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


Please leave a comment or ask me a question ...

389 thoughts on “Ask Me A Question

  • Walter Vargas

    Hi Dr Sarah,

    I hope this message finds you well. Is possible to pay for your services as health and nutrition advisor?
    Thank you so much for your support. Kind Regards

  • Martin Lindsay

    Dear Sarah. I have enjoyed reading your informative books, newsletters and websites for many years now (Overcoming High Blood Pressure is easily the most authoritative and practical book on treating hypertension I’ve read in the past ten years), but am curious to know which writer, author or commentator, particularly those specialising in heart health (if you had to pick just one) you read yourself for advice. Many thanks.


    Is there any nutritional supplement, that could help me recoverig ,after a bone fracture,caused by falling down?I am 62 with mild osteopenia.I am already taking Ω3,and a multimineral formula for healthy bones

    • DrSarahBrewer Post author

      Hi Makrini, Sorry to hear about your fracture. Bone healing needs calcium, phosphorus, vitamin D, vitamin C, magnesium, zinc and vitamin K and these are combined in many supplements. You may also benefit from collagen supplements which form the ‘scaffold’ on which minerals and laid down, and which is reduced in osteopenia. Magnetic therapy has helped stubborn fractures to heal more quickly, too. AVoid excess salt, sugar, caffeine, alcohol and smoking, as these can all interfere with healing. If you are on medication for osteopenia, check with your doctor before taking supplements. Best wishes, Sarah B

  • Kate

    I have recently started taking a 500mg collagen with vitamin C tablet as, some 12 years after the menopause, my skin has become thin. Do you think this will help? Are there other supplements I should consider. Thanks for your advice

  • Eve K

    I know someone who was found to be “low-normal” in Vitamin B-12 a year ago. He is chronically exhausted and has exhibited extremely strange behavior–a total personality change. I only just connected the dots last week after reading that a B-12 deficiency causes chronic exhaustion and dementia-like symptoms. (No one has been able to diagnose or understand the changes in him, so they’ve gone completely untreated for 1.5 years.) A few questions: (1) To remedy a B-12 deficiency, would one just take whatever dose of B-12 is recommended on the bottle? Or does the dosage need to be adjusted according to each person’s specifics? (2) If the blood test that revealed the deficiency was done in Aug. 2016, is it safe to assume that he’s still just as deficient in B-12? Or could this kind of thing change on its own? Thank you!

    • DrSarahBrewer Post author

      Hi Eve, If levels of vitamin B12 are low normal and still within the normal range this may be an incidental finding. Low levels can be due to poor dietary intakes, but can also be due to an inability to absorb B12. It has a complicated absorption mechanism which involves release of a factor from the stomach which enables its absorption further down the gut. If oral absorption isn’t occurring, then levels could well have fallen over the last year, and oral tablets won’t help. Alternative ways to get B12 are by sucking B12 lozenges or using an oral B12 spray so it is absorbed through the mouth lining, or by intramuscular injection. His doctor should be able to advise which approach is needed, and whether or not pernicious anaemia (due to B12 deficiency)is present. Hope that helps, Sarah B

  • Sarah Mackay

    Hello Dr Brewer
    I have a trapped nerve in my neck. It’s affecting my right shoulder arm and hand. I’ve been to see a consultant under my Vitality Healthcare who said it will heal on its own. That was 2 weeks ago. I’ve had the pain for just over 5 weeks. The excruciating pain went after 2 to 3 weeks and now I have numbness and pins and needles in my fingers (thumb, first finger and middle finger) up to my elbow. I have pain at the bottom of my shoulder blade, and in my arm both above and below the elbow, and my arm aches continually. How can I heal it? The consultant said “don’t do things that aggravate it” and “you don’t need physio becuase you have no restriction of movement”. I’m incredibly right-handed, and not ambidextrous at all, so to not do things that aggravate it would mean not doing just about anything, which is not really an option. Everything I do hurts and my arm and lower shoulder blade hurt all the time, as well as the pins and needles.
    I have put a post on Facebook to see what friends might have done in this situation, and they have recommended, and have had personal success with, chiropractice, acupuncture and physio. Vitality Healthcare doesn’t cover chiropractice unless it is referred by a doctor or consultant, so I will pay as the consultant said it will get better on its own so there is no referral.
    My GP is a very young newly qualified GP and doesn’t agree with private medical insurance so we always end up having a heated discussion as she would rather stick me on strong drugs for weeks on end that make me like a zombie and unable to function rather than refer me and find out what the issue is. I think asking her to refer me to a chiropractor would be fruitless.
    Reading up on Cervical Sponsylosis, it seems to me that it is some form of osteoarthritis, so I wonder if Glucosamine and Chondroitin might help? I followed your advise some years ago and cured my mother of her knee problem where medicine and an operation had failed.
    Or do you suggest a different course of action?
    Many thanks in advance for your help.

    • DrSarahBrewer Post author

      Hi Sarah, Sorry to hear about your problems. An anti-inflammatory supplement such as omega 3 and turmeric may help better than glucosamine and chondroitin. Devil’s claw, a traditional herbal medicine, is another option, but can cause indigestion and doesn’t suit everyone. I’ve had great success with using magnetic therapy for conditions such as cervical spondylosis, and am also trialling a microcurrent device called arc4health which is producing good results. Acupuncture and chiropractic can also help. Different approaches help different people, so it’s not easy to know which you will respond to best. Hope you find a solution quickly. Best wishes, Sarah B

  • John Bowles

    Hi Dr Sarah I follow you on Twitter can I ask what is your opinion about taking Black Cumin Seed Oil for general health. Thanks in advance John

    • DrSarahBrewer Post author

      Hi John, A review of black cumin seed oil found it has significant effects on lowering blood pressure. It is anti-inflammatory, antibacterial, lowers cholesterol and improves glucose control in diabetes. I will write a post on it in the near future! Thanks, Sarah B

  • Sonm

    I feel pain in my breast a few days before my periods n thr is change in pattern of periods too ..i think its hormonal problm ..plz suggest me smthg …wht should i do or not to do….i

    • DrSarahBrewer Post author

      Hi Sonm, Breast tenderness can be related to pre-menstrual syndrome. Keep a diary of symptoms so your doctor can evaluated what’s happening. Cutting down on salt intake to reduce fluid retention can help. Magnesium supplements have been shown to improve premenstrual fluid retention symptoms including breast pain, and bloating. Calcium plus vitamin D supplements have also been shown to reduce fluid retention and pain. At one time, evening primrose oil supplements (3g daily) were prescribed for cyclical breast pain and to improve hormone balance. Each supplement tends to help around two out of three women, but must be taken for at least 3 months to assess the effect. Do see your doctor if symptoms persist. Best wishes, Sarah B
      • Agnus castus can relieve a variety of physical and emotional PMS symptoms including irritability, mood changes, headache and breast fullness.

    • DrSarahBrewer Post author

      Depending on your age, it may just be a question of time as breasts continue to grow until the end of puberty. A number of beauty creams and gels claim to tone up the breasts but there is little evidence to support their use. Food supplements appear from time to time that also claim to increase breast growth and firm breast tissue due to plant hormones that are said to stimulate growth of breast tissue in the same way as pregnancy. These tend to be expensive, and their use is controversial as anything that stimulates breast growth could, theoretically, increase breast cancer risks. There are no magic answers, but breast size can appear larger if you wear a bra properly fitted by a trained assistant in a lingerie store to provide padding, lift and support. Hope that helps, Best wishes, Sarah B

  • Kumar

    I am aged 61.Male. My HB was 10 in December. I took iron supplements up to may 2017. I took iron test immediately after stopping iron supplements. The level was 13.6.I stopped taking iron supplements in the HB level is 12.5.anything wrong

    • DrSarahBrewer Post author

      Hi Kumar, Apologies for taking so long to answer – this was in my Askimet spam box for some reason and I only just spotted your question. it’s generally accepted that analysis error can cause two identical blood samples to show a varying Hb result – this error can be as much as 1g/dl if the machine is not properly calibrated. However, it’s important to have regular tests to ensure this isn’t a downward trend. If so, your doctor will want to know about your diet – are you eating good sources of iron such as red meat, for example, or do you rely mainly on plant forms of iron from which absorption is less efficient (vitamin C source such as orange juice can boost this). Your doctor would also want to investigate possible cause of iron loss (hidden bleeding) and look for reasons why you may not be making red blodo cells properly (eg problems affecting kidneys or bone marrow). If it was not your doctor who measured youyr HB and found it was 10 you must seek medical advice as soon as possible – this is not a condition you should treat on your own with iron supplements. If it was a doctor who found a Hb level of 10 then he or she would have been fairly confident of the cause (eg low dietary intakes) if they prescribed iron supplements without requesting further investigations. Hope that helps, best wishes, Sarah B

  • Sharon O'Dwyer

    Hi Sarah, I’m just wondering what you would recommend for lowering cholesterol – food and supplements? thank you, Sharon

  • healthandbeauty21

    the collagen capsules or collagen drinks? you never summarized which ones ultimately work best on your collagen and wrinkle post? I am genuinely interested to know which ones to go for? I love your page! Keep up the good work 🙂

    • DrSarahBrewer Post author

      Hi Charlene, I would opt for collagen drinks as you can get 7g or more collagen in one drink, compared with 1g or less in a typical capsule. Best wishes, Sarah B

  • Jade

    Dear Dr Sarah,
    I suffered hair loss as a result of anaemia. Through a blood test I discovered that my iron levels were extremely low, haemoglobin level was 98 and my ferritin level was 3. I have been taking ferrous fumerate three times a day for a couple of months and I have now changed to a iron supplement with vitamin C instead. I had a blood test last week which showed that my iron level was 17, haemoglobin 139 and ferritin level 27. Through my own research I understand that to improve my hair my ferritin levels need to be over 60. I am 26 years old, don’t smoke/drink, regularly exercise and I eat healthily. I am a vegetarian, eat plenty of fruit and vegetables, fish, eggs, nuts/seeds and greek yogurt. I have changed my diet by adding in spinach, chickpeas, sweet potato and I have been eating food high in vitamin C. I am aware that iron is best absorbed when it is haem iron but I have never eaten red meat and I believe that my anaemia began when I started drinking green tea three times a day as the tannins affected the iron absorption. My periods are not particularly heavy and I am just wondering what I can do to increase my ferritin levels. It has been about 2 years since I was anaemic and although my hair has improved it is not as thick or long as it was. I have read your information page about iron and found it very interesting, confirming facts that I had learnt. I would greatly appreciate your help as I am open to new suggestions which will be of benefit to me. Thank you, Jade.

    • DrSarahBrewer Post author

      HI Jade, Apologies for taking so long to answer – yoru question was in my spammfilter and I’ve only just spotted it. It will take a while to build up your ferritin levels – it’s difficult to take too high a dose of iron without experiencing side effects. You might find it helpful too take an iron supplement that is plant based, such as Floradix iron formula (available as liquid or tablets) or Spatone liquid iron. A caffeine shampoo for thinning hair can also help. Plantur have versions for women under 40 (Plantur 21) or women over 40 (Plantur 39) which can really make a difference when hormone imbalances are involved. Biotin supplements and those designed for hair, skin and nails are another option. It’s also worth asking your doctor whether or not you coudl have an underlying underactive thryoid, too. Hope that helps. Best wishes, Sarah B

  • Johan L

    Hello. I have untreatable epilepsy,grand .al’s often,use Neurontin 400.gx3 +Lyrica 150×3,but get bad side effects,but insane pain in my upper back,neck,shouldsrs killing me. Adviced to use 1gram Taurin daily,b6,.agnesium,and I do that,also turmeric for pain.MSM sometimes too. I’m almost invalidated now,only 36years old,can’t bear the pain or seizures anymore, have any v good advice?.y dic refuses to send me to a painclinic,or giving me steroids,oxycontin(only thing that kills .aybe 30-40%of it,what to do? I can’t besr it anymore,don’t have the money to get Real treatment like in private clinics. Ty ,Johan,Norway

    • DrSarahBrewer Post author

      Hi Johan, Very sorry to hear about your pain. I don’t understand why your doctor refuses to refer you to a pain clinic, and it sounds as if your relationship with your GP has broken down. Your best approach is to ask them why they feel unable to help you, and if they do not re-assess their stance, to ask for a second opininion. I am not familiar with the health system in Norway, but according to this publication dated 2015, ‘GPs function as gatekeepers, as referral to specialist treatment by a GP is required for coverage’ … but that ‘Patients may change their GP twice a year.’ It may be time to do that. I also found HERE that ‘Norway has enshrined the rights of people to receive evaluation and treatment for chronic pain within law.’ The five categories for complex pain disorders seem to make it clear that anyone with severe and difficult to treat pain conditions should be referred. Do go back to see your doctor again to request referral to a pain clinic or a second opinion. If the relationship is beyond salvage, then change to a more caring doctor (ask friends and relatives for recommendations). I do hope that helps. Best wishes, Sarah B


    Shall we keep the Omega 3 and Vit E supplements inside the refrigerator or not.I often read controversary opinions about this matter.

    • DrSarahBrewer Post author

      Good question – it depends on the product so read manufacturer’s storage instructions. In general, capsules can be stored in a cool, dry place (not necessarily a fridge but you can) while liquid oils shoudl be stored in a fridge after opening. If you get fishy burps after taking fish oil capsules, a good trick is to store them in the freezer – this slows their digestion in the stomach so burps are less likely (and they are still absorbed efficiently in the small intestines). Best wishes, Sarah B

  • Hilary Williams

    Hi Sarah
    I’m 57 and have just started to feel very very mild discomfort in my knees – usually on getting up in the morning. I exercise regularly, have flaxseed or chia seeds every morning but feel I may need now to take another supplement (I also regularly take a probiotic for bloating). I’ve been looking at cod liver oil, turmeric, green lipped mussel or rosehip. Just wondered what you thought (I know this is a similar question to a previous one but the discomfort is just beginning). I

  • Ian

    Afternoon Sarah, I have just read the Do as the Doctor does from Healthspan and in it you say you take your supplements at night, I myself take them in the morning, so does it make any difference when you take them?



    • DrSarahBrewer Post author

      Hi Ian, It’s not vital to take them at any particular time – do what fits your lifestyle best. I tend not to eat breakfast (I know, shhhh!) so taking supplements in the morning is less easy. I keep them in my bedside drawer and taking them with my chamomile tea at night. Many cell repair and regeneration processes occur during sleep when growth hormone is secreted, and there is some evidence that minerals such as calcium are best taken at night. Having said that, it’s better to take them at any time rather than not at all. Hope that helps, Sarah B

  • Lynne Gee

    Hello Sarah, I have osteoarthritis in both knees and as well as the pain I suffer from the muscles tightening and making my legs stiff. All my G.P seems to offer is stronger pain relief ie paracetamol and Codeine as I am intolerant to anti inflammatories.

    I am very interested to try alternative pain relief but don’t know which would be best.
    I have read about the benefits of Krill oil, Rosehip extract, Turmeric etc but would really appreciate some advice and guidance.
    I have in the past taken Glucosamine but found it upset my stomach. Also are these suitable if you take medication fot high B.P

    thank you

    • DrSarahBrewer Post author

      Hello Lynne, If you are intolerant to oral anti-inflammatories, you may do better with a topical treatment such as voltarol gel or a natural alternative such as Penetrex or Dynamint which you can read about here. I’ve covered the best supplements for knee pain here in case you haven’t seen it, too. If glucosamine didn’t suit you, you could try a combination product that includes glucosamine plus collagen, ginger, vitamin C and other actives in a liquid formulation (LQ Liquid Health Joint Care) as soluble forms of glucosamine are usually better tolerated. I am a great fan of Healthspan’s OptiTurmeric and Opti-Omega-3. Each supplement tends to provide a clinically meaningful improvement, on average, for 2 out of 3 people. This improvement is usually seen within 6 to 8 weeks, so it’s a question of trying one and seeing how you go. There are several different classes of medication for high blood pressure but you can enter the name of your medicine and the supplement you are thinking of taking HERE to flag up any known interactions. You can also ask a pharmacist. Hope that helps, Sarah B

  • Jodie Novello

    Hi. I have just read your editorial on Lavender oil (ingested) for anxiety. I understand it needs to be pharmaceutical grade. Where can I get this type of Lavender from? Is there a company producing these capsules that were used in the studies quoted? Thankyou

    • DrSarahBrewer Post author

      Hi Jodie, I’ve updated the links to show the products available on Amazon. The original pharmaceutical lavender oil capsules on whigh the research was performed are found in Kalms, CalmAid and several other capsules now. Thanks, Sarah B

  • Debra Harris

    I have been diagnosed with pyrroles by my naturapath and even without caffeine I feel pretty anxious most of the time. my sleep cycle is right out of whack.And I can not remove the visceral layer of fat off my stomach, I need a simple flow chart to show what supplements, I need to turn this around thanks deb harris

    • DrSarahBrewer Post author

      Hi Debra, This is not a condition that is supported by robust evidence. You may find it helpful to read an article by Dr Bill Sukala HERE. If you still wish to try supplements, those that are most often suggested to treat ‘pyroluria’ or ‘pyrrole disorder’ are B complex vitamins (especially vitamin B6 and vitamin B3), vitamin C, zinc and magnesium. As long as you keep within the upper tolerable levels, you should notice a benefit quite quickly if the diagnosis is correct. I hesitate to suggest what supplements you could take, but in the interests of avoiding overdosing, I suggest a general regime of:
      Vitamin B complex that includes 50mg vitamin B6 and 50mg vitamin B3
      A good A-z multivitamin supplying 15mg zinc
      350mg magnesium (to include any magnesium within the multivitamin – more than 400mg magnesium a day can cause loose bowels in some people)
      1000mg vitamin C.
      Depending on where you live, and the amount of sunshine you receive, a vitamin D supplement (eg 25mcg to 50 mcg per day) might also help.
      At the same time, please do see a medical doctor to exclude any underlying medically accepted conditions that need further investigation and treatment, including thyroid problems. My concern with pyroluria is that the list of supposed symptoms is so long that it overlaps many other health conditions that need prescribed medicines. Do let me know how you get on. Best wishes, Sarah B

  • 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

        Dear Sarah
        I’m back again with further questions. The main reason for this is that my partner was diagnosed with gallstones after being admitted to hospital with hepatitis (caused by a blockage). As the referral to the surgeon was made from an in-patients ward, my partner has never had an appointment with the consultant to explain exactly what the situation is with her single large and other smaller gallstones, she has simply been given a date for the surgery to remove her gallbladder and has been told that she will get to ask the surgeon questions on the morning of the operation.

        As you know from my prior contact with you, i was wondering given how the health of my partner’s digestion is critical, would there be other safe and viable ways to deal with these stones or is removal of the gall bladder the only real long term option?

        I saw this article on a new procedure, what are your views on it and my partners suitability (one 27mm by 13mm stone and other small ones). Forgive the source:

        Thank you very much in advance.
        Best JB

      • DrSarahBrewer Post author

        Hi JB, It’s certainly worth asking your GP if the procedure is available in your area on the NHS, or exploring options for referral to other regions, or for private surgery. The quoted 10% risk of complications, ‘including pancreatitis, bleeding, infection and perforation of the gut’ seems high, while the gallstone clearance rate of ‘more than 80%’ seems low. Best wishes, Sarah B

  • 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.