Question: I regularly have a perfumed, floral taste in my mouth. I was recently treated for anemia, but apparently my values are back to normal now. Could the problems be related or is something else causing it?
Dr. Ellie Cannon replies: It is entirely possible that this strange taste is caused by anemia, but it is important to investigate other possibilities.
Anemia, an iron deficiency, occurs when the body does not produce enough red blood cells due to a lack of iron. This often causes fatigue, shortness of breath or palpitations.
An altered sense of taste is a rare side effect of anemia, but can also be due to, for example, a virus or medications.
An unusual side effect is an altered sense of taste, such as a floral taste.
When a patient has anemia, the doctor will usually check the hemoglobin and ferritin levels. Hemoglobin is a protein found in red blood cells that transport oxygen throughout the body and give blood its red color. Ferritin is another blood protein that stores iron.
Anemia patients usually have low levels of both. They will be encouraged to eat a diet richer in iron: leafy greens; legumes and beans; nuts and seeds; and meat, fish and tofu – or take iron supplements to boost levels.
If, as you said, your hemoglobin and ferritin levels have returned to normal, it is unlikely that this strange taste is caused by the anemia. Instead, you may be suffering from the aftereffects of a virus. Bugs, like Covid and flu, can cause odor and taste changes that 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 floral taste persists, I recommend speaking to your doctor so it can be investigated further. You may also consider a full dental assessment, as some mouth or gum conditions can also cause changes in taste.
Question: I am 76 and have been suffering from hypnotic headaches for four years. Coffee before bed seems to help – but this means I have to go to the toilet during 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 caffeine – including tablets – seems to help.
This rare type of headache usually occurs during sleep and wakes people up. That is why it is also called alarm clock headache.
The pain can last up to four hours and usually occurs in the early hours.
Doctors don’t know exactly what causes them, but they mainly affect the elderly and are more common in people who have struggled with migraines.
Although there are few effective treatments for hypnotic headaches, research suggests that the caffeine in coffee appears to improve the debilitating symptoms.
It is used to prevent the occurrence of headaches and also to reduce the uncomfortable feeling once it starts.
But coffee has the side effect of making you have to go to the toilet. A cup of coffee can contain 100 mg of caffeine, although this can vary considerably. 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 same effect and reduce the need to urinate.
However, caffeine is not the only treatment for hypnotic headaches. GPs also prescribe an anti-inflammatory drug called indomethacin or an anti-seizure drug called topiramate. These are only offered if it is safe to use them with other recipes you are using. It may be worth trying one of these medications to see if they work 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. Do we have to worry?
Dr. Ellie Cannon replies: Blood in the urine is a worrying problem and requires an immediate appointment with the doctor. So it’s good to hear that your husband was checked immediately. This is because it could be a sign of bladder, prostate or kidney cancer.
Typically, patients are referred for a cystoscopy, in which a long, thin camera is placed into the urethra to look for signs of cancer in the bladder. Ultrasounds are also used to detect the disease in the kidney, as well as a PSA blood test that could signal prostate cancer.
Although 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 kidneys or bladder. Kidney stones – small crystals that form in the organ – can also cause bleeding.
However, these can be incredibly painful, so most patients will know when they have them.
Stones can also form in the bladder, causing a person to lose blood.
If there is only blood in the urine for a short time and all tests are normal, then that is reassuring. But if the problem persists, it is wise to get tested again.
Liberal Democrat leader Sir Ed Davey has spoken about the challenges of caring for his disabled teenage son John
MPs must deal with the healthcare crisis
I was almost moved to tears earlier this month when I watched a video of Liberal Democrat 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 overhaul the social care system.
However, I can’t help but be frustrated by this comment. Politicians should not need first-hand experience to know that the healthcare system is in crisis.
Doctors and healthcare staff have been sounding the alarm for years. Figures show that more than 2.6 million elderly people cannot get care – whether it is access to a caregiver to help them at home or a bed in a nursing home. This is largely because there are more than 165,000 vacancies in healthcare. We can’t continue like this.
I hope that Sir Ed’s emotional story will wake Sir Keir Starmer and Rishi Sunak to the fact that the social care system needs urgent attention.
Vicky McClure stars in the Paramount+ TV show Insomnia as a lawyer who suddenly can’t sleep
Do you suffer from horrible insomnia like Vicky?
Insomnia is a huge problem, so I was happy to see that there is a new TV drama series that highlights just how awful it is to live with.
Insomnia stars the brilliant Vicky McClure as a high-flying lawyer who suddenly can’t sleep.
Although the show, streaming on Paramount+, overdramatizes sleep deprivation, it’s not a million miles away from my patients’ experiences.
GPs have a range of treatments to offer, including forms of cognitive behavioral therapy (CBT) and medications that can be taken in the short term.
I’m interested to know what methods offered by the NHS, if any, have helped improve your sleep? Register at the email address below and let me know.