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Every year, hundreds of people are rushed to hospital after a choking incident, and hundreds more of these will be fatal. The elderly, young children and babies are particularly vulnerable.
‘Food such as grapes and nuts are common things to choke on – or anything else that’s not cut into small pieces,’ says Dr Rhianna McClymont, Lead GP at Kry. ‘Small toy parts, batteries and balloons are examples of other choking hazards for children too.’
‘Choking can be a life threatening situation, but the best thing to do is stay calm, act quickly and follow the recommended first aid advice,’ Dr McClymont explains.

## How should I help someone who’s choking?

A baby, child or adult will start choking and won’t be able to breathe if their airway becomes blocked, either fully or partly. The following advice is the same for adults and children (over 1 years old).

First of all, if their airway is only partly blocked, the person should be able to speak, cry, cough or breathe. You can help by doing the following:

- Encourage them to keep coughing to clear the blockage
- Ask them to spit out the object if it's in their mouth
- Keep your fingers away from their mouth

They'll usually be able to clear the blockage themselves. But if coughing doesn’t work, you need to act quickly and start doing back blows and abdominal thrusts.

When someone is choking and can’t dislodge the blockage by coughing, they won't be able to make any noise, speak or cry. If they don’t get help immediately to start breathing again, they will become unconscious.

![1- 720x377 - what to do if someone is choking](//images.ctfassets.net/h8qzhh7m9m8u/6FaMhzhhvB2iH8iCrXNen6/e8053d6eb4bc35b11c2d696b49fe23e3/1-_720x377_-_what_to_do_if_someone_is_choking-1.jpg)

## How to give back blows

To carry out a back blow on an adult or child over 1 year old:

- Stand behind the person and slightly to one side
- Support their chest with one hand
- Lean them forward so the object blocking their airway will come out of their mouth, rather than moving further down
- Give up to 5 sharp blows between their shoulder blades with the heel of your hand (between your palm and wrist)
- Check if the blockage has cleared
- If not, give up to 5 abdominal thrusts

![1- 720x377 - what to do if someone is choking-1](//images.ctfassets.net/h8qzhh7m9m8u/4G9naRV85126Qz79Ll6wyv/264dbb421c63dcc299b9c33345353fa2/bfeb9378-620c-406a-b9bf-04c8aa231188.jpg)

## How to give abdominal thrusts

Abdominal thrusts should not be given to children under 1 year old or pregnant women.

To carry out an abdominal thrust on an adult or child over 1 year old:

- Stand behind the person
- Place your arms around their waist and bend them forward
- Clench your fist and hold it just above their belly button
- Put your other hand on top of your fist and pull sharply inwards and upwards
- Repeat this movement up to 5 times

If the person's airway is still blocked after trying back blows and abdominal thrusts, get help immediately:

- Call 999 and ask for an ambulance. Let the operator know the person is choking
- Continue with these cycles of 5 back blows and 5 abdominal thrusts until help arrives

If they lose consciousness and aren't breathing, you should start doing CPR (cardiopulmonary resuscitation). The aim of CPR is to pump blood around the person's body when their heart has stopped beating.

Although this can be a scary situation, it’s important to act quickly. We’ve put together a step by step guide on [how to do CPR](/your-health/learn-how-to-do-cpr-a-step-by-step-guide/) to help you stay calm.

__Tips on helping a choking child__

If you can see the object clearly in the child’s mouth, try to remove it. Don't poke blindly or repeatedly with your fingers – as you could make things worse by pushing the object further and making it harder to remove.

If your child is coughing loudly, encourage them to carry on coughing to bring up what they're choking on and don't leave them alone.

But if your child's coughing isn't helping to dislodge the blockage (or they’re not making a noise), shout for help immediately.

If your child's still conscious, but they're either not coughing or their coughing isn't working, start using back blows.

The advice is slightly different for a baby (a child under 1 year old), so if you’re a new parent it’s a good idea to familiarise yourself with what to do in this situation.

__How do I stop a baby from choking?__

__Back blows__

- Sit down and lay your baby face down along your thighs, supporting their head with your hand
- Give up to 5 sharp back blows with the heel of one hand in the middle of the back, between their shoulder blades

__Chest thrusts__

- Lay your baby face up along your thighs
- Find the breastbone and place 2 fingers in the middle
- Give 5 sharp chest thrusts (pushing their chest in and out by about a third)

__Can you get complications from choking?__

‘If you, your child or baby have any of the following symptoms after choking, it’s important to get medical help as soon as you can, either at A&E, an NHS walk-in centre or by a GP,’ says Dr Rhianna McClymont, Lead GP at Kry.

‘They will carry out various checks to make sure there are no complications or injuries.’

- A persistent cough after choking
- Throat still feels blocked
- Pain or discomfort from abdominal thrusts 


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Dr Rhianna McClymont

Lead GP at Kry

General health and seasonal

What to do if someone starts choking

It’s no secret that alcohol has a detrimental effect on your body. As well as the hangover that shows up the next morning, alcohol can affect both your physical and mental health. 

In the long term, it can increase your risk of [cancer](/medical-advice/cancer/), [dementia](/medical-advice/neurology/dementia/), heart disease and [stroke](/medical-advice/cardiovascular-diseases/stroke/). There’s also evidence that alcohol can impair your memory and reduce fertility. 

The good news is that cutting back or giving up alcohol comes with [clear benefits to your health](/your-health/6-health-benefits-of-drinking-less/) – often within just 1 week. And with more of us considering going sober than ever before, now’s a great time to be more conscious of your drinking.

## How do I know if my drinking is causing damage to my health?

‘We might not realise that our drinking is problematic because aside from a hangover, you can’t tell what’s going on under the surface until it becomes a problem,’ explains Dr Nikki Ramskill, a Kry GP. ‘If you’re regularly drinking above the recommended 14 units of alcohol a week, the negative effects will reveal themselves over time. 

‘Fortunately, there are lots of ways to reduce your alcohol consumption, including having some drink-free days and reducing your glass size to stay within the advice on safe drinking.’

## How long does alcohol stay in my system? 

When you drink alcohol, it passes rapidly into your bloodstream through the stomach and travels to every part of your body – affecting your brain, liver, kidneys and lungs. 

‘Alcohol will stay in the body for different lengths of time depending on your gender, size, age, how regularly you drink and whether you’ve eaten,’ explains Dr Ramskill. 

‘It takes approximately 1 hour for 1 unit of alcohol to leave your body. So, if you’ve had 8 pints of ordinary strength beer (with each pint being 2 units of alcohol), and stopped drinking at midnight, the alcohol won’t be out of your body until about 4pm the next day. 

‘Once alcohol is in your system, your liver breaks it down, or metabolises it, by producing a special enzyme.’ 

## What happens if I cut down on alcohol? 

If you cut back or stop drinking alcohol, there are plenty of short- and long-term benefits. 

### After 1 week: 

__Your sleep will improve__ 

‘There’s a common misconception that alcohol improves sleep,’ says Dr Ramskill. ‘It may help you drift off, but the effects of alcohol mean you’ll get less restorative REM (rapid eye movement) sleep, which is essential for your health.’

After just 1 week of no alcohol, your REM cycle will likely return to normal. You can expect to feel more rested and notice an improvement in your mood and cognitive function. ‘You may notice that your dreams are more vivid or that you're starting to dream again,’ says Dr Ramskill. 

__Your skin may appear healthier__

‘When the body metabolises alcohol, it releases a by-product called acetaldehyde before it is broken down to a less toxic product and removed from the body,’ says Dr Ramskill. ‘Acetaldehyde is toxic to your bodily tissues. It causes you to become dehydrated and increases your chance of skin breakouts.’

By cutting down on alcohol, you may notice your skin improves, including any issues with redness like rosacea. [One study](https://www.aad.org/news/alcohol-and-rosacea-in-women) found that increased consumption of alcohol is associated with a higher risk of [rosacea](/medical-advice/skin-conditions/rosacea/) in women.

### After 1 month:

__You’ll find it easier to maintain a healthy weight__ 

Alcohol has a high calorie count. Just 1 standard glass of wine has 133 calories, while a pint of beer has 239 – about the same as a Mars bar. ‘Alcohol contains lots of calories that don’t offer any nutritional value. These “empty calories” are converted into fat stores, which you'll notice on your waistline,’ explains Dr Ramskill. 

After 1 month of not drinking as much, your body may start to shed excess fat due to all the calories you save. 

__The damage to your liver will be reversed__

The effects of alcohol can lead to [alcohol-related fatty liver disease](/your-health/how-to-reduce-your-risk-of-fatty-liver-disease/). ‘The liver works hard at eliminating toxins from the body. It also performs lots of other really useful functions to help our body function,’ explains Dr Ramskill. 

‘Your liver needs to work harder to break down alcohol. A [fatty liver](/medical-advice/fatty-liver/) can reduce its ability to perform vital functions, leading you to feel sluggish.’ 

After only 2 weeks of abstaining from alcohol, your [liver starts to regenerate](https://www.nhs.uk/conditions/alcohol-related-liver-disease-arld/treatment/). ‘Within 4-8 weeks your liver may be fully recovered,’ says Dr Ramskill. ‘It just depends on how much you drink and what state it was in to begin with.’ 

__Your mental health may improve__

While alcohol may initially make you feel more confident and less anxious, in the long term it can make you more vulnerable to [mental health conditions](/medical-advice/mental-health/) like depression and anxiety. Alcohol can disrupt the balance of chemicals and processes in your brain and affect your thoughts, feelings and behaviour. 

‘Alcohol is a depressant, so people who already have mental health problems may find that this gets worse,’ says Dr Ramskill.

After 4 weeks, your mood will start to improve and you may notice that you have more resilience to cope with life in general.

### After 1 year:

__Your blood pressure will lower__

Regularly drinking too much alcohol can raise your blood pressure. ‘Having high blood pressure puts you at an increased risk of cardiovascular disease because it puts strain on the heart muscle,’ says Dr Ramskill. [One large genetic study](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31772-0/fulltext) found that even light-to-moderate drinking increases blood pressure and the chances of having a stroke. 

‘Across a year, abstaining from alcohol will lower your blood pressure and reduce your risk of stroke or having a [heart attack](/medical-advice/cardiovascular-diseases/heart-attack/),’ explains Dr Ramskill. 

__Your memory will improve__

Alcohol can affect the function of your hippocampus – the part of your brain that forms and stores memory. ‘Drinking too much can also lead to brain damage and may increase your risk of developing dementia,’ says Dr Ramskill. 

However, research suggests that when you stop drinking, some of the brain damage that long-time alcohol can cause may reverse. 

## How can I cut down on alcohol?

Giving up alcohol can be difficult, but the benefits can make it worth the effort. If you’re finding it challenging, here are some ways to help:

- Stay hydrated by swapping every second drink for water or a soft drink
- Have several drink-free days a week
- Let your family and friends know that you want to cut down to encourage their support
- Go for a drink that’s lower in strength (ABV in %) and opt for a smaller wine glass than usual
- When you’re going out, take a fixed amount of money to spend on alcohol 

## When should I speak to a doctor?

If you’re struggling to reduce your drinking, it’s a good idea to speak to a doctor. It’s also worth [booking an appointment](/gp-appointments-online/) if you experience any of the following: 

- You’re worried about your relationship with alcohol
- Your drinking is causing arguments with family, friends or colleagues
- You can’t say no to alcohol 
- You need to drink more to achieve the same effects
- You’re struggling with sleep

__This article has been medically approved by Kry GP, Dr Nikki Ramskill.__


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Acne vulgaris, more commonly known as [acne](/medical-advice/skin-conditions/acne/), is a skin condition that affects most people at some point. It causes spots, oily skin and inflammation that can be hot or painful to touch. 

Every year, 3.5 million visits to the doctors will be made to discuss skin treatment for acne.

## Quick facts:

- In puberty, acne is especially common in teenage boys
- Women can be affected in adulthood due to changing hormones
- Poor hygiene and sexual activity are not causes of acne
- Acne affects the face in 99% of cases, the back in 60% and the chest in 15%

Skin plays a role in our self-perception, so experiencing acne on any level can carry emotional strain and affect self-confidence.

But the good news is, there’s lots that can be done, both in terms of self-help measures and medical treatments.

## What causes acne?

There are sebaceous glands in the skin that are met on the skin’s surface by hair follicles. They produce a fatty substance called sebum, which keeps hair and skin soft.

When we reach puberty, sebum production increases along with the bacterium propionibacterium on the skin. Sometimes sebaceous glands produce more sebum than needed and that’s when acne develops. This is because the excess sebum and skin residue can clog the hair follicle or the sebaceous gland, or because the bacteria enter it, creating an inflammation or infection.

These changes come about because of an upsurge of testosterone and other hormones during puberty and are especially common in teenage boys. The same effects can also become common in women in adulthood, known as [adult acne](/your-health/managing-adult-acne-a-doctors-advice-on-what-really-works/).

## What are the different forms of acne?

Acne vulgaris mostly occurs on the areas of skin where there are more hair follicles found that produce sebum – which is why the face, back and chest are most affected. It can come in different forms.

### Types of spots: Non inflammatory acne

__Whiteheads__ — small bumps that are sebaceous glands where the wall of the hair follicle is closed.

__Blackheads__ — small dark dots that occur when the hair follicle is open and sebum and bacteria there have turned black because of contact with air.

### Types of spots: Inflammatory acne
__Pimples__ — skin pimples appear as red and swollen bumps that can progress to the types below.

__Papules and pustules__ — these can be hardened, clogged pores surrounded by pink skin, that are usually tender to the touch. 
Sometimes an infection under the skin’s surface can lead to painful bumps filled with fluid (called pustules) that are yellow or white in colour.

__Nodules and cysts__ — these can be painful to the touch and look red and inflamed.

## What is post-inflammatory hyperpigmentation? 
Post-inflammatory hyperpigmentation (PIH) appears as a result of damage to the skin, following an inflammatory skin condition like acne vulgaris.

It appears as dark flat spots of discolouration across the face and body. Depending on the person’s skin tone and the level of discolouration, these patches are usually brown or black in colour.

Men and women are equally at risk, and while all skin types can get post-inflammatory hyperpigmentation, it occurs more in people with darker skin tones. 

## Differences between mild acne, moderate acne and severe acne

### Mild acne
White and blackheads mostly, with occasional pimples.

### Moderate acne 
More inflammatory papules and pustules that are less than 5mm in diameter, as well as pimples, blackheads and whiteheads.

### Severe acne 
Nodules and cysts that are more than 5mm diameter (along with all or some of the above). In very severe cases, these may join together and leak fluid onto the skin’s surface.

## Skin treatment for acne

Mild cases of acne can often be treated at home with the help of your pharmacist. For moderate acne that’s not clearing up, talk to a Kry GP about some of the treatments they can offer. In some cases you may be referred to a dermatologist.

### From the pharmacy

For mild acne, over-the-counter products are available that may take up to 8 weeks to make a difference. These include creams that can work on the bacteria causing the skin pimples as well as cleansers, gels and lotions that work on recurring mild acne and may also help prevention.

### From a Kry GP

If your acne has more sore red pustules or papules, or you develop hard lumps under the skin – nodules or cysts – see a GP. They will be able to recommend a course of treatment that is suitable for you. They’ll rule out other conditions that may mimic some features of acne (like [rosacea](/medical-advice/skin-conditions/rosacea/) or a [hair follicle infection](/medical-advice/skin-conditions/folliculitis/)).

Then they can offer a wide range of prescription treatments. These can include prescription creams, topical and oral antibiotics or birth control pills (if you’re not planning on getting pregnant). The latter can help moderate the hormonal action behind the acne.

It’s usually recommended to try any prescribed treatment for around three months. If your acne isn’t clearing up after that, talk to your doctor about changing your treatment.

### From a dermatologist

If acne treatments from your pharmacy and GP are not working, they may refer you to a dermatologist for further treatment.

A specialist dermatologist can also advise you about treatments available for acne scarring (such as post-inflammatory hyperpigmentation).

## What about adult acne?

For women, hormonal changes related to age or lifestyle and changes in the skin – sometimes triggered by stress – can bring on acne. In this case, the same treatments above apply.

Though because skin is less resilient, it may be better to avoid harsh stripping products and choose milder exfoliating lotions to encourage cell turnover (like those containing salicylic acid – see above).

There’s a theoretical chance that antioxidants like vitamin C in skincare may help acne scarring by stimulating collagen production. But we need more recent studies on whether this helps active acne. Using topical vitamin C could help reduce redness that may be associated with adult acne.

If you develop erratic periods, increased bodily or facial hair growth, alopecia (excessive hair loss from the head) alongside the acne, you may have [polycystic](/your-health/severe-period-pain-endometriosis-or-pcos-how-can-you-tell-the-difference/) ovarian syndrome (PCOS). This can be diagnosed by a doctor.

## How to help acne with lifestyle changes

### 1. Don’t over-cleanse 
Spots are not down to poor hygiene, but this is a myth. If you cleanse too aggressively, you may irritate your skin and treatments may sting. Look for non-comedogenic (this means non-pore blocking) products. Ideally wash twice a day with a gentle cleanser that is pH-matched to the skin and use a non-oily moisturiser. Look for oil-free or water-based non-comedogenic make-up. Never pick or squeeze spots.

### 2. Stop smoking 
More spots under the skin surface (acne inversa) occur in smokers. The toxins in cigarettes and vapes and the blood vessel constriction they promote will not be doing skin any favours in general.

### 3. Try to manage your stress 
Stress can exacerbate any skin condition and research has found that, especially in women, high stress levels can increase the severity of acne. You often can’t avoid it, but you can choose to deal with it better. Try yoga, [breathing techniques](/your-health/3-breathing-exercises-a-psychologist-recommends/) and meditation.

### 4. Don‘t wear too much make-up 
Water-based make-up is less likely to block your pores and cause acne breakouts. Always remove make-up before bed.

### 5. Drink plenty of water 
Dehydration does not help any skin or inflammatory condition (including acne) so [keep well hydrated](/your-health/why-is-hydration-so-important-a-doctors-guide/).

### 6. Take care of your gut health 
A nourishing diet for gut health along with good levels of probiotics (that’s healthy bacteria from fermented foods such as sauerkraut, kimchi and natural yogurt) may play a role in healthy skin.

### 7. Get enough vitamin D 
Vitamin D deficiency means we have less protection from inflammation in the body, which may worsen acne. Make sure you get enough sunshine and [vitamin D-rich foods](/your-health/do-i-have-a-vitamin-d-deficiency-symptoms-causes-and-treatments/).

### 8. Eat an anti-inflammatory diet 
We’re beginning to understand the influence of nutrition over the different systems in our bodies, including the skin. Although more research into this area is needed, many studies are now suggesting there’s enough evidence to encourage avoiding high glycaemic index foods like sugary foods and carbohydrates. For good skin health, it is preferable to eat a diet rich in fresh fruits, vegetables, lean meats, fish and seafood.


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Acne types and their treatments - help to clear your skin

Your immune system is built to protect you against disease. If viruses attack the body, a healthy immune system will kick in. While it’s hard to avoid all winter viruses, there are some easy ways to boost your immune system that can become part of your daily routine.

‘We’re all more likely to catch a cold or winter bug since being in isolation. As well as colds and flu spreading faster during these colder months, our immune systems are being exposed to lots more infections than this time last year,’ reminds Dr McClymont. 

‘It’s natural to be worried that your immune system is low or weaker than usual, but there are plenty of things that can help our bodies fight off infection.’

## Why is the immune system so important?

Our immune system can get weaker as we get older. This puts us at risk of experiencing more serious side effects of viruses like Covid-19 or developing an immunodeficiency disorder. So it’s really important to stay fit and healthy at any age.

Particularly this year with the rise of [colds and flu](/your-health/how-to-prepare-for-a-post-lockdown-spike-in-colds-and-flu/) and Covid-19 numbers still high, it’s a good time to try and strengthen the immune system to help prevent the spread of germs and protect ourselves and others.

## Does my immune system need to be stronger?

‘In healthy people, lifestyle factors play a big role in contributing to the immune system – like stress, lack of sleep, recurrent illness, and poor diet. And this impact on the immune system can increase our susceptibility to infection,’ explains Dr McClymont.

But what are the tell-tale signs your immune system could do with a boost?

### Constant sniffles 

Having the occasional [cold](/medical-advice/infections/common-cold/), especially during winter, is very normal. But if you’re constantly bunged up, your body could be telling you it’s not equipped to fight off germs effectively. Having several colds in a short space of time that linger for a while could be a sign something’s up with your immune system.

### Regular infections 

Similarly, having multiple infections a year in your sinuses, throat and ears can be a warning sign and suggests your immune system isn’t doing its job properly. In some cases it might be due to an underlying health condition, so it’s best to get medical advice.

### Too much stress 

How does [stress affect the body](/your-health/physical-signs-of-stress-on-the-body/)? Long-term stress can impact your immune system as it reduces the amount of white blood cells that fight off infection. The lower your white blood cell levels, the more likely you are to get sick. 

### Always feeling tired 

We all get tired from non-stop working weeks and having a busy schedule but if you’re feeling permanently drained, your immune system may not be functioning like it should. There are many reasons to [feel constantly tired](/your-health/why-am-i-always-tired/) and help is available – speak to a doctor who can help you work out why your energy levels are dipping.

### Tummy troubles 

The gut is essential to the immune system, so if you’ve experienced persistent changes in your digestive system like diarrhoea or constipation, it may be a sign your immune system is struggling. But like with any overlapping symptoms, other causes of [digestion problems](/medical-advice/digestive-problems/) like IBS or Crohn's disease need to be ruled out first.

## How to boost your immune system – 5 tips

‘Lots of people want to know how to keep their immune system functioning well during winter,’ says Dr McClymont.

‘While there are many foods touted to be good for immunity like blueberries, ginger and turmeric, there are no specific diets or foods that have been directly proven to boost the immune system.’ 

The best thing you can do is maintain a healthy lifestyle. Here are Dr McClymont’s tips to get you started.

### 1. Immune boosting foods

- The best approach is to maintain a balanced and nutritious diet full of vitamins, minerals and antioxidants. All the usual suspects – lean meat, fish, grains, pulses, and 5 portions of fruit and vegetables a day.
- Try to have a mix of colours on your plate. The wider the variety of colours you eat, the more types of phytochemicals you consume, which are essential for fighting inflammation in the body.
- If you don’t always have the fresh foods in, stock up on a few portions of frozen or tinned fruit (no added sugar) and veg. This alternative is just as nutritious as fresh, because it’s frozen so quickly after being picked.

### 2. Stay active

Regular physical activity is really important for boosting your immune system. So try to maintain an exercise routine at home – as long as you feel fit enough. If you’re not a member of a gym, introduce a daily walk, run or cycle, even just for 20 minutes. It’s a great excuse for getting some fresh air and [vitamin D](/your-health/do-i-have-a-vitamin-d-deficiency-symptoms-causes-and-treatments/) too.

### 3. Prioritise your sleep

There are many positive effects of sleep on the body, but it’s natural to not sleep well every night, particularly during times of stress and [anxiety.](/medical-advice/mental-health/anxiety/) That makes it even more essential to prioritise your sleep and put in place [good sleep habits](/your-health/4-ways-to-sleep-better-during-the-pandemic/), like avoiding caffeine, limiting screen time close to bedtime and keeping anything work-related outside the bedroom.

### 4. Try to reduce stress

This is not always easy, but try not to neglect activities that help you feel relaxed like walking in nature, deep-breathing, listening to music, practicing yoga and meditating. Whatever you find most relaxing. Staying in touch with family and friends can really help manage your stress levels too.

### 5. Make time to talk

Just because you can’t always see people in person doesn’t mean you can’t connect. Picking up the phone to chat rather than messaging can make a world of difference to your overall health – whether it’s a quick catch up or a more meaningful conversation. 

## Essential vitamins for the immune system

To go one step further, make sure your diet includes a mix of these vitamins and minerals associated with a strong immune system.

__Vitamin A__ – found in liver, milk and cheese and green leafy vegetables.

__Vitamin C__ – found in oranges, tomatoes, kiwis, blackcurrants, peppers and broccoli.

__Vitamin D__ – found in oily fish, eggs, fortified breakfast cereals and dairy products (and sunshine of course).

__Zinc__ – found in meat, poultry, eggs, cheese, as well as root veg, nuts and seeds.

__Selenium__ – found in wholegrain bread, eggs, poultry, fish and shellfish.

‘A balanced diet is always the best option to boost your immune system, as well as sticking to the [recommended limits for alcohol](https://www.nhs.uk/live-well/alcohol-support/calculating-alcohol-units/) and caffeine. If you’re concerned your diet is restricted or does not cover enough of the above foods, then it’s a good idea to take a multivitamin during winter’ says Dr McClymont.
‘And to make sure you get enough vitamin D all year round, a daily 10-microgram supplement is recommended in autumn and winter. Even more so for people that don’t go outside much or cover most of their skin.’

## How can a doctor help?

These ideas are a great starting point to strengthen your immune system. But if you have, or suspect you have a medical problem or a weak immune system, always speak to a GP first.

‘Lots of patients I speak to worry that they have a weak immune system if they get frequent colds or coughs, and want to know the best immune system boosters’ says Dr Rhianna McClymont. 

‘But the reality is that viral infections are extremely common – especially at this time of year – and are not usually a sign of anything serious. Following the above lifestyle advice to strengthen your immune system is the best way to help prevent winter viruses and stay healthy,’

However, if you’re experiencing recurrent viruses or health problems like [pneumonia](/medical-advice/respiratory-conditions/pneumonia/) or kidney infections, it could be a sign of a poorly-functioning immune system. A GP or hospital team can talk you through any tests or treatment that’s needed.


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Find out the best doctor-approved immune boosters and how to strengthen your immune system this winter.

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 How to boost your immune system | Kry UK

How to boost your immune system this winter

Whether it’s a quiet rasp or a harsher noise, snoring can be disruptive not only for bed partners and roommates but also for snorers themselves. 

Snoring is very common. Usually, it isn’t caused by anything serious, but sometimes it can be linked to an underlying health problem and can affect your sleep quality. 

## What causes snoring?

‘The snoring sound can be caused by different parts of your airway, including your nose, your uvula [the dangly bit at the back of your throat], your pharynx [the back of your throat] and tonsils, and the base of your tongue,’ says Dr Nikki Ramskill, a Livi GP.

‘Snoring happens when any of these parts of your airway relax and collapse down. The collapsed parts then vibrate when air passes over them as you breathe in and out. It’s normal for this to happen during sleep, but not everyone snores.’

## Who usually snores?

Almost everyone snores occasionally, but research shows that [snoring becomes more common](https://www.nature.com/articles/s41467-020-14625-1) as we get older. ‘Snoring is a common problem in people between the ages of 40-60, especially men,’ says Dr Ramskill. It happens regularly in nearly half of men and around one-quarter of women. Snoring also appears to run in families.

## Why do people snore?

‘Snoring isn’t usually caused by an underlying disorder, but some conditions make snoring more likely – including obesity, an underactive thyroid, enlarged tonsils or any cause of nasal blockage, like [having a cold](https://www.livi.co.uk/medical-advice/infections/common-cold/) or a deviated septum [when the wall separating your nostrils is pushed to one side].’

Sometimes, our lifestyle habits play a role in whether we snore or not. ‘We’re more likely to snore after drinking alcohol, especially if it’s before bed,’ says Dr Ramskill. ‘Those who smoke regularly, take sleeping tablets or sedatives, or prefer to sleep on their back are also more prone to snoring.’

## What’s the link between weight and snoring?

Research has shown that [being overweight can disrupt your sleep and lead to snoring](https://academic.oup.com/qjmed/article/107/12/949/1582992).‘This is because excess weight on the airways makes them more likely to collapse,’ says Dr Ramskill. ‘This can then lead to poor sleep quality, causing you to wake up tired.’ 

There’s a strong link between being overweight and developing a medical problem called obstructive sleep apnoea (OSA). ‘Sleep apnoea is a serious condition that occurs when the airway collapses so much that it temporarily stops you from breathing,’ says Dr Ramskill.

‘When this happens in the middle of the night, your oxygen blood level can drop, forcing you to wake up. This might be with a gasp, and it can be quite frightening to witness.’

## How can I assess how serious my snoring is?

If you want to check whether your snoring is a problem, Dr Ramskill recommends the [STOP-Bang questionnaire.](https://academic.oup.com/qjmed/article/107/12/949/1582992) The more questions you answer yes to, the higher your risk of sleep apnoea.

- Do you snore loudly (loud enough to be heard through closed doors)?
- Do you often feel tired, fatigued or sleepy during the day?
- Has anyone observed you stop breathing during your sleep?
- Do you have or are you being treated for high blood pressure?
- Is your BMI more than 35?
- Are you over 50 years old?
- Is the circumference of your neck more than 40cm?
- Are you male?

Answering yes to any of these questions doesn’t mean you have sleep apnoea – only that your risk might be higher. It’s a good idea to share your score with a doctor, as it’ll help them decide whether or not to refer you to a specialist. 

## How can I stop snoring?

There are a few strategies you can try to help your snoring – from simple lifestyle changes to more specialised snoring devices and remedies.

### 1. Make a few simple lifestyle changes
An effective way to address your snoring is aiming for an all-round healthy lifestyle. If you’re concerned about snoring, try:

- Maintaining a healthy weight
- Exercising regularly
- Lowering your alcohol consumption
- Reducing or stopping smoking
- Taking fewer sedative medications, if you take any

### 2. Sleep on your side

Snoring can be related to sleeping on your back, so you can also try sleeping on your side. Dr Ramskill also recommends a technique called the ‘tennis ball trick’. ‘Try sewing a tennis ball into the back of a tight-fitting shirt to prevent you from rolling onto your back during the night,’ she says.

### 3. Alleviate allergy symptoms (if you have them)
‘If your snoring is triggered by hay fever or allergic reactions, try to hoover regularly, including on the mattress, and don’t allow any pets on the bed,’ says Dr Ramskill. ‘If you suffer from hay fever, try not to hang washing outside to dry in the summer.’

### 4. Try a snoring aid

When it comes to tackling snoring itself, there are several snoring aids and remedies to try:

- If you suffer from nasal congestion, try a decongestant or steroid nasal sprays. You can also try nasal strips and nasal dilators, which can be purchased from pharmacies.
- If you’re a mouth-breather, you can buy a chin strap to keep the mouth closed, or a vestibular shield to close off the mouth and force breathing through the nose.
- Some people find acupressure rings worn on the fingers helpful; these can be purchased online.

Always speak to a doctor before trying a new remedy.

## What’s the treatment for sleep apnoea?

When snoring is caused by a serious condition like sleep apnoea, you may need more sophisticated treatment. 

‘People with sleep apnoea will sometimes be offered a CPAP machine – this stands for continuous positive airway pressure,’ says Dr Ramskill. ‘A CPAP machine is fitted tightly around the nose and mouth and forces the airways open with a strong pressure of air when the person breathes in. This stops the oxygen from dropping in the blood and they feel much better for it.’ 

It can be hard to get used to sleeping with a CPAP machine, but using it every night will give you the best results. 

## What should I do if my sleeping partner or roommate snores?

Sleeping near someone who snores can be challenging, whether it’s the occasional bother or a total disruption. ‘While snoring might seem like a trivial thing, it can really impact relationships,’ says Dr Ramskill.

‘Thankfully, there are lots of things you can do. To maximise your sleep quality, try good quality earplugs (wax ones might work better than foam), use white noise or a fan to drown out the snoring, and try to fall asleep before your partner.’

Finally, tackle the problem as a team. Whether your partner is making ambitious lifestyle changes or simply trying a snoring aid, supporting their efforts can help you both get a good night’s sleep. 

## When should I see a doctor about my snoring?

It’s important to bear in mind that not everyone who is overweight and snores automatically has OSA. ‘More often than not, snoring is nothing to be worried about,’ says Dr Ramskill. ‘But it’s important to talk to a doctor if you’re experiencing signs of potential sleep apnoea.’

Dr Ramskill advises you to seek health advice about snoring if:

- You snore 3 or more nights per week
- Your snoring is very loud
- You make gasping, choking or snorting sounds
- In the daytime, you feel sleepy or find it hard to concentrate
- You wake up with morning headaches and congestion

‘If you’ve noticed any of these signs, it’s important to address the issue with a doctor who can determine if additional testing or treatment is necessary,’ says Dr Ramskill.

__This article has been medically approved by Dr Nikki Ramskill, a Livi GP.__


kry.co.uk > Your health >  How to stop snoring 

See a GP about snoring

livi.co.uk > Your health >  How to stop snoring 

2100x1200 stop snoring

Snoring can be a minor nuisance or a sign of an underlying health problem. Read our doctor’s guide for advice on how to tackle snoring for a better night’s sleep

kry.co.uk > Meta information > How to stop snoring

How to stop snoring – a doctor’s guide | Kry UK

 How to stop snoring 

Everyone wants to live a healthier life, but kick-starting healthy habits can feel like hard work. Take New Year’s resolutions – [less than one-quarter of us](https://pubmed.ncbi.nlm.nih.gov/2980864/) actually achieve them, likely as a result of overly ambitious or restrictive goals. The good news is that we can turn to research to help us narrow down which habits are worth the effort. 

‘It can be difficult to form new habits. But there are some thought processes and behaviours you can practise to help you make these long-lasting changes, like setting small and manageable goals or focusing on what makes you feel good,’ says Madeleine Gauffin, Psychologist at Livi.

## 5 simple habits for a healthier lifestyle 

You don’t need to make drastic changes to reap the benefits of a healthy lifestyle – here are some simple habits worth adopting right now. 

### Habit 1: Nurture your social connections 

__Why it’s worth it:__

Research has shown that strong social connections, through friendship, family and community, might be one of the most important things for our physical and mental health – while [loneliness and social isolation](https://www.livi.co.uk/your-health/how-does-social-isolation-impact-your-mental-health/) are well-established risk factors for poor health. Some studies have found that feeling lonely can [increase your risk of stroke, heart disease and depression. ](https://www.pnas.org/content/110/15/5797)

__Kick-start the habit:__

- __Schedule it__ – The pandemic made it more difficult for us to connect and you may be feeling more anxious about socialising. Try to overcome that by making plans to see or call a friend or family member at least twice a week. 

- __Widen your circle__ – Make a conscious effort to widen your social network by volunteering in your community or joining a social group like a choir, book club or exercise class. 

### Habit 2: Prioritise your sleep quality 

__Why it’s worth it:__

Never underestimate the power of sleep – the recommended [6-9 hours of sleep per night](https://www.nhs.uk/live-well/sleep-and-tiredness/how-to-get-to-sleep/) allows our bodies and brains to repair and recover. As well as boosting immunity, a good night’s sleep helps you maintain a healthy weight, increases fertility and boosts your mental wellbeing. [Regular poor sleep](https://www.livi.co.uk/your-health/5-sleep-problems-to-discuss-with-a-doctor/) puts you at [increased risk of diabetes, heart disease, cancer, obesity and depression.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267703/) 

__Kick-start the habit:__

- __Be realistic__ – Head to bed just half an hour earlier than you usually would, then gradually bring forward the time to help you get your full 6-9 hours. 

- __Go outside__ – [Bright light exposure during the day](https://www.sciencedirect.com/science/article/pii/S2352721821001285?via%3Dihub) can help us feel sleepier in the evening and improve sleep quality. Try to go outdoors as much as possible during the day for better sleep. 

### Habit 3: Squeeze more movement into your day 

__Why it’s worth it:__

There’s strong evidence to show that getting at least 2.5 hours of moderate exercise per week can help [reduce the risk of heart disease and stroke](https://www.who.int/news-room/fact-sheets/detail/physical-activity). In fact, the benefits of being more physically active are numerous – from maintaining a healthy body weight and improving our mental health to lengthening our life expectancy. The challenge is [fitting regular exercise into our routines. ](https://www.livi.co.uk/your-health/how-to-fit-exercise-into-your-daily-life/)

__Kick-start the habit:__

- __Start with 30__ – Adding just half an hour of moderate exercise into your day can make a difference to your health. A little more movement and a little less sedentary time all adds up, so try jogging to the bus, using a standing desk or dancing to music more often. 

- __Try a team sport__ – Research shows that [recreational physical activity](https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-1002) (moving for leisure or as part of a team) has more beneficial outcomes than occupational physical activity like heavy lifting or labouring for work. Try a new sport or join a running club to reap the physical and social benefits.

### Habit 4: Eat more colourful food on a regular basis

Why it’s worth it:

Generally, the more colourful your food choices, the [more nutritious your diet](https://www.researchgate.net/publication/333577389_A_Review_of_the_Science_of_Colorful_Plant-Based_Food_and_Practical_Strategies_for_Eating_the_Rainbow). Colourful, plant-based foods contain natural compounds called phytonutrients, which have antioxidant and anti-inflammatory benefits. One study found that people aged over 65 who [eat the colourful Mediterranean diet](https://www.livi.co.uk/your-health/feel-good-food/), which is high in fruit and vegetables, nuts, whole grains, fish and healthy fats, have a [lower risk of dying from any cause. ](https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/mediterranean-diet-and-mortality-in-the-elderly-a-prospective-cohort-study-and-a-metaanalysis/F2D6B083AA187849477112DB77820521)

__Kick-start the habit:__

- __Try for 2__ – You don’t have to eat the rainbow all at once. Set yourself the challenge of adding 2 different-coloured fruits and vegetables to every meal, then gradually fill your shopping basket with a wider variety of colours over time.

- __Choose frozen__ – To get a wider range of fruits and vegetables all year round, look to the frozen section – they’re usually just as nutritious as fresh ones.

### Habit 5: Make time to do the things you love

__Why it’s worth it:__

This is no easy or small habit to start. But research tells us not to overlook the power of finding meaning and purpose in our life – doing more of the things that make us feel worthy, included and part of something. Not only does it make you happier, but it may also help to lower your risk of health problems like [stroke and depression](https://www.sciencedirect.com/science/article/abs/pii/S0022399913000391?via%3Dihub). 

__Kick-start the habit:__

- __Make a list__ – Sit down and put together a list of all the things that make you feel good or excited to get out of bed in the morning and circle a few you want to prioritise more in your life.

- __Try one new thing__ – Maybe you’ve always wanted to try yoga, writing or kickboxing, or you want to learn a new language. You don’t need to take on 100 hobbies to feel more fulfilled – just start with a new activity one afternoon or evening a week and see how it makes you feel.

## 4 tips to make healthy habits stick 

Setting a plan to make some healthy new habits is all well and good, but achieving them can be more of a challenge. Here are some ways to stay motivated and make your healthy habits more likely to stick.

### 1. Stack your habits 

‘This means tying your new habit to an existing one,’ says Gauffin. ‘Researchers have found that it can take an average of 66 days before [habits become automatic](https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.695.830&rep=rep1&type=pdf), so start a new habit by adding it to something you already do every day.’ 

For example, after you’ve brushed your teeth, add a 3-minute meditation. ‘It’s crucial to create some space for your new healthy habits and allow them to become part of your daily life,’ adds Gauffin.

### 2. Choose behaviours that feel good 

‘Discover what really motivates you. What do you want from life? Are you living the way you want?’ says Gauffin. ‘The motivation for personal and deeper change can be found in asking these kinds of questions. 

‘Are you creating new habits because you want to or are you trying to please someone by changing things in your life? The motivation has to come from you – otherwise, it’s not sustainable.’ 

Choosing to do something because we enjoy it is called intrinsic motivation – as opposed to extrinsic motivation, where we’re motivated to perform a behaviour to earn a reward or avoid punishment. Plan an exercise date with a friend because it makes you feel good, or choose healthy meals because you enjoy the process of finding new recipes. 

### 3. Be flexible with yourself 

‘Often, other things in life can get in the way – and that’s okay,’ explains Gauffin. ‘Introducing new habits shouldn’t be a struggle. So, if your new habit isn’t realistic, set a new one. Nothing good comes from pushing or punishing. Give yourself credit with rewards instead, and encourage yourself.’ 

### 4. Stick with small habits 

‘Start with small, specific and concrete habits,’ says Gauffin. Set yourself up for success with realistic goals. That way, you’re more likely to be able to sustain them.

## When should I speak to a doctor? 

If you’re struggling to keep new habits and think other health concerns may be getting in the way, a doctor can help identify if there may be any underlying issues. You might want to speak to a doctor: 

- If you’re [lacking energy](https://www.livi.co.uk/your-health/why-am-i-always-tired/) or feeling less enjoyment in daily life
- If loneliness or stress is affecting your daily life  
- If you’re struggling to maintain a healthy weight  
- If you’re regularly having difficulty sleeping

__This article has been medically approved by Livi Psychologist Madeleine Gauffin.__


kry.co.uk > health lifestyle > CTA 

See a GP about a healthier lifestyle

Livi.co.uk > Your health > These 5 habits will help you live a healthier lifestyle

How to form healthy habits that stick

Looking for inspiration to set healthier lifestyle habits? Our guide will show you where to start and how to make lasting change with five key goals 

Kry.co.uk > Your health > These 5 habits will help you live a healthier lifestyle

5 habits to help you live a healthier lifestyle | Kry UK

These 5 habits will help you live a healthier lifestyle

Blood sugar, also called blood glucose, comes from eating or drinking carbohydrates and sugar. It supplies the muscles, brain and other organs with energy. 

‘Your body aims to keep your blood sugar level in balance,’ says Dr Nikki Ramskill, a Kry GP. ‘With the central heating in your house, a thermostat is set so that when it’s too cold, the heating clicks on until it’s the right temperature again. Your body has a similar system, so when your blood sugar level is too low or high, hormones kick in to correct it.’ 

If you’re healthy, your sugar level looks after itself. Some people have a condition where you need to manage your blood sugar, known as diabetes. 

## How does diabetes affect blood sugar? 

‘Diabetes is a serious condition where the body’s system for balancing blood sugar isn’t working properly,’ Dr Ramskill explains. 

A hormone called insulin helps your body use blood sugar for energy. ‘Insulin allows the sugar in your bloodstream to enter your cells,’ says Dr Ramskill. ‘If you have diabetes, your body stops making or responding to insulin. The sugar gets stuck in the bloodstream, leading to higher blood sugar levels.’ 

Diabetes is common, affecting just under [1 in 10 adults](https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(19)31230-6/fulltext). 

## What are the different types of diabetes? 

The main types of diabetes are: 

- [Type 1 diabetes](/medical-advice/autoimmune-diseases/type-1-diabetes/): When you stop producing insulin and need to take regular injections to control your blood sugars. 

- Type 2 diabetes: When you still make insulin but stop responding to it. Blood sugars are managed by diet, activity or medication. 

- Prediabetes: When your blood sugars start to increase, which is a sign you are developing diabetes. 

- Gestational diabetes: When you have high blood sugar during pregnancy. This must be lowered to keep you and your baby healthy. 

‘The advice varies for each type of diabetes, so it’s important to understand which one you have,’ says Dr Ramskill. 

## What is a normal blood sugar level? 

For people without diabetes, blood sugar stays between 4.0 and 5.9 mmol/L. 

‘Even in healthy people, blood sugar rises slightly after eating carbohydrates until hormones rebalance it. The swings are much greater for people with diabetes,’ explains Dr Ramskill. 

## What’s the target blood sugar for people with diabetes? 

If you have diabetes, you should aim to keep your blood sugar within a certain range, usually:

- Before meals: 4.0 to 7.0 mmol/L
- 90 minutes after meals: 5.0 to 9.0 mmol/L

‘These ranges are generalisations,’ says Dr Ramskill. ‘A doctor will provide personal targets that are realistic for you.’ 

When you have diabetes, your blood sugar will sometimes go outside your target range. Here are some things that cause high or low blood sugar:

![High and low blood sugar 720x579](//images.ctfassets.net/h8qzhh7m9m8u/jjnZ5C2tTWiWUvHyFqBJz/9e0e3a348ba482ea769b7da115bd5ef8/High_and_low_blood_sugar_720x579.png)

Some people need to check their blood sugar to make sure it doesn’t go too high or too low. 

## When should I check my blood sugar? 

‘People usually only need to check their levels themselves if they take medication that causes low blood sugar, such as insulin or sulphonylureas,’ says Dr Ramskill. ‘How often you need to test depends on your diabetes type, lifestyle and which medication you take.’ 

It could be once a day or as many as seven times a day. A doctor can tell you how often to check and how to do it.

## What happens when my blood sugar is too low? 

Low blood sugar is less than 4.0 mmol/L, known as hypoglycaemia or a ‘hypo’. If you’ve got low blood sugar, you might have symptoms including:
- Hunger
- Shakiness
- Sweatiness
- Dizziness
- A racing heart 
- Confusion, agitation or anxiety

Low blood sugar levels can be dangerous. It’s important to treat it quickly by eating or drinking a sugary snack and keeping an eye on your levels until they come back up.

## What happens when my blood sugar is too high? 

High blood sugar, also known as hyperglycaemia, can cause symptoms including: 

- Feeling very thirsty 
- Needing to pee a lot
- Blurry vision
- Frequent infections 

If your sugar levels are high or you feel very unwell, you need to check for ketones or seek medical advice, as well as take action to lower your levels. [Untreated high blood sugar](https://www.ncbi.nlm.nih.gov/books/NBK555976/) can lead to a medical emergency. 

Over time, even slightly high blood sugar can cause complications like kidney failure, nerve damage and strokes. Lowering your blood sugar to the target range helps reduce your risk of these things.

## 7 tips from a doctor for managing blood sugars 

Managing your blood sugar levels helps keep diabetes from interrupting your life too much. Here are some recommendations on where to start:

### 1. Follow your care plan

‘Make sure you follow the advice from your care provider,’ says Dr Ramskill. ‘This may mean taking your medication properly, increasing activity or making [healthier food choices](/your-health/8-ways-to-make-healthier-food-choices-every-day/).

‘It can be a big change, so you need to be honest with people in your life. Tell your friends, family and co-workers that you need certain allowances. They should support you to follow your care plan.’ 

### 2. Know your numbers

‘Depending on your type of diabetes, you may need to regularly measure your blood sugars, or you might need a regular check called a HbA1C test,’ says Dr Ramskill. Some people also look at their [time spent in range](https://care.diabetesjournals.org/content/early/2019/06/07/dci19-0028), which shows the full highs and lows of their blood sugar.

‘Whichever way your blood sugars are monitored, it’s important to keep records. That way, you can see how your levels are changing and talk to your care provider about what’s working for you.’

### 3. Understand how different food affects your blood sugars

‘Some carbohydrates are simple – just a couple of sugars joined together to make a little molecule. They go into our bloodstream quickly and cause a large sugar spike,’ explains Dr Ramskill. 

‘Other carbohydrates are more complex and take longer to break down, so when you eat them, your blood sugar doesn’t spike so high.’

To predict how different food affects your blood sugar, there are two main things to think about: 

- How many carbohydrates am I eating? 
- How long will this meal take to digest? 

These two factors affect the [glycaemic load](https://www.health.harvard.edu/diseases-and-conditions/the-lowdown-on-glycemic-index-and-glycemic-load) of the meal, a measurement of how much it will raise your blood sugar. ‘Eating food with a high glycaemic load makes it harder to manage blood sugars,’ explains Dr Ramskill. 

The table below gives you examples of glycaemic loads in different meals.

![Glycemic index 720x363](//images.ctfassets.net/h8qzhh7m9m8u/64UTjvuHsADJqoXQCUx7Un/b4dcf617cbb9ec665b8244225e69b35b/Glycemic_index_720x363.png)

Adapted from [Atkinson FS et al. Diabetes Care](https://covariants.org). 2008.

Eating foods high in fibre, fat or protein also slows down digestion to give a lower and slower spike. ‘Speaking to a dietician can help you to understand how different food affects you,’ says Dr Ramskill. 

### 4. Learn how physical activity affects your blood sugars

In general, physical activity makes you more sensitive to insulin and so helps lower blood sugar. Even light activity, like [walking](/your-health/the-power-of-walking-for-your-health/), can make a difference. ‘For people with type 2 diabetes, an active lifestyle is an important part of their blood sugar management and can sometimes reverse their diabetes,’ says Dr Ramskill.
‘For type 1, it’s about being aware of how your insulin and exercise interact.’ 

Activity can raise or lower blood sugar depending on the [duration and type of activity](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4954144/). If you take insulin or medication, speak to your care provider about how to avoid exercise-related hypos. 

### 5. Make gradual changes 

‘Make sustainable changes under the guidance of your care team. For type 2 diabetes, work towards a healthy lifestyle that you can keep up long term,’ says Dr Ramskill. 

For type 1, keeping a blood sugar diary can help you to spot patterns so you can make gradual adjustments to your insulin. 

### 6. Consider the bigger picture

Alcohol, [stress](/your-health/physical-signs-of-stress-on-the-body/), pregnancy, menopause, certain medications, fasting (like during Ramadan) and irregular sleep can all cause unpredictable effects on blood sugar. 

‘A GP or diabetes team can help you tailor your approach to manage the more complicated side of blood sugars,’ says Dr Ramskill. 

### 7. Be kind to yourself 

Looking after your blood sugar can feel like a full-time job. ‘Diabetes burnout is a very real thing. Be kind to yourself and know that your control won’t always be perfect,’ reassures Dr Ramskill. ‘If you’re feeling overwhelmed or losing motivation, speak to a doctor. They can give you extra support to get you back on track.’ 

## What questions should I ask a doctor about my blood sugar levels?

Your care provider can help you to manage your blood sugars. When you speak to them, you might find it helpful to ask the following questions: 

- What are my target blood sugar ranges throughout the day? 
- How often should I check my blood sugar levels?
- What do these numbers mean?
- What changes need to be made to my diabetes care plan?

If you think you may have undiagnosed diabetes or are struggling to manage your blood sugars, it’s important to speak to a doctor as soon as possible.

__This article has been medically reviewed by Dr Nikki Ramskill, a Kry GP.__ 


kry.co.uk > blood sugar > CTA

See a GP about diabetes

Kry.co.uk > Your health > What you need to know about managing your blood sugar

2100x1200 Blood sugar

A doctor explains the basics of managing blood sugar to help you live well with diabetes.

kry.co.uk > Meta information > What you need to know about managing your blood sugar

What you need to know about managing your blood sugar | Kry UK

What you need to know about managing your blood sugar

Gout is a common condition that causes sudden flare-ups of painful arthritis in your joints, usually the big toe. The condition affects around 2 in 100 people in the UK and is more common in men than women, particularly as they get older.

Because gout pain is often triggered by a diet of rich foods, it’s common for flare-ups to get worse over the Christmas period. 

‘Gout is a more common condition at this time of year, usually causing a joint to become hot, red, painful and swollen,’ says Dr McClymont. 
‘Fortunately, there are lots of small changes and dietary habits you can make to reduce the risk of gout flare-ups and control symptoms without the need for medication,’ she explains.

## Where does gout pain occur?

Gout symptoms can develop in almost any joint. Although usually only one joint is affected at a time, in some cases people experience multiple joint flares. It usually affects joints towards the ends of the limbs, including:

- Toes (usually the big toe)
- Ankles
- Midfoot (where your shoelaces are)
- Knees
- Wrists
- Fingers
- Elbows

If you do not get proper gout treatment, it's likely to affect more of your joints over time. 

## What causes gout?

Gout is caused by a buildup of uric acid in your blood and muscles. Uric acid is created by your body to break down purines (found in lots of rich foods like game meat and red wine) – and normally your kidneys will remove any uric acid from the food you eat. 
Having a high level of uric acid can cause harmful crystals to form in your joints and kidneys, which can lead to gout symptoms.

Family history can play a part in your risk of gout too. Research shows that gout can run in the family, with 1 in 5 people diagnosed having a close family member with the condition.

Other contributing factors include certain medication and underlying medical conditions like [high blood pressure](/medical-advice/cardiovascular-diseases/hypertension/), [diabetes](/medical-advice/autoimmune-diseases/type-1-diabetes/), kidney disease, [obesity](/your-health/what-is-being-overweight-or-obese-and-where-can-you-find-help/) and osteoarthritis.

## Is there a recommended diet for gout?

‘Eating a healthy and balanced diet has lots of benefits, but the most important part of a preventative gout diet is reducing the levels of purine,’ Dr McClymont says.
‘This will help prevent sudden attacks of gout and reduce your risk of having repeated flare-ups,’ she continues. 
‘While it might be difficult to cut these foods out altogether, it’s worth being aware of the trigger foods that cause gout. Moderation, especially this time of year, is key.’

## Foods that can cause gout symptoms

- Foods high in refined sugar like biscuits and cakes
- Seafood like prawns, lobster, mussels and clams
- Fizzy drinks and fruit juices
- Alcohol (especially beer, ale, fortified or red wine and port)
- Liver, kidney, heart and other offal
- Game meat (rabbit, venison, pheasant, veal and duck)

## Low-purine foods that are kinder to gout

You don’t need to limit all tasty foods. The following foods make up a healthy gout diet.

- Milk, yoghurts and cheese
- Dairy-free alternatives including soya
- Eggs
- Fruits and vegetables
- Breads and cereals
- Pasta, rice and noodles

## Advice for drinking when you have gout

It can be hard for some of us to avoid it altogether over the festive period. Here are 5 tips from Dr McClymont on how to strike a balance, so you can enjoy yourself without making gout symptoms worse.

1. Avoid red wine and beer as these have a high purine content – white wine and spirits are better alternatives for a festive drink

2. [Stay hydrated](/your-health/why-is-hydration-so-important-a-doctors-guide/) by drinking lots of water (at least 8 cups a day)

3. Factor in a few alcohol free days each week – for example the days between Christmas and New Year

4. Keep below the recommended units of alcohol per week (14 units a week)

5. Stay clear of soft drinks high in fructose, like fizzy drinks and fruit juices, or choose the less sugary options

## What can I do to relieve gout pain?

‘The main symptom of gout is a sudden and severe pain in a joint. The skin over the affected joint will often be swollen, hot and red. An attack of gout usually lasts up to a week then should start to ease,’ Dr McClymont explains.

Gout usually will not cause lasting damage to your joints if it’s treated immediately. If you think you’re experiencing an attack of gout symptoms:

- Take pain relief, and any medicine you've been prescribed by your doctor to treat an attack of gout
- Keep the affected limb rested and raised
- Drink plenty of water to stay well hydrated
- Cool down the joint with an ice pack or bag of frozen peas

## Do I need to see a doctor for gout?

We always recommend speaking to a GP as soon as possible if:

- Your pain or gout symptoms are getting worse
- You have a high temperature too
- You feel nauseous or cannot eat

These symptoms could mean you have an infection inside your joint and need urgent medical help.

If you’re experiencing recurrent gout flare-ups, a GP may discuss other options for gout treatment, like medication. This will usually be considered if lifestyle changes are not helping.


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Gout is a form of arthritis that’s often triggered by rich foods and alcohol. Read our doctor’s guide to help keep gout symptoms and pain under control.

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