A Question Of Health

Can I delay another baby? What's in this cow cure?

Q. I became a mother for the first time six months ago and I am now 39. My husband is very keen for a second child, but I would like to wait a little longer before trying again. I am aware that as I get older it becomes progressively more difficult to conceive, and have a healthy pregnancy and baby. What do you advise?

Pregnant Pause

Q. I became a mother for the first time six months ago and I am now 39. My husband is very keen for a second child, but I would like to wait a little longer before trying again. I am aware that as I get older it becomes progressively more difficult to conceive, and have a healthy pregnancy and baby. What do you advise?

A. If you became pregnant relatively quickly with your first baby, the chances are you will again. Fertility rates do decrease, and pregnancy does become more complicated as you get older, and the risks of chromosome abnormalities such as Down's syndrome increase. But waiting for another six or 12 months is unlikely to make your chances of a successful pregnancy significantly worse. You have not had very long to recover from the birth of your first child. If you feel that it would be better to wait a bit, you should give yourself the time that you need.

Checkout Check-Up

Q. I had a cholesterol check at my local Asda supermarket a few weeks ago and I was told by the nurse that the levels were a little high. My total cholesterol was 6.5 and my LDL (bad cholesterol) was five. I was advised to take more exercise, and eat more fresh fruit and fish. I am a 55-year-old man. I am 71 kg and 1.90m, so I am reasonably slim. I try to take regular exercise by walking two to three miles a day, and there is no history of heart problems in my family. Do the test result levels warrant the need for me to start eating special yoghurt or margarine such as Benecol, or to take any of the over-the-counter statin tablets that are now available, to bring down my cholesterol?

A. The United Kingdom is the first country in the world where statins - powerful and effective cholesterol-lowering drugs - are available without a prescription. Most experts agree that high cholesterol levels make it more likely that you will have a heart attack or develop furred-up coronary arteries. And there is increasing evidence that even if your cholesterol levels are "normal", you can reduce your risks by lowering them even further. So it seems logical that someone like you could benefit from trying to lower your cholesterol levels. If you eat a reasonably low-fat diet, there is probably not much more you can do to lower your cholesterol levels by changing your diet. The special yoghurts and margarines such as Benecol and Flora Pro-Activ contain plant sterols and stanols, which are chemicals that reduce the amount of cholesterol that is absorbed through the intestine. The manufacturers claim that eating them every day can reduce cholesterol levels by up to 15 per cent. Over-the-counter statins are available in a lower dose than would normally be prescribed. They have not been used at this dose for long enough for us to know if they make any real difference in terms of preventing heart attacks and heart disease. You are unlikely to gain great benefit from lowering your cholesterol with margarine or statins, because your risk of heart attack is probably already quite low. But you are unlikely to do yourself much harm, so I wouldn't say that you shouldn't try them.

Taking The Pee

Q. Cow-urine distillate was granted a US patent a couple of years ago and is said to cure even some complicated diseases in humans. Is there any scientific evidence that it works?

A. In 2002 there was a flurry of publicity, mostly in the Indian press, when some Indian scientists obtained a US patent for cow-urine distillate. They claimed that, when it was combined with anti-cancer drugs or antibiotics, it "enhanced" their effectiveness. The urine is supposed to help cells absorb the drugs. The fact that the scientists obtained a patent does not mean that cow urine distillate actually does what they claim. It is a traditional remedy that has been used in India for centuries. But there is no reliable scientific evidence that it works as a medical treatment for anything.

Have your say. A reader writes

CR had burning feet that were cured by surgery:

"Could the burning feet symptoms of your questioner be caused by a Morton's neuroma? I was diagnosed with two on the nerve endings between my second and third, and third and fourth, toes last year after an MRI scan. I was experiencing dull pain that became sharper after walking for any length of time. I had suffered from this for some years in both feet and last year I had surgery to remove the swollen nerve endings in my right foot and I am now much more comfortable. I am hoping to have he left foot done later this year."

CFG from Hertfordshire suggests an organisation that specialises in helping people with tremor:

"Support groups and help are available from the National Tremor Foundation, Harold Wood Hospital (DSC), Gubbins Lane, Romford, Essex RM3 0BE. Phone free on 0800 328 8046; www.tremor.org.uk."

Send your questions and suggestions to: A Question of Health, The Independent, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182; or e-mail health@independent.co.uk

Dr Kavalier regrets that he is unable to respond personally to questions