Doctor Q&A: Can drinking cold water raise your blood pressure? Dr Renee Hoenderkamp answers your questions

Hi doctor, are there any supplements you would recommend for hip pain? I am in agony but dread the thought of a hip replacement so willing to try anything at this point. Thank you 

As we age and our joints start to develop osteoarthritis which is wear and tear. The hip joint is commonly affected and of course, as we are bi-pedal animals and weight-bearing constantly it can be completely destructive to normal life. And weight is critical in alleviating that pressure; for every extra 10lb of body weight you carry, an extra 50-70kg goes through your hips and knees!

The first answer to any joint pain is to do regular stretching, strengthening and stabilisation. This will then build support around the joint and help lessen pain. A good physio should be able to devise a routine that you can do at home every day. I have finally got rid of my shoulder pain by doing daily exercise for it.

Then in terms of supplements, there are several that make claims for joint pain and there is mixed and limited evidence because supplements do not get big pharma excited or interested enough to run expensive trials. But having said that have a look at:

1. Turmeric.

There is good evidence for it as an anti-inflammatory and as a side effect, it appears to have anti-cancer properties. Curcumin is the active compound in the yellow-hued spice, turmeric, which is a staple of Indian curries. In the body, it acts as a powerful anti-inflammatory agent, blocking the same inflammation-promoting enzyme as the COX-2 inhibitor drug, celecoxibI uses Turmeric and Gold from Healthspan for both these reasons.

2. Glucosamine and Chondroitin

One of the most commonly used supplement combos for arthritis. They are components of cartilage which naturally occur to cushion the joints.

A large National Institutes of Health study called the GAIT trial compared glucosamine and chondroitin, alone or together, with an NSAID 9iburpofen/naproxen etc) and placebo in people with knee OA. Glucosamine improved pain and function, but not much better than the placebo. However, a 2016 international trial found the combination to be as effective as the NSAID celecoxib at reducing pain, stiffness and swelling in knee OA.

3. S-adenosyl-methionine (SAM-e)

SAM-e is a natural compound in the body with anti-inflammatory, cartilage-protecting and pain-relieving effects. In studies, it was about as good at relieving OA pain as ibuprofen and celecoxib.

In a study of 367 people with knee OA, a 1,500 mg daily dose of curcumin extract was as effective as 1,200 mg a day of ibuprofen.

I hope that gives you some pointers. Always check with your doctor first to make sure there are no interactions with other meds you take or illnesses you have. Good luck!

Hi Doc, what is the best way to deal with acid reflux? Mine keeps persisting and it's causing me serious grief. Regards  

This is one of the most common issues that GPs deal with. Acid reflux is when acid that should remain in the stomach in order to digest food, finds its way through the valve at the top of the stomach (sphincter) into the oesophagus and causes pain, a cough, a sour taste in the mouth, sore throat, breathing issues, trouble swallowing and even the feeling of a lump in the throat.

It is important to prevent/cure long-term reflux as it increases the risk of oesophagitis (inflammation of the cells of the oesophagus, narrowing of the oesophagus and causing pre-cancerous cells in the oesophagus known as Barrett's oesophagus.

There are a few things that increase the risk of getting reflux and these include obesity, hiatus hernia, pregnancy, delayed stomach emptying (weight loss jabs do this) and connective tissue disorders.

The first approach to curing reflux is always lifestyle and can be hard but if done religiously does work:

• Lose weight
• Don’t smoke

Avoid:

• Tomatoes
• Chocolate
• Spicy food
• Caffeine
• Fatty/fried food
• Peppermint
• Alcohol

Some medications can cause irritation to the stomach and lead to reflux and the main culprits are ibuprofen, naproxen, aspirin, and diclofenac so avoid these if possible and use a stomach protector (Proton pump inhibitor) if you have to use them.

I would always recommend a simple poo test to see if you have a common stomach bacteria called Helicobacter Pylori which can be treated easily if you do.

In terms of over-the-counter and prescription meds, there are three types:

• Antacids such as Gaviscon which you take AFTER each meal and before bed
• H2 Blockers: stop acid production and include cimetidine and famotidine
• PPI’s: Stronger acid blockers including omeprazole, lansoprazole

Now whilst I am happy with a short-term use of a PPI to help ease things up, longer-term use has some serious effects which include bone density loss and a lower threshold for pneumonia so I would caution their use and perhaps use them whilst making the lifestyle changes above, which do work.

Thereafter, I would start with herbal remedies and it is about finding one that works for you and doesn’t irritate (remember, peppermint is great for the colon but an irritant to the stomach).

These include:

• Alkaline foods such as bananas, melon, and cauliflower.
• Ginger has a long history in Chinese medicine as a digestive aid.
• Milk is a natural antacid
• Baking soda (one teaspoon mixed with water and sipped slowly) can neutralise stomach acid
• Apple cider vinegar a (small amount diluted in a cup of water, never neat)

These are just a few of many potential solutions but this is a good overview and of course, I can’t finish without suggesting a good probiotic and the one I use is Symprove which has good data from UCH as the only one that can survive the stomach and reach the colon.

Start with natural approaches and lifestyle and hopefully, you won’t need long-term medication!

Hi doc, can cold water increase your blood pressure? I read that a curious study that found it causes short-term but significant jump in BP. Is there anything in this? Thank you 

I am not sure if you mean drinking cold water or swimming in it so will look at both.

Drinking cold water.

There are indeed quite a few studies on this and most seem to come to the conclusion that drinking cold water, four degrees centigrade was used in one study, does seem to cause a transient increase in both systolic (the top number) and diastolic (the bottom number) blood pressure readings which persist for around 20 minutes in young healthy subjects. It is suggested in some studies as a treatment for hypotension (symptomatic low blood pressure)!

What the ramifications of this are clinically are unclear. It could theoretically cause a problem in older people, those with already raised BP or those at risk of stroke.

Cold water swimming

No doubt plunging the body into cold water causes a sudden, rapid increase in heart rate and blood pressure known as the cold shock response. The shock also places stress on the heart and makes it work harder.

Having said this many health benefit claims of cold water swimming/immersion/showers claim an immune system benefit. Many people enjoy regular cold dips and swims and the message here is to do it sensibly. So acclimatise slowly, prepare beforehand and if you have a cardiac history, speak to your doctor for guidance. But remember, the emotional and physical benefits of exercise, and being out in nature are vast and over time will accumulate so as always start anything new with moderation and work up.

To learn more about the link, here is a measured article.