Q. I have large dark circles under my eyes with a little puffiness. I have used eye cream for some time but to no avail. I get plenty of sleep and fresh air, and eat healthily and drink lots of water. What causes this problem, and how I can reduce it?
A. Plenty of people get dark circles under their eyes. When I was young, the explanation was "tiredness", but I'm sure it's possible to have dark circles even if you are not tired. Medical scientists who have studied dark circles have come up with a couple of explanations. As you get older, the skin gets thinner. As the skin under the eyes thins, it becomes more translucent. Beneath this skin are bones and blood vessels. This combination of dark blood and bone becomes more visible, in the form of "dark circles". There also seems to be a genetic tendency in some families towards dark circles. This may just be that some families have thinner skin than others. But there are other factors that we simply do not understand. Smoking damages the elastic structure of the skin, and this can contribute to dark circles. I'm afraid I don't have a good solution, but will publish any suggestions that readers send in.
Q. Since last summer I have been suffering from muscle twitching in my arms, ribs, stomach, legs, eyes, etc, usually in the same spot. It is particularly noticeable after I have been for a long walk. When I mentioned the twitching to my doctor a few months ago, he didn't seem concerned. I find the constant twitching very tiring, and wonder if it will ever go away. I have noticed that my heart skips a beat when the twitching is bad, and wonder if the two are connected. I am 40 years old and in good health.
A. Muscle twitching does not usually have a sinister cause. But very occasionally it is the first symptom of something serious. Nearly all adults have experienced the odd twitch from time to time. A common site is the eyelids, which seem prone to twitching at times of stress, tiredness and anxiety. The twitching can be annoying, but it is barely visible to other people and usually disappears within hours or days, only to return when things get stressful again. Muscular twitches can occur almost anywhere in the body where there are muscles. The fact that your twitches are worse after prolonged exercise is a common complaint. When muscles have been used a lot they sometimes become a bit twitchy. But if your twitching is constant, it is worthy of further investigation. Discuss it again with your doctor. A blood test to look at your sodium, potassium, calcium and magnesium levels might be worthwhile. If these are normal and the twitching worsens, or is associated with any muscle weakness, you need to consult a neurologist.
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HD of Hereford has firm advice for the person with burning feet:
After the poor man has changed his incompetent doctor, and been diagnosed with peripheral neuropathy by a neurologist, he should contact The Neuropathy Trust, PO Box 26, Nantwich, Cheshire CW5 5FP ( www.neuropathy-trust.org). I'm a fellow-sufferer, and the trust is there for people like us.
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