My husband, 73, feels cold all the time. He wears thermals and always needs the house heated — he even feels cold in summer. Can you help?
Maralyn Endlar, Salford.
The question here is whether there’s a medical diagnosis to explain this constant cold feeling — or whether it is simply your husband’s physiology.
Our body temperature is controlled by the hypothalamus, a structure deep in the brain.
It monitors the temperature of the bloodstream and makes adjustments so that the body’s core temperature remains within a narrow band, close to 37c.
These adjustments include triggering sweating to cool you down, and shivering to warm you up (the brain tells the muscles to move, which generates heat).
You say in your longer letter that your husband is in good health, has a stable body weight and a good appetite — all good signs.
The question here is whether there’s a medical diagnosis to explain this constant cold feeling — or whether it is simply your husband’s physiology. Our body temperature is controlled by the hypothalamus, a structure deep in the brain
But he’s also very light, weighing 9 st 7 lb, and I suspect doesn’t have much body fat. So he’s relatively under-insulated, and that could be one factor leading to his oversensitivity.
Some medications such as those given for angina and high blood pressure can also lead to sensitivity to cold (by increasing blood flow through the skin and causing greater heat loss).
Another potential factor is low mood — I have treated patients for depression who, in their distress, feel so cold that they spend all day sitting over an electric heater. This is possibly the result of the inertia and lethargy, with less muscle action, that depression can cause.
Some medications such as those given for angina and high blood pressure can also lead to sensitivity to cold (by increasing blood flow through the skin and causing greater heat loss)
It may also be that the hypothalamus is affected. It is close to the areas in the brain involved in mood regulation.
It might be helpful to try the following physical challenge to assess your husband’s body temperature control: go for a brisk, one-mile walk and see how he feels when he gets home.
If he feels warmer than his usual cold state, try to incorporate a couple of such walks a day — it may help make a difference.
I’ve been diagnosed with glaucoma in my right eye and my vision is slightly fuzzy. But tests show my eye pressure readings are in the normal range. What could be the cause?
Gerry Lester, Oulton, Staffs.
Glaucoma is a common eye condition where the optic nerve is damaged, causing a loss of vision.
We often speak of glaucoma as if it’s a single condition, but in fact there are actually four types. The most common form of it is primary open-angle glaucoma.
The damage to the optic nerve occurs in the main because the eye isn’t able to drain fluid properly. A key factor is the angle between the iris and the cornea, the clear window at the front.
The degree of this angle, which can be affected by age, injury and other factors, determines how well the eye is able to drain.
With the primary open-angle form, which develops very slowly, the drainage angle is still open, but other parts of the drainage system are not working properly.
There is also angle-closure glaucoma, which is rare and may develop rapidly. Here, the angle narrows because the iris has bulged and the eye cannot drain.
The other two types are congenital glaucoma, usually present at birth and caused by an abnormality of the eye, and secondary glaucoma, caused by an injury or other eye condition.
The traditional view is that the damage to the optic nerve is caused by increased pressure from a build-up of fluid.
But it’s now thought that it can also be caused by a disease affecting the axons, the cells of the optic nerve.
So while raised eye pressure is associated with most cases of glaucoma, it’s not always so.
In fact, as many as 40 per cent of patients with open-angle glaucoma have normal eye pressure.
Vision loss caused by glaucoma can’t be reversed, but treatments — including eye drops and surgery — can prevent it worsening. The goal is to lower eye pressure to 30 per cent below the initial reading when diagnosed, even in patients such as yourself who don’t have raised pressure.
This is because lowering the pressure is the only established method for slowing the progress of the disease and preventing loss of sight. We don’t know why, but it helps.
Write to Dr Scurr
Write to Dr Scurr at Good Health, Daily Mail, 2 Derry Street, London, W8 5TT or
email email@example.com — include your contact details. Replies should be taken in a general context and always consult your own GP with any health worries.
In my view… GPs should not be working from home
Alarmed by the rising cases of strep A, I’m prompted to ask: how can any GP still be working from home, with consultations online or by phone?
It was recently reported that one GP works from home in Cornwall, yet her practice is more than 250 miles away in West Sussex. To diagnose scarlet fever, the main illness caused by strep A infection (the same bacteria can also cause tonsillitis, pneumonia, impetigo and cellulitis), you need a throat swab.
This is cultured in a lab to identify whether the infection is caused by bacteria or a virus. If bacteria are to blame, the type needs to be identified so appropriate antibiotics can be prescribed.
A throat swab requires a physical examination by a doctor. Anything other than that is second-class treatment. Cutting corners can lead to avoidable deaths.
Alarmed by the rising cases of strep A, I’m prompted to ask: how can any GP still be working from home, with consultations online or by phone? A stock image is used above
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