Ask Me A Question

If you have any nutrition questions, please use the comments box below and I will answer as soon as possible. I can, of course, only give general advice. If you have any persistent symptoms or health problems that worry you, please consult your own doctor.

“Diets, like clothes, should be tailored to you.” Joan Rivers


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52 thoughts on “Ask Me A Question

  • JB

    Dear Dr Brewer
    I am seriously impressed and grateful at your speed of and clearly genuine in your response. I give you my sincerest thanks. I had wondered myself regarding what you say about my partner’s bowel and digestive ecosystem already having been adapted to an incorrectly functioning gallbladder. This makes a great deal of sense to me. It’s also very reassuring to hear from someone as experienced and qualified as yourself that living a healthy, normal life without a gallbladder is a reasonable expectation.

    Once again, thank you so much for your extremely prompt and helpful reply. It is lovely to know that there are people who truly dedicated and genuine in there desire and intentions to help other people, and it is always special come into contact with such people. Thank you. I have only recently found your work, but i will be taking a much closer look, as there is clearly a great deal of very valuable and usable advice and information.

    Wishing you and yours the very best,

  • JB

    I would greatly appreciate a prompt response. I am seriously worried about my partner, who was diagnosed with MS 5 years ago after an attack that affected the vision in her left eye. Her MS is managed through diet and this has worked brilliantly. We focus on avoiding/repairing leaky gut, promoting great digestion and a very healthful diet. However, recently she has had a gallstone attack, which resulted in jaundice, hepatitis and an overnight stay in hospital (all cleared up now). An ultrasound scan has shown that my partner has a large 27mm and a number of small gallstones. Having researched gallstones, it seems a most cause of the stones has been my partner being on the contraceptive pill for many years.

    The hospital has stated offer gallbladder removal as the only way to address her gallstones. I am worried of the effects this will have on her digestion long term and the management of her MS, through an anti-inflammatory diet (packed with key nutrients) and lifestyle. I am struggling to find information for us to to decide the best route forward. Is it possible to remove the cause (i.e. stop taking the Pill) and dissolve such a large stone with medication or ox bile? Is this approach too risky? And is gallbladder removal is the best course of action, is it possible to ensure that the effects upon digestion and inflammation of the intestines (due to dripping bile) be corrected through supplementation, etc? I would very much appreciate any help and advice you can offer.
    Thanks in anticipation

    • DrSarahBrewer Post author

      Hi JB, I have information on diet and gallstones HERE which you may already have seen, and there is a link to the Multiple Sclerosis Diet HERE. In an ideal world it would be possible to remove the stone and retain the gallbladder, but in practice this rarely works well. Stones usually reform because the gallbladder doesn’t contract properly which can occur for a variety of reasons that are not properly understood. Surgery to remove a stone but retain the gallbladder would cause additional swelling and scarring, and the essential oils used to dissolve a stone can irritate the gallbladder lining and lead to inflammation and further stiffening. The end result is that bile is once again retained and concentrated so that salts and cholesterol precipitate out. When the gallbladder is removed, bile trickles into the gut regularly rather than being squirted in when needed. For most people this causes no problems, although a few people do experience diarrhoea (postcholecystectomy syndrome). In fact, because a large stone is present, gallbladder emptying is most likely already dysfunctional and the bowel has already adapted to bile trickling down as-and-when it is produced. Perhaps you can discover how others with MS have fared after gallbladder surgery via the Overcoming Multiple Sclerosis forum at I hope that helps. As I write this I’m looking at my own gallstone in a glass container – it was the size of a quail’s egg and I’m very glad it is now sitting on my shelf! Best wishes, Sarah B

  • Barbara Hately

    I have just developed Rosacea at the age of 65 (already have Psoriasis) and the cream prescribed by my doctor isn’t holding it. I am currently on a course of antibiotics to try to knock it out in the hope that the cream will then be sufficient but am reluctant to go down the route of permanent antibiotics. Any suggestions for more natural remedies or changes in diet that might help?

    Many thanks in advance for any advice you are able to give.


    • DrSarahBrewer Post author

      Hi Barbara, Here is some of the general advice I included in my book Eat Well Stay Well: Some people find it helpful to follow an alkaline diet that avoids acid-forming foods. Although some fruits such as oranges, lemons, limes and tomatoes are acid to taste, the way they are processed in your body uses up acid so that fruit, vegetables and salads are the main alkaline-forming foods in the diet and following a plant-based diet is key. For sweetness, use Stevia, honey, maple syrup or agave syrup instead of sugar, and drink plenty of water. Following an alkaline diet means cutting out some grains (barley, oats, quinoa, rice, wheat), dairy products (cheese, milk, ice-cream, yoghurt), animal proteins (eggs, poultry, meats, seafood), beer and wine. However, these foods are important sources of protein, vitamins and minerals so it is best to follow a strict alkaline diet under the supervision of a medical nutritionist. If it doesn’t show benefits within a month, then switch back to your usual way of eating to avoid long-term deficiencies. If you decide to follow it long-term, then ensure you take a good vitamin and mineral supplement. Avoid alcohol, spicy foods, coffee, tea, sodas, foods with preservatives, colourings, artificial sweeteners and other additives. Use a non-greasy high protection sun cream (SPF 15 or higher) or apply a product that reflects and blocks out ultra-violet rays with titanium dioxide or zinc oxide. Applying Aloe vera gel twice a day can reduce inflammation. Skin redness and visible small capillaries can be treated with creams containing vitamin K, or with pulsed intermittent light or laser therapy. I hope that helps. Best wishes, Sarah B

    • DrSarahBrewer Post author

      An excellent question, which I referred to the scientists who developed Fruitflow. Their response was: “Pycnogenol,a maritime pine bark extract, contains two major types of compound – phenolic acids and procyanidins. The procyanidins in particular are certainly likely to enhance the overall benefits of Fruitflow, because they have been shown to affect endothelial function. So I would say that combining the two would be a good strategy, not only for enhancing the antiplatelet effect but also for overall cardiovascular health.’ Best wishes, Sarah B

  • A Hazel Waterson

    Dear Sarah,

    I suffer from both ME & fibromyalgia and, lately, after 3 years of unrelenting stress, I have hit a lengthy period of profound exhaustion and have shown no signs of picking.

    Recent blood tests show my iron level to be 18. It has gradually decreased, from 26, over the last couple of years. Whilst my iron level is not deficient my GP feels I could benefit from an iron supplement to see if this helps, at all, with the extreme fatigue, although we do realize it is very much a part of the ME/fibro.

    As of 2 days ago, I was prescribed ferrous fumarate 210mg (approximately 69mg of elemental iron), 1 tablet tds. However, already I am experiencing constipation. I have always used supplements from Healthspan and I’m aware that the iron tablets they produce have a coating to help prevent this. I was wondering if it is ethically correct to ask if you could advise what an equivalent dose of the Healthspan product would be?

    Many thanks.

    Hazel W

    • DrSarahBrewer Post author

      Hi Hazel, was the test for ferritin levels? Normal for women is a wide range form 12 to 150ng/ml so at 18, you certainly have room for improvement. Do you know why your iron levels are on the low side? This can be due to diet (eg not eating much meat), known blood loss (eg heavy periods) or hidden blood loss (eg from a peptic ulcer). I’m assuming that all the usual tests (thyroid function, vit B12/folate, vit D etc) are OK. You can find food sources of iron here, if needed. HS Ironcare only provides 14mg iron per tablet with a recommended dose of 1 a day. One brand that is less constipating is Vitron-C, which is widely prescribed in the US, and provides 65mg elemental iron per tablet as ferronyl iron. This is a carbonyl iron powder which has a higher iron level than ferrous salts and is significantly more bioavailable. For constipation ensure that you have good intakes of magnesium and drink 2 to 3 litres water per day (plus fruit and veg for fibre) and a good probiotic supplement. Magnesium and co-enzyme Q10 supplements are often helpful for boosting cell energy production in ME and fibromyalgia. I also recommend the amazing Squatty Potty – a simple device that lifts your feet so you can bear down on the toilet a lot more naturally and easily.
      Hope that helps. I’ve just written a post on constipation here, and will also prepare a page on fibromyalgia.

  • Elizabeth Knight

    Dear Sarah,
    Had an endoscopy December, which showed up 2 x 1mm erosions in antrum and put on omeprazole for 8 weeks to heal them. Still have some burning in stomach on and off but very little heartburn and taking Gaviscon Advance now. Will Echinacea tablets, garlic pills or DGL liquorice help and if so, can they be taken along with Gaviscon. I have some Echinacea drops but they are in ethanol and have been avoiding alcohol as advised its a no no with gastric probs. My aim is to completely recover with my diet rather than be dependent on ppis.

    Thank you for your help and advice Sarah.
    Kind regards

    • DrSarahBrewer Post author

      Hi Elizabeth, I’ve checked the Natural Medicines interaction database, which advises caution in combining omeprazole with Echinacea and with garlic and with DGL licorice, as these supplements may, theoretically, reduce metabolism of the medication so blood levels rise to cause side effects. The risk of interactions is not definite but is rated as moderate. Once you have stopped the omeprazole, your doctor may support you in trying natural approaches. Manuka honey is traditionally used for its antibiotic action to help suppress the bacteria (Helicobacter pylori) that can cause stomach ulceration. Probiotics are traditionally used to help suppress H. pylori, too, and no known interactions are cited with omeprazole. Another option is Aloe vera, but not until omeprazole is stopped as this also has a moderate risk of interaction. I will add posts on Manuka honey and Probiotics soon. Best wishes, Sarah B

  • Richard Thornley

    Hi I am a diabetic and have a BMi-34 I recently read that if I could increase my bacteriotes in my gut this may help me loose weight My question is once I have detoxes should I use butyrate or L glutamine and berberine to increase the no of bacteriotes Thankyou for your help

    • DrSarahBrewer Post author

      Hi Richard,There are no simple answers to weight loss. The most effective method for most people with diabetes is to follow a lower carb/GI diet and to concentrate on eating healthy monounsaturated and omega-3 fats. If you are on medication, this will need reviewing by your doctor before you drastically change your diet, and your blood glucose and medication doses monitored closely to ensure you maintain good control without having a hypo. If you have type 2 diabetes, this can be reversed by cutting back on carbs and losing weight in an approach pioneered by the Obsidian Retreat. A probiotic supplement providing at least 5 strains of bacteria in doses of at least 2 billion, taken daily, will help to improve the balance of bacteria in the gut which will themselves produce butyrate. While l-glutamate can aid weight loss and glucose control, diet shoudl ieally always come first. Hope that helps. Best wishes, Sarah B

  • Christine Messenger

    Putting away the vacuum cleaner, I felt my back twinge, next day I could hardly get out of bed. The doctor prescribed Naproxen 500 gm, I have taken them for a week but have now left them off, as there was no improvement. Reading your article on Gopo joint health, would that help, when I cough or sneeze it rips my back apart, & in the morning I can hardly get out of bed or even to turn over is horrendous.
    I look forward to your advice,
    Kind regards
    Christine. I am 78 yrs old, 7stone 7 lbs….

    • DrSarahBrewer Post author

      Hi Christine, It sounds as if you need an x-ray to see if you have an osteoporotic fracture of a vertebral bone in your back. Do let your doctor know that things are not getting better – if you are in this much pain your doctor will want to know. Best wishes, Sarah B

  • KW

    I am interested in the claims made for cutting out soya and increasing polyphenols (specifically berries) in the diet as per Dr Gundry. I have struggled with exhaustion for years, and increasingly, dry skin/eczema and flatulence despite a gluten-free diet (diagnosed 25 years ago). I upped my soya intake for peri-menopause reasons about a year ago – perhaps this wasn’t a good idea? (I’m 45, have a physical part-time job, a BMI of around 22 but need 12-15 hours of sleep a day. Is it worth me experimenting with expensive polyphenol supplements or will adding a handful of berries to my daily porridge make any difference?

    • DrSarahBrewer Post author

      Hi Kay, Tiredness all the time can have numerous underlying causes, and it’s important to have a full medical check-up from your doctor to exclude anaemia, thyroid orother organ imbalances, irregular heart beat or autoimmune conditions. Lack of some nutrients such as iron, magnesium, B vitamins and CoQ10 are sometimes a factor – if you don’t take supplements you may find it helpful to take a good multivitamin and a CoQ10 supplement. Polyphenols are found in fruit and veg – especially berries as you say – but you would need to eat a lot more than the usual 5-a-day servings to gain significant benefit for fatigue. One polyphenol-rich supplement that is gaining a lot of attendion in sports for improving sleep quality, exercise performance and reducing fatigue is cherry juice extracts. Do let me know how you get on. Best wishes, Sarah B

  • Jane Bryant

    I have a diet that is very high in vegetables not through any daft diets I just find that this is good for me and my digestion.
    I have 2 meals a day both of which are huge because of the salad I eat, (Lettuce, Cucumber, Tomato, Peppers, Carrot, Swede, Celery Cauliflower) + Grilled Chicken.
    Obviously I do vary the ingredients the above is a general list.
    My question is I apear to have a high intake of Vit A and B3 but low in D, E and B12 also low in Omega-3 and Omega-6
    is this a problem and if it is what should I do about it?

    • DrSarahBrewer Post author

      Hi Jane, it sounds as if you have a very healthy diet! The form of vitamin A found in fruit and veg is in the form of carotenoid pigments – if you eat too many of these your skin can turn an interesting shade of orange. This is not harmful. If you know you are low in vitamin D , B3, B12 and vitamin E then it’s a good idea to eat more foods containing these (see links) or to consider a supplement. Vitamin D deficiency in particular is common during winter months. MOst people woudl benefit from obtaining more omega-3 and less omega-6 to improve the ratio between these. Excess omega-6 can promote inflammation which omega-3s help to suppress (and also provide heart benefits). If you could eat more oily fish (eg salmon, mackerel, fresh tuna, herring, sardines) that would help to redress the balance. Otherwise an omega-3 fish oil supplement is a good option. Best wishes, Sarah B

  • Laura

    Dear Sarah,
    I recently read that you may have written an article on Rosacea, I would be very interested to hear any advice and information you might be able to offer on this condition, before finally being diagnosed with this I have experienced severe flare ups on my skin (facial) and this also adversly affects my eyes over the past 2.5 years, I am a woman of 35 years of age, am very active and eat a healthy , well balanced diet. I often have to resort to back to back courses of antiobiotics (oral) and various eye drops and ointments, which seem to control this for a while, but again it flares up and I feel I am never going to be able to manage it well and dislike having to continually take antiobiotics and would much rather if there was a more natural approach I could adopt which may control the symptoms.
    I recently read some articles on possible links between Rosacea and gut health, suggesting links between inflammation and healthy/unhealthy bacteria in the gut which can be the cause or contribute to such conditions, I know there are many supplements you can take to support a healthy digestive system, but would like to ask if you have any advice to offer on possible supplements, those suggested are Burdock, Probiotics, Curcumin and Tumeric or dietary requirements which might help to manage this condition better going forward.

    I would be grateful for any advice you might be able to offer.

    With Thanks

    • DrSarahBrewer Post author

      Hi Laura, Here’s some information from my book Eat Well Stay Well. Rosacea can respond to following an alkaline diet that avoids acid-forming foods. Fruit, vegetables and salads are the main alkaline-forming foods in the diet. Following an alkaline diet also means cutting out some grains (barley, oats, quinoa, rice, wheat), dairy products (cheese, milk, ice-cream, yoghurt), animal proteins (eggs, poultry, meats, seafood), beer and wine. However, these foods are important sources of protein, vitamins and minerals so it is best to follow a strict alkaline diet under the supervision of a nutritionist. Avoid spicy foods, coffee, tea, sodas, foods with preservatives, colourings, artificial sweeteners and other additives. For sweetness, use Stevia, honey, maple syrup or agave syrup instead of sugar. Drink plenty of water. Your doctor can advise if topical antibiotics might help – if continuing with oral antibiotics, then a probiotic supplement will help to avoid intestinal side effects. Turmeric has anti-inflammatory actions that can benefit both bowel and skin Use a non-greasy high protection sun cream (SPF 15 or higher) or apply a product that reflects and blocks out ultra-violet rays with titanium dioxide or zinc oxide. Applying Aloe vera gel twice a day can reduce inflammation. Skin redness and visible small capillaries can be treated with creams containing vitamin K, or with pulsed intermittent light or laser therapy. I will write a post on this as soon as I can on my other blog Best wishes, Sarah B

    • DrSarahBrewer Post author

      Hi Agnes, If your doctor supports you stopping statin medication, then Plant Sterols have an authorised health claim relating to lowering cholesterol levels. If you are experiencing statin side effects, then taking vitamin D and co-enzyme Q10 supplements may reduce these so you can continue on your medication.Hope that helps.

  • LT

    I read your 2002 article in Telegraph about replacing Aspirin with Pycnogenal. But I note also from your website that Fruitflow is recommended. How to compare the 2? What is the dosage for replacing a baby aspirin? Any difference whether it’s for primary or secondary prevention? Your help and advice much appreciated.

    • DrSarahBrewer Post author

      The latest research (published in November 2016) shows that a single dose of Fruitflow (150mg) results in a similar antiplatelet effect to a single dose of 75mg mini-aspirin.
      As it has an authorised EFSA health claim and has no side effects, I usually prefer Fruitflow to pycnogenol for general health. Having said that, pycnogenol has been shown to reduce platelet aggregation in smokers so for anyone who can’t quit smoking, that may be the better option. I an only give general information. If you have any medical condition or are on any prescribed medication it is important to consult your doctor for individual advice and to check for potential interactions. If someone is already on aspirin, they should only stop this, or switch to fruitflow, on the advice of their own doctor.

    • DrSarahBrewer Post author

      Hi Patricia, Herbal medicines classed as ‘adaptogens’ are traditionally used to support adrenal function. These include ashwadanha, rhodiola, ginseng, maca and siberian ginseng. The stress response depletes levels of vitamin C and key B vitamins such as B5, B6 and B12, as well as magnesium so a multivitamin is also a good idea. Other supplements to consider include turmeric, which has a natural corticosteroid action, co-enzyme Q10 which may improve adrenal cell function, omega-3 and probiotics which have a general immune boosting effect. Thanks for asking the question – it is an important subject and I will aim to include a page on how to eat to beat adrenal fatigue soon.

      • Patricia Key

        Many thanks for your reply. I look forward to reading your page on eating to beat adrenal fatigue.

  • Frances Turner

    Hello, my right femur is very thin and fragile as a result of multiple fractures sustained in a motor accident. I’ve recently had surgery again and the bone is not healing. My consultant has recommended a balanced diet and no alcohol. I’m currently taking adcal3 and have a reasonable diet. Could you recommend any foodstuffs or supplements that may be beneficial to my healing. I’m 75 years old and as active as I can be in my condition ie gardening and walking a lot with the aid of crutches. Thank you.

  • Frances Lewis

    Hello I read your article on hair thinning over the last 6 years i have been losing a lot of hair and have bold patches at the back of my head. I take thyroxine and i think it is thining my hair. I have a blood test every year and i am on the right dosage 75mgs. Also I take Symbicort inhaler only a few puffs a week, my asthma is under control. I am 67 years of age and I eat lots of fruit a vegetable. I hope you can give me good advice. Thank you for your patience. Frances

  • fungoful

    my 83 year old mother, has had 4 gallstone attacked in 4 months, with previously no problems. What triggers and attacked and what can she take other than pain killers when it happens

    • DrSarahBrewer Post author

      Having experienced this myself I know how unpleasant it is. Eating fat/oils can trigger gallbladder contraction and push a stone into the mouth of the highly sensitive duct leading from the gallbladder. However, following a low fat diet isn’t necessarily the answer as this causes the gallbladder to remain quiescent and can allow bile to ‘sludge’ and more stones to form. Vitamin C can help by reducing cholesterol in bile. I have written about reducing gallstones here An op to remove the gallbladder is fairly routine these days, and their is an oral treatment (Rowatinex) to dissolve stones – although they will often reform, it could help avoid an op. These are covered in my book Overcoming Gallstones which is linked to from the gallstone page if you need more info. Hope this helps.

    • DrSarahBrewer Post author

      Hi Helen, Evidence-based guidelines from the American Academy of Neurology recommend that ginkgo bioloba should be considered as treatment for tardive syndromes. If the person involved is on prescribed medication, however, check with a pharmacist in case of interactions. Other ‘natural’ approaches for which there is some anecdotal evidence include taking vitamin B1 or vitamin B6 but there is no definite evidence of benefit. You can find the full paper relating to these guidelines here. Hope that helps.

  • Anne-Marie Miraglia

    I read an article where you mentioned magnetic patches to improve blood flow. Where can these be obtained from?

    Many thanks

  • Roger Hill

    Bookmarked! Your site has already answered several questions I had about glucosamine and diabetes. I haven’t had the “loo” problem with magnesium, but now I know not to overdo it. So much good information. Both my wife and I find your website both interesting and helpful, Looking forward to digging into your archives.

  • Ilyssa

    This is really great information. Thank you for sharing. I love the idea of food as medicine. Unfortunately it is hard to find doctors that subscribe to that. When I ask about possible dietary options for a health issue I have I am told “take your meds” and expected that that is that. Ugh. It certainly can’t hurt to make better nutritional choices!

    • DrSarahBrewer Post author

      Hi Ilyssa, Nutrition contributes to just about every health situation – with the possible exception of ingrowing toenails. Lack of vitamins and minerals is one of the most common reasons for feeling tired, poor immunity, dry skin, hormone imbalances – health niggles that medicine can do little for if dietary deficiencies are not corrected.

  • Paula

    Hi there, I love this really informative site and how you organise it into specific medical queries.
    My husband has psoriasis which is quite difficult to treat as it is on the palms of his hands and on his shins.
    As he is a builder you can imagine it does get very sore and painful especially if he is working with water such as working with mixing concrete etc.
    Do you recommend any herbal remedy to cleanse from the inside to lessen his symptoms?
    Thanks in advance.

    • DrSarahBrewer Post author

      Psoriasis has been linked with abnormalities in essential fatty acid metabolism and those found in omega-3 fish oils (EPA and DHA) may help to improve itching, scaling and redness. Dead Sea mineral salts/mud can also help – German patients are even prescribed trips to the Dead Sea for treatment. Mahonia ointment (made from the Oregon grape extract) and Zambesia Botanica – a cream made from the African Kigelia tree – can also improve lesions. Some practitioners advise milk thistle and globe artichoke extracts to improve liver function, which may improve the rate at which new skin cells are produced, although there is little research into this. Cutting back on processed foods and reducing intakes of red meat, dairy, cheese, eggs and refined sugars have helped some people, but if following a restricted diet long-term it’s important to take a multivitamin and mineral supplement, and to seek nutritional advice to avoid deficiencies.