, feet, knees and hips.
There is no cure or targeted drug treatments. When it gets severe, patients may be offered joint replacement surgery.
However, in the early stages, osteoarthritis is usually treated with painkillers and lifestyle changes, the most important of which is exercise because it prevents joints from stiffening.
NHS physiotherapists provide tailored exercises to improve mobility and hopefully reduce the pain of the affected joints.
But any exercise will help, especially swimming and tai chi. There is great advice on the website of the charity Versus Arthritis. Unfortunately, waiting times to see NHS osteoarthritis physiotherapists and specialists are very long at the moment.
Some patients waiting for scans pay for them at private clinics and then opt back into NHS care. This can save waiting time, but can also be costly.
Another option would be to see a private physiotherapist while waiting for an NHS expert. They can provide a full assessment and training sessions, which will hopefully make things bearable.
Have slimming jabs helped you quit booze?
At present, these drugs are not being offered as anti-addiction treatments, but there are several big studies looking into the link
I’m fascinated by the growing evidence that weight-loss drugs appear to help patients overcome unhealthy habits such as drinking and smoking.
It’s something I’ve heard from many of my patients. They tell me that along with cutting out the food ‘noise’ which makes them feel hungry, the injections, Mounjaro and Wegovy, also reduce their compulsion to have a glass of wine or a cigarette.
At present, these drugs are not being offered as anti-addiction treatments, but there are several big studies looking into the link. I think it will only be a matter of time before they are used in this manner too.
Did weight-loss jabs help you to quit alcohol or cigarettes? Please write in and let me know.
An end to the hell of hay fever
There is exciting news for hay fever sufferers – scientists say they have developed a vaccine-like nasal spray that could slash the symptoms.
The experimental treatment creates a shield inside the nose that blocks the effects of pollen particles.
It has so far only been tested on mice but researchers are confident it could be ready for human use in five years.
For many, hay fever leads to nothing more serious than itchy eyes and a running nose.
But for some who suffer severely, it can be a life-limiting issue which stops them enjoying time outdoors during certain months.
There are several hay fever medications available over- the-counter or by prescription, but none of them are particularly effective.
It’s an issue that is close to my heart, as my teenage son has a particularly acute form of hay fever. So I know first-hand just how desperately patients need a better treatment option.
- Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk
- Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context
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