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My 73-year-old husband feels cold all the time. He wears thermal clothes and always needs to heat the house, even he feels cold in summer. Can you help?
Maralyn Endlar, Salford.
The question here is whether there is a medical diagnosis to explain this constant feeling of cold, or if 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 stays within a narrow band, close to 37°C.
These adjustments include causing 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 is a medical diagnosis to explain this constant feeling of cold, or if 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 lbs, and I suspect he doesn’t have a lot of body fat. Therefore, it is relatively poorly insulated, and that could be a factor leading to its hypersensitivity.
Some medications, such as those given for angina and high blood pressure, can also cause sensitivity to cold (by increasing blood flow through the skin and causing further heat loss).
Another potential factor is low mood: I have treated patients with depression who, in their anguish, feel so cold that they spend all day sitting on an electric heater. This is possibly the result of inertia and lethargy, with less muscle action, which can cause depression.
Some medications, such as those given for angina and high blood pressure, can also cause sensitivity to cold (by increasing blood flow through the skin and causing further heat loss).
It may also be that the hypothalamus is affected. It is close to the areas of the brain involved in mood regulation.
It might be helpful to try the following physical challenge to assess your husband’s body temperature control: Take a brisk walk a mile and see how you feel when you get home.
If you’re feeling hotter than your usual cold state, try incorporating a couple of such walks into your day; can help make a difference.
I have been diagnosed with glaucoma in my right eye and my vision is a bit blurry. But tests show that my eye pressure readings are within the normal range. What could be the cause?
Gerry Lester, Oulton, Staff.
Glaucoma is a common eye condition in which the optic nerve is damaged, leading to loss of vision.
We often talk about glaucoma as if it were a single condition, but there are actually four types. The most common form is primary open-angle glaucoma.
Damage to the optic nerve occurs mainly because the eye is unable to drain fluid properly. A key factor is the angle between the iris and the cornea, the transparent window at the front.
The degree of this angle, which can be affected by age, injury, and other factors, determines how well the eye can drain.
With the primary form of open angle, 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 can 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 in the eye, and secondary glaucoma, caused by an injury or other eye condition.
The traditional view is that damage to the optic nerve is caused by increased pressure due to fluid buildup.
But it is now thought that it may also be caused by a disease that affects the axons, the cells of the optic nerve.
So while elevated eye pressure is associated with most cases of glaucoma, it’s not always the case.
In fact, up to 40 percent of patients with open-angle glaucoma have normal eye pressure.
Vision loss caused by glaucoma cannot be reversed, but treatments, including eye drops and surgery, can prevent it from getting worse. The goal is to lower eye pressure to 30 percent below the baseline reading when diagnosed, even in patients like you who don’t have elevated pressure.
This is because lowering blood pressure is the only established method of slowing the progression of the disease and preventing vision loss. 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 drmartin@dailymail.co.uk – please include your contact details. Answers should be taken in a general context and always consult your own GP if you have any health problems.
In my opinion… GPs shouldn’t work from home
Alarmed by the rise in strep A cases, it prompts me to ask: how can a GP continue to work from home, with consultations online or by phone?
It was recently reported that a GP works from home in Cornwall, but his practice is over 250 miles away in West Sussex. To diagnose scarlet fever, the main disease caused by strep A infection (the same bacteria can also cause tonsillitis, pneumonia, impetigo, and cellulitis), a throat swab is needed.
This is grown in a laboratory to identify whether the infection is caused by bacteria or a virus. If bacteria are to blame, it is necessary to identify the type so that the appropriate antibiotics can be prescribed.
A throat swab requires a physical examination by a doctor. Anything other than that is second class treatment. Taking shortcuts can lead to preventable deaths.
Alarmed by the rise in strep A cases, it prompts me to ask: how can a GP continue to work from home, with consultations online or by phone? A stock image is used above
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