£35 heart screening test is ‘feasible and cost effective’ says new study

Holly and Arabella CAPTION: Arabella  (pictured bottom) and Holly playing volleyball just weeks before Arabella’s death in May 2013

A year ago next week my 16-year-old daughter Holly’s beautiful, funny, clever,kind, best friend Arabella died. Her mum Clare found her in her bedroom with her GCSE revision books around her. She’d had a normal quiet Sunday with her cousins and grandmother and gone upstairs to study for the following day’s exams and her heart had simply stopped

Arabella was bright, exuberant, hilarious, athletic and the picture of a good health with boundless energy and had not been ill. She had suffered a sudden cardiac death – completely out of the blue and without any warning.

To say she has left a massive hole in all our lives is an understatement – it is a vast gaping chasm and we mourn her every day and the wonderful fun-packed life she should be still living now. Arabella loved horse riding , tennis, Duke of Edinburgh hikes and keeping ducks in her back garden and amongst other achievements had learned all the words to the South African National Anthem (by watching YouTube videos), a song that was played at her unspeakably sad funeral. She loved Barack Obama, Prince William and Kate, the Arctic Monkeys, the Lion King, hugging, Twitter, ‘Toddlers and Tiaras’ and lying in bed (a lot). She could have been anything she wanted when she grew up, the world was at her feet.

Arabella was a member of a large extended loving family but there is always an empty place at their table now.My daughter misses walking to school with her and texting her lines from ‘Friends’ and receiving the next line back in seconds – they were word-perfect on all the scripts. But so many other people miss her too for so many different reasons.

 

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CAPTION: 12 young people a week die a sudden cardiac death in the UK

Could screening save lives?

Arabella is one of 12 young people who die from a previously undetected heart condition every week in the UK (yes it really is that many). I was vaguely aware of the charity Cardiac Risk in the Young’s (CRY) work before Arabella’s death, but have since learned more about their fantastic work in screening young people for potential heart problems, funding research into the causes of sudden cardiac deaths and their work with bereaved families and young people who are diagnosed with a heart condition as a result of screening. They do an amazing job.Open the pages of CRY’s quarterly fundraising newsletter though and I promise you you’ll struggle to hold back the tears – there are pages and pages of photographs of all the other young people who have died – young sportsmen on the football pitch, teenagers off on their gap years, fresh-faced graduates,  beautiful new brides,fathers in their 20s, mums who will never see their toddlers grow up – it is heartbreaking. Every death is as tragic as Arabella’s.

I’ve since had two of my daughters screened (the other one will be screened when she turns 14), at one of the mobile screening sessions CRY organise around the country and no problems were detected. I did it because Arabella’s mum Clare said had she known about screening then she would have paid for a test every year of Arabella’s life. Many of the screening sessions are funded by relatives of young people who have died They all feel passionately as Clare does that they don’t want the same tragedy to be repeated in another family. The test takes about 15 minutes . CRY wants all young people to be screened – so do I .

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Is screening cost-effective?
Until now health economists have argued these deaths are too rare for it to be cost-effective to screen for cardiac conditions, but now research based on work funded by CRY at St George’s Hospital , London, presented today at the EuroPPrevent 2014 Congress has proved that it is both “feasible and cost effective”.

In the study more than 12,000 people aged between 14 and 35 were screened at a cost of £35 (40 euro) each; rates of subsequent referral for further investigation were low and considered of “a relative low additional cost” to health services. Dr Rajay Narain, Clinical Research Fellow from the Department of Cardiovascular Sciences, St George’s University of London (and CRY) explained that the most publicised cases of sudden cardiac death ( SCD) in young people occur in elite sports players and athletes. Yet the majority of cases occur as a result of inherited cardiac conditions (such as hypertrophic cardiomyopathy), and a large proportion of these, he adds, can be detected during life. SCD in a young person is likely to have resulted from an arrhythmia caused by a mutation in one of the cardiac ion channels or from other inherited conditions affecting the muscles of the heart.
‘To prevent such tragedies,’  said  Dr Narain.’Sporting and scientific bodies recommend pre-participation screening in young athletes. However, this approach is controversial because of cost – and most SCDs in the young are likely to occur in non-competitive athletes. It was thus our aim to see if population screening was feasible in this age group.’
The study involved the screening of 12,000 young people irrespective of their athletic ability. Only 13% were considered elite athletes. Screening was performed at a cost of £35 per individual and comprised a health questionnaire, 12-lead ECG and consultation with a cardiologist. Those with abnormalities had an echocardiogram on the day or were referred for further evaluation.
Results showed that almost one-in-ten of the population (9.4%) were sent for echocardiography on the day, and 2.7% (323 individuals) were referred for further assessment. Of these who responded to the questionnaire and completed their follow-up investigations (189), a cardiac pathology (or findings necessitating regular follow-up) were identified in 31 (16%). The most common were heart block (10), irregular heart rhythm (9) and valvular heart disease (6). Different cardiomyopathies were evident in 11 cases.
By applying such a screening programme as the one investigated here, Dr Nairn said that many of the sudden deaths from these conditions, which number around 12- 15 per week in the UK, can be prevented.

Population screening to prevent SCD in young people is “possible and achievable” said Dr Narain, who added: “Most developed countries have the potential for creating an infrastructure in high schools similar to established immunisation programmes. There is evidence that teachers, coaches and even volunteering parents could be trained in ECGs. The incentive is prudent – 25–30% of the population in the Western world is now aged 18 or under.”

 

Park life                                                        CAPTION : Arabella (behind) was full of life

Write to your MP
Practically every MP  will have had young people like Arabella die a SCD in their constituencies so maybe it’s worth a letter to yours asking when  a national screening programme in schools is going to be introduced?  Arabella’s constituency MP Colonel Bob Stewart  ( whose daughter was a classmate of Arabella’s) has already done his bit by mentioning Arabella’s death in a parliamentary debate asking :’Can Arabella’s death and the death of hundreds of others of children and young adults be used as a spur to reinvigorate the NHS campaign to identify young people who may suffer a heart attack as a result of a problem that has not been detected, difficult as that maybe?

Jeremy Hunt said at the time ( last June), that he was waiting from advice from the national immunisation and screening committee ‘on the right way forward in this respect’ Let’s hope someone puts this research paper right under their noses today.

We can’t bring Arabella back and screening may or may not have detected a heart abnormality in her case – but we may be able to stop more young people dying in the same way.

In the mean time contact CRY to get your child screened  – here’s the link http://www.c-r-y.org.uk/ecg.htm

 

 

Do you bloat after you eat bread or pasta? You may want to read this…..

This article now regularly gets about 500 views a week from all over the worlds so I’m shamelessly reblogging it as there is obviously a lot of interest in this subject. Anyone want to give me a book deal?

whatsupwithyourhealth.wordpress.com

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CAPTION: Pasta contains gluten which can cause bloating

It’s a mystery that has puzzled gastroenterologists for years. Why do they see so many patients who complain of bloating ,diarrhoea and stomach pain after eating foods  such as bread and pasta, but who test negative for coeliac disease? And more importantly why do many appear to get better when they switch to a gluten-free diet?

Yes, a minority  will test positive for coeliac disease , an auto immune condition where the body produces antibodies to gluten ,a protein found in wheat and other grains including barley and rye. The antibodies cause damage to the villi that line the small intestine (their job is to  absorb food). Eventually, the villi shrink and food and nutrients begin to pass through the  body without being absorbed leading to vitamin and mineral deficiencies.

Doctors can diagnose coeliac disease with a blood test for antibodies…

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Why you don’t have to be a sun worshipper to get skin cancer

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CAPTION: WATCH THAT MOLE

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I tan easily, rarely burn and prefer a “healthy” glow to a deathly white pallor.Like all health journalists I wear sun cream. And a hat.And I sit in the shade and reapply cream regularly, but I  have to admit I do love a bit of sunshine.

I don’t have freckles or red hair or have a penchant for tanning booths.With an indoor “office” job and limited time to soak up the sun’s rays, a darkish skin tone, brown hair (underneath my highlights) and not many moles, I didn’t think I’d be at high risk of skin cancer. I think I was guilty of thinking It Won’t Happen To Me.But now I’m thinking differently.

That’s because I’ve spent a couple of hours interviewing Dr  Bav Shergill, a consultant dermatologist at the Queen Victoria Hospital, East Grinstead, this week and I’ve finally realised that you don’t have to be a sun worshipper to be at risk of developing skin cancer. Dr Shergill  was acting as a spokesman for a fundraising campaign from the British Skin Foundation charity called It Takes Seven highlighting the fact that seven people a DAY in the UK now die from malignant melanomas, the most serious type of skin cancer.

 

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CAPTION: Bob Marley the reggae singer had malignant melanoma < IMAGE SHUTTERSTOCK>

The It Takes Seven campaign is aiming to raise money for more research into the cause of malignant melanoma as there is currently no cure once the disease has spread. More than 13,000 people are now diagnosed with malignant melanoma every year in the UK and there are 2,000 deaths. Malignant melanoma cases have risen by a fifth since the mid 1970s and the cancer is now the second most common in the 15 to 34 age group .Of course we all travel more now and the population is aging and some people still love tanning salons – but not all skin cancer patients have engaged in high risk activities, have freckles, red hair or are older. One girl I interviewed this week was just 19 when she developed malignant melanoma. The reggae singer Bob Marley died from  malignant melanoma – highlighting the fact that all races can get it.

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I’ve interviewed six people this week for the Daily Mail Good Health section about their experiences of  skin cancer. Like me – none of them thought they were at high risk and there wasn’t a sun worshipper amongst them. None of them were beach bums  or went to tanning salons.One man had dark hair and brown eyes and thought he tanned easily, a primary school teacher got skin cancer from sitting in her conservatory and another lady just forgot to wear her hat when she was gardening and developed skin cancer on her scalp.  It really is that easy.  Hardly any of them took holidays abroad much, or if they did it was just a fortnight in the Med once a year. One girl can remember burning at the beach …. but it was at Bognor Regis. These people just spent a little time outdoors every day – jogging ,walking their dogs or pottering in their gardens – but maybe they just didn’t apply enough sun cream or didn’t reapply it often enough.

Dr Shergill explained to me that although the sun’s  UVB rays ( responsible for most cases of sun burn), reflect off glass, UVA rays can penetrate through and cause people to develop skin cancer in some cases.To prove it he emailed me an alarming  photograph of an American office worker who’d sat in the same corner office seat for 15 years next to the window. She had developed skin cancer and more visible signs of aging on one side of her face only -the one facing the window.The same thing happens to truck drivers too, as rays can penetrate  windscreens  and driver cab windows as well.

As Dr Shergill was telling me all this I started to think hmm just like me. I walk my  dog every day and don’t put cream on unless it’s practically a heat wave and only really bother if it’s a hot day at the beach or if  I’m on holiday abroad.You can read the full article here in today’s Daily Mail http://www.dailymail.co.uk/health/article-2615283/Think-sun-worshippers-skin-cancer-Wrong-As-rates-malignant-melanoma-soar-six-sufferers-share-stories-proving-ANYONE-fall-victim-deadly-disease.html 

Dr Shergill said so much is still unknown about malignant melanoma – no-one knows for instance why some people get malignant melanomas in parts of the body never exposed to the sun. He says scientists desperately need to do more  research to find out more about the causes and develop new treatments – so this  is why it’s so important to support the It Takes Seven campaign.

This summer I’ll still be having a tan – but this time it will be a fake one out of a bottle and I’ll be spending much more time in the shade.With a bigger hat. And I’ll be applying  factor 50 sun cream  – you need two tablespoons to cover  your whole body each time you apply, according to Cancer Research UK – so it’s going to be expensive for my family of five – but worth it for peace of mind. Also, I won’t be getting a conservatory anytime soon or aiming to land a top job in a corner office.

You can read more about Imogen Cheese’s personal experience of  having malignant melanoma at her brilliant blog  www.melanomarollercoaster.co.uk – if you have just been diagnosed with skin cancer this is essential reading.

 

 

Don’t get SAD…. get goggles

photo(27)                                                                     CAPTION: Forget the beach … summer is over

I don’t want to keep blogging about the same subjects BUT if you suffer from Seasonal Affective Disorder now is the time you really should be upping your game.

In the UK we’ve just had a golden summer that we’ll probably talk about for years to come in the same way some of us still harp on about the Summer of 1976 ,(if you missed it and were living overseas: it didn’t rain that much). Look out the window this morning and you’ll see fog… there’s no denying summer is over now.When the weather ‘turned  ‘last week and the collective  ‘grey skies’ gloom descended, the chatter  I picked  up (I’m hardly GCHQ but I listen to Facebook,  my kids , husband,  passengers on the train, fellow journos at press dos and  people at the dentist’s surgery), was that we’re all feeling miserable again.

I won’t bore you with lengthy explanations of what SAD is or its cousin winter blues (I call it SAD-Lite).  For that you’ll have to read my earlier blog here (Why we’ve all still got the winter blues), but it’s important to know that using a SAD lamp NOW in the run up to the clocks going back on October 27 and through the winter, may help prevent you getting the blues. Admittedly, the National Institute of Clinical Excellence don’t agree that there is enough evidence on this and says SAD should be treated like depression with antidepressants, but the Seasonal Affective Disorder Association do recommend lamps and if you feel fine in the summer and  don’t like pills (like  me) they might be worth a try.

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CAPTION: Light evenings are fading fast

More about light therapy

Anyway  lamps simulate summer light conditions so levels of the ‘ body clock ‘ hormone melatonin are reset to the amount produced in the summer. A bright, sunny day provides around 100,000 LUX (the measure of brightness) — typical indoor domestic lighting only has 200-500 LUX, so most people use SAD lamps with 10,000 LUX. The advice is to use the lamps daily for varying periods, depending on light intensity in autumn and winter, but also in summer if there is no sun.

I was just about to dust off my SAD lamp  to start bathing myself in blue light every morning when an email pinged into my inbox from Luminette  to tell me they are now making SAD goggles – so you don’t have to stay in one place while you get your daily dose of LUX …how convenient. They have been developed by the University of Liege in Belgium to try to improve compliance with light therapy as lots of people are apparently too busy  to sit in front of a light box.Unlike traditional light therapy treatments, Luminette enables you to get  light therapy on the move – ideal for people like me who tend to fidget and  flit about.

According to the PR blurb Luminette® uses a combination of a light source and a hologram with a patented matrix, to increase the number of light rays that pass through the retina, thereby mimicking the effects of natural light. The press release claims  they offer the same therapeutic effects as bulkier  ‘light box’ devices.

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CAPTION: Goggle therapy…yes I look like a daft zombie but it’s all in the name of science

Well, reader on your behalf I have been wearing  said goggles loaned this week from Luminette and I can report they are comfortable, resting just above your nose and you quite forget you have them on. I even answered the door to the postman forgetting I was wearing them. As they give your eyes a glassy zombie look – he got quite a shock. I’ve worn them whilst I’m working (although there is a glare if you look at the computer screen), eating breakfast , clearing up and reading the paper. They are battery-powered so you don’t have to plug into a socket and cost £199  plus VAT http://www.sad-lighthire.co.uk/product/luminette-sad-light-therapy-visor-introductory-offer/176.

Apparently if light therapy is going to work for you, you usually feel better within a week  and I’m definitely feeling more upbeat, so fingers crossed. Anyway I’ll keep you posted.

Watch the 2 minute video – http://www.youtube.com/watch?v=cQ

For more information on SAD and Winter Blues read  http://www.dailymail.co.uk/health/article-2299045/Winter-blues-Tired-grumpy-hungry-Why-grey-skies-syndrome-blame-.html#ixzz2fRlyjq2d

“Killer” balloons – the truth about living with latex allergy

shutterstock_99203546  < CAPTION> Everyone loves balloons – but for latex allergy sufferers they can be deadly

When Beth Redpath stepped out of her car outside her home she instantly felt the  familiar prickle of an allergic reaction  beginning in her throat.  ‘My breathing became tight and shallow and a red rash started to appear on my throat,’ recalls Beth. ‘Within minutes I was having a full-blown anaphylactic reaction – wheezing , gasping for breath and erupting in hives. It was terrifying.’

Luckily, Beth’s  mother was  on hand to call 999 and  inject her with adrenaline – but the attack was one of her worst, and in the ambulance Beth’s mother feared her 28-year-old  daughter would die. This attack was triggered by latex in freshly laid tarmac on the pavement outside her drive, which she had inhaled after it became airborne, but previous episodes have been triggered  by everything from preservatives in champagne corks, rubber-backed carpets, medical gloves  and elastic bands. She has also developed a nightmarish cross reactivity to some fruits and vegetables which contain proteins similar to those in latex – so now some foods trigger attacks too.

The road works episode is the latest in 27 emergency hospital admissions  Beth, a marketing manager from Surrey, has had to endure in the last 18 months because of her allergy to latex – a protein found in rubber sap, used in countless  everyday products from medical and cleaning rubber gloves,  car tyres and airbags, to condoms, elastic bands, office equipment and even champagne  corks, but also  balloons, paints and tarmac.

You can read Beth’s full story here in today’s Daily Mail Good Health section http://www.dailymail.co.uk/health/article-2353187/The-hidden-epidemic-allergy-affects-thousands-triggered-roadworks.html

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CAPTION: Latex rubber sap is a natural product used in thousands of everyday items and difficult to avoid

Beth wanted to do a story in a national newspaper  about her latex allergy because she is frustrated at the lack of awareness  surrounding the condition. She told me: ‘Everybody thinks the latex allergy problem has gone away because most NHS hospitals now use either latex-free or low protein gloves – but there are still hundreds of thousands of people who remain sensitised to latex and there are  just so many products containing latex in everyday use that it is increasingly difficult to avoid.

‘For instance, I’ve even walked into a hospital foyer and come across a charity handing out latex balloons – triggering an attack. The same thing happened at trade exhibition I attended recently. Despite the organisers assuring me that there would be no balloons at the event, a supplier brought them along and decorated stalls with them. The same thing has happened  to me in restaurants too. I can’t even go to a supermarket  without wearing a mask because there is a  risk food may have been contaminated with latex in a processing plant or factory. I can’t live a normal life.’shutterstock_125575664CAPTION: LATEX GLOVES:  The HIV/ Aids  epidemic in the 1980s and early ’90s triggered an upsurge in latex allergy cases

Whilst  some people with latex allergy will suffer nothing more than an itchy rash when they encounter latex gloves  (known as a type IV sensitivity), some people  (like Beth) will go onto develop  a more severe type 1 allergy which produces hay fever type symptoms and  hives and can result in a full-blown anaphylactic reaction. Beth developed a mild type IV sensitivity to latex at 16 when she started using latex gloves  during her science A levels studies but this turned into a type 1 sensitivity  at 21 and 18 months ago she had her first  anaphylactic reaction.

Latex is  increasingly hard to avoid and although many hospital either use latex-free or low-protein, hundreds of thousands of people remain sensitised to  it and  are theoretically at risk of developing a type 1 allergy and having an anaphylactic reaction.

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< CAPTION> Some  wine   corks may contains preservatives containing latex

The latex allergy problem clearly hasn’t gone away – although if you talk to some people you’ll get the impression that particular health problem is done and dusted and has all been solved by  medical staff wearing latex free gloves etc. For latex allergy sufferers though the problem is  still very real: another women I interviewed for the Daily Mail piece has had so many anaphylactic attacks in the last 17 years that  she barely leaves the house unless a relative trained to use an EpiPen can accompany her.

Latex balloons appear to be the biggest bugbear as they can literally pop up from  nowhere and cause anaphylactic attacks. So next time you’re having a party or organising promotional activities at work, spare a thought for Beth Redpath and think twice about the  latex balloons  (or buy foil ones instead). … for some, the consequences  could be life threatening.

For more information go to

www.anaphylaxis.org.uk      

www.lasg.org.uk

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P.S. Here’s a  link to another article  I’ve written about allergies  http://www.dailymail.co.uk/health/article-2242522/Did-eating-chicken-tikka-deadly-allergy.html

Are you perimenopausal?

shutterstock_103185746The classic signs of the menopause are well known; hot flushes, night sweats and irregular periods. But there are other symptoms in the preceding so-called perimenopausal years – that are not so well known and if you’re  a woman in your late forties (like me) you might want to know about them….

Palpitations, joint pain, dizzy spells, depression, memory problems, thinning hair, panic attacks, changes in taste, indigestion, itchy skin conditions and receding gums are just some of the seemingly unrelated symptoms that can start to affect women in the two-to-three year window before their menopause. Yet many symptoms  are investigated and treated individually in isolation and not recognised as being connected to hormone changes.

Professor John Studd, a consultant gynaecologist at the London PMS and Menopause Clinic, says there are stacks of symptoms that can be attributed to hormone changes in the perimenopause. One of the symptoms is skin formication – an itchy sensation like crawling insects. Not everyone gets them of course – that depends on how sensitive you are to the hormones oestrogen and progesterone. If you’ve  been badly affected by premenstrual syndrome (PMS) or postnatal depression in the past, though, you’re more likely to suffer from depression in the perimenopausal years.

Mandy Flynn, a 49 year old bank cashier from Kenley , Surrey, whom I interviewed for this piece  for Daily Mail Good Health http://www.dailymail.co.uk/health/article-2324019/Menopause-The-unexpected-signs-youre-hit-it.html started suffering from a string of seemingly unrelated health problems  as she hit her mid 40s. These included dizzy spells, hyperventilation, heavy aching joints, an itchy skin condition on her neck , indigestion, memory problems and anxiety. Mandy dismissed her symptoms as minor ailments and put up with them for 18 months before seeing her GP – but wondered why she was suddenly falling apart . She was shocked when her GP suggested all the symptoms were related and part of the perimenopause – as at the time she was still having periods and had none of the classic menopause symptoms such as  hot flushes and night sweats.

shutterstock_31102336 CAPTION: Hot flushes are a classic sign of the menopause < IMAGE > SHUTTERSTOCK

What causes perimenopausal symptoms?

There are cells called oestrogen receptors all over the body that are targets for the female sex hormone  oestrogen. As the levels of the hormone fluctuate in the perimenopause, the cells react and cause symptoms . For instance – muscles have oestrogen receptors  and falling levels can trigger pain. Changes in oestrogen levels can also affect levels of collagen ( a naturally occurring protein)  found in the skin, joints, hair, nails,bladder and vagina. Professor Studd says  loss of collagen causes muscle pain and skin formication – a creeping itching sensation similar to insects crawling under the skin.  Too often these symptoms are not recognised  as signs of the perimenopause – and instead women often undergo unnecessary investigations and are prescribed treatments that are ineffective – because the underlying problem is hormonal.

Miss Claudine Domoney , consultant obstetrician and gynaecologist at the Chelsea and Westminster Hospital, says women can often undergo more tests and treatment that end up doing more harm than good. For instance , she says joint and muscle pain in perimenopausal women are much more likely to be due to hormone changes rather than an auto immune condition such as rheumatoid arthritis, which is what might be diagnosed.’ The treatment is much easier and more acceptable than other treatments for musculo-skeletal disorders , such as steroids.’

These symptoms often resolve within a week when women try hormone replacement therapy.

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CAPTION:  Anxiety and depression are common signs of hormone imbalances  in the perimenopause

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Equally though, some experts argue that not all medical conditions that appear in the perimenopause years  can be attributed to hormones. Endocrinologist Dr Mark Vanderpump from the Royal Free Hospital says that thyroid problems are very common in the years before the menopause but these symptoms will not respond to HRT because the thyroid problem needs treating first. He says:  ‘ Symptoms of the menopause and thyroid disorder can overlap and one can mask the other.’

On balance though – if you’ve noticed a string of weird symptoms  as you hit your mid forties it might be worth asking your doctor if she thinks they are connected to the perimenopause and considering a trial of HRT. It might  just save you an awful lot of other investigations and complicated treatments with side effects  – and you won’t feel like you’re suddenly falling apart either.

PS: If you are struggling with classic menopausal night sweats – take a peek at the  The Fine Bedding Company’s range of Perfect Balance TM pillows, mattress toppers and duvets ( from £30) – they’re covered and filled with a special fibre blend called  Lysoft –  don’t ask me how but somehow it keeps you warm and cool at the same time helping regulate your body temperature and keeping moisture  away from your body so you don’t wake up bathed in sweat. Even if you’re not menopausal  the duvets are  great for  coping with the  ever-changing British climate.

Why we’ve all still got the winter blues

shutterstock_75285766                                                 CAPTION:Wet weekends are dampening our spirits

Winter 2012/2013 seems to be lingering well past its sell-by date  here in the UK.  I don’t know about you, but I’ve had enough of grey skies, freezing temperatures, chilly easterly winds and yet more rain (and snow!).

The weather forecast for this week   is not exactly  putting a spring in my step either: the Met Office is predicting it could be turning  even colder.It doesn’t help that the Long Winter was preceded by the Non Existent Summer….  but don’t get me going  on that one either. In case you’ve forgotten though, 2012 was the wettest summer in 100 years with 370.7mm of rain – it was also the least sunny summer for 25 years with only 413 hours of sunshine. January this year had only 37.3 hours of sunlight compared to 58.3 the previous year and February wasn’t much better. March is  reported to be the coldest for 50 years.

I can’t be the only one who is finding the weather a bit of a downer.

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CAPTION:   Like dormice we humans can feel like hibernating too

The (late) Winter Blues

Professor  Chris  Thompson, formerly professor of psychiatry at Southampton University , now head of the Priory Group, says it has been an appalling year for SAD sufferers and also sufferers of  the winter blues – a type of SAD Lite with milder symptoms. The Seasonal Affective Disorder Association agree and say they have been receiving  calls since last July when it was also cloudy and gloomy. Sales of  light boxes used to treat SAD are up by 20 per cent according to Philips. You can read more about what the experts  say here in my article in today’s Daily Mail Good Health section  http://www.dailymail.co.uk/health/article-2299045/Winter-blues-Tired-grumpy-hungry-Why-grey-skies-syndrome-blame-.html

Anyway, I confess: I get the winter blues –  not full-blown Seasonal Affective Disorder but a sort of SAD -lite. In the winter, I’m a tad grumpy, eat too many biscuits and want to hibernate. I don’t feel like this at all in the other half of the year – quite the reverse – I love socialising and am a real glass half-full type. My low mood usually lifts off in spring – I’ve never needed medical treatment – but this year it’s just going on too long.

Winter blues,  according to the  UK Seasonal Affective Disorder Association (SADA), is a milder version  of SAD – the classic symptoms of which are low mood,  excessive sleepiness, cravings for carbohydrates (toast or hot cross bun anyone?) etc. Other symptoms of SAD include waking up in the night or early morning, not wanting to socialise, feeling tense and/or irritable, heavy aching limbs, weight gain and stomach problems, sweating, cramps and needing to urinate frequently.

Symptoms start in Autumn and lift in Spring. Only  this year they’re not lifting – because so far There Has Been No Spring.

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                                                         CAPTION: Spring flowers  are yet to appear

Who gets it?

Estimates vary – but around seven  per cent of people are thought to be affected by SAD in the UK – although experts believe many cases go unreported  so the true figure may be higher. You’re unlikely to be diagnosed with SAD unless you’ve suffered the symptoms for two or more consecutive winters.However around 17 per cent of us are  estimated  to suffer from the winter blues – that’s at least 10 million people in the UK – and my guess is that figure is a lot higher this year.

What causes it?

There are various theories as to what causes SAD and winter blues  but most centre on the effect of light on the brain. One theory is that light stimulates a part of the brain called the hypothalamus, which controls mood, appetite and sleep. It is thought that in people with SAD, lack of light and a problem with the brain chemicals produced in the hypothalamus, may be to blame for their symptoms.

Is it genetic?

Various studies have shown that between 29 and 64 per cent of people with SAD come from families with a history of the disorder suggesting there is a genetic element. Whilst no research has isolated a “SAD gene”,  some progress has been made in understanding a possible genetic basis to the disorder.

Latest research from the University of Virginia in the US has suggested that SAD may be linked to a genetic mutation in the eye that makes SAD patients less sensitive to light. These individuals have lower levels of a photo-pigment receptor called melanopsin which regulates alertness and circadian rhythms (the body’s natural 24 cycle of biological activity/sleep). These individuals may need brighter light levels to maintain normal functioning during the winter months. Not all  SAD sufferers have this mutation – known as the melanopsin mutation –  but scientists  in the study found  individuals with two copies of the mutation had a reasonable chance of developing SAD.

 Winter survival tips

  • Light boxes: The UK Seasonal Affective Disorder Association (SADA) says that light therapy (exposure to very bright light at least 10 times the intensity of domestic lighting), for up to four hours a day is effective in alleviating SAD symptoms in around 85 per cent of cases – and it works within a few days.A 2006 double blind randomised controlled trial conducted on 92 patients called the CAN-SAD study  compared the effectiveness of light box  treatment with the antidepressant Fluoxetine. It  found both were equally effective  – working for 67 per cent of patients , but patients treated with light box treatment showed improvement sooner and had less side effects. SADA says light therapy is not suitable if you are taking antidepressants or anti-epilepsy medication or have a sensitivity to light though.The National Institute of Clinical Excellence – the independent body that advises the UK government on the effectiveness of treatments  – says there is no strong evidence to support the use of light therapy  and recommends SAD be treated  like depression with psychological therapies and  SSRIs.

CAPTION: The Philips go LITE BLU

Light boxes are not available on the NHS  but you can buy them from around £180 or hire them for around £18 a month.The strength of light is measured in units called LUX (a measure of brightness).  Look for one certified as a medical device EC93/42. It can be set up to use whilst you are watching TV or working on a computer. I start using mine in the run–up to the clocks changing in October – some people even need them in the summer if sunlight hours are low. For what it’s  worth  I ‘ve used the Philips go LITE BLU.

Some newer research studies suggest that low intensity blue light devices may be more beneficial than high intensity white light in treating SAD because blue light activates melanospin, but these  studies  based on very small  numbers  of patients, so more research is needed into this.

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CAPTION:  Log fires and hot chocolate: Winter does have its compensations

  • Cognitive Behavioural Therapy:At the risk of sounding like Anne of Green Gables – a lot of it is down to making the best of a bad job and focusing  on the good things about winter.  I’m thinking cosy evenings by the wood burner, hearty stews, hot chocolate, watching Call the Midwife and wrapping up warm for walks on frosty mornings . I once completed an online course in cognitive behavioural therapy (talking therapy) called Beating the Blues  (it’s available on GP  prescription)  for a magazine feature I was writing. I found it helpful for reframing negative thought patterns. Okay, it doesn’t work when it’s pouring with rain all day and hardly gets light – but cold, crisp days aren’t so bad (although even these are wearing a bit thin by late March admittedly).
  • SSRI antidepressants:  If your depressive symptoms are severe you may full blown SAD so  see your GP for advice . They may prescribe Selective Serotonin Re-uptake Inhibitors  (SSRIS). These  can help because they raise levels of  serotonin  the “feel good” chemical  in the brain and boost your mood. I’ve never taken these as my symptoms have never been severe enough to warrant them, but experts recommend them as a treatment for depression and they work for millions of people, although like most drugs they do have side effects including nausea, low sex drive, sleep problems, blurred vision and dry mouth.

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       CAPTION: Poppy my Wheaten Terrier is an outdoor enthusiast whatever the weather

  • Get outside: One expert I interviewed about SAD says a daily dose of the great outdoors works even better if you have a purpose  – so try walking your dog, training for a  running race or gardening. Aim for an hour outdoors every day.I also have a garden chair set up outside my back door in the precise spot where a slither of sun sometimes appears on  a winter lunch break.  Latest research says low levels of vitamin D are not implicated in SAD – but I take a supplement anyway (Vitabiotics Ultra Vitmain D ),  because deficiencies are associated with so many other illnesses. If nothing else I figure  it’s a great back-up

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CAPTION: Rhodiola – or golden root can be drunk as a tea or taken in tablet form

  • Herbal remedies: St John’s Wort is the most  well known herbal remedy for mild to moderate  depression and  there is research to support its effectiveness. However it’s not suitable if you’re on light therapy or taking antidepressants and it can also interact with a whole host of other medicines including: the contraceptive pill , Hormone Replacement Therapy, thyroxine, some blood pressure pills and the blood-thinning treatment warfarin so always inform your doctor you are taking St John’s Wort if you are on any of these prescription drugs.

But for winter blues (aka SAD Lite) the less well- known Rhodiola Rosea may be worth a try. Not heard of it? It’s been traditionally used in chilly climes like  Eastern Europe, Siberia and Scandinavia  to cope with living in a cold climate and a stressful life. Rhodiola isn’t marketed for SAD – but for stress , anxiety and exhaustion. Rhodiola Rosea (also known as golden root) enhances physical and mental performance, stimulates the nervous system and fights depression, according to the Sloan-Kettering Cancer Center in the US. Studies are limited in humans but include  one paper published in 2007 which showed   improvements in depression and another in 2000 where the results showed improvements in the symptoms of generalised anxiety disorder.  Latest research  just published  this month suggests rhodiola may be  useful for increasing stamina and endurance in marathon runners. Try Schwabe’s Vitano or  Healthspan’s Rhodiola

  • Curb  carb cravings: My strategy is to eat a good breakfast – by which I mean one that fills you up and stops you feeling hungry. My favourites are porridge or Weetabix (both  release energy slowly throughout the morning avoiding  dramatic drops in blood sugar),  or poached egg on wholemeal toast, (the combination of protein and carbohydrate  is said to be particularly good for satiety).  Soup and oatcakes are  my other other staples.
  • Winter sun holidays: I used to book these in the days before I had three expensive children – and again I think they work wonders. So if you can afford it book a ticket to sunnier climes – now.

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                                                  CAPTION: Tulips in spring – let’s hope they make an appearance  …. soon

British (and European) Summertime officially begins on  Sunday 31 March 2013so let’s hope Spring shows its face after that.  There are  even rumours that the  late spring could mean we are in for a heatwave.In the meantime if anyone spots the sun TEXT ME  –  immediately. That garden chair by my back door? It’s got my name on it…….

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And here’s something to cheer you up …..Gene Kelly followed by George Harrison – what a treat….