DR ELLIE CANNON: Is it too late for my pregnant daughter to take folic acid?
My daughter has just discovered she is eight weeks pregnant. We’re delighted but I’m worried as she hasn’t been taking folic acid supplements.
Should she start now or is there no point this far into her pregnancy?
Last week, the Government announced that folic acid, a B-vitamin vital for red blood cells, was to be added to flour. This is something that already happens in the US and Canada.
Earlier this month, experts raised concerns over low uptake of folic-acid supplements in younger women, as health messages about the importance of taking them weren’t reaching the Facebook generation.
My daughter has just discovered she is eight weeks pregnant. We’re delighted but I’m worried as she hasn’t been taking folic acid supplements. Should she start now or is there no point this far into her pregnancy?
Experts have long supported the supplementation of folic acid for pregnant women before 12 weeks of pregnancy. The measure is there to prevent what are known as neural tube defects in babies, including spina bifida, a lifelong disability that can cause weakness in the legs and nerve problems.
The neural tube – the spinal cord and brain – has already developed by day 28 of pregnancy, so starting supplementation after week four of a pregnancy will not prevent these diseases. But it will still contribute to the good health of both mother and baby.
Pregnancy multivitamins usually contain the appropriate quantity of folic acid, and simple folic-acid supplements are available on the high street at the recommended dose of 400 micrograms a day.
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It is also found in leafy vegetables and fortified breakfast cereals.
For the past two years I’ve been getting red bruises on my hands and arms even when I lightly bang myself against something. My GP says I don’t need to be concerned. Is there anything I can do to prevent it? I am 65 years old.
Bill battles cancer… and boredom
Bravo to BBC presenter Bill Turnbull, 62, above, who has prostate cancer and spoke last week about an aspect of treatment that rarely draws attention: how mind-numbingly boring it can be.
Cancer is a physical ‘fight’, but the mental battle to get up and through every day, the loneliness and the lack of a normal routine are just as challenging.
I spent many mornings last year chatting with a friend in a chemo suite. Even as a doctor, it’s hard to know how to help a friend when they are diagnosed but just being there, and listening, is one easy and meaningful way of offering support.
Bruises happen when the small blood vessels near the skin are knocked during an injury – the initial mark is the blood that has leaked out which then changes colour as the body reabsorbs it.
With age, the skin is more fragile, with less cushioning fat, so a smaller injury would result in bruising more easily. This is termed senile purpura and typically affects the arms and hands only. Patients with purpura will often comment that they haven’t even noticed knocking themselves.
Any medication that affects blood clotting would result in more bruising – including medications such as aspirin and anticoagulants, like warfarin, as well as steroids which thin the skin. Over-the-counter supplements can also thin the blood and allow more frequent bruising – ginkgo for example. Easy bruising can be the result of an underlying blood problem, for instance a deficiency or malfunction with the platelets, small cells within the blood responsible for clotting. Problems can arise from blood cancers as well as autoimmune conditions.
Bruising just from a rub or a slight touch warrants further examination, either with a GP or a haematologist, initially with a series of blood tests.
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