From low white blood cells to HRT worries – Dr Jeff answers your health questions
DR Jeff Foster is The Sun on Sunday’s new resident doctor and is here to help YOU.
43, splits his time between working as a GP in Leamington Spa, Warks, and running his clinic, H3 Health, which is the first of its kind in the UK to look at hormonal issues for both men and women.
See and email at [email protected].
Q) I’M 55 and I recently had a blood test that indicated my white blood cell levels are slightly down. What causes this and is there anything that can be done to boost them?
Richard Bertin Barry, Vale of Glamorgan
A) When it comes to low white cells, it is more a measure of by how much and in what context rather than whether it is low or not.
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Medical causes for a low white cell count include some cancer treatments (such as chemotherapy), some thyroid medicines, leukaemia, HIV, hepatitis, some medicines for mental illness and some autoimmune conditions such as colitis or rheumatoid arthritis.
However, not all causes of low white cell counts are due to an illness.
Nutritional issues include deficiencies in folic acid, and B12, and excess alcohol consumption.
Any mild viral illness can cause a transient drop in white blood cells.
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Your doctor will help you decide if the result is significant or not. In most cases, if the result is borderline, a re-test is enough to see levels normalise.
Q) I WENT through the menopause at 43 I am now 67. I have had depression for a number of years and been on fluoxetine, sertraline and citalopram but they don’t help for long. I asked to try HRT but my doctor said not to, as it’s too late. What do you think?
Rita Barkley Greater Manchester
A) When it comes to depression and antidepressants, there are lots of reasons why they may stop working.
These include changes in work or home environments, alcohol or drug use, pregnancy or other medications that interact.
Some people do just find that the medicines seem to work for a short period and then it is almost as if their bodies have got used to the medication.
In these circumstances, it might be that the medicines have never really had a truly antidepressant effect.
The brief period of improvement might be down to the transient surge in serotonin or even via a placebo effect.
Fluoxetine, sertraline, and citalopram are all from the same family of antidepressants, so another option is to consider a different type of antidepressant.
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There is also good evidence that a combination of talking therapies and medication produces better outcomes for patients than medication alone.
In terms of HRT, you should talk to a menopause specialist to determine what symptoms you have, whether your depression could be improved through HRT and if this would be safe for you.