DR ELLIE: Here's how to get an Ozempic from your GP

I am 68, overweight and my blood pressure is alarmingly high. Since the menopause, I’ve been constantly exhausted. I’ve read so much about the benefits of Ozempic, and wonder if it might work for me. Should I ask my GP for a prescription?

Ozempic – or semaglutide – is a diabetes drug which leads to weight loss. This is because the injection suppresses the appetite, meaning patients eat less.

The manufacturer has begun selling it specifically as an anti-obesity drug, under the brand name Wegovy. This year, the NHS announced it would offer Wegovy to some obese patients.

Theoretically, patients can get an NHS prescription if their BMI is over 35 and have a weight-related disease, such as diabetes or high blood pressure.

But the drug’s supply is limited – mainly due to huge worldwide demand – so few patients have been able to get it.

Also, it must be prescribed by a weight-management specialist – not a GP – meaning patients must also wait for a referral, which can take some time.

Ozempic – or semaglutide – is a diabetes drug which leads to weight loss through suppressing the appetite, meaning patients eat less

This is frustrating as many Britons could benefit from semaglutide, but – due to the vanity of well-off people who want it to get a bit slimmer –those less financially fortunate are forced to wait.

It is important to realise that semaglutide is not a wonder drug, despite the claims. People generally lose about 20 per cent of their weight – significant in terms of health but it may not bring a huge cosmetic change.

NHS patients prescribed it must still eat healthily and take regular exercise.

Unpleasant side effects include nausea and vomiting, which often disappear in a few weeks or months. but some find these too debilitating to continue with the injections.

Regardless, fighting obesity is vital and it’s true that, for many, semaglutide is a game-changer.

Anyone who thinks they might benefit should talk to their GP who can outline the options and, if appropriate, refer them to a weight-management specialist who may prescribe the drug.

I had a brain scan recently that revealed white spots. I asked my GP what this meant and he said it was ‘just wear and tear’. I’m still worried. Should I make lifestyle changes so it doesn’t get any worse? I am 68 years old.

Wear and tear is an unhelpful term. White spots often indicate what we call white-matter lesions. These abnormalities have always been considered a sign of blood vessels ageing in the brain.

This is similar to the furring up of arteries and heart disease.

White spots on brain scans often indicate white-matter lesions, which have always been considered a sign of blood vessels ageing

Blood vessels in the brain can atrophy in a similar manner, and this is considered a risk factor for stroke, mini stroke and vascular dementia.

It would not be uncommon to see this change in someone with high blood pressure, for example, and it may not cause symptoms. As people age, the number of these spots increases.

Some experts regard white spots as a normal part of ageing – wear and tear, indeed – but if there are quite a few, it shouldn’t be seen as benign. If these have been seen on a brain scan but trivialised, I assume there aren’t many and the spots are not a big concern. But it is still worth going back and querying this.

The end of life can be ‘beautiful’

I was struck, last week, by an interview with former M&S boss Robert Swannell about losing his wife Patricia to breast cancer, aged 71.

Remarkably, he described the end of her life – which was meticulously planned – as ‘beautiful’. When the couple learned Patricia’s cancer was incurable in 2021, they faced it head on and organised important activities like recording her final conversations with her children.

How we end life is always a highly personal thing and one that’s never easy to talk about.

But we avoid these conversations and plans to our detriment – so often, I hear that bereaved patients regret not having said this or done that when they ‘had the chance’. Helping make end-of- life preparations is something GPs get involved in nowadays – we call it advanced care planning. We ask people what they might want when the time comes. It’s so important to be open about your wishes, although it can be tough.

Have you made a plan for your death? Please write and let me know.

Keeping a normal weight, exercising and avoiding smoking and alcohol are important to help reduce and prevent white spots.

Background conditions such as high blood pressure, diabetes and high cholesterol must be treated stringently to avoid further damage to the blood vessels.

When I eat, my nose runs and I sneeze for five minutes. This is humiliating. What’s happening?

This could be oral allergy syndrome, also known as pollen food syndrome. It happens among hay fever sufferers when the body mistakenly recognises certain fruit and veg, mostly when eaten raw, as being the same as pollen due to the similar chemical structure.

The most common food triggers are apples, peaches, kiwi, hazelnuts and almonds, but almost any fruit, vegetable or nut can cause a reaction. People can even react to herbs.

It can be very difficult to identify the triggers but a food diary can help. This may rule out things that it isn’t.

It may be worth trying an antihistamine tablet from the pharmacy to see if it solves the problem. If it does, it is safe for most people to take the tablets regularly to quell an allergy.

Nose running and sneezing after eating can also be something called non-allergic rhinitis where the nose runs usually on eating hot or spicy food.

We think this happens due to an abnormal nerve reflex, and unlike pollen food syndrome this is not an allergy.

If antihistamines are not helpful then this may be the issue. An ENT specialist should be involved to consider specialist nose sprays to reduce your symptoms.

A man suffering a ‘women’s issue’…

A male patient came to me with discomfort and redness in – to be blunt – his penis. The instant concern would be an infection, but after carrying out numerous tests, all negative, I referred him to a dermatologist.

He was diagnosed with lichen sclerosus, a condition that causes itching, pain and swelling in the genitals. It blights the lives of thousands of women and usually hits after the menopause. But men can get it, too – albeit far less commonly. How many men are being misdiagnosed or don’t know what to do because of the lack of awareness?

Many other conditions usually associated with women can also plague men – including osteoporosis, urinary tract infections and even breast cancer. I’d like to know if you are a man who has been diagnosed with a ‘women’s problem’. Write to me at the address below.