Ask the doctor: I've beaten shingles... so why am I still in so much pain?

Dr Martin Scurr continues to be dealing with patients in excess of 3 decades and is among the country's leading Gps navigation. Here he takes up shingles as well as an hypothyroidism...

I'd a poor situation of shingles 5 years ago and also have been playing bouts of severe discomfort which stick to the trail from the shingles. The discomfort isn't continuous, but strikes all of a sudden. Are you aware what this really is or why it happens, and just how do you need to cope with the discomfort? Mrs K. Sutton, Chelmsford, Kent.

Severe discomfort after shingles is known as publish-herpetic neuralgia

Dr Scurr states... The discomfort that you have needed to tolerate for such a long time is known as publish-herpetic neuralgia - herpes zoster to be the medical term for shingles.

As you've found, the discomfort could be severe. It's often only older patients who're affected, although it isn't obvious why.

Shingles is really a virus infection of your skin 1 in 5 people can get it in the course of existence.

The problem is not something 'catch' from another person, but continues to be laying dormant within your body for a long time and also has been re-triggered.

The initial infection was using the chicken pox virus (probably in early childhood). The defense mechanisms trapped herpes within the nerve cells near to the spinal-cord, in a site known as the dorsal root ganglion.

Anything later in existence that reduces your immunity - age, stress or major illness - makes it possible for herpes to visit to your skin, along a physical nerve.

Firstly you notice a bout of burning or itchiness discomfort, frequently difficult to explain, lasting a few days.

Then your characteristic rash evolves - this begins being an section of redness which becomes sore spots over about 7 days. The rash affects the part of the skin provided through the physical nerve along that the virus has travelled.

The rash can happen anywhere on our bodies, although most generally around the chest or abdomen - using the proven fact that in chicken pox, the spots are more numerous around the trunk.

If this sounds like the situation, the rash will extend in the spine, around inside a swathe towards the front.

Together with the rash there's frequently a higher temperature and headache (you are feeling flu-like).

The sore spots retain the chicken pox virus and anybody in touch with the rash will build up chicken pox after fourteen days approximately if they're not already immune.

But you will not develop shingles after connection with you aren't shingles since your body creates the virus itself.

Even if your shingles have removed up, the results could be lengthy-lasting, as you've discovered. It isn't obvious why this discomfort happens, although it's thought it's triggered by harm to the nerve cells.

Suffering lengthy-term bouts of discomfort over many years is miserable, especially as regular discomfort-killing pills provide no relief. But you will find methods for reducing or perhaps getting rid of the discomfort using drugs particularly made to focus on neuropathic (nerve cell-produced) discomfort.

The most typical could well be amitriptyline, a medication that has been used at greater doses for several years being an antidepressant it functions by functioning on the communication between nerve cells.

You will find other more recent drugs, for example pregabalin, which reduce irritability in hurt nerve calls. It's almost sure that something is useful for you. If a person drug does not have the desired effect then it is a situation of with patience dealing with another options.

Such treatment requires experience and talent, and frequently a GP will refer patients to some discomfort clinic to determine a professional acquainted with the strategy needed.

Even only at that late stage, this might help alleviate your suffering.

I've an hypothyroidism and am taking 100mcg of thyroxine daily. I in addition have a big lump on my small neck that your consultant really wants to remove, together with my thyroid.

I am worried I'll put on weight because the thyroid controls metabolic process. I understand I am on thyroxine, and can that be sufficient by itself to help keep my weight stable? I am 9st and 5ft 7in, and pleased with my weight. Mrs F. Youngs, Burnham-on-Crouch, Kent.Dr Scurr states... I realize nervousness, however i can reassure you that taking thyroxine means you do not need the thyroid itself anymore, so getting it removed should not cause you to put on the pounds.

A thyroid problem can be found in the leading from the neck - it's two lobes, one on both sides from the windpipe, along with a hooking up bridge of tissue which crosses just below the larynx. It's an endocrine gland, meaning it releases its product - within this situation, thyroid the body's hormones - in to the blood stream.

By doing this the the body's hormones can achieve distant body tissue.

These the body's hormones regulate the speed of numerous chemical processes in your body, including metabolic process.

If there is not an adequate amount of a thyroid problem the body's hormones, the metabolic process slows lower, and also you put on pounds (in addition to developing other signs and symptoms including fatigue, dry hair and skin, a inclination to feel cold and constipation).

Request DR SCURR

Have you got a health question for Dr Scurr? He'll answer an array of readers' queries each week. Email Dr Scurr, A Healthy Body, Daily Mail, 2 Derry Street, London W8 5TT, or e-mail drmartin@dailymail.co.united kingdom

Dr Scurr cannot enter personal correspondence. Please include information. His replies cannot affect individual cases and really should be used inside a general context. Always talk to your own GP with any health worries.

Thyroid failure is typical, affecting 10 percent of ladies and 6 percent of males older than 65 - even though it is frequently present in much more youthful people, even just in their 20s.

It's often triggered by a car-immune disease, in which the body's own antibodies attack a thyroid problem.

Because the gland is progressively broken, it creates less the body's hormones. At the beginning of the problem, the gland itself frequently increases - this really is known as a goitre, and appears just like a large smooth lump. It's based in the lower area of the front from the neck. (This isn't the only real reason for goitre - a thyroid problem frequently increases in females on excess estrogen-that contains dental birth control methods, and often just increases up.)

Once you have been recommended thyroxine, a man-made form of a thyroid problem the body's hormones, you'll need a yearly bloodstream test to check on your hormonal levels are correct which you're taking the right dose. Tthere shouldn't be further problems.

Your specialist may have reasons for getting rid of the lump that has grown inside your neck.

Out of your letter, it's not obvious when the lump belongs to a thyroid problem or whether it's an enlarged lymph node nearby - you will find amounts of those right in front from the neck as anybody that has had tonsillitis or glandular fever knows.

It isn't usual to get rid of the gland in simple thyroid failure there might be yet another reason.

Incidentally... You need to create a diagnosis. You may think that facile, but it is something which anybody who uses an alternate specialist must think carefully about.

The truth is, you cannot give someone treatment for those who have no clue what you're dealing with - you are able to help someone deal with signs and symptoms, however, you can't treat them.

Think hard before using alternative treatment: You need to possess a diagnosis

So diagnosis is essential. And which makes it requires a mix of abilities: an appearance of understanding, the opportunity to recognise designs and judgement. Training a physician takes six years at college, then 2 yrs in hospital.

For General Practice after this you undergo another 3 years of coaching, area of the time like a junior hospital physician in a variety of areas and part being an apprentice inside a general practice like a GP registrar.

To ensure that makes as many as 11 many years of training after departing school to make a GP.

Even that could change as you will find intends to boost the GP training section to four or perhaps 5 years, making 12 or 13 years in most.

Your investment old jibe that Gps navigation joined family medicine simply because they were not sufficiently good to become specialists. The thought dominates: shall we be held sufficiently good to be a GP?

Contrast medical training using the training of the alternative counselor.

4 years for osteopathy, 2 or 3 years for any nutritional expert and 3 years maybe for acupuncture. Some alternative practitioners set up their brass plates after even shorter courses of study.

I don't discourage patients from seeking alternative therapy, but it's therapy, not diagnosis.

Make an effort to to avert this route until, or unless of course, an experienced diagnostician has applied his years of refined pattern recognition for your complaint.

Sure, go alternative when major disease continues to be excluded and there's an excuse for another method of manage the signs and symptoms. But otherwise, save your valuable money.