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General health

Iron is one of our body’s metabolic giants. It’s one of the most abundant metals on our planet, with the paradox being that we don’t always have enough of it. Iron deficiency is the most common nutritional disorder in the world, affecting around 500 million people worldwide.

## Am I iron deficient?

The only way to really know if we’re running low on iron is to have a blood test. If you were definitely iron deficient, this would reveal a ferritin level below 15mcg/L – ferritin is a protein that binds with iron in our bodies to give us an indication of the body’s stores. That said, you may have some signs or symptoms of iron deficiency:

- Fatigue
- Difficulty concentrating
- Feeling irritable
- Pallor (paleness)
- A sore tongue
- Dry or rough skin
- Dry and damaged hair, or hair loss
- Nail changes
- Painful cracks at the corners of the mouth
- Headache 
- Tinnitus (ringing in the ear)
- Iron-deficiency anaemia

We mostly worry about iron deficiency because it can lead to an anaemia if not corrected. Very common symptoms of iron deficiency anaemia are a little more noticeable and tend to include:

- Fatigue
- Breathlessness

And sometimes:

- Chest pain
- No symptoms at all

## What are the causes of low iron?

There are several causes. Our modern-day diets are often partly to blame although they’re rarely the single cause. Our diets aren’t always rich in sources of iron, particularly if we’re vegetarian or vegan (animal sources contain iron in a form that is more easily absorbable). In premenopausal women, the most common cause of iron deficiency is heavy periods. In every other adult, it’s blood loss from the gastrointestinal tract. More specific causes include:

- Aspirin
- NSAIDs, like ibuprofen and naproxen
- Pregnancy (physiological requirements are 3 times that of menstruating women)
- Gastric ulcers
- Coeliac disease
- Cancer

We mostly worry about iron-deficiency anaemia when we don’t know what the cause is, because it might signal blood being silently lost from the bowel, which would need further investigations to exclude cancer.

## What can I do if I think I have low iron?

If you’re otherwise healthy, it’s still fairly unlikely your iron level will be low; an estimated 3% of women and 8% of men in the UK have an iron-deficiency anaemia, although we can have low iron without being anaemic. If you think there’s a chance, book an appointment with a Kry doctor for a conversation about it. Beyond a simple blood test, a doctor will tailor their assessment to include you, not just the number – personal context is everything.

## What iron-rich foods can I add to my diet?

Doctors find it difficult to write articles that don’t include some advice about eating well. Why? – because it’s so important, and usually a part of our lifestyle we can improve or make simple yet effective changes to. A balanced and nutritious diet is a cornerstone of healthy living more generally, but rich sources of iron are found in many different foods.

- Red meat including beef, lamb and pork
- Fish and poultry
- Pulses and legumes like beans, peas and lentils
- Dark green, leafy vegetables like spinach, cabbage and broccoli
- Tofu
- Nuts and seeds

Sources of vitamin C also help by increasing the amount of iron absorbed by the gut. But when it comes to longevity, many experts would tell you to eat less, and mostly plants. The message being, don’t eat steak every night to ward off low iron.

## What will the doctor do if I have low iron?

It depends on your personal context: your age, sex, medical history, any medication you’re taking, whether you have symptoms of iron deficiency, and what those symptoms are. In general terms, we’ll do the following:

1.	Establish if you do have low iron or an iron-deficiency anaemia
2.	Find out why
3.	Treat and manage the cause

Firstly, we’d organise a blood test to establish if you are iron deficient; but if you have symptoms of some kind or a medical history of note, we might perform several additional tests. For example, if you told us you were tired a lot of the time recently, we’d undertake a screen for other causes of tiredness, like an underactive thyroid. If we then find that you are indeed low in iron, or that you have an iron-deficiency anaemia, we’ll investigate the cause.

This may not be necessary if for example, you’re a premenopausal woman with heavy periods, but we may refer urgently for a colonoscopy if you’re a man. Once we’ve made an assessment, we’ll usually prescribe iron supplements and manage the cause. So in the case of [heavy periods](/your-health/what-causes-heavy-or-irregular-periods-a-doctors-guide/), this would be a discussion around contraceptive methods which can help significantly.

## What supplements are available, and should I take iron anyway?

There are several formulations that we commonly use: ferrous sulphate, ferrous fumarate, and ferrous gluconate. There are reasons doctors may choose one over another, but they’re all effective. Side effects commonly include constipation, diarrhoea, abdominal discomfort and nausea, but people often tolerate them well after some time, and the dose is adjustable. People also report dark stools.

In general, we wouldn’t recommend supplements unless we’ve identified a particular deficiency or you’re particularly at risk of one. If you’re unsure, speak with us and we can advise you further. 

## What are the other symptoms of bowel cancer?

Iron-deficiency anaemia is a finding for some, but symptoms you should speak to a doctor about include abdominal pain, bleeding from the bottom, unexplained loss of appetite or weight loss. But having these symptoms does not mean you have cancer, and we can reassure you if that’s the case.

## What are the other symptoms of anaemia?

There are many causes of anaemia, with iron deficiency being just one of them. Anaemia can also be related to kidney problems, B12 or folate deficiency, or genetic factors (for example, in people with thalassaemia). Symptoms again include pallor, fatigue, breathlessness, and headache.

## What is pernicious anaemia?

This is an autoimmune condition that prevents B12 from being properly absorbed in the stomach, which ultimately causes an anaemia. It’s relatively rare.

## What if I’m worried my child might have low iron?

Symptoms of iron deficiency in children can be similar, but the causes tend to be different, with nutrition being more relevant. Speak to your health visitor, midwife, doctor or us here at Kry.

__This article was written by Dr Samuel Menon, Lead GP at Kry.__


kry.co.uk > Your health > A doctor’s guide to iron deficiency

A doctor’s guide to iron deficiency

Iron deficiency is very common, but many people have symptoms for years before discovering the cause. Dr Samuel Menon, Lead GP at Kry, answers your questions

Iron deficiency symptoms & causes | Doctor's guide | Kry

General health and seasonal

## Quick facts
-	Research suggests it takes around 90 seconds for angry feelings to subside
-	Anger activates the fear centre in the brain, making it hard to think clearly
-	It may also mask feelings of disappointment or sadness
-	Being silent when you’re angry can become passive-aggression — being assertive instead is helpful

You don’t have to look far to see that anger is one of the prevailing emotions right now. With nearly a year of restrictions, lockdowns and negative news stories, the inevitable worry, anxiety, stress and frustration is causing more people to feel angry. 

A recent UK study  found that the coronavirus crisis has led to an increase in anger, arguments and confrontations. More than half of the population said they’ve felt angry with other people as a result of their behaviour in relation to the crisis. 

## Why do we get angry?

Feelings of anger can arise if you’re stressed, overwhelmed, fearful, under pressure, threatened, frustrated and powerless or when your expectations are not being met.  

But anger also often masks other emotions like sadness or disappointment, which is why it’s sometimes referred to as a ‘gateway’ emotion. ‘Anger can mask feelings you either don’t want to feel, don’t know how to deal with, or you’re not fully aware of,’ explains Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Livi. 

There may be biological causes too, for example some people get angry when they’re hungry, have been drinking alcohol or haven’t had enough sleep.

## What happens in the brain and body when we get angry?

Anger activates the amygdala  (the part of the brain where you process emotions like anxiety, stress and fear) and this stimulates the sympathetic nervous system, triggering the ‘fight or flight’ response. ‘When you’re in this state of “survival” mode your amygdala takes control or hijacks your brain,’ Gauffin explains. ‘There’s no time for calm, measured thought which makes it much harder to think clearly and easier to react impulsively.’ 

## Is there such a thing as good and bad anger?

‘Anger isn’t always bad,’ says Gauffin. ‘It can be healthy, for example, if you feel your boundaries are being crossed, or someone is being abusive. Your anger alerts you that something isn’t right and can motivate you to take action or move on.’ 

Being silent when you’re angry isn’t always helpful though. ‘Passive aggression is where you sulk, stonewall, patronise, undermine, use sarcasm and evasion, instead of saying how you really feel, so it is still a form of anger. 

‘Being assertive is the healthiest, most effective way of communicating your thoughts, feelings and needs,’ says Gauffin. That means feeling your anger, calming it down and responding when you feel ready. 

## What are the signs that my anger is a problem?

‘If anger is not addressed, it can have a negative impact on relationships, family, friends and work colleagues,’ says Gauffin.  

Here are some of the signs  that anger may be a problem, for you or someone close to you:

- Not being able to express emotions in a calm and healthy way
- Struggling to compromise without getting angry
- Becoming angry or violent after drinking alcohol
- Ignoring people or refusing to speak to them
- Outward aggression — for example by shouting, swearing, being physically violent or threatening. Read more about the [signs of emotional abuse ](https://www.livi.co.uk/your-health/10-signs-of-emotional-abuse-in-a-relationship/)
- Turning aggression inwards – this can lead to depression, isolation and self-harm

Here are the red flag symptoms that show you, or your partner, needs to seek help for anger issues:

- Blowing up over little things
- Frequent outbursts of anger and rage that seem to spring from nowhere
- Resorting to physical violence, intimidation and threats — this is never acceptable
- Always blaming the other person
- Not taking responsibility for your reactions
- Breaking things
- Anger has led to being arrested
- Constant arguments with family and friends

## 7 ways to manage anger 

If you have repeated anger problems, or someone close to you has, you might want to consider seeing a psychologist who can help you to manage your feelings in a healthier way, says Gauffin. 

‘How we learn to cope with anger is often influenced by upbringing. If you grew up in a violent, aggressive environment, you’re more likely to react with anger in an inappropriate way,’ she says. 

‘Or, alternatively, you may find anger so destructive that you avoid conflict and are afraid to acknowledge your own anger, because you associate anger with being out of control. 

‘Likewise, if you were never allowed to show your feelings, you may have a tendency to suppress anger or turn it inwards. But this can turn into depression.’

Here are some suggestions for positive ways to deal with anger.

#### Long-term fixes:

### 1.	Get to know your emotional patterns

‘A psychologist can help you recognise the signals of anger in your body and the behaviour patterns that you fall into whenever you feel angry,’ says Gauffin. ‘They can also help you to explore underlying emotions like sadness, low self-esteem, disappointment or frustration that may be fuelling your anger. This will help you to get to the root of your anger and learn more effective ways to express how you feel.’

### 2.	Try Cognitive Behavioural Therapy (CBT)

‘CBT techniques can help you change how you react to certain situations that trigger your anger,’ Gauffin asserts. ‘A psychologist can also help you develop a greater awareness of what your anger flash points are and what you can do to manage them in a calmer, more measured way.’

### 3.	Learn to manage stress and anxiety better

‘Stress and anxiety can cause you to feel overwhelmed and this can exacerbate anger issues,’ says Gauffin. ‘Learning stress management techniques like focused breathing exercises, visualisation, meditation, progressive muscle relaxation and mind-body exercises such as yoga or tai chi, can give you tools to help you manage stress before it can overwhelm you.’ Read more about [breathing exercises to help you manage stress](https://www.livi.co.uk/your-health/3-breathing-exercises-a-psychologist-recommends/). 

#### Short-term fixes:

### 4.	The 90-second anger fix

Next time you feel angry, count to 90 before you react. Neuroscience suggests that it takes 90 seconds for feelings of anger to subside.  If you can remain calm during this time, the brain circuitry that anger stimulates settles down and this de-escalates your reaction. From that point, you’re better placed to respond calmly, rather than reacting without thinking it through.

### 5.	Get to know your anger warning signs

Learn to recognise how anger feels in your body.  So, you can take steps to manage anger and calm down before it gets out of control. This may include:

- Knots in your stomach
- Breathing faster
- Clenching your hands or jaw
- Pounding heart
- Tensing your shoulders
- Feeling restless

When you start to feel like this, the best thing you can do is to take time out — walk away, do a breathing exercise, listen to some calming music, talk to a friend who will listen. Or tune into a meditation app where you can access calming techniques and meditations to specifically manage your anger.

### 6.	Breathe away tension

The quickest way to reduce tension and stress and lower adrenaline levels when you’re feeling angry is to focus on your breathing, ideally trying to lengthen your exhalation, which has a calming effect on the brain.  

__Try this exercise:__ Slowly breathe in through your nose, counting to 4 as you do so. Pause a moment or two and breathe out through your mouth, slowly counting to 8. Repeat until you feel calmer

### 7.	Help for when someone else gets angry

- Stay calm. This may be difficult but it’s important you stay calm to stop anger escalating.
- Listen and let someone have their say. Often when people feel they are being listened to, they feel better understood and this helps to calm their anger.
- Take time out. ‘If things get too heated, suggest time out, where you go away until the person has calmed down,’ says Gauffin. ‘Say something like “I’m going for a walk, and we can talk again when I come back.”
- Set boundaries by stating clearly and calmly the actions, words and behaviours you will and will not accept.
- And always walk away or call for help if someone’s behaviour makes you feel unsafe.

__This article has been approved by Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Livi.__


Livi.co.uk > Your health > How to cope with anger – in yourself and those close to you 

Anger 1600x900

Angry feelings are natural, but learning to manage them can help you avoid outbursts. Madeleine Gauffin, Licensed Psychologist and Psychotherapist at Kry, offers her advice around dealing with anger, with both short and longer-term tips

Kry.co.uk > Your health > How to cope with anger – in yourself and those close to you 

How to cope with anger – in yourself and those close to you 

If having sex hasn’t been high on your agenda in the past 12 months, that’s okay. Studies suggest we’re having less sex, with a quarter of UK adults reporting having had none at all in the past year and 40% saying they’d had less sex because of [lowered libido](https://www.livi.co.uk/your-health/8-causes-of-low-libido-a-doctors-guide/) related to Covid anxiety.    

But did you know that sex comes with many health benefits, including to help you deal with increased stress? Here are some of the proven reasons sex can be good for you.

## 1.	It can help reduce stress and regulate your mood 

Sex is a great way to reduce levels of stress. A recent study  shows that emotional and physical intimacy, which doesn’t have to be sexual, helps to lower the stress chemical cortisol in men and women. 

Sexual intimacy can also help reduce feelings of anxiety and depression as it triggers the release of three mood-boosting chemicals — dopamine, endorphins and oxytocin.  Endorphins in particular are brain chemicals activated by exercise and sex with natural opiate-like properties that can help to reduce pain and regulate mood. 

## 2.	It boosts bonding and libido

Dopamine is a chemical released by the brain in response to pleasure. It plays a major role in reward-motivated behaviour and actually activates libido through flirting or the anticipation of seeing, talking to or being with your partner. 

Oxytocin, also known as the love hormone,  is activated by touch, intimacy and sex and promotes a deeper sense of bonding between couples. It’s also the hormone that bonds a mother to her newborn baby and has anti-inflammatory and calming effects. 

The good news is that even just holding hands, showing affection and cuddling up with your partner is enough to trigger the release of this powerful chemical and get you in the mood for sex. 

## 3.	It promotes better sleep

That post-orgasmic wave of sleepiness you get is the release of the hormone prolactin, which induces a relaxing, soporific effect in both men and women after sex.  Prolactin is produced in the pituitary gland and is usually associated with [breastfeeding and lactation in women](https://www.livi.co.uk/your-health/breastfeeding-whats-happening-in-your-body/), but men produce it too in smaller amounts. 

The combined effect of oxytocin, the lowering of cortisol (see above) and the increase in prolactin after an orgasm suggests that sexual activity may be part of an underlying neuro-hormonal mechanism that makes it easier to fall asleep after sex.  A recent study shows that sex at bedtime can help women who suffer from insomnia feel more relaxed and get a better night’s sleep. 

## 4.	It can enhance brain power

Whatever your age, research suggests regular sex can benefit your brain health. In a recent study when women aged 18–29 were asked to memorise lists of faces and words, those who reported having more frequent sex had better verbal recall. 

One theory (which scientists are investigating further) is that sexual activity may promote the growth of new neurons (neurogenesis) in the hippocampus — the part of the brain to do with learning and memory. In another study,  this time of adults aged 50-89, sexual activity was associated with better memory in men and women. 

## 5. It helps maintain sexual function

Weak pelvic floor muscles can lead to sexual dysfunction. In fact, research  shows that having sex at least once a week may help prevent erectile dysfunction in elderly men. A more recent study shows that sexually active women have stronger pelvic floor muscles and higher sexual function. 

During sex, you use your pelvic floor, a group of muscles surrounding your genitals that support your pelvic organs, abdomen and spine.

In men, pelvic floor muscles help coordinate and control ejaculation.  In women, a strong pelvic floor helps to increase sensitivity and lead to stronger orgasms. 

There are lots of reasons why pelvic floor muscles can become weak, like ageing, pregnancy, childbirth and being overweight. Having sex leads to natural contractions of your pelvic floor that help keep those muscles toned and strong (and enhances sexual pleasure).

## 6. It just makes you happy

If you’re having physically and emotionally satisfying sex with a primary partner, this leads to greater happiness in both men and women.  Regular physically and emotionally satisfying sex with your partner keeps you topped up with the love hormone oxytocin, enhancing bonding and emotional intimacy.  One study  shows that the sexual afterglow of loving, pleasurable sex can last between couples for as long as 2 days.  

## Solo sex has benefits, too

If you’re not currently having regular sex with another person, you don’t have to miss out on the benefits. 

Like partner sex, masturbation that leads to sexual pleasure or orgasm also triggers the release of feel-good hormones that include endorphins, dopamine, oxytocin, serotonin and prolactin. These can help to alleviate stress, improve sleep quality, reduce pain (including, one study says, [migraines](https://www.livi.co.uk/your-health/9-types-of-headache-and-what-you-can-do/) and [period pain](https://www.livi.co.uk/your-health/what-causes-heavy-or-irregular-periods-a-doctors-guide/) ) and leave you feeling calmer, happier and more relaxed. Masturbation can also help to improve sexual confidence as it allows you to get to know and feel more comfortable with your own body.


livi.co.uk > Your health > 6 health benefits of sex

6 health benefits of sex

Whether you’re having sex for intimacy and pleasure or just for fun, its benefits extend beyond the bedroom. Here are some of the ways a healthy sex life can enhance your wellbeing

kry.co.uk > Your health > kry.co.uk > 6 health benefits of sex

Reviewer > Dr Rhianna

IMG 20200730 224911 865[33] (1)

Dr Rhianna McClymont

Lead GP at Kry

## Quick facts

- Wearing a high SPF can help protect your skin against windburn and damaging UVA rays
- The thicker the moisturiser, the more protection it provides
- Warm showers or baths instead of hot ones help prevent dry skin

Winter brings double trouble for our skin. The combination of low humidity outside and central heating inside increases the risk of dryness, itchiness and other irritations and flare-ups. Dr Vasiliki Vanky, a Kry GP, provides solutions to some of your most common winter skin issues.

## How can I help prevent dry skin in winter? 

Start by getting an understanding of your skin’s structure. The outer layer, known as the epidermis, is made up of tiny cells, called keratinocytes, which are constantly dying and being replaced. These cells overlap, like the tiles on a roof, and are glued together with an oily substance known as sebum. This provides a protective barrier which keeps moisture in, and irritants and allergens out. 

If these ‘tiles’ become damaged or dislodged, the skin loses moisture which leads to dryness and irritation.  So, maintaining this protective layer is the key to preventing most of our common winter skin problems. 

You can help to maintain your skin by…
- Drinking plenty of fluids
- Using a humidifier or bowls of water around the house to increase indoor humidity  
- Applying a moisturiser immediately after your shower or bath
- Using a hand cream after washing your hands
- Wearing gloves outside
- Minimising smoking and alcohol as both dry the skin

You don’t need to spend a fortune on moisturisers. Just because a cream is more expensive doesn’t mean it’s better than cheaper ones, says  Dr Vanky. Speak to a pharmacist for further guidance.

## What can I do about itchy skin? 

Avoid scratching, as this only adds to the damage and it could introduce a bacterial infection from your hands.

Any fragrance-free moisturiser will reduce the itching. But emollients — such as petroleum jelly or paraffin-based creams — are particularly useful as they are greasy and restore the skin’s waterproof barrier.

‘The terms emollient and moisturiser can be confusing and there’s not an agreed medical definition,’ says Dr Vanky. ‘In simple terms both are moisturising, but emollients tend to be greasier and thicker while moisturisers can include quite liquid lotions.

‘If you’re using emollients several times a day for a few weeks and it’s not helping, see a doctor as you may need a cortisone cream,’ says Dr Vanky.

Talk to a doctor if you have recurrent or severe problems or your symptoms don’t improve after 7 to 14 days of treatment at home. 

## Am I over-washing my skin? 

Excessive washing, particularly with hot water and detergent-based products, depletes the sebum and natural oils which hold the cells on the skin’s outer layer in place. That’s why over-washing can damage your skin’s protective barrier leaving it dry and irritated.  

To maximise the moisture in your skin, limit your shower or bath to 5 or 10 minutes. Use warm water rather than hot, and only enough fragrance-free cleanser (fragrance in body washes and soaps can dry out and irritate your skin) to remove dirt and grime without creating a thick lather.  

## How are dry air and central heating affecting my skin?  

Central heating reduces humidity in the air which damages the skin’s barrier and can lead to dry, itchy skin.  Going from cold, dry air outside to warm dry air inside only adds to the problem.

Some people find humidifiers help, because they put moisture back into the air and increase relative humidity. But there is no clear evidence they reduce skin dryness and they can increase levels of irritant dust mites. If you want to try it, putting a bowl of water into each room will have much the same effect without the cost. 

## Why do I get red, itchy skin patches in winter? 

Cold temperatures outside and heating inside lead to dryness and then repeatedly rubbing and scratching your skin can result in thickened, often red patches. This is most common in hands and feet and can lead to painful cracking. 

Some studies also suggest low temperatures and low humidity increase inflammation in your skin, potentially making it more reactive to irritants and allergens.  

If using moisturiser doesn’t clear up these patches, you may need to use a cortisone cream for up to 15 days. These are available over-the-counter from pharmacies or on prescription.  

## How can I stop my eczema flaring up in winter?  

Cold, dry weather increases the risk of flare-ups of atopic dermatitis, which is the most common form of eczema and also of asteatotic eczema, which is more prevalent as we get older and characterised by inflamed, cracked skin.   

Dr Vanky says, ‘The best way to avoid dry skin and eczema is to use moisturising creams every day.’

If you have been doing that and your [eczema](/medical-advice/skin-conditions/eczema/) is persisting, talk to a Kry doctor who can assess what your skin condition needs.

## How do I protect my skin from windburn?

Wind dries the skin, which can lead to roughness and tiny cracks. This accelerates the loss of natural moisturisers and reduces the skin’s elasticity. It also accelerates shedding of damaged skin cells — and with them, any sunscreen or moisturiser you have applied.   Over time, this combination of wind and sun damage accelerates skin’s ageing. 

You can help prevent problems by wearing protective clothing and using a rich emollient sunscreen when you’re going out on windy days (even if there is no obvious sun, UVA rays can still damage your skin). It’s also important to reapply emollient sunscreens to fully reap the benefits. 

__This piece has been medically approved by Dr Vasiliki Vanky, Kry GP.__


kry.co.uk > Your health > 7 winter skin questions answered

7 winter skin questions answered

If you get itchy skin, red patches or eczema flare-ups in the cold weather, there are simple solutions that can help. Kry GP Dr Vasiliki Vanky answers your winter skin questions

## Quick facts

- 40% of children test positive for strep bacteria in their throats
- Children catch up to 10 colds a year
- Most infections pass quickly and can be treated at home

Colds, sickness bugs and other infections are more common in winter — especially in children. But contrary to popular belief, it’s not actually the cold weather that causes them.

‘It’s because we spend more time indoors,’ says Dr Tommy Södergren, Livi paediatric consultant. ‘The air is drier, which encourages viruses, and we have more close contact with friends and family — which helps infections spread.’

Children are particularly vulnerable, even when social distancing and other national restrictions put a limit on social contact. This is largely because, however hard you try, their hygiene habits may not always be ideal and they’re probably exposed to lots of other children at school.

Dr Södergren has advice on how to spot 7 of the most common winter illnesses, and what to do.

## 1.	Colds, coughs and sniffles

Children catch up to 10 colds a year,  so it’s likely your child will experience at least 1 this winter.

While it takes a couple of days for cold symptoms to appear, they’re usually worse in the first 2-3 days. This is also the time when your child will be most likely to pass on the virus, though they will be infectious for around 2 weeks. 

### How to spot colds in children
Symptoms like coughing, runny nose, congestion and sneezing are caused by swelling of the mucosa (the moist, inner lining of the mouth, nose and lungs) as well as build-up of fluid in these areas. This is an immune response designed to make life uncomfortable for the virus and, ultimately, clear it.

### What to do
Infants don’t have the capacity to cough and clear mucus from their airways, so keep their heads and shoulders elevated, Dr Södergren says. Saline nasal sprays and drops can be used to ease congestion.

Give paracetamol for symptom relief, and plenty of fluids. Colds are caused by viruses, so antibiotics have no effect.

## 2.	Flu

Flu is most infectious when symptoms first start, and remains infectious for up to a week.  

### How to spot flu in children
It’s difficult to tell the difference between a severe cold and a mild case of flu, says Dr Södergren. But you tend to get more fever with flu, and it often starts with a dry cough. This can persist for 2 weeks, or more. Other symptoms include headache, muscle and joint pain, generally feeling unwell, sore throat and a runny nose.  To relieve symptoms, use the same relief as for colds.

### Is it flu or Covid-19?
Children with Covid-19 tend to have mild symptoms, and a third have none. Apart from cough, fever and losing their sense of smell and taste, the most common clues in children are diarrhoea, vomiting and abdominal cramps.    

Although children are more likely to catch the new variant of Covid-19 which first emerged in the UK, the good news is that most continue to show mild or no symptoms. And, there is no evidence that it causes more serious illness. 

Speak to a GP if you suspect your child has Covid-19, or has any of the red-flag symptoms below.

## 3.	Respiratory syncytial virus (RSV)

RSV is a common virus which infects the lower respiratory tract. Almost all children will be infected with RSV before they are aged 2 and, in most cases, it causes only mild cold symptoms. 

Dr Södergren says in adults and older children, it’s difficult to tell the difference between RSV and a mild cold. 

### What to do
For most people, this is simply a matter of treating symptoms, says Dr Södergren (see Colds, coughs and sniffles, above). However, for some children the RSV virus will turn into bronchiolitis (see below). 

## 4.	Bronchiolitis 

Bronchiolitis is a more serious inflammation in the smallest airways in the lungs. In babies and young children, where the lower respiratory tract is still developing, the RSV virus can lead to bronchiolitis. 

### How to spot bronchiolitis in children
Symptoms of bronchiolitis include a rasping dry cough, rapid or wheezy breathing, being irritable, not wanting to feed and vomiting after feeding. Symptoms are at their worst from days 3-5 and can last for up to 3 weeks.  

### What to do
Keeping your child upright will make it easier for them to breathe. Try giving smaller, more frequent feeds. Infants over the age of 2 months can be given paracetamol for fever. Steam will also help to loosen mucus.

Speak to a doctor if your child has taken less than half their usual feed for 2 or 3 feeds, is breathing rapidly, has not had a wet nappy for 12 hours or more, or has a persistent temperature of 38C or higher. 

## 5.	Ear infection

Ear infections can be painful for children, especially at night. Almost all ear infections that occur in children  are secondary bacterial infections in the middle ear, which can follow a viral infection such as a cold or flu.  

### How to spot ear infections in children
Excess liquid produced in the ear usually drains away through a tiny tube to the throat, but if this becomes swollen and blocked, fluid builds up. Viral infections cause inflammation in this tube and make it easier for bacteria to travel up and infect the fluid.  The main symptom will be ear pain at night. 

### What to do
Dr Södergren advises using alternating doses of both paracetamol and ibuprofen if one alone doesn’t work. Anything that clears congestion will also help.

‘In the old days, we used to prescribe antibiotics, but we know now that most infections clear in around 3 days,’ he says. 

Speak to a GP if there is any fluid coming from the ear, as this is a sign that the eardrum has been perforated, if there is no sign of improvement after 2 or 3 days or your child is in a lot of pain.

Antibiotics may be prescribed if your child is very unwell, has symptoms of a more serious illness or is at high risk of complications.  

If ear infections recur, your doctor may recommend inserting tiny tubes, called grommets, into the eardrum to drain fluid and equalise pressure, but there is no evidence that antibiotics help with recurrent infections. 

## 6.	Strep throat

Streptococcus is a bacteria that causes a sore throat and is widespread in children.

### How to spot it
Your child will have a sore, red throat and is also likely to have fever, headache and swollen glands in the neck and below the jaw.

‘If you went into any school and tested children for strep, almost 40% would be positive,’ says Dr Södergren.  And even if they had a sore throat, that doesn’t mean you would treat them with antibiotics as most infections clear up by themselves, he asserts.

### What to do
Treat symptoms with paracetamol and provide plenty of cool drinks. There is no evidence that medicated lozenges help, but sucking on hard sweets or an ice lolly will soothe symptoms.

Viruses are the most common cause of sore throats, and usually antibiotics won’t help these infections. 

But speak to a doctor if symptoms persist, as occasionally strep infections do require antibiotics. 

## 7. Norovirus (Winter vomiting bug)

Norovirus is a highly infectious stomach bug that peaks during winter. While anyone can catch it, children in particular can easily pick it up because they share toys, spend a lot of time in close contact with friends and carers, and often put their hands in their mouths. 

### How to spot norovirus in children

Symptoms start within a day or 2 of being infected and usually include nausea, diarrhoea and vomiting — which is more common in children than adults. It can also cause headache, a high temperature and aching arms and legs.  

It usually only lasts a couple of days, but people can be contagious for up to 2 days after symptoms pass. 

### What to do
In the meantime, Dr Södergren advises encouraging children to keep drinking fluids, but don’t stress if they only take small amounts, and avoid milk. 

Speak to a doctor if your child is weak, or tired and is not interested in play.

## How to prevent winter infections

Ultimately the only way to prevent your child catching winter bugs is to keep them away from their friends and family. But you can reduce the risk by:

- Avoiding anyone with obvious symptoms
- Encouraging your child to wash their hands after using the toilet and before meals
- Discouraging them, if possible, from putting their hands in their mouth, chewing their nails, or rubbing their eyes
- Cleaning toys, chairs and work surfaces regularly
- Making sure they are eating healthily and getting plenty of exercise
- Encouraging the whole family to cover their nose and mouth with a tissue when they cough or sneeze — and to wash their hands after binning the tissue
- Following social distancing and hygiene regulations in your area

If occasional colds and coughs are inevitable for children, know that there are also several steps you can take to [support your child’s immune system](https://www.livi.co.uk/your-health/how-to-boost-childrens-immunity-this-winter-7-tips/).

## Red flag symptoms — when to see a doctor

Parents should seek immediate advice if their child:

- Is under 3 months old and has a temperature of 38C or higher
- Is 3 to 6 months old and has a temperature of 39C or higher
- Has had a high temperature for 5 days or more
- Has a high temperature which does not come down with paracetamol
- Has signs of dehydration
- Keeps vomiting and can’t keep fluids down
- Has diarrhoea for more than 7 days or vomiting for more than 2
- Breathing difficulties, shallow breathing or any other change in their breathing
- Has a rash that doesn’t fade when you press a glass against it
- Is bothered by light
- Is drowsy and difficult to wake
- Has unusually cold hands and feet
- Has pale, blotchy, blue or grey skin
- Has a weak, high-pitched cry that is not like their normal cry

With the Livi app, you can easily add a child to your account and see a GP by video if they’re feeling unwell.

__This article has been medically approved by Dr Tommy Södergren, Livi paediatric consultant.__


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livi.co.uk > Your health > 7 common children’s winter illnesses and their symptoms

7 common children’s winter illnesses and their symptoms

During winter, it’s normal to be more anxious about your child’s health. While most winter illnesses in children are not serious, it’s helpful to know how to recognise them and what to do. Kry Paediatric Consultant Dr Tommy Södergren has advice

kry.co.uk > Your health > 7 common children’s winter illnesses and their symptoms

Since the start of the coronavirus crisis last March, our lives have been different. With little sense of what the future may hold, and worn down by repeated lockdowns and restrictions, it’s not surprising our rates of anxiety have increased.

In the UK, a recent study  showed that 57% of people were experiencing significantly more anxiety as a result of lockdowns. 

But rest assured, help is available. Start by gaining a better understanding of what makes you vulnerable to anxiety, and discover the options available to help you manage it.

Here our experts have answered some commonly asked questions about anxiety.

## What are the main symptoms of anxiety?

‘Anxiety can be mild or severe,’ says Madeleine Gauffin, Licensed Psychologist and Licensed Psychotherapist at Kry. ‘Physical symptoms may include a fast heartbeat, dry mouth, tightness in your chest, a churning stomach, sweating, shallow breathing, light-headedness, nausea and restlessness. 

‘You may also develop aches, pains and headaches or grind your teeth at night. Mentally you could feel tense, nervous and unable to relax. It may feel difficult to stop worrying and with that can come feelings of dread or panic. You might also feel indecisive and find it hard to concentrate.’ 

##  What can anxiety do to your body?

‘When you’re anxious your body goes into “fight or flight” mode,’ says Gauffin. This is an automatic response, activated by the sympathetic nervous system in response to a real or perceived threat of danger. 

‘It causes your heart rate and blood pressure to go up, your breathing to increase and your adrenal glands to produce an excess of the stress hormones adrenaline and cortisol. 

‘If you’re always anxious, this puts you in a constant state of hyper-alert, which is exhausting for the body and not good for your health in the long term.’ 

Research suggests that experiencing long-term anxiety may increase the risk of developing physical health problems like heart disease,  high blood pressure and  type 2 diabetes.  

##  How can anxiety cause depression?

‘It’s fairly common for people with anxiety to also suffer from depression,’ says Gauffin. 

‘If you’re constantly living in a state of anxiety and fear, this can have a severe impact on your ability to focus on other things, and the quality of your life may start to suffer. 

‘This, in turn, may cause you to withdraw from friends and family, because you simply can’t handle communicating with anyone when you’re feeling anxious. 

‘It can also mean you find it hard to concentrate, which can then affect your performance at work, leaving you feeling hopeless or bad about yourself. This cycle can lead to depression.’ 

##  What kind of anxiety do I have?

‘There are several different types of anxiety disorders,’ says Gauffin. 

__Generalised anxiety disorder__
‘Generalised anxiety disorder (GAD) is when you feel anxious more or less all the time. There’s no one specific reason as anything can make you feel anxious. As soon as you stop worrying about one thing, you find something else to worry about. People with GAD live in a state of constant low-level anxiety and this can be very tiring.’ 

__Health anxiety__
‘Health anxiety is when you constantly worry about your health. You imagine that every little symptom could be a serious disease. For example, if you get a headache, you worry you might have a brain tumour. Health anxiety is often triggered when there’s some area of your life that you feel you can’t control. 

__Social anxiety disorder__
‘Social anxiety disorder (sometimes called social phobia) is the fear of being in social situations. This could include meeting or talking to people, speaking on the phone, eating or drinking in public, speaking in public, groups or meetings and feeling as if you’re being watched

__Phobias__
‘A phobia is an overwhelming fear of something like an object, animal or situation. As this triggers severe anxiety, you do everything you can to avoid it. 

__Panic disorder__
‘Panic disorder is when you experience [panic attacks](/your-health/6-causes-of-panic-attacks-and-expert-tools-for-how-to-cope/) out of the blue for no obvious reason.’ 

A GP can be the first port of call to help you identify whether you have anxiety and if so, the type you might have. 

##  Where does anxiety come from?

‘Anxiety disorders stem from all sorts of reasons,’ says Gauffin. ‘Some people are naturally very sensitive and prone to developing anxiety. It can also be an inherited trait, particularly if there’s a history of anxiety in your family. 

‘Anxiety is also often triggered by traumatic life events in the past. For example, if you were criticised or abused as a child, you’re more likely to develop an anxiety disorder as an adult. 

‘Too much stress can also trigger anxiety — for example, work stress, worrying about finances, having a health condition or serious illness, going through divorce or a bereavement. 

‘Also, lifestyle factors like not getting enough sleep, drinking too much, not exercising or eating healthily can cause or make anxiety worse.’

##  What can I do when anxiety hits? 

Although it’s important to talk to a doctor or psychologist about your anxiety, there are a number of tools you can use to cope in the moment when your anxiety feels overwhelming. Here are 4. 

#### 1.	Try a quick breathing exercise 
Next time you feel anxious, try this simple breathing exercise to help calm your nervous system and reduce stress in your body, Gauffin suggests:

- Sit or lie down comfortably
- Exhale completely
- Gently and slowly inhale through your nose for the count of 4
- Gently exhale through your mouth for the count of 4
- Pause and hold for the count of 4
- As you breathe, imagine your breath moving around the image of a square
- Repeat for 1 or 2 minutes, or until you feel calmer

#### 2.	Get active — even when you don’t want to
‘When you feel anxious, it can make you want to curl up in a little ball,’ says Gauffin. ‘Yet, the best thing is to do the opposite and get moving. For example, jumping, swaying, stretching or dancing to music can help shift your energy from an anxious state to a calmer one.’ 

[Exercise](/your-health/5-reasons-to-keep-exercising-outside/) is also one of the best ways to help you manage your anxiety in the longer term. ‘Exercise triggers the release of endorphins (“feel-good” chemicals in the brain) that enhance emotional wellbeing,’ Gauffin points out.

Recent research  showed that high intensity aerobic exercise like jogging, running or brisk walking, 2-5 times a week for at least 2 weeks, is effective in reducing anxiety. 

#### 3. Get into the habit of naming your fears
‘Anxiety is always about fear. So, when you feel anxious, acknowledge that it’s okay to feel afraid and soothe yourself with some self-compassionate understanding,’ says Gauffin. 

‘Notice where you feel your emotions most intensely in your body. This could be your chest, heart, throat or abdomen,’ she adds. 

‘Then, ask yourself, “What is it that I’m really afraid of? What is my body trying to tell me?” Think about what area in your life you feel overwhelmed by, scared about or lacking control over. Is there something — however small — you can do to change this? Or, perhaps talking to a friend or journaling about it could help you manage your fearful thoughts? Consider talking to a psychologist, or having a course of psychotherapy to help you too.’

#### 4. Look for self-help support
‘If your anxiety symptoms are mild, then a self-help course, book or mental health app may help you control and improve your symptoms,’ says Dr Rhianna McClymont, Lead GP at Kry. 

‘You can find a wide range of resources to download at the[ NHS Mental Health apps library](https://www.nhs.uk/apps-library/category/mental-health/). Simple lifestyle changes like increasing your exercise levels, improving the quality of your sleep, and reducing your alcohol and caffeine intake can also help anxiety.’ 

##  What treatment is available for anxiety? 

‘Psychological treatments for anxiety such as Cognitive Behavioural Therapy (CBT) are recommended and very effective,’ says Dr McClymont. ‘Your doctor can refer you to a psychological service that could provide this treatment. 

‘In people with severe symptoms, some medications can also be helpful. These include medications that can reduce the physical symptoms of anxiety, such as tremors, or drugs like antidepressants which can help to improve mood and anxiety symptoms.’  

##  How do I know I need help for my anxiety?

‘If your anxiety symptoms are interfering with your daily life and activities,’ says Dr McClymont. ‘Or, if you feel they are adversely affecting you in any other way, then you should always speak to your doctor, or a Kry doctor for further help.’ 

__This article has been approved by Madeleine Gauffin, Licensed Psychologist and Licensed Psychotherapist at Kry, and Dr Rhianna McClymont, Lead GP at Kry.__


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Kry.co.uk > Your Health > Need help for anxiety? Here are your questions answered

Get help for anxiety

As the pandemic continues, so does its impact on our mental health. If you’re feeling more fearful or anxious than ever, Kry’s experts have advice that can help

Kry.co.uk > Your health > Need help for anxiety? Here are your questions answered

Need help for anxiety? Here are your questions answered

Most GPs would agree that prevention is better than cure. Doctors have worked and studied hard to help give patients the best care they can, but what they really want is for us all to be well-informed and on top of our health, to minimise the risk of becoming unwell. 

We spoke to __Dr Rhianna McClymont, Lead GP at Kry__, who shares some important advice about what doctors really want their patients to know.

## 1. Get it checked ASAP
Don’t ignore any symptoms that have been worrying you – even if it turns out to be nothing, always let a doctor make that call. ‘I often hear “I didn’t want to bother you, doctor” – but if something’s concerning you, especially if it’s been there a while, it’s best to get it checked out,’ says Dr McClymont.

During the pandemic, many patients have put off seeing a doctor about their symptoms because they’re worried about contracting the virus, or they don’t want to burden the health system. That’s totally understandable, but since the pandemic began, doctors have been seeing an increase in late presentations of serious conditions like strokes and heart attacks. So if you have a new problem or symptom, see a GP.

By using an app like Kry, you can usually get a video appointment within minutes of registering. Kry GPs can offer medical advice and the reassurance you need for most symptoms, and can refer you to see a specialist if you need to see one.

## 2. Antibiotics aren’t always the answer
Antibiotics are an incredible tool we have to treat a whole host of bacteria. But they can’t be used for everything, and will have no effect at all on viruses. So no matter how under the weather you feel when you have flu or another viral infection, antibiotics aren’t the answer.

‘It’s so important that you don’t use antibiotics when they’re not needed. If you do, you’ll likely increase bacterial resistance to them, so they don’t work as well when you really need them to. What’s more, antibiotics can have unpleasant side effects, so sometimes it’s not worth running the risk’ advises Dr McClymont.

## 3. Mental health should be a priority
‘The fact we need to get physical symptoms checked out is a given, but don’t forget to get help or advice for your mental health, too. Doctors genuinely care about your wellbeing, and mental health is just as important as physical,’ says Dr McClymont.

‘Mental health symptoms can even show physically. Anxiety, for instance, can cause palpitations, shortness of breath or dizziness, and depression can augment pain.’ 

If you suspect you might be struggling with your mental health, you can speak to a Kry GP, who can help you better understand your problems, and give you advice and support on how to deal with things that feel difficult.

## 4. Family history is important to know
Many conditions, like eczema, asthma, high cholesterol and certain types of cancers, run in families. So if your parents or siblings are affected by something, you may have a higher chance of getting it too.

‘It may be uncomfortable to talk to your parents or family members about health, but knowing their medical history will help you be more aware of any future risks,’ says Dr McClymont.

‘Get to know your family history and try to have more open conversations about health – you’ll be glad you did once you’re older’.

## 5. Please, don’t be shy!
‘Many patients – men and women – put off coming to the doctor because they’re feeling awkward or consider their symptoms embarrassing,’ Dr McClymont highlights.

Whether it’s a cervical cancer screening, a prostate exam or a discussion about poo, there’s nothing too intimate for a doctor or nurse – they’ve seen it all before!

‘I’ve lost count of the number of times a patient has apologised to me that she hasn’t trimmed her pubic hair. This is a classic example of something that I wouldn’t even take notice of,’ says Dr McClymont.

The truth is, doctors don’t mind. They just want to help treat your symptoms, or give you the right advice to prevent illness occurring in the first place. If you have a symptom you need to get checked out, you can see a GP through Kry without having to leave your home. 


Kry.co.uk > 5 things doctors want patients to know

Kry.co.uk > Your Health > 5 things doctors want patients to know

CEC8187.jpg 1

5 things doctors want patients to know

##  Quick facts

- Omega-3 oils (found in oily fish like salmon and mackerel) could have anti-inflammatory effects on joints
- Eating a Mediterranean-style diet — rich in oily fish, wholegrains and vegetables —  can also be helpful  
- Regular exercise is considered the most effective, non-drug treatment for reducing osteoarthritis pain 

When the temperature drops, many people find that their hands, knees, feet, back or hips can feel stiff, tender, sore or ‘creaky’. For those with osteoarthritis – the most common form of arthritis – joints can also feel painful and inflamed.

Osteoarthritis most commonly develops in the mid-40s or older, and tends to run in families . It’s thought that more than 40 million people in Europe suffer from it,  with more women affected than men. 

##  What is arthritis?

There are two types of arthritis — osteoarthritis, which is more common and usually age-related, and rheumatoid arthritis which can affect people of any age. 

‘Osteoarthritis is often referred to as the “wear and tear” arthritis,’ says Dr Rhianna McClymont, Lead GP at Livi. ‘It’s caused by the protective cartilage inside joints, which acts as a ‘shock absorber’, becoming damaged and wearing down. This causes pain and swelling, which is normally most severe when moving the joint.’

Osteoarthritis pain usually lasts for less than 30 minutes at a time. It affects the smooth cartilage lining of the joint, making movement more difficult than usual. It most often develops in the hands, lower back and neck, and in weight-bearing joints like the knees, hips and feet. 

Rheumatoid arthritis (RA) on the other hand, is an auto-immune condition in which the immune system starts to attack the joints. Although it’s far less common, RA can affect anyone, including the very young, and the earlier you seek medical help for it, the better the outcome. RA causes prolonged pain in the joints, including stiffness and swelling. It commonly affects the small joints of the fingers and toes, the wrists, elbows, shoulders and knees and the neck and jaw. 

##  How is arthritis diagnosed?

If you have pain that gets worse the more you use your joints, a stiffness that’s not there in the mornings, or any of the symptoms above, talk to a doctor. 

##  Does arthritis pain really get worse in winter?

In the cold winter months, many people with osteoarthritis complain that their joints feel worse.  One study in 2019 suggested that those with the condition were 20% more likely to suffer pain on days when it’s windy and humid.  

‘Although I often hear from patients that their joint pain gets worse in the winter months, the exact science on this is unclear,’ says Dr McClymont. 

‘Some theories suggest lower atmospheric pressure  is the cause, others relate to increased sensitivity of nerves in cold weather  or reduced exercise/activity levels during winter months, leading to increased stiffness and pain. However, these are all hypothetical and at present we just don’t have a definite answer for this.’

Whatever the reason, while osteoarthritis is an incurable condition, the good news is that there are ways to manage the pain. 

## Here’s what can help winter arthritis pain:
__1.__	__Maintain a healthy weight__

‘If you are obese, and therefore carrying extra weight, that puts extra strain on the joints and can exacerbate osteoarthritis,’ says Dr McClymont. ‘Regular exercise and a healthy diet plan to [maintain a healthy weight and BMI](https://www.livi.co.uk/your-health/5-simple-tips-for-a-healthy-bmi/) are ideal.’ 

There’s strong evidence that losing weight can improve your overall health and physical function and this applies to those with osteoarthritis.  Losing just 10% of your weight — if you are overweight or obese — can lead to significant improvement in symptoms of osteoporosis and pain relief. 

A Livi doctor can help you with a plan toward achieving a healthy weight. 

__2.__ __Eat a joint-friendly diet__

Experts recommend that those with osteoarthritis aim to eat at least 1 portion of oily fish, like salmon or mackerel a week.  The omega-3 oils found within the fish have anti-inflammatory properties that may help those suffering with this condition.  

A Mediterranean-style diet that includes healthy oils, nuts and wholegrains may also help. One study found that patients with osteoarthritis had a significant reduction in pain after switching to a wholefoods, plant-based diet.  Patients in the study also lost weight without counting calories or limiting portions.  

A deficiency in vitamin K  (found in olive oil and margarine) may increase the risk of osteoarthritis, so there is some suggestion that increasing this vitamin may help — talk to a doctor about this option first.  

Vitamin D is also needed for bone cartilage and health. Although it’s found in egg yolk, liver and oily fish, it’s mainly absorbed via sunlight so most people should consider taking a supplement of around 10mg per day, especially during winter months.  

__3.__	__Cut down on pro-inflammatory foods__

Some foods are believed to be pro-inflammatory for joints, which means they could make symptoms worse. These include omega-6 polyunsaturated fats found in corn, sunflower and safflower oils, as well as saturated fats found in animal products. It may be helpful to remove as much fat from meat as possible before you cook and replace omega-6 fats with oils and spreads rich in mono-unsaturated fats like rapeseed and olive oils. 

__4.__	__Prioritise exercise__

Research shows that people with osteoarthritis can benefit from exercise, though they may be concerned about their pain getting worse.  In fact, exercise is considered the most effective, non-drug treatment for reducing pain and improving movement for patients with osteoarthritis. Brisk walking, swimming, jogging, yoga and strength-training are all beneficial. The weekly recommendation for aerobic exercise is 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise a week.  

__5.__	__Keep your joints warm__

‘Keeping joints warm may help alleviate pain as warmth relaxes muscles and reduces stiffness,’ says Dr McClymont.

Warm showers and baths, heating pads, electric blankets and covering joints with gloves or even wrapping hands around hot drinks can all help with keeping your pain at bay in winter. 

__6.__	__Talk to a doctor about your pain__

It’s important to have a dialogue going with a doctor about how your arthritis is affected and your pain levels.

There are different pain-relief medicines you can take for osteoarthritis, depending on the severity of the condition and other health concerns. 

These include over-the-counter drugs like paracetamol or your GP may prescribe a non-steroidal anti-inflammatory drug (NSAID) or opioid. 

In the UK, a doctor may also prescribe capsaicin cream, which works by blocking the nerves that send pain messages to the brain. 

‘If over-the-counter medications like paracetamol or ibuprofen have not been sufficient to control osteoarthritis pain, then a doctor may prescribe stronger painkillers,’ says Dr McClymont. 

__7.__	__Consider shock-absorbing footwear__

If the pain is in your hips, knees or feet you might want to consider special footwear.  ‘Supportive footwear with shock-absorbing properties is excellent to help with osteoarthritis, as this reduces the strain through the joints of the foot and leg,’ says Dr McClymont. 

‘Shoe insoles that have foot-arch support and shock-absorbing cushioning can usually be bought from a pharmacy,’ she explains. 

‘An NHS podiatrist would also be able to carry out a biomechanical foot assessment and provide appropriate insoles if osteoarthritis symptoms indicate this is necessary.’

A consultation with a Livi doctor may be helpful to assess your joint symptoms and recommend the best next steps. 


Livi.co.uk > Your Health > 7 ways to help arthritis pain in winter

 7 ways to help arthritis pain in winter

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