kry.co.uk > Your health

Health information, articles, news and advice for NHS patients.

kry.co.uk > Your health > Metainfo

Your health | KRY

Whether your method of protection failed or you didn’t use anything, don’t panic – unprotected sex happens. 

‘If you’ve had unprotected sex, there’s always the possibility of pregnancy and sexually transmitted infections (STIs). Although this can be a scary situation, there are help and options available,’ says Dr Samuel Menon, Lead GP at Kry.

Here are some steps you can take to avoid unwanted pregnancy and look after your sexual health. 

## First of all, what exactly counts as unprotected sex? 

When they’re used the right way, condoms and other barrier methods play a key role in protecting you against pregnancy and STIs. Unprotected sex usually means sex without any form of contraception or condom, but sometimes a condom may break or come off during sex, or it might not have been used correctly or forgotten altogether. 

## What to do straight after unprotected sex

### Empty your bladder

Though it won’t protect you from contracting an STI, peeing after sex can help to reduce your risk of getting a urinary tract infection (UTI). Although UTIs can occur in both sexes, women are 30 times more likely to get a UTI than men. 

‘Peeing helps flush out bacteria before it’s able to get into the urethra and other parts of the urinary system,’ says Dr Menon. ‘This is particularly important for women who are more susceptible to UTIs after sex.’ 

## What to do the next day 

### Consider emergency contraception 

If you’re not using any form of hormonal contraception and an unplanned pregnancy is a concern, you can take emergency contraception. There are 2 types of emergency contraception: 

The emergency contraceptive pill, often known as the morning-after pill
The copper intrauterine device (also called the IUD or coil) 

There are 2 kinds of the morning-after pill, which work by stopping or delaying the release of an egg (ovulation). Levonelle should be taken within 72 hours (3 days) of sex, and ellaOne should be taken within 120 hours (5 days) of sex to prevent pregnancy. ‘The effectiveness of the emergency pill depends on how soon after unprotected sex you take it,’ says Dr Menon.

‘The IUD is the most effective way to prevent pregnancy, and it’s also the most effective form of long-term contraception,’ advises Dr Menon. ‘It must be inserted by a health professional within 5 days of unprotected sex, and like all emergency contraceptives, it is more effective the sooner you have it.’ 

Right now, only the copper IUD is available for emergency contraception. But when it comes to long-term contraception, you can choose either the copper or hormonal IUD.

You can get emergency contraceptives free from some doctor’s surgeries and sexual health clinics. The emergency contraceptive pill is also available from some pharmacies. 

### Speak to your doctor about HIV exposure

‘If you’re concerned that you may have been exposed to HIV, contact a doctor or sexual health clinic as soon as possible because you may be suitable for post-exposure prophylaxis (PEP), a short course of medicine that can dramatically reduce the chance of HIV infecting your body after you’ve been exposed to it,’ says Dr Menon.

For PEP to work, it must be started within 72 hours – and it works best if taken within 24 hours. It’s estimated to  reduce the chance of HIV infection by at least 80%.

### Take stock of how you’re feeling mentally

Make time to check in with yourself, because it’s normal to experience a wide range of emotions after unprotected sex. Share how you’re feeling with a trusted friend or member of the family. They can listen to you, offer support and help you think your options through. Or arrange an [appointment with a doctor](/gp-appointments-online/), who’ll be able to offer advice on counselling or recommendations for organisations that can help. 

## What to do 2 weeks to 1 month later 

### Take a pregnancy test

The only way to know if you’re pregnant is to take a pregnancy test. The earliest sign of pregnancy is often a missed period. You may also experience tender, swollen breasts, feel sick and experience mood swings.

‘Taking a test at least 3 weeks (21 days) from the last time you had unprotected sex or on the first day of your missed period will give you the most accurate result,’ says Dr Menon.

You can buy a reliable home pregnancy test from a pharmacy and most supermarkets, or get a free test and confidential advice from a doctor or sexual health clinic. 

### Get tested for STIs 

Look out for signs of an STI ‘If you develop symptoms of an STI, get yourself tested immediately,’ says Dr Menon. Symptoms and signs of an STI include: 

- Unusual discharge from the vagina, penis or anus
- Pain during sex 
- Pain when ejaculating or peeing
- Lower tummy pain 
- Unusual vaginal bleeding 
- Blisters, sores or warts around your vagina, penis or anus

Whether you’ve experienced symptoms or not, it’s best to get tested after unprotected sex because some STIs produce no symptoms at all. 

Waiting 2 weeks after unprotected sex to take an STI test will provide more accurate results. This is because all STIs have a window period. 

The most common STIs with a window period of 2 weeks include:

#### Chlamydia
Look out for an unusual discharge from the vagina or penis, and vaginal bleeding after sex and between periods, pain when peeing and pelvic pain in women. If left untreated, chlamydia can lead to pelvic inflammatory disease (PID), which can cause infertility. Screening is done through a urine or swab test.

#### Gonorrhoea
Symptoms include pain when peeing and green or yellow discharge from the vagina or penis. Less commonly, it can affect the eyes and throat. Testing is done through a urine or swab test. 

‘Virtually all STIs are treatable,’ says Dr Menon. If you’re feeling nervous about getting tested, ask a friend to go with you. Free STI testing is available at sexual health clinics. 

## What to do 2 to 6 months later

### Get another STI test 

‘There are some STIs that take longer to detect. During this period, it’s important not to have unprotected sex with anyone,’ says Dr Menon. 

Common STIs that are tested for at a later stage include:

#### Syphilis
You can be tested for syphilis after 3 months. Symptoms may include painless sores or ulcers on the vagina, penis, anus or mouth, followed by a rash and flu-like symptoms. If left untreated, syphilis can cause long-term health problems. A blood test can diagnose syphilis.

#### HIV
You can be tested for HIV after 45 days. Although there are often no or minimal symptoms in the first few years, the infection weakens the immune system and can lead to more serious conditions, including tuberculosis and cancers such as lymphomas. Testing is done by taking a blood or saliva sample.

## How can I protect myself next time? 

If you’re sexually active, there are some steps you can take to protect your sexual health and prevent pregnancy: 

- Always have a supply of condoms or barrier methods available 
- Check the expiration date on the condom wrapper or box 
- Take good care of your condoms: keep them away from heat and light, and don't open them with anything sharp, such as scissors or teeth
- Choose condom-friendly lubricants – oil-based lubricants can damage the latex of the condom, causing it to rip 
- Consider the right size of condom to avoid slippage or breakage. If you’re not sure about the size, try a variety pack 
- Clean sex toys after every use. If you’re sharing toys with different partners, cover them with a new condom each time because they can pass on STIs and infections 
- Think about regular STI testing 

## What should I do if I’ve been sexually assaulted?

If you’ve been sexually assaulted, it’s important to remember that it isn’t your fault. If you’re in immediate danger, you should call the police. 

Sexual assault includes being physically forced or emotionally manipulated into any sexual act without your consent. This includes a partner deliberately removing or damaging a condom during sex without telling you. 

You can report sexual assault to the police by dialling 999 or 101 or by visiting your local police station. You can also report it online. Alternatively, confidential medical and emotional support is available at sexual assault referral centres (SARCs). 

__This article has been medically reviewed by Dr Samuel Menon, Lead GP at Kry.__


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Kry.co.uk > Your health > I had unprotected sex – what should I do? 

If you’ve had unprotected sex, taking action now can protect your health today and in the future.

Unprotected sex

If you’ve had unprotected sex, taking action now can protect your health today and in the future. Get expert advice from a Kry Lead GP.

I had unprotected sex – what should I do? | Kry UK

General health

General health and seasonal

I had unprotected sex – what should I do? 

Familiar with the discomfort of constipation? You’re not alone – nearly everyone has experienced it at one time or another. It’s estimated that 1 in 7 adults and 1 in 3 children  suffer from constipation at any one time, women are twice as likely to have constipation as men,  and older adults are 5 times more likely than younger adults  to have it. 

Your poo and how often you go to the loo can indicate a lot about your overall health and wellbeing. After your digestive system has absorbed all the usable nutrients from food, you poo to get rid of the remaining bodily waste that’s no longer required. 

‘It’s important to keep an eye on your bowel habits so that problems with the digestive system can be picked up,’ says Dr Rhianna McClymont, Lead GP at Kry. 

## What is constipation? 

[Constipation](/medical-advice/digestive-problems/constipation/) generally means that you have uncomfortable or infrequent bowel movements. You’re likely to be constipated if you:

- have fewer than 3 bowel movements a week 
- pass hard, pellet-like poos
- need to strain on the toilet 

Constipation is usually temporary and resolves within a few days or weeks, but for others, it can be long term and continue for several weeks or longer. This is known as chronic constipation. 

## What causes constipation?

There are many possible causes, and often it might be difficult to identify the exact cause. Here are some of the most common causes of constipation to look out for: 

### 1.	Eating a high-fibre diet 

Research suggests that high-fibre diets are essential for a healthy bowel.  Not only does fibre help to reduce the risk of bowel cancer and heart disease, but it can also prevent and ease constipation. 

‘Fibre works by bulking out our stools – it increases their size and makes them softer. Larger, softer stools move more quickly through your digestive system and are easier to pass, helping to keep you regular,’ says Dr McClymont. 

You can find plenty of fibre in fruit, vegetables, whole grains, nuts, seeds and oats. If you feel that you might not be eating enough of it, you’ll want to gradually increase your intake, as suddenly eating a lot more fibre can cause digestive problems like [bloating](/your-health/a-doctors-tips-to-help-bloating/), gas or diarrhoea.

### 2.	 Not moving enough

Staying physically active helps to keep your gut moving. ‘Regular exercise gets your heart pumping and sends more blood to your intestines. This helps to stimulate a series of wave-like contractions (peristalsis) within the bowel, which helps to move food through the digestive system,’ explains Dr McClymont.

Research backs this too – one study found that aerobic exercise like walking was an effective treatment for patients with constipation.  

### 3.	Switching up your routine or holding in your poo 

We’ve all been there – a simple change of routine can be enough to throw off your regular poo habits. ‘Sporadic access to a bathroom, a sudden change in diet or increased time spent sitting can all cause you to become constipated,’ says Dr McClymont. 

‘Similarly, ignoring the urge to poo can also cause constipation because the longer the stool stays in the bowel, the more water gets reabsorbed, making it harder and more difficult to pass.’ So, when you feel the need to go, go.

### 4.	Emotional factors

You might become constipated when you’re anxious or stressed. This is because your brain and gut are closely linked – just as an unhappy digestive system can send signals to the brain, a troubled brain can send signals to the gut. The impact of [stress](/medical-advice/mental-health/anxiety/), anger, anxiety and [depression](/medical-advice/mental-health/depression/) can all affect your bowel movements.

High levels of stress can also affect digestive disorders, including [irritable bowel syndrome (IBS)](/medical-advice/digestive-problems/irritable-bowel-syndrome-ibs/). ‘One of the symptoms of IBS is constipation,’ says Dr McClymont. ‘If this is a symptom for you, you might find that it gets worse as you feel more stressed.’

### 5.	Some medicines 

Constipation is a common side effect of some medicines, including painkillers containing codeine and opioids. ‘Opioid medications can hinder the movement of the gut, resulting in constipation,’ says Dr McClymont. 

Other medications that can cause constipation include iron supplements, non-steroidal anti-inflammatory drugs such as ibuprofen, blood pressure medications, antidepressants and antihistamines.

### 6.	Pregnancy and postpartum 

Constipation is very common during pregnancy. One study found that women are 2-3 times more likely to experience constipation during pregnancy and straight after childbirth than when they’re not pregnant.  

‘During pregnancy, progesterone levels increase,’ explains Dr McClymont. ‘This hormone causes your muscles to relax, including those within the digestive system. This causes slower-moving stools through the intestines, leading to constipation. Postpartum constipation is also very common in the first few days after delivery, and for some women, it may continue for several months.’

### 7.	Neurological conditions 

Constipation is more common in people with conditions that affect the nervous system, such as multiple sclerosis and Parkinson’s disease. ‘When nerves are damaged, it impacts the ability of the intestines to move food along towards the rectum and push stools out,’ explains Dr McClymont.

## How can I prevent and ease constipation? 

The good news is that in most cases, making some small lifestyle changes can lower your risk of developing it in the first place. Here are Dr McClymont’s suggestions:

- Aim to eat 30g fibre a day by eating more fruit, vegetables and whole grains
- Add some sorbitol, a naturally occurring sugar found in apricots, apples, plums, prunes and raisins, to your diet
- Drink plenty of fluids (about 8-10 cups per day) to prevent dehydration
- Aim to go to the bathroom at the same time each morning, and prioritise enough time to empty your bowel
- Try to do at least 150 minutes of physical activity like walking, running, cycling or swimming each week 
- Change your toilet position and try using a small footstool under your feet. This is a simple way to pass bowel movements more easily 
- Practice relaxation techniques, such as deep breathing exercises or meditation, if you feel that emotional factors might be triggering your constipation 

## When should I speak to a doctor about constipation?

‘If your constipation isn’t improving with lifestyle changes or you’ve been constipated for a long time, it’s best to discuss it with a doctor,’ advises Dr McClymont.

‘If you notice any symptoms such as blood in your poo, feeling unusually tired or bloated, a persistent change in your poo habits or losing weight unintentionally, it’s worth making an [appointment](/gp-appointments-online/) for a check-up.’

__This article has been medically reviewed by Dr Rhianna McClymont, Lead GP at Kry.__


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Kry.co.uk > Your health > Why am I constipated? 7 possible causes 

Why am I constipated? 7 possible causes 

Expert advice from a Kry Lead GP on how to help constipation, plus what constipation might be caused by

Why am I constipated? 7 possible causes | Kry UK

Family

Family health

Research shows that [nearly half of people aged 50+ have had knee pain in the previous year](https://cks.nice.org.uk/topics/knee-pain-assessment/background-information/prevalence-of-knee-pain/), and out of these, a third had spoken to a GP about their symptoms in the same 12 months. Knee pain is very common in people of all ages.

Knee pain can be commonly caused from an injury like a ruptured ligament, torn cartilage or bleeding in the joint – especially if you play lots of high-impact sports like tennis or football. There are several different underlying causes of knee pain too, which can be harder to diagnose.

‘As you get older, you’re more likely to experience mild knee pain symptoms from daily wear and tear,’ says Dr Rhianna McClymont, Lead GP at Kry. 
‘Usually this is nothing to worry about – but if you notice the pain is getting worse, affecting your daily activities or you have other persistent symptoms, speak to a doctor.’

## What knee pain symptoms should I look out for?

On top of injuries and age-related conditions, there are many causes of knee pain and knee inflammation. The symptoms you experience will vary depending on the cause.

Here are some common symptoms to look out for, and reasons most people speak to a doctor about getting knee pain treatment.

- Stiffness
- Swelling
- Redness or warm to touch
- Knee clicking or popping
- Unable to straighten your knee
- Knee feeling unstable or giving way
- Locking of the knee joint

## What are the common causes of knee pain?

Sustaining an injury is by far the most common and often unavoidable reason for experiencing knee pain and swelling. 

A meniscus tear is a typical knee injury, particularly for athletes or people who play contact sports. The meniscus is a piece of cartilage that cushions your femur (thighbone) and tibia (shinbone). There are two in each knee joint.

‘Whether your injury is a sprain, torn ligament or menisci, dislocation or broken bone, you’ll usually get some fairly instant knee pain, swelling and tenderness. And the knee pain will be more intense depending on how badly you’re injured,’ explains Dr Rhianna McClymont.

Underlying conditions usually cause knee pain to come on more gradually instead. While this list is by no means exhaustive, GPs tend to see the following conditions causing chronic knee pain.

### 1. Osteoarthritis
This is the most common form of arthritis, and one that usually develops with old age or overuse of joints. It causes damage to the articular cartilage, which you need to protect your knees. Osteoarthritis of the knee can cause swelling of the tissues around your joints too. Although there’s no cure, a doctor can recommend ways to reduce the strain on your knees which may improve your symptoms.

### 2. Rheumatoid arthritis
Rheumatoid arthritis can develop at any age and can affect almost every joint in your body. The autoimmune condition can cause knee pain and swelling over a long period of time. There may not always be an obvious trigger for this type of knee pain and you may experience flare ups even after resting.

### 3. Gout
Symptoms of gout include very sudden and severe pain in your joints, commonly affecting the big toe as well as the knee joint. On top of getting sharp pain, the affected area usually becomes swollen, red and tender to touch.

### 4. Infection (septic arthritis)
A common infection of the knee joint is septic arthritis. If you’re not sure what’s causing your knee pain, and your knee is very swollen and hot, it could be an infection.

Other symptoms of an infection include having a fever and feeling generally unwell. It’s important to go straight to A&E if you think this might be the case.

### 5. Tendonitis
Tendonitis in the knee happens when the tendons around your knee become inflamed. This kind of knee inflammation can be brought on by lots of intense exercise, especially jumping and squatting (common in sports like basketball and tennis). As with other conditions, symptoms may include a swollen knee that’s warm and tender to touch.

### 6. Bursitis
If you have particular knee pain on bending (that gets worse when you kneel or bend down), it could be bursitis. This knee inflammation is caused by repetitive movement in your knee, or kneeling for a long period of time and is sometimes referred to as ‘housemaid’s knee’. Bursitis can lead to fluid building up over the knee joint which causes further swelling.

### 7. Osgood-Schlatter’s disease
Unlike many knee conditions, this one is much more common in teenagers and young adults who play a lot of sports. The disease causes swelling and tenderness just underneath the knee (in the bony part).

## Self help for knee pain

‘When knee pain is severe, limiting your activities or has persisted for a long time it’s best to speak to your own doctor for a diagnosis and for advice on the best knee pain treatment for your condition,’ says Dr Rhianna McClymont.

‘In the meantime, there’s a few simple ways you can look after your knees, prevent any further damage and help manage your symptoms.’

- Rest your knee to reduce any repetitive strain and give yourself time to heal – a really important one if you’re getting knee pain from exercise, or knee pain from walking      

- Ice your knee to minimise swelling, which works well for acute and chronic knee conditions

- Protect your knee from further trauma with knee padding or a splint, to help keep your knee straight and avoid knee pain when walking up stairs (if you can’t use a lift instead!)

- Elevate your knee as much as you can to help reduce swelling and minimise knee pain from sitting

- Compress your knee with a brace or wrap to reduce knee inflammation - speak to a doctor if you’re not sure how to apply correctly or whether this is suitable for your knee  

## When to speak to a doctor

For most people, minor knee problems should begin to settle within 6 weeks. 

But it’s always best to speak to a GP if your knee pain gets worse, or your knee starts to lock or give way, and hurts when you’re not moving it. 
If you’re not able to extend or bend your knee at all, it needs to be checked out as soon as possible. Look out for any deformities or lumps around the knee joint too.

A GP can make a referral for you to see a specialist for further investigation or treatment.

Phone 111 if you have difficulty putting any weight on your sore leg or your knee becomes immediately swollen after an injury.

__This article has been medically reviewed by Dr Rhianna McClymont, Lead GP at Kry.__


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Kry.co.uk > Your health > What your knee pain might be telling you

What your knee pain might be telling you

 A doctor’s guide to the causes and treatment of knee pain

What your knee pain might really mean | Kry UK

Dealing with eczema can be incredibly difficult and unpredictable. Eczema is an inflammatory skin condition that makes your skin red, dry, itchy, cracked and sore.

The condition is more common than you might think, affecting an estimated 1 in every 5 children and up to 3% of adults worldwide. 

‘A flare-up occurs when eczema symptoms worsen,’ says Dr Rhianna McClymont, Lead GP at Livi. ‘For some people, there’s no apparent reason, but individual triggers may include soaps and detergents, cold and dry weather, allergies, or infections.’ 

## What does eczema look and feel like? 

Eczema flare-ups can affect any part of the skin, but the areas most commonly affected tend to be the face, the hands and the sensitive areas of skin around the joints, such as the back of the knees or inside the elbows. 

‘Typically, eczema appears as patches of itchy and cracked, scaly or peeling skin that can feel rough to the touch,’ explains Dr McClymont. Sometimes the skin may also appear blistered, weepy, thickened, crusty, bumpy or swollen.

## What does eczema look like on white, black and brown skin?

Eczema affects people of all skin tones and ethnicities and it can look different depending on your skin type. ‘On lighter skin tones, affected areas usually appear inflamed and red in colour with dark pink patches,’ says Dr McClymont.

‘On darker skin tones, affected areas of skin may appear darker than the rest – this is known as hyperpigmentation. Eczema patches tend to look purple, dark brown or ashen grey.’ As the skin heals, it may temporarily become lighter, known as hypopigmentation. 

Black skin may be particularly susceptible to eczema, but the severity of flare-ups is often underestimated as the redness from inflammation may be difficult to see.

![7 doctor’s tips for managing eczema flare-ups ](//images.ctfassets.net/h8qzhh7m9m8u/2LACCUgFpYcETEA0f0b23W/464e189c6bfb691899d2bc6b327cfbbb/2100x1200_Exzema-flare-ups_Article.png)

## How do I know if I have an infection?

If your skin becomes swollen or sore, begins to blister or develops a yellow crust, you may have an infection. Antibiotic creams or tablets may be required to treat it. 

## What causes an eczema flare-up?

There are a variety of potential triggers for eczema flare-ups, from soaps and detergents to wool, sweat, stress and skin infections. Environmental factors, such as smoke, pollen, heat, low humidity and cold weather, and certain foods, such as dairy and nuts, could also be the cause. 

## How can I manage and ease eczema flare-ups?

Not all treatments work for everyone with eczema, but it’s important not to give up hope. Depending on the severity, treatments may include lifestyle changes, prescription medication and over-the-counter remedies. 

Here are some options you can try to help manage your symptoms during an eczema flare-up:

### 1. Resist the urge to scratch 
‘Scratching can make eczema worse and eventually lead to dry, leathery and thickened skin. It may also leave you vulnerable to infection since it’s easier for bacteria to get into cracked skin,’ says Dr McClymont. ‘Keep kids’ fingernails short and try putting mittens on their hands at night. A doctor might recommend antihistamines for a short time, as some types are sedating and can help your child sleep.’ 

### 2. Moisturise your skin regularly with emollient
Using moisturising treatments (emollients) regularly is one of the most effective ways to manage your eczema. Available over the counter as creams, lotions or bath oils, emollients cover your skin with a protective film to trap in moisture.

‘Apply emollients liberally twice every day – even when your skin appears “normal” – to prevent flare-ups occurring,’ advises Dr McClymont. ‘When your skin is worse, use them more frequently – up to 5 or 6 times a day. It’s also important to use emollients each time you wash your hands.’ 

### 3. Consider using steroid creams for a short period
Steroid creams – also known as topical corticosteroids – can be used to reduce swelling, redness and itching. ‘If the severity of your flare-up isn’t improving with regular emollient use, steroid creams can be useful in the short term as they reduce inflammation in the skin,’ says Dr McClymont. 

‘You can buy a mild steroid cream, such as hydrocortisone, over the counter from a pharmacy, and stronger creams are available with a prescription from a GP. In rare cases of severe eczema, oral steroid tablets may be considered.’ 

### 4. Pinpoint your triggers 
‘Most people have individual triggers, and it’s worth keeping note of when your eczema is at its worst to identify skin products, environmental factors or foods that may aggravate it,’ says Dr McClymont. Try keeping a diary to help you become aware of potential things to avoid.

### 5. Find support to help you deal with stress 
Emotional stress can trigger eczema symptoms, and a recent clinical study found that people with eczema have an increased risk of developing [depression ](https://www.livi.co.uk/medical-advice/mental-health/depression/)and [anxiety](https://www.livi.co.uk/medical-advice/mental-health/anxiety/). ‘If your eczema is affecting you, talk to a doctor. Treatments like cognitive behavioural therapy (CBT) can help manage your response to stress and reduce the impact living with eczema has on your mental health,’ explains Dr McClymont. 

### 6. Discover the benefits of light therapy 
Already tried all of the above? Light therapy could be an effective option, but you will need a referral to a dermatologist. ‘Light therapy, or phototherapy, is a treatment that uses ultraviolet (UV) light. It works by reducing inflammation in the skin,’ says Dr McClymont. 

### 7. Talk to a specialist 
If your eczema symptoms are getting worse, your doctor or dermatologist may recommend other treatments, including specialised creams called topical immunomodulators. These act on the immune system to reduce skin inflammation and improve eczema. ‘They can be very effective and a good alternative to steroid creams – particularly in people who have frequent flare-ups,’ says Dr McClymont.

Using bandages and wet wraps can also help calm eczema flare ups and are usually applied or prescribed by a doctor or dermatologist. They stop you from scratching and protect your skin from dryness by helping it absorb emollients.

__This article has been medically reviewed by Dr Rhianna McClymont, Lead GP at Livi.__


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Livi.co.uk > Your health >  7 doctor’s tips for managing eczema flare-ups 

7 doctor’s tips for managing eczema flare-ups 

Discover the best ways to ease the most common type of eczema, atopic dermatitis. With advice from a Kry Lead GP.  

Kry.co.uk > Your health >  7 doctor’s tips for managing eczema flare-ups 

7 doctor’s tips for managing eczema flare-ups | Kry UK

Keeping a good posture is something that can often be forgotten, especially when we’re busy working or on-the-go – but it’s essential for looking after your body’s musculoskeletal health. 

Musculoskeletal conditions are injuries or disorders of the muscles, nerves, tendons, joints, cartilage, and spinal discs. They add [up to nearly a third of all GP appointments](https://www.england.nhs.uk/elective-care-transformation/best-practice-solutions/musculoskeletal/)in England. 

Lower back and neck pain are also the biggest cause of years lost to disability in the UK, with chronic joint pain (or osteoarthritis) affecting more than 8.75 million people.

## Why is good posture important?

‘Although there’s no such thing as “perfect posture”, it’s a good idea to avoid staying in positions that feel uncomfortable. People often notice a link between recurring aches and pains, and sitting in a certain position for too long,’ says Dr McClymont  

Bad posture can cause pain in the neck, back, shoulders, legs and feet, as well as secondary pain in the head. On top of adding to stress and fatigue levels, poor posture can lead to more serious musculoskeletal conditions.

This is why it’s best to stay as active as possible, know how to improve your posture and look after your body.  

The NHS and the [British Chiropractic Association](https://chiropractic-uk.co.uk/posture/) have lots of free advice on how to correct your posture – which involves more than just sitting up straight! They also talk through exercises you can do to support your muscular health in everyday life.

## What are your postural muscles?

Postural muscles are also known as core stability muscles, and are found in your abdomen, pelvis and back. They act as natural scaffolding to stabilise and hold your body together. It’s very important to have strong and healthy postural muscles to help maintain good posture, coordination and balance.

‘Your postural muscles can only function properly if your body is correctly aligned,’ Dr McClymont explains. ‘Otherwise a vicious cycle of muscle weakness and poor posture may occur through injury or lack of use. In time, your core muscles will then start to become less efficient.’ 

## What causes poor posture?

There are many different reasons for poor posture – whether you’re relaxing at home, working or travelling around. Here are 6 of the most common.

### Slouching in a chair

Although this doesn’t always cause discomfort, slouching over time can put a lot of strain on your muscles and soft tissue. This can also increase tension in the muscles, and in turn, pain.   

### Sticking your bum out
If this is how you naturally stand or you have a noticeable curve in your lower back, you may have already been diagnosed with hyperlordosis. This is an exaggerated curvature of the lumbar spine, causing [lower back pain](/your-health/what-can-help-my-lower-back-pain-a-doctors-tips/).

Carrying [excess weight around the stomach](/your-health/is-your-waste-size-putting-your-health-at-risk/), pregnancy and wearing high heels can all contribute to this type of poor posture.

### Standing with a flat back
If your pelvis is tucked in and your lower back is straight instead of naturally curved, you will end up stooping forward. This can make it uncomfortable to stand for long periods of time.  

This type of posture is often caused by an imbalance in your muscles, or sitting down for too long. As this position can make you lean your neck and head forwards, it often causes neck and upper back pain.

### Leaning on one side
Lots of us will lean more on one leg – this standing posture is often more comfortable if you’ve been on your feet for a while. But instead of using your core muscles to hold your body upright, you’re applying added pressure on one side of your lower back and hip.

Over time, this can lead to muscle imbalances around the pelvis, and further strain to muscles in your lower back and buttocks.

Carrying heavy backpacks on one shoulder, or carrying a toddler on one hip, are other common causes of distributing weight unevenly.  

### A hunched back and angled chin
Most of us can be guilty of hunching over our laptop or computer keyboard from time to time, and this can be a sign that you have a tight chest or a weak upper back. If this sitting down posture is maintained for long periods of time, it can contribute to having a rounded upper back, as well as stiffness in the shoulders.

Using our smartphones can cause similar bad posture problems and neck pain like ‘text neck’. Poking your chin is another common posture mistake caused by having a hunched back, sitting too low at your desk, or having a computer screen set too high.

### Rounded shoulders
Having rounded shoulders are typically caused by poor posture habits, muscle imbalances or focusing too much on certain exercises, like chest strength (while neglecting the upper back). If you notice that you are falling into this posture regularly, it may indicate that you have a tight chest and a weak upper back.

## 6 ways to improve your posture 

‘Whether you’re mostly sitting or standing, there are quite a few simple ways to improve your posture day to day,’ reassures Dr McClymont. Here, she shares 6 of them to get you started. 

### 1. Stand tall
Perhaps the most obvious way to improve posture is by standing straight and tall as much as you can. Imagine a string is attached to the top of your head, near the back, and pulling you upwards. 

### 2. Make sitting properly a habit
Get into the habit of sitting correctly rather than slouching in chairs. It may not feel comfortable initially because your muscles are not conditioned to support you in the correct position, but when you're sitting down, make an effort to sit your bum back in your chair and push your shoulders back.

### 3. Check your desk setup
Try not to hunch over your desk, laptop or computer keyboard. Have a proper look at your work set-up, especially if you’re working from home. It’s really important to have an appropriately sized desk and chair, lined up correctly with the position of your computer, screen and keyboard. Find out [how to adjust your workstation](https://www.nhs.uk/live-well/healthy-body/how-to-sit-correctly/) to improve your posture at work.

### 4. Keep your shoulders back
When you’re sitting and standing, pull your shoulders back to avoid the strain on your back of having rounded shoulders. Simple exercises like the plank, bridges, pull-ups and chest stretches can help strengthen your core, upper back and chest muscles, and help correct rounded shoulders.

### 5. Balance your weight
Although it may not feel natural, stand with your weight equally distributed across both sides of your body, rather than mostly on one leg. Like anything, practise this regularly for it to feel more normal. 

### 6. Exercise
Introduce a few daily exercises to strengthen your core (postural muscles). Back extensions are one of the best exercises to correct posture. Yoga and pilates are another great form of exercise to improve core stability and strength, as well as [looking after your wellbeing](/your-health/lockdown-20-a-doctors-wellbeing-tips/).

## How to help persistent bad posture problems

‘If you’re not able to get relief from posture exercises and your aches and pains persist, it’s a good idea to speak to your GP. You may be referred to a physiotherapist for further assessment and treatment, who can recommend exercises you can do at home to strengthen your postural muscles,’ says Dr McClymont.

You can also get more advice from a local chiropractor who will be able to make an assessment and help you start moving again without pain.

__This article has been medically approved by Dr Rhianna McClymont, Kry Lead GP.__


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Kry.co.uk > Your health > How to improve your posture – a doctor’s guide

How to improve your posture

Expert advice from a Kry doctor on improving posture

 How to improve your posture – and why it's important | Kry UK

Health tips

How to improve your posture – a doctor’s guide

Changes in hormone levels are a natural part of ageing. For women, oestrogen levels drop drastically during the menopause – but do men experience something similar?

A term predominately used by the media, the ‘male menopause’ is used to describe an age-related decline in testosterone and the symptoms associated with it – including low energy, poor concentration, weight gain and [erectile dysfunction](/your-health/erection-problems-a-doctors-guide-to-getting-help/).

‘The term “male menopause” isn’t quite right because the declining fertility in men is very different from menopause in women,’ explains Dr Céline Guyomar, a Kry medical doctor. ‘Male hormones decline gradually with age. However, a small proportion of men experience testosterone deficiency, also known as hypogonadism and androgen deficiency, where the body is unable to make enough testosterone,’ she says.

## So, what exactly is testosterone and what happens to it as I get older?

Testosterone – often described as the male sex hormone – plays an important role in emotional and physical wellbeing. In men, it’s primarily made in the testicles – also called the testes. ‘Testosterone is responsible for the production of sperm and red blood cells. It also stimulates sex drive, maintains muscle and bone strength and regulates the distribution of body fat,’ says Dr Guyomar. 

Men start to produce testosterone during puberty, peaking at around the age of 20. From the age of 30, testosterone levels normally start to decrease by around 1% to 2% per year. Known as the andropause, this decline happens more gradually than female menopause and is unlikely to cause any issues in itself.

## Can certain lifestyle factors trigger menopause-like feelings? 

Reaching middle age can mean a few life adjustments. Many of us experience changes to our health, the loss of relationships or loved ones, or problems with money. Thinking about your life as if it’s at the halfway stage could also lead to a ‘midlife crisis’. In situations like these, some people may get ‘male menopause’-like symptoms, such as self-doubt, shifts in energy levels, mood changes, lowered motivation, a lack of self-esteem and [changes in sexual drive](/your-health/8-causes-of-low-libido-a-doctors-guide/#:~:text=A%20low%20libido%20can%20be,an%20issue%20within%20the%20relationship.).

Other things that can contribute to menopause-like feelings include:

- A poor diet
- Not exercising enough
- Lack of sleep
- Drinking too much alcohol

## But what about testosterone deficiency? 

In some cases, symptoms of the ‘male menopause’ may be caused by testosterone deficiency – or hypogonadism – which happens when the testes begin to work less efficiently and make few or no hormones. One large European study found that testosterone deficiency affects about 2% of males aged 40-79 and about 5% of men aged 70-79.

Although hypogonadism can occur at any age, men are more likely to develop it as they get older. Known as late-onset hypogonadism, this condition affects around 2% to 6% of older men. Some of the most common symptoms include:

- An increased risk of breaking a bone 
- Decreased muscle mass and strength
- Decreased growth of body hair
- Hot flushes and sweats
- A decreased libido
- Erectile dysfunction
- Infertility 
- Low self-esteem
- Changes in mood, e.g. [anger](/your-health/how-to-cope-with-anger-in-yourself-and-those-close-to-you/), depression, irritability and sadness
- Fatigue
- Poor concentration and memory
- Increased body fat
- [Trouble sleeping](/your-health/5-sleep-problems-to-discuss-with-a-doctor/)

## What causes testosterone deficiency? 

Hypogonadism can be caused by normal ageing. ‘Other factors that can affect testosterone include injury to the testicles, being overweight, alcohol misuse, a sedentary lifestyle, certain medical conditions – such as cancer, HIV, lupus, mumps and organ failure – and some medicines,’ says Dr Guyomar. 

Hypogonadism rates are also higher among men with high blood pressure, diabetes, prostate disease, [asthma](/medical-advice/respiratory-conditions/asthma/) and chronic obstructive pulmonary disease (COPD).

## What can I do to help boost my testosterone?

‘Certain lifestyle choices can speed up the decline of testosterone,’ says Dr Guyomar. Here are some lifestyle changes you can make to increase your testosterone levels naturally:

__1. Maintain a healthy weight__
A raised body mass index (BMI) can have a direct and negative impact on testosterone levels. One study found that being overweight was the most significant risk factor for testosterone deficiency in men.

__2. Cut back on alcohol__
Drinking excessive amounts of alcohol affects the system of endocrine glands and [hormones involved in male reproductive health](/your-health/male-fertility-9-lifestyle-factors-that-help/#:~:text=For%20couples%20experiencing%20difficulties%20in,fertilise%20an%20egg%20during%20conception). It reduces levels of luteinising hormone (LH), one of the main hormones that controls the body’s reproductive system. Produced in the pituitary gland, LH stimulates the production of testosterone. 

__3. Stay active__
Exercising regularly has heaps of health benefits, from improving muscle strength to reducing the risk of disease. One study found that resistance strength training may also boost testosterone levels. 

__4. Prioritise sleep__
Sleep is essential for the body to function correctly. As well as lowering the risk of heart disease and [depression](/medical-advice/mental-health/depression/), sleep can also help to maintain testosterone levels. Research has shown that one week of sleeping just five hours a night lowered testosterone by as much as 15%. 

__5. When should I speak to a doctor?__
If you’re in your late forties or older and you’re experiencing symptoms, it’s important to talk to your doctor. As well as ruling out low testosterone levels, they can also check for other conditions that may be causing your symptoms. 

‘Your doctor may also ask you some questions from the screening questionnaire for androgen deficiency in ageing males (ADAM),’ says Dr Guyomar. These questions include: 

1. Do you have a decrease in libido?
2. Do you lack energy?
3. Do you have a decrease in strength and/or endurance?
4. Have you lost height?
5. Have you noticed a decreased enjoyment of life?
6. Are you sad and/or grumpy?
7. Are your erections less strong?
8. Have you noticed a recent deterioration in your ability to play sports?
9. Are you falling asleep after dinner?
10. Has there been a recent deterioration in your work performance?

__This article has been medically reviewed by Dr Céline Guyomar, a Kry medical doctor.__


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Kry.co.uk > Your health > The ‘male menopause’ – what does the medical evidence say?

The ‘male menopause’ – what does the medical evidence say?

Can a decline in male hormones be compared to the menopause? Dr Céline Guyomar, a Kry medical doctor, explains what you need to know about the ‘male menopause’

What is the ‘male menopause’? | Kry UK

Men Health

Men's Health

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Having a baby is one of the most wonderful moments in a person’s life. But it leads to physical and emotional body changes that can cause anxiety for new parents. 

‘Often, these changes are perfectly normal and are nothing to worry about,’ says Dr Elisabeth Rosen, a Kry specialist in women’s health. ‘But occasionally, you may need to seek further medical advice.’ 

Here’s our doctor’s guide on what to expect and what you can do at home to help — or, when to get a medical opinion.  

## 1. Lower back pain

A condition known as symphysiolysis (sometimes called symphysis pubis dysfunction) can cause pain in your lower back after having a baby. ‘Symptoms usually start around week 18 of the pregnancy and anyone can suffer from it,’ says Dr Elisabeth Rosen. ‘It’s thought to be connected to the loosening of the ligaments and joints between the lower back and pelvis thanks to hormonal changes while pregnant.’ 

### Self-help
If you’re suffering with severe pain in your lower back after having a baby, talk to your doctor. If you have general back pain after pregnancy, the NHS recommends:

- While feeding your baby, sit with your back well supported and straight. Put a small pillow or cushion behind your waist to support your lower back. Make sure your feet can reach the floor
- Kneel or squat (do not bend your back) to do tasks that are near the floor, like picking up toys or bathing your baby
- Change a nappy on a raised surface. You could kneel on the floor next to a sofa or bed. Never leave your baby unattended on a raised surface, in case they fall off

### When to talk to a doctor
‘If you need painkillers regularly for more than 2 weeks, see your GP,’ says Dr Rosen. ‘They may suggest alternative painkillers, a TENS machine [which uses mild electrical current to relieve pain], acupuncture or a back belt which you can buy or sometimes borrow from your delivery ward to help support the lower back.’

Read more about [lower back pain](/your-health/what-can-help-my-lower-back-pain-a-doctors-tips/) and how you can help manage it.

## 2. Pelvic floor problems

Most women who give birth vaginally will suffer some form of damage to their pelvic floor area such as a mild or moderate tear. This can lead to pain, discomfort, dyspareunia, incontinence and [constipation](/medical-advice/digestive-problems/constipation/) for a couple of weeks postpartum but should slowly resolve. 

### Self-help
‘Immediately after the birth you can apply an ice pad or cold compress to help the blood vessels constrict and reduce the pain,’ says Dr Rosen. ‘Pain killers can also help and make sure you start your pelvic floor exercises from as early as possible.’ 

### When to talk to a doctor
‘Usually the pain and discomfort will disappear in the first 2-6 weeks,’ says Dr Rosen. ‘Persisting problems should be taken up at your 6-week postpartum check-up. There, the midwife will be able to investigate your pelvic floor through a gynaecological examination and refer suspected persisting damage to your pelvic floor for further treatment’.  

## 3. Episiotomy stitches

It’s common for women who have a vaginal birth to have some kind of natural tear or episiotomy (a cut made by a health professional). These are normally stitched up within an hour of the birth and should heal within a month.

### Self-help
‘Shower each day rather than taking a bath for as long as you’re still bleeding as baths could let bacteria enter your uterus,’ says Dr Rosen. ‘Change your sanitary pads regularly and don’t have sex until you’ve stopped bleeding — usually around the 6-8 week mark. 

It’s useful to examine your wound and stitches regularly using a mirror, just to check for any changes. Don’t worry if the wound feels itchy or irritated. This is actually a good sign that the wound is healing. Massaging baby oil into the area often helps.’

### When to talk to a doctor
‘If you get a high temperature it could be a sign of infection, so see your midwife or a GP straight away,’ says Dr Rosen. ‘If the pain or swelling gets worse or there is a smelly discharge from the wound, also seek medical help.’ 

## 4. Bruising and infection after a C-section

Around 1.4 million C-sections are performed every year in Europe. ‘Like all major surgeries, a C-section risks infection through the cut as well as damage to the nerve and bruising is common,’ says Dr Rosen. ‘Most women will be able to take up light exercise within 2 weeks and normal exercise after 6 weeks but there may be decreased or a ‘tickling’ sensation as the nerves try to repair themselves.’ 

### Self-help
‘Keep the scar clean and examine it regularly for any changes,’ says Dr Rosen. ‘Many women try to “be strong” and continue with daily life but if you need painkillers, take them for at least the first 2 weeks after the birth. 

### When to talk to a doctor
‘If you develop a high temperature or the scar becomes warm, there is an increase in pain, swelling or redness or you see any kind of liquid — apart from blood — oozing out, consult your doctor as it might be a sign of infection,’ says Dr Rosen. ‘If your pain is increasing rather than slowly decreasing you should also seek help.’

## 5. Piles

Haemorrhoids or piles, are swollen veins in or around your bottom and are common both in pregnancy and after giving birth. Up to 35% of pregnant women are thought to suffer from them. ‘Piles normally start during pregnancy due to the increased pressure from the baby on the abdominal wall,’ says Dr Rosen. ‘Many women don’t realise they have them until they experience itching or they spot blood on the toilet paper but they are usually very treatable.’

### Self-help
Drink lots of fluid and eat plenty of fibre to keep your poo soft so you’re not straining. Keep your bottom dry and clean. Try to gently push the pile back inside the rectum using your finger. Use a haemorrhoid cream or suppository which you can buy from the pharmacist.

### When to talk to a doctor
‘Most of the time you can treat piles successfully at home but if you’re really suffering over a long period of time and painkillers are not helping, or you keep bleeding from the rectum, see your doctor,’ says Dr Rosen. 

## 6. Bleeding after birth (lochia)

It’s natural for women to bleed for around 2-6 weeks after giving birth either vaginally or via C-section. The bleeding is a mixture of mucous, blood and tissue shed after your birth as your womb lining is being replaced.

### Self-help
‘Shower every day, keep changing your sanitary pads and don’t have sex until the bleeding has completely stopped,’ Dr Rosen advises. 

### When to talk to a doctor
‘If you suddenly start to bleed more or see clots in the blood you should seek medical attention,’ says Dr Rosen. ‘Sometimes there may be pieces of placenta or membrane left inside and you might need medication to help the cervix dilate again or – in rare cases – you may need surgery. If you have a high temperature after birth, also see a doctor as this could be a sign of infection.’ 

## 7. Sore and swollen labia and vulva 

It’s natural for the vagina and the whole surrounding area to feel sore after giving birth vaginally, says Dr Rosen. 

### Self-help
‘You can use cold pads on the swelling as well as a local anaesthetic cream and take painkillers if you need them,’ says Dr Rosen. ‘I’d also suggest urinating in the shower to dilute the stinging sensation of the urine acid on this area.’ Follow the general advice above for pelvic floor problems too.

### When to talk to a doctor
‘If you continue to have pain while urinating after a week it might be a sign of a urinary tract infection,’ says Dr Rosen. ‘A GP will be able to confirm this easily with a test and prescribe antibiotics.’

## 8. Separated stomach muscles (Diastasis Recti)

Around 60% of women will suffer from separated stomach muscles, or diastasis recti, during pregnancy. It’s caused by the muscles that run down the middle of your stomach separating as the baby puts more pressure on the abdomen during pregnancy. The amount of separation varies from woman to woman but most of the time, the stomach reverts back around 8 weeks after the birth.

### Self-help
Gently exercise the stomach and core. Dr Rosen says, ‘Look for an app for new mums that provides exercises to help reduce the size of separation between the muscles.’ 

### When to talk to a doctor
‘If you still have separation of more than 2cm after 2 months or it’s giving you pain, seek medical advice,’ says Dr Rosen. ‘The GP may refer you to a physiotherapist and in rare cases you may need surgery.’

## 9. Hair and skin changes 

‘Hormonal changes during pregnancy can affect women in different ways and some report they have glowing skin while others say they have [acne](/medical-advice/skin-conditions/acne/)’ says Dr Rosen. 

‘Some women report hair loss after giving birth but actually, this is down to their levels of oestrogen changing. While pregnant, the level of oestrogen is high which stops your hair falling out at the same rate as it would have if you weren’t pregnant. When that drops after birth, you shed the hair you would have normally shed that stayed in place thanks to your pregnancy.’ 

### Self-help
‘It’s vital to maintain a nutritious, healthy diet, get as much sleep as possible and perhaps take a multivitamin for new mums,’ says Dr Rosen. ‘Iron tablets may also help, although these can cause constipation so be wary.’

### When to talk to a doctor
If you’re losing your hair in just one place, rather than from all over the head, it’s a good idea to seek medical advice. Hair loss can be a sign of [hyperthyroidism (an overactive thyroid)](/your-health/thyroid-symptoms-overactive-underactive/) but that is unusual in postpartum women as doctors keep a close eye on thyroid levels during pregnancy. 

## 10. Hormone changes

‘If you’re breastfeeding, you may have dryness in your vagina due to low oestrogen and it may be itchy or uncomfortable when you have sex,’ says Dr Rosen. ‘The onset of the baby blues is also down to hormone changes and tends to arrive around day 3 after giving birth.’ 

### Self-help
Vaginal dryness can be helped with lubricants which can be bought over the counter. ‘Being aware that the baby blues can kick in around day 3 is important for both you and your partner as awareness is half the battle,’ says Dr Rosen. ‘Usually these feelings disappear after a couple of weeks.’ 

### When to talk to a doctor
If you’re still feeling low after a couple of weeks you may be [experiencing postnatal depression](/your-health/help-for-postnatal-depression/). ‘This is common and you shouldn’t be afraid of seeking medical help,’ says Dr Rosen. ‘You may need some kind of talking therapy such as CBT or we can prescribe antidepressants, even if you’re breastfeeding.’ 

__This article has been medically approved by Dr Elisabeth Rosen, Kry/Kry doctor and women’s health specialist.__


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Kry.co.uk > Your health > 10 post-baby body changes — advice from a women’s health specialist

10 post-baby body changes — advice from a women’s health specialist

 Your body will look and feel different after you’ve had a baby. Learn what to expect, with advice from a Kry doctor and women’s health specialist

 10 post-pregnancy body changes – a doctor’s guide | Kry UK

Thyroid problems are among the most common health conditions in the world, affecting an estimated 200 million people globally. But not many of us fully understand the thyroid’s function and the key hormones involved.

The butterfly-shaped gland is found in the front of the neck and plays a big role in our health. The hormones it produces help to regulate our metabolism, growth and development, and maintain our energy levels and reproductive system. 

Here, Livi medical doctor Dr Céline Guyomar has answered some of your biggest questions about the thyroid-stimulating hormone (TSH), including when to speak to a doctor. 

## What is TSH and what has it got to do with thyroid hormones?

The thyroid makes 2 hormones – triiodothyronine (T3) and thyroxine (T4) – and releases them into the blood. They regulate lots of different things in the body, including energy, metabolism, muscle strength, appetite, breathing and organ function. 

‘When someone has too little or too much of these hormones in their bloodstream, this means that they have a [thyroid disorder](https://www.livi.co.uk/your-health/thyroid-symptoms-overactive-underactive/),’ Dr Guyomar explains. 

TSH is also a hormone. It helps to make sure we have the right balance of thyroid hormones in our blood. 

By secreting TSH, the anterior pituitary gland in the brain regulates the levels of T3 and T4 in the blood. When there’s too little, it releases more TSH, telling the thyroid to make more thyroid hormones. When there is enough, TSH production stops.

## How and why do our TSH levels change?

People with underactive thyroids (hypothyroidism) may have too much TSH in their blood because there’s not enough T3 or T4 to tell the brain to stop making it. 

People with overactive thyroids, or hyperthyroidism, can have too much T3 and T4 in the blood, which blocks the brain from making TSH.

Levels can also change with each stage of life. TSH levels usually spike in newborn babies shortly after birth, for example.

In addition, TSH levels are lower during the first 3 months of pregnancy when the additional needs of the body result in changes to the thyroid’s anatomy and function. This is why TSH tests are performed during pregnancy.

## When would doctors measure my TSH?

There are 5 main reasons clinicians might measure TSH levels, according to Dr Guyomar:

1. To check for suspected thyroid dysfunction
2. To find out whether an abnormality in the secretion of thyroid hormones originates in the thyroid or the pituitary gland 
3. To check a thyroid disorder treatment is working
4. To monitor thyroid hormone levels during pregnancy 
5. To screen for congenital hypothyroidism in newborn babies

## How do doctors measure TSH?

Doctors use a blood test to measure TSH. Normal ranges vary but are between 0.5 mIU and 2.50 mIU per ml of blood.

People with high TSH levels may have hypothyroidism. In rare cases, it could be a sign of a pituitary gland tumour.

Low TSH is often a sign of hyperthyroidism. A second possibility is a toxic adenoma, which is an uncommon, non-cancerous tumour.

If TSH levels are too high or too low, doctors will usually carry out further tests, such as checking T3 and T4 levels, before making a diagnosis. 

They may also check for other thyroid antibodies, including.

- Thyroid peroxidase antibodies (TPO), which can be a sign of Hashimoto disease or Graves’ disease
- Thyroglobulin antibodies (Tg), which can be a sign of Hashimoto disease 
- TSH receptor antibodies, which can be a sign of Graves’ disease

Read our [article on thyroid symptoms](https://www.livi.co.uk/your-health/thyroid-symptoms-overactive-underactive/) for more information on these thyroid-related disorders.

## Are thyroid problems hereditary?

Some forms of thyroid cancer, such as medullary thyroid cancer, are genetic, says Dr Guyomar.

‘There’s also a form of inheritance whereby members of the same family might have different thyroid problems, but the thyroid diseases can be different’ she says. ‘For example, a grandmother may have hyperthyroidism and a daughter may have hypothyroidism.’

## When should I speak to a doctor?

Anyone who has symptoms of an overactive or underactive thyroid should speak to a doctor. 

Typical symptoms of hypothyroidism are:

- Tiredness
- Muscle aches
- Weight gain
- A slow heart rate
- Sensitivity to cold

The most common symptoms of hyperthyroidism are:

- Sensitivity to heat
- Weight loss
- Anxiety
- Irritability
- An unusually fast heart rate
- Insomnia
- Shortness of breath 

‘In both cases, some psychological troubles, such as depression, could also be present,’ says Dr Guyomar. If you’re experiencing infertility issues, you should also request a thyroid check. 

__This article has been medically reviewed by Dr Céline Guyomar, a Livi medical doctor.__


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Speak to a GP about your thyroid 

Livi.co.uk > Your health > Everything you need to know about the thyroid-stimulating hormone

Everything you need to know about the thyroid-stimulating hormone

Dr Céline Guyomar explains the role of the thyroid-stimulating hormone and how to spot the signs of a health issue. Learn more about your thyroid health with Kry.

Kry.co.uk > Your health > Everything you need to know about the thyroid-stimulating hormone

Doctor’s guide to the thyroid-stimulating hormone (TSH) | Kry UK

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