I drink water constantly but have terrible dry mouth. What’s wrong with me? DR KAYE reveals the simple solution to get rid of the problem for good… and the serious immune condition it could be hiding
I have terrible dry mouth all the time. I drink water constantly but that doesn’t help for long. What could be wrong with me?
Dr Philippa Kaye answers: A dry mouth could be a sign of anything from dehydration to an autoimmune condition.
The medical term for a dry mouth is xerostomia and it occurs when glands in the mouth do not produce enough saliva to keep the mouth moist.
Most people will temporarily experience the symptom at some point, usually either because of dehydration, stress or a cold. However, others develop a long-lasting version of the problem.
At its most severe, it can be a surprisingly debilitating problem as it can impact speech, swallowing, taste and even raises the risk of mouth infections.
Dry mouth is a very common medication side effect. Antidepressants, antipsychotics, antihistamines, muscles relaxants, urinary incontinence drugs and high blood pressure tablets are all known to trigger dry mouth.
Patients who suspect that their dry mouth may be caused by their medication and are struggling with the side effect should talk to their GP about reducing the dose or possible alternative treatments that they could potentially try instead.
Other medical treatments, such as radiotherapy and chemotherapy, can also affect the salivary glands. In these cases, while it may abate when treatment is over, there are also artificial saliva sprays and gels that can keep the mouth moist.
There are also a number of medical conditions that can trigger dry mouth. One of those is Sjogren’s syndrome, which occurs when the body’s immune system begins to attack the glands that produce both tears and saliva, leading to a dry mouth and eyes.
The medical condition Sjogren’s syndrome, which occurs when the body’s immune system begins to attack the glands that produce saliva, leads to dry mouth
If a GP suspects Sjogren’s syndrome, they may refer the patient to a specialist, such as a rheumatologist or ophthalmologist, who can make a diagnosis. The specialist might carry out a blood test that looks for signs of Sjogren’s.
However, the disease does not always show up in the blood. Some patients may be asked to carry out a saliva flow test, which involves spitting into a container over a fixed time to see how much saliva is produced.
There is no cure for Sjogren’s, but the symptoms can be managed, usually with saliva substitutes. There are also drugs, like the tablet pilocarpine, which can stimulate the glands to produce more saliva.
The blood sugar condition diabetes can also trigger dry mouth. Treating the underlying diabetes – typically with diet changes and, if required blood sugar-lowering medicine – can also combat the dry mouth.
Parkinson’s, a progressive brain disorder condition, can also lead to dry mouth. Unfortunately, Parkinson’s treatments, like the drug levodopa, also trigger dry mouth.
Patients are normally advised to chew sugar-free chewing gum or sugar-free pastilles, which can stimulate saliva production. In severe cases, Parkinson’s patients may need to use saliva substitutes.
GP, author and broadcaster Dr Philippa Kaye says there are two effective drug treatments for hair loss, minoxidil and finasteride
I’m a 74-year-old woman and my hair has started falling out. Is there anything that can stop hair loss at this point in life?
Dr Philippa Kaye answers: There are drugs that can help with hair loss at any age – but it’s also important to consider any possible underlying causes of the problem.
Age-related hair loss, or involutional alopecia, occurs to most people who reach later life. As the body ages, the number of new hairs we produce declines. So, when hair falls out, it is not replaced.
Hair loss can also occur for women as a result of the menopause. The female sex hormone oestrogen promotes hair thickness and growth. When oestrogen levels decline, so too can hair growth.
For some women, hormone replacement therapy, or HRT, can help with hair loss. However, the gels, patches and pills do not help with hair growth for all women.
It’s worth seeing a GP about any unexplained hair loss, so they can rule out any underlying health conditions that could be behind it. These include a thyroid disorder or a vitamin deficiency, like vitamin B12 or iron.
There are also other causes of hair loss that are unrelated to age. These include tightly pulling back, braiding or repeatedly dying hair. Stress can also trigger the distressing issue.
There are two effective drug treatments for hair loss, minoxidil and finasteride. Both can be taken either as tablets or a foam rubbed into the scalp. While finasteride is the more powerful drug, it has not been extensively tested in older women, which is why these patients are usually advised to take topical minoxidil instead.
Topical minoxidil is not usually prescribed on the NHS and tends to cost around £25-a-month through a private pharmacy. For older women, it should prevent any further hair loss, but only as long as the patient continues to take it.
