Could this VERY common kitchen spice be stopping your medication from working? DR MARTIN SCURR replies

I have been prescribed the blood thinner edoxaban as I have atrial fibrillation. I also take turmeric to counteract joint pain, but have been advised to stop as they shouldn’t be combined. Is this correct?

Stuart Kira, Hatfield, Herts.

Dr Martin Scurr replies: Preventing blood clots is vital in patients with atrial fibrillation, a rhythm disorder where the upper chambers of the heart no longer contract fully (the muscle fibres effectively ‘quiver’ in an uncoordinated way).

As a result, blood can pool, allowing clots to form. The danger is that any clots could be pumped out of the heart and end up blocking arteries, with often serious consequences (i.e. a heart attack or stroke).

You’re on one of the newest blood-thinning drugs, called direct oral anticoagulants (DOACs). They target clotting factors in the blood. Warfarin, the standard treatment, instead reduces vitamin K, which is needed to produce blood-clotting factors in the first place.

DOACs are effective and easier to use as you don’t need regular blood tests to check the dose, as you do with warfarin.

Meanwhile, many people take turmeric for joint pain – it’s thought to have an anti-inflammatory effect, although the evidence is scant.

And there is also research to show that turmeric – specifically its active compound curcumin – can affect the production of clotting factors such as fibrinogen, while also stopping blood platelets clumping together (platelets are vital for blood clotting). Indeed, its effects are comparable to taking low-dose aspirin.

This is why taking turmeric supplements with blood thinners, including DOACs, is undesirable and possibly even dangerous. Consuming large amounts of turmeric in food is also probably unsafe in your case.

I am 74 and have had COPD for 15 years. I recently saw a consultant who said I was eligible for a lung-reduction operation. How successful is this?

Glynn Buckle, Driffield, East Yorkshire.

Chronic obstructive pulmonary disease (COPD) is an umbrella term for conditions characterised by severe shortness of breath. The most common form of it is emphysema, where the walls of the alveoli – the tiny spaces where oxygen is absorbed and carbon dioxide exuded – have been destroyed.

Lung volume reduction (LVR) involves removing part of one or both lungs and can lead to an improvement in the ability to breathe. Because of the damage to the lung tissue, the collagen and fibres separating the alveoli are progressively broken down, causing larger pockets to form.

Stale air becomes trapped, causing the lungs to over-inflate over time. The airways in turn become floppy, so patients struggle to breathe.

Removing non-functioning lung tissue allows the healthier areas of the lung to expand and function better.

The procedure is only suitable if the defined sections, known as lobes, of the lungs are affected – as is often the case with emphysema. There are three lobes in the right lung and two lobes in the left – removal of the upper lobes will result in less air trapping, easier breathing and ultimately an improvement in daily life and survival.

If the emphysema is spread across the lungs, this surgery isn’t suitable – partly because there isn’t a specific area of the lung to remove. The same is true if the patient also has heart failure.

Such surgery is understandably daunting, but rest assured it can make a real difference. I have seen many patients benefit.

To qualify, you’ll need tests on your lung capacity and heart function, as well as a CT scan of the lungs.

Only then will doctors decide if it’s the right option for you. I hope this is the case, as the benefits are beyond doubt.

In my view… Fat jabs can help save the NHS

So-called fat jabs Wegovy and Mounjaro have helped revolutionise weight loss, but I wonder if the NHS is missing a trick by not utilising them more.

Just as we now know statins have benefits beyond lowering cholesterol (having anti-inflammatory and antioxidant effects), these GLP-1 weight-loss drugs don’t just regulate blood sugar and reduce appetite.

One of the most dangerous effects of obesity is liver scarring. This results in fatty liver, or metabolic dysfunction-associated steatohepatitis (MASH), which can lead to liver cirrhosis and liver cancer.

There is evidence GLP-1 drugs can reduce liver fat and inflammation and help improve its function – remarkable given that previously the worst cases needed a liver transplant or even died from their condition.

The self-injected drugs aren’t without side effects (nausea, for example) but, given spiralling obesity is draining the finances of the NHS, I think it would be prudent to make these injections more readily available to the estimated one in five in the UK who now have fatty liver – even if they do not meet the criteria currently imposed.