By Dr Fred Kavalier
Casebook
I’ve been suffering for the past two or three years with severe night sweats. I am a 42-year-old man who is relatively healthy. My GP has sent me for an X-ray (to rule out TB, I think) which did not show anything abnormal. The GP is at a loss to provide me with any advice. This doesn’t happen every night, although it does seem to be increasing in frequency.
There are certain symptoms that ring alarm bells for doctors, and night sweats is one of them. I am reassured by the fact that you seem to be healthy even though you have had these sweats for two or three years. TB is one possible cause, and it’s good to know that your chest X-ray is normal. But not all types of TB show up on a chest X-ray.
Your doctor also needs to think about blood diseases, such as lymphoma or leukaemia, and unusual infections. Hormonal abnormalities, including an overactive thyroid and rare hormone- secreting tumours, also need to be considered. Another common cause of night sweats is too much alcohol. Talk to your GP about having more tests.
CHICKENPOX DURING PREGNANCY
I am 24 weeks pregnant and I’m worried about chickenpox, as my three-year-old son has been exposed to it at his nursery. Is there any chance that the baby will be infected or damaged by chickenpox?
Chickenpox can cause problems to babies in the womb, but these problems are relatively uncommon. The first important question is whether you have had chickenpox yourself. If you have had chickenpox, then there is nothing to worry about, because you will be immune and this immunity will protect the baby in the womb.
If you are not sure whether or not you have had chickenpox, you should have a blood test to see if you are immune. You should know the results within a couple of days. If a pregnant woman who is not immune catches chickenpox during the first 20 weeks of pregnancy, there is a small risk (about two in 100) of the baby having fetal varicella syndrome. This can cause limb deformities, brain damage and damage to the eyes and skin of the baby.
Between 20 and 36 weeks of pregnancy, chickenpox in the mother will not harm the baby. Chickenpox in the last four weeks of pregnancy can infect the baby in the womb, and this can sometimes be severe and even life-threatening.
HYDROGENATED OIL
I am trying to find a calcium/vitamin D3 supplement which does not contain hydrogenated oil. The information is not provided in direction leaflets. My GP suggests asking a pharmacist, but I get no clear answer. Are pharmaceutical companies obliged to declare whether an oil listed in ingredients is hydrogenated? How can I find a suitable product?
Pharmaceutical companies (and food supplement and vitamin manufacturers) use a variety of “non-medicinal ingredients” when they manufacture drugs. There are strict European regulations about what ingredients can be used. Companies are required to include all the ingredients (including the inactive ones) in the labelling of the drug. However, these regulations only apply to medicines.
At least four different oils are used in medicine manufacture: arachis oil (peanut oil), soya oil, castor oil and sesame oil. When soya oil is hydrogenated, the label should say “hydrogenated soya oil”. When unhydrogenated soya oil is used, the label should say “soya oil”.
Unfortunately, there is at least one product (Calcichew-D3) with hydrogenated soya oil that simply says “vegetable fat” on the label. You can look up a list of additional ingredients on the website of the electronic Medicines Compendium (emc.medicines.org.uk). Now I have a question for you: why are you so concerned about swallowing tiny amounts of hydrogenated soya oil?
Readers write
VS, a dentist, gives some information on the lights that dentists use:
You said that dentists use UV light. We most certainly do not! The light we use is of a short wavelength, but absolutely not UV. We shield the rays with amber plastic simply due to the intensity of the light.
Please send your questions and suggestions to A Question of Health, ‘The Independent’, Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182 or e-mail to [email protected]. Dr Kavalier regrets that he is unable to respond personally to questions.
(c) 2008 Independent, The; London (UK). Provided by ProQuest LLC. All rights Reserved.
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