I am desperately overweight but my doctor has banned me from Mounjaro. Is this right? DR ELLIE reveals the frightening jab health risk you can't ignore - and why it's got doctors worried
I am 80 and desperately need to lose weight. I’ve asked my GP if I can be prescribed Mounjaro but she says I can’t because I have chronic kidney disease. Is this true?
There is no reason someone with chronic kidney disease cannot have weight-loss injections – provided the right precautions are taken.
Chronic kidney disease occurs when the organ can no longer function properly. It is a progressive disease, which means it cannot be cured and gets worse over time.
It’s also often caused by obesity and diabetes – in fact, most people with diabetes will have some degree of kidney disease.
Mounjaro is a weight-loss drug known as a GLP-1 agonist, which tricks the body into thinking it is full. One of the risks for kidney disease patients on these drugs is dehydration. This is because many on the jabs stop feeling the need to drink water – and, over time, dehydration can significantly speed up the progression of the disease.
This risk must be balanced with benefits. Research shows losing weight is an effective way to slow the disease. In fact, the jabs seem to lower inflammation, further protecting against damage. They also help lower blood pressure – a significant driver of kidney disease.
Kidney disease patients taking weight-loss jabs need regular blood tests to fight dehydration
In order to combat dehydration, kidney disease patients taking GLP-1 injections should have regular blood tests, and it may be safer to stick to low doses.
As long as these steps are taken, there’s no reason someone with kidney disease should not be able to try weight-loss jabs.
However, it’s worth pointing out the NHS only offers weight-loss jabs to patients with a BMI above 40 who also have specific weight-related conditions, such as diabetes and heart disease. At present, kidney disease does not qualify.
I have asthma, but recently it has been worse than usual. I cough all the time, my nose runs and I have tightness in my chest. I don’t use my blue inhaler as it doesn’t seem to help. Should I be worried?
Anyone with these symptoms who has asthma should seek a GP check-up as soon as possible, because they are all signs of uncontrolled asthma, which can be dangerous.
Asthma affects the airways, where the tubes carrying air in and out of the lungs become inflamed, over-sensitive and can narrow. It often develops in childhood, and is more common in people with allergies or eczema.
Previously, most patients were given a blue inhaler, called salbutamol. However, this is not a treatment, but it relieves symptoms when they flare up, such as wheezing or tightness in the chest. Often patients don’t need anything more as their episodes are few and far between. However, when they are regularly experiencing asthma symptoms, they may need more intensive treatment.
Nowadays this usually involves a type of inhaler called an anti-inflammatory reliever. This can prevent inflammation and relieve the uncomfortable symptoms when they arise. Anti-inflammatory relievers contain salbutamol, which is why people who use one don’t need a blue inhaler too.
Anyone with disruptive asthma symptoms should speak to their GP about trying the reliever or a different treatment. This is crucial because, left untreated, asthma can be deadly.
A GP may also look into other possibilities for the symptoms, including allergies which can be treated with antihistamine tablets. In rare cases a tight chest can be a sign of a heart problem, so a GP might send a patient to hospital for scans.
I just found out that I have osteoarthritis in my neck. I’m 78 and it has been causing me considerable pain for some time. How can I ease the discomfort?
While there is no cure, the best treatment for osteoarthritis is exercise – regardless of where the condition occurs.
Osteoarthritis is a painful joint problem triggered by long-term wear-and-tear. This is why it is common in older adults.
The typical places in the body for osteoarthritis are the hips and knees, but the neck can also be affected.
Patients are advised to take painkillers – from over-the-counter tablets to prescription anti-inflammatories.
However, keeping the joints mobile is crucial.
One way to do this is regular exercise, such as brisk walking, running or swimming. There are also forms of exercise aimed at improving mobility, such as yoga, pilates and tai chi.
I would also recommend the exercises that are demonstrated on the Arthritis UK website.
However, for many patients, exercise can be a struggle due to arthritic pain. In these cases, physiotherapy may be necessary to return mobility – and reduce pain – in the region.
A physiotherapist can provide specific exercises and stretches for affected areas that would need to be repeated regularly – often several times a day.
Neck osteoarthritis might improve with a firm pillow, as this can provide better support.
It’s also advised not to sleep on more than one pillow.
New NHS quiz could save lives
The Healthy Choices Quiz targets those aged between 40 and 60, providing a score out of ten
I am really impressed by a new online NHS five-minute quiz that can help adults spot their own unhealthy habits.
Launched last week, the Healthy Choices Quiz is aimed at those between the ages of 40 and 60 but offers support for adults of all ages.
It asks about all aspects of your lifestyle, from exercise to sleep, alcohol intake and mood. It then gives a score out of ten, to explain how at-risk you are of serious health problems later in life.
Crucially, when concerning habits are spotted, it directs towards free online resources that can help. For example, anyone who drinks above the recommended weekly limit is given the option to download a free-to-use app that advises on how to cut down on alcohol.
I’d really advise everyone – no matter their age or health – to give it a go. You can find it at: nhs.uk/better-health/healthy-choices-quiz
Tell me how you got your cholesterol down
We're coming up to Christmas, which is always a time when healthy diets go out the window.
However, I’m concerned many people do not realise that simple diet changes could slash their cholesterol, cutting their risk of a deadly heart attack or stroke.
These days we have effective tablets – statins – that can bring down levels of the fatty substance that builds up in blood vessels. However, for some, statins are not enough, and many patients have worries about uncommon side effects. For them, diet changes could be life-saving.
So I recommend cutting down on red meat and eating plenty of oats and soy – such as edamame beans and tofu – as well as plant sterols, which can be bought as tablets or are found in nuts and which are high in fibre.
Have you found a way to get your cholesterol down without statins? Please write in and let me know.
