DR. ELLIE CANNON: Why do I always feel so nauseous when I wake up?

Why do I always feel so nauseous when I wake up?

A few months ago I started feeling nauseous and this lasted about an hour before I passed. More recently, I’ve been experiencing the same nausea every now and then during the day.

My GP ordered blood tests, but they came back normal. The doctor is now dumbfounded. Any ideas?

I cannot stress enough that any new and persistent symptom, especially if you are over 50, should always be thoroughly examined by a doctor. For most people, nausea is a transient symptom that lasts only a few days.

It is not common to feel nauseous every morning and regularly throughout the day.

Blood tests give us a general picture of health and can sometimes point to serious causes, but they are not a complete picture.

Frequent nausea can be caused by acid reflux, gastritis, migraines, anxiety or, much more rarely, pancreatic cancer. None of these would necessarily be highlighted in a routine blood test.

DR.  ELLIE CANNON: I can't stress enough that any new and persistent symptom, especially if you're over 50, should always be thoroughly examined by a doctor.  For most people, nausea is a transient symptom that lasts only a few days (file photo)

DR. ELLIE CANNON: I can’t stress enough that any new and persistent symptom, especially if you’re over 50, should always be thoroughly examined by a doctor. For most people, nausea is a transient symptom that lasts only a few days (file photo)

Nausea is a common side effect of medication and should always be considered as a possible cause.

It can also be related to certain foods, as well as alcohol – especially in excess.

Any new symptom, especially if it is persistent and significant, may require further investigation. For persistent nausea, this may involve stool tests or an ultrasound, as well as tests such as an endoscopy. This involves passing a tube with an attached camera down the throat and into the stomach, which is inconvenient.

I have been taking the pill venlafaxine for anxiety every day for 25 years. It works, but sometimes I feel like I’m in a bubble and my marriage has suffered from my total lack of libido. Is there an alternative without this effect?

Venlafaxine is an antidepressant prescribed in the UK for Generalized Anxiety Disorder – the name we give to the mental illness which means that people feel constantly anxious, rather than in response to specific events.

More from Dr. Ellie Cannon for The Mail on Sunday…

It is a type of drug known as a serotonin-norepinephrine reuptake inhibitor, or SNRI. These work by increasing the levels of chemicals called serotonin and norepinephrine in the brain, which are linked to mood and energy.

They were developed to be more effective than selective serotonin reuptake inhibitors, or SSRIs, and while there is mixed evidence that they treat depression, they have been shown to be effective for anxiety.

As with all drugs, they have side effects. For many people, the pros outweigh the cons. But when the side effects are so great that they affect quality of life and relationships, it’s good to explore other options.

The most common side effects of venlafaxine are nausea, drowsiness, constipation, and lack of energy. It is also known to raise blood pressure and affect blood sugar levels in people with diabetes.

Sexual problems are a recognized side effect of antidepressants and many medications used for mental illness.

There are other medications available to treat anxiety, including those of the SSRI group, such as escitalopram. It may also be that side effects are reduced with a lower dose.

After 25 years, any change in medication has to be taken incredibly slowly. In such a case, tapering off medication would take months before a new tablet is slowly introduced. Any trial of new medication should be carefully supervised by a general practitioner or psychiatrist.

I have developed a prickly itch on my thighs, buttocks, arms, neck and chin – with no rash. It all started when I got a Covid shot and it has gotten worse since my booster. Could it be an allergy to the vaccine?

Itching may sound trivial, but it can be a troubling symptom. It also often perpetuates itself, such as when we itch, we scratch, which makes the itch worse.

Itching in sweaty areas such as armpits, inner thighs and neck can indicate a number of things. Warm, moist places are ideal for the development of a fungal or yeast infection such as thrush. There may not be an obvious rash, but it’s worth trying an antifungal or thrush cream for a few weeks to see if it helps.

The other possibility with itching in these areas is urticaria – itchy, red, raised patches or spots that develop due to high levels of a chemical called histamine in the skin.

Histamine is released as part of the immune system’s response, but it can also be caused by eating certain foods, exposure to heat or cold, infection, or in response to medication.

Whatever the cause, it’s a good idea to try an oral antihistamine regularly to help ease the itching. It also helps to soothe the skin as scratching is reduced. On the advice of a pharmacist, antihistamines can be taken at night and during the day.

Skin reactions are listed in the official advice as common side effects of all vaccinations. This should therefore be reported by the doctor as a possible side effect of the Covid jab, using the MHRA ‘Yellow Card’ reporting system.

Are you a struggling new mum found adrift by the NHS?

In my opinion, the NHS has never been particularly good at post-natal care for women.

For example, it’s long been known that as many as one-fifth of new moms develop depression or a similar problem, but it’s only relatively recently that we were told to ask about mental health during the six-week checkup.

And I’ve had patients with severe pelvic problems after childbirth who then suffered in silence for years after being told by (often male) GPs to ‘watch and wait’ – as if these problems were part of the course.

DR ELLIE CANNON: In my opinion the NHS has never been particularly good at postnatal care for women (file photo)

DR ELLIE CANNON: In my opinion the NHS has never been particularly good at postnatal care for women (file photo)

DR ELLIE CANNON: In my opinion the NHS has never been particularly good at postnatal care for women (file photo)

Recently I have received a few reports that have concerned me. A new mom with suspected pelvic organ prolapse — when one or more of the organs in the pelvis slip from their normal position and protrude into the vagina — was told to go private if she wanted to be seen soon.

Yes, services are being stretched thinner than ever. But it is unacceptable for women to become adrift at such a vulnerable time.

Are you or do you know someone who has been left without medical assistance after childbirth, or has been sent off or told that they cannot receive treatment? I’d love to hear from you so we can investigate. Write me.

Covid rules hit children – again

I was on BBC Newsnight last weekend and spoke of my dismay at the return of restrictions which seem to be targeting children and young people.

Do you have a question for Dr. Ellie?

Email DrEllie@mailonsunday.co.uk or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.

dr. Ellie can only answer in a general context and cannot respond to individual cases, or give personal answers. In case of health problems, always consult your own doctor.

Face masks have been reintroduced in shops and on public transport, which I welcome. Although many adults unfortunately do not adhere to them, we insist that children wear them at school. Meanwhile, the pubs are full of Christmas-goers, exposed again, but Christmas plays are cancelled.

At best, this feels unfair. But I’d also suggest it’s pure Covid theater designed to look like something is being done but in reality pretty pointless and not evidence based.

I was a little worried that I would be accused of being ‘anti-mask’ or a Covid denier, but in fact I found that many of my colleagues agreed. Schools are not the hubs of Covid: There is much evidence that school fees are just a reflection of what is going on in local communities. If Covid is skyrocketing everywhere, it will be in schools too.

We must remember that limitations have both disadvantages and advantages, and that children have endured enough disruption and loss to protect adults.

Are you or do you know someone who has been left without medical assistance after childbirth, or has been sent off or told that they cannot receive treatment? I’d love to hear from you so we can investigate. Write me.

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