DR ELLIE CANNON: Have blood pressure tablets made me lose my appetite and should I be worried?

Recently I was given a blood pressure tablet called amlodipine. Suddenly, whether I eat or not, I feel full. I’ve completely lost my appetite. Personally, I’m quite happy with it since I’m overweight and therefore not tempted to snack anymore. But it’s very strange. Do I have to worry?

Medications often have side effects and it is not always clear who gets them and to what extent. Often they can be mild and settle down within a week or so.

Amlodipine is a commonly used blood pressure tablet, but changes in appetite or satiety are not listed as known side effects.

It is known to cause digestive problems such as constipation, heartburn, nausea and abdominal pain – all of which can affect appetite or how your stomach feels.

With a new problem like this, perfectly timed to start medication, I would usually give it two to four weeks to clear up.

But feeling full all the time should be investigated if it persists. Fortunately, when it comes to the tablets, there is a huge range of other blood pressure medication that the doctor can offer.

And our appetites can change for many reasons, such as nervousness, stress, and other physical health issues.

But feeling too full to eat can be a worrying sign that the stomach is under pressure and filling up too quickly, for example if there is a tumour. This could be a problem in the stomach or something pressing on the stomach from another abdominal organ. Therefore, it should be checked by a doctor.

I have a rash under my breasts that is painful and prevents me from wearing a bra. My doctor said I have something called intertrigo and gave me a special spray for it. However, it doesn’t seem to make any difference. Can you help?

Intertrigo is a type of rash usually found in areas of skin-to-skin contact, often in areas such as under the breasts, armpits, or groin.

In larger people it can also occur in skin folds of the abdomen and in babies in the neck folds. Fungal and yeast infections thrive in these areas because they are warm and humid and the air cannot circulate properly. It tends to be painful, with itching or a burning sensation, a common complaint.

The first stage of treatment for this is to somehow limit skin-to-skin contact and reduce the heat and moisture in these areas.

The area under the breasts should be dried thoroughly after washing and kept as cool as possible with light clothing.

A barrier cream may be helpful. These are normally thick white creams, often used as nappy cream, available from regular pharmacists.

Antifungal creams are also often used alongside something anti-inflammatory to reduce pain and inflammation, for example a mild steroid cream. Antifungal and steroid creams are sold in pharmacies.

If it is very bad despite treatment, it may be worth taking antifungal tablets and continuing to use the barrier creams at the same time. These would be given on the doctor’s prescription.

Sometimes intertrigo is also infected with bacteria, so another line of treatment may involve taking a cotton swab from the sore skin and treating it with an appropriate antibiotic.

Intertrigo is worse in people with type 2 diabetes or those who regularly take steroid tablets or immunosuppressants. If this is the case, only stronger treatment from the GP can work.

Over the past few months, I feel like I’ve been overcome by extreme exhaustion, which seems to come out of nowhere. It happens most days at 5pm and at 9pm I have to go to bed. I am a woman, 49 years old and in good health. I am also very active. What could it cause?

There are a few common and obvious causes that can happen to a 49 year old woman to leave her inexplicably exhausted. The first would be menopause.

When female hormones change and especially estrogen levels drop, women can feel incredibly tired – unlike anything they’ve experienced before. This can also be exacerbated by the harsher periods of perimenopause — the transitional stage before menopause when hormones fluctuate — which can cause iron deficiency, also known as anemia. Fatigue is a symptom of that.

This can also happen if you don’t get enough iron in your diet – which can be a problem for vegans. Certain forms of deficiency in another vitamin called B12 also occur in an autoimmune disease called pernicious anemia, meaning the body doesn’t absorb B12. Anemia, from any cause, can be detected with a simple blood test.

Another common cause of exhaustion in the mid-40s is an underactive thyroid.

This affects about one in 50 people and is when the thyroid gland in the front of the neck does not produce enough of the hormone thyroxine which is responsible for maintaining metabolism.

Other symptoms of thyroid hormone deficiency include constipation, weight gain, muscle aches, and hair loss.

Extreme or persistent exhaustion can also occur after viral infections, such as Covid.

We don’t hit adults, so why should we hit our children?

I was disappointed to see the government reject a call last week to ban child spanking. So in England it remains legal to spank a child if it is a ‘reasonable punishment’.

This is not the case in Scotland and Wales. I know a lot of people think it’s okay to hit a child and many older adults have the “I got hit and it worked out” attitude. Others think teens are unruly because they lack discipline.

I reject all those arguments. Studies show that smacking has long-term psychological consequences for many children. Most importantly, what kind of lesson do we teach children when we resolve quarrels with physical force?

As Sir Peter Wanless, chief executive of the NSPCC, said last week: ‘It cannot be right that it is illegal in this country to hit an adult but that a child is not given equal protection.’

According to government polls, about two-thirds of Britons agree with me. I am interested to know how true that figure is.

Gamblers need to talk

You may be surprised to learn that gambling addiction is one of the most common mental health problems I see in middle-aged people.

Studies estimate that about two million people are at risk because it is such an easily accessible habit. That’s why this week I’m teaming up with the charity GambleAware to get people thinking before placing a bet, and talking to their loved ones about gambling habits.

One of the most disturbing statistics I’ve learned is that three-quarters of those who worry that a loved one is addicted don’t talk to them about it. It’s hard, but it’s vital. Don’t start a conversation by blaming them for losing money. Instead, talk about how much you care about them and your concerns.

GPs have information on local support groups, or try the National Gambling Helpline (0808 8020 133) for advice.