A Question of Health

Why do I always feel so hot? And will Botox get rid of the wrinkles above my upper lip?

I'm overheating

I'm overheating

Q. I get very hot, in all types of weather. I very rarely need a coat and I sometimes sweat. I am 10 stone, very fit and don't smoke. What could cause this?

A. People who always feel hot do not usually have anything medically wrong with them. Very occasionally, there is an underlying problem, but it is rare to discover a clear cause for the type of heat intolerance that you describe. Top of the list of possible causes is an overactive thyroid gland. If the thyroid gland is producing too much thyroid hormone, the body's rate of metabolism is increased. One symptom of this is feeling hot all the time. Other symptoms of an overactive thyroid gland include weight loss and a tremor of the hands and fingers. Excess thyroid hormone can also cause the eyes to bulge, because of tissue swelling behind the eyeballs. There are a couple of extremely rare causes of feeling hot all the time. If the skin is abnormal and unable to secrete sweat, the body tends to get overheated. This condition, called anhidrosis, can be present from birth because of a genetic defect. There are also one or two drugs that can cause a feeling of being overheated. I suggest that you have your thyroid hormone levels checked. If these are normal, you just have to live with your heat intolerance.

Toothy problem

Q. Can you please advise me how to reduce the appearance of wrinkles above my upper lip. Due to dental problems, most of my upper teeth are missing. Would injections of Botox help? Is there any laser treatment that would reduce the wrinkles?

A. The wrinkles in your upper lip are the result of your dental problems. So the best solution may be to do something about your missing teeth. The lips are held in their natural position by the teeth and gums. If teeth are missing, the lips tend to collapse inwards, and this is the cause of the wrinkles. Discuss the problem with a dentist. If there is no dental solution to the problem, I doubt that anything will be effective. Botox is a powerful drug that paralyses muscles. When it is injected, the muscle fibres in the area of injection are unable to contract. It can help to reduce wrinkles that are caused by muscular tension, such as "worry lines" on the forehead. But it won't be able to prevent the lips from collapsing inwards if there are no teeth present. I am not aware of any laser treatment that would be of any use.

Send your questions and suggestions to A Question of Health, 'The Independent', Independent House, 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