DR ELLIE CANNON: Are statins to blame for my kidney disease?
Q: I’ve been taking a statin and a blood-pressure pill for several years now. However, at a recent check-up I was informed that I had developed chronic kidney disease, which came as a total shock. I am 80 and have always enjoyed good health. Could my medication have caused this kidney problem?
Dr Ellie replies: Statins and blood pressure medication are crucial drugs to reduce the risk of heart disease – but, in some cases, these pills can cause other problems.
Statins reduce cholesterol, which is one of the fats in the bloodstream that can contribute to deadly heart disease or having a stroke.
Statins are not known to cause chronic kidney disease, however in rare cases the pills can trigger a condition called rhabdomyolysis which can damage the kidneys.
One of the most common types of blood-pressure medicines are angiotensin receptor blockers, or ARBs, and often have an effect on the kidneys.
Statins are not known to cause chronic kidney disease, however in rare cases the pills can trigger a condition called rhabdomyolysis which can damage the kidneys
These ARB medicines relax the blood vessels by blocking the production of certain hormones in the kidney, which helps lower blood pressure. However, this can also limit kidney function, which can sometimes lead to chronic kidney disease, where the organs slowly stop working.
However, it is important to point out that the benefits of taking these drugs almost always outweigh the risks.
High blood pressure is one of the most common causes of chronic kidney disease. This means that not taking ARB drugs is more likely to lead to kidney disease than taking them.
The medicines are even deemed safe enough to be regularly prescribed to patients who already have kidney problems, albeit at a lower dose.
What’s more, chronic kidney disease is an exceedingly common condition, which affects around one in five people over the age of 80.
Whatever the cause, it’s crucial that you find out the severity of your chronic kidney disease.
In the meantime, don’t stop taking your other regular prescriptions unless your doctor says otherwise.
Q: After recently suffering a stroke, I developed severe pain and was prescribed daily morphine. However, it makes me feel like a zombie for hours afterwards. My GP says slow-release morphine tablets are not currently available in the UK – is there anything else I can take instead?
Dr Ellie replies: Unfortunately GPs and pharmacists are spending a lot of time at the moment dealing with medication shortages.
For somebody with chronic pain, the situation is particularly dire. Pain management is a whole speciality of medicine in itself, and it can take months or even years of trying out different regimes and non-pharmaceutical options to help somebody through.
So it is incredibly frustrating and debilitating to find a regime and it not be available here.
Using regular opioid medications may also not be the best option to relieve pain.
A pain management team or pain clinic can look at all the options to help treat someone with chronic pain holistically and safely.
This would involve medication but also psychological therapy and exercise treatments as well.
Consider looking beyond the opioid medications to anti-inflammatories and topical treatments, as well as nerve painkillers. A GP should be able to prescribe one of these alternatives as well as refer you to a pain specialist.
Q: I am a 67-year-old woman and have always had a sluggish bowel system. Last year I was diagnosed with diverticulitis. I’ve started exercising more and eating plenty of fibre, but I still struggle with the symptoms. What should I do?
Dr Ellie replies: Diverticular disease is a bowel condition that causes people to suffer on-and-off pain in the lower part of the abdomen. It happens when little pouches form in the lower parts of the bowels called the colon.
It can cause bloating, constipation, diarrhoea and, most commonly, tummy pain, particularly on the left side. It can also cause mucus or blood in the stool.
Increasing the amount of fibre you consume is one of the most important and effective means of combating this.
It should always be done slowly, to avoid triggering possible bloating and wind.
Adults need about 30 grams of fibre a day, and most of us in the UK don’t eat enough, according to Government figures.
Fibre in breakfast cereals or porridge is a good start, alongside fruit and vegetables with their skins, rye crackers, oatcakes and nuts or seeds.
Alongside this, in order for the fibre to do its job, you need to drink two to three litres of fluid a day to help with the bowel movements. Exercise also helps. Specific laxatives, called bulk-forming laxatives that contain a lot of fibre, are also used, which can help ease the constipation or diarrhoea that many sufferers experience.
A GP can also offer prescriptions for anti-cramping medications, to help with pain.
The charity Guts UK has excellent advice available on diverticular disease, including easy ways to increase fibre in meals. You can find out more by visiting gutscharity.org.uk.
What do you do to keep the grey at bay?
Going grey has always been considered a fact of life – a fate awaiting almost all of us, some sooner than others.
And in all my years as a GP, I’ve never had a patient ask if anything can be done to banish their silver locks. It has always been viewed as an inevitability – even for stars like George Clooney, below with wife Amal.
But while the process is largely dictated by your genes, it turns out there may be things you can do to slow the encroaching grey hairs.
In recent years, research has found simple steps such as tackling stress and wearing a hat in the sun can keep the grey at bay – at least for a while. So have you managed to keep your own hair colour into later life and, if so, what’s your secret? Please write me at the email address below and let me know.
There’s still cover if you’re ill abroad
One of my big travel worries after Britain left the European Union was the prospect of having to fork out for medical treatment if any of the family got ill on holiday.
But I’ve only recently discovered that while the European Health Insurance Card (EHIC) – which entitled all UK citizens to free emergency care anywhere in Europe – was scrapped after Brexit, it has been replaced by something called the UK Global Health Insurance Card (GHIC) which offers almost identical benefits in the EU and some other countries.
If your old EHIC card has yet to expire you can carry on using it until it does, then replace it with a GHIC, which is simple to obtain via the NHS website.
You’ll still need travel insurance, though, because the GHIC card will not cover the cost of medical repatriation – where you are flown home under the care of a doctor – nor non-urgent treatments, such as prescriptions.
Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk
Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.
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