My husband has suddenly lost 4st – should I worry? Dr Zoe Williams urges reader to seek immediate help

IS alcohol good for health?

It’s a topic that is often contested, and certainly those who like a tipple will prefer to think that drinking in moderation is good for you.

Certainly, there has been research that suggests this.

But while studies may find antioxidants in red wine are good for the heart, or hops in beer reduce inflammation, that is not the same as saying alcohol is good for health.

While a wine a day is normal in some long-living populations, like in Sardinia, it’s the healthy, active and sociable lifestyles – not the plonk – that gives them longevity.

The World Health Organization says “no level of alcohol consumption is safe”.

Yet UK guidelines suggest 14 units per week is safe.

Why? Alcohol is an enjoyable part of people’s lives and the guidelines are there to help them make informed choices.

Sticking to 14 units can lower risk of hazards linked to alcohol, which include heart attack, stroke, mental health issues and more.

But let’s be clear, no amount of alcohol conveys benefit to health, but keeping drinking to low levels minimises the risk of harm.

Here’s a selection of what readers have asked me this week.

Worried over hubby’s weight loss

Q: MY husband is 66 and has lost nearly four stone without trying to.

He was always a big man but now he looks frail.

He has bad arthritis and bone spurs on his fingers.

Lately his knees have improved but the pain has gone to underneath his feet.

Some days he can hardly walk.

I have bought him compression socks, creams, gadgets and wraps to no avail.

His GP told him it is old age and to just keep taking painkillers. It has been over six months.

His blood pressure is low but used to be too high.

Blood tests have shown nothing.

A: I hear your distress and concern and no wonder.

Four stones of unexplained, and unintentional weight loss definitely requires further investigation and he might need to be referred on a two-week wait suspected cancer pathway.

There are possible non-cancer causes too.

But first, I would say it is important to get him assessed for cancer and have this either diagnosed or ruled out.

Several types of cancer can cause weight loss, including colorectal, gastro-oesophageal, lung, pancreatic or urological cancer, which includes the kidney, prostate, bladder and testicles.

Does he have any other symptoms, apart from those due to arthritis?

These could help the GP make the best decision on which cancer pathway he should be referred on.

Sometimes the GP will do investigations first, such as a CT scan if he has tummy pains or vomiting, or a chest X-ray if he has a cough or has been a smoker.

If the GP can’t access the investigations urgently then the referral should go ahead.

Regarding his blood pressure, this has likely come down due to the weight loss, and if he is still taking his medication for blood pressure this should be reviewed as it likely needs reducing or stopping.

Q: I have been taking a teaspoon of olive oil every morning before I eat anything.

Am I doing harm?

A: No, I don’t see why a teaspoon of olive oil daily would do any harm and there are proven health benefits from ensuring that we include healthy fats, such as olive oil, into our diet.

I can’t find any benefits that specifically relate to taking it while you are being treated with chemotherapy, but there are some reported claims of ways it can improve health in general.

Studies show it can alleviate constipation and there are also studies that have found people having haemodialysis can benefit from it as it helps to soften stools.

It may benefit heart health in many people too.

Olive oil has anti-inflammatory and antioxidant properties and a recent meta analysis (the best type of study) concluded that olive oil consumption seems to exert beneficial actions in terms of cancer prevention.

Smaller scale studies have found some other health benefits as well.

One study found olive oil ingestion resulted in a 22 per cent reduction in blood sugar after eating a meal and another study of 253 women found olive oil consumption improved bone density.

While I can’t find any reason to suggest that it is harmful, please do mention this to your oncologist, in case it affects the way medicines are absorbed, for example.

The chemotherapy treatment you’re due to receive will be very individualised to you, and so the only person who will know for certain if there’s any reason for you not to take it would be your oncologist.

As already discussed there are many benefits to olive oil though, especially when eaten raw.

So say for example your oncologist advises not to have it first thing in the morning if there is a risk of it interacting with medication absorption, it should still be fine to have it alongside meals.

It could be drizzled over dishes or used to make delicious salad dressings.

Severe pain since op

Q: ABOUT six or seven years ago a horse jumped on my foot.

I had an operation, after which I immediately had severe pain, as I do to this day.

I’ve tried every painkiller and antidepressant that exists, as well as acupuncture and reiki.

Walking eases the pain but when I stop I have what I call stinging nettle pain and constant muscle movement.

You can see my foot moving of its own accord.

I’m 70 now and don’t have any other conditions other than taking thyroid medication.

A: It sounds like you’ve received a whole array of treatments including ones for neuropathy, better known as nerve pain.

Neuropathy can occur when there’s permanent damage to the nerves and they then send abnormal signals to the brain.

So, the brain might perceive that there is still an injury even though the tissues have healed.

You can get fasciculations when nerves are damaged, like twitching movements. Is this what the involuntary movements are like?

Sometimes walking may override these abnormal brain signals by activating nerves in a different way and nerve pain does tend to be worse at night.

Your description of it being like stinging nettles suggests a potential alternative diagnosis of chronic regional pain syndrome.

My guess would be that your pain is most likely from nerve damage or CRPS, both of which can be difficult to treat.

It sounds like you have tried a wide range of medicines so the next step in my opinion will be to get some relief from a more psychological approach, which is the mainstay of treatment for CRPS and can be effective for neuropathy too.

This would be about retraining the brain, essentially.

Your brain is perceiving damage and trauma when there isn’t an injury any more.

Your medical team can refer you or you can refer yourself online by searching for NHS talking therapies.

There are also some benefits of self-management – people with CRPS are encouraged to educate themselves on the condition and learn techniques such as relaxation to help manage the pain.

There are also exercises and desensitisation techniques.

So please don’t feel like there is nothing more to try and I hope that this advice leads you to a solution.