Q: My friends and I are in our 80s and we’re naturally concerned about memory loss. We see there are supplements that claim to improve memory, but we can’t believe it’s possible. Are they a waste of money?
NW
A: Memory loss and dementia are something we fear even more than cancer these days, surveys suggest, and I know there are lots of people who put their trust in supplements.
Typically, these include the herb ginkgo biloba. There are 40 different flavonoids — a type of antioxidant — in the ginkgo biloba leaf and extracts have been shown variously to increase blood flow through arteries in some areas of the brain, or to alter the way the nerve cells of the brain use sugar as the main fuel.
But, despite more than 400 clinical studies of this herb, none of these effects has been consistently shown to prevent or treat changes in memory function.
So you and your friends are right: there are no supplements — or, indeed, prescribed drugs — that stop mild cognitive impairment, or reverse a decline into dementia in those who are showing signs of mental deterioration, which is enough to make any difference to real life.
The advertising around such supplements is persuasive but spare yourselves the false hopes — and cost — and concentrate instead on taking daily exercise such as any physical complaints may permit.
Be meticulous about keeping your blood pressure within the normal range, and avoid tobacco use and anything more than the most minimal alcohol intake.
There is plenty of advice about activities that are helpful in preventing memory decline — such as learning a language, taking up a musical instrument or taking part in other activities such as playing table tennis or ballroom dancing.
These push the mind-body connection and improve neural pathways — so while they won’t restore lost memory function, they have been shown to help preserve it from further decline.
Q: I have small sores just inside my right nostril, a recurring problem for the past five years. My doctor has prescribed two different creams, Naseptin and Bactroban, neither of which has made any difference. I’d be grateful if you could help me.
CH
A: A sore spot inside one nostril is a common problem, typically caused by a condition called nasal vestibulitis. This is triggered by damage to the delicate lining, caused by blowing too hard or picking, for instance, leading to infection.
Using a potent antibiotic cream, such as the Naseptin and Bactroban you’ve been prescribed, should heal it.
But, as neither has worked in your case, this suggests to me that you don’t have an infection.
Another possible explanation is that it is a basal cell carcinoma (BCC). This is the most common form of skin cancer, making up 80 per cent of skin cancers diagnosed in the UK.
Unlike melanoma, reassuringly, it does not spread distantly. A BCC typically causes ulcerated skin that fails to heal.
Confirming a BCC diagnosis involves having a biopsy under a local anaesthetic. Here, a tiny piece of the ulcerated area is removed and sent to a lab for analysis.
The good news is that there is effective treatment, which will eradicate the lesion and the area should finally heal.
There are several treatment options for BCC — a chemotherapy cream, radiotherapy to the area or surgical removal (as an outpatient, under a local anaesthetic). The specialist will decide which is most appropriate.
I recommend that you talk to your GP about referral to a dermatologist or ear, nose and throat consultant for examination, and a probable biopsy.
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