I’ve just been diagnosed with chronic kidney disease, and the only symptoms I’ve noticed are some weight loss and lower back pain. My doctor advised me to increase my water intake. Are there additional steps I should consider?

Dr. Ellie Cannon responds: It’s vital for individuals with chronic kidney disease to adopt lifestyle changes to avoid serious complications that can be life-threatening.

This condition leads to a gradual decline in kidney function. Initially, it may not cause symptoms or harm, but if it advances unchecked, it can result in heart disease, diabetes, and organ failure.

Indeed, staying well-hydrated is advantageous for those with kidney disease, as it enhances kidney efficiency. Nonetheless, hydration alone is not a comprehensive treatment for the disease.

Experiencing weight loss might indicate more advanced kidney disease, so it’s essential to report this symptom to your general practitioner.

If the disease is progressing rapidly, there are medications available to slow it down. These include daily tablets known as SGLT-2 inhibitors, with options like empagliflozin, dapagliflozin, canagliflozin, and ertugliflozin.

Uncontrolled high blood pressure and diabetes also raises the risk of developing dangerous late-stage kidney disease, so it’s crucial that patients with these underlying conditions are on the right medicines.

However, when caught early, chronic kidney disease can be successfully fought through lifestyle changes.

It’s true that drinking plenty of water is beneficial for kidney disease patients. This is because staying hydrated boosts kidney function. However, alone, it is not an effective treatment for the condition, writes Dr Ellie Cannon (picture posed by model)

Quitting smoking and alcohol and maintaining a healthy body weight are the most important steps to take. Regular exercise – about 150 minutes per week – has also been shown to slow kidney disease.

A balanced diet is important too, such as eating five portions of fruit and vegetables a day and avoiding excessive amounts of fat, salt and sugar.

My period has been going on for over a month. I’m 28 and this happens quite often. My GP has told me to take birth control but doesn’t seem interested in finding the root cause of the problem. What should I do?

Dr Ellie Cannon replies: Irregular periods are often caused by underlying conditions that can be treated.

It is not normal for a 28-year-old to be bleeding for a month, but the most common cause of this symptom is polycystic ovary syndrome, or PCOS.

This is where cysts form on the ovaries. It’s normally diagnosed via an ultrasound scan and a blood test.

Treatment involves lifestyle changes, such as losing excess weight, as well as drugs such as the contraceptive pill and the diabetes tablet metformin, which can help regulate the menstrual cycle.

Endometriosis, where the uterine lining grows outside of the uterus itself, can also lead to bleeding – but it is usually associated with significant pain as well. In rare cases, vaginal bleeding can be a sign of cancer, which is why it is always important to visit a GP for an examination.

Bleeding for a month can also trigger anaemia – a condition caused by an iron deficiency that causes fatigue, weakness and shortness of breath.

Dr Ellie Cannon: the GP who’s always here for you 

I’ve never had chickenpox but my GP tells me I need the shingles vaccine. Given you can’t get shingles if you haven’t had chickenpox, this seems unnecessary. What should I do?

Dr Ellie Cannon replies: Everyone who is offered the shingles vaccine stands to benefit from it.

Shingles is caused by the chickenpox virus (varicella-zoster virus), which is usually caught in childhood and then remains in the body for life. Later in life, as the immune system weakens, the virus can flare-up again, causing a painful rash known as shingles.

The vast majority of people have had chickenpox – even without realising it. While the condition usually triggers a red spotty rash, not everyone will get this. That means it is difficult to know with certainty whether someone is carrying the chickenpox virus or not.

That’s why everyone turning 65, aged between 70 to 79 and those over 18 with a severely weakened immune system is offered a shingles vaccine – regardless of whether they think they have had chickenpox or not. Shingles is an agonising condition that can also lead to long-term nerve pain. So every step should be taken to avoid it.

Moreover, there is growing evidence that the shingles vaccine may have other health benefits. One recent study found that patients given the jab are markedly less likely to develop dementia.

Useless with money? it could be an illness

It seems like most weeks I hear from patients who say debt and financial troubles are severely impacting their mental health.

But what I think many people do not realise is that poor financial planning can be a sign of a far bigger psychological problem.

Overspending to a dangerous level, taking financial risks and racking up huge debts are all symptoms of mental illnesses such as bipolar disorder, where patients have extreme mood changes.

In fact, there is even a condition called oniomania – which is characterised by the compulsive urge to buy things. These issues can be effectively treated, usually through talking therapy.

But, left untreated, they can lead to serious financial difficulties. That’s why I think more patients with spending problems should talk to their GP about a possible diagnosis.

Have you been affected by compulsive spending that left you in debt? Did you manage to find help? Write and let me know.

Ditch these addictive painkillers 

Codeine tablets are effective at lowering pain levels and used to be handed out to a wide range of patients, but particularly those with chronic lower back pain (picture posed by model)

I’m concerned at the number of people who rely on the opioid painkiller codeine to function.

The tablets are effective at lowering pain levels and used to be handed out to a wide range of patients, but particularly those with chronic lower back pain. However there has been an NHS effort to get people off codeine. The drug is highly addictive, and it can also lead to drowsiness and difficulty breathing.

Despite the risks of codeine being well-known now, I still see many patients who are desperate to stay on it. They feel like it is the only thing that reduces their pain and allows them to get through the day.

This attitude is worrying. Opioid painkillers do not fix the causes of pain – they simply mask its effects. Chronic pain patients would be better off doing physiotherapy or talking therapy – two treatments that appear to be able to reduce pain levels in the long term.

Do you rely on codeine? Has your GP tried to take you off the tablets?

Please let me know using my email address below.

Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk. Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.