Q: I regularly have a perfumed, flowery taste in my mouth. I have recently been treated for anaemia but my levels are now apparently back to normal. Could the problems be connected or is something else the cause?
Dr Ellie Cannon replies: It is entirely feasible that this strange taste could be caused by anaemia – but it’s important to explore other possibilities.
Anaemia, an iron deficiency, occurs when the body does not produce enough red blood cells due to a lack of iron. This often causes tiredness, shortness of breath or heart palpitations.
An altered sense of taste is an uncommon side effect of anaemia, but it can also be down to a virus or medications, for example
One uncommon side effect is an altered sense of taste – such as a flowery flavour.
When a patient has anaemia, their GP will usually check their haemoglobin and ferritin levels. Haemoglobin is a protein found in the red blood cells that carry oxygen around the body and gives blood its red colour. Ferritin is another blood protein which stores iron.
Anaemia patients usually have low levels of both. They will be encouraged to eat a more iron-rich diet: leafy vegetables; pulses and beans; nuts and seeds; and meat, fish and tofu – or take iron supplements to boost levels.
If, as you mentioned, your haemoglobin and ferritin levels are back to normal, it’s unlikely this strange taste is caused by the anaemia. Instead, it is possible you might be suffering the after-effect of a virus. Bugs, such as Covid and flu, can trigger smell and taste changes, which can last for weeks or even months.
A change in taste is also a known side effect of medications including antibiotics, antihistamines and chemotherapy.
If the flowery taste persists, I recommend talking to your GP so it can be explored further. You might also consider a full dental assessment as some mouth or gum disorders can trigger taste changes, too.
Q: I’m 76 and have suffered hypnic headaches for four years. Coffee before bed seems to help – but this means I have to use the toilet in the night. Would it be safe for me to take caffeine tablets instead?
Dr Ellie Cannon replies: Hypnic headaches can be a terrible pain but, luckily, it does appear that 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 typically occurs in the early hours.
Doctors are unsure what triggers them but they primarily affect the elderly and are more common among people who have struggled with migraines.
While there are few effective treatments for hypnic headaches, research suggests that the caffeine in coffee appears to improve the debilitating symptoms.
It is used to prevent the head pains occurring and also to reduce the uncomfortable sensation once it begins.
But coffee has the side effect of making you need the toilet. A cup of coffee can have 100mg of caffeine – although this can vary significantly. A Pro Plus tablet – one of the most popular brands of caffeine pills – contains 50mg of caffeine, so taking two of these would have the equivalent effect and reduce the need to pee.
However, caffeine is not the only treatment for hypnic headaches. GPs also prescribe an anti-inflammatory drug called indomethacin or an epilepsy medication called topiramate. These would only be offered if it was safe to take them alongside any other prescriptions you are taking. It might be worth trying one of these medicines to see if they work just as well – if not better – than caffeine.
Q: My husband, who is 48, recently urinated blood. His GP referred him for a scan but nothing was found. Should we be concerned?
Dr Ellie Cannon replies: Blood in the urine is a worrying problem and warrants an immediate GP appointment, so it is good to hear that your husband got checked straight away. This is because it can be a sign of bladder, prostate or kidney cancer.
Usually patients will be referred for a cystoscopy, which involves inserting a long, thin camera up the urethra to look for signs of cancer inside the bladder. Also, ultrasound scans are used to look for the disease in the kidney, as well as a PSA blood test which could flag up prostate cancer.
Though 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 which form inside the organ – can also trigger bleeding.
However, these can be incredibly painful, so most patients will know when they have them.
Stones can also form in the bladder and may cause someone to pass blood.
If blood in the urine only occurs briefly and all tests are normal, then that is reassuring. But if the issue continues, it would be wise to get tested once more.
Liberal Democrats’ leader Sir Ed Davey has spoken about the challenges of caring for his disabled teenage son, John
MPs must deal with care crisis
I was moved nearly to tears earlier this month when I watched a video of the Liberal Democrats’ 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 social care system.
However, I can’t help but also be frustrated at this remark. Politicians shouldn’t need a first-hand experience to know the care system is in crisis.
Doctors and care staff have been raising the alarm for years now. Figures suggest more than 2.6 million elderly people are unable to get care – whether that is access to a care worker to assist them at home or a bed in a nursing home. This is largely due to the fact there are more than 165,000 care staff vacancies. We cannot go on like this.
I hope Sir Ed’s emotional tale will wake up Sir Keir Starmer and Rishi Sunak to the fact 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 horrific insomnia like Vicky?
Insomnia is a massive issue, so I was pleased to see that there is a new TV drama series which highlights how awful it is to live with.
The programme, Insomnia, stars the brilliant Vicky McClure as a high-flying lawyer who suddenly finds it impossible to sleep.
While the show, streaming on Paramount+, over-dramatises sleep deprivation, it is not a million miles away from the experiences of my patients.
GPs have a range of treatments to offer, including types of cognitive behavioural therapy (CBT) and medication which can be taken in the short-term.
I’m interested to know what methods offered on the NHS, if any, have helped to improve your sleep? Please write in using the email below and let me know.
Source: Mail Online
