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Health: A Question of Health - with Dr Fred Kavalier

I read that isotonic "sports"drinks help relieve cramp, so when one of my clients said she was suffering from it at night, I suggested she drink some. She says they make her feel more energetic. She also suffers from polymyalgia rheumatica and osteoporosis. Do these drinks have adverse effects? Will they do her any harm?

Isotonic sports drinks claim to maintain the body's levels of glucose and salts during exercise, but in fact their main benefit comes from the water that they contain, which prevents dehydration during exercise. The most serious risk for your client comes from drinks such as Lucozade, which contain extremely high levels of sugar. People who are on the verge of developing diabetes can be pushed into a severe diabetic state by high sugar levels. I suspect your client would obtain as much benefit from a cup of tea with a teaspoon of sugar in it, and her bank balance would remain in a healthier state as well.

A blood test has discovered that my liver enzymes are abnormal. What is the significance of this?

Blood screening tests usually measure the liver enzymes in the blood. When these are abnormally elevated, it is important to look for the reason. The liver enzymes (AST, ALT, GGT and alkaline phosphatase) are released into the bloodstream when the liver is being damaged.

There is a long list of possible causes - the commonest are viral infections such as hepatitis or glandular fever, and liver damage from drinking too much alcohol. Alcohol is a potent chemical that attacks and kills liver cells. Further blood tests, together with scans of the liver, will usually identify the exact cause of abnormal liver enzymes.

What is the correct way to deal with a tooth that has been knocked out?

Quick action is necessary to have any hope of saving a tooth that has been knocked out of its socket. The longer the tooth is out, the less chance it will survive. The British Dental Association advises keeping the tooth in the side of your mouth to stop it from drying out, and seeing a dentist as soon as possible.

Send questions to A Question of Health, `The Independent', 1 Canada Square, Canary Wharf, London E14 5DL; fax 0171-293 2182; or e-mail: health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to all questions.