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Q: I regularly have a floral, perfumey taste in my mouth. I was recently treated for anemia, but apparently my levels are now back to normal. Could the problems be related or is there another cause?
Dr. Ellie Cannon responds: It is entirely possible that this strange taste could be caused by anemia, but it is important to explore other possibilities.
Anemia, an iron deficiency, occurs when the body does not produce enough red blood cells due to a lack of iron. This usually causes tiredness, shortness of breath, or heart palpitations.
An altered sense of taste is a rare side effect of anemia, but it can also be caused by a virus or medications, for example.
A rare side effect is an altered sense of taste, such as a floral taste.
When a patient has anemia, their GP usually checks their hemoglobin and ferritin levels. Hemoglobin is a protein found in red blood cells that carries oxygen throughout the body and gives blood its red color. Ferritin is another blood protein that stores iron.
Patients with anemia often have low levels of both. They will be encouraged to consume a diet richer in iron: leafy green vegetables; legumes and beans; Nuts and seeds; and meat, fish and tofu, or take iron supplements to increase levels.
If, as you mentioned, your hemoglobin and ferritin levels have returned to normal, it is unlikely that this strange taste is caused by anemia. Instead, you may be suffering from the after-effects of a virus. Insects, like Covid and the flu, can cause changes in smell and taste, which can last weeks or even months.
A change in taste is also a known side effect of medications such as antibiotics, antihistamines, and chemotherapy.
If the floral taste persists, I recommend speaking to your GP so it can be explored further. You might also consider a complete dental evaluation, as some mouth or gum disorders can also cause changes in taste.
Q: I am 76 years old and have suffered from hypnotic headaches for four years. Coffee before bed seems to help, but that means I have to go to the bathroom at night. Would it be safe for me to take caffeine pills?
Dr. Ellie Cannon responds: Hypnotic headaches can be a terrible pain, but fortunately, caffeine (including tablets) seems to help.
This rare type of headache usually occurs during sleep and wakes people up, which is why it is often known as an alarm clock headache.
The pain can last up to four hours and usually appears in the first few hours.
Doctors aren’t sure what triggers them, but they mainly affect older people and are more common among people who have struggled with migraines.
While there are few effective treatments for hypnotic headaches, research suggests that the caffeine in coffee appears to improve debilitating symptoms.
It is used to prevent headaches and also to reduce the uncomfortable feeling once it starts.
But coffee has the side effect of making you need to go to the bathroom. A cup of coffee can have 100 mg of caffeine, although this can vary significantly. One Pro Plus tablet, one of the most popular brands of caffeine pills, contains 50 mg of caffeine, so taking two of them would have the equivalent effect and reduce the need to urinate.
However, caffeine is not the only treatment for hypnotic headaches. GPs also prescribe an anti-inflammatory drug called indomethacin or an epilepsy medication called topiramate. These will only be offered if it is safe to take them along with any other prescription medications you are taking. It might be worth trying one of these medications to see if they work as well (if not better) than caffeine.
Q: My husband, who is 48 years old, recently urinated blood. His GP referred him for a scan, but nothing was found. Should we be worried?
Dr. Ellie Cannon responds: Blood in the urine is a worrying problem and warrants an immediate appointment with the GP, so it is good to know that your husband was examined immediately. This is because it can be a sign of bladder, prostate or kidney cancer.
Typically, patients will be referred for a cystoscopy, which involves inserting a long, thin camera down the urethra to look for signs of cancer inside the bladder. Additionally, ultrasounds are used to look for kidney disease, as well as a PSA blood test that could detect prostate cancer.
Although cancer is the most serious cause of blood in the urine, it is not the most common.
The typical reason for this symptom is an infection, usually in the kidney or bladder. Kidney stones (small crystals that form inside the organ) can also cause bleeding.
However, these can be incredibly painful, so most patients will know when they have them.
Stones can also form in the bladder and cause someone to pass blood.
If blood in the urine appears only briefly and all tests are normal, then this is reassuring. But if the problem continues, it would be wise to get tested once again.
Liberal Democrat leader Sir Ed Davey has spoken out about the challenges of caring for his disabled teenage son, John.
Parliamentarians must face the welfare crisis
I was moved almost to tears earlier this month when I watched a video of Liberal Democrat leader Sir Ed Davey discussing the challenges of caring for his disabled teenage son, John.
In the clip, which has been viewed more than six million times online, Sir Ed explains that the experience means he is “passionate and determined” to fix the welfare system.
However, I can’t help but feel frustrated by this comment. Politicians should not need first-hand experience to know that the care system is in crisis.
Doctors and health personnel have been sounding the alarm for years. Figures suggest that more than 2.6 million older people are unable to receive care, whether it be access to a health worker to help them at home or a bed in a care home. This is largely because there are more than 165,000 vacant healthcare staff positions. We can’t continue like this.
I hope Sir Ed’s emotional story awakens Sir Keir Starmer and Rishi Sunak to the fact that the social care system needs urgent attention.
Vicky McClure stars in the Paramount+ TV show Insomnia as a lawyer who suddenly finds it impossible to sleep.
Do you suffer from terrible insomnia like Vicky?
Insomnia is a huge problem, so I was pleased to see that there is a new TV drama series highlighting how horrible it is to live with.
The show, Insomnia, stars the brilliant Vicky McClure as a high-flying lawyer who suddenly finds it impossible to fall asleep.
While the show, streaming on Paramount+, overdramatizes sleep deprivation, it’s not far removed from my patients’ experiences.
GPs have a variety of treatments to offer, including types of cognitive behavioral therapy (CBT) and medications that can be taken short-term.
I’m interested to know what methods offered on the NHS, if any, have helped improve your sleep. Please write using the email below and let me know.