For several weeks now I have been feeling extremely tired and need to take naps every day. I went to the GP and had blood tests done but nothing worrying came up. I started taking Mounjaro four months ago to lose weight, but the fatigue started only two months ago. What could be the cause?
Dr. Ellie Cannon responds: Sudden tiredness is always a reason to see a doctor, as it can sometimes be a sign of life-threatening diseases such as cancer.
A GP can perform a blood test to look for signs of tumors, as well as rule out other causes such as anemia, a blood disorder that occurs when there are not enough healthy red blood cells.
Another possible cause of fatigue is a thyroid problem.
An underactive thyroid gland (a butterfly-shaped gland in the neck that produces crucial hormones) can leave people tired and lead to constipation, hair loss, and weight gain. Again, a blood test can detect this problem.
Mounjaro is a weight loss drug that works by suppressing hunger hormones in the body. This means that patients receiving the weekly injection eat significantly less food than they would otherwise. It is very effective and, as a result, many obese patients lose up to a quarter of their body weight.
However, it has a number of side effects and tiredness (or lethargy, as it is also known) is considered very common.
Because the medication is given in gradually increasing doses over several months, patients may begin to experience symptoms several months after onset.
However, another concern about these weight loss medications is that patients are not getting enough vital nutrients because they eat such small amounts of food.
This may mean that some patients do not get enough iron, B12 or vitamin D.
The lack of these nutrients can cause intense fatigue.
To evaluate whether Mounjaro is causing side effects, it might be worth going back to a smaller dose to see if the problem lessens.
A few years ago I tripped and banged my shins on some stone steps. The bruises eventually went away, but since then I have suffered stabbing, burning pains on the front of my shins whenever I kneel or put pressure on the area. What can I do to end the agony?
A cream called capsaicin, made from chili peppers, can reduce nerve pain
Pain that continues long after an injury and is triggered by physical contact is often due to nerve damage.
Nerves are fibers that run through the entire body and are responsible for the sensations we feel. If the nerves are damaged, these feelings can go wrong. This can cause debilitating symptoms such as stabbing, burning, or itching pain. It is not uncommon for the area to become hypersensitive, meaning that the slightest physical contact can cause severe pain.
GPs can refer patients for testing for nerve damage, known as a nerve conduction study. However, when the symptoms clearly match those of a nerve problem, this is often not necessary.
Doctors prescribe specific medications for nerve pain, since pain relievers like codeine do not work. Doctors can usually prescribe amitriptyline, gabapentin, and duloxetine.
Amitriptyline may be helpful for anyone whose nerve pain causes sleep loss, as it improves deep sleep. When the pain is in a localized area, doctors may offer a cream called capsaicin. It is made with chili peppers and can nullify nerve pain.
Unfortunately, none of these treatments are 100 percent effective and many patients find that it may take some time for the pain to go away.
My GP put me on statins after a blood test revealed my cholesterol was high. However, after only a few months I had to stop them because I had a bad reaction. I have heard that plant sterols are a safe and natural alternative to statins. Should I take these instead?
Dr. Ellie answers: High cholesterol is one of the main risk factors for heart disease and stroke.
Over time, high cholesterol levels mean that fatty deposits can build up in your blood vessels.
This can lead to blocked arteries, which can have life-threatening consequences.
A healthy diet and regular exercise can reduce cholesterol levels. But the most effective treatment is statins, daily pills that limit the amount of cholesterol created.
For most, statins are safe and effective. However, some struggle with side effects such as muscle aches. Plant sterols are a plant-based supplement that has been shown to help fight cholesterol. The nutrient is found in most fruits, vegetables and legumes.
Studies show that eating a diet rich in plant sterols can reduce LDL (the bad type of cholesterol) by up to a tenth. However, statins can reduce LDL levels by up to half.
If someone cannot take statins, there are other effective medications that GPs can offer. It is essential that anyone stopping taking statins speaks to their GP as soon as possible.
- WRITE TO DR. ELLIE: Do you have any questions for Dr. Ellie Cannon? Email DrEllie@mailonsunday.co.uk
- Dr. Cannon cannot engage in personal correspondence and her responses should be taken in a general context.
Over 40… did you know that you can obtain a health MOT?
During the appointment, your GP will monitor your blood pressure, weight, cholesterol and risk of diabetes.
Have you had your NHS health check? It turns out that most people don’t keep their appointments.
Often called a mid-life MOT, it is offered to people over 40 and can be carried out up to age 74.
During the appointment, your GP will monitor your blood pressure, weight, cholesterol and risk of diabetes. These measurements can give a good indication of whether someone is at risk of developing life-threatening diseases, such as heart attacks and strokes.
But according to new NHS data, less than half of guests turn up. I find this surprising since it is something very easy to do.
Have you received an invitation for an NHS health check? Did you attend? And if he didn’t, what was his reasoning? Please write to me and let me know.