The side effect of slimming injections that is common but little known, reveals DR. ELLIE – and why you SHOULD go to the doctor if it bothers you

A few years ago I tripped and hit my shins on a stone staircase. The bruising eventually went away, but since then I have had shooting, burning pain in the front of my shins when I kneel or put pressure on the area. What can I do to end the pain?

A cream called capsaicin, made with chili peppers, can take away nerve pain

Pain that persists long after an injury and is caused by physical contact is often due to nerve damage.

Nerves are fibers that run throughout the body and are responsible for the sensations we feel. If the nerves are damaged, these feelings can go wrong. This can lead to debilitating symptoms such as shooting, burning or pricking pain. It is not uncommon for the area to become hypersensitive, meaning the slightest physical contact can lead to severe pain.

General practitioners can refer patients for a nerve damage test, also called a nerve conduction study. But if the symptoms clearly resemble those of a nerve problem, this is often not necessary.

Doctors prescribe specific medications for nerve pain, because painkillers such as codeine do not work. Normally, doctors can prescribe amitriptyline, gabapentin and duloxetine.

Amitriptyline may be useful for anyone whose nerve pain leads to sleep loss because it improves deep sleep. If the pain is in a localized area, doctors may offer a cream called capsaicin. This is made with chili peppers and can relieve nerve pain.

Unfortunately, none of these treatments are 100 percent effective and many patients find that it may take some time for the pain to subside.

For several weeks now I have been experiencing extreme fatigue and have to take a nap every day. I went to the doctor and had blood tests done, but nothing worrying came up. I started taking Mounjaro four months ago to lose weight, but the fatigue only started two months ago. What could be the cause?

Sudden fatigue is always a reason to consult a doctor as it can sometimes be a sign of life-threatening diseases such as cancer.

A doctor can perform a blood test to look for signs of tumors, but also to rule out other causes, such as anemia – a blood disease that occurs when there are not enough healthy red blood cells.

Another possible cause of fatigue is a thyroid problem.

An underactive thyroid – a butterfly-shaped gland in the neck that produces crucial hormones – can make people tired and cause constipation, hair loss and weight gain. Again, a blood test can detect this problem.

Mounjaro is a weight loss drug that works by suppressing hunger hormones in the body. This means that patients who receive the weekly injection eat significantly less food than they otherwise would. It is very effective; many obese patients lose up to a quarter of their body weight as a result.

However, it has a number of side effects and fatigue – or lethargy as it is also called – is reported to be very common.

Because the drug is given in gradually increasing doses over several months, patients may begin to experience symptoms several months after starting.

However, another concern with these weight loss medications is that patients are not getting enough essential nutrients because they are eating such small amounts of food.

This may mean that some patients are not getting enough iron, B12 or vitamin D.

A deficiency of these nutrients can lead to severe fatigue.

To assess whether Mounjaro is causing side effects, it may be worth returning to a smaller dose to see if the problem subsides.

I was given statins by my GP after a blood test showed my cholesterol was high. However, after just a few months I had to stop taking it because I had a bad reaction. I have heard that plant sterols are a safe and natural alternative to statins. Should I take this instead?

High cholesterol is one of the leading risk factors for heart disease and stroke.

Over time, elevated cholesterol levels allow fatty deposits to build up in the arteries.

This can ultimately block the arteries, leading to life-threatening consequences.

A healthy diet and regular exercise can lower cholesterol levels. But the most effective treatment is statins – daily pills that limit the amount of cholesterol produced.

For most, statins are safe and effective. However, some suffer from side effects such as muscle pain. Plant sterols are a plant-based supplement that has been shown to help fight cholesterol. The nutrient is found in most fruits, vegetables and legumes.

Studies show that eating a diet rich in plant sterols can lower LDL – the bad type of cholesterol – by as much as a tenth. Yet statins can reduce LDL levels by as much as half.

If someone cannot take statins, there are other effective medications that their doctor can offer. It is crucial that anyone who stops taking statins talks to their doctor as soon as possible.

• WRITE TO DR. ELLIE: Do you have a question for Dr. Ellie Cannon? E-mail DrEllie@mailonsunday.co.uk
• Dr. Cannon cannot enter into personal correspondence and her responses must be placed in a general context.

Over 40… did you know you can get a health MOT?

During the appointment, your doctor will check your blood pressure, weight, cholesterol and diabetes risk

Have you had your NHS health check? It turns out that most people don’t show up for their appointment.

Often referred to as the midlife MOT, it is offered to over-40s and can be done up to the age of 74.

During the appointment, your doctor will check your blood pressure, weight, cholesterol and diabetes risk. These measurements can provide a good indication of whether someone is at risk of developing life-threatening conditions such as heart attacks and strokes.

But fewer than half of those invited are turning up, according to new NHS data. I find this amazing because it is so easy to do.

Have you received an invitation for the NHS health check? Were you present? And if not, what was your reasoning? Please write it and let me know.