How to fix cold hands, by DR ELLIE. From the conditions that can cause it (including thyroid problems) to the drugs you don’t know are making it worse, the ultimate guide

How do I get rid of my constantly cold hands?

In order to tackle chronic cold hands, it’s crucial to work out whether the symptom is triggered by an underlying medical condition.

Some people have naturally cold hands, largely due to poor blood circulation. For these people, mittens and gloves may be a non-negotiable during autumn and winter. 

Keeping the rest of the body warm also improves hand temperature. So people with this problem should, when the temperature drops, wear thermal layers and a hat.

There are also steps that people can take to improve circulation. These include exercise and staying hydrated. Meanwhile, overconsumption of caffeine and alcohol worsen the issue. So too does smoking.

However, there are also conditions that can lead to cold hands. A problem with the thyroid – the gland that produces crucial hormones – can cause the problem. 

This issue – known as an underactive thyroid – would normally also be associated with fatigue, weight gain and mood changes. A GP can carry out a blood test that looks for this problem. 

Once diagnosed, there are drugs to boost thyroid function, which should improve the cold hands.

There is also a condition called Raynaud’s disease, where small blood vessels in the fingers and toes temporarily spasm, leading to reduced flow and painfully cold hands. When these spasm episodes occur, the fingers will often turn white or blue due to a lack of blood circulation.

It often occurs when temperatures are low.

The condition is more common in those with immune system conditions such as rheumatoid arthritis or lupus. Women are also more likely to be affected.

Taking certain medicines can worsen the symptoms. These include beta blockers (tablets often used to treat anxiety), hormone replacement therapy and the contraceptive pill.

The symptoms of Raynaud’s can be managed by taking a blood pressure tablet called nifedipine.

I keep getting C. diff infections. I’m constantly on antibiotics but these seem to only work for a bit before the infection comes back. Would a daily probiotic like Yakult help?

There is evidence that some probiotics can help combat C. diff infections.

The infection, also known as clostridioides difficile, is a bacteria that overgrows in the gut. It often arises after someone has strong antibiotics for a different infection.

This can strip the gut of healthy good bacteria.

Without these natural defences, a C. diff infection can take hold in the gut, leading to diarrhoea, cramping and an urgent need to go to the toilet. For the elderly or frail, a C. diff infection can lead to being admitted to hospital or even death. And, for many, the infection will keep returning.

It’s more common in over-65s. It can also be triggered by long-term use of anti-heartburn drugs such as omeprazole.

Antibiotics are always necessary when treating a C. diff infection. But once the infection has gone, there are steps patients can take to reduce the risk of it coming back. One is to stop taking any medication that could be harming the gut, such as heartburn tablets.

However, another is to take a probiotic. This is a daily drink that contains billions of healthy bacteria which should, over time, boost gut health and make it more resilient against C. diff.

Many, such as Yakult, are not strong enough to make any difference to the gut of someone with C. diff. It’s important that any considering taking a probiotic use one that contains at least two billion bacteria in each dose. There is research that specific bacteria, saccharomyces boulardii and lactobacillus rhamnosus, are particularly beneficial. Two brands that may be worth trying are Optibac and Bio-Kult. But they won’t work for everyone. And it’s crucial to take probiotics daily.

I’ve lost my voice due to leukoplakia. Is there anything that would help?

Lifestyle changes are key to tackling leukoplakia.

The condition is where white patches form on the mouth, tongue or throat. Sometimes they can form on the vocal cords, impacting speech.

Left untreated, leukoplakia can, in rare cases, turn into cancer. This is why it’s crucial anyone with these patches is seen by a specialist – in this case, that would be an ear, nose and throat doctor, also known as an ENT. In severe cases, a specialist might recommend surgery to remove the patches.

However, in many cases quitting smoking and alcohol can make a big difference. Heartburn also makes leukopakia worse.

So, combating any existing heartburn is key to tackling leukoplakia. This is normally done through diet changes.

Fatty foods and processed meats tend to make it worse. As do sugary drinks and excessive caffeine.

Managing COPD… with more than just drugs 

Every week, I see patients who are – quite literally – running out of breath.

Life has become exhausting. Getting dressed, walking to the shops, even climbing a flight of stairs takes effort.

Cause? Chronic obstructive pulmonary disease (COPD). An umbrella term for emphysema or chronic bronchitis, it affects roughly 1.4 million people. Yet is oddly invisible.

It’s not quite as hopeless as it once was. Treatment has come on in leaps and bounds with new inhalers. But it’s still an incurable and often life-limiting condition.

Rehabilitation programmes offer some formalised help through exercise, nutrition and psychological therapy.

But I wonder how many realise the importance of nutrition and exercise. How do you manage your COPD outside of the drugs? Write in to let me know.

Side-effects of private prescribing 

My surgery is increasingly clogged with patients who have been prescribed weight-loss injections remotely, developed side-effects or complications and have then been told to see their GP.

The problem is obvious. We didn’t prescribe the drug, we often don’t know the clinical rationale behind it and we rarely have access to the monitoring or follow-up that should have been in place from the start.

But when things go wrong, the responsibility still lands with us. In theory, remote prescribing can work. In practice, too many private providers seem happy to take payment when treatment is straightforward only to step back when problems develop.

If companies are allowed to prescribe powerful drugs, they must take responsibility when problems arise. Selling the drug without owning the follow-up is not acceptable.

Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk