Reading with interest your column, and recent letters to the editor, about side effects of statins, I bring to your attention an on-going localised reaction I am still having to a Shingles vaccination which I had in the middle of October last. You may/may not be aware that the NHS is offering this new vaccine to all 70 year olds, which age I attained last July: hence when offered it by my GP I took it up, although I’ve never suffered from Shingles. A few days after the vaccination I developed a localised reaction around the site of it which is still ongoing and which my GP has now referred me twice to hospital for tests.
The reaction ranges from a stinging sensation to an ache: not disabling in any way but certainly irritating! I first was referred to the local musculoskeletal clinic who thought I might have water on the site: an MRI scan showed this was not so. I’ve now been referred to a Neurologist next month. My GP has reported this to the Yellow Card Scheme, but I do wonder whether others have had this side effect from what is a new vaccine?
I don’t expect a reply but thought you might like to know!
Dear Andrew M,
Thanks for drawing attention to the side-effects of the shingles vaccine. This can, as you will know, cause an inflammatory reaction with pain and redness at the site of the injection – and yours seems to be a more serious variant of this. Perhaps a short course of ibuprofen may be of value.
For years I have found migril to be the only thing that worked for my migraines. Have been unable to obtain it for the last month and chemist just saying there is a manufacturing problem. Do you know if it has been withdrawn? Thank you for your help.
Regards Mrs M I
Dear Mrs I,
Thanks for your query to which I do not know the answer but I notice a similar preparation to Migril, Cafergot, was discontinued in 2012. It is possible this might be a marketing ploy by the drug companies to promote the sale of newer more expensive anti-migraine drugs.
I have an unusual conundrum for you. I am a physiotherapist and a patient of mine, BS, a lady in her early 70s gets a bitter ‘metallic’ taste in her mouth on effort-usually involved with large arm movements, but it can also occur following more strenuous body activity.
She has a history of cerebral haemorrhage secondary to cerebral cavernous malformation, and right hemiparesis. She has reduced use of her right arm and has balance problems , but she can walk distances reasonably well with some assistance.
None of her medical consultants have been able to explain this.
(Ms) Gill S MCSP
Dear Ms S,
Thanks for your most interesting query. I would suspect this bitter taste in the mouth might be exertion induced acid reflux. This can be prevented with an acid-suppressant drug such as Omeprazole.
Dear Dr Le Fanu,
I would like to ask your advice on my lower back pain please. I am 35 years old. I have had very bad lower back pain since about spring 2008. It is on my lower central and right hand side and the nerve that goes from this region into my leg and foot is also affected (sciatica). It gets very bad at times and I can barely move without pain. It then will ease off for a while and I can manage again but then return.
I used to be very active – running and swimming and cycling a lot. I did run a marathon just before the pain started and fear I may have damaged my back permanently from this. I can do no sport now. I find just sitting at my work desk very painful and have to stand a lot of the time rather than sit. I have had a lying down mri scan. Which uncovered two bulging discs. Also an xray I had when I was 16 said I had marked lumbar scoliosis.
I have been doing core stability exercises religiously since the pain began, but this does not seem to help much.
I have seen various consultants but with no way forward. Do you think I should try and get a weight bearing mri scan as I have heard these can reveal the back and any issues more clearly. Also would you recommend a consultant or specialist I can see to help me with a way forward to try and reduce the pain? I have heard of caudal epidurals but I am very scared of injections as I have heard these have risks of paralysis and nerve damage and may only just mask the pain for a while.
Any advice would be greatly appreciated, many thanks
Thanks for your query and my sympathies for this severe chronic back pain that has so impaired your mobility and is, I gather, related to a series of problems in your lumbar spine . I would not have thought that a weight bearing MRI scan is likely to clarify matters further. I would suggest you contact Dr Clifford Harley (07810620058) who is an orthopaedic physician based in London with a lot of experience in dealing with this type of problem. Alternatively Mr Jeremy Hucker (01895 628891) specialises in the sort of minimally invasive procedures such as facet joint injections and caudal epidurals than can be very helpful.
I have been suffering with Interstitial Cystitis for nearly five years (although it was only diagnosed in the last eighteen months). It is extremely painful having a chronically inflamed bladder and my life is ruled by how I can manage the daily pain. I have given up alcohol, caffeine, smoking, chocolate and many other foods and am trying a wheat/gluten free diet, I have also had to retire from work as a Teaching Assistant.
The pain can be relieved for a short time if I urinate (this in itself can be painful), because my bladder is so small now. I am not incontinent but have to
empty my bladder quite frequently (I am 57), particularly during the night (between 10pm and 6am) it can be up to 13 times. Constipation also adds to the
discomfort. Sitting and walking are most uncomfortable although I am trying to get to a yoga class twice a week as exercise is supposed to be good.
I have had cystate installations which I believe have helped slightly and am still taking anti acid…is Milk of Magnesia any good? I and many others need help
our lives are dominated by this condition and the constant pain for which no one seems to be able to offer any suggestions or relief. I dream of having one pain free normal day a week. I believe recently there was a Health drink mentioned in one of your articles perhaps I could try it! Any suggestions please.
Very best Regards
Thanks for being in touch and your account of the distressing symptoms caused by your interstitial cystitis. I note you have consulted a urologist who has organised some appropriate treatment. My only suggestion, if you have not tried it already, is you should discuss with your doctor a trial of the acid-suppressant drug Cimetidine which, it is claimed, can be of considerable value in some patients.
Dear Doctor LeFanu,
Having read a recent DT headline and your frequent comments on statins and their effects I can no longer resist reporting the following experience which may interest you.
Some years ago I was prescribed Atorvastatin, 40 mg. to be taken once a day, which from time to time I would forget to take.
As it happens I also play chess competitively to at least average club standard. When I forgot to take the tablets I gained the impression that I could see things over the board more clearly. Now chess players are graded by a process which, while not perfect, gives a pretty good idea of a player’s strength so it naturally occurred to me to wonder if stopping the tablets altogether would bring about an improvement in my playing standard.
A consultant cardiologist who I see regularly assured me that not taking Atorvastatin for a couple of months would be unlikely to have any harmful effects. I accepted his advice when within a year my grading shot up be nearly thirty points to a standard I was last at about thirty years ago, some way above the average of club players in the UK. I also came equal first or second in three successive tournament, an achievement which I have never before managed to accomplish.
It would clearly be rash to draw the obvious conclusion. For a start I had been at the lower standard for some years before I began taking Atorvastatin. Also there is no obvious explanation for the improvement. Clearly I did not become brainier but I did notice that my opponents for some reason reason would often not take advantage of clearly superior positions, clearly won games in one or two cases. That could be because I was evaluating positions more clearly than I had before though I do have two explanations of my own, one of them rather odd and relating to opponents not taking advantage of superior positions..
None the less the experience does seem suggestive and naturally one wonders if chess players could contribute to an assessment of the effects of statins on cognitive achievement.
Thanks for your fascinating account of the subtle cognitive effect of statins on your chess playing. I will mention this in the column of the 31st March.
About 5½ years ago I had a parathyroid gland removed. A biopsy of the gland revealed that it was malignant. As a result, half of my thyroid was removed as a precaution. Although I have had no further problems with my remaining parathyroid glands, I am increasingly getting erratic heartbeats, tremors in my hands and upper torso, and severe tiredness. Various GPs and the Consultant Endocrinologist have requested T4 blood tests from time to time. All the blood tests have come back more or less normal, and generally with a request that they be repeated 6 months later.
The question that I have, and which the Consultant seems to unwilling to answer, is whether the remaining part of my thyroid is struggling to maintain my thyroxin levels, thereby causing the symptoms that I am getting. Would a low dose of thyroxine relieve the thyroid and remove the symptoms?
I would be interested to know if any of your readers have experienced similar problems following removal of part of the thyroid.
Dear John G,
Thanks for your most interesting query. The symptoms you describe are certainly suggestive of an overactive thyroid – though I do not think this is related, in the way you propose, to the operation on your parathyroid gland. You should discuss further with your doctor the significance of those ‘more or less’ normal thyroid function tests as a low normal TSH is still compatible with an overactive thyroid.
Dear Dr. James,
I’m 71 years old, reasonably fit & active for my age. I take Amlodipine 5mg & Valsartan 80mg, for high blood pressure. Also, I take Qvar 100, twice a day for my asthma. I enjoy a few pints of beer, two/three times a week at the local pub. Last week, I had four pints of beer one evening & walked home. On the way home, I called to visit a friend, for a cup of tea & a chat. Shortly after arriving, whilst sitting down in the chair, I got a fit of coughing. Next thing I slumped back in the chair, with my eyes closed. My friend rushed over to me, calling my name & was preparing to ring for an ambulance. After about four seconds, I opened my eyes & was OK. I had clearly “blacked-out” for some reason?
What could be the cause of this?
Do I need any tests?
Thanks for your query. This fainting episode you describe is known as Cough Syncope and is due to the fall in blood pressure caused by pressure changes within the chest cavity brought on by a severe bout of coughing. It is a benign condition and does not warrant further investigation.
My partner is a 58 male and has just started on warfarin a week ago as he has irregular heartbeat he has started to get hot sweats fluttering in his chest, giddiness, headache please can you advise on what to do many thanks
Thanks for your query. The symptoms you describe are certainly not typical of the side effects of Warfarin so there could be some other explanation such a viral illness. Still their onset so soon after starting the medication is clearly suspicious and were these symptoms to persist you might need to take a different form of blood thinning drug.
Dear Dr Le Fanu
I do hope that you or your readers can explain my medical query.
Having always had cold feet at night I now have the opposite but the right foot, above the instep, is worse and heats up until it feels as if is burning yet it is just normal temperature to the touch. The right foot feels swollen but it isn’t and it burns with heat all day and going to bed the leg gets hot with it and often keeps me from getting to sleep. During the evening I can sit with my feet up and right shoe off which helps and I often sit with a cold pack on it but I can’t do that at night in bed.
I am 77 years old and have walking difficulties due to osteoarthritis. I take paracetamol and occasional ibuprofen for the pain but it doesn’t seem to make much difference. I have been to my doctor about this but she says it must be my age. Is it just poor circulation?
Dear V H,
Thanks for your query. It sounds from the description of your symptoms that they are due to ‘burning foot syndrome’ caused by the disturbed functioning of the sensory nerves to the leg known as a Peripheral Neuropathy. There is regrettably no specific treatment but the drug Gabapentin is said to be of value.
I refer to the recent comments in your column.
I have had excess mucus since Nov 2012 but since March last year this has resulted in a mucous drip which seems to go down my Trachea and causes a wheeze which requires repeated coughs to release. This is usually 3-4 periods each day, there has not been a free mucous cough day in one year now.
I have had chest x-ray and recent nose scope which saw no polyps etc.
I am on steroid nose spray which has improved my breathing and the mucous a little the wheeze/cough remains.
I am told in my area (East Grinstead) 1 in 4 people suffer from rhinitis?! But I know of no other person that has coughed for a full year.
Is this usual?
I assume the Erythromycin is for the non-allergic and the other antihistamine for the allergic rhinitis ? How do I find out which I am? And is there any hope for the cough or is that it for the rest of my life (I am 63)
Dear John W,
Thanks for your query. It is possible you may have become sensitive to, for example, the house dust mite or other allergens to account for your symptoms. This is best clarified by patch testing at an allergy clinic I would have thought it probable you would benefit from a course of Erythromycin as described in the column.
I am sure you must have been inundated with emails on this subject but I would like to briefly tell you of my experience. I was prescribed these when all GP s were trawling through their patients and blanket prescribing.
I too suffered horrendous muscular pain, could hardly get out of a chair, had CT scans and full body MRI. All showed nothing. I read your article of a few years ago and immediately stopped taking them. However I still experience numbness in my feet and I have learned to live with this. I can still play golf and walk 18 holes,but I am sure as I get older this will get worse.C’est la vie!!
You are so right to warn people,
Dear Jenny H,
Thanks for being in touch. Regrettably – as in your situation – the statins can have long term adverse side-effects. It is encouraging that you are still managing to get round the golf course!
I am 70 years old and have for many many years taken Statins as I have a raised familial cholesterol level. I too have all the aches and pains; however recently I was found to have a very low vitamin D levels and at the moment I am taking 20,000 bio Vitamin D3 capsules – 3 once a week for 14 weeks. The aches and pain are greatly reduced.
Dear Janet D,
Thanks for that most interesting observation and drawing attention to the causes other than statins for these muscular aches and pains.
Dear Dr. Lefanu,
Regarding the report on adverse reactions to statins, have you thought that the reason the people on placebos had the same side effects was because it is the constituents put in tablets that cause the problems. I take thyroxine and had to change brands because of the ingredients. Eltroxin was mysteriously removed and I had taken it for some time with some energy sapping side effects.
Dear Priscilla C,
Thanks for your query. It is certainly the case that the relative effectiveness of different brands of the same drug can be influenced by their formulation. This is not however the explanation for the supposedly low level of statin side effects which is due rather to under-reporting by the pharmaceutical companies.
I have been following the statins thread with interest if only because I do NOT take them. However, as I am on the border for type 2 diabetes I have been told quite often that I should have high cholesterol but do not.
Many years ago I had bouts of constipation but before I got to the GP I realised, courtesy of the Reader’s Digest, that I had probably been eating too much Raisin Bran in hotel for breakfast. A blood test showed elevated blood sugar and off I was sent. My GP told ne to make sure that WHEN I collapse in the street I must tell people I am diabetic. 10 years later and I am still waiting for that collapse. My diet is low in all the things that are supposed to be bad though I still imbibe.
I also have raised BP and for 5 years I was given a string of tablets none of which did any good. The contraries I could get but not reduced BP. In May 2013, I was allowed onto the ‘expensive’ list and now take Valsartan. It has already started to stop working leaving with only the one cure. 2 glasses of Red Wine!!!! That drops my BP 25 sys in about 20 minutes and keeps it there for hours. I have resveratrol tablets but at the suggested 250mg I do not think they are as good as the wine. I am a regular booze cruiser but even so the cost is quite high albeit rather pleasant. Bitter is nearly as good, lager is middling as is rose but white wine, of which I have 2 favourites, is useless.
The question in this is why if BP so important that I was allowed to have high BP for 5 years before being given proper treatment? Personally, I much more favour Pulse as that better indicates how the pump is actually working. In Florida last December I was running 250 sys while calmly sending emails. I never worked out out who was the real patient as the nurses could not understand why I was not having a heart attack! [My BP rarely got above 140/90 which the US has now suggested is OK!]
Which now takes me back to the Diabetes and drug reactions.
June 2012, I climbed out of a canyon in the Languedoc and then walked over a mile to get the car because I felt my grandchildren would be tired. My daughter has said that she, my son and their families only did the climb because ‘granddad had done it’!
June 2012, one week later, I started on Metformin.
Late August 2012, I was taking antibiotics and corticosteroids for a severely blocked nose and had 3 further courses that year.
February 2013, I was diagnosed with Nasal Polyps.
April 2013, I spent 2 days in a Florida hospital with breathing problems that I feel may have been a panic attack. I had a number when I returned home starting the day after my insurers tried to avoid payment of my $ 24,000 bill for 2 nights in hospital; plus ambulance services!!!!! The agreement to pay the bill and no more attacks!!!
July 2013, I became aware that I had been taking Metformin since my blockage had started, or from 1 week before. I stopped the drug and to date my diabetic status has not changed above the 7.2 level.
October 2013, December 2013 and February 2014, I have had 3 chronic breathing attacks that lead to 2 short hospital stays. Each has treated me for Asthma though in Florida in December that was quickly dismissed.
March 2014, I had a consultant here insist I am asthmatic. He insists that I am an asthmatic whose polyps come from that and would not understand the timeline above. He actually dismissed my evidence as irrelevant which begs the question as to where the asthma came from and why so suddenly. I will try for another opinion with a Consultant who is more scientifically minded! I await my operation and a return to see this man with relish.
On the other hand I suggest I am having asthma type symptoms brought on by the blockage dripping from the polyps ‘gumming’ up my airways and hence my lungs that started soon after I first took Metformin. When my nose is ‘clearish’ then what I blow out is not unlike what I cough up when blocked. And very nasty and thick it is, too! I have only one thing to keep even partially free and that is an OTC spray Oxymetazoline Hydrochloride which has a regular 2 day failure every few weeks. And very oddly the improved and sunny weather!!!!!!
A Google search last week – why did I never do that earlier? – supplied FDA evidence of a small number of people with polyps who took Metformin, and I mean small. But like the statin ‘conclusion’ it requires cause and effect to be seen. How many statin sufferers have had their reactions logged officially? And in my defence I cite the peculiar fact that Metformin helps deal with Polycystic Ovary Syndrome. As a man that worries me on a number of levels!! It also makes me question drug testing standards when drugs created for one reason help totally different ones. Are we being pushed drugs that actually no-one really knows about? After all Metformin could just as easily have killed women with that syndrome and would any one have noticed quickly?
I hope my GP will check his records as his Metformin patients come in to see whether there is even 1 extra sufferer. If even one more patient has it in a small surgery that would have amazing and far reaching consequences. My ENT consultant who will ‘do’ my polyps, if my lungs even get clear enough for an anaesthetic, I hope to also get checking. In the meanwhile ……… ?
Dear Richard F,
Thanks for being in touch. I would have thought it most unlikely that the Metformin you are taking for your diabetes is implicated in causing your nasal polyps.