DR ELLIE: This is how you get an Ozempic from your GP

September 21, 2024

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DR ELLIE: This is how you get an Ozempic from your GP

I am 68, overweight and my blood pressure is alarmingly high. Since menopause I have been exhausted all the time. I have read so much about the benefits of Ozempic and am wondering if it would work for me. Should I ask my doctor for a prescription?

Ozempic – or semaglutide – is a diabetes drug that leads to weight loss. This is because the injection suppresses the appetite, causing patients to eat less.

The manufacturer has started selling it specifically as an anti-obesity drug, under the brand name Wegovy. This year, the NHS announced that it would offer Wegovy to some obese patients.

In theory, patients can get a prescription from the NHS if their BMI is over 35 and they have a condition related to their weight, such as diabetes or high blood pressure.

But supplies of the drug are limited, largely due to the huge global demand, meaning few patients have been able to get it.

Furthermore, it must be prescribed by a weight management specialist, not a GP. This means that patients must also wait for a referral, which can take some time.

Ozempic – or semaglutide – is a diabetes drug that causes weight loss by suppressing appetite, meaning patients eat less

This is frustrating because many Britons could benefit from semaglutide, but – due to the vanity of wealthy people who want to be a little thinner – those less well off are forced to wait.

It is important to realize that semaglutide is not a miracle cure, despite the claims. People generally lose about 20 percent of their weight – significant in terms of health, but it may not bring about a huge cosmetic change.

NHS patients prescribed this drug must still eat healthily and exercise regularly.

Unpleasant side effects include nausea and vomiting, which often disappear within a few weeks or months. However, some find these side effects too debilitating to continue with the injections.

Either way, it is of great importance to combat obesity and it is true that semaglutide is a ‘game changer’ for many.

If you think you might benefit from it, it is best to contact your GP. He or she can explain your options and, if necessary, refer you to a weight management specialist who can prescribe the medication.

I recently had a brain scan that showed white spots. I asked my GP what this meant and he said it was ‘just wear and tear’. I am still worried. Should I change my lifestyle to stop it getting worse? I am 68 years old.

Wear and tear is a useless term. White spots often indicate what we call white matter lesions. These abnormalities have always been considered a sign of aging of blood vessels in the brain.

This is similar to limescale in the arteries and heart disease.

White spots on brain scans often indicate white matter abnormalities, which have always been considered a sign of aging of the blood vessels

Blood vessels in the brain can atrophy in a similar way. This is considered a risk factor for stroke, mini-stroke and vascular dementia.

It would not be unusual to see this change in someone with high blood pressure, for example, and it may not cause any symptoms. As people age, the number of these spots increases.

Some experts consider white spots to be a normal part of aging—wear and tear, yes—but if there are quite a few, it shouldn’t be considered benign. If they’re seen on a brain scan but downplayed, I’d assume there aren’t many and the spots aren’t a big deal. But it’s still worth looking into.

The end of life can be ‘beautiful’

I was struck last week by an interview with former M&S director Robert Swannell, about the loss of his wife Patricia to breast cancer at the age of 71.

Remarkably, he described the end of her life – which had been meticulously planned – as “beautiful”. When the couple learned in 2021 that Patricia’s cancer was terminal, they took it in stride, organising important activities such as recording her last conversations with her children.

The way we end our lives is always very personal and it is not always easy to talk about.

But we avoid these conversations and plans to our own detriment – I hear so often from survivors who regret not having said or done this when they ‘had the chance’. GPs are now involved in helping people prepare for the end of life – we call it advanced care planning. We ask people what they want when the time comes. It is so important to be open about your wishes, although it can be difficult.

Have you made a plan for your death? Please write to me and let me know.

It is important to maintain a normal weight, exercise and not smoke or drink alcohol to reduce and prevent white spots.

Background conditions such as high blood pressure, diabetes and high cholesterol must be treated rigorously to prevent further damage to the blood vessels.

When I eat, my nose runs and I have to sneeze for five minutes. This is humiliating. What happens?

This could be oral allergy syndrome, also known as pollen food syndrome. It occurs in hay fever sufferers when the body mistakenly recognizes certain fruits and vegetables, usually eaten raw, as the same as pollen due to their similar chemical structure.

The most common food triggers are apples, peaches, kiwis, hazelnuts, and almonds, but almost any fruit, vegetable, or nut can cause a reaction. People can even react to spices.

It can be very difficult to identify the triggers, but a food diary can help. This can rule out things that aren’t.

It may be worth trying an over-the-counter antihistamine tablet to see if it clears up the problem. If it does, it is safe for most people to take the tablets regularly to control an allergy.

A runny nose and sneezing after eating can also indicate non-allergic rhinitis, where the nose usually runs after eating spicy or hot foods.

We believe this is caused by an abnormal nerve reflex and, unlike pollen-food syndrome, is not an allergy.

If antihistamines don’t help, this could be the problem. An ENT specialist should be consulted to consider special nasal sprays to help reduce your symptoms.

A man who suffers from a ‘woman problem’…

A male patient came to me with discomfort and redness in, to put it bluntly, his penis. The first concern would be an infection, but after running numerous tests, all negative, I referred him to a dermatologist.

He was diagnosed with lichen sclerosus, a condition that causes itching, pain and swelling in the genitals. It ruins the lives of thousands of women and usually occurs after menopause. But men can get it too, although much less often. How many men are misdiagnosed or do not know what to do because of the lack of awareness?

Many other conditions that are usually associated with women can also affect men, including osteoporosis, urinary tract infections, and even breast cancer. I would like to know if you are a man who has been diagnosed with a “woman’s problem.” Write to me at the address below.

September 21, 2024

0 4 5 minutes read