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QI HAD a routine blood test for cholesterol done by the nurse at my GP's surgery. She has told me that it is a little high but I have not been given any treatment. I am rather concerned. What do you advise?

C.M., Redditch

ACHOLESTEROL in the blood has many functions not all of them bad. There are broadly speaking two main types and it is the ratio between these two types which is relevant rather than the absolute level. Also important is any family history of heart attac ks, strokes, etc and whether the patient with high blood pressure, drinks a lot of alcohol or is a smoker. Exercise and obesity are also relevant. If you have none of these risk factors, then a moderate elevation of cholesterol is perfectly acceptable. R educing the saturated fat content in your diet is often all that is necessary. Try reducing butter and animal fat and replacing it with sunflower or olive oil based spreads.

QI KEEP having to go to the doctor with vaginal thrush. He keeps giving me creams and pessaries but they don't always work. He never seems to have time to examine me. Do I need to see a specialist?

A.T., Sutton

ATHRUSH is a common cause for vaginal itching but there are other causes. If you have not responded to treatment it would be a good idea to get the practice nurse to take a swab to make sure there is no other cause for the symptoms, such as infections l ike bacterial vaginosis. Thrush tends to be commoner in women with diabetes, on high dose contraceptive pills and after courses of certain antibiotics. Simple home measures include eating a sensible balanced diet, avoiding wearing tight synthetic undercl othes and avoiding perfumed bath additives and vaginal douching. Some women swear by the local application of natural yoghurt and although soothing, this treatment is messy and not suitable for all cases!

QTHE nipple on my left breast has become itchy and red over the last few months. I have tried changing my bra and applied various creams, but it seems to be spreading.

What treatment would you advice?

S.P., Nuneaton

AIN your letter you do not state how old you are, but the symptoms particular in older women need to be thoroughly investigated by a specialist. It may well be a simple nipple infection, but underlying breast disease needs to be ruled out and it is vita l that you see your doctor as soon as possible so that you can be referred to a specialist.
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Publication:Sunday Mercury (Birmingham, England)
Date:Oct 18, 1998
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