WHATEVER your gender, hair loss can be distressing.
I see patients weekly who feel their confidence slipping away, yet affects roughly half of men and 40 per cent of women by age 50.
Dr Zoe helps a reader with agonising plantar fasciitisCredit: Olivia West
It is often hereditary, but hair follicles are incredibly sensitive to your internal health.
So things like iron deficiency (), thyroid dysfunction or severe stress can contribute – all of which are manageable.
Clinically, the most effective treatments that may be worth money include , an over-the-counter foam, and finasteride, prescription tablets for men (not on NHS).
Minoxidil increases blood flow to follicles, while finasteride can block hormones that shrink follicles.
Stop the treatment and the hair loss returns.
Hair-boosting shampoos may help to make hair look better, but they don’t do much for the root cause (excuse the pun).
If you’ve noticed sudden loss or thinning, ask a chemist or your GP, who can book a blood test to rule out treatable causes.
Here’s a selection of readers’ questions this week . ..
My ‘plantar fasciitis’ is a real pain
Q: I AM a 67-year-old male and was diagnosed with in my right foot two years ago.
The pain is now so bad, it is keeping me awake at night.
A reader was diagnosed with plantar fasciitis two years agoCredit: Getty
As well as exercises, I have tried almost every “cure” from the internet, including insoles, special shoes, ankle supports and pain relief creams and sprays.
I am not even sure it is PF. My pain is at the back of my heel/ankle and it is very tender to touch.
My ankles are not swollen and I do not have .
A: You’re quite right to question the diagnosis.
Plantar fasciitis typically causes pain on the sole of the heel, especially with the first steps in the morning.
Pain at the back of the heel or ankle may be more suggestive of a different problem, most commonly Achilles tendinopathy (irritation of the tendon at the back of the ankle), or sometimes inflammation of the small fluid-filled sac in that area.
These conditions can cause tenderness to touch, pain when walking and discomfort at night – and they don’t always respond to the same treatments used for plantar fasciitis.
In musculoskeletal medicine, we also think about the joint above and below the area of pain.
So, in your case, although the pain is currently concentrated at the heel, it’s important to consider the ankle joint as well, because problems there can sometimes refer pain into the heel.
If symptoms are ongoing and not improving as expected, it would be reasonable to ask for further assessment, such as an ankle X-ray or more detailed imaging.
Pain management is often centred around targeted physiotherapy, particularly exercises that gradually strengthen the Achilles tendon.
Footwear can help, but often slightly cushioned or heeled shoes reduce strain more than flat insoles.
If you haven’t already been seen by the musculoskeletal specialist team, then I’d suggest requesting a referral.
Q: I HAD my right hip replaced a year ago. The operation went well, but I now have a swollen right foot and need crutches to walk.
I have seen my doctor many times, but still don’t know what is causing it. I have had scans, X-rays etc, but everything seems normal.
A reader is now using crutches after a hip replacementCredit: Getty
Oedema has been ruled out.
I am a 69-year-old man and I’m in pain and it makes me depressed.
A: I’m so sorry, it sounds both physically and emotionally exhausting.
A swollen, painful foot that’s affecting your ability to walk a year after hip replacement needs looking at as a whole picture.
It’s reassuring that scans and X-rays showed nothing serious, like a fracture or obvious structural problem.
However, that doesn’t mean there isn’t a cause.
When swelling isn’t due to simple fluid (oedema), other possibilities might include inflammation within the joints (such as arthritis or gout), tendon or ligament problems or nerve-related pain, particularly if your walking pattern changed after your hip surgery.
Even subtle changes in how you walk can place a lot of extra strain on the foot over time.
Complex regional pain syndrome is uncommon but can develop after injury or surgery.
It’s not the most likely explanation, but is worth considering, particularly as symptoms are ongoing.
It typically causes persistent, often severe pain, swelling, sensitivity to touch and changes in skin colour or temperature.
The symptoms can feel out of proportion to what scans show.
Because this has been going on for some time and is now affecting your mobility and mood, it would not be unreasonable to ask your GP for a fresh review, focusing on the foot and how symptoms have evolved.
A musculoskeletal specialist, podiatrist or pain clinic could help build a clearer picture. In the meantime, elevating the foot when resting, gentle movement within your limits, supportive footwear and pain management strategies may help.
Many conditions like this are treatable once properly recognised.
Do I put garlic on menu for cholesterol control?
Q: WHAT are your thoughts on using aged garlic instead of statins (atorvastatin) to control cholesterol?
A: It’s understandable to look for more “natural” ways to manage , particularly if you are concerned about long-term medication.
, including aged garlic extract, has been studied for its potential heart health benefits, and some research suggests it may have a small effect on lowering cholesterol levels.
However, the key word here is small.
The cholesterol-lowering effect of garlic is generally modest and variable, and not nearly as strong or predictable as statins.
Statins such as atorvastatin have been extensively studied and are proven to significantly reduce the risk of heart attacks and strokes in those who already have heart disease (secondary prevention) and those at higher risk (primary prevention).
That doesn’t mean garlic has no place at all.
As part of a healthy diet, it may contribute to overall cardiovascular health, and some people choose to take it alongside other lifestyle measures.
But it shouldn’t be seen as a replacement for statins, particularly in people who have been prescribed them because of higher cardiovascular risk.
It’s also worth noting that supplements can interact with medications and aren’t regulated in the same way as prescription drugs.
If you’re considering stopping or replacing your statin, it’s important to discuss this with your GP first.
They can review your individual risk and talk through the pros and cons in your specific case.
In most situations, the best approach is a combination of evidence-based medication (when needed) and lifestyle measures such as diet, exercise and weight management – and consuming garlic can be included as a lifestyle measure.
Eze Chidiebere Paul
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