kry.co.uk > Your health

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

kry.co.uk > Your health > Metainfo

Your health | KRY

## Quick facts

- Smokers are 14 times more likely to develop severe disease
- On average, it takes around 30 quit attempts before smokers succeed in giving up
- Psychological, over-the-counter and medical help is available 


It’s never a good time to be a smoker and right now is no different.

As well as the clear links to increased risk of heart disease, stroke, lung disease and many other cancers, studies have shown that smokers with Covid-19 are far more likely to go on to develop serious and sometimes fatal complications.
 
Cigarette toxins cause lung damage, reducing lung capacity and the ability to use oxygen. That means that once someone who smokes gets Covid-19, they can potentially become very ill quickly – sometimes worse than non-smokers – and may develop severe pneumonia. Part of this is because tiny hairs (cilia) that help clear infection from the lungs don’t work so well in smokers. In China, smokers were found to be 14 times more likely to develop severe disease. 

The World Health Organisation have also said that the physical act of smoking and possibly sharing smoking paraphernalia means smokers also have a greater chance of getting infected.


__Don’t give up on giving up__

It is estimated that half a million British people have tried to quit since the onset of the coronavirus pandemic.  
If the current situation has made you consider giving up smoking, you may have tried already without success. But that’s no reason to despair – research has found it takes an average of 30 attempts to give up before people finally succeed in kicking the habit.

When you stop smoking you will notice the following effects. 
After:

- 20 minutes - blood pressure and heart rate drop
- 12 hours - carbon monoxide (toxin) drops in your blood to normal
- 2 weeks - circulation and lung function improve
- 4 weeks - coughing and shortness of breath improve
- 1 year - your risk of coronary heart disease is half that of a smoker
- 5 years - your stroke rate is the same as a non-smoker
- 10 years - your risk of all cancers is much lower
- 15 years - your risk of coronary heart disease is the same as someone who never smoked


__First, some steps to getting yourself ready:__


__1.__ __Set the scene__

Once you have made the decision to quit, tell everyone – make a quit plan and then set a quit date.
 
Now, remove smoking items from your home, your car and – if you’re travelling to work – your workplace.
 
At least for a while, minimise smoking ‘cues’ such as alcohol – these are things you associate habitually with smoking.
 
Ask others to respect your decision by not smoking around you.


__2.__ __Know the side effects to expect__

Know what side effects can occur as your body withdraws from its addiction to nicotine. Then be prepared to deal with them. Most commonly, this will include headaches so make sure you sleep, hydrate, exercise and eat well.
 
You may also experience more coughing. This is because those cilia in your lungs come to life again making you temporarily cough more. Drink plenty of water. You might also find having hot drinks, such as tea with honey, can help.


__3.__ __Be ready__

‘Acknowledge that quitting smoking is a process. Motivation changes over time and setbacks are not uncommon,’ says Jesper Enander, chief psychologist, Kry.
 
‘For success, make a list of pros and cons and work out why you want to quit. Give yourself slack if things go wrong and get back to the plan as soon as you can,’ he advises.
 
‘Identify situations where you might be tempted, such as parties or stress. Then, plan in advance how you will deal with the urge to smoke. For example, buy chewing gum so when cravings hit, you can chew instead of smoking’.


__4.__ __Know your options__

Thankfully, there are now more options than ever to help you give up smoking. If something doesn’t work for you, try something else. Here’s a summary:


__5.__ __Talking and communication__

You can find local stop smoking support services and groups through the [NHS Smokefree site](https://www.nhs.uk/smokefree/help-and-advice/local-support-services-helplines#bt4Q3X2d7CKUh5Ml.97). 

Allen Carr’s famous book, The Easy Way to Stop Smoking claims to change the thought processes around the need to smoke. Although there have not been enough formal studies done on this method, there are abundant anecdotal success stories from patients.


__6.__ __Nicotine Replacement Therapy (NRT)__

Nicotine replacement therapy (NRT) bought over-the-counter from the chemist, or prescribed by your regular NHS GP or smoking-cessation service can take the form of gum, tablets, oral strips, lozenges, spray or inhalators. These can be good for immediate cravings as they are short-acting.  
 
Long-acting NRT options such as patches can be helpful for cravings by delivering nicotine to your system over the course of a day. Various strengths are available so you can be gradually weaned down. Patches are removed at night so you can sleep (as nicotine is a stimulant).
 
Treatment with NRT lasts 8 to 12 weeks after which you gradually wean yourself off.
 
Side effects include insomnia, upset tummy, dizziness, headaches, sore skin from patches, sprays irritating nose and throat. Talk to your doctor if these don’t resolve.
 
If you have kidney, liver, cardiovascular problems or are pregnant/breastfeeding discuss NRT with your GP first.


__7.__ __E-cigarettes__

Many have successfully quit real cigarettes using e-cigarettes. However, we don’t have long-term data on their safety.
 
In one study, rates for stopping smoking with e-cigarettes were 83% higher than using traditional NRT.
 
However, they can cause mouth or throat irritation and some investigators suggest long term e-cigarettes may cause other damage and also be addictive. 
 
Be mindful of your use of e-cigarettes and make sure you discuss this with your doctor first.


__Getting medical help__

Do consider speaking to a pharmacist first for advice on over-the-counter medications.

If you’ve tried other methods to give up smoking without success, it may be useful to speak to your GP about the other treatments that are available and whether these are suitable for you. 


__Reviewed By: Dr Rhianna McClymont, Lead GP, Kry__
 





kry.co.uk > Your health >Giving up smoking – what help is available?

Giving up smoking – what help is available?

If you have tried giving up smoking before without success, don’t despair. There are now more options than ever to help


General health

General health and seasonal

## Quick facts

- Obesity has nearly tripled worldwide in the past 2 decades
- Fat around the middle may carry an increased risk of illness
- There are psychological, behavioural and medical treatments available from your doctor

Being far over your ideal weight can bring feelings of helplessness. Your decision to take action is a deeply personal one. When you are ready, help is at hand.

In the UK, more than 60% of adults are deemed overweight or obese. Over the past two decades, obesity has nearly tripled worldwide.

## What do the words ‘overweight’ and ‘obesity’ mean?

The World Health Organization describes being overweight or obese as ‘abnormal or excessive fat accumulation that may impair health’. The term ‘obese’ generally means a much higher amount of body fat than ‘overweight’. We use body mass index (BMI) to distinguish between the two.

The World Health Organization (WHO) classifies the result for adults as:

- __Underweight__ <18.5
- __Healthy weight__ 18.5-24.9
- __Overweight__ 25-29.9
- __Obese__ >30

Be aware, though, that a BMI score might not always mean the equivalent degree of fatness. For example, heavier muscular athletes with minimal body fat might have a high BMI but not carry the same health risks as less muscular people with the equivalent BMI.

## What’s the difference between being overweight and obesity?

Being overweight is a signal that you need to take action. A doctor will assess the risk presented by being overweight as more important if other risk factors are present. These include a larger waist size (see below), high blood pressure and family history of disease as well as lifestyle factors such as poor diet and smoking.

Obesity is associated with an increased risk of disease, which seems most evident when the BMI score is above 35. This is related not only to the amplified physical effects on our breathing and movement of carrying excess fats, but also to the metabolic effects on our body’s function and internal organs. All of these can potentially lead to illness. Some of these effects might also be present if you are overweight, but to a lesser degree - and your doctor will assess this.

## What are some of the benefits of losing weight?

- __Reduced risk of disease__
Whether you’re classified as overweight or obese, losing just 5-10% of your weight could reduce your risk of developing the following: 
- Cardiovascular disease and heart attack
- Type 2 diabetes
- Joint and muscle problems
- Some cancers
- Gallbladder disease
- Sleep disorders, such as sleep apnoea.

- __Improved fertility__
Losing excess body weight increases your chances of being successful if you are trying for a baby. It also reduces your risks of miscarriage . It is important to note that being underweight also negatively affects fertility. The key is to be in a healthy weight range (see above).

- __Reduced risk of disease__
Not everyone’s confidence is impacted by being overweight - but if your weight affects you emotionally, your self-esteem might be low. Losing weight may increase your physical confidence and encourage more activity and socialising.

- __Reduced risk of Covid-19 complications__ 
Mounting evidence suggests that obesity can increase the risk of suffering potentially fatal complications if you contract Covid-19. Losing weight could lower this risk.

## Does it matter where most of my body fat is located?

Excessive tummy fat is an indicator of fat around your internal organs. This is called ‘visceral fat’, and it secretes a protein that increases resistance to insulin – the hormone that your pancreas makes to process glucose – putting you more at risk of long-term health problems such as type 2 diabetes.

Fats around the middle of your tummy also produce inflammatory proteins that can trigger heart disease and cause blood pressure to rise. Fat on our arms and legs do not have this effect.

Sometimes doctors look at waist size in conjunction with BMI when they are assessing a patient’s risk of disease from being overweight or obese.

Waist circumferences larger than 88cm for women and 102cm for men are linked with a higher risk of serious medical conditions. In fact, a large amount of fat around the middle may put you at more risk of heart disease, breast cancer, colorectal cancer and Alzheimer’s disease.

## What causes overweight and obesity?

It’s easy to assume that too many calories in and not enough burned off is the prime reason you’re overweight or obese. But many other – sometimes insidious – factors can contribute which make it more difficult to maintain a healthy weight. These are just some:

- __Easy access to high-calorie foods__
Energy-dense foods and drinks high in fats and sugars are everywhere we turn. Marketing for such foods is aggressive and targets consumers from an early age. Moreover, average portion sizes have increased over the past decade, so you might not even be aware of how much more you’re eating.

- __Low protein content in unhealthy foods__
Healthy protein leads to more satiety after eating, so we feel the need to eat less. Processed and junk foods often contain little of these healthy proteins, so your system doesn’t always register feeling full.

- __Moving less__
This has been exacerbated by coronavirus-related social restrictions worldwide, with more hours spent on laptops, phones and watching TV. 

- __Genetic factors__
People’s metabolisms respond in different ways to diets and lifestyles because genes play a role in our shapes, sizes and weight fluctuations.

- __Binge eating disorder__
Binge eating disorder is the most common eating disorder, and is characterised both by eating an unusually large amount of food over a short duration of time, and feeling a sense of loss of control over one’s eating during this time. Studies have shown that people suffering from Binge Eating disorder are 3-6 times more likely to be obese than the general population. This disorder is often accompanied by feelings of sadness, anxiety or guilt. It can be effectively treated with a course of cognitive behavioural therapy (CBT) to help break this pattern. Talk to your Kry doctor for further advice regarding this...

- __Medicines__
Steroid medications, anticonvulsants, some diabetes medicines, antidepressants and antihistamines are all linked with weight gain. But before you make any changes to your medication, please talk to your doctor.

- __Illnesses__
Certain illnesses can play a part in weight gain, such as polycystic ovary syndrome (PCOS), Cushing’s disease and an underactive thyroid. 

## What works for weight loss?

Slow weight loss is more likely to stay off, research has found. So, aim to lose no more than 1-2lb (0.5-1kg) a week.

Crash diets do not generally work. Initial weight loss is usually fluid and the weight is often regained when you start eating normally again.

These are some simple things you can do today to start your journey:

- __Eat well__ Eat a balanced calorie-controlled diet that is high in nutrients. For more information and ideas on a balanced diet visit [NHS Eat Well](https://www.nhs.uk/live-well/eat-well/). Your GP may also be able to advise. 
- __Move more__ Make time for 2.5-5 hours’ weekly activity such as jogging, aerobics or dancing or low-impact exercise such as walking, swimming, yoga, cycling or Pilates.
- __Get connected__ Slimming groups can be useful to help you get motivated and stay connected to others on the same journey.

## What else can my doctor offer?

If your BMI measurement suggests you’re either overweight or obese, a good starting point is your Kry doctor. He/she is well equipped with psychological, behavioural and even medical solutions to help improve your quality of life, health and wellbeing.

It’s useful to keep a food and exercise diary in the 2 weeks leading up to your appointment, if you can.

Your Kry GP can:
- Listen to your weight concerns.
- Examine your food and exercise diary.
- Explain the benefits of losing weight and the risks of not doing anything.
- Do blood tests to check for medical causes, and check your blood sugar and cholesterol levels.
- Help you set achievable goals, plan for a start date and set review dates to track your progress.
- Discuss the options of speaking to a psychologist if it appears that a condition such as low mood, anxiety or binge eating is affecting your eating patterns (a course of talking therapy such as CBT can help change the way you think about food and eating).
- In some areas of the UK, and depending on your weight and other factors such as whether you have high blood pressure or diabetes, your doctor can also refer you to a weight loss and exercise programme. Check with your doctor if this is something that is available in your area.
- If needed — usually as a last resort ­— they may discuss medication and surgical options with you.

Whatever you do, don’t despair. There is help available to enhance your decision to embark on a healthier lifestyle and we are here to support you along the way.

__Reviewed by 
Dr Rhianna McClymont, Lead GP, Kry__

kry.co.uk > Your health > What is being overweight or obese, and where can you find help? 

What is being overweight or obese, and where can you find help? 

What is being overweight or obese? We can help you understand the terms overweight and obesity, their causes and where to find help.


## Quick facts 

- Prevention is the best policy — but be prepared and carry first aid essentials
- Cooling sprays and gels provide rapid relief from muscle sprains
- Rehydration salts speed recovery

Life doesn’t always go to plan — particularly when young children are part of your life. So, it’s wise to be prepared with a first aid kit of the essentials needed to treat a range of summer injuries and health issues.

You can buy ready-made kits which include the basics, such as plasters, alcohol wipes and an antiseptic cream. But it’s easy to create your own, and tailor it to cover the family’s activities, [allergies](https://www.livi.co.uk/medical-advice/allergies/) and individual needs.

Start with a waterproof, drawstring bag which you can sling over a shoulder or buggy. Then use our list to ensure that you’re the mum, or dad, who is well-prepared this summer.

## 1. Water

You won’t find it in ready-made kits but a bottle of water is often the first thing you’ll need to rinse an injury, wash off an irritant, or provide a distraction from discomfort. It also ensures healthy hydration or rehydration in the event of tummy troubles, sunburn or heat stroke — especially when used with rehydrating salts (see below).

## 2. Sunscreen

Prevention is always the best policy, so use a sunscreen that protects against both UVA (a 3 star-rating or more) and UVB (an SPF of 30 or higher). As a guide, adults need 2 teaspoons to cover the neck, arms and face, or 2 tablespoons when wearing a swimsuit. But as children come in all sizes, the best advice is to apply it liberally and regularly.

Read more about [sun safety for the family.](https://www.livi.co.uk/your-health/how-to-enjoy-the-sun-safely-and-what-to-do-about-sunburn/) 

## 3. Disposable gloves

More of us are carrying them already because of Covid-19 but using thin gloves will also prevent any cross-contamination while treating cuts, abrasions and other injuries. Look for non-latex, powder-free gloves if allergies are an issue.

## 4. Hand sanitiser

Regular use of a hand-sanitising gel or wipes is essential when it isn’t possible to wash your hands. Use hand sanitiser before eating or after touching high-traffic surfaces such as handrails. Be sure to choose products which work against both bacteria and viruses.

## 5. Bandages and plasters

Start with a selection of sterile gauze, stretch bandages and waterproof plasters. You might also want to add transparent film dressings. These act as a second skin and are great for grazes and awkward but accident-prone areas such as knees and elbows. Butterfly bandages, also known as wound-closure strips, are useful for deeper cuts.

## 6. Insect repellent

Repellents which contain 50% DEET are the best for most pests. Make sure you reapply often. 

## 7. Antiseptic liquid and cream
To clean and dress wounds and insect bites.

## 8. Tweezers
Essential for removing splinters that aren’t embedded, and ticks (with these, make sure you latch onto the head and don’t just pull off the body). Read more about prevention and treatment of [tick bites.](https://www.livi.co.uk/your-health/tick-bites-what-you-need-to-know/) 

## 9. Small scissors
You’ll need them to cut bandages. They’re also useful for trimming nails if you stub a toe or tear a fingernail.

## 10. Cooling spray or gel

To reduce pain and inflammation, muscle strains and sprains should be cooled as quickly as possible. You probably won’t have ice or a cold pack to hand, but you can carry a cooling spray or gel. Check the instructions as some are not suitable for young children — in this case, a damp cloth or towel will help. Strap the injury with elasticated bandaging, then elevate and rest it as much as possible for 48 hours.

## 11. Painkillers

Ibuprofen is a versatile painkiller which provides relief from sunburn, bites, injuries and any aches but do not give it to children who suffer from asthma. As it’s also anti-inflammatory, it’s particularly useful for muscle sprains. Paracetamol is not anti-inflammatory but it does reduce fever. Young children are more likely to accept liquids or lozenges. Make sure you don’t exceed the recommended dose. Ibuprofen can be used in babies from 3 months but is not recommended for anyone with asthma. Paracetamol syrups can be used for infants from the age of 2 months and tablets for children aged from 6 years.

## 12. Antihistamines

Oral antihistamines are useful for helping to calm allergies and insect bites, though some of these can cause drowsiness. Topical antihistamines, which are applied to the skin, are not recommended.

## 13. Hydrocortisone cream

Also known as corticosteroid cream, this over-the-counter cream provides rapid relief from insect bites and stings as well as prickly [heat rash](https://www.livi.co.uk/your-health/how-to-prevent-and-and-treat-summer-rashes/). But it is not suitable for children aged under 10, unless on a doctor’s advice.

## 14. Rehydration salts

Usually a combination of sugar and salts, rehydration salts are available in convenient sachets. They help ensure rehydration after vomiting, diarrhoea or heat exhaustion. Do note that with heat stroke or exhaustion it’s also important to cool the patient as quickly as possible.

## 15. Aloe vera

Gels made from aloe vera retain skin moisture, so they are useful to ease the pain and tightness of sunburn. Aloe vera gels can also help relieve dry, itchy skin and promote wound healing. Look for one which is at least 95% aloe vera. Moisturisers with aloe won’t have the same effect.

livi.co.uk > Your health > 15 summer first aid kit essentials

15 summer first aid kit essentials

Whether you’re holidaying somewhere local or have managed to get a flight abroad, stock up on these holiday first aid essentials


kry.co.uk > Your health > 15 summer first aid kit essentials

With so much conflicting advice about weight loss, it’s easy to go down a path that doesn’t work for you. But don’t blame yourself. It is likely that some of the information about weight management you’ve been receiving is inaccurate. 

## Here we take a look at some common weight loss myths:

## 1. ‘All calories are equal’

Calories are definitely not created equal. Say you eat a biscuit that’s 100 calories. This won’t have the same nutritional benefits as a small fillet of rainbow trout with the same calorific value. The biscuit contains ‘empty’ calories that have little nutritional value. The fish will provide you with protein, essential omega-3 fatty acids and other key nutrients, as well as keeping you fuller for longer.  

Nutrient-dense foods, such as fresh fruits, vegetables and lean proteins, are usually high in nutrients and lower in calories. They provide us with the vitamins, minerals and other nutrients that we need for our bodies to function healthily.

It’s much easier to lose weight and control your appetite when you’re eating more nourishing foods. Research shows that nutrient-dense foods such as vegetables, nuts, whole grains and fruit are more beneficial for weight loss than foods high in processed ingredients (such as white flour and sugar), which are associated with weight gain.

 __What you can do__

- Choose foods that are high in nutrients, such as fresh vegetables, fruit, nuts, seeds, beans, lentils, leafy greens, lean meat, fish, poultry and eggs.
- Avoid processed foods and drinks where you can.

## 2. ‘Eating fat makes you fat’

Including healthy fats in your diet stimulates your metabolism and helps fill you up, so you’re more likely to feel satisfied after eating and less likely to be hungry between meals.

Moderately increasing the amount of good fats in your diet and reducing simple carbohydrates (including white pasta and bread) may help with weight loss.

__What you can do__

- Eat more healthy fats, such as oily fish (including sardines, salmon, herring and mackerel), avocados, olive oil, nuts and seeds.
- Avoid sugar and processed carbohydrates.

## 3. ‘It’s all about what you eat’

Sometimes changing your diet isn’t enough. If you’re finding it hard to lose weight, there may be other factors contributing.

Stress, for example, can make it harder to lose weight. If you’re producing too much of the stress hormone cortisol, this triggers an increase in blood sugar and insulin levels and causes more weight to be stored, particularly around the abdomen.

There is also emerging evidence that an imbalance of gut bacteria (dysbiosis) may make it harder to lose weight, as beneficial gut bacteria are involved in healthy metabolism, digestion and appetite control. 

__What you can do__

- Find ways to reduce stress such as meditation or mind-body exercises including Tai chi or yoga.
- If stress is chronic and ongoing seek help from a GP. 
- Include healthy fermented foods such as live yogurt, kefir, sauerkraut and kimchi in your diet. This will help balance your gut bacteria.

 ## 4. ‘Being overweight is your own fault’ 

There’s much more to obesity and being overweight than is commonly thought. So don’t beat yourself up if you have trouble with weight management.

A report by The British Psychological Society states that most people become overweight or obese as a result of a complex combination of biological, psychological and social factors.

The report highlights that people most likely to be an unhealthy weight may have a high genetic risk of developing obesity. High levels of stress, including major life challenges and trauma, can also make some people more susceptible to weight gain. Financial difficulties can also make it hard to access affordable, healthy food.

There may also be medical reasons. For example, hypothyroidism, a condition where not enough thyroid hormone is produced, affecting metabolism and causing the body to slow down. 

Lack of sleep can also play a part. It affects the hunger hormone, ghrelin, that increases appetite, and the satiety hormone, leptin, which makes you feel full. Sleep deprivation can cause ghrelin to rise and leptin to fall, which often leads to over-eating. A UK review of several studies has shown that sleep-deprived people consume on average, an extra 385 calories a day.

__What you can do__

- Talk to your Kry GP, if you’ve been suffering from insomnia or stress for more than two weeks. 

## 5. ‘There’s one single best diet for everyone’

When it comes to weight loss, there’s simply no such thing as one size fits all according to a recent study.

Researchers looked at the responses to meals of 1,100 adults (60 percent of them twins) over two weeks, measuring blood sugar, insulin, fat levels and other markers.

The results revealed a wide variation in blood responses to the same foods, and personal differences in metabolism, gut microbiome, meal timing and exercise.

This is only partly explained by genetic factors. The results suggest a personalised approach to nutrition is likely to provide the best results for weight loss.

__What you can do__

- Forget fad diets and find a weight loss regime that works for you. 
- Get advice on nutrition and weight loss from the NHS ‘[how to diet](https://www.nhs.uk/live-well/healthy-weight/how-to-diet/)’ site. 

__Reviewed by Dr Rhianna McClymont, Lead GP, Kry__

kry.co.uk > Your health > 5 weight loss myths exploded

5 weight loss myths exploded

Some commonly-held beliefs about weight loss are simply not accurate. Know the full picture – and talk to your GP – before deciding on a healthy lifestyle to suit you


## Quick facts:

- A nutrient-rich diet and daily exercise can help give you a steady supply of energy
- If you’ve been feeling constantly tired for more than 4 weeks, talk to your Kry doctor to rule out medical causes

Do be aware however, that if you have felt constantly tired for 2 weeks or more, there might be a medical reason why. [Read our article](/your-health/whats-causing-your-tiredness/) on some of the medical causes of tiredness to find out whether you could benefit from speaking to a doctor about it.

## How your body makes energy

In simple terms, the sugars, fats and proteins in the foods and drinks you consume are turned into energy by your body. It does this using a complex system of converting these substances into ‘fuel’ you can use to power through your life. 

Certain lifestyle factors — for example, stress, environmental pollution or [drinking too much alcohol](/your-health/6-health-benefits-of-drinking-less/) — can damage this delicate energy production process and lead to lack of energy and fatigue.
 
The good news is that a few simple healthy changes can support your body’s energy production processes. 

## 1. Eat a nutrient-rich diet

A healthy, balanced diet low in sugar and processed foods is essential to helping maintain your energy levels. Including healthy proteins and complex carbohydrates at each meal for example, will help keep your blood sugar stable so you have a steady supply of energy throughout your day.

Research shows that certain nutrients in particular are also beneficial for energy production. The most important of these include:

- __B vitamins__  — found in wholegrains, nuts, seeds, fruits, beans, lentils, dark-green leafy vegetables, eggs, meat, fish, milk and cheese.
- __Magnesium__ — good sources include avocados, nuts, seeds, wholegrains, salmon, halibut, mackerel and dark chocolate (more than 70% cocoa).
- __Zinc__ abundant in chicken, tofu, nuts, seeds, oysters, lentils and oats.
- __Glutathione__ — found in Brussels sprouts, broccoli, garlic, chives, tomatoes, cucumber, walnuts and almonds.
- __Carnitine__ — sources include red meat, chicken, milk, fish, beans and avocados.
- __Antioxidants__ — key antioxidants include vitamin A (found in meat, fish, eggs, yellow and orange fruit and vegetables such as squash, pumpkin, sweet potato), vitamin C (found in all fruit and vegetables but especially citrus fruit, kiwi fruit and strawberries) and vitamin E (found in sunflower seeds, almonds, salmon, avocados, Brazil nuts, trout and hazelnuts).

## 2. Take care of your gut health

Making sure your intestine is populated with a healthy balance of gut bacteria is crucial to keeping energy levels topped up. A healthy gut enhances the nutrients you absorb from the food you eat, so they’re more available for your body to use for energy.

To help [keep your gut healthy](/your-health/how-your-gut-bacteria-affects-your-immune-system/), make sure you eat probiotic foods such as kefir, live yoghurt and sauerkraut, which all contain healthy bacteria. 

Also, opt for plenty of fibrous vegetables, also known as ‘prebiotic’ foods. These help feed healthy bacteria and include avocados, leeks, asparagus, bananas, onions, garlic and Jerusalem artichokes.

## 3. Reduce your stress levels

Stress has a detrimental impact on your vitality. A recent review of 23 studies has shown that psychological stress and negative emotional states such as anxiety and depression have an adverse effect on the body’s energy production systems.
 
Your energy levels will benefit if you can reduce stress by taking up relaxation techniques such as meditation, yoga and spending time in nature. These practices work by switching on the body’s parasympathetic nervous system, responsible for its essential ‘rest and recharge’ processes. It’s the reason you always feel better after a yoga class!

## 4. Get enough exercise – especially HIIT training

As we age the energy-generating capacity of our bodies’ cells slowly decreases. But, one way to halt this process is to exercise more. 

A new study shows that exercise, in particular high intensity interval training (HIIT), may enhance the body’s energy levels. In HIIT, you carry out a particular exercise such as running, cycling, walking, rowing or resistance training (for example, push-ups, squats and lunges) as fast and hard as you can for a short period, such as 30-60 seconds. Then you rest for another 30-60 seconds and continue in that pattern for 2-20 minutes.
  
A recent Australian study found that doing HIIT for only 2 minutes a day was as beneficial for your body’s cells as doing 30 minutes of moderate exercise.

## 5. Get enough sleep

Perhaps most of all, 7-8 hours of restful sleep (if you can manage it) will help you feel refreshed every day. There is no lifestyle measure on earth that can make up for the effects of a lack of sleep, we’re afraid. If insomnia is draining your energy, speak to your Kry doctor about options available. 

Remember though, if your tiredness is not relieved by any amount of sleep, there may be a medical cause. So, don’t suffer in silence — talk to your Kry doctor. We can help. 





Call out

kry.co.uk > Your health > 5 ways to increase your energy levels

5 ways to increase your energy levels

A few simple lifestyle measures can help get your body’s complex energy production systems working optimally 

## Quick facts

- Hot, humid weather is a recipe for summertime skin rashes.
- Some garden and forest plants can irritate the skin or increase sensitivity to sunlight.
- Over-the-counter anti-itch creams from the pharmacy can help resolve many summer rashes.

Heat, perspiration and exposed skin are just a few of the causes for itching during summer. But there is plenty you can do to calm symptoms and reduce the risk of these skin irritations.

## Heat rash (also known as prickly heat)

One of the most common summer skin problems is heat rash or prickly heat. This occurs when sweat glands become blocked and perspiration is trapped under the skin. It resembles a series of pinpricks and feels itchy and uncomfortable, and usually, the rash is more prominent after a shower.

Children and babies are particularly prone to heat rash. It most often appears around the armpits, groin and other areas where sweat collects. Heat rash is not contagious.

### How to prevent heat rash

Take a cool bath or shower, or apply a damp cloth or ice pack for up to 20 minutes at a time, to ease itching.

Calamine lotion will help calm symptoms. If it’s severe, a pharmacist may recommend hydrocortisone cream (for children over the age of 10) or oral antihistamines. Avoid using scented shower gels or creams. A GP can help with how to prevent heat rash if over-the-counter options don't work.

## Allergies

Skin allergies such as eczema (atopic dermatitis) may flare up and cause more itching during summer, because of exposure to pollen and in those who suffer from hay fever. Again, areas where sweat accumulates are most likely to be affected.

Eczema is characterised by dry, cracked and itchy skin and is treated with a moisturising emollient. Choose the right one for specific problems:

- Lotion thin and easily spread, this is best for damaged or hairy skin
- Sprays are ideal for skin that is sore, infected, or hard to reach
- Creams are readily absorbed, which makes them good for daytime use
- Ointments are best for very dry, thickened skin and night-time use.

Topical steroid creams can also help eczema. These come in a range of strengths, from mild creams which are available over the counter, to much stronger prescription-strength formulations.

## Problem plants

Stinging nettles are a common cause of rashes and itching during summer. These perennial plants are covered with hollow stinging ‘hairs’, or needles. These inject stinging chemicals into the skin.

You’ll know immediately if you’ve come into contact with stinging nettles as pinpricks of pain are quickly followed by raised white or red bumps on the skin. Wash the affected area to clear any hairs and avoid scratching the rash — it should begin to subside after an hour or two.

Calamine lotion will help ease the irritation. Some people swear by rubbing the rash with a dock leaf — though the science on this is light.

Occasionally nettles can provoke a more extreme allergic response. If you or someone in your family has a history of allergies, ask your doctor or a pharmacist about the correct precautions.

Some plants — including daisies, anemones, clematis, euphorbia and hellebore — contain chemicals which are skin irritants. And others, such as rue, hogweed and parsnip plants contain sap which makes skin extremely sensitive to sunlight.

Wash off the irritant as quickly as possible and apply calamine lotion. Seek advice from a pharmacist in cases of severe rash or discomfort.

Citrus juice can also cause this sort of photosensitivity, so be careful to rinse any spills when you’re out in the sun.

## Swimming rashes and itches

Swimmer’s itch — or cercarial dermatitis — is an itchy rash caused by tiny worms called schistosomes. These parasites are becoming increasingly common in freshwater lakes and ponds throughout Europe and the UK. They’re particularly prominent where there are water birds and mammals. You are more likely to encounter them in warm, shallow water — which makes children particularly susceptible.

The rash resembles reddish pimples or blisters and can appear within minutes, or days, after swimming or paddling in infested water. Areas covered by swimsuits or waders will not be affected, but symptoms tend to worsen after each exposure.

Avoid swimming in areas known to be affected, and minimise the risk by rinsing and drying exposed skin immediately after leaving the water. Use a waterproof sunscreen, as there are reports that this provides some protection from the parasites.

Swimmer’s itch usually clears in a couple of days. But in the meantime, apply cool compresses, soak in a bath of Epsom salt or baking soda, and use an over-the-counter corticosteroid cream if necessary. See your doctor if the rash persists for more than 3 days, or if there is any sign of pus, as this could indicate an infection.

Some blue-green algae release toxins which cause rashes and illness. These have been found in waters as diverse as England’s Lake District to the southern beaches of Sweden. These algae blooms are usually short-lived — but avoid swimming where you see them. The rash is an allergic reaction and severity will depend on the length of exposure and concentration of algae. The treatments for allergies, above, will help ease symptoms.

Heavily chlorinated pools and the hard, chalky water found in the south and east of England, can also cause atopic eczema and contact dermatitis. It’s wise to rinse off after swimming and apply an emollient, especially if you’re prone to these problems. A spray-on emollient provides quick, all-over relief.


livi.co.uk > Your health > How to prevent and treat summer rashes

How to prevent and treat summer rashes

Hot weather, swimming, plants and even animals can cause skin rashes and itching. Our guide will help you to be prepared this summer


kry.co.uk > Your health > How to prevent and treat summer rashes

How to Prevent Heat Rash - Treatment & Symptoms of Rashes in Summer

## Quick facts:

- Tiredness is a natural process; a sign you need rest
- However, if you have felt constantly tired for more than 4 weeks, talk to your doctor as there may be a medical reason

it’s perfectly normal to feel tired. Maybe you’ve had a late night, are sleep-deprived because of family demands, or have been working long hours. The tiredness you feel is a signal that you need to stop, slow down and rest. If you’re overweight, pregnant or on certain medications, you’re also more likely to feel tired. 

Natural tiredness passes. You go to bed, you sleep and you wake up feeling refreshed. But if you’ve been feeling constantly tired for more than 4 weeks and no amount of rest or sleep helps, there might be a medical reason.

Here we outline some common conditions that may be causing your exhaustion. 

## 1.  Iron deficiency anaemia

Does anaemia cause tiredness? it’s one of the most common symptoms, so if you feel tired and lacking in energy, you might be anaemic.

Iron deficiency anaemia is caused by a lack of iron. You need iron to make haemoglobin, a protein in red blood cells that transports oxygen around the body. Typical symptoms include tiredness, shortness of breath, heart palpitations and pale skin.

Less common symptoms include headaches, dizziness, tinnitus, hair loss, painful ulcers in the corners of your mouth, spoon shaped nails and restless legs.

Anaemia may be caused by a diet that’s low in iron, conditions such as stomach ulcers or Crohn’s disease, surgery, or in women it could be due to heavy menstrual bleeding, pregnancy or childbirth.

For vegetarians who eliminate meat, anaemia can be due to an iron deficiency. For vegans, who give up all animal products including dairy, eggs, and even honey, anemia can also be caused by vitamin B12 deficiency.

__How your GP can help__

Speak to your GP. A blood test will confirm whether you’re anaemic. If your red blood cells are small then you’ll be advised to either amend your diet, take over-the-counter supplements or be prescribed iron tablets.

__What can you do__

Eat more foods rich in iron, such as dark-green, leafy vegetables, pulses such as beans and lentils, pumpkin seeds, wholegrains, fish and lean red meat. If you’re vegan or vegetarian, you might need iron supplements. 

## 2.  Nutritional deficiency

Being tired all the time may be a sign of a nutrient deficiency. Here are some of the most common ones that can cause tiredness.

- __Vitamin B12 :__ Essential for the production of red blood cells, a deficiency can lead to vitamin B12 deficiency anaemia – called pernicious anaemia. This is most often caused by an auto-immune disorder that prevents the body absorbing vitamin B12 from the food you eat. But occasionally it may be caused just by a diet that is low in vitamin B12. Foods that contain vitamin B12 include meat, salmon, cod, dairy products and eggs – so those who are vegan or vegetarian, may also need supplements.
Symptoms include extreme fatigue, disturbed vision, pins and needles, muscle weakness, irritability, depression, poor memory and concentration.
A blood test will confirm whether you are low in vitamin B12. Will taking vitamin B12 prevent fatigue? There is evidence to show it helps. Injections or tablets of vitamin B12 are usually used as treatment.

- __Vitamin D3 :__ Studies have shown a strong connection between vitamin D3 deficiency and fatigue. This is especially common in elderly people who don’t get outside as much. Sunlight on your skin is the best source of vitamin D. Foods that contain vitamin D3 include oily fish, mushrooms, egg yolks and fortified foods.

__How your GP can help__

Tell your GP about your symptoms. They may need to organise blood tests to identify the vitamins and minerals you might be low in.

## 3.  Hypothyroidism (underactive thyroid)

If you constantly feel exhausted and also have other symptoms such as weight gain, depression, muscle aches, joint pain, dry skin, brittle nails, thinning hair, loss of libido and irregular or heavy periods (in women), you might have an underactive thyroid. This is when your thyroid is not producing enough thyroid hormones, which causes your whole system to slow down — and makes you tired all the time.

__How your GP can help__

Tell your GP about your symptoms. They may need to organise a  thyroid function test. This looks at levels of thyroid stimulating hormone (TSH) and thyroxine (T4) in the blood. A high level of TSH and a low level of T4 could mean you have an underactive thyroid.

An underactive thyroid is usually treated by taking daily thyroid hormone replacement tablets. Certain foods can help to support your thyroid function, including leafy greens, vegetables, fruit, organic lean meat and fish.

## 4.  Depression

Overwhelming fatigue might be a symptom of depression. A recent study shows that fatigue is one of the most frequently reported physical symptoms of depression, occurring in more than 90% of patients. 

Psychological symptoms of depression might include continuous low mood or sadness, poor concentration, low self-esteem, feeling tearful, irritable, anxious and worried. 

Other symptoms might include moving and speaking more slowly, changes in appetite, unexplained aches and pains and lack of energy.

__How your GP can help__

If you experience symptoms of depression for most of the day, every day for more than 2 weeks then you should talk to your doctor. When you’re depressed it may seem that nothing makes a difference, but it’s vital that you seek help. 

Treatment may involve making lifestyle changes such as eating healthily, exercise, giving up smoking or drinking (nicotine and alcohol can make depression worse).

Your GP may  refer you for talking therapies such as Cognitive Behavioural Therapy (CBT) or prescribe medication to help you recover. It’s important that you do get help. Left untreated, depression can interfere with all aspects of your life.

## 5.  Other causes your GP might investigate

This is by no means an exhaustive list of all the many medical causes of tiredness.

Your doctor will ask you questions about the symptoms accompanying your tiredness and may carry out tests.

These include inflammatory conditions such as coeliac disease, in which your immune system reacts to a protein in gluten. 

Other considerations include sleep disorders such as sleep apnoea, in which you wake on numerous occasions during the night because your breathing stops and starts. This symptom is often related to obesity, so if you suffer from that and/or experience a lot of daytime sleepiness, ask your doctor about sleep apnoea.

Your tiredness could also be down to mental fatigue. it’s worth discussing this with your doctor, as a psychological option such as a course of talking therapy might help you to recover. 

In some cases, unexplained tiredness might be a symptom of something more serious.  That’s why it’s better to talk to your doctor about it, rather than ignore the issue. It’s what we’re here for.

__Reviewed by: Dr Harriet Bradley, Kry Medical Director__ 


kry.co.uk > Your health > What’s causing your tiredness?

What’s causing your tiredness?

It’s not always easy to tell the difference between feeling naturally tired and the type of exhaustion that might have a medical cause. Our guide will help


What's causing your tiredness? Causes, Symptoms & Treatment

What’s causing your tiredness? 

Holidays are a time to relax, switch off and enjoy time with family and friends.
 
We often think about how to give ourselves a physical rest to ‘recharge our batteries’. But most of us  rarely consider how to rest emotionally –  by connecting better with ourselves and our loved ones during our precious time off.
 
Being emotionally healthy means we’re better placed to accept and manage our full range of feelings. Research suggests building emotional resilience also helps sustain our overall health and wellbeing. 
 
Even if you’re not getting away and just having a holiday at home, this is still an opportunity to make your holiday time count emotionally as well as physically.

## 1. Give yourself permission to rest

In today’s hyper-connected world, it can be hard to switch off and relax. Giving yourself permission to stop and unwind is vital.
 
You might find you’re tempted to plan lots of activities into your schedule and pack in everything you don’t usually have time for.
 
But ‘it’s important to allow yourself time to rest,’ says Lina Anderhell, Kry registered psychologist. ‘Recovery should be a part of the holiday, even if that’s hard with children or family. You might have to be pretty strict and plan times when you can let everyone know you need some me-time to rest and recover.’
 
Holidays exist for a reason and Anderhell recommends asking yourself what is important to you and exploring your own emotional needs as a starting point.

## 2. Figure out what you need from this break

Tapping into your emotions and being in tune with how you’re feeling is important in understanding what you need from a break. This can help to ‘guide our behaviours,’ says Anderhell. ‘If we feel drained or exhausted, it’s a signal we need to take time for recovery. If we feel anxious, it’s a prompt that we need to deal with something.’
 
Anderhell notes that how we improve our wellbeing and take time to recover is an individual thing. ‘The common misconception is that recovery has to be a passive thing, lying on the sofa,’ she says.
 
But while getting enough sleep and rest is important, Anderhell suggests there are different kinds of active recovery that can be beneficial for our emotional wellbeing.
 
- Low-intensity workouts such as Pilates
- Walking/hiking
- Being outside in nature
- Doing work in the garden
- Socialising with friends
- Yoga and meditation
 
What you do for work can also be a factor in what you decide to do while on holiday. If you read a lot in your job, you might find that sitting and reading is not what you want to do, but exercise and getting outdoors could work better for you.

## 3. Be present for what you’re doing

[Practising mindfulness](/your-health/why-mindfulness-matters/) is one way to help reduce stress and anxiety. Being more mindful can also help us be more present for friends and family, by increasing our focus on the moment (if you’re unfamiliar with it, the [Headspace App](https://www.headspace.com) is a simple way to learn mindfulness).
 
While on holiday, Anderhell says that simple things we can do include putting away our phone, turning off our computer and making sure we have out-of-office replies to work emails to help us stay more present.
 
‘Actively try to be present when you’re hanging out with friends or family and not be distracted by other feelings or thoughts,’ she says. ‘One thing is to notice when you feel distracted and to shift the focus back to what you want or who you want to focus on,’ she says.

## 4. Set aside time for meaningful bonding with friends and family

Research has found there are five ways to improve our wellbeing: connect, be active, take notice, learn, and give.
 
Connection and social relationships are critical to promote your wellbeing. Spending meaningful time with friends and family while on holiday is a great way to improve your emotional health.
 
Try to create opportunities for having quality time together such as planning meals, cooking and eating together and playing games.


## 5. Make an effort to make memories

Lasting memories are created when we engage our senses. Breaking your routine and sharing experiences is a chance to create good memories and increase your positivity ratio. This refers to the total amount of positive feelings compared to negative that you experience.
 
Here are some ideas:

- __Explore:__ All our senses are triggered when we experience something or somewhere new. You could travel to different places, spend a day out at a special event or historic landmark.

- __Create something together:__ Working together as a team, using your imagination and engaging your senses by making something are great ways to create memories. It might be a new recipe, a scrapbook, or building a snowman or den in the garden.

- __Be active and get outside:__ Relaxation that’s passive doesn’t create memorable occasions. It’s why sitting on the sofa scrolling through our phone is not something we hold as a cherished memory. Cycling, outdoor games, hikes and sport activities are fun, easy to do, budget-friendly and memorable.

- __Learn something new:__ Learning new things isn’t left in the classroom. Doing this with friends and family is a fun way to strengthen connections and gain a sense of accomplishment.


## 6. Use respectful dialogue to deal with conflicts

‘Conflict with families or partners can be common during holiday times,’ notes Anderhell.
 
One way of minimizing conflicts is to talk to the people you are going to spend holiday with beforehand, so that you have the same expectations and that everyone gets to do a little of what they wish for, she advises.
 
However, Anderhell says it’s not always possible or healthy to avoid an argument. This is especially the case if there is a conflict or problem that prevents you from enjoying yourself.
 
In order to deal with conflict in a healthy way, use positive communication and respectful dialogue. Anderhell suggests:

- Plan to have a conversation at a reasonable time for everybody involved.
- Don’t blame and point fingers.
- Use statements such as: ‘I feel…’ or ‘I need…’ that express your needs and emotions.

This helps to defuse heated arguments by expressing things from your perspective, rather than blaming the other person. It opens up the conversation for everybody to share their feelings and come to a resolution.

## 7. Tap into your creativity

When you’re on holiday and your mind is more relaxed it might be easier to get creative, think outside the box and to tackle things in new ways.
 
So, holiday time can be a chance to explore different combinations of ideas and test out different solutions. If you’re facing a particular problem, try keeping a journal or drawing about it, or talking it through on a long walk with a partner or friend – when your mind is relaxed you may find a creative solution that you couldn’t think of in your everyday life, because of the stress you were under.
 
Your downtime could be the perfect opportunity to make plans, set new goals, jot down notes, develop a creative project, and form new ideas. Getting creative on holiday in this way can also help you feel more motivated to get back to work after it.

__This article has been reviewed by Lina Anderhell, Kry registered psychologist.__



kry.co.uk > Your health > How to increase your emotional wellbeing on holiday

How to increase your emotional wellbeing on holiday

From making memories to bonding with friends and family, there are simple ways to get the most emotional health benefits  from  your holidays


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