WHEN you speak to a GP they may sometimes ask about your family’s medical history.
I promise we’re not just being nosy.
Dr Zoe Williams answers questions sent in by readers
It’s important we know a bit about your close relatives – in particular your parents, siblings and grandparents – to help us work out your risk of getting certain conditions.
This includes heart disease, type 2 diabetes, some cancers – including breast, bowel, ovarian and prostate – as well as issues such as high blood pressure and cholesterol.
If you get the chance, have a chat with your parents and ask about their health.
Good topics to cover include age of menopause, any problems in pregnancy or childbirth as well as any history of breast, testicular or prostate cancers or mental health issues.
Meanwhile, here’s what readers have been asking me this week.
Q: MY mum, gran and grandfather all had Alzheimer’s. How likely is it that I’ll get it?
A: This is a really important question and one I get asked about with regard to a lot of conditions, from dementia to cancer.
It’s completely natural to worry that you might end up with the same condition as a parent or grandparent, especially if you’ve been closely involved in their care.
Alzheimer’s is the most common cause of dementia, but there other causes too, including vascular dementia (the second- most common type), and combined they make up more than 80 per cent of all dementia cases.
Neither Alzheimer’s nor vascular dementia are typically classed as hereditary, which means they are not directly passed from parent to child by way of faulty genes — but there are some exceptions which I will explain.
Our individual risk comes from a combination of our entire genetic make-up and the environment we live in. As well as genes being passed down, often lifestyle habits and how we live can be passed along too — and this can make certain diseases more likely to run in families.
The good news is, we can change our lifestyles and habits, and there are many things we can all do to reduce our risk significantly. Vascular dementia has the same risk factors as heart disease, so while family history is a factor, a healthy lifestyle is more important.
Avoid smoking, aim for a healthy diet, be active, manage stress and be sure high blood pressure or diabetes is well managed.
Reducing the risk of Alzheimer’s through lifestyle is all of the above, plus keeping the brain active and being sociable.
Age is the biggest factor when it comes to Alzheimer’s, with your risk of getting the condition doubling every five years after the age of 65, so I wonder what age your mum and grandparents were when they were diagnosed?
There are some rare types of dementia that do have more of a familial link.
Frontotemporal dementia is an uncommon type that causes problems with behaviour and language. Around 40 per cent of people diagnosed with it will have a family history.
Early or young onset dementia — when a person is diagnosed with dementia before they are 60 — is more likely to be down to a gene, so if your mum or grandparents were diagnosed young, it is worth speaking to your GP.
Huntington’s disease and familial prion disease are very rare diseases that also cause dementia. Both have a genetic link, with a 50/50 chance of being passed from child to parent.
You would have already been counselled if a parent had been diagnosed with either of these. All in all, the majority of cases aren’t inherited. In fact, according to the Alzheimer’s Society fewer than one in 100 cases of Alzheimer’s is genetically linked.
So it’s unlikely you’ll end up with it, especially if you have a healthy lifestyle.
Q: MY teen daughter feels really withdrawn from me. I don’t know how to get her to open up and I’m worried about her stress levels and mental health with mock GCSE exams due.
A: It’s a really tough time at the moment to be of GCSE age — 15 or 16. These young people were 12 or 13 when the pandemic started and we’re seeing a lot of young people struggling with the fallout from that.
GCSEs also feel like a difficult time because they are stepping stones for the next stage of life, so whether that’s an apprenticeship or A-levels, they aren’t without consequence. Having said that, there are things you can do.
Does your daughter have an active social life? If she’s withdrawn from you, that’s one thing, but if she’s withdrawn from engaging with lots of things, it could be a symptom of anxiety or another mental health condition.
If she’s still going out and meeting friends or doing the things she’s always done for fun, there might be less cause for concern.
Are her eating and sleeping erratic? If she’s staying up late, sleeping in and not eating and it’s a sudden change, then again this might be a cause for some concern.
She is at an age where parents’ evenings are still happening, so you are entitled to check in with her teachers to see if they’ve noticed any changes in her behaviour.
The phrasing of your question suggests you’ve tried to get her to open up, but children and young people often don’t want formal sit-down chats.
Suggest a walk, a drive or a shopping trip and see if she opens up when she’s distracted by something else — often teen feelings can appear too huge to articulate, so a distraction can help. If she doesn’t open up straight away, be patient, let her know it’s an open door and she can come to you any time.
If she’ll talk, try helping her to reframe the things she’s worried about. Is it exam concerns? If so, how can you help with a plan of revision or are there extra sessions at school she can attend?
Finally — and this is something we only realise with age — if the worst happens and she doesn’t get the grades she wants, it’s not the end of the world. There are so many routes to get to where we want to be.
Got a question for Dr Zoe? Email her at [email protected]
Saliva’s odd after Covid
Q: I HAD Covid last year, but ever since I’ve had a problem with my saliva. I’ve seen my GP and she diagnosed a post-nasal drip and referred me to an ENT clinic and I’m awaiting an appointment, but I don’t feel she’s got the right diagnosis.
My saliva is bubbly and thicker, like phlegm. I visited my dentist and mentioned it, and he said he was aware of another patient with a similar problem post-Covid.
My mother had oesophageal cancer. I’m looking for advice, help and reassurance.
A: There are a number of things that can change saliva viscosity and it has been noted as a symptom during infection with Covid and afterwards.
While oesophageal cancer can cause saliva changes, it tends to be a symptom with advanced disease and you’d almost definitely experience such things as swallowing difficulty much earlier.
Some other causes include medication side-effects, dehydration, salivary gland stones, Sjorgen’s syndrome and excess mucus production, which can cause post-nasal drip.
When you have post-nasal drip or a stuffy nose, it can cause you to breathe through your mouth, causing your mouth to dry out and your saliva to thicken.
I think an ENT referral is appropriate and they will have the expertise and access to the investigations to help further establish the cause of your symptoms and offer some solutions.
In the meantime, have a chat with your pharmacist about which products might help, including saliva substitutes.